Sample records for bone ct scan

  1. CT-scanning of ancient Greenlandic Inuit temporal bones

    DEFF Research Database (Denmark)

    Homøe, P; Lynnerup, N; Videbaek, H


    bones. The CT-scans showed sclerosing and obliteration of the air cells and even destruction of the cellular septae, and a high degree of irregularity of the cells. Sclerosing of the surrounding bone tissue was also found. The findings in one cranium were dubious and could both be regarded...... as a congenital malformation or an infection in infanthood. CT-scan confirms and even adds to the results of conventional X-ray of temporal bones making hypotheses of paleopathology more reliable. The findings also support the environmental theory of pneumatization of the air cell system in the temporal bones....

  2. Head CT scan (United States)

    Brain CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial; CAT scan - brain ... hold your breath for short periods. A complete scan usually take only 30 seconds to a few ...

  3. Cervical spine CT scan (United States)

    ... defects of the cervical spine Bone problems Fracture Osteoarthritis Disc herniation Risks Risks of CT scans include: ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  4. CT-scanning of the temporal bone in an inner ear malformation

    Energy Technology Data Exchange (ETDEWEB)

    Murata, K.; Hosoi, H.; Isono, M.; Ohta, F. (Kinki Univ., Higashi-Osaka, Osaka (Japan))


    CT-scanning of the temporal bone revealed a fine contour of the inner ear anomaly in a 8-year-old boy with total deafness on the right. In the inner ear there was a globular mass with a small protrusion anteriorly and with a probably immature superior semi-circular canal. The globular mass was considered to be the utriculosaccular capsule, and the anterior protrusion to be an incipient cochlear duct. CT-scanning of the temporal bone may bring significant progress in diagnosis of inner ear anomalies. Detailed configuration of an inner ear may be shown before histological examination.

  5. Accuracy of cancellous bone volume fraction measured by micro-CT scanning

    DEFF Research Database (Denmark)

    Ding, Ming; Odgaard, A; Hvid, I


    Volume fraction, the single most important parameter in describing trabecular microstructure, can easily be calculated from three-dimensional reconstructions of micro-CT images. This study sought to quantify the accuracy of this measurement. One hundred and sixty human cancellous bone specimens...... which covered a large range of volume fraction (9.8-39.8%) were produced. The specimens were micro-CT scanned, and the volume fraction based on Archimedes' principle was determined as a reference. After scanning, all micro-CT data were segmented using individual thresholds determined by the scanner...

  6. Normal SUV values measured from NaF18- PET/CT bone scan studies.

    Directory of Open Access Journals (Sweden)

    Aung Zaw Win

    Full Text Available Cancer and metabolic bone diseases can alter the SUV. SUV values have never been measured from healthy skeletons in NaF18-PET/CT bone scans. The primary aim of this study was to measure the SUV values from normal skeletons in NaF18-PET/CT bone scans.A retrospective study was carried out involving NaF18- PET/CT bone scans that were done at our institution between January 2010 to May 2012. Our excluding criteria was patients with abnormal real function and patients with past history of cancer and metabolic bone diseases including but not limited to osteoporosis, osteopenia and Paget's disease. Eleven studies met all the criteria.The average normal SUVmax values from 11 patients were: cervical vertebrae 6.84 (range 4.38-8.64, thoracic vertebrae 7.36 (range 6.99-7.66, lumbar vertebrae 7.27 (range 7.04-7.72, femoral head 2.22 (range 1.1-4.3, humeral head 1.82 (range 1.2-2.9, mid sternum 5.51 (range 2.6-8.1, parietal bone 1.71 (range 1.3-2.4.According to our study, various skeletal sites have different normal SUV values. SUV values can be different between the normal bones and bones with tumor or metabolic bone disease. SUV can be used to quantify NaF-18 PET/CT studies. If the SUV values of the normal skeleton are known, they can be used in the characterization of bone lesions and in the assessment of treatment response to bone diseases.

  7. Multimodal imaging of the human temporal bone: A comparison of CT and optical scanning techniques (United States)

    Voie, Arne H.; Whiting, Bruce; Skinner, Margaret; Neely, J. Gail; Lee, Kenneth; Holden, Tim; Brunsden, Barry


    A collaborative effort between Washington University in St. Louis and Spencer Technologies in Seattle, WA has been undertaken to create a multimodal 3D reconstruction of the human cochlea and vestibular system. The goal of this project is to improve the accuracy of in vivo CT reconstructions of implanted cochleae, and to expand the knowledge of high-resolution anatomical detail provided by orthogonal-plane optical sectioning (OPFOS). At WUSL, computed tomography (CT) images of the cochlea are used to determine the position of cochlear implant electrodes relative to target auditory neurons. The cochlear implant position is determined using pre- and post-operative CT scans. The CT volumes are cross-registered to align the semicircular canals and internal auditory canal, which have a unique configuration in 3-D space. The head of a human body donor was scanned with a clinical CT device, after which the temporal bones were removed, fixed in formalin and trimmed prior to scanning with a laboratory Micro CT scanner. Following CT, the temporal bones were sent to the OPFOS Imaging Lab at Spencer Technologies for a further analysis. 3-D reconstructions of CT and OPFOS imaging modalities were compared, and results are presented. [Work supported by NIDCD Grants R44-03623-5 and R01-00581-13.

  8. Alternative oblique head CT scanning technique reduces bone artifact and improves interpretability of brainstem anatomy

    Directory of Open Access Journals (Sweden)

    Sam Douglas Kampondeni


    Full Text Available Brainstem pathology due to infections, infarcts and tumors are common in developing countries, but neuroimaging technology in these resource-poor settings is often limited to single slice, and occasionally spiral, CT. Unlike multislice CT and MRI, single slice and spiral CT are compromised by bone artifacts in the posterior fossa due to the dense petrous bones, often making imaging of the brainstem non-diagnostic. With appropriate head positioning, the petrous ridges can be avoided with 40˚ sagittal oblique scans parallel to either petrous ridge. We describe an alternative sagittal oblique scanning technique that significantly reduces brainstem CT artifacts thereby improving clarity of anatomy. With Inst­itutional Ethical approval, 13 adult patients were enrolled (5 males; 39%. All patients had routine axial brain CT and sagittal oblique scans with no lesions found. Images were read by 2 readers who gave a score for amount of artefact and clarity of structures in the posterior fossa. The mean artifact score was higher for routine axial images compared to sagittal oblique (2.92 vs. 1.23; P<0.0001. The mean anatomical certainty scores for the brainstem were significantly better in the sagittal oblique views compared to routine axial (1.23 vs. 2.77; P<0.0001. No difference was found between the two techniques with respect to the fourth ventricle or the cerebellum (axial vs. sag oblique: 1.15 vs. 1.27; P=0.37. When using single slice CT, the sagittal oblique scanning technique is valuable in improving clarity of anatomy in the brainstem if axial images are non-diagnostic due to bone artifacts.

  9. Spinal uptake mimicking metastasis in SPECT/CT bone scan in a patient with superior vena cava obstruction. (United States)

    Rager, Olivier; Nkoulou, René; Garibotto, Valentina; Boudabbous, Sana; Arditi, Daniel


    A 46-year-old female patient with a mediastinal neuroendocrine carcinoma complicated by superior vena cava syndrome was referred for a bone metastatic workup. Bone scan with SPECT/CT showed several vertebral fixations without alterations on the unenhanced CT, but a CT scan with injection of contrast media showed vertebral densities matched to the lesions described on the SPECT/CT. This pattern confirmed presence of collateral paths through vertebral veins due to superior vena cava syndrome. Lack of metastases was confirmed by MRI.

  10. Methodologies for Development of Patient Specific Bone Models from Human Body CT Scans (United States)

    Chougule, Vikas Narayan; Mulay, Arati Vinayak; Ahuja, Bharatkumar Bhagatraj


    This work deals with development of algorithm for physical replication of patient specific human bone and construction of corresponding implants/inserts RP models by using Reverse Engineering approach from non-invasive medical images for surgical purpose. In medical field, the volumetric data i.e. voxel and triangular facet based models are primarily used for bio-modelling and visualization, which requires huge memory space. On the other side, recent advances in Computer Aided Design (CAD) technology provides additional facilities/functions for design, prototyping and manufacturing of any object having freeform surfaces based on boundary representation techniques. This work presents a process to physical replication of 3D rapid prototyping (RP) physical models of human bone from various CAD modeling techniques developed by using 3D point cloud data which is obtained from non-invasive CT/MRI scans in DICOM 3.0 format. This point cloud data is used for construction of 3D CAD model by fitting B-spline curves through these points and then fitting surface between these curve networks by using swept blend techniques. This process also can be achieved by generating the triangular mesh directly from 3D point cloud data without developing any surface model using any commercial CAD software. The generated STL file from 3D point cloud data is used as a basic input for RP process. The Delaunay tetrahedralization approach is used to process the 3D point cloud data to obtain STL file. CT scan data of Metacarpus (human bone) is used as the case study for the generation of the 3D RP model. A 3D physical model of the human bone is generated on rapid prototyping machine and its virtual reality model is presented for visualization. The generated CAD model by different techniques is compared for the accuracy and reliability. The results of this research work are assessed for clinical reliability in replication of human bone in medical field.

  11. Assessment of the increased calcification of the jaw bone with CT-Scan after dental implant placement

    Energy Technology Data Exchange (ETDEWEB)

    Yunus, Barunawaty [Faculty of Dentistry, Hasanuddin University, Makassar (Malaysia)


    This study was performed to evaluate the changes of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). This retrospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference of HU before and after implant installation. The mean HU of jaw bone was 542.436 HU and 764.9 HU before and after implant placement, respectively (p<0.05). The means HUs for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased change of HU of jaw bone was less in the cases which needed longer period for osseointegration. CT-Scan could be used to assess the change of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement.

  12. Lumbar spine CT scan (United States)

    CAT scan - lumbar spine; Computed axial tomography scan - lumbar spine; Computed tomography scan - lumbar spine; CT - lower back ... your breath for short periods of time. The scan should take only 10 to 15 minutes.

  13. Bone Densitometry (Bone Density Scan) (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Densitometry (DEXA) Bone densitometry, also called dual-energy ... limitations of DEXA Bone Densitometry? What is a Bone Density Scan (DEXA)? Bone density scanning, also called ...

  14. CT scan evaluation of glenoid bone and pectoralis major tendon: interest in shoulder prosthesis (United States)

    Obert, Laurent; Peyron, Christelle; Boyer, Etienne; Menu, Gauthier; Loisel, François; Aubry, Sébastien


    Introduction: The shoulder arthroplasty brings satisfaction to patients in terms of quality of life and indolence. However whether anatomic implant or reverse, it does not escape from the loosening of the glenoid component. Moreover, optimal implantation is required to ensure the functional outcome without shortening of the arm. The purpose of this study is obtain CT scan evaluation of the glenoid bone stock in order to optimize glenoid component implantation and obtain a reference to determine optimal humeral component placement in case of humeral proximal fracture. Materials and methods: Between 2010 and 2011 we have analyzed 200 intact shoulder’s CT. We measured maximal and minimal width in the transverse plane of the glenoid, the distance from the pectoralis major (PM) tendon to the humeral head, the greater tubercle, change of curvature and the anatomical neck. Results: Mean maximum width was 27.4 ± 3.4 mm and mean minimum width was 15.5 ± 2.8 mm. Distances between upper edge of PM tendon to: humeral head, greater tubercle, change of curvature and anatomical neck were respectively: 67.6 ± 9.98 mm, 57.8 ± 10.3 mm, 28.7 ± 9 mm, and 34.2 ± 9.7 mm. Conclusion: Our study has produced an assessment of glenoid bone stock for optimal positioning of the glenoid implant but also to obtain a reference to determine the ideal location of the humeral component in the case of proximal humerus fracture. PMID:27716461

  15. Three-dimensional CT imaging with a helical scan on temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Honghan; Hiraishi, Kumiko; Uesugi, Yasuo; Sakakura, Atsushi; Yoshikawa, Shuji; Shimizu, Takaya; Sueyoshi, Kozo; Narabayashi, Isamu [Osaka Medical Coll., Takatsuki (Japan)


    To evaluate the usefulness of three-dimensional (3D) CT on the lesions of temporal bone, we studied 19 patients with disorders on the region of temporal bone by high speed helical CT. The results showed that 8 patients with congenital hearing disorder had deficiency of the auditory ossicles, 2 patients with chronic otitis media had deformity and shortness of the auditory ossicles, 4 patients with trauma had fracture of the temporal bone (1 patient was complicated by doubtful fracture of the incus), 5 patients (4 patients with acquired hearing disorder and 1 patient with otorrhea) had space-occupying lesions. 3-D helical CT could detect abnormal findings on all the patients and it was an important examination for the temporal bone. (author)

  16. Percutaneous Bone Biopsies: Comparison between Flat-Panel Cone-Beam CT and CT-Scan Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Tselikas, Lambros, E-mail:; Joskin, Julien, E-mail: [Gustave Roussy, Interventional Radiology Department (France); Roquet, Florian, E-mail: [Gustave Roussy, Biostatistics Department (France); Farouil, Geoffroy, E-mail: [Gustave Roussy, Interventional Radiology Department (France); Dreuil, Serge, E-mail: [Gustave Roussy, Medical Physics Department (France); Hakimé, Antoine, E-mail:; Teriitehau, Christophe, E-mail: [Gustave Roussy, Interventional Radiology Department (France); Auperin, Anne, E-mail: [Gustave Roussy, Biostatistics Department (France); Baere, Thierry de, E-mail:; Deschamps, Frederic, E-mail: [Gustave Roussy, Interventional Radiology Department (France)


    PurposeThis study was designed to compare the accuracy of targeting and the radiation dose of bone biopsies performed either under fluoroscopic guidance using a cone-beam CT with real-time 3D image fusion software (FP-CBCT-guidance) or under conventional computed tomography guidance (CT-guidance).MethodsSixty-eight consecutive patients with a bone lesion were prospectively included. The bone biopsies were scheduled under FP-CBCT-guidance or under CT-guidance according to operating room availability. Thirty-four patients underwent a bone biopsy under FP-CBCT and 34 under CT-guidance. We prospectively compared the two guidance modalities for their technical success, accuracy, puncture time, and pathological success rate. Patient and physician radiation doses also were compared.ResultsAll biopsies were technically successful, with both guidance modalities. Accuracy was significantly better using FP-CBCT-guidance (3 and 5 mm respectively: p = 0.003). There was no significant difference in puncture time (32 and 31 min respectively, p = 0.51) nor in pathological results (88 and 88 % of pathological success respectively, p = 1). Patient radiation doses were significantly lower with FP-CBCT (45 vs. 136 mSv, p < 0.0001). The percentage of operators who received a dose higher than 0.001 mSv (dosimeter detection dose threshold) was lower with FP-CBCT than CT-guidance (27 vs. 59 %, p = 0.01).ConclusionsFP-CBCT-guidance for bone biopsy is accurate and reduces patient and operator radiation doses compared with CT-guidance.

  17. Investigation of the vestibular aqueduct and the cochlear aqueduct by temporal bone CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Shimizu, Ryuichi; Kamei, Tamio; Ito, Fumihide (Gunma Univ., Maebashi (Japan). School of Medicine)


    The visualization of the vestibular aqueduct and the cochlear aqueduct was investigated by temporal bone CT scan. The vestibular aqueduct was visualized in horizontal CT sections of 70.0% of normal ears, 61.5% of ears with chronic otitis media, 58.3% of ears with combined hearing impairment, 66.7% of ears in cases of sudden deafness, 70.8% of ears of patients with sensorineural hearing impairment without sudden deafness, 71.4% of cases of vertigo without hearing impairment and 12.5% of both diseased and contralateral ears of patients with Meniere's disease. Only in Meniere's disease was the vestibular aqueduct less visible in the diseased than in the normal ear (P<0.01). The cochlear aqueduct was visible in coronal sections of 50.0% of normal ears, 76.9% of those with chronic otitis media, 58.3% of those with combined hearing impairment, 66.7% of those with sudden deafness 41.7% of those with sensorineural hearing impairment without sudden deafness, 50.0% of the diseased ears of patients with Meniere's disease, 37.5% of the contralateral ears of those with Meniere's disease and 64.3% of those with vertigo without hearing impairment. Although the cochlear aqueduct was thus highly demonstrable in patients with chronic otitis media or sudden deafness, the difference between the percentage of visualization in these diseased and in normal ears was not statistically significant.

  18. Template-based automatic extraction of the joint space of foot bones from CT scan (United States)

    Park, Eunbi; Kim, Taeho; Park, Jinah


    Clean bone segmentation is critical in studying the joint anatomy for measuring the spacing between the bones. However, separation of the coupled bones in CT images is sometimes difficult due to ambiguous gray values coming from the noise and the heterogeneity of bone materials as well as narrowing of the joint space. For fine reconstruction of the individual local boundaries, manual operation is a common practice where the segmentation remains to be a bottleneck. In this paper, we present an automatic method for extracting the joint space by applying graph cut on Markov random field model to the region of interest (ROI) which is identified by a template of 3D bone structures. The template includes encoded articular surface which identifies the tight region of the high-intensity bone boundaries together with the fuzzy joint area of interest. The localized shape information from the template model within the ROI effectively separates the bones nearby. By narrowing the ROI down to the region including two types of tissue, the object extraction problem was reduced to binary segmentation and solved via graph cut. Based on the shape of a joint space marked by the template, the hard constraint was set by the initial seeds which were automatically generated from thresholding and morphological operations. The performance and the robustness of the proposed method are evaluated on 12 volumes of ankle CT data, where each volume includes a set of 4 tarsal bones (calcaneus, talus, navicular and cuboid).

  19. A three-dimensional reconstruction of the temporal bone by the helical scanning CT and its clinical application

    Energy Technology Data Exchange (ETDEWEB)

    Yonekawa, Hiroyuki; Ohashi, Masami; Miyashita, Souji; Gotoh, Mizuho; Nemoto, Satohiko; Kikuchi, Hideki (Azabu Triology Hospital, Sapporo (Japan)); Sakai, Noboru; Inuyama, Yukio


    The current availability of 3 dimensional (3-D) imaging from Computed Tomography (CT) has yielded new anatomical information and pre- and postoperative evaluations. However, little discussion as to the 3-D structural image of the temporal bone has been reported because conventional CT does provide sufficient data to produce such images. The helical scanning CT gathers continuous and multiple slice image data since it consists of an X-ray tube that continuously rotates around the patient while the patient moves continuously into the CT scanner. Thus, application of the helical scanning CT has made it possible to reconstruct 3-D images of the minute and complicated structure of the temporal bone. We evaluated 3-D images from 9 typical cases, examined from February to October 1992. As a result, we found that the 3-D images reconstructed with this system are useful for evaluation of the postoperative state of tympanoplasty, the diagnosis of anomalies of the bony labyrinth, and examining the extent of bone destruction induced by trauma, cholesteatoma, etc. (author).

  20. Bone scan (United States)

    ... legs, or spine fractures) Diagnose a bone infection (osteomyelitis) Diagnose or determine the cause of bone pain, ... 2015:chap 43. Read More Broken bone Metabolism Osteomyelitis Review Date 12/10/2015 Updated by: Jatin ...

  1. Biomechanical Role of Bone Anisotropy Estimated on Clinical CT Scans by Image Registration. (United States)

    Taghizadeh, Elham; Reyes, Mauricio; Zysset, Philippe; Latypova, Adeliya; Terrier, Alexandre; Büchler, Philippe


    Image-based modeling is a popular approach to perform patient-specific biomechanical simulations. Accurate modeling is critical for orthopedic application to evaluate implant design and surgical planning. It has been shown that bone strength can be estimated from the bone mineral density (BMD) and trabecular bone architecture. However, these findings cannot be directly and fully transferred to patient-specific modeling since only BMD can be derived from clinical CT. Therefore, the objective of this study was to propose a method to predict the trabecular bone structure using a µCT atlas and an image registration technique. The approach has been evaluated on femurs and patellae under physiological loading. The displacement and ultimate force for femurs loaded in stance position were predicted with an error of 2.5% and 3.7%, respectively, while predictions obtained with an isotropic material resulted in errors of 7.3% and 6.9%. Similar results were obtained for the patella, where the strain predicted using the registration approach resulted in an improved mean squared error compared to the isotropic model. We conclude that the registration of anisotropic information from of a single template bone enables more accurate patient-specific simulations from clinical image datasets than isotropic model.

  2. CT scan of choristoma

    Energy Technology Data Exchange (ETDEWEB)

    Moriki, A.; Morimoto, M.; Sada, Y.; Kurisaka, M.; Mori, K.


    Choristoma is a rare tumor that occurs in the pituitary gland. The case presented here is a 44-year-old male. A plain CT scan demonstrated a slight high-density mass near the posterior clinoid of the sella turcica, while a moderate and homogeneous enhancing effect and a clear borderline were shown by an enhanced CT scan. A cornal CT scan study showed that the tumor extended from the intrasellar to the suprasellar region. The diagnosis of choristoma was made by means of histology.

  3. Semiautomated three-dimensional segmentation software to quantify carpal bone volume changes on wrist CT scans for arthritis assessment. (United States)

    Duryea, J; Magalnick, M; Alli, S; Yao, L; Wilson, M; Goldbach-Mansky, R


    Rapid progression of joint destruction is an indication of poor prognosis in patients with rheumatoid arthritis. Computed tomography (CT) has the potential to serve as a gold standard for joint imaging since it provides high resolution three-dimensional (3D) images of bone structure. The authors have developed a method to quantify erosion volume changes on wrist CT scans. In this article they present a description and validation of the methodology using multiple scans of a hand phantom and five human subjects. An anthropomorphic hand phantom was imaged with a clinical CT scanner at three different orientations separated by a 30-deg angle. A reader used the semiautomated software tool to segment the individual carpal bones of each CT scan. Reproducibility was measured as the root-mean-square standard deviation (RMMSD) and coefficient of variation (CoV) between multiple measurements of the carpal volumes. Longitudinal erosion progression was studied by inserting simulated erosions in a paired second scan. The change in simulated erosion size was calculated by performing 3D image registration and measuring the volume difference between scans in a region adjacent to the simulated erosion. The RMSSD for the total carpal volumes was 21.0 mm3 (CoV = 1.3%) for the phantom, and 44.1 mm3 (CoV = 3.0%) for the in vivo subjects. Using 3D registration and local volume difference calculations, the RMMSD was 1.0-3.0 mm3 The reader time was approximately 5 min per carpal bone. There was excellent agreement between the measured and simulated erosion volumes. The effect of a poorly measured volume for a single erosion is mitigated by the large number of subjects that would comprise a clinical study and that there will be many erosions measured per patient. CT promises to be a quantifiable tool to measure erosion volumes and may serve as a gold standard that can be used in the validation of other modalities such as magnetic resonance imaging.

  4. Bone Densitometry (Bone Density Scan) (United States)

    ... of DXA Bone Densitometry? What is a Bone Density Scan (DXA)? Bone density scanning, also called dual-energy x-ray absorptiometry ( ... is today's established standard for measuring bone mineral density (BMD). An x-ray (radiograph) is a noninvasive ...

  5. Visualization of postoperative anterior cruciate ligament reconstruction bone tunnels: Reliability of standard radiographs, CT scans, and 3D virtual reality images

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan); J.W. Potters (Jan Willem); A.H.J. Koning (Anton); C.H. Brown Jr Jr. (Charles); J.A.N. Verhaar (Jan); M. Reijman (Max)


    textabstractBackground and purpose: Non-anatomic bone tunnel placement is the most common cause of a failed ACL reconstruction. Accurate and reproducible methods to visualize and document bone tunnel placement are therefore important. We evaluated the reliability of standard radiographs, CT scans, a

  6. Comparative study on measured variables and sensitivity to bone microstructural changes induced by weightlessness between in vivo and ex vivo micro-CT scans. (United States)

    Sun, Lian Wen; Wang, Chao; Pu, Fang; Li, De Yu; Niu, Hai Jun; Fan, Yu Bo


    Depending on the experimental design, micro-CT can be used to examine bones either in vivo or ex vivo (excised fresh or formalin-fixed). In this study we investigated if differences exist in the variables measured by micro-CT between in vivo and ex vivo scans and which kind of scan is more sensitive to the changes of bone microstructure induced by simulated weightlessness. Rat tail suspension was used to simulate the weightless condition. The same bone from either normal or tail-suspended rats was scanned by micro-CT both in vivo and ex vivo (fresh and fixed by formalin). Then, bone mineral density (BMD) and microstructural characteristics were analyzed. The results showed that no significant differences existed in the microstructural parameters of trabecular bone among in vivo, fresh, and formalin-fixed bone scans from both femurs and tibias, although BMD exhibited differences. On the other hand, most parameters of the tail-suspended rats measured by micro-CT deteriorated compared with controls. Ex vivo scanning appeared to be more sensitive to bone microstructural changes induced by tail suspension than in vivo scanning. In general, the results indicate that values obtained in vivo and ex vivo (fresh and fixed) are comparable, thus allowing for meaningful comparison of experimental results from different studies irrespective of the type of scans. In addition, this study suggests that it is better to use ex vivo scanning when evaluating bone microstructure under weightlessness. However, researchers can select any type of scan depending upon the objective and the demands of the experiment.

  7. Bone scanning in otolaryngology. (United States)

    Noyek, A M


    Modern radionuclide bone scanning has introduced a new concept in physiologic and anatomic diagnostic imaging to general medicine. As otolaryngologists must diagnose and treat disease in relation to the bony and/or cartilaginous supporting structures of the neurocranium and upper airway, this modality should be included in the otolaryngologist's diagnostic armamentarium. It is the purpose of this manuscript to study the specific applications of bone scanning to our specialty at this time, based on clinical experience over the past three years. This thesis describes the development of bone scanning in general (history of nuclear medicine and nuclear physics; history of bone scanning in particular). General concepts in nuclear medicine are then presented; these include a discussion of nuclear semantics, principles of radioactive emmissions, the properties 99mTc as a radionuclide, and the tracer principle. On the basis of these general concepts, specific concepts in bone scanning are then brought forth. The physiology of bone and the action of the bone scan agents is presented. Further discussion considers the availability and production of the bone scan agent, patient factors, the gamma camera, the triphasic bone scan and the ultimate diagnostic principle of the bone scan. Clinical applications of bone scanning in otolaryngology are then presented in three sections. Proven areas of application include the evaluation of malignant tumors of the head and neck, the diagnosis of temporomandibular joint disorders, the diagnosis of facial fractures, the evaluation of osteomyelitis, nuclear medicine imaging of the larynx, and the assessment of systemic disease. Areas of adjunctive or supplementary value are also noted, such as diagnostic imaging of meningioma. Finally, areas of marginal value in the application of bone scanning are described.

  8. Technical aspects of CT scanning. (United States)

    Maravilla, K R; Pastel, M S


    The advent of computed tomography (CT) has initiated a technological revolution which continues to the present time. A brief review of basic principles of CT scanning is presented, and the evolution of modern CT scanner systems is traced. Some early indications of future trends are also presented.

  9. Cardiac CT Scan (United States)

    ... combine these pictures to create a three-dimensional (3D) model of the whole heart. This imaging test ... findings from earlier chest x rays. Different CT scanners are used for different purposes. A multidetector CT ...

  10. Chest CT Scan (United States)

    ... can combine these pictures to create three-dimensional (3D) models to help show the size, shape, and ... a medical imaging facility or hospital. The CT scanner is a large, tunnel-like machine that has ...

  11. {sup 99m}Tc-HDP Pinhole Bone Scan Features of Undetached Osteochondritis Dissecans of the Femoral Condyle: Report of a Case with Radiography, CT, and MRI Correlation

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee [Sung Ae Hospital, Seoul (Korea, Republic of); Choi, Woo Hee [Seoul St. Mary' s Hospital, Catholic University Medical School, Seoul (Korea, Republic of)


    OCD may be initiated by arrest of bone growth and subchondral osteosclerosis followed by either cartilage hypertrophy with calcification or enfolding with osteochondral bridging. Diagnosis can be made in most instances using magnetic resonance imaging (MRI) or computed tomography (CT) or invasive arthroscopy. As to usefulness of conventional radiography (CR) opinions diverge as some held it to be of limited value while others valuable. The controversy seems to be due to semantic confusion of OCD from osteonecrosis (ON) which are different entities. This report will describe a case of undetached OCD occurred in the medial femoral condyle in a middle-aged female. It was free of symptom and incidentally discovered on {sup 99m}Tc-HDP pinhole scan performed for patellar injury. Pinhole scan findings of OCD are correlated to those of CR, CT, and MRI. An electronic search of literature failed to reveal earlier publication of bone scan features of undetached OCD. Pathologically, OCD differs from ON in that the fragment in the former condition comes off from a normal vascular bony bed while that in the latter separates from an avascular bony bed. Indeed, bone fragment in ON is devascularized but that in OCD maintains vascularity until weighted images, respectively and the halo showed low signal intensity on both T1 and T2 images.

  12. Pelvic CT scan (United States)

    ... Results Mean Abnormal results may be due to: Abscess (collection of pus) Bladder stones Broken bone Cancer ... A.M. Editorial team. Related MedlinePlus Health Topics Anal Cancer Bladder Cancer Bladder Diseases Cervical Cancer Colorectal ...

  13. Using PET/CT Bone Scan Dynamic Data to Evaluate Tibia Remodeling When a Taylor Spatial Frame Is Used: Short and Longer Term Differences

    Directory of Open Access Journals (Sweden)

    Henrik Lundblad


    Full Text Available Eighteen consecutive patients, treated with a Taylor Spatial Frame for complex tibia conditions, gave their informed consent to undergo Na18F− PET/CT bone scans. We present a Patlak-like analysis utilizing an approximated blood time-activity curve eliminating the need for blood aliquots. Additionally, standardized uptake values (SUV derived from dynamic acquisitions were compared to this Patlak-like approach. Spherical volumes of interest (VOIs were drawn to include broken bone, other (normal bone, and muscle. The SUVm(t (m=max, mean and a series of slopes were computed as (SUVm(ti-SUVm(tj/(ti-tj, for pairs of time values ti and tj. A Patlak-like analysis was performed for the same time values by computing ((VOIp(ti/VOIe(ti-(VOIp(tj/VOIe(tj/(ti-tj, where p = broken bone, other bone, and muscle and e = expected activity in a VOI. Paired comparisons between Patlak-like and SUVm slopes showed good agreement by both linear regression and correlation coefficient analysis (r=84%,rs=78%-SUVmax,r=92%, and rs=91%-SUVmean, suggesting static scans could substitute for dynamic studies. Patlak-like slope differences of 0.1 min−1 or greater between examinations and SUVmax differences of ~5 usually indicated good remodeling progress, while negative Patlak-like slope differences of −0.06 min−1 usually indicated poor remodeling progress in this cohort.

  14. TU-C-12A-12: Differentiating Bone Lesions and Degenerative Joint Disease in NaF PET/CT Scans Using Machine Learning

    Energy Technology Data Exchange (ETDEWEB)

    Perk, T; Bradshaw, T; Muzahir, S; Jeraj, R [University of Wisconsin, Madison, Wisconsin (United States); Meyer, E [Case Western Reserve University School of Medicine, Cleveland, Ohio (United States)


    Purpose: [F-18]NaF PET can be used to image bone metastases; however, tracer uptake in degenerative joint disease (DJD) often appears similar to metastases. This study aims to develop and compare different machine learning algorithms to automatically identify regions of [F-18]NaF scans that correspond to DJD. Methods: 10 metastatic prostate cancer patients received whole body [F-18]NaF PET/CT scans prior to treatment. Image segmentation resulted in 852 ROIs, 69 of which were identified by a nuclear medicine physician as DJD. For all ROIs, various PET and CT textural features were computed. ROIs were divided into training and testing sets used to train eight different machine learning classifiers. Classifiers were evaluated based on receiver operating characteristics area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV). We also assessed the added value of including CT features in addition to PET features for training classifiers. Results: The training set consisted of 37 DJD ROIs with 475 non-DJD ROIs, and the testing set consisted of 32 DJD ROIs with 308 non-DJD ROIs. Of all classifiers, generalized linear models (GLM), decision forests (DF), and support vector machines (SVM) had the best performance. AUCs of GLM (0.929), DF (0.921), and SVM (0.889) were significantly higher than the other models (p<0.001). GLM and DF, overall, had the best sensitivity, specificity, and PPV, and gave a significantly better performance (p<0.01) than all other models. PET/CT GLM classifiers had higher AUC than just PET or just CT. GLMs built using PET/CT information had superior or comparable sensitivities, specificities and PPVs to just PET or just CT. Conclusion: Machine learning algorithms trained with PET/CT features were able to identify some cases of DJD. GLM outperformed the other classification algorithms. Using PET and CT information together was shown to be superior to using PET or CT features alone. Research supported by the Prostate

  15. Significance of temporal bone CT scan for exposure of the facial canal and the lateral semicircular canal in cholesteatoma

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Ki Joon; Kim, Dong Jin; Kim, Myung Soon; Kim, Young Ju; Kweon, Joon [Wonju College of Medicine, Yonsei University, Wonju (Korea, Republic of)


    By reviewing retrospectively the HRCT findings in 130 surgically proven cases of chronic otitis media with cholesteatoma, we estimated the sensitivity, specificity, and positive predictability of the HRCT compared to surgical findings. For exposure of the facial canal, the sensitivity, specificity, and positive predictability was 59.7%, 84.9%, and 85.2% respectively. For exposure of the lateral semicircular canal, the sensitivity was 80.6%, the specificity 99.0%, and the positive predictability 96.2%. Conclusively, the diagnostic accuracy of preoperative temporal bone CT regarding the state of the lateral semicircular canal seems to be highly reliable. Gross invasion of the facial canal can be usually detected. However, relatively low sensitivity suggests that evaluation of the ultra-thin structures of the tympanic segment is often problematic.

  16. Radiography, Bone Scan, and F-18 FDG PET/CT Imaging Findings in a Patient with Paget's Disease

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eun Tae; Kim, Sung Eun [Korea University Guro Hospital, Seoul (Korea, Republic of)


    Background A 52-year-old female patient sought evaluation at our hospital for an incidental abnormal finding on an abdominal radiograph. The initial radiograph showed irregular sclerotic changes involving the right pelvic bone. At the same time, bone scintigraphy showed intense hot uptake in the right iliac and pubic bones. CT images showed characteristic thickening of the pelvic brim, suggesting the mixed phase of Paget's disease. The level of alkaline phosphatase (ALP) was 266 IU/I. {sup 18}F-FDG PET/CT images also showed diffusely increased {sup 18}F-FDG uptake in the right pelvic bone. However, the findings of {sup 18}F-FDG PET/CT were less notable than those of bone scintigraphy. We report the imaging findings of a patient with Paget's disease evaluated by radiography, bone scintigraphy, and {sup 18}F-FDG PET/CT.

  17. Bone marrow metastases from alveolar rhabdomyosarcoma with impressive FDG PET/CT finding but less-revealing bone scintigraphy. (United States)

    Yang, Jigang; Zhen, Lishi; Zhuang, Hongming


    An 18F-FDG PET/CT scan was performed in a 26-year-old man with a known alveolar rhabdomyosarcoma for staging. The PET/CT scan showed abnormally increased FDG activity involving almost all bones in the imaged regions. In contrast, 99mTc-MDP whole-body bone scan demonstrated only very limited bone metastases.

  18. Diagnosis of ossicular deformities and inner ear anomalies by high resolution CT scanning of the temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    Isono, Michio


    A comparative study was undertaken to determine the optimum slice thickness and slice gaps that can define the fine contour and continuity of the ossicles and the inner ear. Horizontal tomography was proved to be contributory enough to obtain the whole ossicular chains and the whole labyrinthine capsule. Comparison of 1.5 mm slice thickness / 1.5 mm slice gaps, 1.0 mm slice thickness / 1.0 mm slice gaps and 1.5 mm slice thickness / 1.0 mm slice gaps revealed that the last condition was optimal for demonstrating the ossicular chains, the first for the inner ear. A significant relationship was found between CT findings and surgical findings of ossicular chains in chronic otitis media and cholesteatoma. Radiological classification of the inner ear malformation, which was obtained by this method, were agenesis of the whole labyrinthine capsule, agenesis of the cochlea, slight protrusion of the cochlear growth, poor cochlear turning, agenesis of all the semicircular canals, anterior semicircular canals (s.c.) without posterior and lateral s.c., anterior s.c. without hypoplasia of posterior s.c. and aplasia of lateral s.c., and smallness of the vestibule. (author) 59 refs.

  19. Efficacy of DR, CT and MRI in bone tumors

    Institute of Scientific and Technical Information of China (English)

    Yanjiao Zhang; Xuefeng Cui; Changcheng Li; Shenjiang Li


    Objective:The aim of the study was to investigate the ef icacy of digital radiography (DR), computed tomography (CT) and magnetic resonance imaging (MRI) in bone tumors. Methods:Fifty-five patients with histological y confirmed bone tumors underwent imaging examinations. Fifty-five patients were performed DR, 21 CT and 20 MRI. Results:DR of 51 pa-tients clearly revealed bone changes. DR of 40 patients wel showed marginal. Twenty tumors appeared periosteal reaction on DR and 19 calcification on DR. CT scan of 21 patients clearly depicted bone changes, marginal and calcification and CT scan of 8 revealed periosteal reaction. MRI scan of 20 patients al showed marginal and soft-tissue mass and bone marrow edema was prominent in 8 patients. Conclusion:DR is the first imaging approach for born tumors. CT wel reveal the extent and minute structure of the bone tumors, the extent, soft-tissue mass and bone marrow edema are more dramatical y demon-strated on MRI imaging. DR integrates with CT and MRI, is helpful in diagnosis of bone tumors.

  20. Interesting bone scans - unusual findings

    Energy Technology Data Exchange (ETDEWEB)

    Dobson, M.; Wadhwa, S.S.; Mansberg, R.; Fernandes, V.B. [Wollongong Hospital, Wollongong, NSW (Australia)


    A 59-year-old female with carcinoma of the colon and known liver metastatic disease was referred for bone scan to evaluate for bone metastases. Although no bone metastases were found, there was abnormal uptake noted in the liver corresponding to a metastatic calcified lesion. The only other findings were of degenerative disease in the cervical spine, right shoulder and small joints of the hands. A 69-year-old male with carcinoma of the prostate and right side low back pain was referred for bone scan. No focal abnormalities to suggest metastatic disease were identified; findings within the cervical spine, lumber spine and knees were presumed secondary to degenerative disease. Intermittent pain persisted and the patient was referred for a repeat bone scan six months later. Previous scan findings of degenerative disease and no metastatic disease were confirmed; however, closer inspection revealed an enlarged right kidney with significant retention of tracer in the pelvicalyceal system suggesting possible obstruction. A Retrograde pyelogram was performed, and no obvious obstruction demonstrated. As bone scan findings were very suggestive of obstruction, a DTPA scan with lasix was performed showing a dilated right collecting system with no functional obstruction. Given the degree of dilation, it is possible that the patient experiences intermittent PUJ obstruction causing his symptoms. A 33-year-old male with insulin dependent diabetes mellitus and viral arthritis was referred for a bone scan. A three phase revealed increased uptake in the region of the knee and leR proximal tibia. Delayed whole body images revealed multiple focal areas of osteoblastic activity in the leR tibia. Abnormal uptake was also seen in the upper third of the leR femur. The remainder of the skeletal survey was normal. X-ray correlation of the leR tibia and femoral findings was undertaken. Combinating unilateral changes on bone scan and X-ray although very suggestive of sclerotic polyostotic

  1. Extramedullary pulmonary hematopoiesis causing pulmonary hypertension and severe tricuspid regurgitation detected by {sup 99m} technetium sulfur colloid bone marrow scan and single-photon emission computed tomography/CT

    Energy Technology Data Exchange (ETDEWEB)

    Ali, Syed Zama; Clarke, Michael John; Kannivelu, Anbalagan; Chinchure, Dinesh; Srinivasan, Sivasubramanian [Dept. of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore (Singapore)


    Extramedullary pulmonary hematopoiesis is a rare entity with a limited number of case reports in the available literature only. We report the case of a 66-year-old man with known primary myelofibrosis, in whom a {sup 99m}technetium sulfur colloid bone marrow scan with single-photon emission computed tomography (SPECT)/CT revealed a pulmonary hematopoiesis as the cause of pulmonary hypertension and severe tricuspid regurgitation. To the best of our knowledge, this is the first description of {sup 99m} technetium sulfur colloid SPECT/CT imaging in this rare condition.

  2. Evaluation strategies in CT scanning

    DEFF Research Database (Denmark)

    uncertainty. This investigation includes measurements of two industrial items, an aluminum pipe connector and a plastic toggle, a hearing aid component. These are measured using a commercial CT scanner. Traceability is transferred using tactile and optical coordinate measuring machines, which are used...

  3. Combined bilateral idiopathic necrosis of the humerus and femur heads: Bone scan, X-ray, CT, and MRI findings. Kombinierte beidseitige idiopathische Nekrose der Humerus- und Femurkoepfe: Skelettszintigraphie, Roentgen-, CT- und MRT-Befunde

    Energy Technology Data Exchange (ETDEWEB)

    Piepenburg, R.; Hahn, K. (Mainz Univ. (Germany). Klinik fuer Nuklearmedizin); Doll, G. (Mainz Univ. (Germany). Klinik fuer Roentgendiagnostik); Grimm, J. (Mainz Univ. (Germany). Orthopaedische Klinik)


    Untreated aseptic bone necroses close to a joint commonly leads to severe secondary arthrosis and destruction of the joint within a short time. Therefore, only a diagnosis in an early stage of the disease offers the chance of a successful joint- preserving therapy. In cases of clinically suspected aseptic bone necrosis but still negative or doubtful X-ray findings, bone scans or MRI are reliable methods of verifying the diagnosis. (orig./MG).

  4. Bone Scan "Hot Spot" at the Superior Lateral Orbital Margin Fronto-zygomatic Suture Uptake Characterized with Tc-99m MDP SPECT/CT. (United States)

    Thang, S P; Tan, A E H; Goh, A S W


    Findings of a solitary "hot spot" at the superior lateral orbital margin on bone scan scintigraphy is not uncommonly seen, and is often dismissed as a benign lesion. However, the exact etiology is indeterminate. We present two cases in which hybrid single photon emission computed tomography/computed tomography imaging was able to characterize and localize this uptake, demonstrating correlation to the right fronto-zygomatic suture.

  5. Contextual Analysis of CT Scanned Pig Carcasses

    DEFF Research Database (Denmark)

    Lyckegaard, Allan; Larsen, Rasmus; Christensen, Lars Bager;


    Knowledge of the weight of tissue types in pig carcasses is generally only available after manual dissection. The use of computed tomography (CT) has demonstrated to be a promising approach to gain knowledge on the lean meat weight (Romvari, 2005), but less effort has been put into gaining...... knowledge about the weight of other tissue types from CT. Knowing the weight of individual tissue types will directly give access to other measures such as the weight of the carcass and the Lean Meat Percentage (LMP). Until now, most analyses of CT scans have been based on the Hounsfield spectra that does...... not consider the spatial context in CT scan. Applying contextual methods from the field of image analysis we hope to make a virtual dissection of pig carcasses....

  6. Growth arrest line mimicking lymphoma involvement: The findings of {sup 99m}Tc-MDP bone SPECT/CT and serial bone scan in a child with non-Hodgkin's lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chan Woo; Kim, Ji Young; Choi, Yun Young; Lee, Seung Hun; Lee, Young Ho [Hanyang University Medical Center, Seoul (Korea, Republic of)


    Growth arrest lines appear as dense sclerotic lines parallel to the growth plate of long bones on radiography. We describe the case of a 9-year-old female with growth arrest lines initially masquerading as lymphoma involvement on {sup 99m}Tc-MDP bone scintigraphy who had been treated with chemotherapy for non-Hodgkin's lymphoma about 3 years previously. Subsequent regional bone SPECT/CT clearly diagnosed the growth arrest lines, and retrograde review of previous bone scintigraphy demonstrated line migration in this patient. Growth arrest lines should be considered a possible diagnosis on bone scintigraphy, especially in the surveillance of children who have experienced severe childhood infections, malnutrition, immobilization, or treatment with immunosuppressive or chemotherapeutic drugs that may inhibit bone growth.

  7. Growth Arrest Line Mimicking Lymphoma Involvement: The Findings of (99m)Tc-MDP Bone SPECT/CT and Serial Bone Scan in a Child with Non-Hodgkin's Lymphoma. (United States)

    Kim, Chanwoo; Kim, Ji Young; Choi, Yun Young; Lee, Seunghun; Lee, Young-Ho


    Growth arrest lines appear as dense sclerotic lines parallel to the growth plate of long bones on radiography. We describe the case of a 9-year-old female with growth arrest lines initially masquerading as lymphoma involvement on (99m)Tc-MDP bone scintigraphy who had been treated with chemotherapy for non-Hodgkin's lymphoma about 3 years previously. Subsequent regional bone SPECT/CT clearly diagnosed the growth arrest lines, and retrograde review of previous bone scintigraphy demonstrated line migration in this patient. Growth arrest lines should be considered a possible diagnosis on bone scintigraphy, especially in the surveillance of children who have experienced severe childhood infections, malnutrition, immobilization, or treatment with immunosuppressive or chemotherapeutic drugs that may inhibit bone growth.

  8. CT scan of bacterial and aseptic meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Takemoto, Kazumasa; Saiwai, Shigeo; Tamaoka, Koichi (Kobe Central Municipal Hospital (Japan))


    CT scans of the patients with aseptic and bacterial meningitis were reviewed and compared to previous reports. In aseptic meningitis, no abnormal CT findings were observed. In bacterial meningitis, CT findings were ventricular dilatation, subdural fluid collection, parenchymal low density, intracerebral hematoma and meningeal enhancement after contrast injection. Three patients among 48 suffered from status epileptics during the course of the illness. All of the 3 patients developed parenchymal inhomogeneous low density and progressive ventricular dilatation which did not improve after ventricular peritoneal shunt surgery. We believe that these changes are most likely due to hypoxic hypoxemia during epileptic seizure and meningitis itself seems to play a little role.

  9. Use of Gamma Correction Pinhole Bone Scans in Trauma

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Youg Whee [Sung Ae Hospital, Seoul (Korea, Republic of); Chung, Youg An; Park, Jung Mee [Catholic Univ. of Korea, Seoul (Korea, Republic of)


    {sup 99}mTc hydroxydiphosphonate (HDP) bone scanning is a classic metabolic nuclear imaging method and the most frequently performed examination. Clinically, it has long been cherished as an indispensable diagnostic screening tool and for monitoring of patients with bone, joint, and soft tissue diseases. The HDP bone scan, the pinhole scan in particular, is known for its ability to detect increased, decreased, or defective tracer uptake along with magnified anatomy. Unfortunately, however, the findings of such uptake changes are not specific in many traumatic bone disorders, especially when lesions are minute and complex. This study discusses the recently introduced gamma correction pinhole bone scan (GCPBS), emphasizing its usefulness in the diagnosis of traumatic bone diseases including occult fractures; and fish vertebra. Indeed, GCPBS can remarkably enhance the diagnostic feasibility of HDP pinhole bone scans by refining the topography, pathologic anatomy, and altered chemical profile of the traumatic diseases in question. The fine and precise depiction of anatomic and metabolic changes in these diseases has been shown to be unique to GCPBS, and they are not appreciated on conventional radiographs, multiple detector CT, or ultrasonographs. It is true that MR imaging can portray proton change, but understandably, it is a manifestation that is common to any bone disease.

  10. Depiction of Nidi and Fibrovascular Zones of Osteoid Ostemas Using Gamma Correction Tc 99m HDP Pinhole Bone Scan and Conventional Radiograph, and Correlation with CT, MRI, and PVC Phantom Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Youg Whee [Sung Ae Hospital, Seoul (Korea, Republic of); Kim, Sung Hoon; Chung, Yong An; Bahk, Won Jong; Park, Jung Mee; Kang, You Mee; Choi, Woo Hee; Park, Young Ha; Sohn, Hyung Sun; Kim, Byung Ki; Chung, Soo Kyo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)


    For the precise imaging diagnosis of osteoid osteoma (OO), the identification of the nidus and fibrovascular zone (FVZ) is essential. However, the latter sign has received little attention because it is difficult to demonstrate. We applied the recently introduced gamma correction (GC) to depict the FVZ on pinhole bone scan (PBS), conventional radiography (CR), and computed tomography (CT). Non gamma correction MRI was also analyzed for reference. Ten patients with histologically proven diagnoses of OO were enrolled in this retrospective study. PBS, CR, and CT were processed by GC to demonstrate the nidi and FVZ as distinct yet integrating components of OO. PBS was performed using a 4mm pinhole collimator 3 h after iv injection of 925 to 1, 110 MBq (25 to 30mCi) of Tc 99m HDP, and anteroposterior and mediolateral CR and transverse CT were taken according to the standard technique. MRI sequences included T1 and T2 weighted images. For gamma correction, we utilized the Photo Correction Wizard program of ACD Photo Editor v3. 1. A team of three qualified nuclear physician radiologists, two nuclear physicians, and one MRI specialist read bone scans, radiographs, and MRIs of OO according to each specialty, and orthopaedic aspects and histology were reviewed by one qualified orthopedic surgeon and two qualified pathologists, respectively. Each observer first read the images separately with basic information about the aim of the study given and then in concert. Interpretive disagreement was settled by discussion and consensus. On pinhole scan, nidi were presented as areas of intense tracer uptake in all cases, and, importantly after GC, a thin ring like zone with lower tracer uptake became visible in seven out of ten cases. GCCR also revealed a thin lucent zone that circumscribed the nidi in six out of ten cases and GCCT in two of four cases. MRI, without GC, presented nidi with high signal in the center and a thin ring like zone with low signal in the periphery in five out

  11. Gout: Value of bone scanning

    Energy Technology Data Exchange (ETDEWEB)

    Oliva, J.P.; Cardenas, R.; Bell, L.; Gonzalez Griego, J.


    11 male patients with gout were studied by means of bone scintigraphy with /sup 99m/TcMDP. This diagnostic method rendered possible the diagnosis of clinically or roentgenologically occult bone involvement. Bone scintigraphy may be useful procedure to monitor therapy of gout.

  12. Complications in CT-guided Procedures: Do We Really Need Postinterventional CT Control Scans?

    Energy Technology Data Exchange (ETDEWEB)

    Nattenmüller, Johanna, E-mail:; Filsinger, Matthias, E-mail:; Bryant, Mark, E-mail:; Stiller, Wolfram, E-mail:; Radeleff, Boris, E-mail:; Grenacher, Lars, E-mail:; Kauczor, Hans-Ullrich, E-mail:; Hosch, Waldemar, E-mail: [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (Germany)


    PurposeThe aim of this study is twofold: to determine the complication rate in computed tomography (CT)-guided biopsies and drainages, and to evaluate the value of postinterventional CT control scans.MethodsRetrospective analysis of 1,067 CT-guided diagnostic biopsies (n = 476) and therapeutic drainages (n = 591) in thoracic (n = 37), abdominal (n = 866), and musculoskeletal (ms) (n = 164) locations. Severity of any complication was categorized as minor or major. To assess the need for postinterventional CT control scans, it was determined whether complications were detected clinically, on peri-procedural scans or on postinterventional scans only.ResultsThe complication rate was 2.5 % in all procedures (n = 27), 4.4 % in diagnostic punctures, and 1.0 % in drainages; 13.5 % in thoracic, 2.0 % in abdominal, and 3.0 % in musculoskeletal procedures. There was only 1 major complication (0.1 %). Pneumothorax (n = 14) was most frequent, followed by bleeding (n = 9), paresthesia (n = 2), material damage (n = 1), and bone fissure (n = 1). Postinterventional control acquisitions were performed in 65.7 % (701 of 1,067). Six complications were solely detectable in postinterventional control acquisitions (3 retroperitoneal bleeds, 3 pneumothoraces); all other complications were clinically detectable (n = 4) and/or visible in peri-interventional controls (n = 21).ConclusionComplications in CT-guided interventions are rare. Of these, thoracic interventions had the highest rate, while pneumothoraces and bleeding were most frequent. Most complications can be detected clinically or peri-interventionally. To reduce the radiation dose, postinterventional CT controls should not be performed routinely and should be restricted to complicated or retroperitoneal interventions only.

  13. CT scan correlates of gesture recognition. (United States)

    Ferro, J M; Martins, I P; Mariano, G; Caldas, A C


    The ability to recognise gestures was studied in 65 left-hemispheric stroke patients whose lesions were located by CT scan. In the acute stage (first month) frontal lobe and basal ganglia were frequently involved in patients showing inability to recognise gestures. In the later (third to fourth month) and chronic stages (greater than 6 months) parietal lobe involvement was important; lesions causing gesture recognition impairment were larger, had more extensive and frequent parietal involvement and produced less temporal lobe damage than those causing aural comprehension defects. These findings are discussed in the light of recent models of cerebral localisation of complex functions.

  14. 99mTc-MDP bone scan combined with CT in the clinical value of breast cancer%99mTc-MDP骨显像联合CT在乳腺癌术后的临床价值

    Institute of Scientific and Technical Information of China (English)

    黄晓红; 智生芳; 蒋宁一


    Objective To evaluate the value of clinical application of the combination of CT and 99mTc-MDP bone scan in the follow-up monitoring of cancer recurrences of the breast cancer patients previously treated with both mastecomy and chemotherapy Methods 253 female breast cancer patients treated with mastectomy and chemotherapy within the past one year were enrolled in this study. All of them underwent CT,99mTc-MDP bone scan. calculation of the sensitivity, specialty, accuracy, were analyzed. Results There were 122 patients had the bone metastasis in 253 patients diagnosed breast cancer. the incidence rate was 48.2% . The thoracic part had the most incident of osseous metastasis(50.9%) ,then the vertebral body(41.8%) ,pelvis(25.4%),limbs bone (14. 5 %), skull and the other parts(9. 1%). The sensitivity, specialty, accuracy of 99mTc-MDP bone scan in determining osseuous metastasis were 93.2% 、90. 7% 、91.3% respectively;The sensitivity, specialty,accuracy of CT in the detection of cancer recurrence were 58. 2% 、87.8% 、73.5% respectively in CT scan.When combining 99mTc-MDP bone scan with CT scan,they were 93.4% 、91.6% 、92.5% respectively. Conclusion The incidence rate of osseous metastasis is very high for the breast cancer patients, and the incidence of the osseous metastasis has definite rules and features. the combination of CT and 99mTc-MDP in the follow-up studies of the breast cancer patients previously treated with both mastectomy and chemotherapy can obtain the higher sensitivity, specialty and accuracy, making a significant contribution to the value of clinical application.%目的 探讨99mTc-MDP骨显像联合CT在乳腺癌术后早期随访中,检测其复发及转移临床价值.方法 对253例术后病理确诊的乳腺癌患者一年后分别进行99mTc-MDP骨显像、CT扫描,计算灵敏度、特异性、准确性以及分析骨转移的特点.结果 253例乳腺癌全身骨显像中,发现复发或转移者122例,发生率为48.2%,99mTc-MDP发

  15. Diagnosis of pituitary microadenomas by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Sakoda, K.; Gen, M.; Yonezawa, M.; Ohta, M.; Matsumura, S. (Hiroshima Univ. (Japan). School of Medicine)


    The presence of pituitary microadenomas can be established by the detection of minor changes on polytomograms of the sella turcica. However, as this method is a procedure for detecting secondary changes due to adenoma, it is understandable that microadenomas which fail to present secondary changes cannot be picked up. From this point of view, we investigated the possibility detecting changes in the pituitary itself by means of CT. An axial scan of pituitary microadenomas by EMI-1010 showed that some of the PRL secreting adenomas and all of the GH secreting adenomas showed areas of high density, and that some of PRL secreting adenomas and all the ACTH secreting adenomas showed areas of low density at the site of the adenomas. On a coronal scan with GE/X2, the normal pituitary is highly enhanced, and an absorption coefficient of 70 - 80 is demonstrated, but on an axial scan the coefficient becomes 25 - 35 due to the partial-volume effect. On a coronal scan pituitary microadenomas are shown as hypodense-lucent or isodense as a normal pituitary. However, the absorption coefficient of the hypodense-lucent area was 50 - 60; this is not low, but is, rather, a high density. At present, it is our belief that it is most effective to use a coronal angle with a high-resolution scanner in the diagnosis of pituitary microadenomas.

  16. Role of bone scan in rheumatic disease

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Young [Hanyang University College of Medicine, Seoul (Korea, Republic of)


    Rheumatic diseases can be categorized by pathology into several specific types of musculoskeletal problems, including synovitis (e.g. rheumatoid arthritis), enthesopathy (e.g. ankylosing spondylitis) and cartilage degeneration (e.g. osteoarthritis). Skeletal radiographs have contributed to the diagnosis of these articular diseases, and some disease entities need typical radiographic changes as a factor of the diagnostic criteria. However, they sometimes show normal radiographic findings in the early stage of disease, when there is demineralization of less than 30-50%. Bone scans have also been used in arthritis, but not widely because the findings are nonspecific and it is thought that bone scans do not add significant information to routine radiography. Bone scans do however play a different role than simple radiography, and it is a complementary imaging method in the course of management of arthritis. The image quality of bone scans can be improved by obtaining regional views and images under al pin-hole collimator, and through a variety of scintigraphic techniques including the three phase bone scan and bone SPECT. Therefore, bone scans could improve the diagnostic value, and answer multiple clinical questions, based on the pathophysiology of various forms of arthritis.

  17. Does low-field dedicated extremity MRI (E-MRI) reliably detect bone erosions in rheumatoid arthritis? A comparison of two different E-MRI units and conventional radiography with high-resolution CT scanning

    DEFF Research Database (Denmark)

    Duer-Jensen, A; Ejbjerg, B; Albrecht-Beste, E;


    underwent CR, CT and two E-MRI examinations (Esaote Biomedica Artoscan and MagneVu MV1000) of one hand during a 2-week period. In all modalities, each bone of the wrist and MCP joints was blindly evaluated for erosions. MagneVu images were also assessed for the proportion of each bone being visualised...

  18. The role of 18F–NaF PET/CT in metastatic bone disease

    Directory of Open Access Journals (Sweden)

    Mine Araz


    Conclusion: Although further prospective clinical studies in specific cancer populations are indicated to set the place of 18F–NaF PET/CT in diagnostic scheme, the results of this pilot study from our country support the superiority of 18F–NaF PET/CT in investigation of bone metastasis over 99mTc-MDP bone scan and 18F-FDG PET/CT in various malignancies. 18F–NaF PET/CT is coming forward as a single step bone seeking study, considering all the advantages, but especially potential of detecting occult metastases and reliably directing patient management.

  19. Prediction of trabecular bone qualitative properties using scanning quantitative ultrasound (United States)

    Qin, Yi-Xian; Lin, Wei; Mittra, Erik; Xia, Yi; Cheng, Jiqi; Judex, Stefan; Rubin, Clint; Müller, Ralph


    Microgravity induced bone loss represents a critical health problem in astronauts, particularly occurred in weight-supporting skeleton, which leads to osteopenia and increase of fracture risk. Lack of suitable evaluation modality makes it difficult for monitoring skeletal status in long term space mission and increases potential risk of complication. Such disuse osteopenia and osteoporosis compromise trabecular bone density, and architectural and mechanical properties. While X-ray based imaging would not be practical in space, quantitative ultrasound may provide advantages to characterize bone density and strength through wave propagation in complex trabecular structure. This study used a scanning confocal acoustic diagnostic and navigation system (SCAN) to evaluate trabecular bone quality in 60 cubic trabecular samples harvested from adult sheep. Ultrasound image based SCAN measurements in structural and strength properties were validated by μCT and compressive mechanical testing. This result indicated a moderately strong negative correlations observed between broadband ultrasonic attenuation (BUA) and μCT-determined bone volume fraction (BV/TV, R2=0.53). Strong correlations were observed between ultrasound velocity (UV) and bone's mechanical strength and structural parameters, i.e., bulk Young's modulus (R2=0.67) and BV/TV (R2=0.85). The predictions for bone density and mechanical strength were significantly improved by using a linear combination of both BUA and UV, yielding R2=0.92 for BV/TV and R2=0.71 for bulk Young's modulus. These results imply that quantitative ultrasound can characterize trabecular structural and mechanical properties through measurements of particular ultrasound parameters, and potentially provide an excellent estimation for bone's structural integrity.

  20. High resolution CT of temporal bone trauma

    Energy Technology Data Exchange (ETDEWEB)

    Youn, Eun Kyung [Korea General Hospital, Seoul (Korea, Republic of)


    Radiographic studies of the temporal bone following head trauma are indicated when there is cerebrospinal fluid otorrhea or rhinorrhoea, hearing loss, or facial nerve paralysis. Plain radiography displays only 17-30% of temporal bone fractures and pluridirectional tomography is both difficult to perform, particularly in the acutely ill patient, and less satisfactory for the demonstration of fine fractures. Consequently, high resolution CT is the imaging method of choice for the investigation of suspected temporal bone trauma and allows special resolution of fine bony detail comparable to that attainable by conventional tomography. Eight cases of temporal bone trauma examined at Korea General Hospital April 1985 through May 1986. The results were as follows: Seven patients (87%) suffered longitudinal fractures. In 6 patients who had purely conductive hearing loss, CT revealed various ossicular chain abnormality. In one patient who had neuro sensory hearing loss, CT demonstrated intract ossicular with a fracture nearing lateral wall of the lateral semicircular canal. In one patient who had mixed hearing loss, CT showed complex fracture.


    Institute of Scientific and Technical Information of China (English)

    Zheng Shuxian; Zhao Wanhua; Lu Bingheng; Zhao Zhao


    In the prosthetic socket design, aimed at the high cost and radiation deficiency caused by CT scanning which is a routine technique to obtain the cross-sectional image of the residual limb, a new ultrasonic scanning method is developed to acquire the bones and skin contours of the residual limb. Using a pig fore-leg as the scanning object, an overlapping algorithm is designed to reconstruct the 2D cross-sectional image, the contours of the bone and skin are extracted using edge detection algorithm and the 3D model of the pig fore-leg is reconstructed by using reverse engineering technology. The results of checking the accuracy of the image by scanning a cylinder work pieces show that the extracted contours of the cylinder are quite close to the standard circumference. So it is feasible to get the contours of bones and skin by ultrasonic scanning. The ultrasonic scanning system featuring no radiation and low cost is a kind of new means of cross section scanning for medical images.

  2. Diagnosis of pituitary adenomas by bone window CT. A comparative study with hypocycloidal tomography

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, S.; Sato, O.; Tsuchita, H.; Nakagaki, Y.; Tsuruta, J. (Sapporo Medical Coll. (Japan))


    The CT scan is useful for the diagnosis of pituitary adenomas when they are well enhanced and show remarkable suprasellar extension. However, the deformity or the destruction of the sella turcica by pituitary adenomas is not well demonstrated by the conventional CT scan because of the artifacts or the partial volume effect elicited by the surrounding bony structures. To overcome these difficulties, the authors have developed the bone window CT scan, which demonstrates not only the soft tissue of the tumor, but also the bony changes of the sella turcica. The bone-window CT scan means a CT scan by the reverse-mode-display method, with a window width of 400 and a window level of 100. We analysed 36 cases of the sella turcica in pituitary adenomas by the bone-window CT scan in both axial and coronal sections and compared the results with those by hypocycloidal tomography. From the deformities of the sella turcica, we classified five types of sellar changes in pituitary adenomas. The bone window CT scan proved to be useful for the detection of not only the tumor mass but also the deformities of the sella. From the findings of the sellar deformities, the intrasellar location and the mode of extrasellar extension of the pituitary adenomas were defined. But the disadvantage of the bone window CT scan lies in the inaccurate delineation of the tumor extension into the sphenoid sinus or upward to suprasellar area and in the poor diagnostic value for pituitary microadenomas. These disadvantages will be supplemented by hypocycloidal tomography or conventional enhanced CT scan.

  3. Use of Bone Scan During Initial Prostate Cancer Workup, Downstream Procedures, and Associated Medicare Costs

    Energy Technology Data Exchange (ETDEWEB)

    Falchook, Aaron D. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Salloum, Ramzi G. [Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina (United States); Hendrix, Laura H. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Chen, Ronald C., E-mail: [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States)


    Purpose: For patients with a high likelihood of having metastatic disease (high-risk prostate cancer), bone scan is the standard, guideline-recommended test to look for bony metastasis. We quantified the use of bone scans and downstream procedures, along with associated costs, in patients with high-risk prostate cancer, and their use in low- and intermediate-risk patients for whom these tests are not recommended. Methods and Materials: Patients in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database diagnosed with prostate cancer from 2004 to 2007 were included. Prostate specific antigen (PSA), Gleason score, and clinical T stage were used to define D'Amico risk categories. We report use of bone scans from the date of diagnosis to the earlier of treatment or 6 months. In patients who underwent bone scans, we report use of bone-specific x-ray, computed tomography (CT), and magnetic resonance imaging (MRI) scans, and bone biopsy within 3 months after bone scan. Costs were estimated using 2012 Medicare reimbursement rates. Results: In all, 31% and 48% of patients with apparent low- and intermediate-risk prostate cancer underwent a bone scan; of these patients, 21% underwent subsequent x-rays, 7% CT, and 3% MRI scans. Bone biopsies were uncommon. Overall, <1% of low- and intermediate-risk patients were found to have metastatic disease. The annual estimated Medicare cost for bone scans and downstream procedures was $11,300,000 for low- and intermediate-risk patients. For patients with apparent high-risk disease, only 62% received a bone scan, of whom 14% were found to have metastasis. Conclusions: There is overuse of bone scans in patients with low- and intermediate-risk prostate cancers, which is unlikely to yield clinically actionable information and results in a potential Medicare waste. However, there is underuse of bone scans in high-risk patients for whom metastasis is likely.

  4. An anatomically shaped lower body model for CT scanning of cadaver femurs

    Energy Technology Data Exchange (ETDEWEB)

    Tanck, Esther; Deenen, J C W; Verdonschot, Nico [Orthopaedic Research Laboratory, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB Nijmegen (Netherlands); Huisman, Henk Jan [Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Kooloos, Jan G [Department of Anatomy, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Huizenga, Henk [Department of Radiotherapy, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands)], E-mail:


    Bone specific, CT-based finite element (FE) analyses have great potential to accurately predict the fracture risk of deteriorated bones. However, it has been shown that differences exist between FE-models of femora scanned in a water basin or scanned in situ within the human body, as caused by differences in measured bone mineral densities (BMD). In this study we hypothesized that these differences can be reduced by re-creating the patient CT-conditions by using an anatomically shaped physical model of the lower body. BMD distributions were obtained from four different femora that were scanned under three conditions: (1) in situ within the cadaver body, (2) in a water basin and (3) in the body model. The BMD of the three scanning protocols were compared at two locations: proximally, in the trabecular bone of the femoral head, and in the cortical bone of the femoral shaft. Proximally, no significant differences in BMD were found between the in situ scans and the scans in the body model, whereas the densities from the water basin scans were on average 10.8% lower than in situ. In the femoral shaft the differences between the three scanning protocols were insignificant. In conclusion, the body model better approached the in situ situation than a water basin. Future studies can use this body model to mimic patient situations and to develop protocols to improve the performance of the FE-models in actual patients. (note)

  5. Relationship between Hounsfield unit in CT scan and gray scale in CBCT (United States)

    Kamaruddin, Noorshaida; Rajion, Zainul Ahmad; Yusof, Asilah; Aziz, Mohd Ezane


    Cone-beam computed tomography (CBCT) is an imaging system which has advantages over computed tomography (CT). Recently, CBCT has become widely used for oral and maxillofacial imaging. In CT scan, Hounsfield Unit (HU) is proportional to the degree of x-ray attenuation by the tissue. In CBCT, the degree of x-ray attenuation is shown by gray scale (voxel value). The aim of the present (in vitro) study was to investigate the relationship between gray scale in CBCT and HU in CT scan. In this descriptive study, the anthropomorphic head phantom was scanned with CBCT and CT scanner. Gray scales and HUs were detected on images at the crown of the teeth, trabecular and cortical bone of mandible. The images were analyzed to obtain the gray scale value and HU value. The obtained value then used to investigate the relationship between CBCT gray scales and HUs. For the statistical analysis, t-test, Pearson's correlation and regression analysis were used. The differences between the gray scale of CBCT and HU of CT were statistically not significant, whereas the Pearson's correlation coefficients demonstrated a statistically significant correlation between gray scale of CBCT and HU of CT values. Considering the fact that gray scale in CBCT is important in pre assessment evaluation of bone density before implant treatments, it is recommended because of the lower dose and cost compared to CT scan.

  6. Automatic segmentation of pulmonary segments from volumetric chest CT scans.

    NARCIS (Netherlands)

    Rikxoort, E.M. van; Hoop, B. de; Vorst, S. van de; Prokop, M.; Ginneken, B. van


    Automated extraction of pulmonary anatomy provides a foundation for computerized analysis of computed tomography (CT) scans of the chest. A completely automatic method is presented to segment the lungs, lobes and pulmonary segments from volumetric CT chest scans. The method starts with lung segmenta

  7. Segmentation of anatomical structures in chest CT scans

    NARCIS (Netherlands)

    van Rikxoort, E.M.


    In this thesis, methods are described for the automatic segmentation of anatomical structures from chest CT scans. First, a method to segment the lungs from chest CT scans is presented. Standard lung segmentation algorithms rely on large attenuation differences between the lungs and the surrounding

  8. Collar Osteophytes Mimicking Osteonecrosis in Planar Bone Scintigraphy and Usefulness of SPECT/CT Images. (United States)

    Juang, Jr-Jian; Chen, Yi-Hsing; Tsai, Shih-Chuan; Lin, Wan-Yu


    The use of prednisolone is one major risk factor for osteonecrosis in patients with systemic lupus erythematosus. Bone scintigraphy can be a diagnostic tool for early diagnosis. We present a case who had collar osteophytes at the bilateral femoral heads, which mimicked osteonecrosis in the planar bone scintigram. An SPECT/CT scan avoided this pitfall and increased the diagnostic accuracy for osteonecrosis.

  9. Preoperative CT scanning of 70 cases of rheumatic valvular disease

    Energy Technology Data Exchange (ETDEWEB)

    Take, Akira; Matuzaki, Shigeru; Oki, Shinichi (Jichi Medical School, Minamikawachi, Tochigi (Japan)) (and others)


    Seventy patients with rheumatic valvular disease were evaluated with preoperative CT scanning. The correlation of the obtained CT images to the operative findings were examined. Left atrial thrombi were found in 24 cases at the operation. CT scan had detected thrombi in 19 cases (79.2%) and echocardiography in 15 (62.5%). CT failed to find them in 5 cases in which the left atrial thrombi were less than 3 g. Echocardiogram, however, failed to detect thrombi in 9 cases, the largest being 14 g. There were 15 cases with left atrial calcification, in which 10 cases had left atrial thrombi. Nine cases out of these 10 cases had rough left atrial surface after thrombectomy. Early postoperative CT of 10 with left atrial calcification showed recurrent left atrial thrombi in 4 (40%) cases. Mitral valve calcification was found in 42 cases during operation. CT scan was able to detect it in 40 (95.2%), while echocardiogram detected in 34 cases (81.0%) (p<0.05). All mitral valves with calcification required replacement. Out of 30 cases with non calcified mitral valves, 9 underwent OMC, and the other 21 underwent mitral valve replacement. Aortic valve calcification was found in 9 out of 11 cases of aortic stenosis. All has been diagnosed by CT scan. In conclusion, 1. in detecting the left atrial thrombi, CT scan was superior to echo-cardiography, and provided useful information for planning the operative procedure including atrial approach and valvular manipulation, 2. CT scan could detect calcification of left atrial wall which had high incidence of thrombus formation and rough left atrial surface, 3. CT scan could detect calcification of both mitral and aortic valve, and showed the severity of valvular structural changes. (author).

  10. Diagnostic accuracy of CT scan in abdominal blunt trauma

    Institute of Scientific and Technical Information of China (English)

    Javad Salimi; Khadyjeh Bakhtavar; Mehdi Solimani; Patrcia Khashayar; Ali Pasha Meysamie; Moosa Zargar


    Obiective: To evaluate the sensitivity and specificity of CT scan findings in Patients ith blunt abdominal trauma admitted to the university hospital.Methods: All the atients ith blunt abdominal trauma admitted at a tertiary teaching trauma center in Iran between 2005 and 2007 were enrolled in this study.In the absence of any clinical anifestations,he patients underwent a diagnostic CT scan.Laparatomy was performed in those with positive CT results.Others were observed for 48 hours and discharged in case no problem as reported;otherwise they underwent laparatomy.Information on patients'demographic ata,mechanism of trauma,indication for CT scan,CT scan findings,results of laparotomy ere gathered.The sensitivity,specificity and accuracy of the CT-scan images in regard ith the organ injured were calculated.The sensitivity,specificity and accuracy of the T scan were calculated in each case.Results: CT Scan had the highest sensitivity for etecting the injuries to liver (100%) and spleen (86.6%).The specificity of the method or detecting retroperitoneal hematoma (100%) and injuries to kidney (93.5%) was higher han other organs.The accuracy of CT images to detect the injuries to spleen,liver,idney and retroperitoneal hematoma was reported to be 96.1%,94.4%,91.6% and 91.6% espectively.Conclusion: The findings of the present study reveal that CT scan could econsidered as a good choice,especially for patients with blunt abdominal trauma in eaching hospitals where the radiologic academic staff is not present in the hospital in the night shifts.

  11. CT of temporal bone - IV. inner ear

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jae Yoon; Sung, Kyu Bo; Youn, Eun Kyoung; Park, Youn Kyeung; Lee, Young Uk [Koryo general Hospital, Seoul (Korea, Republic of)


    Temporal bone CT was done in 697 patients from April 1985 to October 1989. The abnormal findings were seen in 453 patients, which were chronic otitis media in 355 patients, fracture in 49 patients and congenital anomaly in 44 patients, etc. The abnormal findings of inner ear were observed on 46 patients. The results were summarized as follows : 1. The incidence of inner ear involvement by chronic otitis media was 7.3% (26/355 : labyrinthine fistula in 17 patients, labyrinthitis ossificans in 9 patients). Labyrinthine fistula was most commonly located on lateral semicircular canal (15/17, 88.2%). 2. Fusion of vestibule with lateral semicircular canal and formation of common cavity was demonstrated incidentally in 5 patients (0.7% of total number of temporal bone CT), and bilateral in 3 patients. 3. The incidence of inner ear anomaly in congenital ear anomaly was 11.4% (5/44). All cases were bilateral and three patients showed associated middle ear anomaly. 4. The incidence of involvement of bony labyrinth in temporal bone fracture was 10.2% (5/49). Labyrinthine fracture was seen all patients of transverse(3) and mixed fracture(1). In longitudinal fracture, labyrinthine fracture was seen in 2.2% (1/45). 5. Others were traumatic labyrinthitis ossificans(1), intracanalicular acoustic neuroma(3) and facial nerve neuroma(1)

  12. CT scan findings in cerebral paragonimiasis

    Energy Technology Data Exchange (ETDEWEB)

    Udaka, Fukashi; Okuda, Bungo; Okada, Masako; Okae, Shunji; Kameyama, Masakuni (Chikamori Hospital, Kochi (Japan))


    Computed tomography was performed on 5 patients with chronic cerebral paragonimiasis. CT showed solitary or multiple, amorphous, round, or oval calcifications, and ventricular enlargement in all 5 cases. A large low-density area is also found in 4 of the 5 cases. These CT findings are compatible with previously reported findings of simple X-ray films of the skull, pneumoencephalography, and pathological studies.

  13. CT evaluation of primary epiphyseal bone abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Azouz, E.M. (Dept. of Radiology, McGill Univ., Montreal Children' s Hospital, PQ (Canada)); Greenspan, A. (Dept. of Radiology, California Univ., Davis School of Medicine, Sacramento, CA (United States)); Marton, D. (Dept. of Radiology, Montreal Univ., Hopital Ste Justine, PQ (Canada))


    We reviewed the clinical, radiographic, and computed tomographic (CT) findings in eight children with a histologically proven diagnosis of epiphyseal or apophyseal osteomyelitis. In all cases the femur was involved: in five the osteomyelitis was localized in the femoral condyle, in two it was in the greater trochanter, and in one it was in the femoral head epiphysis. In four of the six cases of epiphyseal involvement there was associated joint effusion or septic arthritis. CT examination may demonstrate a serpentine tract, a sequestrum, cortical destruction or adjacent soft tissue swelling and can differentiate osteomyelitis from other epiphyseal lucent lesions, particularly chondroblastoma and osteoid osteoma. Early diagnosis helps avoid delays in initiating antibiotic or surgical treatment caused by the unusual (epiphyseal or apophyseal) location of the bone abscess. (orig./GD)

  14. Relationship between Hounsfield Unit in CT Scan and Gray Scale in CBCT. (United States)

    Razi, Tahmineh; Niknami, Mahdi; Alavi Ghazani, Fakhri


    Background and aims. Cone-beam computed tomography (CBCT) is an imaging system which has many advantages over computed tomography (CT). In CT scan, Hounsfield Unit (HU) is proportional to the degree of x-ray attenuation by the tissue. In CBCT, the degree of x-ray attenuation is shown by gray scale (voxel value). The aim of the present study was to investigate the relationship between gray scale in CBCT) and Hounsfield Unit (HU) in CT scan. Materials and methods. In this descriptive study, the head of a sheep was scanned with 3 CBCT and one medical CT scanner. Gray scales and HUs were detected on images. Reconstructed data were analyzed to investigate relationship between CBCT gray scales and HUs. Results. A strong correlation between gray scales of CBCT and HUs of CT scan was determined. Conclusion. Considering the fact that gray scale in CBCT is the criteria in measurement of bone density before implant treatments, it is recommended because of the lower dose and cost compared to CT scan.

  15. Spinal CT scan, 2. Lumbar and sacral spines

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawa, Hiroshi (Aichi Medical Univ., Aichi (Japan))


    Plain CT described fairly accurately the anatomy and lesions of the lumbar and sacral spines on their transverse sections. Since hernia of the intervertebral disc could be directly diagnosed by CT, indications of myelography could be restricted. Spinal-canal stenosis of the lumbar spine occurs because of various factors, and CT not only demonstrated the accurate size and morphology of bony canals, but also elucidated thickening of the joints and yellow ligament. CT was also useful for the diagnosis of tumors in the lumbar and sacral spines, visualizing the images of bone changes and soft tissues on the trasverse sections. But the diagnosis of intradural tumors required myelography and metrizamide CT. CT has become important for the diagnosis of spinal and spinal-cord diseases and for selection of the route of surgical arrival.

  16. 骨纤维异常增殖症影像诊断对比分析%Analysis of manifestations of Fibrous Dysplasia of Bone on X - ray and CT Scan

    Institute of Scientific and Technical Information of China (English)

    韦林森; 韦东风; 张克池


    目的对骨纤维异常增殖症的X线与CT诊断分析.方法回顾性分析54例由病理证实的骨纤维异常增殖症的X线与CT征象特点.结果54例中单骨型33例,多骨型19例,Albright综合症2例.X线表现比较复杂,常见有囊状改变、毛玻璃样改变、丝瓜瓤样改变及虫蚀样改变4种骨改变.CT表现有囊状低密度影、毛玻璃样改变、斑块样硬化.结论骨纤维异常增殖症的影像诊断以X线平片为首选,头颅等较复杂部位的影像诊断以CT为佳.%Objective To analyze the manifestations of fibrous dysplasia of bone(FDB) on X - ray and CT.Methods Fifty - four cases with FDB confirmed by pathology were enrolled in the study and their manifestations of FDB on X - ray and CT were reviewed.Results Out of 54 cases, 33 showed fibrous dysplasia of single bone, 19 showed fibrous dysplasia of multi - bones and the rest two showed Albright syndrome.X - ray performance was more complex with common signs of pouch shape change, rough hyalo- like change, sponge groud- flesh type and moth- eaten type.CT features of lesions were pouch shape low density shade, rough hyalo - like change and motting type hardening.Conclusion X - ray film should be the first choice in diagnosis of fibrous dysplasia.CT is highly sensitive in displaying lesions of more complex parts, like skull.

  17. Thin-section CT scan of the pituitary gland

    Energy Technology Data Exchange (ETDEWEB)

    Fukuda, T.; Inoue, Y.; Taniguchi, S. (Osaka City Univ. (Japan). Faculty of Medicine)


    Topographic anatomy of the pituitary fossa was studied by 2 mm thin-section CT scan (Somatom II). Nineteen with normal pituitary (control group) and 20 with suspected pituitary abnormality were selected. Plain and contrast CT were performed in all cases. Contrast CT was carried out immediately after the rapid infusion of 220 ml of 30% iodinated contrast medium. In all of control group but two, pituitary gland was detected as homogeneous density and its density was the same as the density of normal brain tissues, and was enhanced in degree of about 25 CT number. In 2 cases, small low density was visualized in the pituitary gland. Pituitary gland was differentiated from cavernous sinus was usually higher than the pituitary gland. In the abnormal group, microadenoma of the pituitary gland was diagnosed in 5 cases and 3 out of 5 cases was proved by surgery. All 3 microadenomas proved slightly dense by plain CT and enhanced higher than normal pituitary gland by contrast CT. Polytomograms showed no abnormality of the sella turcica in one of these 3 cases. Although 3 microadenomas were detected by the abnormal enhancement, we are not sure whether all microadenoma can be detected by CT alone. Arachnoid herniation into the pituitary fossa was diagnosed in 7 of the control group and 2 of the abnormal group. Four out of these 9 cases were verified by using Metrizamide CT. By plain thin-section CT, the diagnosis of arachnoid herniation seems to be possible without Metrizamide CT.

  18. Neurological ct Scan Value for Ictus in Cienfuegos Province

    Directory of Open Access Journals (Sweden)

    Idaylí Pérez Rodríguez


    Full Text Available Backgrounds: CT scan constitutes a very important technique in the diagnosis of the cerebrovascular disease. The impact this transcendental event had and will continue having in the medicine area is impossible to state in terms of dimensions during the next years. Objective: To determine the neurological CT scan value for ictus in our milieu. Methods: A retrospective, prospective, longitudinal study of a series of cases performed during a review of statistical reports as well as that of Stroke data base which stores information of patients with neurocitus in our province, and which is based on others aspects founds by means of neurological CT scan. Results: CT scan allowed us to diagnose the type of cerebrovascular event (75.55 % ischemic events, 24.45% hemorrhagic events. It also contributed to the necessary data such as the localization (with predominium of 35.55% in more than one area, and 7.40 % in the parietal area. The presence of cerebral edema was verified in 16.29% of the cases as well as displacement of the midline in 7.40 % both associated to a torpid evolution. It incorporated the Fisher and Le Roux scales showing their prognosis value with elevated measures for deceased patients and decreased values for survivors without disability. Conclusions: The diagnosis and prognosis value were proved as well as CT scan behavior in our milieu. These aspects permit the reliable introduction of new therapeutic modalities in our province.

  19. CT scan of the brain (image) (United States)

    ... CAT scan (computed tomography) is a much more sensitive imaging technique than x-ray, allowing high definition not only of the bony structures, but of the soft tissues. Clear images of organs such as the brain, muscles, joint structures, veins ...

  20. Classication Methods for CT-Scanned Carcass Midsections

    DEFF Research Database (Denmark)

    Skytte, Jacob Lercke; Dahl, Anders Lindbjerg; Larsen, Rasmus


    Computed tomography (CT) has successfully been applied in medical environments for decades. In recent years CT has also made its entry to the industrial environments, including the slaughterhouses. In this paper we investigate classication methods for an online CT system, in order to assist...... in the segmentation of the outer fat layer in the mid- section of CT-scanned pig carcasses. Prior information about the carcass composition can potentially be applied for a fully automated solution, in order to optimize the slaughter line. The methods comprise Markov Random Field and contextual Bayesian classication......, and are adapted to use neighbourhood information in 2D and 3D. Articial Poisson noise is added to the provided dataset to determine how well each of the methods handles noise. Good noise handling will allow lower dose scannings. The investigated methods did not perform better than the reference model in terms...

  1. Quantitative bone scanning after asymptomatic Charnley arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Mullaji, A.B. (University Department of Orthopedic and Accident Surgery, Royal Liverpool University Hospital, Lierpool (United Kingdom)); Tood, R.C. (Department of Orthopedics, Black Notley Hospital, Braintree (United Kingdom)); Robinson, S. (Department of MedicaL Physics, Colchester General Hospital, Colchester (United Kingdom)); Critchley, M. (Department of Nuclear Medicine, Royal Liverpool University Hospital, Liverpool (United Kingdom))


    To establish the normal pattern of postoperative tracer uptake we performed 73 [sup 99m]technetium methylene disphosphonate scans following primary Charnley hip replacements for arthrosis in 68 patients without clinical, hematological and radiographic complications. The patients were divided into 7 subgroups according to the period, 6-24 months, between surgery and scan. There were 10-12 patients in each subgroup. A high-resolution gamma camera with a large filed of view was used. Ratios of uptake in each of 10 peri-prosthetic zones to normal bone were calculated. Femoral uptake was found to decrease in linear fashion from 6 to 12 months after surgery. Thereafter the uptake remained unaltered at levels nearly twice the normal ones in the greater trochanter and nearly 1.5 times in the lesser trochanter, returning to almost normal levels in other zones. Acetabular uptake remained elevated throughout. (au) (20 refs.).

  2. {sup 18}F-FDG PET/CT bone/bone marrow findings in Hodgkin's lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging

    Energy Technology Data Exchange (ETDEWEB)

    Moulin-Romsee, Gerard [Universite Paris 7, Service de Medicine Nucleaire, Hopital Saint-Louis, Assistance Publique-Hopitaux de Paris (France); Institut Curie, Nuclear Medicine, Paris (France); Hindie, Elif; Filmont, Jean-Emmanuel; Moretti, Jean-Luc [Universite Paris 7, Service de Medicine Nucleaire, Hopital Saint-Louis, Assistance Publique-Hopitaux de Paris (France); Cuenca, Xavier; Brice, Pauline; Sibon, David [Hopital Saint-Louis, Haemato-Oncology, Paris (France); Decaudin, Didier; Anitei, Marcela [Institut Curie, Haematology, Paris (France); Benamor, Myriam [Institut Curie, Nuclear Medicine, Paris (France); Briere, Josette [Hopital Saint-Louis, Pathology, Paris (France); Kerviler, Eric de [Hopital Saint-Louis, Radiology, Paris (France)


    Accurate staging of Hodgkin's lymphoma (HL) is necessary in selecting appropriate treatment. Bone marrow trephine biopsy (BMB) is the standard procedure for depicting bone marrow involvement. BMB is invasive and explores a limited part of the bone marrow. {sup 18}F-FDG PET/CT is now widely used for assessing response to therapy in HL and a baseline study is obtained to improve accuracy. The aim of this retrospective analysis was to assess whether routine BMB remains necessary with concomitant {sup 18}F-FDG PET/CT. Data from 83 patients (newly diagnosed HL) were reviewed. All patients had received contrast-enhanced CT, BMB and {sup 18}F-FDG PET/CT. Results of BMB were not available at the time of {sup 18}F-FDG PET/CT imaging. Seven patients had lymphomatous involvement on BMB. Four patients had bone involvement on conventional CT (two with negative BMB). All patients with bone marrow and/or bone lesions at conventional staging were also diagnosed on {sup 18}F-FDG PET/CT scan. PET/CT depicted FDG-avid bone/bone marrow foci in nine additional patients. Four of them had only one or two foci, while the other had multiple foci. However, the iliac crest, site of the BMB, was not involved on {sup 18}F-FDG PET/CT. Osteolytic/sclerotic lesions matching FDG-avid foci were visible on the CT part of PET/CT in three patients. MRI ordered in three other patients suggested bone marrow involvement. Interim and/or end-therapy {sup 18}F-FDG PET/CT documented response of FDG-avid bone/bone marrow foci to chemotherapy in every patient. {sup 18}F-FDG PET/CT highly improves sensitivity for diagnosis of bone/bone marrow lesions in HL compared to conventional staging. (orig.)

  3. Volumetric analysis of corticocancellous bones using CT data

    Energy Technology Data Exchange (ETDEWEB)

    Krappinger, Dietmar; Linde, Astrid von; Rosenberger, Ralf; Blauth, Michael [Medical University Innsbruck, Department of Trauma Surgery and Sports Medicine, Innsbruck (Austria); Glodny, Bernhard; Niederwanger, Christian [Medical University Innsbruck, Department of Radiology I, Innsbruck (Austria)


    To present a method for an automated volumetric analysis of corticocancellous bones such as the superior pubic ramus using CT data and to assess the reliability of this method. Computed tomography scans of a consecutive series of 250 patients were analyzed. A Hounsfield unit (HU) thresholding-based reconstruction technique (''Vessel Tracking,'' GE Healthcare) was used. A contiguous space of cancellous bone with similar HU values between the starting and end points was automatically identified as the region of interest. The identification was based upon the density gradient to the adjacent cortical bone. The starting point was defined as the middle of the parasymphyseal corticocancellous transition zone on the axial slice showing the parasymphyseal superior pubic ramus in its maximum anteroposterior width. The end point was defined as the middle of the periarticular corticocancellous transition zone on the axial slice showing the quadrilateral plate as a thin cortical plate. The following parameters were automatically obtained on both sides: length of the center line, volume of the superior pubic ramus between the starting point and end point, minimum, maximum and mean diameter perpendicular to the center line, and mean cross-sectional area perpendicular to the center line. An automated analysis without manual adjustments was successful in 207 patients (82.8%). The center line showed a significantly greater length in female patients (67.6 mm vs 65.0 mm). The volume was greater in male patients (21.8 cm{sup 3} vs 19.4 cm{sup 3}). The intersite reliability was high with a mean difference between the left and right sides of between 0.1% (cross-sectional area) and 2.3% (volume). The method presented allows for an automated volumetric analysis of a corticocancellous bone using CT data. The method is intended to provide preoperative information for the use of intramedullary devices in fracture fixation and percutaneous cement augmentation techniques

  4. MRI of patients with cerebral palsy and normal CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Bogaert, P. van; Szliwowski, H.B. (Hopital Erasme, Brussels (Belgium). Dept. of Neurology); Baleriaux, D.; Christophe, C. (Hopital Erasme, Brussels (Belgium). Dept. of Radiology (Neuroradiology))


    Three children with clinical evidence of cerebral palsy (CP) and normal cerebral computed tomography (CT) scans were evaluated by magnetic resonance imaging (MRI) to identify CT-undetectable white matter lesions in the watershed zones of arterial territories. The two patients with spastic diplegia showed bilateral lesions either in the subcortical regions or in the occipital periventricular regions. The patient with congenital hemiplegia exhibited unilateral lesions in the periventricular region. We conclude that MRI is more informative than CT for the evaluation of patients with CP. (orig.).

  5. Incidental Findings on CT Scans in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Ryan J. Thompson


    Full Text Available Objectives. Incidental findings on computed tomography (CT scans are common. We sought to examine rates of findings and disclosure among discharged patients who received a CT scan in the ED. Methods. Retrospective chart review (Aug-Oct 2009 of 600 patients age 18 and older discharged home from an urban Level 1 trauma center. CT reports were used to identify incidental findings and discharge paperwork was used to determine whether the patient was informed of these findings. Results. There were 682 CT scans among 600 patients: 199 Abdomen & Pelvis, 405 Head, and 78 Thorax. A total of 348 incidental findings were documented in 228/682 (33.4% of the scans, of which 34 (9.8% were reported to patients in discharge paperwork. Patients with 1 incidental finding were less likely to receive disclosure than patients with 2 or more (=.010. Patients age <60 were less likely to have incidental findings (<.001. There was no significant disclosure or incidental finding difference by gender. Conclusions. While previous research suggests that CT incidental findings are often benign, reporting to patients is recommended but this is rarely happening.

  6. Analysis of cranial CT-scan findings in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Wada, F.; Andoh, T.; Une, K.; Takamatsu, T. (Kitakyushu Municipal Sogo-Ryoiku Center (Japan))


    CT-scan findings of 87 cerebral palsied children were studied. They consist of 23 cases of spastic quadriplegia, 9 cases of diplegia, 12 cases of paraplegia, 24 cases of athetosis and mixed type, and 19 cases of hemiplegia. In the former four types, ventricular dilatation and cortical atrophy were measured and abnormal changes in cerebral substance and cerebellar atrophy were observed. Spastic quadriplegia showed most intense changes in every aspect of the abnormalities, while paraplegia had almost normal appearance. Athetosis and mixed type had moderate changes. Hemiplegia always showed asymmetrical view on CT-scan, dilatation of lateral ventricle or atrophy of hemisphere in contralateral side being observed.

  7. Automated lung segmentation of low resolution CT scans of rats (United States)

    Rizzo, Benjamin M.; Haworth, Steven T.; Clough, Anne V.


    Dual modality micro-CT and SPECT imaging can play an important role in preclinical studies designed to investigate mechanisms, progression, and therapies for acute lung injury in rats. SPECT imaging involves examining the uptake of radiopharmaceuticals within the lung, with the hypothesis that uptake is sensitive to the health or disease status of the lung tissue. Methods of quantifying lung uptake and comparison of right and left lung uptake generally begin with identifying and segmenting the lung region within the 3D reconstructed SPECT volume. However, identification of the lung boundaries and the fissure between the left and right lung is not always possible from the SPECT images directly since the radiopharmaceutical may be taken up by other surrounding tissues. Thus, our SPECT protocol begins with a fast CT scan, the lung boundaries are identified from the CT volume, and the CT region is coregistered with the SPECT volume to obtain the SPECT lung region. Segmenting rat lungs within the CT volume is particularly challenging due to the relatively low resolution of the images and the rat's unique anatomy. Thus, we have developed an automated segmentation algorithm for low resolution micro-CT scans that utilizes depth maps to detect fissures on the surface of the lung volume. The fissure's surface location is in turn used to interpolate the fissure throughout the lung volume. Results indicate that the segmentation method results in left and right lung regions consistent with rat lung anatomy.

  8. Segmentation of multiple knee bones from CT for orthopedic knee surgery planning. (United States)

    Wu, Dijia; Sofka, Michal; Birkbeck, Neil; Zhou, S Kevin


    Patient-specific orthopedic knee surgery planning requires precisely segmenting from 3D CT images multiple knee bones, namely femur, tibia, fibula, and patella, around the knee joint with severe pathologies. In this work, we propose a fully automated, highly precise, and computationally efficient segmentation approach for multiple bones. First, each bone is initially segmented using a model-based marginal space learning framework for pose estimation followed by non-rigid boundary deformation. To recover shape details, we then refine the bone segmentation using graph cut that incorporates the shape priors derived from the initial segmentation. Finally we remove overlap between neighboring bones using multi-layer graph partition. In experiments, we achieve simultaneous segmentation of femur, tibia, patella, and fibula with an overall accuracy of less than 1mm surface-to-surface error in less than 90s on hundreds of 3D CT scans with pathological knee joints.

  9. Artifacts and pitfalls of high-resolution CT scans. (United States)

    Hahn, F J; Chu, W K; Anderson, J C; Dobry, C A


    Artifacts on CT images have been observed since the introduction of CT scanners. Some artifacts have been corrected with the improvement of technology and better understanding of the image formation and reconstruction algorithms. Some artifacts, however, are still observable in state-of-the-art high-resolution scans. Many investigations on CT artifacts have been reported. Some artifacts are obvious and some are similar to patterns commonly associated with pathological conditions. The present report summarizes some of the causes of artifacts and presents some artifacts that mimic pathology on clinical scans of the head and spine. It is the intention of this report to bring these artifacts and potential pitfalls to the attention of the radiologists so that misinterpretation can be avoided.

  10. Serial CT scans and Menkes' kinky hair disease

    Energy Technology Data Exchange (ETDEWEB)

    Nakada, Eizo; Kameyama, Junji; Yoshimitsu, Hajime; Mori, Mikio; Tanaka, Mutsuo; Yoshimitsu, Kazunori.


    Menkes' kinky hair disease is a sex-linked recessive disorder of copper metabolism, characterized by progressive psychomotor deterioration, seizures, and peculiar hair structure. We examined serial CT scans of patients with this disease. A 2,210-g male infant was delivered after an uneventful gestation of 36 weeks. His one-minute Apgar score was 9. His uncle had died at 1 year of age. His first cousin was also diagnosed as having Menkes' kinky hair disease when our patient was 2 years old. Shortly after birth he had mild respiratory distress. At 5 days of age, he developed setting-sun signs. The first CT scan, at 10 days of age, revealed mild posterior fossa hemorrhages. At 3 months of age, myoclonic seizures began, and the CT scan revealed subdural effusion and mild brain atrophy. The seizures were controllable by using phenobarbital, valproic acid, and nitrazepam. He did not follow light or a fixate, but the fundi were normal. He was diffusely hypotonic. At 9 months of age, the seizures became uncontrollable. The CT scans at 15 and 31 months of age showed subdural hemorrhage and/or brain atrophy. At 15 months of age, the serum copper level was 42 g/dl, while the serum ceruloplasmin level was 3.2 mg/dl. He exhibited severe developmental failure. At 4 years of age, he died.

  11. The CT flare response of metastatic bone disease in prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Messiou, Christina; deSouza, Nandita M. (Cancer Research UK Clinical Magnetic Resonance Research Group, Inst. of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey (United Kingdom)), email:; Cook, Gary (Dept. of Nuclear Medicine, Royal Marsden NHS Foundation Trust, Surrey (United Kingdom)); Reid, Alison H.M.; Attard, Gerhardt; Dearnaley, David; deBono, Johann S. (Inst. of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey (United Kingdom))


    Background New or worsening bone lesions in patients responding to treatment, known as the flare phenomenon is well described on 99mTc-MDP bone scintigraphy, but to our knowledge has not previously been described on CT. The appearance of new or worsening bone sclerosis on CT in patients with prostate cancer may therefore be erroneously classified as disease progression. Purpose To assess the incidence of osteoblastic healing flare response at 3-month CT assessment in patients with castrate-resistant prostate cancer and to identify associated features that enable differentiation from progressive metastatic bone disease at 3 months. Material and Methods CT scans of 67 patients with castrate-resistant prostate cancer undergoing treatment were reviewed by a radiologist blinded to clinical outcome. Changes in number, size, and density of metastatic bone lesions were documented and Response Evaluation Criteria in Solid Tumours (RECIST) in soft tissue lesions, alkaline phosphatase, prostate specific antigen, and 99mTc-MDP bone scans were used for correlation. Results Of the 39 patients who had 3- and 6-month follow-up, eight patients (21%) demonstrated an increase in number, size, or density of sclerotic lesions on the 3-month CT scan despite improvement in PSA and soft tissue lesions. Three out of eight patients (8%) maintained partial response/remained stable at follow-up and were defined as showing a flare response: in this group bone metastases evident on CT showed a qualitative and quantitative increase in density and no lesions faded at 3 months. In contrast, in all patients who progressed at 3 months by PSA/RECIST criteria (n = 8) bone lesions showed a mixed pattern with some lesions increasing and others decreasing in density. Conclusion The incidence of flare response of metastatic bone disease evident at 3-month post-treatment CT in patients with prostate cancer undergoing systemic treatment is 8%. In patients with falling PSA and stable/responding soft tissue

  12. Utility of CT scan for the diagnosis of chest wall tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Khalil, A.; Le Breton, C.; Tassart, M.; Korzec, J.; Bigot, J.M.; Carette, M.F. [Department of Radiology, Tenon Hospital, Paris (France)


    The objective of this study was to determine the utility of CT scan findings for the diagnosis of chest wall tuberculosis, excluding the spine. We reviewed 15 patients (13 Africans and 2 Indians) with chest wall tuberculosis, retrospectively. The radiologic examination consisted of a plain X-ray and a CT scan of the chest for each patient. The site of disease was the rib in 13 patients or the body of the sternum in 2 patients. One rib was involved in 11 patients, 2 contiguous ribs (one site) in 2 patients, and bilateral disease (two sites) was observed in the remaining patient. The 14 rib sites involved the posterior arc or costovertebral joint in 11 cases, the anterior arc in 2 cases, and the anterior and middle arc in 1 case. The CT scan findings were an abscess (n = 14) or a soft tissue mass (n = 2), osteolytic lesions (n = 13), periosteal reaction (n = 10), and sequestrum (n = 14). Bone sclerosis was observed only in 3 cases of rib involvement. The association of a soft tissue abscess, an osteolytic lesion, and sequestrum, especially in immigrants to France, suggests chest wall tuberculosis on CT scan. (orig.) With 5 figs., 2 tabs., 11 refs.

  13. Technical Note: Reliability of Suchey-Brooks and Buckberry-Chamberlain methods on 3D visualizations from CT and laser scans

    DEFF Research Database (Denmark)

    Villa, Chiara; Buckberry, Jo; Cattaneo, Cristina;


    Previous studies have reported that the ageing method of Suchey-Brooks (pubic bone) and some of the features applied by Lovejoy et al. and Buckberry-Chamberlain (auricular surface) can be confidently performed on 3D visualizations from CT-scans. In this study, seven observers applied the Suchey......-Brooks and the Buckberry-Chamberlain methods on 3D visualizations based on CT-scans and, for the first time, on 3D visualizations from laser scans. We examined how the bone features can be evaluated on 3D visualizations and whether the different modalities (direct observations of bones, 3D visualization from CT......-scan and from laser scans) are alike to different observers. We found the best inter-observer agreement for the bones versus 3D visualizations, with the highest values for the auricular surface. Between the 3D modalities, less variability was obtained for the 3D laser visualizations. Fair inter...

  14. [CT findings of the temporal bones in Waardenburg's syndrome]. (United States)

    Irie, K; Ogata, H; Mitsudome, A


    We reported three cases of Waardenburg's syndrome and discussed CT findings of the temporal bones. Two cases of these patients were mother and daughter. Case 1, a two-year-old girl, had lateral displacement of the medial canthi, a broad nasal root, hetero-chromic iridis, left ptosis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules, short lateral semicircular canal, and absent right posterior semicircular canal. The mother had congenital deafness, heterochromia iridis, and a white forelock and showed similar abnormal CT findings of the temporal bones. Case 2, a one-year-old boy, had lateral displacement of the medial canthi, a broad nasal root, partial heterochromia iridis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules and absence of semicircular canals except the right lateral semicircular canal. These cases were diagnosed as Waardenburg's syndrome on the basis of the characteristic features.

  15. Three dimensional CT of stapes. Stapedial imagings in dry temporal bone and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Edamatsu, Hideo; Kubota, Osamu; Yamashita, Koichi [Kanazawa Medical Univ., Ishikawa (Japan)


    This study was performed to evaluate the usefulness and limitations of three dimensional (3-D) imagings of stapes in the middle ear by high speed helical CT. One dissected human temporal bone, ten normal and diseased ears were scanned with a slice of 1.0 mm and reconstructed in a thickness of 0.2-0.5 mm. Every specimen of 3-D can be observed in any plane and from any direction. Ossicular imagings of the temporal bone in 3-D were reconstructed as if the malleus, incus and stapes were observed under microscope. The whole structure of stapes was impossible to be represented by two dimensional CT heretofore in use, but 3-D in our study showed the head, crus and foot plate of the stapes in detail. Stapedial imagings of 3-D CT in normal ears showed the same findings as those recorded in temporal bone. Preoperative diagnostic findings of ossicles in the affected ears were very useful. Especially in ossicular anomalies, 3-D CT was positive in diagnosis and its accuracies were confirmed with operative observation. For the postoperative evaluation concerning the ossicular reconstruction, i.e. TORP and PORP, 3-D CT was also important method. It could present an anatomical relation between those prosthesis and the oval window. High speed helical CT can scan an object more quickly and clearly than formerly used CT, and its biological damage for human is less than that of the others. 3-D CT can be more clearly reconstructed with helical CT than former CT. (author).

  16. Evaluation of Response to Therapy in a Patient with Lung Cancer: Correlation of Sclerotic Bone Lesions with F 18 FDG PET/CT and Bone Scintigraphy

    Directory of Open Access Journals (Sweden)

    Filiz Özülker


    Full Text Available A 64-year-old male patient with small cell lung cancer underwent Fluorine-18 fluorodeoxyglucose (F 18 FDG positron emission tomography (PET/CT scan which revealed multiple F 18 FDG uptake in the spine, both humeri, ribs, pelvis and proximal long bones. There was no obvious lytic or sclerotic bone destruction accompanying these lesions on CT component of the study. After the patient received six courses of chemotherapy a repeat F 18 FDG-PET/CT was performed for evaluation of therapy response. The PET/CT showed the presence of multiple sclerotic lesions on CT without FDG uptake, corresponding to the bone lesions on the previous PET/CT scan. A concomitant Tc 99m Methylene diphosphonate (Tc 99m MDP bone scintigraphy (BS revealed no pathologically increased Tc 99m MDP uptake in the skeletal system. The FDG avid lesions in the skeletal system, which were not sclerotic initially, were transformed into FDG non-avid sclerotic lesions after chemotherapy. This was attributed to the direct effect of previous successful therapy for bone metastases, leading to the transformation of metabolically active disease, into blastic metabolically inactive metastases. In conclusion, a F 18 FDG negative bone lesion, which is sclerotic on CT, may represent post-treatment osteoblastic change rather than active tumor and BS might play a role in the discrimination of these two situations. (MIRT 2011; 20: 29-33

  17. Temporal bone trauma: correlative study between CT findings and clinical manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hee; Kim, Hyung Jin; Kim, Jae Hyoung [College of Medicine, Gyeongsang National University, Jinju (Korea, Republic of)


    To assess how accurately computed tomography (CT) can demonstrate the abnormal findings which are believed to cause the clinical signs and symptoms of hearing loss (HL), vertigo and facial paralysis (FP) in patients with temporal bone trauma. The authors studied CT scans of 39 ears in 35 patients with temporal bone trauma. CT scans were performed with 1-1.5 mm slice thickness and table incrementation. Both axial and coronal scans were obtained in 32 patients and in three patients only axial scans were obtained. We analyzed CT with special reference to the structural abnormalities of the external auditory canal, middle ear cavity, bony labyrinth, and facial nerve canal, and correlated these findings with the actual clinical signs and symptoms. As to hearing loss, we evaluated 32 ears in which pure tone audiometry or brainstem evoked response audiometry had been performed. With respect to the specific types of HL, CT accurately showed the abnormalities in 84% (16/19) in conductive HL, 100% (2/2) in sensorineural HL, and 25% (2/8) for mixed HL. When we categorized HL simply as conductive and sensorineural, assuming that mixed be the result of combined conductive and sensorineural HL, CT demonstrated the abnormalities in 89% (24/27) for conductive HL and 50% (5/10) for sensorineural HL. Concerning vertigo and FP, CT demonstrated abnormalities in 67%(4/6), and 29% (4/14), respectively. Except for conductive HL, CT seems to have a variable degree of limitation for the demonstration of the structural abnormalities resulting sensorineural HL, vertigo or facial paralysis. It is imperative to correlate the CT findings with the signs and symptoms in those clinical settings.

  18. Brain CT scanning of children with purulent meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Mishima, M.; Suzuki, M.; Nagata, M.; Kawamura, G.


    Nine of 21 children with purulent meningitis showed abnormal findings in brain CT when admitted. All of the abnormal group were less than 12 months of age, but 75 % of the normal group were more than 1 year old. The period of positive CRP was longer and the level of sugar in CSF was lower in abnormal group when compared with normal group. Because convulsion and EEG abnormalities were observed similarly in both groups, it may be difficult to determine the organic changes of the brain clinically. Brain CT scanning is recommended as soon as possible after the onset of purulent meningitis.

  19. MR and CT findings of temporal bone langerhans cell histiocytosis

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jae Ig; Lee, Hee Jung; Kim, Heung Sik [Keimyung Univ. School of Medicine, Dongsan Medical Center, Taegu (Korea, Republic of)


    To describe the MRI and CT findings of temperal bone langerhans cell histiocytosis. The MRI (n=8) and CT (n=7) findings of nine lesions of temporal bone Langerhans cell histiocytosis in six children were retrospectively reviewed. Eight lesions were pathologically confirmed and one was clinically diagnosed. The findings were analyzed for bilaterality, location, lesion extent, signal intensity, the attenuation of soft tissue lesions seen at MRI or precontrast CT, enhancement pattern at MRI or CT, and the pattern of bony destruction at CT. Bilateral involvement was present in three of six patients (50%). Lesions were most frequently located in the mastoid (n=8, 89%), followed by the petrous ridge (n=6, 67%), and the squamous portion (n=3, 33%). Seven (78%) lesions extended to the ipsilateral cavernous sinus (n=3), sphenoid bone (n=3), orbit (n=2), or epidural space (n=2). The signals of the soft tissue lesions were isointense in five cases (63%) on T1-weighted images and hyperintense in six (75%) at MRI, and homogeneous in five (71%) at CT. All lesions demonstrated bony destruction without periosteal reaction and five (71%) showed ill-defined destruction, with crossing sutures. Familiarity with findings of predominant mastoid involvement, isointense or isodense soft tissue lesions seen on T1-weighted images or at precontrast CT, with relatively homogeneous enhancement at CT, and irregular bony destruction with crossing sutures may be helpful in narrowing the diagnosis of temporal bone langerhans cell histiocytosis.

  20. Craniofacial and temporal bone CT findings in cleidocranial dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, Guido E. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Clinica Alemana de Santiago, Departamento de Imagenes, Santiago (Chile); Caruso, Paul A.; Curtin, Hugh D. [Massachusetts Eye and Ear Infirmary and Harvard Medical School, Department of Radiology, Boston, MA (United States); Small, Juan E. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Massachusetts Eye and Ear Infirmary and Harvard Medical School, Department of Radiology, Boston, MA (United States); Jyung, Robert W. [Massachusetts Eye and Ear Infirmary and Harvard Medical School, Department of Otology, Boston, MA (United States); Troulis, Maria J. [Massachusetts General Hospital and Harvard Medical School, Department of Oral and Maxillofacial Surgery, Boston, MA (United States)


    Cleidocranial dysplasia (CCD) is a multistructural polyostotic genetic disorder that results from mutation of the CBFA1 gene. Hearing loss is a frequent finding in CCD. We describe the CT craniofacial findings in CCD and provide a comprehensive discussion of the CT temporal bone findings in these patients. (orig.)

  1. Three-dimensional helical CT imaging of bone and joint diseases in the trunk and the hip joints. Pt. 1

    Energy Technology Data Exchange (ETDEWEB)

    Gong Hohghan [Jangxi Medical Coll. (China). First Affiliated Hospital; Hiraishi, Kumiko; Doi, Miwako; Matsui, Ritsuo; Simizu, Tadafumi; Sueyoshi, Kouzou; Narabayashi, Isamu


    To confirm the utility of CT scan images for orthopedic surgeons managing patients with complex disorders, we have produced and studied three-dimensional images from helical CT scans of 28 patients with various bone and joint disorders in the trunk and the hip joint. The CT scanner employed was a Toshiba X-force, and the 3D-CT images were constructed on an X-link50. The 3D images obtained could be observed from various projections. Congenital vertebral malformations, spondylosis, OPLL, osteonecrosis, fractures, and bone tumors were examined, and the 3D helical CT images brought useful information to bear on the spatial location and extent of the lesions. Therefore, 3D helical CT should become an indispensable tool for both preoperative examination and post-operative follow-up studies in orthopedic surgery. (author)

  2. {sup 68}Ga-DOTA-NOC PET/CT in comparison with CT for the detection of bone metastasis in patients with neuroendocrine tumours

    Energy Technology Data Exchange (ETDEWEB)

    Ambrosini, Valentina; Nanni, Cristina; Castellucci, Paolo; Allegri, Vincenzo; Montini, Giancarlo; Franchi, Roberto [S. Orsola-Malpighi University Hospital, Department of Nuclear Medicine, Bologna (Italy); Zompatori, Maurizio [S. Orsola-Malpighi University Hospital, Department of Radiology, Bologna (Italy); Campana, Davide; Tomassetti, Paola [S. Orsola-Malpighi University Hospital, Department of Internal Medicine, Bologna (Italy); Rubello, Domenico [S. Maria della Misericordia Hospital, Department of Nuclear Medicine, Rovigo (Italy); Fanti, Stefano [S. Orsola-Malpighi University Hospital, Department of Nuclear Medicine, Bologna (Italy); Azienda Ospedaliero Universitaria di Bologna, Unita Operativa di Medicina Nucleare, Padiglione 30, Policlinico S.Orsola-Malpighi, Bologna (Italy)


    To retrospectively evaluate the sensitivity, specificity and accuracy of {sup 68}Ga-DOTA-NOC PET/CT and CT alone for the evaluation of bone metastasis in patients with neuroendocrine tumour (NET). From among patients with NET who underwent {sup 68}Ga-DOTA-NOC PET/CT between April 2006 and November 2008 in our centre, 223 were included in the study. Criteria for inclusion were pathological confirmation of NET and a follow-up period of at least 10 months. PET and CT images were retrospectively reviewed by two nuclear medicine specialists and two radiologists, respectively, without knowledge of the patient history or the findings of other imaging modalities. PET data were compared with the CT findings. Interobserver agreement was evaluated in terms of the kappa score. Clinical and imaging follow-up were used as the standard of reference to evaluate the PET findings. PET was performed for staging (49/223), unknown primary tumour detection (24/223), restaging (32/223), restaging before radioimmunotherapy (1/223), evaluation during therapy (12/223), equivocal findings on conventional imaging (4/223 at the bone level; 61/223 at sites other than bone), and follow-up (40/223). A very high interobserver agreement was observed. CT detected at least one bone lesion in only 35 of 44 patients with a positive PET scan. In particular, PET showed more lesions in 20/35 patients, a lower number of lesions in 8/35, and the same number in 7/35. The characteristics of the lesions (sclerotic, lytic, mixed) on the basis of the CT report did not influence PET reading. PET revealed the presence of at least one bone metastasis in nine patients with a negative CT scan. Considering patients with a negative PET scan (179), CT showed equivocal findings at the bone level in three (single small sclerotic abnormality in two at the spine level, and bilateral small sclerotic abnormalities in the humeri, femurs and scapula). Clinical follow-up confirmed the PET findings in all patients; thus there

  3. CT assisted biomimetic artificial bone des

    Institute of Scientific and Technical Information of China (English)

    WANG Xian-gang; ZHANG Chao-zong; GUO Zhi-ping; TIAN Jie-mo


    @@ In the recent years, bioceramic materials have been widely used in the clinics. They are mainly fabricated as the substitution of human hard tissue, such as artificial bone and false tooth. As a medical implant, those that have similar structure to human bone have better biocompatibility and osteoinductional property. So it is necessary to design bone model close to human bone.

  4. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ... CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, ...

  5. Bone scan findings in calcific tendinitis at the gluteus maximus insertion: some illustrative cases

    Directory of Open Access Journals (Sweden)

    Karel Van Damme


    Full Text Available We describe the bone scan and single-photon emission computed tomography/computed tomography findings in calcific tendinitis of the gluteus maximus and discuss its pathophysiology. Although this tendinopathy is mostly self-limiting, awareness of this disease is important for 2 reasons. First, it may explain acute hip symptoms in patients in the resorptive phase of the calcifications. Second, it should be considered as a differential diagnosis for bone scan hot spots in the vicinity of the gluteus maximus tendon and for cortical erosion seen in that region on X-rays or CT.

  6. CT scan findings of patients with Rett syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Hisaharu; Takanashi, Aiko; Hirayama, Yoshito; Sakuragawa, Norio; Arima, Masataka; Tateno, Akihiko; Koide, Hiroyoshi.


    CT findings and clinical features were analyzed in 16 female patients with Rett syndrome, whose ages were between 4 and 20. Fifteen patients had microcrania. Twelve patients were able to stand and run; however, the remaining 4 patients had the only ability to sit. CT revealed an atrophy of the ponse and various degrees of dilatation in the Silvian fissure, frontal sulcus, and space between the cranium and the frontal polar lobe. An atrophy in the frontal lobe, cerebral cortex surrounding the Silvian fissure, and white matter directly below the cortex seemed to have an important role in the occurrence of this syndrome. There was, however, no definitive correlation between the degree of atrophy and both the patient's age and motor function. Serial CT scannings with clinical process are required. (Namekawa, K).

  7. Progression of CT scan findings in Rett syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Hisaharu; Hirayama, Yoshito; Sakuragawa, Norio; Arima, Masataka (National Center of Neurology and Psychiatry, Kodaira, Tokyo (Japan))


    Progression of the lesions revealed by CT scan was observed in five girls with Rett syndrome. The most distinct and common finding was progressive dilatation of Sylvian fissures, frontal extracerebral space, interhemispheric fissure, and sulci mainly in frontal lobe. It may indicate progressive lesion in the frontal and the temporal lobes. In addition, dilatation of the anterior horns of the lateral ventricles and the third ventricle was noted in some cases. Brainstem and cerebellum were small at any age with some morphological development as the patients became elder. Neither malformations nor abnormalities in density were found in any case. It is concluded that the main lesion of Rett syndrome on CT scan is progressive and localized in the frontal and the temporal lobes. (author).

  8. Brown Tumor Shown Flare Phenomenon On Bone Scan After Parathyroidectomy

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Kwang Ho; Park, Seol Hoon; Baek, So Ra; Chae, Sun Young; Koh, Jung Min; Kim, Jae Seung; Moon, Dae Hyuk; Ryu, Jin Sook [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)


    Brown tumor is the benign bone lesion consists of woven bone and fibrous tissue without matrix, which develop due to chronic excessive osteoclastic activity such as hyperparathyroidism. Usually they appear with normal uptake or occasionally focally increased uptake on bone scan. We present a case with brown tumor shown more increased uptake and more number of lesions on bone scan after parathyroidectomy, and lesser increased uptake on serial bone scans without any other treatment through several months. This finding is thought to be similar to 'flare phenomenon' which is occasionally seen after treatment of metastatic bone lesions of malignant cancer, and may represent curative process of brown tumor with rapid normal bone formation.

  9. Analysis of functional CT scan in cervical vertebral disease

    Energy Technology Data Exchange (ETDEWEB)

    Hirofuji, Eiichi; Tanaka, Seisuke; Tomihara, Mitsuo; Kita, Hiroshi; Yamasaki, Hiroyuki


    The atlantoaxial joint showed displacement in various directions in rheumatoid arthritis and cervical spondylosis. The displacements were promoted by anterior flexion and rotatory movements, exerting great influences on the spnial cord. The intervertebral space between the 5th and 6th vertebra showed narrowing of the vertebral canal in cervical spondylosis and was promoted by posterior flexion to affect the spinal cord to a great extent. Functional CT scan was useful for observation of pathologic conditions of vertebral diseases.

  10. Combination of CT scanning and fluoroscopy imaging on a flat-panel CT scanner (United States)

    Grasruck, M.; Gupta, R.; Reichardt, B.; Suess, Ch.; Schmidt, B.; Stierstorfer, K.; Popescu, S.; Brady, T.; Flohr, T.


    We developed and evaluated a prototype flat-panel detector based Volume CT (fpVCT) scanner. The fpVCT scanner consists of a Varian 4030CB a-Si flat-panel detector mounted in a multi slice CT-gantry (Siemens Medical Solutions). It provides a 25 cm field of view with 18 cm z-coverage at the isocenter. In addition to the standard tomographic scanning, fpVCT allows two new scan modes: (1) fluoroscopic imaging from any arbitrary rotation angle, and (2) continuous, time-resolved tomographic scanning of a dynamically changing viewing volume. Fluoroscopic imaging is feasible by modifying the standard CT gantry so that the imaging chain can be oriented along any user-selected rotation angle. Scanning with a stationary gantry, after it has been oriented, is equivalent to a conventional fluoroscopic examination. This scan mode enables combined use of high-resolution tomography and real-time fluoroscopy with a clinically usable field of view in the z direction. The second scan mode allows continuous observation of a timeevolving process such as perfusion. The gantry can be continuously rotated for up to 80 sec, with the rotation time ranging from 3 to 20 sec, to gather projection images of a dynamic process. The projection data, that provides a temporal log of the viewing volume, is then converted into multiple image stacks that capture the temporal evolution of a dynamic process. Studies using phantoms, ex vivo specimens, and live animals have confirmed that these new scanning modes are clinically usable and offer a unique view of the anatomy and physiology that heretofore has not been feasible using static CT scanning. At the current level of image quality and temporal resolution, several clinical applications such a dynamic angiography, tumor enhancement pattern and vascularity studies, organ perfusion, and interventional applications are in reach.

  11. Benign incidental findings of osteopoikilosis on Tc-99m MDP bone SPECT/CT: A case report and literature review. (United States)

    Tsai, Szu-Ying; Wang, Shan-Ying; Shiau, Yu-Chien; Wu, Yen-Wen


    Osteopoikilosis is a benign but rare condition characterized by bone islands throughout the osseous tissue, which could be easily confused with bone metastasis. We present a case of a 37-year-old man presented to orthopedic outpatient clinic with right hip pain for 2 weeks. There were multiple, small punctate lesions scattered throughout the skeleton on radiograph. Subsequent Tc-99m methylene diphosphonate (MDP) bone scan with pelvic single-photon emission computed tomography (SPECT)/computed tomography (CT) showed multiple enostoses without abnormal focal MDP uptake. Therefore, clinical diagnosis was compatible with osteopoikilosis while bone metastasis was unlikely. The symptoms then improved by conservative treatments. Osteopoikilosis is usually an incidental finding on radiograph or CT, and a normal MDP confirmed the diagnosis by excluding bone metastasis. It is important for clinicians to recognize the specific image features to prevent further unnecessary interventions. In addition, bone SPECT/CT could also make the diagnosis in one step.

  12. Bone marrow scan evaluation of arthropathy in sickle cell disorders

    Energy Technology Data Exchange (ETDEWEB)

    Alavi, A.; Schumacher, H.R.; Dorwart, B.; Kuhl, D.E.


    Twelve patients with sickle cell hemoglobinopathies and arthropathy were studied, using technetium Tc 99m sulfur colloid bone marrow scans. Eight of 12 had decreased marrow radionuclide activity adjacent to painful joints, suggesting obliteration of vessels supplying bone marrow. Four patients without marrow defects on scanning had causes other than infarction for their joint symptoms, viz, small fractures, postinfectious synovitis, degenerative arthritis, and osteochondromas. Roentgenograms never showed bony abnormalities in five patients with marrow infarctions, and, in three others, showed defects several months later than did the marrow scans. Bone marrow scans offer a sensitive and early diagnostic aid in sickle cell hemoglobinopathies with arthropathy.

  13. Colitis detection on abdominal CT scans by rich feature hierarchies (United States)

    Liu, Jiamin; Lay, Nathan; Wei, Zhuoshi; Lu, Le; Kim, Lauren; Turkbey, Evrim; Summers, Ronald M.


    Colitis is inflammation of the colon due to neutropenia, inflammatory bowel disease (such as Crohn disease), infection and immune compromise. Colitis is often associated with thickening of the colon wall. The wall of a colon afflicted with colitis is much thicker than normal. For example, the mean wall thickness in Crohn disease is 11-13 mm compared to the wall of the normal colon that should measure less than 3 mm. Colitis can be debilitating or life threatening, and early detection is essential to initiate proper treatment. In this work, we apply high-capacity convolutional neural networks (CNNs) to bottom-up region proposals to detect potential colitis on CT scans. Our method first generates around 3000 category-independent region proposals for each slice of the input CT scan using selective search. Then, a fixed-length feature vector is extracted from each region proposal using a CNN. Finally, each region proposal is classified and assigned a confidence score with linear SVMs. We applied the detection method to 260 images from 26 CT scans of patients with colitis for evaluation. The detection system can achieve 0.85 sensitivity at 1 false positive per image.

  14. Leigh syndrome. A comparison of CT scanning and pathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Y.; Okamoto, K.; Somiya, K. (Hamamatsu Medical Center, Shizuoka (Japan)); Hokazono, Y.; Tozuka, S.


    A male infant developed hypotonia at 5 months, vomiting, diarrhea, fever, generalized clonic convulsion, tonic spasm and periodical opisthotonus at 8 months, swallowing difficulty at 10 months, pes equinovarus and optic atrophy at 11 months, and then tachypnea, and died at 14 months of age. Parents were consanguinous. Laboratory studies revealed elevated serum LDH, CPK, lactate and Pyruvate. TPP-ATP phosphoryl transferase inhibitor was negative in urine. EEG showed irregular and diffuse slow waves and periodic diffuse spike and waves. CT scan at 9 months of age showed slightly low attenuation areas in the putamen bilaterally. At 11 months, a diffuse cerebral atrophy was found, and the low attenuation of the basal ganglia became more definite. No enhanced lesion was seen at 13 months of age. Thiamine tetra-hydrofurfuryl disulfide and lipoic acid were tried without success. The pathological findings of the brain were astrogliosis and proliferation of capillaries in putamen, thalamus, caudate nucleus, substantia nigra, pontine brachium and cerebral cortex, which were symmetrically involved. The symmetrical cavitation was found in putamen. Optic nerve and mamillary body were spared. CT scan findings corresponded well with the pathology of the necrotic lesions of the brain. It was concluded that these CT scan pictures described above may be diagnostic of Leigh syndrome.

  15. Bone scintigraphy and osteo-articular tuberculosis in transplant patients: a study of 50 bone scans

    Energy Technology Data Exchange (ETDEWEB)

    Coulaud, J.P.; Mechali, D.; Morau, G. (Hopital Claude-Bernard, Paris (France))


    Bone scintigraphy with 99 m technecium labelled phosphorus compounds was achieved in 50 west Africans migrant workers in Paris. Bone and joint tuberculosis was assumed in 20 cases. In 5 of these 20 cases, bone scan, but not X-ray, showed abnormalities, and in 4, bone scan disclosed more localisations than X-rays. In 7 cases, yet, bone scan was normal, with major osteolytic X-rays lesions in 3 cases, minor in 2 cases, and isolated cold abcesses in two more cases: these means 7 false-negative results. Among the 30 other cases, 29 were considered as mechanical vertebral pathology, and 1 sacro-iliitis Brucellosis. Bone scan was normal in 28 cases the 2 others are unexplained false-positive. Although non-specific and not completely reliable, we think that bone-scanning is useful in bone-tuberculosis check-up, especially to obtain early diagnosis and detect multifocal localisations.

  16. Dose profile study in head CT scans using radiochromic films

    Energy Technology Data Exchange (ETDEWEB)

    Ladino G, A. M.; Prata M, A., E-mail: [Universidade Federal de Minas Gerais, Departamento de Engenharia Nuclear, Av. Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte, Minas Gerais (Brazil)


    Diagnostic images of computed tomography generate higher doses than other methods of diagnostic radiology using X-ray beam attenuation. Clinical applications of CT have been increased by technological advances, what leads to a wide variety of scanner in the Brazilian technological pool. It has been difficult to implement dose reduction strategies because of the lack of proper guidance on computed tomography examinations. However, CT scanners allow adjusting acquisition parameter according to the patients physical profile and diagnostic application for which the scan is intended. The knowledge of the dose distribution is important because changes in image acquisition parameters may provide dose reduction. In this study, it was used a cylindrical head phantom in PMMA with 5 openings, what allows dose measurement in 5 regions. In a GE CT scanner, Discovery model of 64 channels, the central slice of the head phantom was irradiated and the absorbed doses were measured using a pencil ionization chamber. Radiochromic film strips were placed in the peripheral and in the central region of the head phantom and was performed a scan of 10 cm in the phantom central region. The scan was performed using the head scanning protocol of the radiobiology service, with a voltage of 120 kV. After scanning, the radiochromic film strips were digitalized and their digital images were used to have the dose longitudinal profiles. The dose values recorded have variation in a range of 18.66 to 23.57 mGy. In the results it was compared the dose index values obtained by the pencil chamber measurement to the dose longitudinal profiles recorded by the film strips. (Author)

  17. Diagnosis of pituitary microadenomas by CT scan. Detection of the microadenoma by high resolution coronal scan

    Energy Technology Data Exchange (ETDEWEB)

    Sakoda, K.; Uozumi, T. (Hiroshima Univ. (Japan). School of Medicine)


    Following a detection of abnormality of pituitary hormone, it is very important to know whether the abnormality is due to pituitary microadenoma for deciding treatment methods. To diagnose pituitary microadenoma, polytomography of the sella turcica has been used. The recently developed high resolution coronal CT scan is prone to be more valuable in diagnosing microadenoma. New findings by this method were reported.

  18. Comparison of (18)F-FDG PET/CT and (99 m)Tc-MDP bone scintigraphy for detection of bone metastasis in osteosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Byung Hyun; Lim, Ilhan; Kim, Byung Il; Choi, Chang Woon; Lim, Sang Moo [Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Nuclear Medicine, Seoul (Korea, Republic of); Kong, Chang-Bae; Song, Won Seok; Cho, Wan Hyeong; Jeon, Dae-Geun; Lee, Soo-Yong [Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Orthopedic Surgery, Seoul (Korea, Republic of); Koh, Jae-Soo [Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Pathology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)


    We compared the diagnostic performance of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and (99 m)Tc-methylene diphosphonate bone scintigraphy (BS) for the detection of bone metastasis in osteosarcoma. We retrospectively reviewed 206 patients with stage II-IV osteosarcoma treated with surgery and chemotherapy as well as at least one paired PET/CT and BS scan (defined as an examination). PET/CT and BS images were interpreted separately. When analyzing the diagnostic yield of a combination of PET/CT and BS (PET/CT+BS), an examination was considered positive if either PET/CT or BS scored positive. The final diagnosis was obtained from histological findings or clinical follow-up with imaging studies for at least 6 months. Diagnostic performances of PET/CT, BS, and their combinations were calculated. Out of 833 examinations in 206 patients, 55 with 101 lesions in 38 patients were confirmed as bone metastases. The sensitivity, specificity, and diagnostic accuracy were 95, 98, and 98 %, respectively, for PET/CT; 76, 97, and 96 %, respectively, for BS; and 100, 96, and 97 %, respectively, for PET/CT+BS in an examination-based analysis. Lesion-based analysis demonstrated that the sensitivity of PET/CT+BS (100 %) was significantly higher than that of PET/CT (92 %) or BS (74 %) alone. BS detected significantly less bone metastases in the growth plate region than outside the growth plate region (22 vs. 77 %). PET/CT is more sensitive and accurate than BS for diagnosing bone metastases in osteosarcoma. The combined use of PET/CT and BS improves sensitivity. (orig.)

  19. Evaluating soft tissue simulation in maxillofacial surgery using pre and post-operative CT scan

    CERN Document Server

    Chabanas, M; Chouly, F; Boutault, F; Payan, Y; Chabanas, Matthieu; Marecaux, Christophe; Chouly, Franz; Boutault, Franck; Payan, Yohan


    One of the most important issue in soft tissue modeling is to assess the quality of the simulations. A validation protocol is presented based on two CT scans of the patient acquired before and after cranio-maxillofacial surgery. The actual bones repositioning realized during the intervention are accurately measured and reproduced. A evaluation of the soft tissue deformation is then computed using a finite element model of the face. The simulations are therefore compared, qualitatively and quantitatively, with the actual outcome of the surgery. This protocol enable to rigorously evaluate different modeling methods, and to assess the clinical relevance of soft tissue simulation in maxillofacial surgery.

  20. Quantification of the accuracy of MRI generated 3D models of long bones compared to CT generated 3D models. (United States)

    Rathnayaka, Kanchana; Momot, Konstantin I; Noser, Hansrudi; Volp, Andrew; Schuetz, Michael A; Sahama, Tony; Schmutz, Beat


    Orthopaedic fracture fixation implants are increasingly being designed using accurate 3D models of long bones based on computer tomography (CT). Unlike CT, magnetic resonance imaging (MRI) does not involve ionising radiation and is therefore a desirable alternative to CT. This study aims to quantify the accuracy of MRI-based 3D models compared to CT-based 3D models of long bones. The femora of five intact cadaver ovine limbs were scanned using a 1.5 T MRI and a CT scanner. Image segmentation of CT and MRI data was performed using a multi-threshold segmentation method. Reference models were generated by digitising the bone surfaces free of soft tissue with a mechanical contact scanner. The MRI- and CT-derived models were validated against the reference models. The results demonstrated that the CT-based models contained an average error of 0.15 mm while the MRI-based models contained an average error of 0.23 mm. Statistical validation shows that there are no significant differences between 3D models based on CT and MRI data. These results indicate that the geometric accuracy of MRI based 3D models was comparable to that of CT-based models and therefore MRI is a potential alternative to CT for generation of 3D models with high geometric accuracy.

  1. Analysis of the acetabulum by CT scan in Japanese with osteoarthritis of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Masanori [Keio Univ., Tokyo (Japan). School of Medicine


    The morphology of the acetabulum was analyzed by CT scan in 66 Japanese patients with osteoarthritis of the hip mainly following congenital dislocation or dysplasia. The CT scan data was analyzed to standardize the pelvic inclination in all directions. In these patients, the acetabular floor had thickened and the acetabulum was located in the anterolateral portion. The bilateral difference in the acetabular anteversion angle was not different between patients and normal individuals, but the acetabular sector angle in patients was smaller than in the normal subjects. As the stage of osteoarthritis of the hip advanced, the thickness of the acetabular floor in the center and posterior portions and the anterior sector angle increased, and the lateralization of the acetabulum advanced, but the anteversion angle decreased. A bone-forming change is characteristic of the anterior acetabulum and acetabular fossa in the center and posterior portions in Japanese patients with osteoarthritis of the hip. In comparison with data obtained by standard radiography, these changes detected by CT scan corresponded to an increase of the width of a tear drop, the lateralization of the femoral head and the lack of the support of the femoral head from the acetabulum. (author)

  2. Computed tomographic (CT) scans in cerebral palsy (CP)

    Energy Technology Data Exchange (ETDEWEB)

    Kolawole, T.M.; Patel, P.J. (King Saud Univ., Riyadh (Saudi Arabia). Dept. of Radiology); Mahdi, A.H. (King Saud Univ., Riyadh (Saudi Arabia). Dept. of Paediatrics)


    The CT findings in 120 cerebral palsied children are analysed. The 72.5% positive findings are correlated with the clinical types, as well as the aetiological basis for the cerebral palsy. The spastic type, 83.3% of the total number of children, had the highest positive findings. The yield was increased in children with seizures (91.3%) and those in the postnatal group (90%), as well as those with birth trauma and neonatal asphyxia (94%). The findings were those of atrophy in 30.8%, hydrocephalus, in 10%, infarct in 11.6%, porencephaly in 8.3% and others. The atropic changes and their patterns are explained. Treatable lesions, such as tumour, hydrocephalus, subdural haematoma, porencephaly and hygroma were identified in 22.5% of cases. It is concluded that CT scan is definitely efficacious in the management of cerebral palsied children. (orig.).

  3. Evaluation of bone substitute materials: comparison of flat-panel based volume CT to conventional multidetector CT. (United States)

    Sauerbier, Sebastian; Duttenhoefer, Fabian; Sachlos, Elefterios; Haberstroh, Jörg; Scheifele, Christian; Wrbas, Karl-Thomas; Voss, Pit Jacob; Veigel, Egle; Smedek, Jörg; Ganter, Philip; Tuna, Taskin; Gutwald, Ralf; Palmowski, Moritz


    Over the last decade tissue engineering has emerged as a key factor in bone regeneration within the field of cranio-maxillofacial surgery. Despite this in vivo analysis of tissue-engineered-constructs to monitor bone rehabilitation are difficult to conduct. Novel high-resolving flat-panel based volume CTs (fp-VCT) are increasingly used for imaging bone structures. This study compares the potential value of novel fp-VCT with conventional multidetector CT (MDCT) based on a sheep sinus floor elevation model. Calcium-hydroxyapatite reinforced collagen scaffolds were populated with autologous osteoblasts and implanted into sheep maxillary sinus. After 8, 16 and 24 weeks MDCT and fp-VCT scans were performed to investigate the volume of the augmented area; densities of cancellous and compact bone were assessed as comparative values. fp-VCT imaging resulted in higher spatial resolution, which was advantageous when separating closely related anatomical structures (i.e. trabecular and compact bone, biomaterials). Fp-VCT facilitated imaging of alterations occurring in test specimens over time. fp-VCTs therefore displayed high volume coverage, dynamic imaging potential and superior performance when investigating superfine bone structures and bone remodelling of biomaterials. Thus, fp-VCTs may be a suitable instrument for intraoperative imaging and future in vivo tissue-engineering studies.

  4. Osteochondroma (Bone Tumor) (United States)

    ... to be the most common benign bone tumor, accounting for 35% to 40% of all benign bone ... imaging scans. Doctors may also request computed tomography (CT) scans or magnetic resonance imaging (MRI) scans to ...

  5. Treatment of alzheimer disease with CT scans - a case report

    Energy Technology Data Exchange (ETDEWEB)

    Cuttler, J.M. [Cuttler & Associates Inc., Vaughan, Ontario (Canada); Moore, E.R. [Dow Chemical Co., Midland, MI (United States); Hosfeld, V.D. [MidMichigan Health, Midland, MI (United States); Nadolski, D.L. [Midland Internal Medicine Associates PC, Midland, MI (United States)


    Alzheimer disease (AD) primarily affects older adults. This neurodegenerative disorder is the most common cause of dementia and is a leading source of their morbidity and mortality. U.S. patient care costs are about 200 billion dollars and will more than double by 2040. This case report describes the remarkable improvement of an advanced AD patient in hospice, who received five CT scans of the brain, about 40 mGy each, over a period of three months. The mechanism appears to be radiation-induced up-regulation of the patient's adaptive protection systems against AD, which partially restored cognition, memory, speech, movement, and appetite. (author)

  6. Bone scanning as a routine examination of patients with mammary carcinoma; a critical consideration. [Preoperative scanning

    Energy Technology Data Exchange (ETDEWEB)

    Heslinga, J.M.; Pauwels, E.K.J.; Zwaveling, A. (Rijksuniversiteit Leiden (Netherlands). Academisch Ziekenhuis)


    The usefulness of bone scanning as a routine examination was evaluated in 136 female patients with mammary carcinoma of whom 81 were staged as Columbia A and 55 as Columbia B/C. The preoperative bone scanning was positive in only 4 patients (2.9%). Consequently, bone scanning is no longer performed in the authors clinic for the preoperative detection of skeletal metastases. Bone scanning as a routine examination at 6-month intervals does not appear to be useful for the first 4 years of the follow-up, either. Most of the patients with a positive bone scan displayed other signs of skeletal metastases at the same time, such as ostealgia and a raised serum alkaline phosphatase level. Further increase of the frequency of bone scanning during the follow-up period would increase the costs considerably, almost prohibitively, even apart from the question whether such a measure might indeed significantly influence the patient's prognosis. The authors conclude that bone scanning should only be performed on the basis of the anamnesis, physical and laboratory findings, both prior to operation and during the follow-up period.

  7. Impact of the planning CT scan time on the reflection of the lung tumor motion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su San; Choi, Eun Kyung; Yi, Byong Yong [Asan Medical Center, College of Medicine, University of Ulsan Ulsan (Korea, Republic of); Ha, Sung Whan [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    To evaluate the reflection of tumor motion according to the planning CT scan time. A model of N-shape, which moved along the longitudinal axis during the ventilation caused by a mechanical ventilator, was produced. The model was scanned by planning CT, while setting the relative CT scan time (T; CT scan time/ventilatory period) to 0.33, 0.50, 0.67, 0.75, 1.00, 1.33 T, and 1.53 T. In addition, three patients with non-small cell lung cancer who received stereotactic radiosurgery in the Department of Radiation Oncology, Asan Medical Center from 03/19/2002 to 05/21/2002 were scanned. Slow (IQ Premier, Picker, scan time 2.0 seconds per slice) and fast CT scans (Light Speed, GE Medical System, with a scan time of 0.8 second per slice) were performed for each patient. The magnitude of reflected movement of the N-shaped model was evaluated by measuring the transverse length, which reflected the movement of the declined bar of the model at each slice. For patients' scans, all CT data sets were registered using a stereotactic body frame scale with the gross tumor volumes delineated in one CT image set. The volume and three-dimensional diameter of the gross tumor volume were measured and analyzed between the slow and fast CT scans. The reflection degree of longitudinal movement of the model increased in proportion to the relative CT scan times below 1.00 T, but remained constant above 1.00 T. Assuming the mean value of scanned transverse lengths with CT scan time 1.00 T to be 100%, CT scans with scan times of 0.33, 0.50, 0.67, and 0.75 T missed the tumor motion by 30, 27, 20, and 7.0% respectively. Slow (scan time 2.0 sec) and Fast (scan time 0.8 sec) CT scans of three patients with longitudinal movement of 3, 5, and 10 mm measured by fluoroscopy revealed the increases in the diameter along the longitudinal axis increased by 6.3, 17, and 23% in the slow CT scans. As the relative CT scan time increased, the reflection of the respiratory tumor movement on planning CT also

  8. Accuracy of bone SPECT/CT for identifying hardware loosening in patients who underwent lumbar fusion with pedicle screws

    Energy Technology Data Exchange (ETDEWEB)

    Hudyana, Hendrah; Maes, Alex [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Hospital Leuven, Department of Morphology and Medical Imaging, Leuven (Belgium); Vandenberghe, Thierry; Fidlers, Luc [AZ Groeninge, Department of Neurosurgery, Kortrijk (Belgium); Sathekge, Mike [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Nicolai, Daniel [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Wiele, Christophe van de [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Ghent, Department of Radiology and Nuclear Medicine, Ghent (Belgium)


    The aim of this retrospective study was to evaluate the accuracy of bone SPECT (single photon emission computed tomography)/CT (computed tomography) in diagnosing loosening of fixation material in patients with recurrent or persistent back pain that underwent lumbar arthrodesis with pedicle screws using surgery and clinical follow-up as gold standard A total of 48 patients (median age 49 years, range 21-81 years; 17 men) who had undergone lumbar spinal arthrodesis were included in this retrospective analysis. SPECT/CT results were compared to the gold standard of surgical evaluation or clinical follow-up. Positive SPECT/CT results were considered true positives if findings were confirmed by surgery or if clinical and other examinations were completely consistent with the positive SPECT/CT finding. They were considered false positives if surgical evaluation did not find any loose pedicle screws or if symptoms subsided with non-surgical therapy. Negative SPECT/CT scans were considered true negatives if symptoms either improved without surgical intervention or remained stable over a minimum follow-up period of 6 months. Negative SPECT/CT scans were determined to be false negatives if surgery was still required and loosening of material was found. The median length of time from primary surgery to bone SPECT/CT referral was 29.5 months (range 12-192 months). Median follow-up was 18 months (range 6-57) for subjects who did not undergo surgery. Thirteen of the 48 patients were found to be positive for loosening on bone SPECT/CT. Surgical evaluation (8 patients) and clinical follow-up (5 patients) showed that bone SPECT/CT correctly predicted loosening in 9 of 13 patients, while it falsely diagnosed loosening in 4 patients. Of 35 negative bone SPECT/CT scans, 12 were surgically confirmed. In 18 patients, bone SPECT/CT revealed lesions that could provide an alternative explanation for the symptoms of pain (active facet degeneration in 14 patients, and disc and sacroiliac

  9. Light scattering in optical CT scanning of Presage dosimeters

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Y; Adamovics, J; Cheeseborough, J C; Chao, K S; Wuu, C S, E-mail: yx2010@columbia.ed


    The intensity of the scattered light from the Presage dosimeters was measured using a Thorlabs PM100D optical power meter (Thorlabs Inc, Newton, NJ) with an optical sensor of 1 mm diameter sensitive area. Five Presage dosimeters were made as cylinders of 15.2 cm, 10 cm, 4 cm diameters and irradiated with 6 MV photons using a Varian Clinac 2100EX. Each dosimeter was put into the scanning tank of an OCTOPUS' optical CT scanner (MGS Research Inc, Madison, CT) filled with a refractive index matching liquid. A laser diode was positioned at one side of the water tank to generate a stationary laser beam of 0.8 mm width. On the other side of the tank, an in-house manufactured positioning system was used to move the optical sensor in the direction perpendicular to the outgoing laser beam from the dosimeters at an increment of 1 mm. The amount of scattered photons was found to be more than 1% of the primary light signal within 2 mm from the laser beam but decreases sharply with increasing off-axis distance. The intensity of the scattered light increases with increasing light attenuations and/or absorptions in the dosimeters. The scattered light at the same off-axis distance was weaker for dosimeters of larger diameters and for larger detector-to-dosimeter distances. Methods for minimizing the effect of the light scattering in different types of optical CT scanners are discussed.

  10. Age estimation by 3D CT-scans of the Borremose Woman, a Danish bog body

    DEFF Research Database (Denmark)

    Villa, Chiara; Møller Rasmussen, Maria; Lynnerup, Niels


    been visualized from CT-scans using the Mimics software from Materialise. Extensive manual editing was necessary, as is common with bog bodies, since the bones were severely degraded and the ordinary range of Hounsfield Units (HU), used for clinical work, is not suitable. Only the cranium, the left...... ribs and the right auricular surface were 3D visualized. Based on these visualizations, the age was estimated by applying macroscopic methods routinely used for skeletal remains: the cranial sutures closure (Meindl & Lovejoy 1985), the sternal rib end (Iscan & Loth 1986) and the auricular surface...... was 16 to 24 years. Many problems had to be addressed. First of all, the degradation of the skeletal tissue does not allow a complete visualization: the bones are demineralized because of the acidic bog environment. Another problem is the subjectivity that can arise during manual editing, especially...

  11. MicroCT Bone Densitometry: Context Sensitivity, Beam Hardening Correction and the Effect of Surrounding Media

    Directory of Open Access Journals (Sweden)

    Philip L. Salmon


    Full Text Available The context-sensitivity of microCT bone densitometry due to beam hardening artefacts was assessed. Bones and teeth are scanned with varying thickness of surrounding media (water, alcohol, biological tissue and it is important to understand how this affects reconstructed attenuation (“density” of the mineralized tissue. Aluminium tubes and rods with thickness 0.127mm–5mm were scanned both in air or surrounded by up to 2cm of water. Scans were performed with different energy filters and degrees of software beam hardening correction (BHC. Also tested were the effects of signal-to-noise ratio, magnification and truncation. The thickness of an aluminium tube significantly affected its mean reconstructed attenuation. This effect of thickness could be reduced substantially by BHC for scans in air, but not for scans in water. Varying thickness of surrounding water also changed the mean attenuation of an aluminium tube. This artefact could be almost eliminated by an optimal BHC value. The “cupping” artefact of heterogeneous attenuation (elevated at outer surfaces could be corrected if aluminium was scanned in air, but in water BHC was much less effective. Scan truncation, changes to magnification and signal-to-noise ratio also caused artificial changes to measured attenuation. Measurement of bone mineral density by microCT is highly context sensitive. A surrounding layer of liquid or biological tissue reduces the ability of software BHC to remove bone density artefacts. Sample thickness, truncation, magnification and signal to noise ratio also affect reconstructed attenuation. Thus it is important for densitometry that sample and calibration phantom dimensions and mounting materials are standardised.

  12. Effects of CT image segmentation methods on the accuracy of long bone 3D reconstructions. (United States)

    Rathnayaka, Kanchana; Sahama, Tony; Schuetz, Michael A; Schmutz, Beat


    An accurate and accessible image segmentation method is in high demand for generating 3D bone models from CT scan data, as such models are required in many areas of medical research. Even though numerous sophisticated segmentation methods have been published over the years, most of them are not readily available to the general research community. Therefore, this study aimed to quantify the accuracy of three popular image segmentation methods, two implementations of intensity thresholding and Canny edge detection, for generating 3D models of long bones. In order to reduce user dependent errors associated with visually selecting a threshold value, we present a new approach of selecting an appropriate threshold value based on the Canny filter. A mechanical contact scanner in conjunction with a microCT scanner was utilised to generate the reference models for validating the 3D bone models generated from CT data of five intact ovine hind limbs. When the overall accuracy of the bone model is considered, the three investigated segmentation methods generated comparable results with mean errors in the range of 0.18-0.24 mm. However, for the bone diaphysis, Canny edge detection and Canny filter based thresholding generated 3D models with a significantly higher accuracy compared to those generated through visually selected thresholds. This study demonstrates that 3D models with sub-voxel accuracy can be generated utilising relatively simple segmentation methods that are available to the general research community.

  13. Radiological Appearance of Extrapulmonary Lesions in Rradiography (CT scan-MRI

    Directory of Open Access Journals (Sweden)

    A. Soltani Shirazi


    Full Text Available Introduction & Background: To make the diagnosis of chest lesions in chest radiography or CT scan easier, lesions are divided into three main groups: lesions of lung parenchyma, lesions of the heart and mediasti-num and lesions with origins of the protective tissues in the chest. Extrapulmonary lesions have various origins ranging from hard tissues like the bone, to soft tissues such as bone marrow or fatty tissue; they usu-ally present with diverse and sometimes misleading signs and symptoms. Knowledge about the radiologic semiolology of these instances helps to prevent mis-taking these lesions with lesions of pulmonary origin. Consequently timely and appropriate treatment can be provided. Here a study of five thousand chest radi-ographies of extrapulmonary lesions with primary diagnosis of pulmonary lesions is presented and the approach to diagnosis is discussed. According to the present study, 56% of extrapulmonary lesions are de-tectable by means of simple primary radiography and by considering radiologic semiology. We reached definite diagnosis by means of lung CT scan. Other lesions were diagnosed after performing biopsy or surgery.

  14. Technical note: early post-mortem changes of human bone in taphonomy with μCT. (United States)

    Le Garff, Erwan; Mesli, Vadim; Delannoy, Yann; Colard, Thomas; Demondion, Xavier; Becart, Anne; Hedouin, Valéry


    Post-mortem interval (PMI) estimation is an important issue in forensic medicine, particularly for criminal purposes and legal limitation periods. The goal of the present study is to examine the evolution of the trabecular cranial vault bone after 4 weeks of conservation in a controlled environment with micro-tomography (μCT) analyses.Four bone samples were extracted from a fresh human cranial vault (a donation to science according to the French law) and conserved in an air-controlled environment. The samples were weighed and μCT scanned at a 10-μm resolution every week after death for a month. The μCT features were identical for every sample. Each set of data from the μCTs was reconstructed, registered, and analyzed in terms of the total volume, bone volume, bone surface, number of trabeculae, trabeculae thickness, and mean distance of the trabeculae. The samples were conserved in a glass box in 20 °C air with 60% humidity in a laboratory hood between each μCT acquisition. Descriptive statistics were determined. Each sample was observed and compared to itself over time.After 1 month of conservation, the mean bone volume (-1.9%), bone surface (-5.1%), and trabecular number (-12.35%) decreased, whereas the mean trabecular separation (+5.55%) and trabecular thickness (+12.7%) increased. Many variations (i.e., increases and decreases) were observed between the extraction of the sample and the end of the 4 weeks of conservation. The present observations may be explained by bone diagenesis. Previous observations have indicated that protein and lipid losses occur with bone weight and volume losses. These diagenesis effects may explain the trabecular modifications observed in the present work. We observed many bone variations with the μCT scans between the beginning and the end of the conservation that had no explanations. Additional studies, particularly studies involving statistics, need to be performed to confirm our observations and explain these results

  15. CT Guided Bone Biopsy Using a Battery Powered Intraosseous Device

    Energy Technology Data Exchange (ETDEWEB)

    Schnapauff, Dirk, E-mail:; Marnitz, Tim, E-mail:; Freyhardt, Patrick, E-mail:; Collettini, Federico, E-mail: [Charite Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Department of Radiology (Germany); Hartwig, Kerstin, E-mail: [Charite Universitaetsmedizin Berlin, Campus Charite Mitte, Department of Haematology and Oncology (Germany); Joehrens, Korinna, E-mail: [Charite Universitaetsmedizin Berlin, Campus Charite Mitte, Department of Pathology (Germany); Hamm, Bernd, E-mail:; Kroencke, Thomas, E-mail:; Gebauer, Bernhard, E-mail: [Charite Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Department of Radiology (Germany)


    Purpose: To evaluate the feasibility of a battery powered intraosseous device to perform CT-fluoroscopy guided bone biopsy. Methods: Retrospective analysis of 12 patients in whom bone specimen were acquired from different locations under CT-fluoroscopy guidance using the OnControl bone marrow biopsy system (OBM, Vidacare, Shavano Park, TX, USA). Data of the 12 were compared to a historic cohort in whom the specimen were acquired using the classic Jamshidi Needle, as reference needle using manual force for biopsy. Results: Technical success was reached in 11 of 12 cases, indicated by central localisation of the needle within the target lesion. All specimen sampled were sufficient for histopathological workup. Compared to the historical cohort the time needed for biopsy decreased significantly from 13 {+-} 6 to 6 {+-} 4 min (P = 0.0001). Due to the shortened intervention time the radiation dose (CTDI) during CT-fluoroscopy was lowered significantly from 169 {+-} 87 to 111 {+-} 54 mGy Multiplication-Sign cm (P = 0.0001). Interventional radiologists were confident with the performance of the needle especially when using in sclerotic or osteoblastic lesions. Conclusion: The OBM is an attractive support for CT-fluoroscopy guided bone biopsy which is safe tool and compared to the classical approach using the Jamshidi needle leading to significantly reduced intervention time and radiation exposure.

  16. The Usefulness of Bone Scan in Electric Burns

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hyung; So, Yong Seon; Kweon, Ki Hyeon; Han, Sang Woong; Kim, Seok Hwan; Kim, Jong Soon; Han, Seung Soo [Hanil Hospital, Seoul (Korea, Republic of)


    Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as determining to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites and bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, scrum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.

  17. A simulation study on proton computed tomography (CT) stopping power accuracy using dual energy CT scans as benchmark

    DEFF Research Database (Denmark)

    Hansen, David Christoffer; Seco, Joao; Sørensen, Thomas Sangild;


    Background. Accurate stopping power estimation is crucial for treatment planning in proton therapy, and the uncertainties in stopping power are currently the largest contributor to the employed dose margins. Dual energy x-ray computed tomography (CT) (clinically available) and proton CT (in...... development) have both been proposed as methods for obtaining patient stopping power maps. The purpose of this work was to assess the accuracy of proton CT using dual energy CT scans of phantoms to establish reference accuracy levels. Material and methods. A CT calibration phantom and an abdomen cross section...... of detectors and the corresponding noise characteristics. Stopping power maps were calculated for all three scans, and compared with the ground truth stopping power from the phantoms. Results. Proton CT gave slightly better stopping power estimates than the dual energy CT method, with root mean square errors...

  18. CT diagnosis and differential diagnosis of otodystrophic lesions of the temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    D' Archambeau, O.; Parizel, P.M.; Schepper, A.M. De (Antwerp University Hospital (Belgium). Department of Radiology); Koekelkoren, E.; Van De Heyning, P. (Antwerp University Hospital (Belgium). Department of E.N.T.)

    The purpose of this study was to assess the diagnostic and differential diagnostic value of high-resolution computed tomography in the evaluation of temporal-bone dystrophies. The study group included 55 patients with osseous abnormalities of the temporal bone in general, and the labyrinthine capsule in particular. In 27 patients the CT scan revealed evidence of otodystrophic lesions. The CT findings in patients with otosclerosis (21 patients), osteogenesis imperfecta (two patients), fibrous dysplasia (one patient). Paget's disease (one patient) and osteoporosis (two patients) are described. The CT scans of 17 patients revealed secondary osseous lesions due to metastasis (five patients), post-inflammatory changes (10 patients) or labyrinthitis ossificans (two patients). Normal variants and congenital mineralization defects were diagnosed in nine patients, Down's syndrome in two. Our results indicate the importance of high-resolution computed tomography as the primary imaging modality in evaluating osseous lesions of the temporal bone and labyrinth. (author). 14 refs.; 13 figs; 2 tabs.

  19. Influence of object location in different FOVs on trabecular bone microstructure measurements of human mandible: a cone beam CT study

    NARCIS (Netherlands)

    Ibrahim, N.; Parsa, A.; Hassan, B.; van der Stelt, P.; Aartman, I.H.A.; Nambiar, P.


    The aim of this study was to assess the influence of different object locations in different fields of view (FOVs) of two cone beam CT (CBCT) systems on trabecular bone microstructure measurements of a human mandible. A block of dry human mandible was scanned at five different locations (centre, lef

  20. Clinical evaluation of dynamic CT scan of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Tokuda, Masamichi


    The clinical usefulness of dynamic CT scans (DCT) of the pancreas was evaluated in 62 normal cases, 9 cases of acute pancreatitis, 24 cases of chronic pancreatitis and 43 cases of carcinoma of the pancreas. The normal pancreas was intensely and homogeneously enhanced on DCT, and peripancreatic vessels were clearly demonstrated, especially the gastroduodenal artery (98.4%). DCT was useful to demonstrate vascular lesions, associated with pancreatitis such as pseudoaneurysm. Although the carcinoma of the pancreas showed poor contrast enhancement on conventional enhanced CT (CCT), 37.2% showed intense contrast enhancement on DCT. Visualization of the gastroduodenal artery by DCT is helpful to decide the extent of tumor. DCT is superior to CCT in demonstrating collateral veins caused by tumor invasion to the portal system in carcinoma. DCT was approximately as accurate as angiography (92.6%) in evaluating tumor invasion to the portal system. DCT is a useful and minimally invasive modality in assessing the resectability of pancreatic carcinoma. DCT may eliminate angiography and surgery in unresectable cases. (author).

  1. Intrapartum FHR monitoring and neonatal CT brain scan

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Yoshiki; Ukita, Masahiko; Nakada, Eizo (Kurashiki Central Hospital, Okayama (Japan))


    The effect of fetal distress on the neonatal brain was investigated by neonatal CT brain scan, FHR monitoring and mode of delivery. This study involved 11 cases of full term vertex delivery in which FHR was recorded by fetal direct ECG during the second stage labor. All infants weighed 2,500 g or more. FHR monitoring was evaluated by Hon's classification. Neonatal brain edema was evaluated by cranial CT histgraphic analysis (Nakada's method). 1) Subdural hemorrhage was noted in 6 of 7 infants delivered by vacuum extraction or fundal pressure (Kristeller's method). 2) Intracranial hemorrhage was demonstrated in all of 3 infants with 5-min. Apgar score 7 or less. 3) Two cases with prolonged bradycardia and no variability had intraventricular or intracerebral hemorrhage which resulted in severe central nervous system damage. 4) The degree of neonatal brain edema correlated with 5-min. Apgar score. 5) One case with prolonged bradycardia and no variability resulted in severe neonatal brain edema. Four cases with variable deceleration and increased variability resulted in mild neonatal brain edema. Two cases with late deceleration and decreased variability resulted in no neonatal brain edema.

  2. Thoracic red bone marrow dose evaluation in CT of patients with carcinoma of the testes

    Energy Technology Data Exchange (ETDEWEB)

    Cruickshank, L. (Mayday Univ. Hospital, London (United Kingdom))


    At the Royal Marsden Hospital many patients are treated for testicular tumours. These patients initially undergo orchidectomy to remove the affected testicle and staging of the disease is also assessed at surgery. Patients classified as stage one, which is testicular involvement alone with no evidence of metastases, are placed on a surveillance, or watch, policy. This involves monthly or bi-monthly chest x-rays, depending on the disease, tumour marker tests and regular CT scans of the chest, abdomen and pelvis, during the first year. As these patients are young, the age range being 15-35 years and the five year survival rate for all testicular tumours is 97%, the radiation dose they were receiving from the CT scans alone warranted investigation, because a high percentage of the body's red bone marrow (33%) is contained within the thorax, and these patients always have a CT scan of the thorax to identify the presence of any intra-thoracic metastases. The aim of this project was to assess the radiation dose to the red bone marrow of the thorax to discover if this dose approached a level at which radiation induced detriment might be significant. (author).

  3. Incidental detection of gastrointestinal stromal tumor by Tc-99m MDP bone scan. (United States)

    Shepherd, Timothy M; Idakoji, Ibrahim A; Pampaloni, Miguel H


    This case demonstrates extraosseous 99m-technetium methylene diphosphonate (Tc-99m MDP) accumulation from a gastrointestinal stromal tumor. A 75-year-old woman underwent a temporal bone CT for conductive hearing loss that showed sclerosis in the right occipital condyle. Follow-up Tc-99m MDP bone scan for osseous metastases instead showed a mass-like extraosseous accumulation of Tc-99m MDP in the anterior left upper quadrant. Differential diagnoses included gastric cancer, lymphoma, metastatic melanoma, systemic hypercalcemia, or heterotopic mesenteric ossification. Contrast CT showed a well-circumscribed mass arising from the stomach, and subsequent pathology confirmed gastrointestinal stromal tumor. These tumors rarely can contain osteoclast-like giant cells and should be considered for extraosseous Tc-99m MDP accumulation.

  4. Effect of low-dose CT and iterative reconstruction on trabecular bone microstructure assessment (United States)

    Kopp, Felix K.; Baum, Thomas; Nasirudin, Radin A.; Mei, Kai; Garcia, Eduardo G.; Burgkart, Rainer; Rummeny, Ernst J.; Bauer, Jan S.; Noël, Peter B.


    The trabecular bone microstructure is an important factor in the development of osteoporosis. It is well known that its deterioration is one effect when osteoporosis occurs. Previous research showed that the analysis of trabecular bone microstructure enables more precise diagnoses of osteoporosis compared to a sole measurement of the mineral density. Microstructure parameters are assessed on volumetric images of the bone acquired either with high-resolution magnetic resonance imaging, high-resolution peripheral quantitative computed tomography or high-resolution computed tomography (CT), with only CT being applicable to the spine, which is one of clinically most relevant fracture sites. However, due to the high radiation exposure for imaging the whole spine these measurements are not applicable in current clinical routine. In this work, twelve vertebrae from three different donors were scanned with standard and low radiation dose. Trabecular bone microstructure parameters were assessed for CT images reconstructed with statistical iterative reconstruction (SIR) and analytical filtered backprojection (FBP). The resulting structure parameters were correlated to the biomechanically determined fracture load of each vertebra. Microstructure parameters assessed for low-dose data reconstructed with SIR significantly correlated with fracture loads as well as parameters assessed for standard-dose data reconstructed with FBP. Ideal results were achieved with low to zero regularization strength yielding microstructure parameters not significantly different from those assessed for standard-dose FPB data. Moreover, in comparison to other approaches, superior noise-resolution trade-offs can be found with the proposed methods.

  5. Clinical analysis of bone scanning in solitary lesion

    Institute of Scientific and Technical Information of China (English)


    A rational analysis procedure for solitary lesions on whole bone scan-ning was offered. This study was undertaken to analyze retrospectively solitary le-sions which obtained final diagnose through the following aspects: (1) diagnosis ofbone metastasis, (2) the incidence of bone metastasis in different tumor, (3) the mostpossible lesion sites indicating bone metastasis, (4) morphological analysis of solitarylesions. The results are: (1) The incidence of solitary lesions in 2465 cases on wholebone scanning is 15.3%. (2) The rate of bone metastasis is 24.8% in 282 patientswith primary malignancy. The rate of bone metastasis is 6.3% in 64 patients withoutprimary malignancy, and the total diagnostic rate of bone metastasis is 21.4% in 346patients. (3) In patients with primary malignancy, the incidence of bone metastasis ofsolitary lesions is as follows respectively: bronchi cancer 36.1%(22/61); breast cancer23.8%(20/84); prostate gland 17.2%(5/29); other urinary system cancer 22.2%(4/18):G.I. system cancer 16.9%(10/59); others 29.0%(9/31). There is no significant differ-ence in different cancer. (4) In patients without primary malignancy, 93.7%(60/64) ofsolitary lesions are benign. (5) From anatomical point of view, we found the diagnos-tic rate of bone metastasis is as follow: 30% in spine; 34.2% in pelvis; 36.4% in skull;10.8% in other bones. There are significant differences in four groups. It is concludedthat: (1) The diagnostic rate of bone metastasis in solitary lesions is 21.4%. (2) Themost possible solitary lesions indicating osseous tumor spread are at spine, pelvic andskull. (3) Special attention to "cold" and streak like lesions should be paid. (4) Aclinical analysis procedure for diagnosis of solitary lesions has been summarized outhere.``

  6. Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Marini, Davide; Agnoletti, Gabriella [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); Brunelle, Francis [University Paris Descartes, UFR Necker-Enfants Malades, Department of Pediatric Radiology, APHP, Paris (France); Sidi, Daniel; Bonnet, Damien [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); Ou, Phalla [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); University Paris Descartes, UFR Necker-Enfants Malades, Department of Pediatric Radiology, APHP, Paris (France)], E-mail:


    Objective: The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of graft and/or coronary angioplasty stenosis in children who had undergone coronary artery surgery. Population and methods: Fifteen consecutive children (8 male and 7 female; age 9.2 {+-} 6.1 years) underwent 64-slice CT because of chest pain or ECG changes mean 4.8 {+-} 3.7 years after surgical coronary artery surgery; 10 patients had coronary angioplasty using a patch from the saphenous vein, four had mammary artery bypass, and one had saphenous vein bypass. Six main segments of the coronary arteries and all the bypass graft considered as a single segment were analyzed and compared with invasive angiography used as the reference standard. Results: CT correctly identified the four children with coronary angioplasty and mammary graft lesions that were confirmed by conventional angiography: one patient had a significant stenosis (>50% stenosis) at the mammary bypass graft anastomosis site; three other had non-significant stenosis (<50% stenosis) including a mild lesion of the saphenous vein patch in two patients and a mild lesion at the anastomosis site of the mammary bypass in one. All segments identified as normal by CT in the other 11 children were also found to be normal by conventional angiography. Conclusion: In centers expert in this technique, 64-slice CT scanning is a promising, rapid, and useful diagnostic technique for evaluating both coronary angioplasty and bypass graft lesions in children who had undergone coronary artery surge0008.

  7. Chondromyxoid fibroma of the temporal bone: CT and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Tarhan, N.C.; Yologlu, Z.; Tutar, N.U.; Coskun, M.; Agildere, A.M. [Baskent Univ. School of Medicine, Bahcelievler Ankara (Turkey). Dept. of Radiology; Arikan, U. [Baskent Univ. School of Medicine, Bahcelievler Ankara (Turkey). Dept. of Pathology


    We present the case of a 44-year-old woman with chondromyxoid fibroma of temporal bone origin. Since this is the least common bone tumor of cartilaginous origin, it is highly unusual to find this tumor in the skull. In fact, the literature describes 18 cases of this form of neoplasia arising in the skull, only 4 of these having originated in the temporal bone. To date, the radiological features of these tumors, and especially features detected using the latest imaging modalities, have not been described in detail. This report is unique in that it is the first to present a case of chondromyxoid fibroma of the temporal bone accompanied by detailed CT and MRI findings. (orig.)

  8. Indeterminate lesions on planar bone scintigraphy in lung cancer patients: SPECT, CT or SPECT-CT?

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Punit; Kumar, Rakesh; Singh, Harmandeep; Bal, Chandrasekhar; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Julka, Pramod Kumar [All India Institute of Medical Sciences, Department of Radiation Oncology, New Delhi (India); Thulkar, Sanjay [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India)


    The objective of the present study was to compare the role of single photon emission computed tomography (SPECT), computed tomography (CT) and SPECT-CT of selected volume in lung cancer patients with indeterminate lesions on planar bone scintigraphy (BS). The data of 50 lung cancer patients (53 {+-} 10.3 years; range 30-75; male/female 38/12) with 65 indeterminate lesions on planar BS (January 2010 to November 2010) were retrospectively evaluated. All of them underwent SPECT-CT of a selected volume. SPECT, CT and SPECT-CT images were independently evaluated by two experienced readers (experience in musculoskeletal imaging, including CT: 5 and 7 years) in separate sessions. A scoring scale of 1 to 5 was used, in which 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign and 5 is definitely benign. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each modality, taking a score {<=}2 as metastatic. With receiver operating characteristic (ROC) curve analysis, areas under the curve (AUC) were calculated for each modality and compared. Clinical and imaging follow-up and/or histopathology were taken as reference standard. For both readers SPECT was inferior to CT (P = 0.004, P = 0.022) and SPECT-CT (P = 0.003, P = 0.037). However, no significant difference was found between CT and SPECT-CT for reader 1 (P = 0.847) and reader 2 (P = 0.592). The findings were similar for lytic as well as sclerotic lesions. Moderate inter-observer agreement was seen for SPECT images ({kappa} = 0.426), while almost perfect agreement was seen for CT ({kappa} = 0.834) and SPECT-CT ({kappa} = 0.971). CT alone and SPECT-CT are better than SPECT for accurate characterisation of indeterminate lesions on planar BS in lung cancer patients. CT alone is not inferior to SPECT-CT for this purpose and might be preferred because of shorter acquisition time and wider availability. (orig.)

  9. A quantitative CT system applied to the femoral shaft and lateral condyle for evaluating bone loss in patients with secondary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Sakurai, Kiyoko [Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Allied Health Sciences; Matsubayashi, Takashi; Tsukamoto, Yusuke


    An improved quantitative CT (QCT) system for evaluating bone loss was reported, which was based on the 3 parameters newly made obtainable on the CT scanner of BOCT (bone CT number, the mean CT number within bone region). PKCT (peak CT number, CT number at the peak of the frequency distribution of CT numbers in the histogram) and MXCT (maximum CT number within bone region). Subjects were 37 patients, who were treated with ordinary dose of 1,25(OH{sub 2})D{sub 3} or were of more progressed symptoms, and 87 normal healthy volunteers. A Quantex apparatus (YMS Co.) was used for CT scanning with the tube voltage of 120 kVp for the femoral shaft and 80 kVp for lateral condyle and vertebra and with slice thickness of 10 mm. A phantom consisting of an aluminum pipe inserted in an acrylic acid resin column was used to obtain the standard CT number, and the standard phantom of the BMD (bone mineral density) package (YMS Co.), in the QCT of the femoral lateral condyles. Results were analyzed by SAS statistical program. The 3 parameters together with BMD were found quite useful far evaluating bone loss in all patients. (K.H.)

  10. Digital forensic osteology: morphological sexing of skeletal remains using volume-rendered cranial CT scans. (United States)

    Ramsthaler, Frank; Kettner, Mattias; Gehl, Axel; Verhoff, M A


    Because of the increasing lack of recent bone collections, ethical issues concerning maceration procedures, and progress in radiological imaging techniques, computed tomography (CT) scans offer an alternative to traditional anthropological bone collection. The present study examined volume-rendered cranial CT (CCT) scans from 50 crania to morphologically evaluate sex characteristics. CCT scans were performed and scored by two teams (Teams A and B) of two examiners each (2x50=100 examinations) to evaluate the occurrence and/or absence of morphological traits. Altogether, 60 of 100 crania (31 Team A+29 Team B) crania were determined to be male, and 40 (19 Team A+21 Team B) were determined to be female when using the scoring system adapted from Knussmann. These results imply a sex determination accuracy rate of 96%. Only in one case was recalculation of weighting factors necessary to determine one additional correct classification. As a single parameter, arcus superciliaris evaluation permitted the most accurate sex determination (female, 84.2%; male, 85.5%). No significant difference in accuracy rates was observed between the two sexes (p<0.65, chi(2)=0.39, Fisher's exact test). Interobserver bias rates for both teams were very low (kappa=0.83). The present study shows that volume-rendered CCT images are suitable for the collection of data concerning morphologic sex determination of skulls. Thus, this method may be helpful in both actual forensic casework and the systematic reevaluation and improvement of classical anthropological methods and their adaptation to changing populations.

  11. A negative bone scan leads to an unusual diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    O`Brien, L. [Royal Brisbane Hospital, Herston, QLD (Australia). Department of Nuclear Medicine


    Full text: A bone scan looking for osteomyelitis or a more sinister pathology was performed on a 7-year-old boy with Von Willebrand``s disease. He presented with symptoms of pain in the left groin and a lump, although there had been no history of direct trauma, and an X-ray report stating that there was an irregular ill-defined area of bony destruction seen in the lower aspect of the left ischium. Blood pool images of the pelvis were acquired soon after an injection of MDP and three hours later a whole body bone scan was done. Results of the bone scan showed that the radiolucent lesion in the left ilium seen on the plain radiographs was not metabolically active on the technetium MDP study. Features compatible with a response to an intraosseous or sub-periosteal haematoma were seen when reviewing the original X-rays and, as there was a spontaneous resolution of the patient``s symptoms, this was considered to be the diagnosis. This study shows that a negative bone scan, which rules out an active bone lesion, is of value in making a diagnosis when used in conjunction with X-rays and a knowledge of the patient``s history.

  12. Improving Depiction of Temporal Bone Anatomy With Low-Radiation Dose CT by an Integrated Circuit Detector in Pediatric Patients (United States)

    He, Jingzhen; Zu, Yuliang; Wang, Qing; Ma, Xiangxing


    Abstract The purpose of this study was to determine the performance of low-dose computed tomography (CT) scanning with integrated circuit (IC) detector in defining fine structures of temporal bone in children by comparing with the conventional detector. The study was performed with the approval of our institutional review board and the patients’ anonymity was maintained. A total of 86 children  0.05). The low-dose CT images acquired with the IC detector provide better depiction of fine osseous structures of temporal bone than that with the conventional DC detector. PMID:25526489

  13. CT-Scans of Cochlear Implant Patients with Characteristics of Pendred Syndrome

    Directory of Open Access Journals (Sweden)

    Sebastian Roesch


    Full Text Available Background: Sensorineural hearing loss (SNHL in newborns is estimated with an incidence around 1:10,000 per year and is divided into syndromic and non-syndromic forms. In case of present retrocochlear function‚ cochlear implantation allows speech and cognitive development in affected children, comparable to that of normal hearing children. Pathogenesis of SNHL remains unclear in many cases. Imaging of the temporal bone, such as computed tomography (CT and magnetic resonance imaging (MRI, can reveal conspicuous findings, e.g. enlarged vestibular aqueduct (EVA and Mondini malformation (MM of the cochlea. These malformations can be a clinical sign for Pendred syndrome. Methods: We screened CT scans of 75 cochlear implant patients for EVA and MM. Results: Six patients were observed to have either EVA alone (n=3, or MM alone (n=2, or a combination of both (n=1. Further malformations of the temporal bone could be found within the whole group, as well. Conclusion: Our results confirm the general opinion on EVA and MM, being commonly found in patients with SNHL. A possible association with Pendred syndrome needs to be confirmed by genetic investigations with search for mutations in the SLC26A4 gene and further clinical tests, such as Perchlorate test for surveillance of thyroid function.

  14. Anatomic Variation of Sphenoid Sinus and Related Structures in Libyan Population: CT Scan Study

    Directory of Open Access Journals (Sweden)

    Hewaidi GH


    Full Text Available Background: Sphenoid sinus is the most inaccessible paranasal sinus, enclosed within the sphenoid bone and intimately related to numerous vital neural and vascular structures. Anatomic variation of the sphenoid sinus is well documented and may complicate surgery in such a place. Objective: To outline the surgically risky anatomic variants of the sphenoid sinus as well as the variable relationships between the sinus and related neurovascular structures, for the safe removal of intrasphenoid and pituitary lesions. Materials and Methods: We undertook a prospective review of 300 paranasal sinus CT scans of Libyan patients; coronal CT scans were obtained by special parameter techniques. We assessed pneumatization of pterygoid process (PP, anterior clinoid process (ACP, and greater wing of sphenoid (GWS; we also examined protrusion and dehiscence of internal carotid artery (ICA, optic nerve (ON, maxillary nerve (MN, and vidian nerve (VN into the sphenoid sinus cavity. Results: Pneumatization of PP, ACP, and GWS were seen in 87 (29%, 46 (15.3%, and 60 patients (20%, respectively. Protrusion of ICA, ON, MN, and VN were noticed in 123 (41%, 107 (35.6%, 73 (24.3%, and 81 patients (27%, respectively; dehiscence of these structures was encountered in 90 (30%, 92 (30.6%, 39 (13%, and 111 patients (37%, respectively. Statistically, there was a highly significant association between ACP pneumatization and ICA protrusion, ACP pneumatization and ON protrusion, PP pneumatization and VN protrusion; and GWS pneumatization and MN protrusion (p-value < 0.001. Conclusion: The sphenoid sinus is highly variable; this variability necessitates a comprehensive understanding of the regional sphenoid sinus anatomy by a detailed CT scan sinus examination before surgery in and around the sinus. This study indicates the possibility of a racial anatomical variation of the sphenoid sinus in the Libyan population.

  15. Three-dimensional visualization and characterization of bone structure using reconstructed in-vitro μCT images: A pilot study for bone microarchitecture analysis

    Energy Technology Data Exchange (ETDEWEB)

    Latief, Fourier Dzar Eljabbar, E-mail: [Physics of Earth and Complex Systems, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Jl. Ganesha 10, Bandung 40132 (Indonesia); Dewi, Dyah Ekashanti Octorina [2Biomedical Engineering Research Division, School of Electrical Engineering and Informatics, Institut Teknologi Bandung, Jl. Ganesha 10, Bandung 40132 (Indonesia); Shari, Mohd Aliff Bin Mohd [Faculty of Electrical Engineering, Universiti Teknologi MARA Malaysia, 40000 Shah Alam, Selangor (Malaysia)


    Micro Computed Tomography (μCT) has been largely used to perform micrometer scale imaging of specimens, bone biopsies and small animals for the study of porous or cavity-containing objects. One of its favored applications is for assessing structural properties of bone. In this research, we perform a pilot study to visualize and characterize bone structure of a chicken bone thigh, as well as to delineate its cortical and trabecular bone regions. We utilize an In-Vitro μCT scanner Skyscan 1173 to acquire a three dimensional image data of a chicken bone thigh. The thigh was scanned using X-ray voltage of 45 kV and current of 150 μA. The reconstructed images have spatial resolution of 142.50 μm/pixel. Using image processing and analysis e.i segmentation by thresholding the gray values (which represent the pseudo density) and binarizing the images, we were able to visualize each part of the bone, i.e., the cortical and trabecular regions. Total volume of the bone is 4663.63 mm{sup 3}, and the surface area of the bone is 7913.42 mm{sup 2}. The volume of the cortical is approximately 1988.62 mm{sup 3} which is nearly 42.64% of the total bone volume. This pilot study has confirmed that the μCT is capable of quantifying 3D bone structural properties and defining its regions separately. For further development, these results can be improved for understanding the pathophysiology of bone abnormality, testing the efficacy of pharmaceutical intervention, or estimating bone biomechanical properties.

  16. Centre for Industrial Application of CT scanning (CIA-CT) – Four years of results 2009-2013

    DEFF Research Database (Denmark)

    De Chiffre, Leonardo; Andreasen, Jan Lasson; Christensen, Lars Bager;

    as a centre of excellence for industrial CT scanning, both nationally and internationally. A network with approx. 40 participants has been established, and a total of 22 students have been educated. Dissemination activities have encompassed: a web page , 8 newsletters, 4 topical...

  17. Confocal laser scanning microscopy in study of bone calcification

    Energy Technology Data Exchange (ETDEWEB)

    Nishikawa, Tetsunari, E-mail: [Department of Oral Pathology, Osaka Dental University, Osaka (Japan); Kokubu, Mayu; Kato, Hirohito [Department of Oral Pathology, Osaka Dental University, Osaka (Japan); Imai, Koichi [Department of Biomaterials, Osaka Dental University, Osaka (Japan); Tanaka, Akio [Department of Oral Pathology, Osaka Dental University, Osaka (Japan)


    Highlights: Black-Right-Pointing-Pointer High-magnification images with depth selection, and thin sections were observed using CLSM. Black-Right-Pointing-Pointer The direction and velocity of calcification of the bone was observed by administration of 2 fluorescent dyes. Black-Right-Pointing-Pointer In dog femora grafted with coral blocks, newly-formed bone was observed in the coral block space with a rough surface. Black-Right-Pointing-Pointer Twelve weeks after dental implant was grafted in dog femora, the space between screws was filled with newly-formed bones. - Abstract: Bone regeneration in mandible and maxillae after extraction of teeth or tumor resection and the use of rough surface implants in bone induction must be investigated to elucidate the mechanism of calcification. The calcified tissues are subjected to chemical decalcification or physical grinding to observe their microscopic features with light microscopy and transmission electron microscopy where the microscopic tissue morphology is significantly altered. We investigated the usefulness of confocal laser scanning microscopy (CLSM) for this purpose. After staggering the time of administration of calcein and alizarin red to experimental rats and dogs, rat alveolar bone and dog femur grafted with coral as scaffold or dental implants were observed with CLSM. In rat alveolar bone, the calcification of newly-formed bone and net-like canaliculi was observed at the mesial bone from the roots progressed at the rate of 15 {mu}m/day. In dog femur grafted with coral, newly-formed bones along the space of coral were observed in an orderly manner. In dog femur with dental implants, after 8 weeks, newly-formed bone proceeded along the rough surface of the implants. CLSM produced high-magnification images of newly-formed bone and thin sections were not needed.

  18. Skeletal idiopathic osteosclerosis helps to perform personal identification of unknown decedents: A novel contribution from anatomical variants through CT scan. (United States)

    De Angelis, D; Gibelli, D; Palazzo, E; Sconfienza, L; Obertova, Z; Cattaneo, C


    Personal identification consists of the comparison of ante-mortem information from a missing person with post-mortem data obtained from an unidentified corpse. Such procedure is based on the assessment of individualizing features which may help in providing a conclusive identification between ante-mortem and post-mortem material. Anatomical variants may provide important clues to correctly identify human remains. Areas of idiopathic osteosclerosis (IO), or dense bone islands (DBIs) characterized by radiopaque areas of dense, trabeculated, non-inflamed vital bone represent one of these, potentially individualizing, anatomical features. This study presents a case where the finding of DBI was crucial for a positive identification through CT-scan. A decomposed body was found in an apartment in June 2014 in advanced decomposition and no dental records were available to perform a comparison for positive identification. Genetic tests were not applicable because of the lack of relatives in a direct line. The analysis of the only ante-mortem documentation, a CT-scan to the deceased dating back to August 2009, showed the presence of three DBIs within the trabecular bone of the proximal portion of the right femur. The same bony district was removed from the corpse during the autopsy and analysed by CT-scan, which verified the presence of the same features. Forensic practitioners should therefore be aware of the great importance of anatomical bone variants, such as dense bone islands for identification purposes, and the importance of advanced radiological technique for addressing the individualizing potential of such variants. We propose that anatomical variants of the human skeleton should be considered as being "primary identification characteristics" similar to dental status, fingerprints and DNA.

  19. Evolving brain lesions in the follow-up CT scans 12 h after traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    Muhammad Sohail Umerani; Asad Abbas; Saqib Kamran Bakhshi; Ujala Muhammad Qasim; Salman Sharif


    Objective: To establish the frequency of evolution in CT appearance from an initial scan to a subsequent scan within 12 h and the prognostic significance of such deterioration. Methods: All patients who presented to Department of Neurosurgery, Liaquat National Hospital and Medical College with traumatic brain injury and received their CT scan within the first 4 h of injury were included in the study. Indications for repeat CT scan were: any deterioration in neurological status after the initial scan, potentially deterio-rating lesion on initial scan with or without worsening neurology, worsening neurological status after the initial CT scan findings, or no neurological improvement after initial management in patients with normal CT scan with significant head injury. This compiled with the data of 107 patients. Results: There were 67 males and 40 females. The cause of trauma of the 70%patients was road traffic accident. In 11 patients, the lesion evolved towards resorption while 32 patients had no significant changes in the subsequent CT scan. Sixty four patients showed an increase in the size of the lesion and 65.6%of them were required surgical intervention subsequently. Conclusions: In case where the initial CT scan performed within 4 h of significant head injury was not correlated with the patient's neurology, it should be repeated within 12 h.

  20. Improving CT scan capabilities with a new trauma workflow concept: Simulation of hospital logistics using different CT scanner scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Fung Kon Jin, P.H.P., E-mail: [Trauma Unit Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Dijkgraaf, M.G.W., E-mail: [Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, Amsterdam (Netherlands); Alons, C.L., E-mail: [Department of Mathematics, VU University Amsterdam, Amsterdam (Netherlands); Kuijk, C. van, E-mail: [Department of Radiology, VU Medical Center, Amsterdam (Netherlands); Beenen, L.F.M., E-mail: [Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Koole, G.M., E-mail: [Department of Mathematics, VU University Amsterdam, Amsterdam (Netherlands); Goslings, J.C., E-mail: [Trauma Unit Department of Surgery, Academic Medical Center, Amsterdam (Netherlands)


    Introduction: The Amsterdam Trauma Workflow (ATW) concept includes a sliding gantry CT scanner serving two mirrored (trauma) rooms. In this study, several predefined scenarios with a varying number of CT scanners and CT locations are analyzed to identify the best performing patient flow management strategy from an institutional perspective on process quality. Materials and methods: A total of six clinically relevant scenarios with variables that included the number of CT scanners, CT scanner location, and different patient categories (regular, urgent, and trauma patients) were evaluated using computer simulation. Each scenario was simulated using institutional data and was assessed for patient waiting times, idle time of CT scanners, and overtime due to scheduling. The best 2- and 3-scanner scenarios were additionally evaluated with the ATW-concept. Results: Based on institutional data, the best 2-scanner scenario distributes all 3 patient categories over both scanners and plans 4 urgent patients per hour while locating both scanners outside of the trauma room. The best 3-scanner scenario distributes urgent and regular patients over all 3 scanners and trauma patients on only 1 scanner and locates all CT scanners outside of the trauma room. The ATW concept reduces waiting times and overtime, while increasing idle time. Conclusion: Choosing the optimal planning and distribution strategies depends on the number and location of available CT scanners, along with number of trauma, urgent and regular patients. The Amsterdam Trauma Workflow concept could provide institutions with the ability of early CT scanning in trauma patients without influencing regular and urgent CT scanning.

  1. Impact of low-dose CT scan in dual timepoint investigations: a phantom study

    DEFF Research Database (Denmark)

    Micheelsen, M A; Jensen, Mikael


    Dual timepoint FDG takeup investigations have a potential for separating malignant lymph nodes from non-malignant in certain cases of suspected lung cancer. One hour seems to be the optimal time interval between the two scans (50-120 min). Many of the new PET scanners benefit from image fusion...... with a CT image and also use the CT for attenuation correction. In any practical hospital setting, 1 hour is too long to occupy the scanner bed and a second CT procedure thus becomes necessary. This study tries to validate to what extent the dose/quality of the second CT scan can be lowered, without...... compromising attenuation correction, lesion detection and quantification. Using a standard NEMA phantom with the GE Discovery PET/CT scanner, taken in and out between scan sessions, we have tried to find the minimal CT dose necessary for the second scan while still reaching tissue activity quantification...

  2. Total-body CT scanning in trauma patients: Benefits and boundaries

    NARCIS (Netherlands)

    Sierink, J.C.


    Computed tomography (CT) scanning has become essential in the early diagnostic phase of trauma care. It is a fast and highly accurate modality for the identification of various injuries and it enables a rapid response to life-threatening problems. Especially total-body CT (TBCT) scanning is increasi

  3. Radionuclide bone scanning in neuroblastoma: skeletal metastases and primary tumor localization of /sup 99m/Tc-MDP

    Energy Technology Data Exchange (ETDEWEB)

    Podrasky, A.E.; Stark, D.D.; Hattner, R.S.; Gooding, C.A.; Moss, A.A.


    Of 42 radionuclide bone scans in 35 children with neuroblastoma, 21 were abnormal for the presence of skeletal metastases. Of the 21 abnormal scans, 16 were corroborated by positive bone-marrow biopsy or clinical data. The false-negative and false-positive rates for bone scanning were 4.8% and 9.5%, respectively. Calcification of the primary tumor was seen on pretreatment computed tomographic (CT) scans in 24 (89%) of 27 cases, while only 13 (48%) of 27 were detectable by plain radiographs. Uptake of /sup 99m/Tc methylene diphosphate /sup 99m/Tc-MDP) by the primary tumor occurred in 20 of 27 cases, but correlation between tumor uptake and calcification was not statistically significant. All children with markedly elevated urinary vanillylmandelic acid exhibited primary tumor uptake. Survival was not affected independently by primary tumor uptake.

  4. Quantification and visualization of alveolar bone resorption from 3D dental CT images

    Energy Technology Data Exchange (ETDEWEB)

    Nagao, Jiro; Mori, Kensaku; Kitasaka, Takayuki; Suenaga, Yasuhito [Nagoya University, Graduate School of Information Science, Nagoya (Japan); Yamada, Shohzoh; Naitoh, Munetaka [Aichi-Gakuin University, School of Dentistry, Nagoya (Japan)


    Purpose A computer aided diagnosis (CAD) system for quantifying and visualizing alveolar bone resorption caused by periodontitis was developed based on three-dimensional (3D) image processing of dental CT images. Methods The proposed system enables visualization and quantification of resorption of alveolar bone surrounding and between the roots of teeth. It has the following functions: (1) vertical measurement of the depth of resorption surrounding the tooth in 3D images, avoiding physical obstruction; (2) quantification of the amount of resorption in the furcation area; and (3) visualization of quantification results by pseudo-color maps, graphs, and motion pictures. The resorption measurement accuracy in the area surrounding teeth was evaluated by comparing with dentist's recognition on five real patient CT images, giving average absolute difference of 0.87 mm. An artificial image with mathematical truth was also used for measurement evaluation. Results The average absolute difference was 0.36 and 0.10 mm for surrounding and furcation areas, respectively. The system provides an intuitive presentation of the measurement results. Conclusion Computer aided diagnosis of 3D dental CT scans is feasible and the technique is a promising new tool for the quantitative evaluation of periodontal bone loss. (orig.)

  5. In vivo longitudinal micro-CT study of bent long limb bones in rat offspring. (United States)

    De Schaepdrijver, Luc; Delille, Peter; Geys, Helena; Boehringer-Shahidi, Christian; Vanhove, Christian


    Micro-computed X-ray tomography (micro-CT) has been reported as a reliable method to assess ex vivo rat and rabbit fetal skeletons in embryo-fetal developmental toxicity studies. Since micro-CT is a non-invasive imaging modality it has the potential for longitudinal, in vivo investigation of postnatal skeletal development. This is the first paper using micro-CT to assess the reversibility of drug-induced bent long bones in a longitudinal study from birth to early adulthood in rat offspring. Analysis of the scans obtained on postnatal Day 0, 7, 21 and 80 showed complete recovery or repair of the bent long limb bones (including the scapula) within the first 3 weeks. When assessing risk the ability to demonstrate recovery is highly advantageous when interpreting such transient skeletal change. In summary, in vivo micro-CT of small laboratory animals can aid in non-clinical safety assessment, particularly for specific mechanistic purposes or to address a particular concern in developmental biology.

  6. Importance of bony analysis for interpreting ear CT scans: part three; ORL - tomodensitometrie de l'oreille. Interet de l'analyse osseuse dans l'interpretation des scanners de l'oreille (troisieme partie)

    Energy Technology Data Exchange (ETDEWEB)

    Serhal, M.; Dordea, M.; Cymbalista, M. [Hopital de Montfermeil, Service de Radiologie, 93 - Montfermeil (France); Halimi, P. [Hopital Europeen Georges-Pompidou, Service de Radiologie, 75 - Paris (France); Iffenecker, C. [Clinique Radiologique, 62 - Boulogne sur Mer (France); Bensimon, J.L


    The accurate description of bony changes in ear CT scans has a great diagnostic and therapeutic impact. The third part shows the way to analyze bone remodeling when CT scan is performed for tumors in the vicinity of the temporal bone, for intra temporal lesions of the facial nerve and for external auditory canal malformations. It demonstrates how bony analysis should be included in postoperative report of ear CT scan. The importance of bony signs in tumors and pseudo tumors of the inner ear are outlined. (authors)

  7. {sup 18}F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    London, Kevin [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia); Stege, Claudia; Kaspers, Gertjan [VU Medical Centre, Divisions of Paediatric Oncology/Haematology, Amsterdam (Netherlands); Cross, Siobhan; Dalla-Pozza, Luciano [The Children' s Hospital at Westmead, Department of Oncology, Sydney (Australia); Onikul, Ella [The Children' s Hospital at Westmead, Department of Medical Imaging, Sydney (Australia); Graf, Nicole [The Children' s Hospital at Westmead, Department of Pathology, Sydney (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Imaging, Sydney Medical School, Sydney, NSW (Australia)


    F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV{sub max} and greater SUV{sub max} reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

  8. Non-invasive transcranial ultrasound therapy based on a 3D CT scan: protocol validation and in vitro results

    Energy Technology Data Exchange (ETDEWEB)

    Marquet, F; Pernot, M; Aubry, J-F; Montaldo, G; Tanter, M; Fink, M [Laboratoire Ondes et Acoustique, ESPCI, Universite Paris VII, UMR CNRS 7587, 10 rue Vauquelin, 75005 Paris (France); Marsac, L [Supersonic Imagine, Les Jardins de la Duranne, 510 rue Rene Descartes, 13857 Aix-en-Provence (France)], E-mail:


    A non-invasive protocol for transcranial brain tissue ablation with ultrasound is studied and validated in vitro. The skull induces strong aberrations both in phase and in amplitude, resulting in a severe degradation of the beam shape. Adaptive corrections of the distortions induced by the skull bone are performed using a previous 3D computational tomography scan acquisition (CT) of the skull bone structure. These CT scan data are used as entry parameters in a FDTD (finite differences time domain) simulation of the full wave propagation equation. A numerical computation is used to deduce the impulse response relating the targeted location and the ultrasound therapeutic array, thus providing a virtual time-reversal mirror. This impulse response is then time-reversed and transmitted experimentally by a therapeutic array positioned exactly in the same referential frame as the one used during CT scan acquisitions. In vitro experiments are conducted on monkey and human skull specimens using an array of 300 transmit elements working at a central frequency of 1 MHz. These experiments show a precise refocusing of the ultrasonic beam at the targeted location with a positioning error lower than 0.7 mm. The complete validation of this transcranial adaptive focusing procedure paves the way to in vivo animal and human transcranial HIFU investigations.

  9. Non-invasive transcranial ultrasound therapy based on a 3D CT scan: protocol validation and in vitro results (United States)

    Marquet, F.; Pernot, M.; Aubry, J.-F.; Montaldo, G.; Marsac, L.; Tanter, M.; Fink, M.


    A non-invasive protocol for transcranial brain tissue ablation with ultrasound is studied and validated in vitro. The skull induces strong aberrations both in phase and in amplitude, resulting in a severe degradation of the beam shape. Adaptive corrections of the distortions induced by the skull bone are performed using a previous 3D computational tomography scan acquisition (CT) of the skull bone structure. These CT scan data are used as entry parameters in a FDTD (finite differences time domain) simulation of the full wave propagation equation. A numerical computation is used to deduce the impulse response relating the targeted location and the ultrasound therapeutic array, thus providing a virtual time-reversal mirror. This impulse response is then time-reversed and transmitted experimentally by a therapeutic array positioned exactly in the same referential frame as the one used during CT scan acquisitions. In vitro experiments are conducted on monkey and human skull specimens using an array of 300 transmit elements working at a central frequency of 1 MHz. These experiments show a precise refocusing of the ultrasonic beam at the targeted location with a positioning error lower than 0.7 mm. The complete validation of this transcranial adaptive focusing procedure paves the way to in vivo animal and human transcranial HIFU investigations.

  10. Body surface area determined by whole-body CT scanning: need for new formulae?

    DEFF Research Database (Denmark)

    Villa, Chiara; Primeau, Charlotte; Hesse, Ulrik;


    Calculation of the estimated body surface area (BSA) by body height and weight has been a challenge in the past centuries due to lack of a well-documented gold standard. More recently, available techniques such as 3D laser surface scanning and CT scanning may be expected to quantify the BSA...... in an easier and more accurate way. This study provides the first comparison between BSA obtained from post-mortem whole-body CT scans and BSA calculated by nine predictive formulae. The sample consisted of 54 male cadavers ranging from 20 to 87 years old. 3D reconstructions were generated from CT scans using...

  11. Optimized Temporal Window for Detection and Characterization of Renal Cell Carcinomas with Dynamic CT Scanning

    Institute of Scientific and Technical Information of China (English)

    Jinhong Wang; Peijun Wang; Xiaohu Zhao; Xinqin Mao; Xiaolong Gao; Jun Liu


    OBJECTIVE To investigate the optimized time period for detection and characterization of renal cell carcinomas (RCC) when the specific CT features appear during spiral dynamic CT scanning, and to optimize an effective scanning protocol of spiral CT for evaluating RCC.METHODS Twenty-four patients with RCC verified by pathology had undergone a dynamic CT (D-CT) scan. A plain scan was employed to select the target slice. Single-level dynamic scanning started at 14-17 s after the intravenous contrast media had been administered, with a scan interval of 4.9 s acquiring a total number of 17~24 frames. A regular CT scan of the whole kidney followed by a delayed single slice acquisition through the target slice in the excretory phase was performed. Images were assessed in two ways: (1) A group of experienced radiologists reviewed the CT images to find when the specific signs appeared and when the CT features of RCC were optimally displayed; (2) Data measurement of the time-density curves (T-DC) of RCC. The exact time was obtained when the densities of the tumor, renal parenchyma, medulla and aorta reached their peak enhancement, thus also the time when the density difference between tumor and parenchyma was at maximum (Max T-M). Based on the slope of the contrast media uptake curve, T-DC types were ranked from the smallest to the biggest of slope as type A, B and C.RESULTS 1. The review of the CT images by the radiologists showed that the CT features of RCC were optimally demonstrated at 70.2 s. The earliest time at which RCC CT features were examined was at 23.9 s. 2. Image data analysis: the time that the density (or CT value) of the tumor mass reached peak enhancement was at 54 s and peak value was at 80.4 Hu for RCC. The time of the maximal difference of densities between tumor and renal parenchyma was at 102 s.CONCLUSION The following proposal is the scanning protocol for detecting RCC recommended by our research: After a plain scan to determine the target level, a

  12. CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Jae; Choi, A. Lam; Yie, Mi-Yeon; Yoon, Ji Young; Jeon, Eui Yong; Koh, Sung Hye; Yoon, Dae Young; Lim, Kyung Ja (Dept. of Radiology, Hallym Univ. Sacred Heart Hospital, Seoul (Korea)), e-mail:; Im, Hyoung June (Dept. of Occupational Medicine, Hallym Univ. College of Medicine, Seoul (Korea))


    Background: Percutaneous injection of bone cement (acrylic cement) during percutaneous kyphoplasty and vertebroplasty can cause symptomatic or asymptomatic complications due to leakage, extravasation or vascular migration of cement. Purpose: To investigate and to compare the incidence and site of local leakage or complications of bone cement after percutaneous kyphoplasty and vertebroplasty using bone cement. Material and Methods: We retrospectively reviewed 473 cases of percutaneous kyphoplasty or vertebroplasty performed under fluoroscopic guidance. Of the 473 cases, follow-up CT scans that covered the treated bones were available for 83 cases (59 kyphoplasty and 24 vertebroplasty). Results: The rate of local leakage of bone cement was 87.5% (21/24) for percutaneous vertebroplasty and 49.2% (29/59) for kyphoplasty. The most common site of local leakage was perivertebral soft tissue (n=8, 38.1%) for vertebroplasty. The most common site of local leakage was a perivertebral vein (n=7, 24.1%) for kyphoplasty. Two cases of pulmonary cement embolism developed: one case after kyphoplasty and one case after vertebroplasty. Conclusion: Local leakage of bone cement was more common for percutaneous vertebroplasty compared with kyphoplasty (P<0.005). The most common sites of local leakage were perivertebral soft tissue and perivertebral vein.

  13. The value of baseline CT head scans in the assessment of shunt complications in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Cantrell, P. (Alder Hey Children' s Hospital, Liverpool (United Kingdom)); Fraser, F. (Alder Hey Children' s Hospital, Liverpool (United Kingdom)); Pilling, D. (Alder Hey Children' s Hospital, Liverpool (United Kingdom)); Carty, H. (Alder Hey Children' s Hospital, Liverpool (United Kingdom))


    The purpose of this study was to determine the value of a baseline CT head scan in the assessment of patients who subsequently presented with symptoms which may have been due to shunt complications (such as blockage or infection). In all these patients the shunt had been inserted in the treatment of hydrocephalus. We conclude that the presence of a baseline scan does not add to the interpretation of CT scans done when the patient presents with symptoms of possible shunt malfunction. (orig.)

  14. Immediate periodontal bone plate changes induced by rapid maxillary expansion in the early mixed dentition: CT findings

    Directory of Open Access Journals (Sweden)

    Daniela Gamba Garib


    Full Text Available OBJECTIVE: This study aimed at evaluating buccal and lingual bone plate changes caused by rapid maxillary expansion (RME in the mixed dentition by means of computed tomography (CT. METHODS: The sample comprised spiral CT exams taken from 22 mixed dentition patients from 6 to 9 years of age (mean age of 8.1 years presenting constricted maxillary arch treated with Haas-type expanders. Patients were submitted to spiral CT scan before expansion and after the screw activation period with a 30-day interval between T1 and T2. Multiplanar reconstruction was used to measure buccal and lingual bone plate thickness and buccal bone crest level of maxillary posterior deciduous and permanent teeth. Changes induced by expansion were evaluated using paired t test (p < 0.05. RESULTS: Thickness of buccal and lingual bone plates of posterior teeth remained unchanged during the expansion period, except for deciduous second molars which showed a slight reduction in bone thickness at the distal region of its buccal aspect. Buccal bone dehiscences were not observed in the supporting teeth after expansion. CONCLUSION: RME performed in mixed dentition did not produce immediate undesirable effects on periodontal bone tissues.

  15. Correction of step artefact associated with MRI scanning of long bones. (United States)

    Rathnayaka, Kanchana; Cowin, Gary; Schuetz, Michael A; Sahama, Tony; Schmutz, Beat


    3D models of long bones are being utilised for a number of fields including orthopaedic implant design. Accurate reconstruction of 3D models is of utmost importance to design accurate implants to allow achieving a good alignment between two bone fragments. Thus for this purpose, CT scanners are employed to acquire accurate bone data exposing an individual to a high amount of ionising radiation. Magnetic resonance imaging (MRI) has been shown to be a potential alternative to computed tomography (CT) for scanning of volunteers for 3D reconstruction of long bones, essentially avoiding the high radiation dose from CT. In MRI imaging of long bones, the artefacts due to random movements of the skeletal system create challenges for researchers as they generate inaccuracies in the 3D models generated by using data sets containing such artefacts. One of the defects that have been observed during an initial study is the lateral shift artefact occurring in the reconstructed 3D models. This artefact is believed to result from volunteers moving the leg during two successive scanning stages (the lower limb has to be scanned in at least five stages due to the limited scanning length of the scanner). As this artefact creates inaccuracies in the implants designed using these models, it needs to be corrected before the application of 3D models to implant design. Therefore, this study aimed to correct the lateral shift artefact using 3D modelling techniques. The femora of five ovine hind limbs were scanned with a 3T MRI scanner using a 3D vibe based protocol. The scanning was conducted in two halves, while maintaining a good overlap between them. A lateral shift was generated by moving the limb several millimetres between two scanning stages. The 3D models were reconstructed using a multi threshold segmentation method. The correction of the artefact was achieved by aligning the two halves using the robust iterative closest point (ICP) algorithm, with the help of the overlapping

  16. Pulmonary infections following bone marrow transplantation: High-resolution CT findings in 35 paediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Davaus Gasparetto, Taisa [Department of Diagnostic Radiology of the Federal Universitie Fluminense, Niteroi (Brazil); Federal University of Rio de Janeiro, Rio de Janeiro (Brazil)], E-mail:; Escuissato, Dante L. [Department of Diagnostic Radiology of the University of Parana, Curitiba (Brazil); Marchiori, Edson [Department of Diagnostic Radiology of the Federal Universitie Fluminense, Niteroi (Brazil); Federal University of Rio de Janeiro, Rio de Janeiro (Brazil)


    Purpose: The purpose of this study was to assess the high-resolution CT findings of paediatric patients who had pulmonary infections following bone marrow transplantation (BMT), and to evaluate the differential diagnosis through high-resolution CT of the various pathogens responsible for pulmonary infections after BMT. Patients and methods: The study included 35 consecutive patients who had documented pulmonary infection, high-resolution CT of the chest performed within 24 h of the beginning of symptoms, and proven diagnosis within 1 week of the onset of symptoms. The pulmonary infections were due to viruses (n = 16), bacteria (n = 9), fungi (n = 9), and protozoa (n = 1). Two radiologists analyzed the CT scans and reached final decisions regarding the findings by consensus. Results: Four patients with confirmed pneumonia had normal high-resolution CT scans. Regarding the viral infections, the most frequent features were areas of ground-glass attenuation (43.7%) and small centrilobular nodules (31.2%). Airspace consolidation (88.9%), small centrilobular nodules (22.2%) and ground-glass attenuation (22.2%) were the most frequent findings in patients with bacterial pneumonia following BMT. Large nodules were seen in 66.7% of the patients with fungal pneumonia, and in only one case of virus infection. The 'halo sign' (n = 5) was seen only in patients with fungal pneumonia. Conclusion: In conclusion, the main causes of pulmonary infection in paediatric patients following BMT share similar high-resolution CT findings. Large nodules and 'halo sign' are more common in patients with fungal infections.

  17. Usefulness of three-phase bone scintigraphy and SPECT/CT for the diagnosis of bone lesions of systemic sarcoidosis

    Directory of Open Access Journals (Sweden)

    Shigeaki Higashiyama


    The findings of the three-phase bone scintigraphy and SPECT/CT suggested the presence of systemic sarcoidosis; however, a subsequent 18Ffluorodeoxyglucose positron emission tomography/CT (FDG-PET/CT could not exclude the possibility of multiple metastases from testicular tumors. Therefore, testicular enucleation was performed, and the pathological examination confirmed the presence of sarcoidosis.

  18. Patient dose estimation from CT scans at the Mexican National Neurology and Neurosurgery Institute (United States)

    Alva-Sánchez, Héctor; Reynoso-Mejía, Alberto; Casares-Cruz, Katiuzka; Taboada-Barajas, Jesús


    In the radiology department of the Mexican National Institute of Neurology and Neurosurgery, a dedicated institute in Mexico City, on average 19.3 computed tomography (CT) examinations are performed daily on hospitalized patients for neurological disease diagnosis, control scans and follow-up imaging. The purpose of this work was to estimate the effective dose received by hospitalized patients who underwent a diagnostic CT scan using typical effective dose values for all CT types and to obtain the estimated effective dose distributions received by surgical and non-surgical patients. Effective patient doses were estimated from values per study type reported in the applications guide provided by the scanner manufacturer. This retrospective study included all hospitalized patients who underwent a diagnostic CT scan between 1 January 2011 and 31 December 2012. A total of 8777 CT scans were performed in this two-year period. Simple brain scan was the CT type performed the most (74.3%) followed by contrasted brain scan (6.1%) and head angiotomography (5.7%). The average number of CT scans per patient was 2.83; the average effective dose per patient was 7.9 mSv; the mean estimated radiation dose was significantly higher for surgical (9.1 mSv) than non-surgical patients (6.0 mSv). Three percent of the patients had 10 or more brain CT scans and exceeded the organ radiation dose threshold set by the International Commission on Radiological Protection for deterministic effects of the eye-lens. Although radiation patient doses from CT scans were in general relatively low, 187 patients received a high effective dose (>20 mSv) and 3% might develop cataract from cumulative doses to the eye lens.

  19. Patient dose estimation from CT scans at the Mexican National Neurology and Neurosurgery Institute

    Energy Technology Data Exchange (ETDEWEB)

    Alva-Sánchez, Héctor, E-mail: [Unidad de Imagen Molecular PET/CT, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Insurgentes Sur 3877 Col. La Fama, 14269, México D.F. (Mexico); Reynoso-Mejía, Alberto [Unidad de Imagen Molecular PET/CT, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Insurgentes Sur 3877 Col. La Fama, 14269, México D.F., Mexico and Departamento de Neuroimagen, Instituto Nacional de (Mexico); Casares-Cruz, Katiuzka; Taboada-Barajas, Jesús [Departamento de Neuroimagen, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Insurgentes Sur 3877 Col. La Fama, 14269, México D.F. (Mexico)


    In the radiology department of the Mexican National Institute of Neurology and Neurosurgery, a dedicated institute in Mexico City, on average 19.3 computed tomography (CT) examinations are performed daily on hospitalized patients for neurological disease diagnosis, control scans and follow-up imaging. The purpose of this work was to estimate the effective dose received by hospitalized patients who underwent a diagnostic CT scan using typical effective dose values for all CT types and to obtain the estimated effective dose distributions received by surgical and non-surgical patients. Effective patient doses were estimated from values per study type reported in the applications guide provided by the scanner manufacturer. This retrospective study included all hospitalized patients who underwent a diagnostic CT scan between 1 January 2011 and 31 December 2012. A total of 8777 CT scans were performed in this two-year period. Simple brain scan was the CT type performed the most (74.3%) followed by contrasted brain scan (6.1%) and head angiotomography (5.7%). The average number of CT scans per patient was 2.83; the average effective dose per patient was 7.9 mSv; the mean estimated radiation dose was significantly higher for surgical (9.1 mSv) than non-surgical patients (6.0 mSv). Three percent of the patients had 10 or more brain CT scans and exceeded the organ radiation dose threshold set by the International Commission on Radiological Protection for deterministic effects of the eye-lens. Although radiation patient doses from CT scans were in general relatively low, 187 patients received a high effective dose (>20 mSv) and 3% might develop cataract from cumulative doses to the eye lens.

  20. Is It Possible to Predict Heart Rate and Range during Enhanced Cardiac CT Scan from Previous Non-enhanced Cardiac CT?


    Horiguchi, Jun; Yamamoto, Hideya; Arie, Ryuichi; Kiguchi, Masao; Fujioka, Chikako; Ohtaki, Megu; Kihara, Yasuki; Awai, Kazuo


    The effect of heart rate and variation during cardiac computed tomography (CT) on the examination quality. The purpose of this study is to investigate whether it is possible to predict heart rate and range during enhanced cardiac computed CT scan from previous non-enhanced cardiac CT scan. Electrocardiograph (ECG) files from 112 patients on three types of cardiac 64-slice CT (non-enhanced, prospective ECG-triggered and retrospective ECG-gated enhanced scans) were recorded. The mean heart rate...

  1. Vascular anatomy of the liver and porta hepatis with dynamic CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Hiramatsu, Yoshihiro; Wada, Mitsuyoshi; Nakajima, Teiichi; Tonooka, Reiko; Matsumoto, Kunihiko


    Vascular anatomy of the liver and porta heaptis demonstrated by dynamic CT scan was studied Identification of the individual vessels was sometimes difficult due to slight differencies in respiratory depths among the scans. Limitation in the number of slices also made the evalution of the vascular anatomy difficult. Angiography was therefore utilized for comparison in identifying the vessels. Dynamic CT scan was proved to be usefull in demonstrating the anteroposterior relationship of the vessels and surrounding structures, which is difficult with convetional angiography without multiple projections. Three dimensional understanding of the vessels was then possible with dynamic CT scan and angiography. When combined with recently advancing digital subtraction angiography, dynamic CT scan might reduce the necessity for conventional angiography with Seldinger's technique. (author).

  2. Brain tumors and CT scan in infants and children, (1). The impact on pediatric neuroradiology

    Energy Technology Data Exchange (ETDEWEB)

    Ohi, S.; Velasco, J.M. (Northwestern Univ., Chicago, IL (USA). Medical School)


    The dramatic change in the neuroradiological procedures have been noted after CT scan was introduced in the last several years. Remarkable decreasing numbers of angiographic, pneumoencephalographic and other invasive neuroradiologic studies as well as nuclear brain scan were also found in the pediatric neuroradiology. The authors analyzed the total numbers of these studies performed in the last several years in pediatric neurological/neurosurgical practice in the light of the impact of CT scan especially in the diagnostic procedures and treatments of brain tumor in children. Although the number of these procedures decreased up to 49% in plain skull X-ray, 54% in cerebral angiography, 70% in pneumoencephalography/ventriculography and 79% in nuclear brain scan after CT scan was installed in our results, it is extremely important to renew understanding of those characteristics in each special procedures. Cerebral angiography as well as pneumoencephalography may give the surgeon more precise ideas of the anatomical relationship between the lesion and other normal structures, especially in the posterior fossa tumor in which CT scan occassionally demonstrates only a gross finding. A case with false negative result and another case with a complicated anatomical structure in CT scan were presented. The significance of cerebral angiography and other invasive studies in the diagnosis and follow up of brain tumor in CT scan were discussed.

  3. The Beatles, the Nobel Prize, and CT scanning of the chest. (United States)

    Goodman, Lawrence R


    From its first test scan on a mouse, in 1967, to current medical practice, the CT scanner has become a core imaging tool in thoracic diagnosis. Initially financed by money from Beatles' record sales, the first patient scan was performed in 1971. Only 8 years later, a Nobel Prize in Physics and Medicine was awarded to Hounsfield and Cormack for their discovery. This article traces the history of CT scanner development and how each technical advance expanded chest diagnostic frontiers. Chest imaging now accounts for 30% of all CT scanning.

  4. Visual and quantitative approach to bone marrow foci of increased glucose uptake on PET/CT in a case of aplastic anaemia

    Energy Technology Data Exchange (ETDEWEB)

    Cicone, F. [Sant' Andrea Hospital, Univ. La Sapienza, Rome (Italy). Nuclear Medicine Dept.; Centre Hospitalier Univ. Vaudois (Switzerland). Nuclear Medicine; Lausanne Univ. (Switzerland); Stalder, M. [Institut Central des Hopitaux Valaisans, Sion (Switzerland). Service of Hematology; Cairoli, A. [Centre Hospitalier Univ. Vaudois (Switzerland). Service of Hematology; Lausanne Univ. (Switzerland); Bischof Delaloye, A.; Prior, J.O. [Centre Hospitalier Univ. Vaudois (Switzerland). Nuclear Medicine; Lausanne Univ. (Switzerland); Geiger, D.


    This case report shows the clinical impact of a FDG-PET/CT in the assessment of bone marrow (BM) of a patient with aplastic anemia. The feasibility of a quantitative approach to BM intensities on FDG-PET is also discussed. In the authors' opinion, a deeper understanding of the factors that might independently affect FDG uptake and the definition of normal ranges of BM SUV (standardized uptake value) might help to interpret PET/CT images. Further research is needed to understand the physio-pathological basis of FDG uptake in BM and the potential value of its quantification. The analysis of the bone marrow on PET/CT is an interesting field of research. A PET/CT scan contributed to differential diagnosis in a patient with suspected bone marrow aplasia for guiding bone marrow biopsies.

  5. Value of CT scan in the diagnosis of primary large bowel lymphoma

    Institute of Scientific and Technical Information of China (English)

    赵修义; 张雪林; 王劲; 郑卫权; 文戈


    Objective:To study the CT imaging of primary large bowel lymphoma and evaluate the value of CT scan.Methods:CT reports of 8 patients with proven primary large bowel lymphoma were retrospectively reviewed.Plain CT scans were done on all patients,enhanced CT scans simultaneously with 5 - 10 mm section thickness,and 5 - 10 mm table increments in 6 cases.Results:Primary involved sites were on the cecum(n = 3),the ascending colon(n = 2),and the rectum(n = 1).The tumor was found in multiple areas of the large bowel in 2 cases.CT appearance fell into 3 typical patterns in our study.The first was focal mass type in 2 cases,with one combined with intussusception and retroperitoneal adenopathy; the second was segmental annular involvement type in 3 cases,with one of them combined with mesenteric adenopathy; the last was diffuse involvement type in 2 cases.Multiple nodules were seen in the rectum in 1 case.Conclusion:CT was found to be accurate in detecting the primary sites and complications of lymphoma,and evaluating invasion of adjacent structures; Focal mass type,segmental annular involvement type and diffuse involvement type are the main patterns of CT features in the primary large bowel lymphoma; The features revealed by CT scan are suggestive of primary large bowel lymphoma in some cases.

  6. Technetium bone scanning as an aid in the diagnosis of atypical acute osteomyelitis in children

    Energy Technology Data Exchange (ETDEWEB)

    Letts, R.M.; Afifi, A.; Sutherland, J.B.


    Technetium bone scanning is a simple, safe and accurate method for the diagnosis of acute osteomyelitis in children whose presenting clinical findings are atypical of bone infection. Bone scanning was effective in the localization of the exact site of osteomyelitis, thus facilitating needle aspiration as well as subsequent surgical decompression. Technetium bone scanning is a diagnostic technique for determining bone infection in children who are unable to communicate adequately or in those whose signs have been modified by previous inadequate antibacterial therapy.

  7. Comparison of FDG-PET/CT and bone scintigraphy for detection of bone metastases in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Steffen; Heusner, Till; Forsting, Michael; Antoch, Gerald (Dept. of Diagnostic and Interventional Radiology and Neuroradiology, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)), email:; Kuemmel, Sherko; Koeninger, Angelika (Dept. of Gynecology and Obstetrics, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)); Nagarajah, James; Mueller, Stefan; Boy, Christian; Bockisch, Andreas; Stahl, Alexander (Dept. of Nuclear Medicine, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany))


    Background Bone scintigraphy is the standard procedure for the detection of bone metastases in breast cancer patients. FDG-PET/CT has been reported to be a sensitive tool for tumor staging in different malignant diseases. However, its accuracy for the detection of bone metastases has not been compared to bone scintigraphy. Purpose To compare whole-body FDG-PET/CT and bone scintigraphy for the detection of bone metastases on a lesion basis in breast cancer patients. Material and Methods Twenty-nine consecutive women (mean age 58 years, range 35-78 years) with histologically proven breast cancer were assessed with bone scintigraphy and whole-body FDG-PET/CT. Twenty-one patients (72%) were suffering from primary breast cancer and eight patients (28%) were in aftercare with a history of advanced breast cancer. Both imaging procedures were assessed for bone metastases by a radiologist and a nuclear medicine physician. Concordant readings between bone scintigraphy and FDG-PET/CT were taken as true. Discordant readings were verified with additional MRI imaging in all patients and follow-up studies in most patients. Results A total of 132 lesions were detected on bone scintigraphy, FDG-PET/CT or both. According to the reference standard, 70/132 lesions (53%) were bone metastases, 59/132 lesions (45%) were benign, and three lesions (2%) remained unclear. The sensitivity of bone scintigraphy was 76% (53/70) compared to 96% (67/70) for FDG-PET/CT. The specificity of bone scintigraphy and FDG-PET/CT was 95% (56/59) and 92% (54/59), respectively. According to the reference standard bone metastases were present in eight out of the 29 patients (28%), whereas 20 patients (69%) were free of bone metastases. One (3%) patient had inconclusive readings on both modalities as well as on MRI and follow-up studies. Bone scintigraphy and FDG-PET/CT correctly identified seven out of eight patients with bone metastases and 20 out of 20 patients free of metastases. Conclusion On a lesion

  8. Bone and gallium scans in mastocytosis: correlation with count rates, radiography, and microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Ensslen, R.D. (Cross Cancer Inst., Edmonton, Alberta); Jackson, F.I.; Reid, A.M.


    Mastocytosis (urticaria pigmentosa) was proven in a patient suffering from severe back pain. A bone scan showed diffusely increased bone activity. Count rates were also abnormally elevated over several areas of the skeleton. Radiographs were consistent with mastocytosis in bone.


    Directory of Open Access Journals (Sweden)

    Arun Kumar


    Full Text Available BACKGROUND: The accurate diagnosis of Chronic Rhinosinusitis (CRS is still a challenge therefore, the American Academy of Otorhinolaryngology - Head and Neck Surgery (AAO - HNS 1 has met in a multidisciplinary encounter and formulated a consensus based on only clinical symptoms. The computed tomography (CT scan and the nasal endoscopy (NE were introduced to make an accurate diagnosis of CRS and verify the disease severity. AIM: The aim of this study is to make a correlation between nasal endoscopy and CT scan in cases of clinically diagnosed Chronic Rhinosinusitis patients. METHOD: A study was carried out on 90 patients at Jhalawar Medical College, Jhalawar (Raj. during Sept. 20 12 to Dec. 2014. Diagnostic Nasal Endoscopy and CT Scan PNS done in patients, suffering from Chronic Rhinosinusitis. As a classification instruments, Metson / Gliklich's classification was used to evaluate the tomographic diagnosis and the Stankiewicz / Chow' s classification to evaluate the endoscopic diagnosis of Chronic Rhinosinusitis. RESULTS: Our study showed high specificity of endoscopy in comparison to CT scan though CT scan results are more sensitive. CONCLUSION: Endoscopy can confirm a Chronic Rhinosi nusitis diagnosis, but cannot rule it out, and that CT should be performed in cases of suspected CRS even if mucopurulence is not noted on endoscopy. The CT scan and the nasal endoscopy making easier the treatment planning and the disease resolution.

  10. 11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma

    Directory of Open Access Journals (Sweden)

    Ambrosini Valentina


    Full Text Available Abstract Background Multiple Myeloma (MM is a B cell neoplasm causing lytic or osteopenic bone abnormalities. Whole body skeletal survey (WBSS, Magnetic resonance (MR and 18F-FDG PET/CT are imaging techniques routinely used for the evaluation of bone involvement in MM patients. Aim As MM bone lesions may present low 18F-FDG uptake; the aim of this study was to assess the possible added value and limitations of 11C-Choline to that of 18F-FDG PET/CT in patients affected with MM. Methods Ten patients affected with MM underwent a standard 11C-Choline PET/CT and an 18F-FDG PET/CT within one week. The results of the two scans were compared in terms of number, sites and SUVmax of lesions. Results Four patients (40% had a negative concordant 11C-Choline and 18F-FDG PET/CT scans. Two patients (20% had a positive 11C-Choline and 18F-FDG PET/CT scans that identified the same number and sites of bone lesions. The remaining four patients (40% had a positive 11C-Choline and 18F-FDG PET/CT scan, but the two exams identified different number of lesions. Choline showed a mean SUVmax of 5 while FDG showed a mean SUVmax of 3.8 (P = 0.042. Overall, 11C-Choline PET/CT scans detected 37 bone lesions and 18F-FDG PET/CT scans detected 22 bone lesions but the difference was not significant (P = 0.8. Conclusion According to these preliminary data, 11C-Choline PET/CT appears to be more sensitive than 18F-FDG PET/CT for the detection of bony myelomatous lesions. If these data are confirmed in larger series of patients, 11C-Choline may be considered a more appropriate functional imaging in association with MRI for MM bone staging.

  11. Dental CT and orthodontic implants: imaging technique and assessment of available bone volume in the hard palate

    Energy Technology Data Exchange (ETDEWEB)

    Gahleitner, Andre E-mail:; Podesser, Birgit; Schick, Susanne; Watzek, Georg; Imhof, Herwig


    Purpose: Palatal implants (PI) have been introduced for orthodontic treatment of dental and skeletal dysgnathia. Due to the restricted amount of bone in this region, precise preoperative anatomic information is necessary. The aim of this study was to determine whether dental CT could serve as a tool to locate the optimal size and position for orthodontic implant placement. Materials and methods: In 32 patients, where palatal implant placement was planned, axial CT scans of the maxillary bone were acquired. Using a standard dental software package (Easy Vision dental software package 2.1, Philips; Best, The Netherlands), paracoronal views were reconstructed and measurements of palatal bone height in 3 mm increments, dorsally from the incisive canal, were performed in the median and both paramedian regions. Results: The overall mean bone height was 5.01 mm (S.D. 2.60), ranging from 0 to 16.9 mm. The maximum palatal bone height was 6.17 mm (S.D. 2.81) at 6 mm dorsally from the incisive canal. Due to the lack of adequate bone (less than 4 mm), implant placement was not performed in 3 cases (7%). In the remaining 39 cases (93.0%), primary implant stability was achieved and complications, such as perforation of the palate, could be avoided. Conclusion: The results demonstrate that dental CT promises to be a valuable tool in evaluating the potential and optimal size and site for orthodontic implant placement.

  12. The use of CT-scanning at the medicolegal external postmortem examination and at the forensic autopsy

    DEFF Research Database (Denmark)

    Leth, Peter Mygind


    Introduction: Can CT-scanning of deceased at the medico legal external examination improve the selection of cases to autopsy? Is CT-scanning a substitute or a supplement to the traditional forensic autopsy? Material: In 2006 60 deceased individuals from Southern Denmark (counties of Fyn and Sønde......Introduction: Can CT-scanning of deceased at the medico legal external examination improve the selection of cases to autopsy? Is CT-scanning a substitute or a supplement to the traditional forensic autopsy? Material: In 2006 60 deceased individuals from Southern Denmark (counties of Fyn...... and Sønderjylland) (15 females and 45 males) were CT-scanned before autopsy. Method: A double-blind prospective investigation of CT-scanning in autopsy cases. A multislice spiral CT-scanner (Siemens Somatom Spirit) was used. Data from the CT-scanning and the autopsy were registered in a computer database...

  13. An Effort to Develop an Algorithm to Target Abdominal CT Scans for Patients After Gastric Bypass. (United States)

    Pernar, Luise I M; Lockridge, Ryan; McCormack, Colleen; Chen, Judy; Shikora, Scott A; Spector, David; Tavakkoli, Ali; Vernon, Ashley H; Robinson, Malcolm K


    Abdominal CT (abdCT) scans are frequently ordered for Roux-en-Y gastric bypass (RYGB) patients presenting to the emergency department (ED) with abdominal pain, but often do not reveal intra-abdominal pathology. We aimed to develop an algorithm for rational ordering of abdCTs. We retrospectively reviewed our institution's RYGB patients presenting acutely with abdominal pain, documenting clinical and laboratory data, and scan results. Associations of clinical parameters to abdCT results were examined for outcome predictors. Of 1643 RYGB patients who had surgery between 2005 and 2015, 355 underwent 387 abdCT scans. Based on abdCT, 48 (12 %) patients required surgery and 86 (22 %) another intervention. No clinical or laboratory parameter predicted imaging results. Imaging decisions for RYGB patients do not appear to be amenable to a simple algorithm, and patient work-up should be based on astute clinical judgment.

  14. The Findings of {sup 99m}Tc-MDP Bone Scan in Primary malignant Bone Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, In Young; Lee, Kung Han; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Kang, Heung Sik; Lee, Sang Hoon; Lee, Han Koo [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    Tc-99m-MDP bone scan was performed in 31 patients with primary malignant bone tumors, 22 patients with osteogenic sarcoma, 5 patients with chondrosarcoma and 4 patients with Ewing's sarcoma. The findings were classified by isotope intensity of accumulation in tumor as grade 1 to 3, overall pattern of isotope distribution in tumor as grade 1 to 3, and distortion of bony outline as grade 1 to 3. Histologic classifications were correlated with scan findings in 22 patients with osteogenic sarcoma. The results were as follows. 1) In 22 patients with osteogenic sarcoma, markedly increased isotope intensity higher than sacroiliac joint with patchy areas of decreased intensity and severe bony distortion were found in 16 patients. The correlations between histologic classification and scan findings were not discovered. 2) In 5 patients with chondrosarcoma, mildly increased isotope intensity with patchy areas of increased intensity and mild bony distortion were found in 4 patients. 3) In 4 patients with Ewing's sarcoma, markedly increased homogenous intensity with moderate bony distortion were found in 3 patients. Conclusively there were common findings in each 3 primary malignant bone tumors and Tc-99m-MDP bone scan was complemented with radiologic studies in differentiating primary malignant bone tumors.

  15. CT muscle scanning in the evaluation of patients with spinal muscular atrophy (SMA)

    Energy Technology Data Exchange (ETDEWEB)

    Sambrook, P.; Rickards, D.; Cumming, W.J.K.


    One hundred with spinal muscular atrophy (SMA) were assessed by CT scanning using a standardised technique. The spectrum of CT abnormality occurring in SMA was observed and by overall analysis the patients were divided into 4 groups. While the CT appearances of these groups correlated well with clinical assessment of severity of disease, the disease process was usually much more widespread than clinical examination suggested. CT abnormality was first observed in the leg and gluteal muscles, progressing to the posterior spinal, thigh, shoulder girdle and sternomastoid muscles. Hypertrophy of sartorius and gracilis was observed in a significant number of patients. Fascial planes were preserved in involved muscles in over half of the patients, even in late-stage disease. Asymmetrical muscle involvement was seen with increasing frequency as the disease process increased in extent as evaluated by CT scanning. There was no discernible difference in the CT appearances in those patients who clinically had limb-girdle, facioscapulohumeral or scapuloperoneal distribution of weakness.

  16. Heart region segmentation from low-dose CT scans: an anatomy based approach (United States)

    Reeves, Anthony P.; Biancardi, Alberto M.; Yankelevitz, David F.; Cham, Matthew D.; Henschke, Claudia I.


    Cardiovascular disease is a leading cause of death in developed countries. The concurrent detection of heart diseases during low-dose whole-lung CT scans (LDCT), typically performed as part of a screening protocol, hinges on the accurate quantification of coronary calcification. The creation of fully automated methods is ideal as complete manual evaluation is imprecise, operator dependent, time consuming and thus costly. The technical challenges posed by LDCT scans in this context are mainly twofold. First, there is a high level image noise arising from the low radiation dose technique. Additionally, there is a variable amount of cardiac motion blurring due to the lack of electrocardiographic gating and the fact that heart rates differ between human subjects. As a consequence, the reliable segmentation of the heart, the first stage toward the implementation of morphologic heart abnormality detection, is also quite challenging. An automated computer method based on a sequential labeling of major organs and determination of anatomical landmarks has been evaluated on a public database of LDCT images. The novel algorithm builds from a robust segmentation of the bones and airways and embodies a stepwise refinement starting at the top of the lungs where image noise is at its lowest and where the carina provides a good calibration landmark. The segmentation is completed at the inferior wall of the heart where extensive image noise is accommodated. This method is based on the geometry of human anatomy and does not involve training through manual markings. Using visual inspection by an expert reader as a gold standard, the algorithm achieved successful heart and major vessel segmentation in 42 of 45 low-dose CT images. In the 3 remaining cases, the cardiac base was over segmented due to incorrect hemidiaphragm localization.

  17. An autopsy case of otogenic intracranial abscess and meningitis with Bezold's abscess: evaluation of inflammatory bone destruction by postmortem cone-beam CT. (United States)

    Kanawaku, Yoshimasa; Yanase, Takeshi; Hayashi, Kino; Harada, Kazuki; Kanetake, Jun; Fukunaga, Tatsushige


    The deceased was an unidentified young male found unconscious on a walkway. On autopsy, outer and inner fistulae of the left temporal bone, subcutaneous abscess in the left side of the neck and head, and an intracranial abscess were noted. A portion of the left temporal bone was removed and scanned by cone-beam computed tomography (CT) (normally used for dentistry applications) to evaluate the lesion. The cone-beam CT image revealed roughening of the bone wall and hypolucency of the mastoid air cells, consistent with an inflammatory bone lesion. According to autopsy and imaging findings, the cause of death was diagnosed as intracranial abscess with Bezold's abscess secondary to left mastoiditis as a complication of otitis media. Although determining the histopathology of bone specimens is time-consuming and costly work, we believe that use of cone-beam CT for hard tissue specimens can be useful in forensic practice.

  18. Use of CT densitometry to predict lung toxicity in bone marrow transplant patients

    Energy Technology Data Exchange (ETDEWEB)

    el-Khatib, E.E.; Freeman, C.R.; Rybka, W.B.; Lehnert, S.; Podgorsak, E.B.


    Total body irradiation (TBI) is considered an integral part of the preparation of patients with hematological malignancies for marrow transplantation. One of the major causes of death following bone marrow transplantation is interstitial pneumonia. Its pathogenesis is complex but radiation may play a major role in its development. Computed tomography (CT) has been used in animal and human studies as a sensitive non-invasive method for detecting changes in the lung following radiotherapy. In the present study CT scans are studied before and up to 1 year after TBI. Average lung densities measured before TBI showed large variations among the individual patients. On follow-up scans, lung density decreases were measured for patients who did not develop lung complications. Significant lung density increases were measured in patients who subsequently had lung complications. These lung density increases were observed prior to the onset of respiratory complications and could be correlated with the clinical course of the patients, suggesting the possibility for the usage of CT lung densitometry to predict lung complications before the onset of clinical symptoms.

  19. A low density area along the ventricular catheter on CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Yasuo; Ishii, Ryoji; Watanabe, Akira; Hirano, Kazuhiro; Kamada, Masaki; Okamura, Hironari (Kawasaki Medical School, Kurashiki, Okayama (Japan))


    Ten patients with hydrocephalus due to various causes, such as subarachnoid or intraventricular hemorrhage, had low density area (LDA) along the ventricular catheter on CT scans. This is an analysis of the 10 patients, with a discussion of the etiology. Ventriculoperitoneal (VS) shunt was performed in 8 patients, and 3 underwent ventricular drainage. None of the patients had postoperative hemorrhage. According to CT findings, the patients were divided into three groups. The first group consisted of 3 patients whose CT scans showed progressive ventricular dilatation and a presence of LDA along the ventricular catheter. After surgical resolution of high intraventricular pressure, repeated CT scans showed a remarkably decreased ventricles and LDA. In this group, an increased intraventricular pressure may play an important role in the formation of LDA. In the second group consisting of 3 patients, there was no postoperative CT evidence of progressive ventricular dilatation, but LDA was present. Follow-up CT scans revealed a decreased lesion. A slightly increased intraventricular pressure may result in LDA. In the last group of 4 patients, CT scans showed a small, irregular, marginal LDA along the ventricular catheter, with no evidence of increased ventricle. On repeated CT scans after conservative treatment, the lesion persisted for several years after VP shunt. There was a good correlation between CT findings and patient age. Children seemed to have a large porencephalic cyst. In conclusion, LDA may be an accumulation of CSF within the unresisting white matter along the ventricular catheter due to increased intraventricular pressure. Various CT patterns seem to depend on the increased degree of intraventricular pressure and the compliance of the surrounding white matter. (N.K.).

  20. Definitive role of CT scanning of the pancreas. The second year's experience. (United States)

    Haaga, J R; Alfidi, R J; Havrilla, T R; Tubbs, R; Gonzalez, L; Meaney, T F; Corsi, M A


    In a group of 188 patients, 192 computed tomographic (CT) scans of the pancreas were done, and the diagnostic accuracy of CT determined relative to other modalities. CT was the most effective method of detecting neoplastic and inflammatory diseases. The full extent of the disease process, including involvement of the retroperitoneum and metastasis to the liver, was visualized with one examination. Calcification and cystic collections associated with pancreatitis were also clearly seen.

  1. Coronal CT scan of paranasal sinuses; Long survey after Caldwell-Luc operation

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Atsuko (Tokyo Metropolitan Komagome Hospital (Japan)); Ikeda, Motohisa; Watanabe, Isamu; Komatsuzaki, Atsushi


    The clinical features were correlated with the coronal CT scan appearance of the paranasal sinuses of 49 patients who had received the Caldwell-Luc operation 16 to 58 years ago. The clinical diagnosis at the time of the CT scan was postoperative maxillary cyst in 22 patients, chronic sinusitis in 21 patients, trigeminal neuralgia in 3 patients, radicular cyst, postoperative ethmoid cyst and inverted papilloma in one patient each. The CT scans of the 91 operated maxillary sinuses showed obliterated cavity in 21 cases, small cavity in 46 cases, and cystic formation in 24 cases. The authors speculated that some maxillary sinuses which appeared in CT scans as small cavities might cause the clinical symptoms of postoperative maxillary cyst in the future. (author).

  2. (18)F-FDG-PET/CT, (123)I-MIBG and (99m)Tc-MDP whole-body scans, in detecting recurrence of an adult adrenal neuroblastoma. (United States)

    Skoura, Evangelia; Oikonomopoulos, Georgios; Vasileiou, Spyridon; Kyprianou, Diogenis; Koumakis, Georgios; Datseris, Ioannis E


    Neuroblastoma is the most common extracranial solid malignancy in children, but is rare in adults. We report the case of a 33 year old man with recurrence of neuroblastoma, 2 years after the excision of the primary tumor in the right adrenal gland. The iodine-123-radioiodinated metaiodobenzylguanidine ((123)I-MIBG) and (99m)Tc-methylene diphosphonate ((99m)Tc-MDP) bone scans and the fluorine-18-fluorodeoxyglucose-positron computed tomography ((18)F-FDG PET/CT) findings in this patient are presented. First, we applied (123)I-MIBG scintigraphy that detected increased uptake at the right adrenal gland region and probably at liver lesions and in several bones. Then, the (99m)Tc-MDP bone scan revealed also increased uptake of the radiopharmaceutical in bones, but there was a discrepancy between these two studies concerning the number and location of the lesions. Then, (18)F-FDG PET/CT scan was performed, which showed increased uptake of (18)F-FDG at the right adrenal gland region with extension to the liver and also in multiple bones. Additionally, an aortocaval lymph node was detected. In conclusion, this case indicated that (18)F-FDG PET/CT has defined the extent of the recurrence of neuroblastoma in a better way than (123)I-MIBG and (99m)Tc-MDP together.

  3. The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression

    DEFF Research Database (Denmark)

    Coxson, Harvey O; Dirksen, Asger; Edwards, Lisa D


    Emphysema is a key contributor to airflow limitation in chronic obstructive pulmonary disease (COPD) and can be quantified using CT scanning. We investigated the change in CT lung density in a longitudinal, international cohort of patients with COPD. We also explored the potential relation betwee...

  4. Micro computed tomography (CT) scanned anatomical gateway to insect pest bioinformatics (United States)

    An international collaboration to establish an interactive Digital Video Library for a Systems Biology Approach to study the Asian citrus Psyllid and psyllid genomics/proteomics interactions is demonstrated. Advances in micro-CT, digital computed tomography (CT) scan uses X-rays to make detailed pic...

  5. Patient-centered clinical impact of incidentally detected abnormalities on chest CT scans

    Directory of Open Access Journals (Sweden)

    Sherine G. Moftah


    Conclusion: The clinically significant different incidental abnormalities on chest CT scans represented 10.4% of all incidental findings, 3.3% were due to malignancies. The clinical impact of incidental abnormalities on chest CT may be of utmost importance on patient care.

  6. Increase in dicentric chromosome formation after a single CT scan in adults. (United States)

    Abe, Yu; Miura, Tomisato; Yoshida, Mitsuaki A; Ujiie, Risa; Kurosu, Yumiko; Kato, Nagisa; Katafuchi, Atsushi; Tsuyama, Naohiro; Ohba, Takashi; Inamasu, Tomoko; Shishido, Fumio; Noji, Hideyoshi; Ogawa, Kazuei; Yokouchi, Hiroshi; Kanazawa, Kenya; Ishida, Takashi; Muto, Satoshi; Ohsugi, Jun; Suzuki, Hiroyuki; Ishikawa, Tetsuo; Kamiya, Kenji; Sakai, Akira


    Excess risk of leukemia and brain tumors after CT scans in children has been reported. We performed dicentric chromosome assay (DCAs) before and after CT scan to assess effects of low-dose ionizing radiation on chromosomes. Peripheral blood (PB) lymphocytes were collected from 10 patients before and after a CT scan. DCA was performed by analyzing either 1,000 or 2,000 metaphases using both Giemsa staining and centromere-fluorescence in situ hybridization (Centromere-FISH). The increment of DIC formation was compared with effective radiation dose calculated using the computational dosimetry system, WAZA-ARI and dose length product (DLP) in a CT scan. Dicentric chromosome (DIC) formation increased significantly after a single CT scan, and increased DIC formation was found in all patients. A good correlation between the increment of DIC formation determined by analysis of 2,000 metaphases using Giemsa staining and those by 2,000 metaphases using Centromere-FISH was observed. However, no correlation was observed between the increment of DIC formation and the effective radiation dose. Therefore, these results suggest that chromosome cleavage may be induced by one CT scan, and we recommend 2,000 or more metaphases be analyzed in Giemsa staining or Centromere-FISH for DCAs in cases of low-dose radiation exposure.

  7. 3D Reconstruction in Spiral Multislice CT Scans

    Directory of Open Access Journals (Sweden)

    M. Ghafouri


    Full Text Available Introduction & Background: The rapid development of spiral (helical computed tomography (CT has resulted in exciting new applications for CT. One of these applications, three-dimensional (3D CT with volume ren-dering, is now a major area of clinical and academic interest. One of the greatest advantages of spiral CT with 3D volume rendering is that it provides all the necessary information in a single radiologic study (and there-fore at the lowest possible price in cases that previously required two or more studies. Three-dimensional vol-ume rendering generates clinically accurate and immediately available images from the full CT data set with-out extensive editing. It allows the radiologist and clinician to address specific questions concerning patient care by interactively exploring different aspects of the data set. Three-dimensional images integrate a series of axial CT sections into a form that is often easier to interpret than the sections themselves and can be made to appear similar to other more familiar images such as catheter angiograms. The data are organized into a 3D matrix of volume elements (voxels. The screen of the computer monitor is a 2D-surface composed of discrete picture elements (pixels. Presenting what is stored in memory (ie, floating within the monitor on a 2D-screen is a challenge, but it is the very problem that 3D reconstruc-tion software has creatively solved. Voxel selection is usually accomplished by projecting lines (rays through the data set that correspond to the pixel matrix of the desired 2D image. Differences in the images produced with various 3D rendering techniques are the result of variations in how voxels are selected and weighted. In this article, I compare 3D volume rendering of spiral CT data with other rendering techniques (shaded surface display, maximum intensity projection and present a brief history of 3D volume rendering and discuss the im-plementation of this promising technology in terms of

  8. Advantage of CT scan in muscular pathology. Personal cases and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Laroche, M.; Rousseau, H.; Mazieres, B.; Bonafe, A.; Joffre, F.; Arlet, J.


    The advantage of CT scans in muscular pathology is studied. The scan, in addition to the diagnosis of tumors and muscular abscesses, permits to differentiate primary myopathies from neurogenic atrophies: in the course of myopathies, the muscle volume is preserved and they appear as a hypodensity; in neurogenic atrophies, the muscle volume is reduced with preserved density. The CT scan permits to determine the extension of these lesions. In the course of polymyositis, certain forms of rheumatid arthritis, the scan discloses a trabecular and 'worm-eaten' aspect of the muscles. This is also observed after long-term steroid therapy and other endocrine diseases (hyperthyroidism, osteomalacia) indicating an infra-clinical myopathy. In vertebral osteoporosis with fractures and patients with chronic lumbalgia, very ofter, an atrophy of the spinal muscle is observed. Finally, in the course of acquired kyphosis of the adult patient (camptocormia), the CT scan suggest an isolated myopathy, with late manifestations, of the paravertebral muscles.

  9. Dual energy CT with one full scan and a second sparse-view scan using structure preserving iterative reconstruction (SPIR) (United States)

    Wang, Tonghe; Zhu, Lei


    Conventional dual-energy CT (DECT) reconstruction requires two full-size projection datasets with two different energy spectra. In this study, we propose an iterative algorithm to enable a new data acquisition scheme which requires one full scan and a second sparse-view scan for potential reduction in imaging dose and engineering cost of DECT. A bilateral filter is calculated as a similarity matrix from the first full-scan CT image to quantify the similarity between any two pixels, which is assumed unchanged on a second CT image since DECT scans are performed on the same object. The second CT image from reduced projections is reconstructed by an iterative algorithm which updates the image by minimizing the total variation of the difference between the image and its filtered image by the similarity matrix under data fidelity constraint. As the redundant structural information of the two CT images is contained in the similarity matrix for CT reconstruction, we refer to the algorithm as structure preserving iterative reconstruction (SPIR). The proposed method is evaluated on both digital and physical phantoms, and is compared with the filtered-backprojection (FBP) method, the conventional total-variation-regularization-based algorithm (TVR) and prior-image-constrained-compressed-sensing (PICCS). SPIR with a second 10-view scan reduces the image noise STD by a factor of one order of magnitude with same spatial resolution as full-view FBP image. SPIR substantially improves over TVR on the reconstruction accuracy of a 10-view scan by decreasing the reconstruction error from 6.18% to 1.33%, and outperforms TVR at 50 and 20-view scans on spatial resolution with a higher frequency at the modulation transfer function value of 10% by an average factor of 4. Compared with the 20-view scan PICCS result, the SPIR image has 7 times lower noise STD with similar spatial resolution. The electron density map obtained from the SPIR-based DECT images with a second 10-view scan has an

  10. Multicentic primary angiosarcoma of bone mimicking metastasis on {sup 18}F-FDG PET/CT in a patient with a history of sigmoid colon cancer: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Min Young; Kim, Seok Ki; Park, Seog Yun; Kwon, Young Mee; Yun, Tak; Kim, Tae Sung [National Cancer Center, Goyang (Korea, Republic of); Lee, Eun Seong [Dept. of Nuclear Medicine, Chung Ang University Hospital, Seoul (Korea, Republic of)


    Primary angiosarcoma of the bone (PAB) is a rare and fatal high-grade malignant vascular bone tumor. We report a rare case of multicentric PAB mimicking bone metastasis in a 59-year-old female patient with a history of sigmoid colon cancer. This patient complained of lower back and pelvic pain and presented with multiple osteolytic bone lesions on plain radiography and pelvic computed tomography. First, bone metastasis of sigmoid colon cancer was suspected. However, on the {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography/computed tomography (PET/CT) scan, the patient presented unusual multiple hypermetabolic osteolytic bone lesions involving contiguous bones of the lower half of the body. After bone biopsy, these lesions were confirmed to be multicentric PAB. To the best of our knowledge, this is the first case report of an {sup 18}F-FDG PET/CT scan in a patient with multicentric primary bone angiosarcoma.

  11. CT assessment of the correlation between clinical examination and bone involvement in oral malignant tumors

    Energy Technology Data Exchange (ETDEWEB)

    Albuquerque, Marco Antonio Portela; Oliveira, Ilka Regina Souza; Cavalcanti, Marcelo Gusmao Paraiso [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Radiologia], e-mail:; Kuruoshi, Marcia Etsuko [Universidade de Sao Paulo (USP), SP (Brazil). Hospital Universitario. Dept. de Radiologia


    Oral cancers have a tendency to invade the surrounding bone structures, and this has a direct influence on the treatment management and on outcomes. The objective of this study was to correlate the clinical parameters (location, clinical presentation and TNM staging) of oral malignant tumors that can be associated with a potential of bone invasion and determine the accuracy of clinical examination to predict bone involvement, using computed tomography (CT). Twenty five patients, with oral malignant tumors were submitted to clinical and CT examinations. CT was considered the standard parameter to evaluate the presence of bone involvement. Clinical assessment of location, presentation form and TNM staging of the tumors were then compared to the CT findings in predicting bone involvement. Bone involvement was observed in 68% of the cases. It was predicted that tumors located in the retromolar trigone and hard palate, with a clinical aspect of infiltrative ulcer or nodule and classified in stage IV had a high potential to cause bone involvement. The clinical examination assessment of these tumors showed to be a valuable tool to predict bone invasion, with high sensitivity (82%) and specificity (87.5%), based on the results found in the CT images. No statistical significance was found between the CT and clinical examinations regarding bone involvement. The identification of some clinical parameters such as location, clinical presentation, and TNM stage, associated with a detailed clinical examination, was considered a valuable tool for the assessment of bone destruction by oral malignant tumors. (author)

  12. MicroCT evaluation of bone mineral density loss in human bones

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Liebert P.; Braz, Delson; Lopes, Ricardo T. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE). Lab. de Instrumentacao Nuclear]. E-mails:; Barroso, Regina C.; Oliveira, Luis F. [Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ (Brazil). Inst. de Fisica]. E-mail:


    Bone is a connective tissue largely composed of an organic protein, collagen and the inorganic mineral hydroxyapatite [Ca{sub 10}(PO{sub 4}){sub 6}OH{sub 2}], which combine to provide a mechanical and supportive role in the body. Depending on the orientation of collagen fibers, two types of bone can be distinguished: trabecular and cortical bone. Degree of mineralization is considered an important feature of bone quality. Changes in the degree of mineralization is generally due to osteoporosis, but many recent studies have already shown that alterations in degree of mineralization can occur due to a large variety of factors. The transmission X-ray microtomography is one of the most popular methods, which provides the spatial distribution of the total absorption coefficient inside the sample. The aim of this study was to investigate the suitability of using microCT as a supplementary tool for the diagnosis of the health status of human bones. Eleven samples were constructed simulating the physiological range of bone mineral density (BMD) found in cortical human bone. The samples represent healthy mixtures of swine compact bone dried at room temperature, powdered and mixed with fat (0 - 100 % by mass). The samples were imaged by a microfocus tube (Fein-Focus) with focal size of about 60 {mu}m ({+-}5%), and a CCD camera (0.143 mm pixel size) coupled with an intensifier tube with fluoroscope screen at the Nuclear Instrumentation Laboratory (COPPE/UFRJ), Brazil. The images were reconstructed and treated with suitable software developed at the Nuclear Instrumentation Laboratory. The mineral content in cortical bone is defined by the volume of dry, fat-free bone per unit bulk volume of the bone. The volumes were calculated from the bone density using the relationship between volume and density. The densities of fat and bone were taken to be 0.95{sup -3} and 1.92{sup -3} respectively. The correlation of the measured absorption coefficient with the mineral content

  13. Independent measurement of femoral cortical thickness and cortical bone density using clinical CT. (United States)

    Treece, G M; Gee, A H


    The local structure of the proximal femoral cortex is of interest since both fracture risk, and the effects of various interventions aimed at reducing that risk, are associated with cortical properties focused in particular regions rather than dispersed over the whole bone. Much of the femoral cortex is less than 3mm thick, appearing so blurred in clinical CT that its actual density is not apparent in the data, and neither thresholding nor full-width half-maximum techniques are capable of determining its width. Our previous work on cortical bone mapping showed how to produce more accurate estimates of cortical thickness by assuming a fixed value of the cortical density for each hip. However, although cortical density varies much less over the proximal femur than thickness, what little variation there is leads to errors in thickness measurement. In this paper, we develop the cortical bone mapping technique by exploiting local estimates of imaging blur to correct the global density estimate, thus providing a local density estimate as well as more accurate estimates of thickness. We also consider measurement of cortical mass surface density and the density of trabecular bone immediately adjacent to the cortex. Performance is assessed with ex vivo clinical QCT scans of proximal femurs, with true values derived from high resolution HRpQCT scans of the same bones. We demonstrate superior estimation of thickness than is possible with alternative techniques (accuracy 0.12 ± 0.39 mm for cortices in the range 1-3mm), and that local cortical density estimation is feasible for densities >800 mg/cm(3).

  14. Adherence to follow-up CT scans in patients with small pulmonary nodules, a retrospective study

    DEFF Research Database (Denmark)

    Johansson, Sofie Lock; Gerner Hansen, Niels-Christian


    Adherence to follow-up CT scans in patients with small pulmonary nodules, a retrospective study The Danish National guidelines have since 2008 suggested serial follow-up CT scans at 3, 6, 12, and 24 months for nodules between 5 and 10 mm and at 12 and 24 months for nodules less than 5 mm in accor...... is that management of the follow-up of small nodules did improve in 2008-2009, but adherence to the guidelines was still limited. We will now implement a prospective program for monitoring the adherence to the follow-up CTs.......Adherence to follow-up CT scans in patients with small pulmonary nodules, a retrospective study The Danish National guidelines have since 2008 suggested serial follow-up CT scans at 3, 6, 12, and 24 months for nodules between 5 and 10 mm and at 12 and 24 months for nodules less than 5 mm...... in the four year period 2006-2009. In 72 cases, 19 in 2006-2007 and 51 in 2008-2009, one or more small nodules, with diameter ≤ 10 mm, were detected on CT in patients with no known recent malignant disease. For these patients follow-up was suggested, either with CT or PET-CT. One of the 70 patients from 2008...

  15. Potential cancer risk associated to CT scan. State of the art of epidemiological studies

    Energy Technology Data Exchange (ETDEWEB)

    Bernier, Marie-Odile; Baysson, Neige Joumy Helene; Jacob, Sophie; Laurier, Dominique [Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses (France). Lab. of Epidemiology


    Introduction: The increasing use of computed tomography (CT) scans in paediatric population raises the question of a possible health impact of ionizing radiation exposure associated with CT scans. Material and methods: Two large cohort studies have been recently published that assessed the risk of cancer related to CT examinations of children and young adults. Methodology and results of these studies are presented. Results: The UK cohort included over 176,000 young people, who underwent one or more CT scans between 1985 and 2002. The Australian study compared the risk of cancer and leukaemia in a population of 680,000 young people exposed to CT scans between 1985 and 2005 to non-exposed similar age people. Both studies showed a significant dose-response relation between exposure to CT and leukaemia or brain tumour risks. These results are consistent with predictions from A-bomb survivors' data. However, uncertainties in dosimetric estimation and potential bias linked to underlying medical conditions should be considered. Conclusion and perspectives: Further studies with more accurate dosimetry and assessment of potential bias and uncertainties are needed. Ongoing national studies and the European collaborative EPI-CT study will help to better understand the relation between low level radiation exposure and cancer and to support recommendations for patients'' radiation protection. (orig.)

  16. Vascular anomalies, sutures and small canals of the temporal bone on axial CT

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, Sabrina [Department of Diagnostic Radiology, University of Halle, E. Grube Str. 40, 06097 Halle (Germany)]. E-mail:; Kunkel, Petra [Department of Diagnostic Radiology, University of Leipzig (Germany); Schul, Thomas [Department of Diagnostic Radiology, University of Leipzig (Germany)


    Purpose: Subtle bony structures, small canals and fine sutures cause sometimes problems in the analysis of CTs of the temporal bone. The aim of this study was: to analyze the visibility of subtle structures and to estimate the incidence of vascular anomalies. Patients and method: We retrospectively analyzed axial scans of 223 high-resolution CTs of the temporal bone obtained as single slice or spiral CT with 1 mm slice thickness. All CTs had clinical indications. Two experienced radiologists studied CTs regarding the visibility of the fine sutures, fissures and small canals and the occurrence of vascular anomalies. Results: The following structures were seen commonly: sphenosquamosal suture (76%), arcuate artery canal (93%), vestibular aqueduct (89%), mastoid emissary vein (82%), singular canal (56%). Not so commonly were observed: tympanosquamosal suture (31%), mastoid canaliculus (28%), lateral sigmoid sinus (28%), petrotympanic fissure (24%), tympanomastoid suture (10%). Seldom we identified: the inferior tympanic canaliculus (6%), high jugular bulb (6%), anterior sigmoid sinus (5%), dehiscent internal carotid artery canal (2%), persistent petrosquamosal sinus (1%), dehiscent jugular bulb (1%). Persistent stapedial artery, aberrant internal carotid artery, dehiscent jugular bulb, high jugular bulb with diverticulum, anterior and dehiscent sigmoid sinus were detected in below 1% of the analyzed temporal bones. The frequency of asymmetry of the jugular foramen, which varied between 3% and 42%, depended on different criterions of size. Conclusion: A profound knowledge of normal anatomy and anomalies of the temporal bone avoids misinterpretation as pathological lesions and iatrogenic bleedings.

  17. Evaluation of Helical CT Scanning in Judging the Invasion and Metastasis of Gastric Carcinoma

    Institute of Scientific and Technical Information of China (English)

    GAOJianbo; KONGXiangquan; GUOHua; LIShuxin; YANGXuehua; LIYintai; ZHANGZhixu


    To determine the accuracy of triphase enhanced helical CT in judging the invasion and metastasis of gastric carcinoma, and to discuss the relation between imaging signs and pathological findings. Methods: Triphase enhanced helical CT scanning was performed in 46 patients with gastric carcinoma. Imaging findings were compared with postoperative pathologic results. Results: (1) The accuracy of helical CT for diagnosing involvement of tunica serosa, lymph node metastasis and distant metastasis was 84.8%, 87.0% and 100~ respectively. (2) CT signs of serosal involvement, lymph node metastasis and distant metastasis were in good accordance with pathological findings (P<0.05). Conclusion: Triphase enhanced helical CT scans can comprehensively and precisely reflect the pathologic characteristics of gastric carcinoma, thus it is a reliable technique for the diagnosis of this disease.

  18. Scanning electron microscopy of erythropoietin-stimulated bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Leblond, P.F. (Hospital of St. Sacrement, Quebec); Chamberlain, J.K.; Weed, R.I.


    This work describes and illustrates the scanning electron microscopic modifications observed in the femoral bone marrow of normal mice 72 hours after a single injection of partly purified sheep erythropoietin and of mice afflicted with a chronic congenital hemolytic anemia analogous to the disease Hereditary Spherocytosis in man. In acordance with previous transmission electron microscopic studies, the observations are consistent with an effect of erythropoietin both on the frequency of cell migration across the normally intact marrow sinus endothelium and on the morphology of sinus adventitial cells. It is suggested that these ultrastructural modifications may be responsible for the greater patency of the marrow-blood barrier under erythropoietin stimulation.

  19. The diagnostic value of PET/CT scanning in patients with cervical cancer

    DEFF Research Database (Denmark)

    Loft, Annika; Berthelsen, Anne Kiil; Roed, Henrik;


    groups: (1) patients suitable for radical hysterectomy including lymph node dissection and (2) patients referred to combined chemo/radiation therapy. The results were compared to histopathological findings and/ or follow-up. RESULTS: Twenty-seven patients underwent radical surgery; four of these had PET......OBJECTIVE: To investigate the clinical value of PET/CT as a supplement to FIGO staging in patients with cervical cancer stage >or=1B. METHODS: This prospective study included 120 consecutive patients. After staging, a whole-body PET/CT scan was performed and these examinations were divided into two....../CT scans revealing pathological foci in the pelvis. Three (11%) were true positive; one was false positive. Twenty-two patients had true negative PET/CT scans concerning pelvic lymph nodes. One patient had a false negative node. For these patients, we found the positive predictive value (PPV) to be 75...

  20. Malignancy rate of biopsied suspicious bone lesions identified on FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A.; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Heggelman, Ben G.F. [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Dubois, Stefan V. [Meander Medical Center, Department of Pathology, Amersfoort (Netherlands)


    To determine the malignancy rate of bone lesions identified on FDG PET/CT in patients who have undergone CT-guided biopsy because of the suspicion of malignancy. This single-centre retrospective study spanned eight consecutive years and included all patients who underwent both FDG PET/CT and CT-guided bone biopsy because of the suspicion of malignancy. The positive predictive value (PPV) for malignancy was calculated, and different patient and imaging characteristics were compared between malignant and benign bone lesions. Of 102 included patients with bone lesions that all showed FDG uptake exceeding mediastinal uptake, bone biopsy showed a malignant lesion in 91 patients, yielding a PPV for malignancy of 89.2 % (95 % CI 81.7 - 93.9 %). In the 94 patients with bone lesions that showed FDG uptake exceeding liver uptake, bone biopsy showed a malignant lesion in 83 patients, yielding a PPV for malignancy of 88.3 % (95 % CI 80.1 - 93.5 %). Higher age, bone marrow replacement of the lesion seen on CT, expansion of the lesion seen on CT, and presence of multifocal lesions on FDG PET/CT were significantly more frequent in patients with malignant lesions than in those with benign bone lesions (P = 0.044, P = 0.009, P = 0.015, and P = 0.019, respectively). Furthermore, there was a trend towards a higher incidence of cortical destruction (P = 0.056) and surrounding soft tissue mass (P = 0.063) in patients with malignant bone lesions. The PPV for malignancy of suspicious bone lesions identified on FDG PET/CT is not sufficiently high to justify changes in patient management without histopathological confirmation. Nevertheless, ancillary patient and imaging characteristics may increase the likelihood of a malignant bone lesion. (orig.)

  1. [The diagnostic value of 99mTc-MDP bone scan and computed tomography for bone metastases of breast cancer: a systematic review]. (United States)

    Yu, Yanxia; Kuang, Anren


    According to the inclusion and exclusion criteria, we searched for relevant original articles in some big Chinese and English databases. The qualities of the studies were evaluated with QUADAS quality assessment tool. A software program, Meta-disc, was used to obtain the pooled estimates and heterogeneity test for sensitivity, specificity, SROC curve, and so on. Finally the 17 article were included. On a per-patient basis, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (LR+), negative likelihood ratio (LR-), diagnostic odds ratio (DOR), Q*, SROC area under curve for 99mTc-MDP bone scan and computed tomography (CT) were 0. 87 and 0.99, 0.81 and 0.98, 3.88 and 13.86, 0.2 and 0.03, 27.73 and 612.17, 0.8418 and 0.9732, 0.9097 and 0.9952, respectively. On a per-focus basis, the pooled SEN, SPE, LR+, LR-, DOR, Q*, SROC area under curve for 99mTc-MDP bone scan was 0.86, 0.97, 13.32, 0.16, 102.4, 0.8944, 0.9528, respectively. For CT, only 1 article were included. This paper demonstrate: whether 99mTc-MDP or CT both have high diagnostic efficiency for bone metastase of breast cancer.

  2. Diagnosis of bone metastases: a meta-analysis comparing {sup 18}FDG PET, CT, MRI and bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hui-Lin; Liu, Tao [Hospital of Soochow University, Department of Orthopaedics, Suzhou (China); Wang, Xi-Ming [Hospital of Soochow University, Department of Radiology, Suzhou (China); Xu, Yong [Public Health School of Soochow University, Department of Epidemiology and Biostatistics, Suzhou (China); Deng, Sheng-Ming [Department of Nuclear Medicine, The first affiliated hospital of Soochow University, Suzhou (China)


    To perform a meta-analysis to compare {sup 18}FDG PET, CT, MRI and bone scintigraphy (BS) for the diagnosis of bone metastases. Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 1995 to January 2010. Software was used to obtain pooled estimates of sensitivity, specificity and summary receiver operating characteristic curves (SROC). 67 articles consisting of 145 studies fulfilled all inclusion criteria. On per-patient basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 89.7%, 72.9%, 90.6% and 86.0% respectively. PET=MRI>BS>CT. (''=''indicated no significant difference, P > 0.05; ''>'' indicated significantly higher, P < 0.05). The pooled specificity estimates for PET, CT, MRI and BS were 96.8%, 94.8%, 95.4% and 81.4% respectively. PET = CT = MRI>BS. On per-lesion basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 86.9%, 77.1%, 90.4% and 75.1% respectively. PET = MRI>BS>CT. The pooled specificity estimates for PET, CT, MRI and BS were 97.0%, 83.2%, 96.0% and 93.6% respectively. PET>MRI>BS>CT. PET and MRI were found to be comparable and both significantly more accurate than CT and BS for the diagnosis of bone metastases. (orig.)

  3. CT scan findings and EEG in systemic lupus erythematodes patients with neuro-psychiatric disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kan, Rumiko; Hagiwara, Mariko; Katayose, Keiko; Yashima, Yuko; Kumashiro, Hisashi


    In 14 patients with systemic lupus erythematodes presenting with neuro-psychiatric disorders, CT scans were compared with encephalographic (EEG) findings. CT findings were markedly abnormal in 6, slight with a sulcal enlargement in 3, and normal in 5. In the group of markedly abnormal CT findings, focal abnormal low density areas were detected in 2, severe generalized cerebral atrophy in one, and severe atrophy of the right hemisphere in one. EEG findings included focal paroxysmal abnormality of high voltage slow burst at the left frontal dominance and positive spike on the right hemisphere. Epileptic seizure and depressed sensorium seemed to be related to CT abnormality. In 3 patients with epileptic seizures, their symptoms were closely related to CT abnormality. Parkinsonisms and depressed sensorium were also related to CT abnormality. (Namekawa, K).

  4. Usefulness of F-18 FDG PET/CT in a case of Kaposi sarcoma with an unexpected bone lesion. (United States)

    Morooka, Miyako; Ito, Kimiteru; Kubota, Kazuo; Yanagisawa, Kunio; Teruya, Katsuji; Hasuo, Kahehiro; Shida, Yoshitaka; Minamimoto, Rhogo; Kikuchi, Yoshimi; Oka, Shinichi


    Bone lesions of Kaposi sarcoma are rare. A 56-year-old man who was HIV positive and was diagnosed with Kaposi sarcoma on the basis of the results of a biopsy of skin lesions, underwent F-18 FDG PET/CT scan for detecting Kaposi sarcoma lesions and other AIDS-related diseases. An abnormal uptake was observed in the lumbar spine. MRI showed a diffuse enhanced spine lesion, and Ga-67 and ²⁰¹Tl scanning were negative. As a result, the lesion was considered to be a Kaposi sarcoma, and the shrinkage of the lesion was noted after the therapy for Kaposi sarcoma.

  5. Three-Dimensions Segmentation of Pulmonary Vascular Trees for Low Dose CT Scans (United States)

    Lai, Jun; Huang, Ying; Wang, Ying; Wang, Jun


    Due to the low contrast and the partial volume effects, providing an accurate and in vivo analysis for pulmonary vascular trees from low dose CT scans is a challenging task. This paper proposes an automatic integration segmentation approach for the vascular trees in low dose CT scans. It consists of the following steps: firstly, lung volumes are acquired by the knowledge based method from the CT scans, and then the data are smoothed by the 3D Gaussian filter; secondly, two or three seeds are gotten by the adaptive 2D segmentation and the maximum area selecting from different position scans; thirdly, each seed as the start voxel is inputted for a quick multi-seeds 3D region growing to get vascular trees; finally, the trees are refined by the smooth filter. Through skeleton analyzing for the vascular trees, the results show that the proposed method can provide much better and lower level vascular branches.

  6. Trends in CT scan rates in children and pregnant women: teaching, private, public and nonprofit facilities

    Energy Technology Data Exchange (ETDEWEB)

    Hoshiko, Sumi; Smith, Daniel; Fan, Cathyn; Jones, Carrie R.; McNeel, Sandra V. [Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA (United States); Cohen, Ronald A. [Children' s Hospital and Research Center Oakland, Department of Radiology, Oakland, CA (United States)


    Radiation exposure from medical sources now equals or exceeds that from natural background sources, largely attributable to a 20-fold increase in CT use since 1980. Increasing exposure to children and fetuses is of most concern due to their heightened susceptibility. More recently, CT use may be leveling or decreasing, but it is unclear whether this change is widespread or varies by type of institution. We sought to characterize trends in CT utilization in California hospitals and emergency departments among children and pregnant women, looking at different types of facilities, such as teaching, private, public and nonprofit institutions. We examined frequency of CT examinations by year from 229 facilities reporting CT usage in routinely collected California statewide data for 2005-2012. We modeled trends overall and by facility type. CT scans for pediatric and pregnant patient visits in the emergency department increased initially, then started to decline after 2008. Among hospital admissions, rates declined or leveled after 2005. In the emergency department, CT rates varied between types of facilities, with teaching hospitals reducing use sooner and more sharply than other types of facilities. CT utilization in California among children and pregnant women has begun to level or decline. Still, population exposure remains at historically high levels, warranting consideration of potential public health implications. Further examination of reasons for trends among hospital types, particularly how teaching hospitals have reduced rates of CT utilization, may help identify strategies for CT reduction without compromising patient care. (orig.)

  7. Eye lens radiation exposure and repeated head CT scans: A problem to keep in mind

    Energy Technology Data Exchange (ETDEWEB)

    Michel, Morgane; Jacob, Sophie [Institute for Radiological Protection and Nuclear Safety, IRSN/DRPH/SRBE/Laboratoire d' Epidemiologie, BP 17, 92 262 Fontenay-aux-Roses (France); Roger, Gilles [Otolaryngology Department, Trousseau Hospital, Paris (France); Pelosse, Beatrice [Ophthalmology Department, Trousseau Hospital, Paris (France); Laurier, Dominique [Institute for Radiological Protection and Nuclear Safety, IRSN/DRPH/SRBE/Laboratoire d' Epidemiologie, BP 17, 92 262 Fontenay-aux-Roses (France); Le Pointe, Hubert Ducou [Radiology Department, Trousseau Hospital, Paris (France); Bernier, Marie-Odile, E-mail: [Institute for Radiological Protection and Nuclear Safety, IRSN/DRPH/SRBE/Laboratoire d' Epidemiologie, BP 17, 92 262 Fontenay-aux-Roses (France)


    Objectives: The deterministic character of radiation-induced cataract is being called into question, raising the possibility of a risk in patients, especially children, exposed to ionizing radiation in case of repeated head CT-scans. This study aims to estimate the eye lens doses of a pediatric population exposed to repeated head CTs and to assess the feasibility of an epidemiological study. Methods: Children treated for a cholesteatoma, who had had at least one CT-scan of the middle ear before their tenth birthday, were included. Radiation exposure has been assessed from medical records and telephone interviews. Results: Out of the 39 subjects contacted, 32 accepted to participate. A total of 76 CT-scans were retrieved from medical records. At the time of the interview (mean age: 16 years), the mean number of CT per child was 3. Cumulative mean effective and eye lens doses were 1.7 mSv and 168 mGy, respectively. Conclusion: A relatively high lens radiation dose was observed in children exposed to repeated CT-scans. Due to that exposure and despite the difficulties met when trying to reach patients' families, a large scale epidemiological study should be performed in order to assess the risk of radiation-induced cataracts associated with repeated head CT.

  8. Sex determination from scapular length measurements by CT scans images in a Caucasian population. (United States)

    Giurazza, F; Schena, E; Del Vescovo, R; Cazzato, R L; Mortato, L; Saccomandi, P; Paternostro, F; Onofri, L; Zobel, B Beomonte


    Together with race, stature and age, sex is a main component of the biological identity. Thanks to its proportional correlation with parts of the human body, sex can be evaluated form the skeleton. The most accurate approach to determine sex by bone size is based on os coxae or skull. After natural disaster their presence can never be guaranteed, therefore the development of methods of sex determination using other skeletal elements can result crucial. Herein, sexual dimorphism in the human scapula is used to develop a two-variable discriminant function for sex estimation. We have enrolled 100 males and 100 females who underwent thoracic CT scan evaluation and we have estimated two scapular diameters. The estimation has been carried out by analyzing images of the scapulae of each patient after three dimensional post-processing reconstructions. The two-variable function allows to obtain an overall accuracy of 88% on the calibration sample. Furthermore, we have employed the mentioned function on a collection of 10 individual test sample from the collection of the "Museo di Anatomia Umana di Firenze" of the Università degli Studi di Firenze; sex has been correctly predicted on 9 skeletons.

  9. Integration of 3D anatomical data obtained by CT imaging and 3D optical scanning for computer aided implant surgery

    Directory of Open Access Journals (Sweden)

    Paoli Alessandro


    Full Text Available Abstract Background A precise placement of dental implants is a crucial step to optimize both prosthetic aspects and functional constraints. In this context, the use of virtual guiding systems has been recognized as a fundamental tool to control the ideal implant position. In particular, complex periodontal surgeries can be performed using preoperative planning based on CT data. The critical point of the procedure relies on the lack of accuracy in transferring CT planning information to surgical field through custom-made stereo-lithographic surgical guides. Methods In this work, a novel methodology is proposed for monitoring loss of accuracy in transferring CT dental information into periodontal surgical field. The methodology is based on integrating 3D data of anatomical (impression and cast and preoperative (radiographic template models, obtained by both CT and optical scanning processes. Results A clinical case, relative to a fully edentulous jaw patient, has been used as test case to assess the accuracy of the various steps concurring in manufacturing surgical guides. In particular, a surgical guide has been designed to place implants in the bone structure of the patient. The analysis of the results has allowed the clinician to monitor all the errors, which have been occurring step by step manufacturing the physical templates. Conclusions The use of an optical scanner, which has a higher resolution and accuracy than CT scanning, has demonstrated to be a valid support to control the precision of the various physical models adopted and to point out possible error sources. A case study regarding a fully edentulous patient has confirmed the feasibility of the proposed methodology.

  10. Pancreas tumor model in rabbit imaged by perfusion CT scans (United States)

    Gunn, Jason; Tichauer, Kenneth; Moodie, Karen; Kane, Susan; Hoopes, Jack; Stewart, Errol E.; Hadway, Jennifer; Lee, Ting-Yim; Pereira, Stephen P.; Pogue, Brian W.


    The goal of this work was to develop and validate a pancreas tumor animal model to investigate the relationship between photodynamic therapy (PDT) effectiveness and photosensitizer drug delivery. More specifically, this work lays the foundation for investigating the utility of dynamic contrast enhanced blood perfusion imaging to be used to inform subsequent PDT. A VX2 carcinoma rabbit cell line was grown in the tail of the pancreas of three New Zealand White rabbits and approximately 3-4 weeks after implantation the rabbits were imaged on a CT scanner using a contrast enhanced perfusion protocol, providing parametric maps of blood flow, blood volume, mean transit time, and vascular permeability surface area product.

  11. Radiation dose reduction at a price: the effectiveness of a male gonadal shield during helical CT scans

    Directory of Open Access Journals (Sweden)

    Erdi Yusuf E


    Full Text Available Abstract Background It is estimated that 60 million computed tomography (CT scans were performed during 2006, with approximately 11% of those performed on children age 0–15 years. Various types of gonadal shielding have been evaluated for reducing exposure to the gonads. The purpose of this study was to quantify the radiation dose reduction to the gonads and its effect on image quality when a wrap-around male pediatric gonad shield was used during CT scanning. This information is obtained to assist the attending radiologist in the decision to utilize such male gonadal shields in pediatric imaging practice. Methods The dose reduction to the gonads was measured for both direct radiation and for indirect scattered radiation from the abdomen. A 6 cm3 ion chamber (Model 10X5-6, Radcal Corporation, Monrovia, CA was placed on a Humanoid real bone pelvic phantom at a position of the male gonads. When exposure measurements with shielding were made, a 1 mm lead wrap-around gonadal shield was placed around the ion chamber sensitive volume. Results The use of the shields reduced scatter dose to the gonads by a factor of about 2 with no appreciable loss of image quality. The shields reduced the direct beam dose by a factor of about 35 at the expense of extremely poor CT image quality due to severe streak artifacts. Conclusion Images in the direct exposure case are not useful due to these severe artifacts and the difficulties in positioning these shields on patients in the scatter exposure case may not be warranted by the small absolute reduction in scatter dose unless it is expected that the patient will be subjected to numerous future CT scans.

  12. Single energy micro CT SkyScan 1173 for the characterization of urinary stone (United States)

    Fitri, L. A.; Asyana, V.; Ridwan, T.; Anwary, F.; Soekersi, H.; Latief, F. D. E.; Haryanto, F.


    A urinary stone is a solid piece of material produced from crystallization of excreted substances in the urine. Knowledge of the composition of urinary stones is essential to determine the suitable treatment for the patient. The aim of this research was to characterize urinary stones using single energy micro CT SkyScan 1173. Six human urinary stones were scanned in vitro using 80 kV in micro CT SkyScan 1173. The produced projection, images, were reconstructed using NRecon (in-house software from SkyScan). The images of urinary stones were analyzed using CT Analyser (CT An) to obtain information of the internal structure and the Hounsfield Unit (HU) value to determine the information regarding the composition of the urinary stones, respectively. The average HU values from certain region of interests in the same slice were compared with spectral curves of known materials from National Institute of Standards and Technology (NIST). From the analysis, the composition of the six scanned stones were obtained. Two stones are composed of cystine, two are composed of struvite, two other stones are composed of struvite+cystine. In conclusion, the single energy micro CT with 80 kV can be used identifying cystine and struvite urinary stone.

  13. Clinical utility of 18 Fluorodeoxyglucose (FDG-PET/CT scans in patients with suspect ocular tuberculosis

    Directory of Open Access Journals (Sweden)

    Salil Mehta


    Full Text Available Systemic imaging of patients with suspect ocular tuberculosis include chest X-rays and computed tomography (CT scans. Reports have suggested a role for 18 fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT scans. We report on the clinical utility of 18 FDG PET/CT in two patients. Case 1: A 38-year-old female patient presented with recurrent anterior uveitis. A 18 FDG-PET scan revealed metabolically active supraclavicular and chest lymph nodes. An aspiration cytology of the cervical lymph node revealed caseating granulomas suggestive of tuberculosis. Case 2: A 58-year-old female patient presented with recurrent anterior uveitis. A 18 FDG-PET scan revealed metabolically active lymph nodes in the neck. A biopsy of the cervical lymph node revealed epithelioid granulomas suggestive of tuberculosis. Both patients were started on standard antitubercular therapy with a subsequent marked reduction of activity. PET/CT scans may suggest the sites of safe high-yield biopsies.

  14. A study of bone uptake according to renal function in the whole body bone scan

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    Cho, Yong In; Jang, Dong Gun [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan (Korea, Republic of); Park, Cheol Woo [Dept. of Radiological Technology Dong-Eui Institute of Technology, Busan (Korea, Republic of)


    Whole body bone scan has been used to confirm bone metastasis and follow-up study with radio isotope. However, if the factors related to 99mTc uptake and waiting time for study are inappropriate, it would be image of low quality. The purpose of present study was to investigate correlation between the evaluation index of renal function and uptake of radiopharmaceuticals. The population for this retrospective study consisted of 387 patients who underwent whole body bone scan between June 2012 and December 2012. As a result of quantitative and qualitative analysis, we were able to confirm that GFR of less than normal range and creatinine levels in blood of more than average are more likely to be under the mean uptake rate. As a result of analysis on the indicator affecting soft-tissue and bone uptake, the correlation of all elements was somewhat low. Also there are no statistically significances due to the other parameters we did not deal with. Therefore, further research on additional factors is needed for exact study and improvement of the image quality.

  15. Efficacy of CT scanning in a group of 174 patients with orthopedic and musculoskeletal problems

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Hamlin, D.J.; Kiss, S.; Lovelock, J.


    One hundred and seventy-four patients with orthopedic and musculoskeletal problems received computed tomography (CT) scans between January 1979 and July 1980. There were 34 trauma patients, 35 patients with known or suspected primary tumors, 20 patients with metastases, 18 patients with suspected spinal stenosis, 25 patients with disc problems, five patients with infections, 13 children with congenital anomalies, and 24 patients with miscellaneous problems. The CT scans proved useful in all the pediatric cases, 97% of the trauma patients, and in the majority of patients with tumors. It appears that absolute indications for CT scanning in orthopedic patients include acute trauma to the spine, pelvis, hip, and shoulder girdles as well as in children with congenital spinal anomalies. Relative indications include determining the extent of the tumor and also aiding in the correct approach for biopsying a lesion.

  16. Serial CT scans of cerebral hypoxia due to prolonged status epilepticus

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    Saiwai, Shigeo; Matsumura, Yasumasa; Tamaoka, Koichi; Fukuda, Teruo; Miyamoto, Takeshi (Kobe Central Municipal Hospital, Kobe (Japan))


    Serial computed tomography (CT) scans of 5 infants with status epilepticus were reviewed. Four out of the 5 infants fortunately had CT scans before status epilepticus because of a convulsion. There was a diffuse and mild low density in the hemisphere, with small ventricles and tight sulci (brain swelling) at 1 to 2 days after ictus. Thereafter, a diffuse low density became apparent except for the cerebellum, the brain stem, the thalamus, and the basal ganglia. Two to 4 weeks after ictus, a localized, mottled low density was demonstrated on the cerebral mantle and atrophic changes became progressively clear. In 3 cases, no abnormal enhancement was elicited on contrast CT scans performed between 5 to 16 days after status epilepticus. We discussed the possible pathophysiological aspects of the brain damage due to ''prolonged status epilepticus.''

  17. Which metabolic imaging, besides bone scan with 99mTc-phosphonates, for detecting and evaluating bone metastases in prostatic cancer patients? An open discussion. (United States)

    Bombardieri, E; Setti, L; Kirienko, M; Antunovic, L; Guglielmo, P; Ciocia, G


    Prostate cancer bone metastases occur frequently in advanced cancer and this is matter of particular attention, due to the great impact on patient's management and considering that a lot of new emerging therapeutic options have been recently introduced. Imaging bone metastases is essential to localize lesions, to establish their size and number, to study characteristics and changes during therapy. Besides radiological imaging, nuclear medicine modalities can image their features and offer additional information about their metabolic behaviour. They can be classified according to physical characteristics, type of detection, mechanism of uptake, availability for daily use. The physiopathology of metastases formation and the mechanisms of tracer uptake are essential to understand the interpretation of nuclear medicine images. Therefore, radiopharmaceuticals for bone metastases can be classified in agents targeting bone (99mTc-phosphonates, 18F-fluoride) and those targeting prostatic cancer cells (18F-fluoromethylcholine, 11C-choline, 18F-fluorodeoxyglucose). The modalities using the first group of tracers are planar bone scan, SPECT or SPECT/CT with 99mTc-diphosphonates, and 18F-fluoride PET/CT, while the modalities using the second group include 18F/11C-choline derivatives PET/CT, 18F-FDG PET/CT and PET/CT scans with several other radiopharmaceuticals described in the literature, such as 18F/11C-acetate derivatives, 18F-fluoro-5α-dihydrotestosterone (FDHT), 18F-anti-1-amino-3-fluorocyclobutane-1-carboxylic acid (FACBC), 18F-2'-fluoro-5-methyl-1-β-D-arabinofuranosyluracil (FMAU) and 68Ga-labeled-prostate specific membrane antigen (PMSA) PET/TC. However, since data on clinical validation for these last novel modalities are not conclusive and/or are not still sufficient in number, at present they can be still considered as promising tools under evaluation. The present paper considers the nuclear modalities today available for the clinical routine. This overview wants

  18. CT scan findings of fungal pneumonia; Diagnose der Pilzpneumonie in der Thorax-CT

    Energy Technology Data Exchange (ETDEWEB)

    Heckmann, M.; Uder, M.; Bautz, W.; Heinrich, M. [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. fuer Diagnostische Radiologie


    The importance of fungal infection of the lung in immunocompromised patients has increased substantially during the last decades. Numerically the most patients are those with neutropenia, e.g. patients with malignancies or solid organ and stem cell transplantation, chemotherapy, corticosteroid use and HIV infection. Although fungal infections can occur in immunocompetent patients, their frequency in this population is rare. The clinical symptoms such as fever accompanied with non-productive cough are unspecific. In some patients progression to hypoxemia and dyspnea may occur rapidly. In spite of improved antifungal therapy morbidity and mortality of these infections are still high. Therefore an early and non-invasive diagnosis is very important. That is why CT and even better High-Resolution-CT (HR-CT) is a very important modality in examining immunocompromised patients with a probability of fungal infection. CT is everywhere available and, as a non-invasive method, able to give the relevant diagnose efficiently. This paper should give an overview about the radiologic findings and possible differential diagnosis of diverse pulmonary fungal infections in CT. Pneumonias caused by Aspergillus, Cryptococcus, Candida, Histoplasma, Mucor and Geotrichum capitatum are illustrated. (orig.)

  19. Initial brain CT scan and shunting outcomes in children with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Andi Anita Utami


    Full Text Available Background Hydrocephalus is one of the most common clinical conditions affecting the central nervous system, with a congenital hydrocephalus incidence of 3-4 per 1000 births. Incidence of acquired types of hydrocephalus is unknown. Brain computerised tomography (CT scan can be used to assess the size of ventricles and other structures. Shunting has long been performed to alleviate hydrocephalus. Shunting has dramatically changed the outlook of children with hydrocephalus, with many of them having normal life expectancies and attaining normal intelligence. Objective To determine the outcomes of shunting in children with hydrocephalus based on initial brain CT scan. Methods We performed a cross-sectional study in Dr. Kariadi Hospital. Initial brain CT scan data were collected from the medical records of children admitted to the Neurosurgery Ward for ventriculoperitoneal (VP shunt surgery from January 2009 to December 2010. We studied the brain CT scan findings before VP shunt surgery and the outcomes of the children after VP shunt surgery. Radiological findings were determined by a radiologist responsible at that time. Results This study consisted of 30 subjects, 19 boys and 11 girls. Initial brain CT scans to assess disease severity revealed the following conditions: lateral ventricle dilatation in 7 subjects, lateral and third ventricle dilatation in 16 subjects, and lateral, third and fourth ventricle dilatation in 7 subjects. After VP shunt surgery, 3 subjects in the lateral, third and fourth ventricle dilatation category died. They were grouped according to their condition. Group 1 consisted of subjects with only lateral ventricle dilatation and subjects with lateral and third ventricle dilatation (23 subjects, while group 2 consisted of subjects with lateral, third and fourth ventricle dilatation (7 subjects. More survivors were found in group 1 than those in group 2. Conclusion Less severe initial brain CT scan findings are associated with

  20. Relationship between lower third molar and mandibular canal; Preoperative evaluation using CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Itou, Masaki; Miyagishima, Toshio; Onizuka, Hiroyuki (Fujieda City Shida General Hospital, Shizuoka (Japan)); Takagi, Norio


    The mandibular canal is often closely related to the lower third molars. During the surgical removal of the third molar, the inferior alveolar nerve in the canal is sometimes damaged leading to impaired sensation in the lower lip. This is one of the most unpleasant postoperative complications. The buccolingual relationship between the lower third molar and the mandibular canal cannot be diagnosed by ortho-pantomography although preoperative evaluation must be carried out radiologically. In present study, the relationship was determined by using CT scan. Forty-seven lower third molars of 35 patients were evaluated preoperatively by CT scan. The mandibular canal of all cases overlapped with the third molar on ortho-pantomography. CT scan was taken in two ways. The first was the Tragion-Menton plane which was nearly parallel to the canal at the apex of the third molar. The second was the plane of the axis of the third molar. Axial CT scan was taken when the third molar erupted horizontally, and coronal CT scan was done when the molar erupted vertically. CT scan examination exactly revealed the position of the mandibular canal in relation to the root of the third molar. The canal was located buccally to the roots in 55 percent of cases, apicobuccally in 6 percent, apically in 23 percent, apicolingually in 6 percent, lingually in 2 percent, and between roots in 6 percent. The results of the present study were consistent with previous reports. In 12 cases, the inferior alveolar neurovascular bundle was visible during operation. It was visible in only 2 of 22 cases when the canal was located buccally. It was visible, on the other hand, in all cases in which the canal was located apicolingually, lingually, and between roots. It also tended to be visible when the canal overlapped more strongly with the third molar on preoperative ortho-pantomography. (author).

  1. Body surface area determined by whole-body CT scanning: need for new formulae? (United States)

    Villa, Chiara; Primeau, Charlotte; Hesse, Ulrik; Hougen, Hans Petter; Lynnerup, Niels; Hesse, Birger


    Calculation of the estimated body surface area (BSA) by body height and weight has been a challenge in the past centuries due to lack of a well-documented gold standard. More recently, available techniques such as 3D laser surface scanning and CT scanning may be expected to quantify the BSA in an easier and more accurate way. This study provides the first comparison between BSA obtained from post-mortem whole-body CT scans and BSA calculated by nine predictive formulae. The sample consisted of 54 male cadavers ranging from 20 to 87 years old. 3D reconstructions were generated from CT scans using Mimics software, and BSA values were automatically extracted from the program. They were compared with nine predictive equations from the literature. Remarkably, close correlations (r > 0·90) were found between BSA values from CT scans and those from the predictive formulae. A mean BSA of the 54 cadavers of 1·84-1·87 m(2) was calculated by all formulae except one, SD values varying between 0·171 and 0·223 m(2) . T-tests revealed significant differences between mean BSA values calculated with CT and three of the formulae. Regression analyses showed intercepts >(0;0) and slopes <1·0 using all predictive equations, with the CT scan determination as gold standard. It is concluded that DuBois and DuBois' equation can be safely used in normal-weight male subjects with high accuracy, but it seems likely that BSA is underestimated in underweight subjects and overestimated in overweight individuals. Creation of new formulae specific for overweight subjects and children may be needed.

  2. An Inflammatory Dentigerous Cyst Shows Rim Uptake on Bone Scan: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Son, Hye Joo; Jeong, Young Jin; Jeong, Jin Sook; Kang, Doyoung [Dong-A Univ. Medical Center, Busan (Korea, Republic of)


    Dentigerous cysts are developmental odontogenic jaw cysts, commonly manifesting in the 2nd and 3rd decades of life. This article presents an extremely rare case of dentigerous cyst showing increased uptake in the peripheral rim on bone scan. Herein, we discuss the clinical, radiographic, and histologic features of dentigerous cysts as well as the pathological mechanism underlying their activities on the bone scan. Bone scan was a sensitive tool for detecting the biologic activity of dentigerous cyst in our case.

  3. Scanning electron microscopy of human cortical bone failure surfaces. (United States)

    Braidotti, P; Branca, F P; Stagni, L


    Undecalcified samples extracted from human femoral shafts are fractured by bending and the fracture surfaces are examined with a scanning electron microscope (SEM). The investigation is performed on both dry and wet (hydrated with a saline solution) specimens. SEM micrographs show patterns in many respects similar to those observed in fractography studies of laminated fiber-reinforced synthetic composites. In particular, dry and wet samples behave like brittle and ductile matrix laminates, respectively. An analysis carried out on the basis of the mechanisms that dominate the fracture process of laminates shows that a reasonable cortical bone model is that of a laminated composite material whose matrix is composed of extracellular noncollagenous calcified proteins, and the reinforcement is constituted by the calcified collagen fiber system.

  4. A vast increase in the use of CT scans for investigating occult hip fractures

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, Robert, E-mail:; Dickenson, Edward, E-mail:; Westacott, Daniel, E-mail:; Baraza, Njalalle, E-mail: njaleb@Doctors.Org.Uk; Srinivasan, Kuntrapka, E-mail: bijusri@Yahoo.Co.Uk


    Background: Early diagnosis in neck of femur fractures has been shown to improve outcome. The National Institute for Clinical Excellence recommends if an occult hip fracture is suspected then an MRI should be performed and if not available within 24 h a CT should be considered. At our centre, emergency MRI is rarely available and so CT is commonly used. Objectives: Our study aims to analyse the trends in CT use over a five year period for the diagnosis of neck of femur fractures. Methods: Both the number of patients with a hip fracture and those undergoing a CT hip to diagnose an occult injury were identified across two district general hospitals between 2006–2007 and 2010–2011. The time from initial radiograph to CT and initial radiograph to operation were calculated. Results: In 2006–2007, of 547 hip fractures, 20 CT hips were performed and 6 reported as a fractured neck of femur (30%). In 2010–2011, of 499 hip fractures, 239 CT hips were performed and 65 fractures were recognised (27%). The mean time from radiograph until CT scan was 2.0 days in 2007 and 3.2 days in 2011, which was a statistically significant difference (p < 0.001). For those diagnosed using a CT scan the mean time from admission X-ray to surgery was 1.2 days in 2007 and 3.6 days in 2011. Conclusion: Clinicians are becoming increasingly reliant on CT for the diagnosis of hip fractures with our data suggesting further imaging is one factor that can delay time to diagnosis and theatre.

  5. Improving depiction of temporal bone anatomy with low-radiation dose CT by an integrated circuit detector in pediatric patients: a preliminary study. (United States)

    He, Jingzhen; Zu, Yuliang; Wang, Qing; Ma, Xiangxing


    The purpose of this study was to determine the performance of low-dose computed tomography (CT) scanning with integrated circuit (IC) detector in defining fine structures of temporal bone in children by comparing with the conventional detector. The study was performed with the approval of our institutional review board and the patients' anonymity was maintained. A total of 86 children0.05). The low-dose CT images acquired with the IC detector provide better depiction of fine osseous structures of temporal bone than that with the conventional DC detector.

  6. Advanced material separation technique based on dual energy CT scanning (United States)

    Zamyatin, Alexander A.; Natarajan, Anusha; Zou, Yu


    We propose a method for material separation using dual energy data. Our method is suitable to separation of three or more materials. In this work we describe our method and show results of numerical simulation and with real dual-energy data of a head phantom. The proposed method of constructing the material separation map consists of the following steps: Data-domain dual energy decomposition - Vector plot - Density plot - Clustering - Color assignment. Density plots are introduced to allow automatic cluster separation. We use special image processing methods, including Gaussian decomposition, to improve the accuracy of material separation. We also propose using the HSL color model for better visualization and to bring a new dimension in material separation display. We study applications of bone removal and virtual contrast removal. Evaluation shows improved accuracy compared to standard methods.

  7. Congenital Pyloric Atresia with Distal Duodenal Atresia- Role of CT Scan

    Directory of Open Access Journals (Sweden)

    Yogender Singh Kadian


    Full Text Available The mainstay of diagnosis of congenital pyloric atresia is by plain X-ray of the abdomen showing a large gas bubble with no gas distally. But very rarely it can be associated with distal duodenal atresia when the baby may present as lump abdomen. In such a situation apart from the X-ray, another radiological investigation is needed to delineate the exact nature of the lump. Since the role of ultrasonography is limited in intestinal pathologies and contrast studies are not informative in atresias, the CT scan is the ideal choice. We had managed a case of pyloric atresia with similar presentation with preoperative CT scan.

  8. Subperiosteal chondroma. Diagnostic value of CT scan imaging in two cases

    Energy Technology Data Exchange (ETDEWEB)

    Lerais, J.M.; Auquier, F.; Baudrillard, J.C.; Durot, J.F.; Laugareil, P.; Wallays, C.; Lefort, G.; Daoud, S.; Gaillard, D.


    Results of CT scan exploration are reported in two cases of subperiosteal chondroma, one in a 4 year old child affecting the anterior tibial tuberosity the other in a 9 year old child involving the upper end of humerus. Data from CT scan imaging were undoubtedly superior to those of conventional radiography and appear to be characteristic of this benign cartilaginous tumor, greatly facilitating correlation between clinical, radiological and pathologic findings. The scanner should allow certain situations to be dedramatized and the surgical attitude adapted when the functional prognosis is involved.

  9. TH-C-18A-02: Machine Learning and STAPLE Based Simultaneous Longitudinal Segmentation of Bone and Marrow Structures From Dual Energy CT

    Energy Technology Data Exchange (ETDEWEB)

    Fehr, D; Schmidtlein, C; Hwang, S; Deasy, J; Veeraraghavan, H [Memorial Sloan Kettering Cancer Center, New York, NY (United States)


    Purpose: To develop a fully-automatic longitudinal bone and marrow segmentation method in the pelvic region from dual energy computed tomography (DECT). Methods: We developed a two-step automatic bone and marrow segmentation method for simultaneous longitudinal evaluation of patients with metastatic bone disease using dual energy CT (DECT). Our approach transforms the DECT images into a multi-material decomposition (MMD) model that represents the voxels as a mixture of multiple materials. A support vector machine (SVM) was trained using a single scan. In the first step of the longitudinal segmentation the trained SVM model detects bone and marrow structures on all available longitudinal scans. Segmentation is further refined through active contour segmentation. In the second step, the segmentations from the individual scans are merged by employing the simultaneous truth and performance level estimation (STAPLE) algorithm. The scans are registered using affine and deformable registration. We found that our approach improves the segmentation in all the scans under reliable registration performance between the same scans. Improving registration was not under the scope of this work. Results: We applied our approach to segment bone and marrow in DECT scans in the pelvic regions for multiple patients. Each patient had three to five follow up scans. All the patients in the analysis had artificial metal prostheses which introduced challenges for the registration. Our algorithm achieved reasonable accurate segmentation despite the presence of metal artifacts and high-density oral contrast in neighboring structures. Our approach obtained an overall segmentation accuracy of 80% using DICE metric. Conclusion: We developed a two-step automatic longitudinal segmentation technique for bone and marrow region structures in the pelvic areas from dual energy CT. Our approach achieves robust segmentation despite the presence of confounding structures with similar intensities as the

  10. Colon distension and scan protocol for CT-colonography: An overview

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    Boellaard, Thierry N., E-mail: [Department of Radiology, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands); Haan, Margriet C. de, E-mail: [Department of Radiology, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands); Venema, Henk W., E-mail: [Department of Radiology, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands); Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands); Stoker, Jaap, E-mail: [Department of Radiology, Academic Medical Center, University of Amsterdam, PB 22660, 1100 DD Amsterdam (Netherlands)


    This article reviews two important aspects of CT-colonography, namely colonic distension and scan parameters. Adequate distension should be obtained to visualize the complete colonic lumen and optimal scan parameters should be used to prevent unnecessary radiation burden. For optimal distension, automatic carbon dioxide insufflation should be performed, preferably via a thin, flexible catheter. Hyoscine butylbromide is – when available – the preferred spasmolytic agent because of the positive effect on insufflation and pain/burden and its low costs. Scans in two positions are required for adequate distension and high polyp sensitivity and decubitus position may be used as an alternative for patients unable to lie in prone position. The great intrinsic contrast between air or tagging and polyps allows the use of low radiation dose. Low-dose protocol without intravenous contrast should be used when extracolonic findings are deemed unimportant. In patients suspected for colorectal cancer, normal abdominal CT scan protocols and intravenous contrast should be used in supine position for the evaluation of extracolonic findings. Dose reduction can be obtained by lowering the tube current and/or voltage. Tube current modulation reduces the radiation dose (except in obese patients), and should be used when available. Iterative reconstructions is a promising dose reducing tool and dual-energy CT is currently evaluated for its applications in CT-colonography. This review also provides our institution's insufflation procedure and scan parameters.

  11. CT scan in diagnosis of pituitary adenomas, 5. CT findings of GH secreting adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Sakoda, K.; Yonezawa, M.; Gen, M. (Hiroshima Univ. (Japan). School of Medicine)


    Clinical findings and radiological findings in 19 cases of GH secreting adenoma were reported. In diagnosis of GH secreting adenoma, conventional radiography and computed tomography of the sella turcica are useful. The CT of this kind of adenomas shows a characteristically higher x-ray absorption coefficient than other adenomas.

  12. The Impact of Sources of Variability on Parametric Response Mapping of Lung CT Scans. (United States)

    Boes, Jennifer L; Bule, Maria; Hoff, Benjamin A; Chamberlain, Ryan; Lynch, David A; Stojanovska, Jadranka; Martinez, Fernando J; Han, Meilan K; Kazerooni, Ella A; Ross, Brian D; Galbán, Craig J


    Parametric response mapping (PRM) of inspiration and expiration computed tomography (CT) images improves the radiological phenotyping of chronic obstructive pulmonary disease (COPD). PRM classifies individual voxels of lung parenchyma as normal, emphysematous, or nonemphysematous air trapping. In this study, bias and noise characteristics of the PRM methodology to CT and clinical procedures were evaluated to determine best practices for this quantitative technique. Twenty patients of varying COPD status with paired volumetric inspiration and expiration CT scans of the lungs were identified from the baseline COPD-Gene cohort. The impact of CT scanner manufacturer and reconstruction kernels were evaluated as potential sources of variability in PRM measurements along with simulations to quantify the impact of inspiration/expiration lung volume levels, misregistration, and image spacing on PRM measurements. Negligible variation in PRM metrics was observed when CT scanner type and reconstruction were consistent and inspiration/expiration lung volume levels were near target volumes. CT scanner Hounsfield unit drift occurred but remained difficult to ameliorate. Increasing levels of image misregistration and CT slice spacing were found to have a minor effect on PRM measurements. PRM-derived values were found to be most sensitive to lung volume levels and mismatched reconstruction kernels. As with other quantitative imaging techniques, reliable PRM measurements are attainable when consistent clinical and CT protocols are implemented.

  13. Bone scans after total knee arthroplasty in asymptomatic patients. Cemented versus cementless

    Energy Technology Data Exchange (ETDEWEB)

    Hofmann, A.A.; Wyatt, R.W.; Daniels, A.U.; Armstrong, L.; Alazraki, N.; Taylor, A. Jr. (Univ. of Utah Medical Center, Salt Lake City (USA))


    The natural history of bone scans after total knee arthroplasty (TKA) was studied in 26 patients with 28 cemented TKAs and 29 patients with 31 cementless TKAs. The bone scans were examined at specified postoperative intervals. Radionuclide activity of the femoral, tibial, and patellar regions was measured. Six patients who developed pain postoperatively were excluded. Bone scans immediately postoperative and at three months demonstrated increased uptake, which gradually decreased to baseline levels at ten to 12 months. Radioisotope uptake was comparable in the cemented and cementless groups, but was highly variable in individual patients and in each of the follow-up periods. A single postoperative bone scan cannot differentiate component loosening from early bone remodeling. Sequential bone scans, as a supplement to the clinical examination and conventional radiography, may prove useful in the diagnosis of TKA failure.

  14. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... have a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these conditions may ... particularly the lungs, abdomen, pelvis and bones. A diagnosis determined by CT scanning may eliminate the need ...

  15. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... have a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these conditions may ... particularly the lungs, abdomen, pelvis and bones. A diagnosis determined by CT scanning may eliminate the need ...

  16. Lumbosacral spine CT (United States)

    ... More Broken bone CT scan Cyst Herniated disk Osteoarthritis Osteomalacia Tumor Review Date 9/8/2014 Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  17. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... entire body will be "inside" the scanner at one time such as with MRI. If an intravenous ... CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, ...

  18. Reduction scan time pitch for media measurement procedures ITV in lung cancer with CT-CT fusion; Reduccion de pitch para scantime medios en procedimientos de medida de ITV en cancer de pulmon con fusion CT-CT

    Energy Technology Data Exchange (ETDEWEB)

    Velazquez Miranda, S.; Ramirez Gutierrez, Y.; Rodriguez Alarcon, C.; Herrador Cordoba, M.


    The evolution of CT technology has led to the non-specific scanners for radiotherapy the scan time maximum is reduced to 2 seconds. This forces us to change the procedure for obtaining similar results.

  19. Interactive lung segmentation in abnormal human and animal chest CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Kockelkorn, Thessa T. J. P., E-mail:; Viergever, Max A. [Image Sciences Institute, University Medical Center Utrecht, 3584 CX Utrecht (Netherlands); Schaefer-Prokop, Cornelia M. [Department of Radiology, Meander Medical Centre, 3813 TZ Amersfoort, The Netherlands and Diagnostic Image Analysis Group, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen (Netherlands); Bozovic, Gracijela [Center for Diagnostic Imaging and Physiology, Skåne University Hospital, Lund University, SE-221 85 Lund (Sweden); Muñoz-Barrutia, Arrate [Cancer Imaging Laboratory, Center for Applied Medical Research, University of Navarra, ES-31008 Pamplona, Navarra (Spain); Rikxoort, Eva M. van [Diagnostic Image Analysis Group, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen (Netherlands); Brown, Matthew S. [Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California 90024 (United States); Jong, Pim A. de [Department of Radiology, University Medical Center Utrecht, 3584 CX Utrecht (Netherlands); Ginneken, Bram van [Diagnostic Image Analysis Group, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen (Netherlands); Image Sciences Institute, University Medical Center Utrecht, 3584 CX Utrecht (Netherlands)


    Purpose: Many medical image analysis systems require segmentation of the structures of interest as a first step. For scans with gross pathology, automatic segmentation methods may fail. The authors’ aim is to develop a versatile, fast, and reliable interactive system to segment anatomical structures. In this study, this system was used for segmenting lungs in challenging thoracic computed tomography (CT) scans. Methods: In volumetric thoracic CT scans, the chest is segmented and divided into 3D volumes of interest (VOIs), containing voxels with similar densities. These VOIs are automatically labeled as either lung tissue or nonlung tissue. The automatic labeling results can be corrected using an interactive or a supervised interactive approach. When using the supervised interactive system, the user is shown the classification results per slice, whereupon he/she can adjust incorrect labels. The system is retrained continuously, taking the corrections and approvals of the user into account. In this way, the system learns to make a better distinction between lung tissue and nonlung tissue. When using the interactive framework without supervised learning, the user corrects all incorrectly labeled VOIs manually. Both interactive segmentation tools were tested on 32 volumetric CT scans of pigs, mice and humans, containing pulmonary abnormalities. Results: On average, supervised interactive lung segmentation took under 9 min of user interaction. Algorithm computing time was 2 min on average, but can easily be reduced. On average, 2.0% of all VOIs in a scan had to be relabeled. Lung segmentation using the interactive segmentation method took on average 13 min and involved relabeling 3.0% of all VOIs on average. The resulting segmentations correspond well to manual delineations of eight axial slices per scan, with an average Dice similarity coefficient of 0.933. Conclusions: The authors have developed two fast and reliable methods for interactive lung segmentation in

  20. Comparison of bone histomorphometry and μCT for evaluating bone quality in tail-suspended rats (United States)

    Sun, Lian-Wen; Huang, Yun-Fei; Wang, Ying; Luan, Hui-Qin; Fan, Yu-Bo


    Astronauts often suffer from microgravity-induced osteoporosis due to their time in space. Bone histomorphometry, the 'gold standard' technique for detecting bone quality, is widely used in the evaluation of osteoporosis. This study investigates whether μCT has the same application value as histomorphometry in the evaluation of weightlessness-induced bone loss. A total of 24 SD rats were distributed into three groups (n = 8, each): tail-suspension (TS), TS plus active exercise (TSA), and control (CON). After 21 days, bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) and μCT, and microstructure was measured by μCT and histomorphometry. BMD was found to have decreased significantly in TS and TSA compared with the CON group. The results of the μCT measurements showed that a change in BMD mainly occurred in the trabecular bone, and the trabecular BMD increased significantly in the TSA compared with the TS group. The comparison of μCT and histomorphometry showed that TS led to a significant decrease in bone volume (BV/TV), trabecular thickness (Tb.Th) and trabecular number (Tb.N), and it led to an increase in trabecular separation (Tb.Sp). However, active exercise can prevent these changes. Significant differences in most parameters between TSA and CON were found by μCT but not by histomorphometry. Additionally, the parameters of these two methods are highly correlated. Therefore, the application value of μCT is as good as histomorphometry and DXA in the diagnosis of weightlessness-induced osteoporosis and is even better in evaluating the efficacy of exercise.

  1. HT-BONE: a graphical user interface for the identification of bone profiles in CT images via extended Hough transform (United States)

    Campi, Cristina; Perasso, Annalisa; Beltrametti, Mauro C.; Piana, Michele; Sambuceti, Gianmario; Massone, Anna Maria


    It has been recently proved that the computational analysis of X-ray Computed Tomography (CT) images allows clinicians to assess the alteration of compact bone asset due to hematological diseases. HT-BONE implements a new method, based on an extension of the Hough transform (HT) to a wide class of algebraic curves, for accurately measuring global and regional geometric properties of trabecular and compact bone districts. In the case of CT/PET analysis, the segmentation of the CT images provides masks for Positron Emission Tomography (PET) data, extracting the metabolic activity in the region surrounded by compact bone tissue. HT-BONE offers an intuitive, user-friendly, Matlab-based Graphical User Interface (GUI) for all input/output procedures and the automatic managing of the segmentation process also from non-expert users: the CT/PET data can be loaded and browsed easily and the only pre-preprocessing required from the user is the drawing of Regions Of Interest (ROIs) around the bone districts under consideration. For each bone district, specific families of curves, whose reliability has been already tested in previous works, is automatically selected for the recognition task via HT. As output, the software returns masks of the segmented compact bone regions, images of the Standard Uptake Values (SUV) in the masked regions of PET slices, and the values of the parameters in the curve equations utilized in the HT procedure. This information can be used for all pathologies and clinical conditions for which the alteration of the compact bone asset or bone marrow distribution plays a crucial role.

  2. X-ray CT high-density artefact suppression in the presence of bones

    Energy Technology Data Exchange (ETDEWEB)

    Wei Jikun [School of Health Sciences, 550 Stadium Mall Drive, West Lafayette, IN 47907-2051 (United States); Chen Laigao [BioImaging Center of Emphasis, Pfizer Global Research and Development, 2800 Plymouth RD, Ann Arbor, MI 48105 (United States); Sandison, George A [School of Health Sciences, 550 Stadium Mall Drive, West Lafayette, IN 47907-2051 (United States); Liang Yun [Department of Radiology, Indiana University Medical School, Indianapolis, IN 46202 (United States); Xu, Lisa X [School of Mechanical Engineering, 585 Purdue Mall, West Lafayette, IN 47907-2040 (United States)


    This paper presents a novel method of reducing x-ray CT high-density artefacts generated by metal objects when abundant bone structures are present in the region of interest. This method has an advantage over previously proposed methods since it heavily suppresses the metal artefacts without introducing extra bone artefacts. The method of suppression requires that bone pixels are isolated and segmented by thresholding. Then artificial CT numbers are assigned to the bone pixels so that their projection profiles are smooth and thus can be properly simulated by a polynomial interpolation. The projection profile of the metal object is then removed to fully suppress the artefacts. The resulting processed profile is fed to a reconstruction routine and the previously preserved bone pixels added back. The new method utilizes two important features of the CT image with metal artefacts: (a) metal and bone pixels are not severely affected by the high-density artefacts and (b) the high-density artefacts can be located in specific projection channels in the profile domain, although they are spread out in the image domain. This suppression method solves the problem of CT image artefacts arising from metal objects in the body. It has the potential to greatly improve diagnostic CT imaging in the presence of these objects and treatment planning that utilizes CT for patients with metal applicators (e.g., brachytherapy for cervix cancer and prostate cryotherapy)

  3. Implant planning and placement using optical scanning and cone beam CT technology

    NARCIS (Netherlands)

    J.M. van der Zel


    There is a growing interest in minimally invasive implant therapy as a standard prosthodontic treatment, providing complete restoration of occlusal function. A new treatment method (CADDIMA), which combines both computerized tomographic (CT) and optical laser-scan data for planning and design of sur

  4. Virtual teeth: a 3D method for editing and visualizing small structures in CT scans

    DEFF Research Database (Denmark)

    Bro-Nielsen, Morten; Larsen, Per; Kreiborg, Sven;


    The paper presents an interactive method for segmentation and visualization of small structures in CT scans. A combination of isosurface generation, spatial region growing and interactive graphics tools are used to extract small structures interactively. A practical example of segmentation of the...

  5. Selection of colon cancer patients for neoadjuvant chemotherapy by preoperative CT scan

    DEFF Research Database (Denmark)

    Nørgaard, Anne; Dam, Claus; Jakobsen, Anders


    invasion (ETI), nodal stage (N-stage), extramural venous invasion (EVI) and the distance from tumor to nearest retroperitoneal fascia (DRF) were retrospectively assessed on the CT scan and compared blindly with the results of the pathological examination, including evaluation of the criteria for adjuvant...

  6. The fissural complex of the lung: anatomy and variations on thin-section CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Soo; Kim, Pyo Nyun; Kim, Il Young; Bae, Won Kyung; Lee, Byoung Ho [College of Medicine, Soonchunhyang University, Cheonan (Korea, Republic of)


    To evaluate further the right minor and major fissure on thin-section narrow-interval CT scans with particular emphases on orientation, degree of completeness. This section CT scans from 10 mm distal to carina to the proximal basal segmental bronchus were obtained at 5 mm invervals in 50 consecutive subjects. Orientation, degree of completeness, and the relationship of the minor and major fissure on thin-section CT scans were analyzed. Four principal types of the minor fissure could be identified according to the highest point of the upper surface of the middle lobe. At bronchus intermedius level, the major fissure appeared with its medial end anterior to lateral end in 45 subjects. The minor fissure was complete in only 10 subjects (20%). Completely absent minor fissure was noted in four subjects (8%). The major fissure was incomplete in 17 subjects (34%) at bronchus intermedius level, the minor and major fissure intersected each other in only 27 subjects (54%). The highest point of intersection was variable. There are much more variations in the fissural complex in our study than in previous reports and these variations can be visualized well on thin-section CT scans.

  7. CT-scan bij stomp buiktrauma bij kinderen : veel stralen en weinig opbrengst?

    NARCIS (Netherlands)

    Nellensteijn, David R; El Moumni, Mostafa; Greuter, Marcel J W; Kneyber, Martin C J; Hulscher, Jan B F


    Blunt abdominal trauma in children occurs fairly frequently. Although computed tomography scanning is considered by many to be the gold standard, in children who are hemodynamically stable, CT images do not usually result in new perspectives that lead to changes in treatment management. However, the

  8. Study Finds Small Increase in Cancer Risk after Childhood CT Scans (United States)

    A study published in the June 6, 2012, issue of The Lancet shows that radiation exposure from computed tomography (CT) scans in childhood results in very small but increased risks of leukemia and brain tumors in the first decade after exposure.

  9. 3D quantification of soil structure and functioning based on PET and CT scanning techniques

    DEFF Research Database (Denmark)

    Garbout, Amin

    . The processed measurements show some expected and a few unexpected effects (or lack of effects) on different characteristics of soil structure. The combination of CT and PET scanning in an air plant soil controller system revealed some very interesting research possibilities. Interactions between soil structure...

  10. Investigation of the potential causes of partial scan artifacts in dynamic CT myocardial perfusion imaging (United States)

    Tao, Yinghua; Speidel, Michael; Szczykutowicz, Timothy; Chen, Guang-Hong


    In recent years, there have been several findings regarding CT number variations (partial scan artifact or PSA) across time in dynamic myocardial perfusion studies with short scan gated reconstruction. These variations are correlated with the view angle range corresponding to the short scan acquisition for a given cardiac phase, which can vary from one cardiac cycle to another due to the asynchrony between heart rate and gantry rotation speed. In this study, we investigate several potential causes of PSA, including noise, beam hardening and scatter, using numerical simulations. In addition, we investigate partial scan artifact in a single source 64-slice diagnostic CT scanner in vivo data sets, and report its effect on perfusion analysis. Results indicated that among all three factors investigated, scatter can cause obvious partial scan artifact in dynamic myocardial perfusion imaging. Further, scatter is a low frequency phenomenon and is not heavily dependent on the changing contrasts, as both the frequency method and the virtual scan method are effective in reducing partial scan artifact. However, PSA does not necessarily lead to different blood volume maps compared to the full scan, because these maps are usually generated with a curve fitting procedure.

  11. Radiographic skeletal survey and radionuclide bone scan in Langerhans cell histiocytosis of bone

    Energy Technology Data Exchange (ETDEWEB)

    Nieuwenhuyse, J.P. van [Department of Radiology and Medical Imaging, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium); Clapuyt, P. [Department of Radiology and Medical Imaging, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium); Malghem, J. [Department of Radiology and Medical Imaging, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium); Everarts, P. [Department of Radiology and Medical Imaging, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium); Melin, J. [Department of Nuclear Medicine, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium); Pauwels, S. [Department of Nuclear Medicine, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium); Brichard, B. [Department of Pediatric Hematology, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium); Ninane, J. [Department of Pediatric Hematology, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium); Vermylen, C. [Department of Pediatric Hematology, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium); Cornu, G. [Department of Pediatric Hematology, Cliniques Universitaires St-Luc, University of Louvain Medical School, Brussels (Belgium)


    Background. The lack of a consensus in the literature on the imaging strategy in Langerhans cell histiocytosis (LCH) bone lesions in childhood. Objective. To evaluate the relative value of radionuclide bone scan (RBS) and radiographic skeletal survey (RSS) in the detection of LCH bone lesions, both in the initial work-up of the disease and during the follow-up period. Materials and methods. Ten children with bone lesions evaluated by means of RSS and RBS in a retrospective study (1984-1993). Results. Fifty radiologically and/or scintigraphically abnormal foci were detected: 27 anomalies in the initial work-up (12 by both RSS and RBS, 8 by RSS only and 7 by RBS only) and 23 additional anomalies during follow-up (10 by both RSS and RBS, 10 by RSS only and 3 by RBS only). RSS+/RBS- lesions (n = 18) are more frequently encountered in the skull (P = 0.038), and more frequently lack radiologic signs of osteoblastic activity (P = 0.020), than RSS+/RBS+ lesions (n = 22). RSS-/RBS+ abnormalities (n = 10) were most frequently insignificant. Conclusion. In the initial work-up both RSS and RBS should be carried out, while in the follow-up only RSS should be performed. (orig.). With 2 figs., 4 tabs.

  12. Correlation between the Degree and Severity of Symptoms and CT scan Changes in Chronic Rhinosinusitis (CRS

    Directory of Open Access Journals (Sweden)

    H. Moghaddasi


    Full Text Available Background/Objective: find out whether any correlation exists between the degree and severity of symptoms as assessed by the SNOT-20 questionnaire and CT scan changes as graded by Lund-Mackay scoring system in chronic rhinosinusitis (CRS."nPatients and Methods: Fifties patients attending the otolaryngology department and diagnosed with CRS were prospectively entered in this study. All patients had their CT scans graded by using the Lund-Mackay  with the sino-nasal outcome questionnaire (SNOT-20. Correlation analysis was conducted to determine whether the CT scan stage as assigned by Lund Mackay staging system correlated with the SNOT-20 scores."nResults: The mean age of our patients was 32.4±8.5 and 32(64% of them were male and 18(36% were female. The mean SNOT-20 was 45±8.7 (29-67 and the mean Lund-Mackay sinus score was 18.5±5 (8- 24.The mean SNOT-20 score was higher for postnasal drip (PND and facial pain, and the lowest mean scores were for dizziness and ear pain. The Pearson's correlation coefficient confirmed that there was a good correlation between SNOT-20 scores and CT scores (Pearson correlation coefficient 0.77; P value, 0.0001."nConclusion: Patients with higher symptom scores are more likely to have CT imaging evidence of rhinosinusitis. In patients with isolated sleep or systematic symptoms, the likelihood of rhinosinusitis is less, even if symptoms are severe. Therefore, in these patients, sinus CT-scan should be considered before treatment to establish the diagnosis of chronic rhinosinusitis due to that a number of these patients may be doing not have rhinosinusitis.

  13. Automatic intrinsic cardiac and respiratory gating from cone-beam CT scans of the thorax region (United States)

    Hahn, Andreas; Sauppe, Sebastian; Lell, Michael; Kachelrieß, Marc


    We present a new algorithm that allows for raw data-based automated cardiac and respiratory intrinsic gating in cone-beam CT scans. It can be summarized in three steps: First, a median filter is applied to an initially reconstructed volume. The forward projection of this volume contains less motion information and is subtracted from the original projections. This results in new raw data that contain only moving and not static anatomy like bones, that would otherwise impede the cardiac or respiratory signal acquisition. All further steps are applied to these modified raw data. Second, the raw data are cropped to a region of interest (ROI). The ROI in the raw data is determined by the forward projection of a binary volume of interest (VOI) that includes the diaphragm for respiratory gating and most of the edge of the heart for cardiac gating. Third, the mean gray value in this ROI is calculated for every projection and the respiratory/cardiac signal is acquired using a bandpass filter. Steps two and three are carried out simultaneously for 64 or 1440 overlapping VOI inside the body for the respiratory or cardiac signal respectively. The signals acquired from each ROI are compared and the most consistent one is chosen as the desired cardiac or respiratory motion signal. Consistency is assessed by the standard deviation of the time between two maxima. The robustness and efficiency of the method is evaluated using simulated and measured patient data by computing the standard deviation of the mean signal difference between the ground truth and the intrinsic signal.

  14. Self-guided clinical cases for medical students based on postmortem CT scans of cadavers. (United States)

    Bohl, Michael; Francois, Webster; Gest, Thomas


    In the summer of 2009, we began full body computed tomography (CT) scanning of the pre-embalmed cadavers in the University of Michigan Medical School (UMMS) dissection lab. We theorized that implementing web-based, self-guided clinical cases based on postmortem CT (PMCT) scans would result in increased student appreciation for the clinical relevance of anatomy, increased knowledge of cross-sectional anatomy, and increased ability to identify common pathologies on CT scans. The PMCT scan of each cadaver was produced as a DICOM dataset, and then converted into a Quicktime movie file using Osirix software. Clinical cases were researched and written by the authors, and consist of at least one Quicktime movie of a PMCT scan surrounded by a novel navigation interface. To assess the value of these clinical cases we surveyed medical students at UMMS who are currently using the clinical cases in their coursework. Students felt the clinical cases increased the clinical relevance of anatomy (mean response 7.77/10), increased their confidence finding anatomical structures on CT (7.00/10), and increased their confidence recognizing common pathologies on CT (6.17/10). Students also felt these clinical cases helped them synthesize material from numerous courses into an overall picture of a given disease process (7.01/10). These results support the conclusion that our clinical cases help to show students why the anatomy they are learning is foundational to their other coursework. We would recommend the use of similar clinical cases to any medical school utilizing cadaver dissection as a primary teaching method in anatomy education.

  15. Thromboembolic Complications Following Spine Surgery Assessed with Spiral CT Scans: DVT/PE Following Spine Surgery. (United States)

    Kim, Han Jo; Walcott-Sapp, Sarah; Adler, Ronald S; Pavlov, Helene; Boachie-Adjei, Oheneba; Westrich, Geoffrey H


    Spine surgery is associated with a significant risk of postoperative pulmonary embolism (PE) and/or deep vein thrombosis (DVT). The goal of this study was to determine which symptoms and risk factors were associated with spiral CT scans positive for PE and/or DVT in the postoperative spine surgery patient. We conducted a retrospective review of all spine patients who underwent a postoperative CT to rule out PE during the period of March 2004-February 2006. The type of surgical procedure, risk factors, symptoms prompting scan ordering, anticoagulation, and treatment were recorded. Logistic regression models were used to determine significant predictors of a positive CT in this patient population. Of the 3,331 patients that had spine surgery during the study period, 130 (3.9%) had a spiral CT scan to rule out PE and/or proximal DVT. Thirty-three of the 130 (25.4%) CT scans were positive for PE only, five (3.8%) for PE and DVT, and three (2.3%) for DVT only. Only 24.5% (32) patients had risk factors for thromboembolic disease, and of these, a history of PE and/or DVT was the only significant risk factor for a positive scan (p = 0.03). No presenting symptoms or demographic variables were noted to have a significant association with PE and/or DVT. The type of surgical procedure (i.e., anterior, posterior, and percutaneous) was not associated with an increased risk for PE and/or DVT. Patients who are undergoing spine surgery with a history of thromboembolic disease should be carefully monitored postoperatively and may benefit from more aggressive prophylaxis.

  16. Analysis of chromosome translocation frequency after a single CT scan in adults. (United States)

    Abe, Yu; Miura, Tomisato; Yoshida, Mitsuaki A; Ujiie, Risa; Kurosu, Yumiko; Kato, Nagisa; Katafuchi, Atsushi; Tsuyama, Naohiro; Kawamura, Fumihiko; Ohba, Takashi; Inamasu, Tomoko; Shishido, Fumio; Noji, Hideyoshi; Ogawa, Kazuei; Yokouchi, Hiroshi; Kanazawa, Kenya; Ishida, Takashi; Muto, Satoshi; Ohsugi, Jun; Suzuki, Hiroyuki; Ishikawa, Tetsuo; Kamiya, Kenji; Sakai, Akira


    We recently reported an increase in dicentric chromosome (DIC) formation after a single computed tomography (CT) scan (5.78-60.27 mSv: mean 24.24 mSv) and we recommended analysis of 2000 metaphase cells stained with Giemsa and centromere-FISH for dicentric chromosome assay (DCA) in cases of low-dose radiation exposure. In the present study, we analyzed the frequency of chromosome translocations using stored Carnoy's-fixed lymphocyte specimens from the previous study; these specimens were from 12 patients who were subject to chromosome painting of Chromosomes 1, 2 and 4. Chromosomes 1, 2 and 4 were analyzed in ∼5000 cells, which is equivalent to the whole-genome analysis of almost 2000 cells. The frequency of chromosome translocation was higher than the number of DICs formed, both before and after CT scanning. The frequency of chromosome translocations tended to be higher, but not significantly higher, in patients with a treatment history compared with patients without such a history. However, in contrast to the results for DIC formation, the frequency of translocations detected before and after the CT scan did not differ significantly. Therefore, analysis of chromosome translocation may not be a suitable assay for detecting chromosome aberrations in cases of low-dose radiation exposure from a CT scan. A significant increase in the frequency of chromosome translocations was not likely to be detected due to the high baseline before the CT scan; the high and variable frequency of translocations was probably due to multiple confounding factors in adults.

  17. Rigid model-based 3D segmentation of the bones of joints in MR and CT images for motion analysis. (United States)

    Liu, Jiamin; Udupa, Jayaram K; Saha, Punam K; Odhner, Dewey; Hirsch, Bruce E; Siegler, Sorin; Simon, Scott; Winkelstein, Beth A


    There are several medical application areas that require the segmentation and separation of the component bones of joints in a sequence of images of the joint acquired under various loading conditions, our own target area being joint motion analysis. This is a challenging problem due to the proximity of bones at the joint, partial volume effects, and other imaging modality-specific factors that confound boundary contrast. In this article, a two-step model-based segmentation strategy is proposed that utilizes the unique context of the current application wherein the shape of each individual bone is preserved in all scans of a particular joint while the spatial arrangement of the bones alters significantly among bones and scans. In the first step, a rigid deterministic model of the bone is generated from a segmentation of the bone in the image corresponding to one position of the joint by using the live wire method. Subsequently, in other images of the same joint, this model is used to search for the same bone by minimizing an energy function that utilizes both boundary- and region-based information. An evaluation of the method by utilizing a total of 60 data sets on MR and CT images of the ankle complex and cervical spine indicates that the segmentations agree very closely with the live wire segmentations, yielding true positive and false positive volume fractions in the range 89%-97% and 0.2%-0.7%. The method requires 1-2 minutes of operator time and 6-7 min of computer time per data set, which makes it significantly more efficient than live wire-the method currently available for the task that can be used routinely.

  18. Preoperative assessment of the cancellous bone mineral density of the proximal humerus using CT data

    Energy Technology Data Exchange (ETDEWEB)

    Krappinger, Dietmar; Roth, Tobias; Gschwentner, Martin; Suckert, Armin; Blauth, Michael; Hengg, Clemens; Kralinger, Franz [Innsbruck Medical University, Department of Trauma Surgery and Sports Medicine, Innsbruck (Austria)


    Osteoporotic fractures of the proximal humerus show an increasing incidence. Osteoporosis not only influences the fracture risk after low-energy trauma, but also affects the mechanical stability of internal fixation. Preoperative assessment of the local bone quality may be useful in the surgical treatment of patients sustaining these injuries. The aim of the present study was to present a method for the preoperative assessment of the local cancellous bone mineral density (BMD) of the proximal humerus using CT data. In the first part of the study, CT scans of 30 patients with unilateral fractures of the proximal humerus after low-energy trauma were used. The local BMD was assessed on the contralateral uninjured side. All 30 patients additionally underwent dual-emission X-ray absorptiometry (DXA) of the lumbar spine, proximal femur, and forearm of the side of the uninjured proximal humerus within 6 weeks after trauma. Three independent trauma surgeons performed measurements on the uninjured proximal humerus twice with a time interval of 4 weeks in order to assess the inter- and intraobserver reliability of the method. In the second part of the study, the local BMD of 507 patients with either proximal humerus fractures or chronic shoulder instability was assessed by a single trauma surgeon. In both parts, the average HU values in standardized ROIs of the humeral head were automatically calculated after correcting for HU values below the water equivalent. A linear calibration equation was computed for the calculation from HU to BMD using a calibration device (EFP). The intra- and interobserver reliability was high (ICC > 0.95). Correlation coefficients between the local BMD of the proximal humerus and other anatomical sites were between 0.35 (lumbar spine) and 0.64 (forearm). We found a high correlation between the local BMD and age. The BMD in the fracture group was significantly lower than in the instability group. These patients were significantly older and more

  19. Value and limits of μ-CT for nondemineralized bone tissue processing. (United States)

    Draenert, Miriam Esther; Draenert, Alice Irène; Forriol, Francisco; Cerler, Michael; Kunzelmann, Karl-Heinz; Hickel, Reinhard; Draenert, Klaus


    An experimental approach was performed on 20 giant rabbits to establish the possibilities and limitations of μ-CT for routine processing of nondemineralized bone tissue. Hydroxyapatite (HA) or β-tricalciumphosphate (β-TCP) bead implants or a melange of both, microchambered and solid, were implanted into a standardized and precise defect in the patellar groove. The bone-healing phase was chosen for the histology considering 1 or 2 days, and 2, 3, and 6 weeks. Normal X-ray and μ-CT were applied on all specimens; five specimens in the 6-week stage were additionally processed according to the full range of conventional nondemineralized bone processing methods. μ-CT increased the possibilities of nondemineralized histology with respect to bone morphometry and a complete sequence of sections, thus providing a complete analysis of the bone response. μ-CT was limited in differentiating bone quality, cell analyses, and mineralization stages. The investigation based on normal X-rays is limited to defining integration and excluding the fibrous and bony encapsulation of loose implants. μ-CT allows a 3D evaluation of newly formed bone which is clearly marked against the ceramic implant. It does not allow, however, for the differentiation between woven and lamellar bone, the presentation of the canalicular lacunar system, or on the cell level, revealing canaliculi or details of the mineralization process which can be documented by high-resolution microradiography. Titer dynamics of bone formation remains the domain of polychromatic sequential labeling. The complete sequence of μ-CT slices enhances the possibilities for routine histology, tremendously allowing to the focus on detail histology to topographically well-defined cuts, thus providing more precise conclusions which take into consideration the whole implant.

  20. Bone SPECT/CT detection of a sequestrum in chronic-infected nonunion of the tibia

    DEFF Research Database (Denmark)

    Madsen, Jan L


    Abstract: Sequestra are dead pieces of bone most often seen in long bones affected with prior or current infection. In addition to antibiotic therapy, chronic osteomyelitis with sequestration requires surgical debridement for cure. The author presents a case of tibial fracture associated with chr......Abstract: Sequestra are dead pieces of bone most often seen in long bones affected with prior or current infection. In addition to antibiotic therapy, chronic osteomyelitis with sequestration requires surgical debridement for cure. The author presents a case of tibial fracture associated...... with chronic osteomyelitis, nonunion, and the presence of a sequestrum that was detected by bone SPECT/CT.  ...

  1. Assessment value of quantitative indexes of pancreatic CT perfusion scanning for malignant degree of pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Jiang-Xia Lei


    Objective:To analyze the assessment value of the quantitative indexes of pancreatic CT perfusion scanning for malignant degree of pancreatic cancer.Methods:A total of 58 patients with space-occupying pancreatic lesions were divided into 20 patients with pancreatic cancer and 38 patients with benign pancreatic lesions after pancreatic CT perfusion. Patients with pancreatic cancer received palliative surgery, and the cancer tissue and para-carcinoma tissue specimens were collected during operation. The differences in pancreatic CT perfusion scanning parameter values and serum tumor marker levels were compared between patients with pancreatic cancer and patients with benign pancreatic lesions, mRNA expression levels of malignant molecules in pancreatic cancer tissue and para-carcinoma tissue were further determined, and the correlation between pancreatic CT perfusion scanning parameter values and malignant degree of pancreatic cancer was analyzed.Results:CT perfusion scanning BF, BV and Per values of patients with pancreatic cancer were lower than those of patients with benign pancreatic lesions; serum CA19-9, CEA, CA125 and CA242 levels were higher than those of patients with benign pancreatic lesions (P<0.05); mRNA expression levels of Bcl-2, Bcl-xL andsurvivin in pancreatic cancer tissue samples were higher than those in para-carcinoma tissue samples, and mRNA expression levels ofP53 andBax were lower than those in para-carcinoma tissue samples (P<0.05); CT perfusion scanning parameters BF, BV and Per values of patients with pancreatic cancer were negatively correlated with CA19-9, CEA, CA125 and CA242 levels in serum as well as mRNA expression levels ofBcl-2, Bcl-xL and survivinin pancreatic cancer tissue, and positively correlated with mRNA expression levels ofP53andBaxin pancreatic cancer tissue (P<0.05).Conclusions:Pancreatic CT perfusion scanning is a reliable way to judge the malignant degree of pancreatic cancer and plays a positive role in guiding clinical

  2. Anatomy-based registration of CT-scan and intraoperative X-ray images for guiding a surgical robot. (United States)

    Guéziec, A; Kazanzides, P; Williamson, B; Taylor, R H


    We describe new methods for rigid registration of a preoperative computed tomography (CT)-scan image to a set of intraoperative X-ray fluoroscopic images, for guiding a surgical robot to its trajectory planned from CT. Our goal is to perform the registration, i.e., compute a rotation and translation of one data set with respect to the other to within a prescribed accuracy, based upon bony anatomy only, without external fiducial markers. With respect to previous approaches, the following aspects are new: 1) we correct the geometric distortion in fluoroscopic images and calibrate them directly with respect to the robot by affixing to it a new calibration device designed as a radiolucent rod with embedded metallic markers, and by moving the device along two planes, while radiographs are being acquired at regular intervals; 2) the registration uses an algorithm for computing the best transformation between a set of lines in three space, the (intraoperative) X-ray paths, and a set of points on the surface of the bone (imaged preoperatively), in a statistically robust fashion, using the Cayley parameterization of a rotation; and 3) to find corresponding sets of points to the X-ray paths on the surfaces, our new approach consists of extracting the surface apparent contours for a given viewpoint, as a set of closed three-dimensional nonplanar curves, before registering the apparent contours to X-ray paths. Aside from algorithms, there are a number of major technical difficulties associated with engineering a clinically viable system using anatomy and image-based registration. To detect and solve them, we have so far conducted two experiments with the surgical robot in an operating room (OR), using CT and fluoroscopic image data of a cadaver bone, and attempting to faithfully simulate clinical conditions. Such experiments indicate that intraoperative X-ray-based registration is a promising alternative to marker-based registration for clinical use with our proposed method.

  3. Role of (99m)Tc-MDP bone scan in the diagnosis of Erdheim-Chester disease. (United States)

    Mukherjee, Anirban; Damle, Nishikant; Bal, Chandrasekhar; Arora, Arundeep; Singhal, Abhinav; Tripathi, Madhavi; Peepre, Karan


    Erdheim-Chester disease (ECD) is a rare systemic non-Langerhans cell histiocytosis. It is a progressive disease of unknown etiology. The (99m)technetium-methylene diphosphonate ((99m)Tc-MDP) bone scan is useful in finding the sites of involvement in the skeleton and is helpful in excluding other causes of bony pain. Also a scintigraphic pattern consistent with ECD should alert the physician to evaluate the patient for visceral sites of involvement using fludeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), as this is known to be fatal at times.

  4. System for the analysis of whole-bone strength from helical CT images (United States)

    Camp, Jon J.; Karwoski, Ronald A.; Stacy, Mahlon C.; Atkinson, Elizabeth J.; Khosla, Sundeep; Melton, L. Joseph; Riggs, B. Lawrence; Robb, Richard A.


    Osteoporosis affects an estimated 44 million Americans. This condition results from bone loss, but the measured change in bone mass does not fully account for the marked decrease in whole-bone structural integrity seen in osteoporosis. In order to study structural changes in bone mineral distribution due to normal ageing and osteoporosis, we have developed a method for progressive analysis of whole-bone mechanical integrity from helical CT images. The system provides rapid semi-automated alignment of femur and vertebrae volume images into standard anatomic reference planes, and calculates bone mineral density in any selected 3D sections of bone. Mineral density measures are obtained using both full-width-half-max contours and threshold-derived masks, and are obtained for cortical bone and trabecular bone separately. Biomechanical properties of the bone cross-section are also assessed, including the 2-D bending moment of the cortical bone region and the integrated flexural rigidity of the cortical region or whole-bone region in arbitrary planes. This method facilitates progressive refinement of the analysis protocol by separating the labor-intensive alignment and landmark selection process from the analysis process. As the analysis protocol evolves to include new measures, previously analyzed images can be automatically reanalyzed, using the image regions originally specified. Initial results show inverse correlation of indices of biomechanical bone strength with age, greater loss of bone strength in the lumbar spine than in the femoral neck, and more trabecular than cortical bone loss at both sites.

  5. Study of CT head scans using different voltages: image quality evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Pacheco de Freitas C, I.; Prata M, A. [Centro Federal de Educacao Tecnologica de Minas Gerais, Centro de Engenharia Biomedica, Av. Amazonas 5253, 30421-169 Nova Suica, Belo Horizonte, Minas Gerais (Brazil); Alonso, T. C. [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Av. Pte. Antonio Carlos 6627, 31270-901 Pampulha, Belo Horizonte, Minas Gerais (Brazil); Santana, P., E-mail: [Universidade Federal de Minas Gerais, Departamento de Anatomia e Imagem, Av. Prof. Alfredo Balena 190, 30130-100 Belo Horizonte, Minas Gerais (Brazil)


    Computed tomography (CT) was introduced to medical practice in 1972. It generates images recognized by high diagnostic potential. CT allows investigation of structures in the human body inaccessible by conventional image methods, replacing invasive methods in many cases. Noise is a kind of variation of brightness observed on CT images, and it is inherent to this method. The magnitude of the noise is determined by the standard deviation of CT numbers of a region of interest in a homogeneous material. The aim of this study is to analyze the noise in head CT images generated by different acquisition protocols using four voltage values. Five different scans were performed using a female Alderson phantom and their images were analyzed with the RadiAnt software. With the average HU values and standard deviation of each scan, the values of noise were calculated in some region of interest. The obtained noise values were compared and it was observed that the 140 kV voltage promotes the in the lower noise in the image, resulting in better image quality. The results also show that the parameters, such as voltage and current, can be adjusted so that the noise can be decreased. Thus, acquisition protocols may be adapted to produce images with diagnostic quality and lower doses in patient. (Author)

  6. National Survey of Radiation Dose and Image Quality in Adult CT Head Scans in Taiwan.

    Directory of Open Access Journals (Sweden)

    Chung-Jung Lin

    Full Text Available The purpose of the present study was to evaluate the influence of different variables on radiation dose and image quality based on a national database.Taiwan's Ministry of Health and Welfare requested all radiology departments to complete a questionnaire for each of their CT scanners. Information gathered included all scanning parameters for CT head scans. For the present analysis, CT machines were divided into three subgroups: single slice CT (Group A; multi-detector CT (MDCT with 2-64 slices (Group B; and MDCT with more than 64 slices (Group C. Correlations between computed tomography dose index (CTDI and signal-to-noise ratio (SNR with cumulated tube rotation number (CTW(n and cumulated tube rotation time (CTW(s, and sub group analyses of CTDI and SNR across the three groups were performed.CTDI values demonstrated a weak correlation (r = 0.33 with CTW(n in Group A. SNR values demonstrated a weak negative correlation (r = -0.46 with CTW(n in Group C. MDCT with higher slice numbers used more tube potential resulting in higher effective doses. There were both significantly lower CTDI and SNR values in helical mode than in axial mode in Group B, but not Group C.CTW(n and CTW(s did not influence radiation output. Helical mode is more often used in MDCT and results in both lower CTDI and SNR compared to axial mode in MDCT with less than 64 slices.

  7. Aphasia caused by intracerebral hemorrhage; CT-scan findings and prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Furuya, Kazuhide; Segawa, Hiromu; Shiokawa, Yoshiaki; Hasegawa, Isao; Sano, Keiji (Fuji Brain Institute and Hospital, Shizuoka (Japan))


    It is generally accepted that cases of aphasia can be divided into several groups according to verbal fluency, auditory comprehension, and repetition abilities. Although many authors have studied aphasia and its location by means of a CT scan, the primary lesion on a CT scan with regard to the subtypes of aphasia still remains controversial. In this report we present our new CT classification for the syndromes of aphasia and the prognosis. Twenty-one patients with intracerebral hematoma (ICH) were followed up for more than 3 months after onset. ICH was classified according to the mode of the horizontal extension of the hematoma on a CT scan. Four lines were decided as follows: Line (a) is between the anterior horn of the lateral ventricle and the midpoint of the third ventricle; Line (b) is the vertical line to the saggital line which originates from the midpoint of the third ventricle; Line (c) is between the trigone of the lateral ventricle and the midpoint of the third ventricle. The CT classification consisted of 4 types: in Type A, ICH was located anterior to line (a); in Type B, ICH was located between line (a) and line (b); in Type C, ICH was located between line (b) and line (c); Type B+C, was a combination of Type B and Type C. Transcortical motor aphasia belonged to the Type A group. Transcortical sensory aphasia belonged to the Type B and Type B+C groups. Wernicke's and anomic aphasia belonged to the Type C group. Conduction and global aphasia belonged to the Type B+C group. Pure Broca's aphasia could not be observed in this series. Several relationships between the syndromes of aphasia and its CT findings were evident. On the other hand, the syndromes of aphasia and the degree of recovery were not correlated, except for global aphasia. (author).

  8. Multislice helical CT (MSCT) for mid-facial trauma: optimization of parameters for scanning and reconstruction; Mehrschicht-Spiral-CT (MSCT) beim Mittelgesichtstrauma: Optimierung der Aufnahme- und Rekonstruktionsparameter

    Energy Technology Data Exchange (ETDEWEB)

    Dammert, S.; Funke, M.; Obernauer, S.; Grabbe, E. [Abt. Roentgendiagnostik I, Georg-August-Univ. Goettingen (Germany); Merten, H.A. [Abt. fuer Mund-, Kiefer- und Gesichtschirurgie, Georg-August-Univ. Goettingen (Germany)


    Purpose: To determine the optimal scan parameters in multislice helical CT (MSCT) of the facial bone complex for both axial scanning and multiplanar reconstructions. Material and Methods: An anthropomorphic skull phantom was examined with a MSCT. Axial scans were performed with continuously increasing collimations (4 x 1.25 - 4 x 2.5 mm), tube current (20 - 200 mA) and table speeds (3.75 mm/rot. and 7.5 mm/rot.). Multiplanar reconstructions in coronal and parasagittal planes with different reconstruction increment and slice thickness were evaluated in terms of image noise, contour artifacts and visualisation of anatomical structures. Results: The best image quality was obtained with a collimation of 4 x 1.25 mm and a - table speed of 3.75 mm/rot. A reconstruction increment of 0.6 mm achieved the best time to image quality relation. With these parameters the bone structures were depicted in an optimal way without artifacts. The tube current could be reduced to 50 mA without significant loss of image quality. The optimized protocol was used for regular routine examinations in patients with facial trauma (n = 66). Conclusions: Low-dose MSCT using thin collimation, low table speed and small reconstruction increments provides excellent data for both axial images and multiplanar reconstructions in patients with facial trauma. An additional examination in coronal orientation is therefore no longer necessary. (orig.) [German] Zielsetzung: Verbesserung der Aufnahme- und Rekonstruktionsparameter in der Mehrschicht Spiral-CT (MSCT) zur Untersuchung des knoechernen Mittelgesichtes in verschiedenen Ebenen. Material und Methode: Ein anthropomorphes Schaedel-Phantom wurde in axialer Schichtfuehrung mit einem MSCT untersucht, wobei die Kollimation (1,25 - 2,5 mm), der Tischvorschubfaktor (Pitch 3 - 6) und der Roehrenstrom (20 - 200 mA) systematisch variiert wurden. Aus den Volumendatensaetzen wurden jeweils koronare und parasagittale Sekundaerreformationen mit unterschiedlichen

  9. Evaluation in the use of bismuth shielding on cervical spine CT scan using a male phantom

    Energy Technology Data Exchange (ETDEWEB)

    Aleme, C.; Mourao, A. P. [Centro Federal de Educacion Tecnologica de Minas Gerais, Biomedical Engineering Center, Belo Horizonte - MG (Brazil); Lyra, M. A., E-mail: [Universidad Federal de Minas Gerais, Department of Nuclear Engineering, Av. Pdte. Antonio Carlos 6627, Pampulha, 31270-91 Belo Horizonte - MG (Brazil)


    The cervical spine is the region of the column that articulates the head and chest. The tests of computed tomography (CT) performed in this region have as main objectives to diagnose fractures, dislocations and tumors. In CT scans the cervical spine volume is limited by the foramen Magnum and the first thoracic vertebra. In this region is the thyroid that is directly irradiated by X-ray beam during cervical scan. Based on this information, it was studied the dose variation deposited in thyroid and in nearby organs, such as: lenses, spinal cord in the foramen Magnum region and breasts, with and without the use of bismuth protector. In this study was used a male anthropomorphic phantom and thermoluminescent s dosimeters (TLD-100) were required to register the individual doses in the organs of interest. CT scans were performed on a GE Bright Speed scanner of 32 channels. With the data obtained, it was found the organ dose variation. The largest recorded dose was in the thyroid. Comparing two scans it was possible to note that the use of the bismuth protector promoted a 26% reduction in the thyroid dose and an increase in the lens dose. (Author)

  10. Evaluation of the image quality of chest CT scans: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Martins N, P. I.; Prata M, A., E-mail: [Centro Federal de Educacao Tecnologica de Minas Gerais, Centro de Engenharia Biomedica, Av. Amazonas 5253, 30421-169 Nova Suica, Belo Horizonte, Minas Gerais (Brazil)


    Computed tomography (CT) is considered one of the most important methods of medical imaging employed nowadays, due to its non-invasiveness and the high quality of the images it is able to generate. However, the diagnostic radiation dose received by an individual over the year often exceeds the dose received on account of background radiation. Therefore, it is important to know and to control the dose distribution in the patient by varying the image acquisition parameters. The aim of this study is to evaluate the variation of the image quality of chest CT scans performed by two phantoms. In this paper, a cylindrical Polymethyl Methacrylate (PMMA) chest phantom was used and a second PMMA phantom has been developed with the same volume but an oblong shape, based on the actual dimensions of a male human thorax, in the axillary region. Ten-centimeter scans of the central area of each phantom were performed by a 16-channel Toshiba CT scanner, model Alexion. The scanning protocol employed was the radiology service protocol for chest scans. The noise survey was conducted within the image of the center slice, in five regions: one central and four peripheral areas close to the edge of the object (anterior, posterior, left and right). The recorded values showed that the oblong phantom, with a shape that is more similar to the actual human chest, has a considerably smaller noise, especially in the anterior, posterior and central regions. (Author)

  11. When to perform positron emission tomography/computed tomography or radionuclide bone scan in patients with recently diagnosed prostate cancer

    Directory of Open Access Journals (Sweden)

    Caldarella C


    Full Text Available Carmelo Caldarella,1 Giorgio Treglia,2 Alessandro Giordano,1 Luca Giovanella2 1Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy; 2Department of Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland Abstract: Skeletal metastases are very common in prostate cancer and represent the main metastatic site in about 80% of prostate cancer patients, with a significant impact in patients' prognosis. Early detection of bone metastases is critical in the management of patients with recently diagnosed high-risk prostate cancer: radical treatment is recommended in case of localized disease; systemic therapy should be preferred in patients with distant secondary disease. Bone scintigraphy using radiolabeled bisphosphonates is of great importance in the management of these patients; however, its main drawback is its low overall accuracy, due to the nonspecific uptake in sites of increased bone turnover. Positron-emitting radiopharmaceuticals, such as fluorine-18-fluorodeoxyglucose, choline-derived drugs (fluorine-18-fluorocholine and carbon-11-choline and sodium fluorine-18-fluoride, are increasingly used in clinical practice to detect metastatic spread, and particularly bone involvement, in patients with prostate cancer, to reinforce or substitute information provided by bone scan. Each radiopharmaceutical has a specific mechanism of uptake; therefore, diagnostic performances may differ from one radiopharmaceutical to another on the same lesions, as demonstrated in the literature, with variable sensitivity, specificity, and overall accuracy values in the same patients. Whether bone scintigraphy can be substituted by these new methods is a matter of debate. However, greater radiobiological burden, higher costs, and the necessity of an in-site cyclotron limit the use of these positron emission tomography methods as first-line investigations in patients with prostate cancer

  12. Multimodal target correction by local bone registration: a PET/CT evaluation. (United States)

    Oliveira-Santos, Thiago; Weitzel, Thilo; Klaeser, Bernd; Krause, Thomas; Nolte, Lutz-Peter; Weber, Stefan; Reyes, Mauricio


    PET/CT guidance for percutaneous interventions allows biopsy of suspicious metabolically active bone lesions even when no morphological correlation is delineable in the CT images. Clinical use of PET/CT guidance with conventional step-by-step technique is time consuming and complicated especially in cases in which the target lesion is not shown in the CT image. Our recently developed multimodal instrument guidance system (IGS) for PET/CT improved this situation. Nevertheless, bone biopsies even with IGS have a trade-off between precision and intervention duration which is proportional to patient and personnel exposure to radiation. As image acquisition and reconstruction of PET may take up to 10 minutes, preferably only one time consuming combined PET/CT acquisition should be needed during an intervention. In case of required additional control images in order to check for possible patient movements/deformations, or to verify the final needle position in the target, only fast CT acquisitions should be performed. However, for precise instrument guidance accounting for patient movement and/or deformation without having a control PET image, it is essential to be able to transfer the position of the target as identified in the original PET/CT to a changed situation as shown in the control CT.

  13. A novel sedimentological method based on CT-scanning: Use for tomographic characterization of the Galicia Interior Basin (United States)

    Mena, Anxo; Francés, Guillermo; Pérez-Arlucea, Marta; Aguiar, Pablo; Barreiro-Vázquez, José Daniel; Iglesias, Alfredo; Barreiro-Lois, Andrés


    Non-destructive techniques of core analysis, especially of marine cores, are being broadly employed for sedimentary, paleoceanographic and paleoclimate research. In particular, Computed Tomography scanning (CT-scanning) allows acquisition of 3D and 2D images, according to desired planes, and thus the identification of sedimentary structures, large grains and their distributions as well as direct measurements of material densities. The most significant contribution of this technique is the possibility of getting results before opening the core. In this work CT-scan data obtained for five cores from the Galicia Interior Basin (GIB, NW Peninsula Iberia) are presented and discussed, focussing on (1) methodology of the CT-scan use, (2) tomographic description of sedimentary facies identified in the GIB, (3) treatment of the numeric data obtained with CT-scanning using specific software (anidoC), and (4) comparison of tomographic data with data obtained by conventional methodologies of core analysis. The most singular feature of GIB cores is the presence of Ice Rafted Debris (IRD) deposited during late Pleistocene Heinrich Events (HE), which can be easily recognized using the CT-scan by the presence of high radio-density grains immersed in a low radio-density matrix. Comparison of CT-scan data with analytical sedimentary data and HE proxies performed on the cores validates the CT-scanning method as a powerful tool to improve correlations, identify well-constrained events, and make more accurate basin reconstructions without opening all the cores in an oceanographic study.

  14. Use of dual-energy CT and virtual non-calcium techniques to evaluate post-traumatic bone bruises in knees in the subacute setting

    Energy Technology Data Exchange (ETDEWEB)

    Ai, Songtao [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Shanghai Ninth People' s Hospital, Department of Radiology, Shanghai (China); Qu, Mingliang; Glazebrook, Katrina N.; Liu, Yu; Leng, Shuai; McCollough, Cynthia H. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Rhee, Peter C. [Mayo Clinic, Department of Orthopedics, Rochester, MN (United States)


    The purpose of this study was to determine the ability of dual-energy computed tomography (DECT) and virtual non-calcium (VNCa) imaging to detect magnetic resonance imaging (MRI)-demonstrated bone bruises several weeks after unilateral knee injury. Patients with unilateral knee injury and MRI-confirmed bone bruises who had undergone a DECT scan of both knees were retrospectively identified. Two radiologists evaluated VNCa images for bruises in four regions per knee without knowing the MRI results. The mean CT numbers were calculated for the lesion-positive and lesion-negative regions of the injured knee, and the contralateral knee. Fourteen patients with a total of 36 regions positive for bone bruises on MRI were identified. The median delay between injury and DECT was 37 days (range, 11-99 days). The mean CT numbers in VNCa images for lesion-positive and lesion-negative regions were -7.6 ± 24.9 HU and -58.2 ± 19.5 HU, respectively. There were no significant differences in mean CT number between the lesion-negative regions in the injured knee and the contralateral knee. No resolution of bruising was seen before week 5, and bone bruising was still identifiable in one out of the two patients scanned at 10 weeks following injury. DECT and VNCa images can identify bone bruising for at least 10 weeks after injury. (orig.)

  15. Processing of microCT implant-bone systems images using Fuzzy Mathematical Morphology (United States)

    Bouchet, A.; Colabella, L.; Omar, S.; Ballarre, J.; Pastore, J.


    The relationship between a metallic implant and the existing bone in a surgical permanent prosthesis is of great importance since the fixation and osseointegration of the system leads to the failure or success of the surgery. Micro Computed Tomography is a technique that helps to visualize the structure of the bone. In this study, the microCT is used to analyze implant-bone systems images. However, one of the problems presented in the reconstruction of these images is the effect of the iron based implants, with a halo or fluorescence scattering distorting the micro CT image and leading to bad 3D reconstructions. In this work we introduce an automatic method for eliminate the effect of AISI 316L iron materials in the implant-bone system based on the application of Compensatory Fuzzy Mathematical Morphology for future investigate about the structural and mechanical properties of bone and cancellous materials.

  16. Technetium phosphate bone scan in the diagnosis of septic arthritis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Sundberg, S.B.; Savage, J.P.; Foster, B.K. (Adelaide Childrens Hospital (Australia))


    The technetium phosphate bone scans of 106 children with suspected septic arthritis were reviewed to determine whether the bone scan can accurately differentiate septic from nonseptic arthropathy. Only 13% of children with proved septic arthritis had correct blind scan interpretation. The clinically adjusted interpretation did not identify septic arthritis in 30%. Septic arthritis was incorrectly identified in 32% of children with no evidence of septic arthritis. No statistically significant differences were noted between the scan findings in the septic and nonseptic groups and no scan findings correlated specifically with the presence or absence of joint sepsis.

  17. Micro-CT analyses of historical bone samples presenting with osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Lamm, C.; Pietschmann, P. [Medical University Vienna (MUV), Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Vienna (Austria); Dockner, M.; Weber, G.W. [University of Vienna, Department of Anthropology, Vienna (Austria); University of Vienna, Core Facility for Micro-Computed Tomography, Vienna (Austria); Pospischek, B.; Winter, E.; Patzak, B. [Museum of Natural History (NHM), Collection of Anatomical Pathology in the Madhouse Tower, Vienna (Austria); Pretterklieber, M. [Medical University of Vienna (MUV), Department of Applied Anatomy, Vienna (Austria)


    Osteomyelitis is an inflammation of the bone marrow mainly caused by bacteria such as Staphylococcus aureus. It typically affects long bones, e.g. femora, tibiae and humeri. Recently micro-computed tomography (μCT) techniques offer the opportunity to investigate bone micro-architecture in great detail. Since there is no information on long bone microstructure in osteomyelitis, we studied historic bone samples with osteomyelitis by μCT. We investigated 23 femora of 22 individuals suffering from osteomyelitis provided by the Collection of Anatomical Pathology, Museum of Natural History, Vienna (average age 44 ±19 years); 9 femora from body donors made available by the Department of Applied Anatomy, Medical University of Vienna (age range, 56-102 years) were studied as controls. Bone microstructure was assessed by μCT VISCOM X 8060 II with a minimal resolution of 18 μm. In the osteomyelitic femora, most prominent alterations were seen in the cortical compartment. In 71.4 % of the individuals with osteomyelitis, cortical porosity occurred. 57.1 % of the individuals showed cortical thinning. In 42.9 % trabecularisation of cortical bone was observed. Osteomyelitis is associated with severe alterations of cortical bone structure otherwise typically observed at old age such as cortical porosity and cortical thinning. (orig.)

  18. CT Scan of Thirteen Natural Mummies Dating Back to the XVI-XVIII Centuries: An Emerging Tool to Investigate Living Conditions and Diseases in History.

    Directory of Open Access Journals (Sweden)

    Enrico Petrella

    Full Text Available To correlate the radiologic findings detected with computed tomography scan with anthropological data in 13 naturally mummified bodies discovered during works of recovery of an ancient church in a crypt in Roccapelago, in the Italian Apennines.From a group of about sixty not-intentionally mummified bodies, thirteen were selected to be investigated with volumetric computed tomography (CT. Once CT scan was performed, axial images were processed to gather MPR and Volume Rendering reconstructions. Elaborations of these images provided anthropometric measurements and a non-invasive analysis of the residual anatomical structures. For each body the grade of preservation and the eventual pathological changes were recorded. Furthermore, in order to identify nutritional and occupational markers, radiologic signs of bone tropism and degenerative changes were analysed and graded.Mummies included seven females and six males, with an estimated age ranging from 20 to 60 years. The first relevant finding identified was a general low grade of preservation, due to the lack of anatomic tissues different from bones, tendons and dehydrated skin. The low grade of preservation was related to the natural process of mummification. Analysing bone degenerative changes on CT scan, the majority of the bodies had significant occupational markers consisting of arthritis in the spine, lower limbs and shoulders even in young age. Few were the pathological findings identified. Among these, the most relevant included a severe bilateral congenital hip dysplasia and a wide osteolytic lesion involving left orbit and petrous bone that was likely the cause of death.Although the low grade of preservation of these mummies, the multidisciplinary approach of anthropologists and radiologists allowed several important advances in knowledge for the epidemiology of Roccapelago. First of all, a profile of living conditions was delineated. It included occupational and nutritional conditions

  19. CT pre-operative planning of a new semi-implantable bone conduction hearing device

    Energy Technology Data Exchange (ETDEWEB)

    Law, Eric K.C.; Bhatia, Kunwar S.S. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Hong Kong, SAR (China); Tsang, Willis S.S.; Tong, Michael C.F. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Otorhinolaryngology, Head and Neck Surgery, Hong Kong, SAR (China); Shi, Lin [The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong, SAR (China); The Chinese University of Hong Kong, Chow Yuk Ho Technology Center for Innovative Medicine, Hong Kong, SAR (China)


    Accommodating a novel semi-implantable bone conduction hearing device within the temporal bone presents challenges for surgical planning. This study describes the utility of CT in pre-operative assessment of such an implant. Retrospective review of pre-operative CT, clinical and surgical records of 16 adults considered for device implantation. Radiological suitability was assessed on CT using 3D simulation software. Antero-posterior (AP) dimensions of the mastoid bone and minimum skull thickness were measured. CT planning results were correlated with operative records. Eight and five candidates were suitable for device placement in the transmastoid and retrosigmoid positions, respectively, and three were radiologically unsuitable. The mean AP diameter of the mastoid cavity was 14.6 mm for the transmastoid group and 4.6 mm for the retrosigmoid group (p < 0.05). Contracted mastoid and/or prior surgery were predisposing factors for unsuitability. Four transmastoid and five retrosigmoid positions required sigmoid sinus/dural depression and/or use of lifts due to insufficient bone capacity. A high proportion of patients being considered have contracted or operated mastoids, which reduces the feasibility of the transmastoid approach. This finding combined with the complex temporal bone geometry illustrates the importance of careful CT evaluation using 3D software for precise device simulation. (orig.)

  20. CT of meningiomas on the posterior surface of the petrous bone

    Energy Technology Data Exchange (ETDEWEB)

    Valavanis, A.; Schubiger, O.; Hayek, J.; Pouliadis, G.


    A detailed analysis of the CT findings in 16 surgically verified cases of meningioma of the posterior surface of the petrous bone is presented. The results indicate that a correct preoperative diagnosis is possible in almost every case. Frequently occuring specific CT criteria for meningioma of the posterior surface of the petrous bone include: hyperdense, homogeneously enhancing, extra-axial, CPA mass; inverse relationship between precontrast attenuation value and degree of contrast enhancement of the tumor; oval shape; obtuse angle between lateral tumor border and posterior surface of petrous bone, and evidence of transcisternal supratentorial tumor extension. Infrequently occuring specific CT criteria include: tumor calcification; hyperostosis or exostosis of the posterior surface of the petrous bone; a comma-shaped tumor configuration in cases with transcisternal tumor extension and evidence of transtentorial tumor extension. Oxygen CT cisternography is the most sensitive and reliable technique for detecting small tumors. The CT differential diagnosis of meningioma of the posterior surface of the petrous bone is discussed.

  1. 浅析骨盆骨折CT扫描的临床效果%Clinical effect of CT scan of pelvis fracture

    Institute of Scientific and Technical Information of China (English)



    objective to the clinical value of CT scan of pelvis fracture of pelvic fracture, improve the diagnosis rate, reduce misdiagnosis, missed diagnosis. Methods a retrospective analysis of 20 cases of pelvic fractures CT scan data. Results by spiral CT scans of 20 patients with diagnosis of pelvic fractures with pelvic hematoma, 4 cases of fracture of obturator muscle contusion in 2 cases, 1 case was bladder rupture. Conclusion pelvic fractures CT scan can reveal cannot be determined X-ray plain film damage, and by spiral CT scanning understanding of the fracture line, the shift of broken bones, and presence of pelvic cavity viscera damage, and provide important basis for clinical diagnosis accurately and properly handle.%目的:浅析骨盆骨折CT扫描的临床价值,提高骨盆骨折的确诊率,减少误诊、漏诊。方法回顾性分析20例骨盆骨折CT扫描资料。结果通过螺旋CT扫描确诊骨盆骨折20例,其中骨折合并盆腔血肿4例,闭孔内肌挫伤2例,膀胱破裂1例。结论骨盆骨折CT扫描可揭示X线平片不能确定的损伤,并通过螺旋CT扫描了解骨折的走行、碎骨片的移位及有无盆腔脏器损伤,为临床精确诊断和正确处理提供重要依据。

  2. Preliminary results of automated removal of degenerative joint disease in bone scan lesion segmentation (United States)

    Chu, Gregory H.; Lo, Pechin; Kim, Hyun J.; Auerbach, Martin; Goldin, Jonathan; Henkel, Keith; Banola, Ashley; Morris, Darren; Coy, Heidi; Brown, Matthew S.


    Whole-body bone scintigraphy (or bone scan) is a highly sensitive method for visualizing bone metastases and is the accepted standard imaging modality for detection of metastases and assessment of treatment outcomes. The development of a quantitative biomarker using computer-aided detection on bone scans for treatment response assessment may have a significant impact on the evaluation of novel oncologic drugs directed at bone metastases. One of the challenges to lesion segmentation on bone scans is the non-specificity of the radiotracer, manifesting as high activity related to non-malignant processes like degenerative joint disease, sinuses, kidneys, thyroid and bladder. In this paper, we developed an automated bone scan lesion segmentation method that implements intensity normalization, a two-threshold model, and automated detection and removal of areas consistent with non-malignant processes from the segmentation. The two-threshold model serves to account for outlier bone scans with elevated and diffuse intensity distributions. Parameters to remove degenerative joint disease were trained using a multi-start Nelder-Mead simplex optimization scheme. The segmentation reference standard was constructed manually by a panel of physicians. We compared the performance of the proposed method against a previously published method. The results of a two-fold cross validation show that the overlap ratio improved in 67.0% of scans, with an average improvement of 5.1% points.

  3. Synchrotron μCT Imaging of Bone, Titanium implants and Bone Substitutes -a Systematic Review of the Literature

    DEFF Research Database (Denmark)

    Neldam, Camilla Albeck; Pinholt, Else Marie


    examinations, SRμCT is considered as a gold standard to image trabecular bone microarchitecture since it is possible in a 3D manner to visualize fine structural elements within mineralized tissue such as osteon boundaries, rods and plates structures, cement lines, and differences in mineralization...

  4. Patellar subluxation syndrome. Observation of the patellofemoral joint using CT-scan

    Energy Technology Data Exchange (ETDEWEB)

    Yagi, Tomonori; Sasaki, Tetsuto; Susuda, Koichi; Moji, Junichi (Hokkaido Univ., Sapporo (Japan). School of Medicine)


    Clinical symptoms of patellar subluxation syndrome associated with pain were investigated for 24 knees of 20 patients, and the state of patella dislocation was observed by CT-scan. The patients had high incidence of an apprehension sign, showing their fear of patellar luxation. Many of them complained of patello-femoral joint pain due to chondromalacia patellae. In order to derive patellar subluxation, the method of CT-Q-contraction was carried out at the extended position of the patellar joint. In patients with patellar subluxation syndrome, the rate of shift in the diseased side was significantly higher than that of the other side, suggesting decreased muscular strength of the musculus vastus of the diseased side. Improvement of the symptoms was seen in all except one of 12 knees operated by the combined method of Green's method with Blauth's more than 6 months before. Availability of this operation was verified by the CT-Q-contraction.

  5. Unusual bone-scan findings in acute osteomyelitis: case report. [/sup 99m/Tc tracer technique

    Energy Technology Data Exchange (ETDEWEB)

    Russin, L.D.; Staab, E.V.


    In osteomyelitis, bone-scan findings precede the appearance of bone changes on radiographs. In cases where focal ischemia occurs, the earliest scan finding may be a cold area that later becomes hot as active periostitis develops.

  6. BoneJ: Free and extensible bone image analysis in ImageJ. (United States)

    Doube, Michael; Kłosowski, Michał M; Arganda-Carreras, Ignacio; Cordelières, Fabrice P; Dougherty, Robert P; Jackson, Jonathan S; Schmid, Benjamin; Hutchinson, John R; Shefelbine, Sandra J


    Bone geometry is commonly measured on computed tomographic (CT) and X-ray microtomographic (μCT) images. We obtained hundreds of CT, μCT and synchrotron μCT images of bones from diverse species that needed to be analysed remote from scanning hardware, but found that available software solutions were expensive, inflexible or methodologically opaque. We implemented standard bone measurements in a novel ImageJ plugin, BoneJ, with which we analysed trabecular bone, whole bones and osteocyte lacunae. BoneJ is open source and free for anyone to download, use, modify and distribute.

  7. Combined bone scintigraphy and indium-111 leukocyte scans in neuropathic foot disease

    Energy Technology Data Exchange (ETDEWEB)

    Schauwecker, D.S.; Park, H.M.; Burt, R.W.; Mock, B.H.; Wellman, H.N.


    It is difficult to diagnose osteomyelitis in the presence of neurotrophic osteoarthropathy. We performed combined (99mTc)MDP bone scans and indium-111 (111In) leukocyte studies on 35 patients who had radiographic evidence of neuropathic foot disease and clinically suspected osteomyelitis. The (111In)leukocyte study determined if there was an infection and the bone scan provided the anatomic landmarks so that the infection could be localized to the bone or the adjacent soft tissue. Seventeen patients had osteomyelitis and all showed increased (111In)leukocyte activity localized to the bone, giving a sensitivity of 100%. Among the 18 patients without osteomyelitis, eight had no accumulation of (111In)leukocytes, seven had the (111In)leukocyte activity correctly localized to the soft tissue, two had (111In)leukocyte activity mistakenly attributed to the bone, and one had (111In)leukocyte accumulation in a proven neuroma which was mistakenly attributed to bone. These three false-positive results for osteomyelitis reduced the specificity to 83%. Considering only the 27 patients with a positive (111In)leukocyte study, the combined bone scan and (111In)leukocyte study correctly localized the infection to the soft tissues or bone in 89%. Uninfected neurotrophic osteoarthropathy does not accumulate (111In)leukocytes. We found the combined bone scan and (111In) leukocyte study useful for the detection and localization of infection to soft tissue or bone in patients with neuropathic foot disease.

  8. Thoracic CT (United States)

    ... lungs; CT scan - chest Images CT scan Thyroid cancer - CT scan Pulmonary nodule, solitary - CT scan Lung mass, right upper ... Chest Injuries and Disorders CT Scans Emphysema Lung Cancer Lung Diseases Pleural Disorders Pneumonia Pulmonary Embolism Tuberculosis Browse the Encyclopedia A.D.A. ...

  9. The prognostic value of brain CT scan in infants with periventricular leukomalacia

    Energy Technology Data Exchange (ETDEWEB)

    Okumura, Akihisa; Hayakawa, Fumio; Kuno, Kuniyoshi (Anjo Kosei Hospital, Aichi (Japan)); Natsume, Jun; Watanabe, Kazuyoshi


    Brain CT scan was performed at 40 weeks of conceptional age in 17 preterm infants with periventricular leukomalacia (PVL). The finding of periventricular low density was not useful in differentiating patients with PVL from normal infants, because this finding was seen in 40% of normal infants. The following findings were characteristic of PVL : (1) a marked low density area in centrum semioval, (2) an irregular outline of ventricular wall, and (3) low density spots in periventricular white matter. The findings of ventricular dilation with irregular wall and marked low density area in centrum semioval were correlated with a finding of volume loss on MRI during late infancy and the severity of neurological impairment, especially in severely affected patients. Marked low density area in centrum semioval was characteristic of severe PVL as demonstrated on brain CT scan. (author).

  10. Automated segmentation of tumors on bone scans using anatomy-specific thresholding (United States)

    Chu, Gregory H.; Lo, Pechin; Kim, Hyun J.; Lu, Peiyun; Ramakrishna, Bharath; Gjertson, David; Poon, Cheryce; Auerbach, Martin; Goldin, Jonathan; Brown, Matthew S.


    Quantification of overall tumor area on bone scans may be a potential biomarker for treatment response assessment and has, to date, not been investigated. Segmentation of bone metastases on bone scans is a fundamental step for this response marker. In this paper, we propose a fully automated computerized method for the segmentation of bone metastases on bone scans, taking into account characteristics of different anatomic regions. A scan is first segmented into anatomic regions via an atlas-based segmentation procedure, which involves non-rigidly registering a labeled atlas scan to the patient scan. Next, an intensity normalization method is applied to account for varying levels of radiotracer dosing levels and scan timing. Lastly, lesions are segmented via anatomic regionspecific intensity thresholding. Thresholds are chosen by receiver operating characteristic (ROC) curve analysis against manual contouring by board certified nuclear medicine physicians. A leave-one-out cross validation of our method on a set of 39 bone scans with metastases marked by 2 board-certified nuclear medicine physicians yielded a median sensitivity of 95.5%, and specificity of 93.9%. Our method was compared with a global intensity thresholding method. The results show a comparable sensitivity and significantly improved overall specificity, with a p-value of 0.0069.

  11. Plain film and CT observations in prostaglandin-induced bone changes

    Energy Technology Data Exchange (ETDEWEB)

    Matzinger, M.A.; Briggs, V.A.; Dunlap, H.J.; Udjus, K.; Martin, D.J.; McDonald, P. (Children' s Hospital of Eastern Ontario, Ottawa, ON (Canada). Dept. of Radiology)


    Prostaglandin E[sub 1] intravenous infusion is used in infants with ductal-dependent cogenital heart disease to maintain ductal patency and prolong life until palliative or corrective surgery is feasible. Complications of prostaglandin administration include fever, diarrhoea, hypotension, apnoea, bradycardia, pseudowidening of the cranial sutures, underossification of the calvarial bones, periostitis, and skin edema. This paper presents dramatic plain radiographic features of prostaglandin-induced bone disease, inlcuding periosteal proliferation and the unusual bone-within-bone apperance, and provides the previously unpublished CT correlation. (orig.).

  12. Camurati-Engelmann's Disease on {sup 99m}Tc-MDP Bone Scan

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hai Jeon; Oh, So Won; Paeng, Jin Chul; Lee, You Kyung; Choi, In Ho; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    A 24 year-old female presented for a {sup 99m}Tc-methylene diphosphonate (MDP) whole body bone scan due to chronic pain in the bilateral lower extremities that has aggravated since 2002. She was diagnosed with Camurati-Engelmann disease (CED) based on the clinical and radiological findings in 2002, and she re-visited our institute to evaluate disease status at this time. CED is a rare autosomal dominant type of bone dysplasia characterized by progressive cortical thickening of long bones, and narrowing of medullary cavity, and thus presents with typical clinical symptoms and signs such as chronic pain in the extremities, muscle weakness, and waddling gait. On the {sup 99m}Tc-MDP bone scan performed to evaluate disease status, intense increased uptake was seen in the skull, facial bones, bilateral scapulae, bilateral long bones, and bilateral pelvic bones, which clearly demonstrated the extent of CED involvement.

  13. Anatomical basis for the interpretation of CT-scan imaging of the lumbar spine. Pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Laredo, J.D.; Bard, M.


    A good understanding of the normal anatomy of the lumbar spine is required for the interpretation of CT-scans obtained for ischiatic or crural neuralgia. An attempt has been made to rely on precise terminology to designate each anatomical region pertaining to the lumbar canal. Examples of tomodensitometric investigations of the normal intervertebral space are given, and criteria allowing for the identification of normal anatomical variations are also provided.

  14. Renal Tumor Cryoablation Planning. The Efficiency of Simulation on Reconstructed 3D CT Scan

    Directory of Open Access Journals (Sweden)

    Ciprian Valerian LUCAN


    Full Text Available Introduction & Objective: Nephron-sparing surgical techniques risks are related to tumor relationships with adjacent anatomic structures. Complexity of the renal anatomy drives the interest to develop tools for 3D reconstruction and surgery simulation. The aim of the article was to assess the simulation on reconstructed 3D CT scan used for planning the cryoablation. Material & Method: A prospective randomized study was performed between Jan. 2007 and July 2009 on 27 patients who underwent retroperitoneoscopic T1a renal tumors cryoablation (RC. All patients were assessed preoperatively by CT scan, also used for 3D volume rendering. In the Gr.A, the patients underwent surgery planning by simulation on 3D CT scan. In the Gr.B., patients underwent standard RC. The two groups were compared in terms of surgical time, bleeding, postoperative drainage, analgesics requirement, hospital stay, time to socio-professional reintegration. Results: Fourteen patients underwent preoperative cryoablation planning (Gr.A and 13 patients underwent standard CR (Gr.B. All parameters analyzed were shorter in the Gr.A. On multivariate logistic regression, only shortens of the surgical time (138.79±5.51 min. in Gr.A. vs. 140.92±5.54 min in Gr.B. and bleeding (164.29±60.22 mL in Gr.A. vs. 215.38±100.80 mL in Gr.B. achieved statistical significance (p<0.05. The number of cryoneedles assessed by simulation had a 92.52% accuracy when compared with those effectively used. Conclusions: Simulation of the cryoablation using reconstructed 3D CT scan improves the surgical results. The application used for simulation was able to accurately assess the number of cryoneedles required for tumor ablation, their direction and approach.

  15. Lumbar spine joint synovial cysts of intraspinal development. CT scan imaging

    Energy Technology Data Exchange (ETDEWEB)

    Vallee, C.; Chevrot, A.; Benhamouda, M. and others

    CT scan imaging findings are described in 22 patients with lumbar spine joint synovial cysts, of intraspinal development, provoking sciatica or lumbosciatica from nerve compression in spinal canal. Diagnosis was suggested by a mass at the posterior joint level, of variable density, sometimes with peripheral calcification, presenting a vacuum appearance on occasions, and with enhanced image with contrast. Differential diagnosis is from excluded hernia and postoperative fibrosis. Posterior intra-articular arthrography can confirm diagnosis and allow treatment with prolonged action corticoid infiltrations.

  16. Intraventricular tuberculoma. Report of four cases in children. [CT scan findings described

    Energy Technology Data Exchange (ETDEWEB)

    Berthier, M.; Sierra, J.; Leiguarda, R.


    Four cases of intraventricular tuberculoma (IVT) in children are here reported. In none of the patients was there clinical evidence pointing to the intraventricular location. CT scan findings comprised three stages of development, namely: immature, mature and old. Ependymal attachment and asymmetric hydrocephalus were present in three cases, meningitis in two and ependymitis in one. Septum pellucidum traction was clearly observed in two patients, strongly supporting an adhesive process characteristic of intraventricular tuberculosis. Following specific treatment, the tuberculomas remitted partially or entirely.

  17. Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of); Ryu, Jeong Ah [Dept. of Radiology, Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of); Kim, Tae Hwan [Dept. of Rheynmatology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)


    Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

  18. Differentiation between eclampsia and cerebrovascular disorders by brain CT scan in pregnant patients with convulsive seizures

    Energy Technology Data Exchange (ETDEWEB)

    Eguchi, Katsuto; Lin, Yaw-Tyng; Noda, Kiyofumi; Saeki, Kazuhiko; Yonezawa, Masaru; Sekiba, Kaoru; Ochiai, Youji


    Six pregnant women with convulsions between 25 to 40 weeks of gestation were experienced. Among them, 4 patients were diagnosed as having intracranial hemorrhage and two as simple eclampsia. With the aid of brain CT scan, one case of arteriovenous malformation was detected and treated surgically with good prognosis for both the mother and the fetus. Two patients were diagnosed to have cerebral hemorrhage with subsequent penetration into the lateral ventricles and were treated conservatively. Their fetuses were delivered alive by cesarean section, but the mothers expired. The other patient with cerebral hemorrhage was treated surgically, and both the mother and the fetus survived. One of the simple eclampsia patients was noted to have a growth retarded fetus at 32 weeks of pregnancy with subsequent intra-uterine death, but the mother recovered after conservative treatment. Another patient at 40 weeks of pregnancy was also treated conservatively and both the fetus and the mother survived. Brain CT scan findings differed between these two eclampsia patients; local brain edema for the second patient and generalized brain edema for the first patient. Thus more active application of brain CT scan is recommended in managing pregnant patients with convulsions.

  19. 3D segmentation of abdominal aorta from CT-scan and MR images. (United States)

    Duquette, Anthony Adam; Jodoin, Pierre-Marc; Bouchot, Olivier; Lalande, Alain


    We designed a generic method for segmenting the aneurismal sac of an abdominal aortic aneurysm (AAA) both from multi-slice MR and CT-scan examinations. It is a semi-automatic method requiring little human intervention and based on graph cut theory to segment the lumen interface and the aortic wall of AAAs. Our segmentation method works independently on MRI and CT-scan volumes and has been tested on a 44 patient dataset and 10 synthetic images. Segmentation and maximum diameter estimation were compared to manual tracing from 4 experts. An inter-observer study was performed in order to measure the variability range of a human observer. Based on three metrics (the maximum aortic diameter, the volume overlap and the Hausdorff distance) the variability of the results obtained by our method is shown to be similar to that of a human operator, both for the lumen interface and the aortic wall. As will be shown, the average distance obtained with our method is less than one standard deviation away from each expert, both for healthy subjects and for patients with AAA. Our semi-automatic method provides reliable contours of the abdominal aorta from CT-scan or MRI, allowing rapid and reproducible evaluations of AAA.

  20. Case of primary pontine hemorrhage of the young adult followed by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Mashiyama, Shoji; Higuchi, Hiroshi; Takahashi, Akira


    A case of primary pontine hemorrhage of the young was reported. He was 22 years of age, who did not have the history of hypertension. He suddenly noticed disturbance of skilled act of his right hand and speech disturbance. He was admitted to our clinic two days after the onset. Neurological examination revealed right facial palsy, disturbance of delicate movement of his right hand and slight dysarthria. Lumbar puncture, after six days from the onset, yielded watery clear cerebrospinal fluid containing 6/3 cells/mm/sup 3/, 27mg/dl of protein and 65.1 mg/dl of sugar. An opening pressure was 75 mmH/sub 2/O. The vertebral angiography revealed no evidence of mass lesion and vascular anomalies. CT scan demonstrated a pontine hematoma, the size of this hematoma sequentially enlarged in follow-up CT scan. His clinical symptoms were gradually aggravated, i.e. cerebellar sign, urinary disturbance and involuntary movement. Conservative therapy was performed and his symptoms gradually improved. The size of hematoma was reduced in follow-up CT scan. The genesis, diagnosis and treatment of primary pontine hemorrhage of the young were discussed. (author).

  1. Prevalence of incidental findings in paranasal sinus in brain and orbital CT scans in pediatric patients

    Directory of Open Access Journals (Sweden)

    Adriano Ferreira da Silva


    Full Text Available In emergency services a significant amount of pediatric patients undergoa brain or orbit CT scans for suspicion other than sinusitis. Assuming thispremise, this study was held to show the incidental findings of the paranasalsinuses of children with nonspecific symptoms such as fever, headache andvomiting that underwent brain or orbits CT scans, without the initial suspicion of sinusitis. In a retrospective study, we evaluated 70 CT scans of the brainand orbits of children between 0 and 12 years. The incidental findings of theparanasal sinuses occurred in 32 cases (45.7%. Mucosal thickening was themost common incidental finding, being observed in 35% of patients, followed bycomplete opacification observed in 28% of cases and incomplete opacificationobserved in 28% of patients. Bilateral involvement occurred in 78% patients.The sinuses most frequently affected were the maxillary sinus followed byethmoid sinuses. The abnormalities were more severe in children under theage of three years. The prevalence of incidental tomographic abnormalities inpatients without an initial diagnosis of sinusitis is high. The predominance ofthese findings are mild abnormalities.

  2. The performance of MRI in detecting subarticular bone erosion of sacroiliac joint in patients with spondyloarthropathy: A comparison with X-ray and CT

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Libin [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Huang, Zhenguo, E-mail: [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Zhang, Xuezhe [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Chan, Queenie [Philips Healthcare, Hong Kong (China); Xu, Yanyan [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Wang, Guochun [Department of Rheumatology, China-Japan Friendship Hospital, Beijing (China); Wang, Wu [Department of Radiology, China-Japan Friendship Hospital, Beijing (China)


    Highlights: • MRI 3D-WS-bSSFP sequence has high spatial resolution and short scanning time. • This is the first time this sequence was applied to detect bone erosion of SI joint. • Its performance was compared with other commonly used diagnostic methods. • Result shows that this sequence is better than X-ray and T1W in the detection of bone erosion. • This sequence can be considered an alternative to CT in showing erosion in SpA patients. - Abstract: Objective: To assess the sensitivity and specificity of detecting subarticular bone erosion of sacroiliac (SI) joint in patients with spondyloarthritis (SpA) using MRI three-dimensional water selective balanced steady-state free precession sequence (3D-WS-bSSFP) and T1-weighted (T1W) sequence. Materials and methods: Radiography, CT and MRI of SI joint from 43 SpA patients were retrospectively analyzed. MRI examination sequences include T1W, short tau inversion recovery (STIR) and 3D-WS-bSSFP. Two radiologists, blinded to clinical data, independently determined bone erosion at bilateral sacral and iliac sides of the SI joint on radiography, CT, T1W and 3D-WS-bSSFP respectively. X{sup 2} test was used to compare the sensitivity of detecting bone erosion among different diagnostic methods. Results: Of the 86 sacral and 86 iliac articular surfaces from the 43 cases, radiography, CT, MRI T1W and 3D-WS-bSSFP showed the presence of bone erosion in 40, 74, 50 and 71 articular surfaces respectively. CT and MRI 3D-WS-bSSFP demonstrated similar sensitivity (x{sup 2} = 0.11, P = 0.74), and both were superior to radiography (x{sup 2} = 15.17, P < 0.01 and x{sup 2} = 12.78, P < 0.01, respectively) and T1W (x{sup 2} = 7.26, P < 0.01 and x{sup 2} = 5.62, P < 0.05). Using CT diagnosis as the gold standard, the sensitivity and specificity of detecting bone erosion for MRI 3D-WS-bSSFP and T1W sequences were 91.8%, 96.9%, and 60.8%, 94.9% respectively. Conclusion: MRI 3D-WS-bSSFP sequence is associated with short scanning time

  3. Splenic hemochromatosis incidentally found on Tc-99m MDP bone scan in a chronic myelogenous leukemia patient who received bone marrow transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Byeong Cheol; Seo, Ji Hyoung; Bae, Jin Ho; Jeong, Sin Young; Lee, Jae Tae; Lee, Kyu Bo [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)


    Tc-99m MDP bone scan was performed to evaluate a generalized bone pain in a 24-year-old male chronic myelogenous leukemia patient who received bone marrow transplantation at 7 months ago. The patient had received large amounts of blood transfusion for managing symptoms related to anemia. Bone scan revealed substantial splenic tracer uptake. Magnetic resonance image and laboratory evidence of hemochromatosis suggests that the presence of large quantities of iron in the spleen of this patient may have been responsible for the splenic uptake of the bone scanning agent. The authors report a c ase of splenic hemochromatosis incidentally found on Tc-99m MDP bone scan.

  4. Bone scan: Indium-WBC correlation in the diagnosis of osteomyelitis of the foot

    Energy Technology Data Exchange (ETDEWEB)

    Eisenberg, B.; Wrege, S.S.; Altman, M.I.; Moore, J.W. (Veterans Administration Medical Center, Albuquerque, NM (USA))


    A retrospective study was performed of 20 podiatric cases using technetium-99m methylene diphosphonate three-phase bone scans along with indium-111 oxine leukocyte scans, as needed, to determine the presence and extent of osteomyelitis of the foot. Using criteria developed at our institution, the authors attempt to provide a mechanism to make a reliable diagnosis for osteomyelitis that has been supported by surgical/pathologic confirmation of long-term clinical follow-up. The sensitivity, using bone scans alone, was 100%, and specificity was 47%. Correlating bone and indium-111 leukocyte scans yielded a sensitivity of 100% with a specificity raised to 81%. Indium-111 leukocyte scans were used in 40% of cases when a definitive diagnosis for osteomyelitis could not be made on the basis of the three-phase bone scan or clinical presentation alone. Indium-111 leukocyte scans were also helpful in delineating the extent of the disease process. The authors present a standard technique for a 5-hour delayed imaging in the three-phase bone scan, as well as marking the foot in the indium-111 leukocyte scan with three routine views obtained for each imaging procedure, to ensure clinical accuracy.

  5. Quality of planar whole-body bone scan interpretations - a nationwide survey

    Energy Technology Data Exchange (ETDEWEB)

    Sadik, May; Suurkula, Madis [Sahlgrenska University Hospital, Department of Clinical Physiology, Goeteborg (Sweden); Hoeglund, Peter [Lund University Hospital, Competence Center for Clinical Research, Lund (Sweden); Jaerund, Andreas [EXINI Diagnostics AB, Lund (Sweden); Edenbrandt, Lars [Sahlgrenska University Hospital, Department of Clinical Physiology, Goeteborg (Sweden); Lund University Research Program in Medical Informatics, Malmoe University Hospital, Department of Clinical Sciences, Malmoe, Malmoe (Sweden)


    The purpose of this study was to investigate, in a nationwide study, the inter-observer variation and performance in interpretations of bone scans regarding the presence or absence of bone metastases. Bone scan images from 59 patients with breast or prostate cancer, who had undergone scintigraphy due to suspected bone metastatic disease, were studied. The patients were selected to reflect the spectrum of pathology found in everyday clinical work. Whole body images, anterior and posterior views, were sent to all 30 hospitals in Sweden that perform bone scans. Thirty-seven observers from 18 hospitals agreed to participate in the study. They were asked to classify each of the patient studies regarding the presence of bone metastasis, using a four-point scale. Each observer's classifications were pairwise compared with the classifications made by all the other observers, resulting in 666 pairs of comparisons. The interpretations of the 37 observers were also compared with the final clinical assessment, which was based on follow-up scans and other clinical data. On average, two observers agreed on 64% of the bone scan classifications. Kappa values ranged between 0.16 and 0.82, with a mean of 0.48. Sensitivity and specificity for the observers compared with the final clinical assessment were 77% and 96%, respectively, for detecting bone metastases in planar whole-body bone scanning. Moderate inter-observer agreement was found when observers were compared pairwise. False-negative errors seem to be the major problem in the interpretations of bone scan images, whilst the specificities for the observers were high. (orig.)

  6. Micro-CT characterization of human trabecular bone in osteogenesis imperfecta (United States)

    Jameson, John; Albert, Carolyne; Smith, Peter; Molthen, Robert; Harris, Gerald


    Osteogenesis imperfecta (OI) is a genetic syndrome affecting collagen synthesis and assembly. Its symptoms vary widely but commonly include bone fragility, reduced stature, and bone deformity. Because of the small size and paucity of human specimens, there is a lack of biomechanical data for OI bone. Most literature has focused on histomorphometric analyses, which rely on assumptions to extrapolate 3-D properties. In this study, a micro-computed tomography (μCT) system was used to directly measure structural and mineral properties in pediatric OI bone collected during routine surgical procedures. Surface renderings suggested a poorly organized, plate-like orientation. Patients with a history of bone-augmenting drugs exhibited increased bone volume fraction (BV/TV), trabecular number (Tb.N), and connectivity density (Eu.Conn.D). The latter two parameters appeared to be related to OI severity. Structural results were consistently higher than those reported in a previous histomorphometric study, but these differences can be attributed to factors such as specimen collection site, drug therapy, and assumptions associated with histomorphometry. Mineral testing revealed strong correlations with several structural parameters, highlighting the importance of a dual approach in trabecular bone testing. This study reports some of the first quantitative μCT data of human OI bone, and it suggests compelling possibilities for the future of OI bone assessment.

  7. TIPS bilateral noise reduction in 4D CT perfusion scans produces high-quality cerebral blood flow maps

    NARCIS (Netherlands)

    Mendrik, A.M.; Vonken, E.J.; Ginneken, B. van; Jong, H.W. de; Riordan, A.; Seeters, T. van; Smit, E.J.; Viergever, M.A.; Prokop, M.


    Cerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of x-ray radiat

  8. TIPS bilateral noise reduction in 4D CT perfusion scans produces high-quality cerebral blood flow maps

    NARCIS (Netherlands)

    A. Mendrik (Adrienne); E.J.P.A. Vonken; B.T.J. van Ginneken (Berbke); J.R. Riordan (John ); H.W.A.M. de Jong (Hugo); T. van Seeters (Tom); E.J. Smit (Ewoud); M.A. Viergever (Max); M. Prokop (Mathias)


    textabstractCerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of

  9. When is a bone scan study appropriate in asymptomatic men diagnosed with prostate cancer?

    Institute of Scientific and Technical Information of China (English)

    Raj P.Pal; Thivyaan Thiruudaian; Masood A.Khan


    Aims: To determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer. Methods: Between November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate-specific antigen (PSA) cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value. Results: Only 1/61 men (1.6%) with a serum PSA ≤ 20 ng/mL had a positive bone scan. However, 2/38 men (4.7%) with a serum PSA 20.1-40.0 ng/mL, 3/20 men (15%) with a serum PSA 40.1-60.0 ng/mL, 7/19 men (36.8%) with a serum PSA 60.1-100.0 ng/mL and 19/38 men (50%) with a serum PSA > 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups. Conclusion: Based on our findings, a bone scan is of limited value in asymptomatic prostate cancer patients presenting PSA ≤ 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis.

  10. Multidetector row computed tomography of acute pancreatitis: Utility of single portal phase CT scan in short-term follow up

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Yongwonn [Department of Radiology, Konkuk University Medical Center, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729 (Korea, Republic of); Park, Hee Sun, E-mail: [Department of Radiology, Konkuk University Medical Center, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729 (Korea, Republic of); Kim, Young Jun; Jung, Sung Il; Jeon, Hae Jeong [Department of Radiology, Konkuk University Medical Center, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729 (Korea, Republic of)


    Objective: The purpose of this study is to evaluate the question of whether nonenhanced CT or contrast enhanced portal phase CT can replace multiphasic pancreas protocol CT in short term monitoring in patients with acute pancreatitis. Materials and methods: This retrospective study was approved by the Institutional Review Board. From April 2006 to May 2010, a total of 52 patients having acute pancreatitis who underwent initial dual phase multidetector row CT (unenhanced, arterial, and portal phase) at admission and a short term (within 30 days) follow up dual phase CT (mean interval 10.3 days, range 3-28 days) were included. Two abdominal radiologists performed an independent review of three sets of follow up CT images (nonenhanced scan, single portal phase scan, and dual phase scan). Interpretation of each image set was done with at least 2-week interval. Radiologists evaluated severity of acute pancreatitis with regard to pancreatic inflammation, pancreatic necrosis, and extrapancreatic complication, based on the modified CT severity index. Scores of each image set were compared using a paired t-test and interobserver agreement was evaluated using intraclass correlation coefficient statistics. Results: Mean scores of sum of CT severity index on nonenhanced scan, portal phase scan, and dual phase scan were 5.7, 6.6, and 6.5 for radiologist 1, and 5.0, 5.6, and 5.8 for radiologist 2, respectively. In both radiologists, contrast enhanced scan (portal phase scan and dual phase scan) showed significantly higher severity score compared with that of unenhanced scan (P < 0.05), while portal phase and dual phase scan showed no significant difference each other. The trend was similar regarding pancreatic inflammation and extrapancreatic complications, in which contrast enhanced scans showed significantly higher score compared with those of unenhanced scan, while no significant difference was observed between portal phase scan and dual phase scan. In pancreatic necrosis

  11. Planned FDG PET-CT Scan in Follow-Up Detects Disease Progression in Patients With Locally Advanced NSCLC Receiving Curative Chemoradiotherapy Earlier Than Standard CT

    DEFF Research Database (Denmark)

    Pan, Yi; Brink, Carsten; Schytte, Tine;


    The role of positron emission tomography-computed tomography (PET-CT) in surveillance of patients with nonsmall cell lung cancer (NSCLC) treated with curatively intended chemoradiotherapy remains controversial. However, conventional chest X-ray and computed tomography (CT) are of limited value...... in discriminating postradiotherapy changes from tumor relapse. The aim of this study was to evaluate the clinical value of PET-CT scan in the follow-up for patients with locally advanced (LA) NSCLC receiving concomitant chemoradiotherapy (CCRT).Between 2009 and 2013, eligible patients with stages IIB-IIIB NSCLC...... were enrolled in the clinical trial NARLAL and treated in Odense University Hospital (OUH). All patients had a PET-CT scan scheduled 9 months (PET-CT9) after the start of the radiation treatment in addition to standard follow-up (group A). Patients who presented with same clinical stage of NSCLC...

  12. [Value of (99)Tc(m)-MDP SPECT/CT in clinical decision-making for nasopharyngeal carcinoma and a comparison of the values of different imaging techniques for diagnosing skull-base bone invasion]. (United States)

    Li, W; Zhang, R S; Zhang, L Q; Lu, B G; Fu, W H


    Objective: To analyze the clinical value of SPECT/CT in diagnosis of skull base bone invasion and clinical decision-making for nasopharyngeal carcinoma (NPC), and to compare their diagnostic value with SPECT/CT, CT, MRI, and MRI combined with SPECT (MRI-SPECT) for skull base bone invasion. Methods: Before treatment, among 348 newly diagnosed NPC patients, CT scan was performed in 186 patients (group A) and the remaining 162 patients received MRI scan (group B). Clinical doctors then made clinical management decisions according to the CT or MRI results. After that, all patients underwent (99)Tc(m)-MDP SPECT/CT examination for nasopharyngeal local tomography, and the results were provided to the clinical doctors to make clinical management decisions again. The changes between the two clinical management decisions were scored according to diagnosis, range of lesion, staging, treatment regimens, and auxiliary examination. The diagnostic value of CT scan, MRI scan, SPECT/CT and MRI-SPECT for skull base bone invasion was then evaluated and compared. Results: In terms of changes in scores of clinical management decisions, the score of group A was 1.387 and group B was 0.951, showing a significant difference between the two groups by Wilcoxon test (Z=6.570, P<0.001). By χ(2) test, there were correlations between CT and SPECT/CT (χ(2) =98.495, P<0.001), and between MRI and SPECT/CT (χ(2) =32.662, P<0.001). The consistency of CT and SPECT/CT (Kappa=0.713) was greater than MRI and SPECT (Kappa=0.449). The sensitivity of CT, MRI, SPECT/CT and MRI-SPECT was 67.1%, 84.5%, 90.8% and 100%, the specificity was 73.3%, 92.3%, 85.6% and 84.6%, and the area under the ROC curve was 0.702, 0.884, 0.882 and 0.923, respectively. Conclusions: SPECT/CT has important impact on clinical management decision for NPC. In the judgement of skull base invasion, the diagnostic value of SPECT/CT is significantly higher than CT and approximately equal to MRI. SPECT/CT should be one of the routine

  13. Incidental internal carotid artery calcifications on temporal bone CT in children

    Energy Technology Data Exchange (ETDEWEB)

    Koch, Bernadette; Jones, Blaise [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Blackham, Aaron [University of Cincinnati College of Medicine, Cincinnati, OH (United States)


    Incidental internal carotid artery (ICA) calcifications are occasionally noted on CT images of the brain and temporal bone. In adults, incidental calcifications have been correlated with increased incidence of hypercholesterolemia, cardiac disease, diabetes and carotid stenosis. To determine the incidence of incidental calcifications of the carotid siphon on temporal bone CT in children. We retrospectively reviewed 24 months of consecutive temporal bone CT examinations in children aged 18 years and younger. CT examinations on 663 patients were reviewed and the presence or absence of ICA calcifications was ranked as absent, questionable or definitive. In patients in whom definitive calcifications were identified, hospital charts were reviewed for evidence of diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, hyperlipidemia and chronic renal disease as potential causes of early atherosclerosis. Of the 663 patients, 25% had definitive calcifications within the wall of the ICA: 6% of children younger than 2 years and 28% of children 12-19 years of age. Incidentally noted ICA calcifications are a common finding on temporal bone CT in children, most likely a physiologic response to turbulent flow at natural bends in the artery rather than secondary to underlying disease predisposing to early atherosclerotic calcification. (orig.)

  14. Repeat CT-scan assessment of lymph node motion in locally advanced cervical cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Bondar, Luiza; Velema, Laura; Mens, Jan Willem; Heijmen, Ben; Hoogeman, Mischa [Erasmus Medical Center Cancer Institute, Department of Radiation Oncology, 3008 AE, Rotterdam (Netherlands); Zwijnenburg, Ellen [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands)


    In cervical cancer patients the nodal clinical target volume (CTV, defined using the major pelvic blood vessels and enlarged lymph nodes) is assumed to move synchronously with the bony anatomy. The aim of this study was to verify this assumption by investigating the motion of the major pelvic blood vessels and enlarged lymph nodes visible in CT scans. For 13 patients treated in prone position, four variable bladder-filling CT scans per patient, acquired at planning and after 40 Gy, were selected from an available dataset of 9-10 CT scans. The bladder, rectum, and the nodal-vessels structure containing the iliac vessels and all visible enlarged nodes were delineated in each selected CT scan. Two online patient setup correction protocols were simulated. The first corrected bony anatomy translations and the second corrected translations and rotations. The efficacy of each correction was calculated as the overlap between the nodal-vessels structure in the reference and repeat CT scans. The motion magnitude between delineated structures was quantified using nonrigid registration. Translational corrections resulted in an average overlap of 58 ± 13% and in a range of motion between 9.9 and 27.3 mm. Translational and rotational corrections significantly improved the overlap (64 ± 13%, p value = 0.007) and moderately reduced the range of motion to 7.6-23.8 mm (p value = 0.03). Bladder filling changes significantly correlated with the nodal-vessels motion (p < 0.001). The motion of the nodal-vessels was large, nonrigid, patient-specific, and only moderately synchronous with the bony anatomy. This study highlights the need for caution when reducing the CTV-to-PTV (PTV planning target volume) margin of the nodal CTV for highly conformal radiation techniques. (orig.) [German] Bei Zervixkarzinompatientinnen wird davon ausgegangen, dass das nodale klinische Zielvolumen (CTV, definiert anhand der grossen Blutgefaesse des Beckens und vergroesserter Lymphknoten) sich synchron mit

  15. An optimal set of landmarks for metopic craniosynostosis diagnosis from shape analysis of pediatric CT scans of the head (United States)

    Mendoza, Carlos S.; Safdar, Nabile; Myers, Emmarie; Kittisarapong, Tanakorn; Rogers, Gary F.; Linguraru, Marius George


    Craniosynostosis (premature fusion of skull sutures) is a severe condition present in one of every 2000 newborns. Metopic craniosynostosis, accounting for 20-27% of cases, is diagnosed qualitatively in terms of skull shape abnormality, a subjective call of the surgeon. In this paper we introduce a new quantitative diagnostic feature for metopic craniosynostosis derived optimally from shape analysis of CT scans of the skull. We built a robust shape analysis pipeline that is capable of obtaining local shape differences in comparison to normal anatomy. Spatial normalization using 7-degree-of-freedom registration of the base of the skull is followed by a novel bone labeling strategy based on graph-cuts according to labeling priors. The statistical shape model built from 94 normal subjects allows matching a patient's anatomy to its most similar normal subject. Subsequently, the computation of local malformations from a normal subject allows characterization of the points of maximum malformation on each of the frontal bones adjacent to the metopic suture, and on the suture itself. Our results show that the malformations at these locations vary significantly (p<0.001) between abnormal/normal subjects and that an accurate diagnosis can be achieved using linear regression from these automatic measurements with an area under the curve for the receiver operating characteristic of 0.97.

  16. CT appearances of unilateral cleft palate 20 years after bone graft surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kolbenstvedt, A.; Aaloekken, T.M. [Rikshospitalet, Oslo (Norway). Dept. of Radiology; Arctander, K. [Rikshospitalet, Oslo (Norway). Dept. of Plastic Surgery; Johannessen, S. [Inst. of Clinical Dentistry, Oslo (Norway)


    Purpose: To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Material and Methods: Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Results: Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Conclusion: Although adherence to the present treatment protocol is considered to give satisfactory functional and cosmetic results, certain abnormalities persist. A knowledge of these is a prerequisite for a complete and final evaluation of the surgical and orthodontic regimen. Cleft palate nasal cavity abnormalities CT.

  17. Computer-assisted solid lung nodule 3D volumetry on CT : influence of scan mode and iterative reconstruction: a CT phantom study

    NARCIS (Netherlands)

    Coenen, Adriaan; Honda, Osamu; van der Jagt, Eric J.; Tomiyama, Noriyuki


    To evaluate the effect of high-resolution scan mode and iterative reconstruction on lung nodule 3D volumetry. Solid nodules with various sizes (5, 8, 10 and 12 mm) were placed inside a chest phantom. CT images were obtained with various tube currents, scan modes (conventional mode, high-resolution m

  18. A measurement-based generalized source model for Monte Carlo dose simulations of CT scans (United States)

    Ming, Xin; Feng, Yuanming; Liu, Ransheng; Yang, Chengwen; Zhou, Li; Zhai, Hezheng; Deng, Jun


    The goal of this study is to develop a generalized source model for accurate Monte Carlo dose simulations of CT scans based solely on the measurement data without a priori knowledge of scanner specifications. The proposed generalized source model consists of an extended circular source located at x-ray target level with its energy spectrum, source distribution and fluence distribution derived from a set of measurement data conveniently available in the clinic. Specifically, the central axis percent depth dose (PDD) curves measured in water and the cone output factors measured in air were used to derive the energy spectrum and the source distribution respectively with a Levenberg–Marquardt algorithm. The in-air film measurement of fan-beam dose profiles at fixed gantry was back-projected to generate the fluence distribution of the source model. A benchmarked Monte Carlo user code was used to simulate the dose distributions in water with the developed source model as beam input. The feasibility and accuracy of the proposed source model was tested on a GE LightSpeed and a Philips Brilliance Big Bore multi-detector CT (MDCT) scanners available in our clinic. In general, the Monte Carlo simulations of the PDDs in water and dose profiles along lateral and longitudinal directions agreed with the measurements within 4%/1 mm for both CT scanners. The absolute dose comparison using two CTDI phantoms (16 cm and 32 cm in diameters) indicated a better than 5% agreement between the Monte Carlo-simulated and the ion chamber-measured doses at a variety of locations for the two scanners. Overall, this study demonstrated that a generalized source model can be constructed based only on a set of measurement data and used for accurate Monte Carlo dose simulations of patients’ CT scans, which would facilitate patient-specific CT organ dose estimation and cancer risk management in the diagnostic and therapeutic radiology.

  19. Two unusual causes of peripatellar nonmetastatic positive bone scans in patients with malignancies: case reports. (United States)

    Turner, J W; Syed, I B; Spencer, R P


    Bone scans performed with 99mTc-polyphosphate in two patients with epidermoid carcinoma of the lung each showed activity in one knee area. In the first case, radiographs of the area revealed Pellegrini-Stieda calcification over the internal femoral condyle. Uptake corresponded to this process, rather than to a lesion deep in the bone. In the second case, the activity accumulation in the right tibia was the only abnormality noted in the scan. An open biopsy revealed Paget's disease, and no radiographic evidence of Paget's disease was found in any other bone. These cases again illustrate that localized accumulation of a bone-scanning agent, in patients with known primary tumors, does not necessarily denote malignancy in bone.

  20. Two unusual causes of peripatellar nonmetastatic positive bone scans in patients with malignancies: case reports

    Energy Technology Data Exchange (ETDEWEB)

    Turner, J.W.; Syed, I.B.; Spencer, R.P.


    Bone scans performed with /sup 99m/Tc-polyphosphate in two patients with epidermoid carcinoma of the lung each showed activity in one knee area. In the first case, radiographs of the area revealed Pellegrini-Stieda calcification over the internal femoral condyle. Uptake corresponded to this process, rather than to a lesion deep in the bone. In the second case, the activity accumulation in the right tibia was the only abnormality noted in the scan. An open biopsy revealed Paget's disease, and no radiographic evidence of Paget's disease was found in any other bone. These cases again illustrate that localized accumulation of a bone-scanning agent, in patients with known primary tumors, does not necessarily denote malignancy in bone.


    Directory of Open Access Journals (Sweden)



    Full Text Available A five years study of CT scan findings in seizure patients is carried out to know the different etiology. Seizure is a finite event of altered cerebral function because of excessive and abnormal electrical discharges of the brain cells. Epilepsy is a chronic condition predisposing a person to recurrent seizures. This study is designed to establish usefulness of CT in defining the etiology of seizures in various age groups in people of Northern Chhattisgarh. This is a retrospective hospital - based study conducted in Radio - diagnosis Department of Chhattisgarh Institute of Medical Sciences, Bilaspur, Chhattisgarh. The study was carried out over a 5 year period. Hospital admissions with history of seizures are very common. Almost 3 - 9% p er 1000 population of total hospital emergencies is seizure cases. Epilepsy is an important health problem in developing countries, where its prevalence can be up to 57 per 1000 population. This study has high prevalence of seizures in First, second, third and fourth decades with decreasing pattern with increasing age. Prevalence in first decade is low as compare to second and third decades. Tuberculoma (9.39% and Neurocysticercosis (3.60% has highest prevalence in partial seizures followed by Focal Cereb ral Edema (6.22% whereas Diffuse Cerebral edema (4.91% seen with Generalised Seizures Cerebral infarct has equally seen in both types of seizures. Brain tumour presented mostly with Generalised seizure (2.07% than in partial seizures (0.98% . Other abno rmal findings like Cerebral calcifications, Diffuse cortical atrophy, Focal cortical atrophy, Sub Arachnoid hemorrhage, Intracerebral Hemorrhage, Hypoxic Ischemic Encephalopathy, Hydrocephalus and few rare diseases like Fahr disease and Tuberous sclerosis have also seen in CT scan in seizure patients. CT scan is valuable in making a diagnosis particularly in Indian subcontinent, where infective causes in form of space occupying lesions and infections are most

  2. SPECT/CT imaging in bone scintigraphy of a case of clavicular osteoma

    Directory of Open Access Journals (Sweden)

    Yuka Yamamoto


    diphosphonate (HMDP. Whole-body image showed a focus of intensely increased uptake in the clavicle. Single photon emission computed tomography/ computed tomography (SPECT/CT images were also acquired and clearly showed intense uptake at the tumor site. Integrated SPECT/CT imaging supplies both functional and anatomic information about bone: the SPECT imaging improves sensitivity compared with planar imaging, the CT imaging provides precise localization of the abnormal uptake, and information on the shape and structure of the abnormalities improves the specificity of the diagnosis.

  3. Scanning electron microscopy analysis of experimental bone hacking trauma of the mandible. (United States)

    Alunni-Perret, Véronique; Borg, Cybèle; Laugier, Jean-Pierre; Bertrand, Marie-France; Staccini, Pascal; Bolla, Marc; Quatrehomme, Gérald; Muller-Bolla, Michèle


    The authors report on a macroscopic and microscopic study of human mandible bone lesions achieved by a single-blade knife and a hatchet. The aim of this work was to complete the previous data (scanning electron microscopy analysis of bone lesions made by a single-blade knife and a hatchet, on human femurs) and to compare the lesions of the femur with those of the mandible. The results indicate that the mandible is a more fragile bone, but the features observed on the mandible are quite similar to those previously observed on the femur. This work spells out the main scanning electron microscopy characteristics of sharp (bone cutting) and blunt (exerting a pressure on the bone) mechanisms on human bone. Weapon characteristics serve to explain all of these features.

  4. Enhancement characteristics of the hepatic parenchyma in CT scanning during splenoportography

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiu-yi; ZHANG Xue-lin; ZHENG Wei-quan; WANG Jin; WEN Ge


    Objective: To evaluate the enhancement characteristics of the hepatic parenchyma during scanning with computed tomography (CT) during splenoportography (CTSP). Methods.. Thirty patients refferred for CTSP were included in the study. Attenuation was measured at different time after contrast medium injection, and time-attenuation curves were created. Enhancement characteristics were evaluated, and the parenchyma-to-tumor difference of attenuation were compared. Results.. CTSP led to high parenchymal enhancement. The highest enhancement value in the left lobe was (218. 0±53. 2) Hu and (246.0± 60. 2) Hu in the right lobe. The difference between the right and left lobes was statistically significant (P<0. 05); The parenchyma-to-tumor difference of (65.3± 25.6) Hu was observed during scanning after injection. Conclusion: The high levels of liver parenchymal enhancement and parenchyma-to-lesion contrast can be achieved within the scanning time with CTSP.

  5. Thalassemia paravertebral tumors and bone marrow scan; Thalassemies, tumeurs paravertebrales et scintigraphie medullaire

    Energy Technology Data Exchange (ETDEWEB)

    Huglo, D.; Rose, C.; Deveaux, M.; Bauters, F.; Marchandise, X. [Centre Hospitalier Universitaire, 59 - Lille (France)


    Two first cousins with thalassemia and with a paravertebral mass had had an indium 111 chloride bone marrow scan. Result of scan influenced therapy: medical treatment in one case where an extramedullary erythropoiesis was confirmed, surgical treatment in the other case. The use of dual-isotope SPECT (indium 111 chloride, HDP{sup -99}Tc) constitutes a contribution to the establishment of diagnosis of extramedullary erythropoiesis, giving to bone marrow scintigraphy a merited importance, avoiding the biopsy. (authors). 15 refs., 5 figs.

  6. A Survey of Pediatric CT Protocols and Radiation Doses in South Korean Hospitals to Optimize the Radiation Dose for Pediatric CT Scanning. (United States)

    Hwang, Jae-Yeon; Do, Kyung-Hyun; Yang, Dong Hyun; Cho, Young Ah; Yoon, Hye-Kyung; Lee, Jin Seong; Koo, Hyun Jung


    Children are at greater risk of radiation exposure than adults because the rapidly dividing cells of children tend to be more radiosensitive and they have a longer expected life time in which to develop potential radiation injury. Some studies have surveyed computed tomography (CT) radiation doses and several studies have established diagnostic reference levels according to patient age or body size; however, no survey of CT radiation doses with a large number of patients has yet been carried out in South Korea. The aim of the present study was to investigate the radiation dose in pediatric CT examinations performed throughout South Korea. From 512 CT (222 brain CT, 105 chest CT, and 185 abdominopelvic CT) scans that were referred to our tertiary hospital, a dose report sheet was available for retrospective analysis of CT scan protocols and dose, including the volumetric CT dose index (CTDIvol), dose-length product (DLP), effective dose, and size-specific dose estimates (SSDE). At 55.2%, multiphase CT was the most frequently performed protocol for abdominopelvic CT. Tube current modulation was applied most often in abdominopelvic CT and chest CT, accounting for 70.1% and 62.7%, respectively. Regarding the CT dose, the interquartile ranges of the CTDIvol were 11.1 to 22.5 (newborns), 16.6 to 39.1 (≤1 year), 14.6 to 41.7 (2-5 years), 23.5 to 44.1 (6-10 years), and 31.4 to 55.3 (≤15 years) for brain CT; 1.3 to 5.7 (≤1 year), 3.9 to 6.8 (2-5 years), 3.9 to 9.3 (6-10 years), and 7.7 to 13.8 (≤15 years) for chest CT; and 4.0 to 7.5 (≤1 year), 4.2 to 8.9 (2-5 years), 5.7 to 12.4 (6-10 years), and 7.6 to 16.6 (≤15 years) for abdominopelvic CT. The SSDE and CTDIvol were well correlated for patients CT in South Korea. The CTDIvol, DLP, and effective dose were generally lower than in German and UK surveys, except in certain age groups.

  7. Scanning electron microscopy analysis of experimental bone hacking trauma. (United States)

    Alunni-Perret, Veronique; Muller-Bolla, Michèle; Laugier, Jean-Pierre; Lupi-Pégurier, Laurence; Bertrand, Marie-France; Staccini, Pascal; Bolla, Marc; Quatrehomme, Gérald


    The authors report on their macro- and microscopy study of bone lesions made by a sharp force instrument (a single blade knife), and a sharp-blunt instrument classified as a chopping weapon (a hatchet). The aim of this work was to attempt to identify the instrument by analyzing the general class characteristics of the cuts. Each weapon was used on human bones. The results indicate that macroscopic analysis is more problematic. The microscopic analysis assessed that characteristics examined were effective in distinguishing sharp from sharp-blunt injury to the bone. The microscope facilitates analysis unachievable with macroscopic methods, some three-dimensional characteristics not visible to the naked eye being clearly defined with its use. Emphasis has been placed on the value of SEM as an anthropologist's tool in bone lesion injuries.

  8. In vitro dose measurements in a human cadaver with abdomen/pelvis CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Da; Padole, Atul; Li, Xinhua; Singh, Sarabjeet; Khawaja, Ranish Deedar Ali; Lira, Diego; Shi, Jim Q.; Otrakji, Alexi; Kalra, Mannudeep K.; Liu, Bob, E-mail: [Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Liu, Tianyu; Xu, X. George [Nuclear Engineering Program, Rensselaer Polytechnic Institute, Troy, New York 12180 (United States)


    Purpose: To present a study of radiation dose measurements with a human cadaver scanned on a clinical CT scanner. Methods: Multiple point dose measurements were obtained with high-accuracy Thimble ionization chambers placed inside the stomach, liver, paravertebral gutter, ascending colon, left kidney, and urinary bladder of a human cadaver (183 cm in height and 67.5 kg in weight) whose abdomen/pelvis region was scanned repeatedly with a multidetector row CT. The flat energy response and precision of the dosimeters were verified, and the slight differences in each dosimeter's response were evaluated and corrected to attain high accuracy. In addition, skin doses were measured for radiosensitive organs outside the scanned region with OSL dosimeters: the right eye, thyroid, both nipples, and the right testicle. Three scan protocols were used, which shared most scan parameters but had different kVp and mA settings: 120-kVp automA, 120-kVp 300 mA, and 100-kVp 300 mA. For each protocol three repeated scans were performed. Results: The tube starting angle (TSA) was found to randomly vary around two major conditions, which caused large fluctuations in the repeated point dose measurements: for the 120-kVp 300 mA protocol this angle changed from approximately 110° to 290°, and caused 8% − 25% difference in the point dose measured at the stomach, liver, colon, and urinary bladder. When the fluctuations of the TSA were small (within 5°), the maximum coefficient of variance was approximately 3.3%. The soft tissue absorbed doses averaged from four locations near the center of the scanned region were 27.2 ± 3.3 and 16.5 ± 2.7 mGy for the 120 and 100-kVp fixed-mA scans, respectively. These values were consistent with the corresponding size specific dose estimates within 4%. The comparison of the per-100-mAs tissue doses from the three protocols revealed that: (1) dose levels at nonsuperficial locations in the TCM scans could not be accurately deduced by simply scaling

  9. MRI and brain spect findings in patients with unilateral temporal lobe epilepsy and normal CT scan

    Directory of Open Access Journals (Sweden)

    P.G. Carrilho


    Full Text Available 26 patients with temporal lobe epilepsy clinically documented by several abnormal interictal surface EEGs with typical unitemporal epileptiform activity and a normal CT scan were studied. Interictal99mTC HMPAO brain SPECT and MRI were performed in all subjects. Abnormalities were shown in 61.5% of MRI (n=16 and 65.4% of SPECT (n=17. Hippocampal atrophy associated to a high signal on T2-weighted MRI slices suggesting mesial temporal sclerosis was the main finding (n=12; 75% of abnormal MRI. MRI correlated well to surface EEG in 50% (n=13. There was also a good correlation between MRI and SPECT in 30.7% (n=8. SPECT and EEG were in agreement in 57.7% (n=l5. MRI, SPECT and EEG were congruent in 26.9% (n=7. These results support the usefulness of interictal brain SPECT and MRI in detecting lateralized abnormalities in temporal lobe epilepsy. On the other hand, in two cases, interictal SPECT correlated poorly with surface EEG. This functional method should not be used isolately in the detection of temporal lobe foci. MRI is more useful than CT as a neuroimaging technique in temporal lobe epilepsy. It may detect small structural lesions and mesial temporal lobe sclerosis which are not easily seen with traditional CT scanning.

  10. Cervical CT scan-guided epidural blood patches for spontaneous intracranial hypotension. (United States)

    Maingard, Julian; Giles, Lauren; Marriott, Mark; Phal, Pramit M


    We describe two patients with spontaneous intracranial hypotension (SIH), presenting with postural headache due to C1-C2 cerebrospinal fluid (CSF) leak. Both patients were refractory to lumbar epidural blood patching (EBP), and subsequently underwent successful CT scan-guided cervical EBP. SIH affects approximately 1 in 50,000 patients, with females more frequently affected. Its associated features are variable, and as such, misdiagnosis is common. Therefore, imaging plays an important role in the diagnostic workup of SIH and can include MRI of the brain and spine, CT myelogram, and radionuclide cisternography. In patients with an established diagnosis and confirmed CSF leak, symptoms will usually resolve with conservative management. However, in a select subgroup of patients, the symptoms are refractory to medical management and require more invasive therapies. In patients with cervical leaks, EBP in the cervical region is an effective management approach, either in close proximity to, or directly targeting a dural defect. CT scan-guided cervical EBP is an effective treatment approach in refractory SIH, and should be considered in those patients who are refractory to conservative management.

  11. Automatic Calibration Method of Voxel Size for Cone-beam 3D-CT Scanning System

    CERN Document Server

    Yang, Min; Liu, Yipeng; Men, Fanyong; Li, Xingdong; Liu, Wenli; Wei, Dongbo


    For cone-beam three-dimensional computed tomography (3D-CT) scanning system, voxel size is an important indicator to guarantee the accuracy of data analysis and feature measurement based on 3D-CT images. Meanwhile, the voxel size changes with the movement of the rotary table along X-ray direction. In order to realize the automatic calibration of the voxel size, a new easily-implemented method is proposed. According to this method, several projections of a spherical phantom are captured at different imaging positions and the corresponding voxel size values are calculated by non-linear least square fitting. Through these interpolation values, a linear equation is obtained, which reflects the relationship between the rotary table displacement distance from its nominal zero position and the voxel size. Finally, the linear equation is imported into the calibration module of the 3D-CT scanning system, and when the rotary table is moving along X-ray direction, the accurate value of the voxel size is dynamically expo...

  12. Case report of subcapsular hemorrhage of the liver in the newborn. Diagnosed and observed by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawa, Masao; Matsumura, Takafumi; Esumi, Noriko; Tsunamoto, Kentaro; Iino, Shigeru (Kyoto Prefectural Univ. of Medicine (Japan))


    A recent case of subcapsular hemorrhage of the liver in a newborn showed that abdominal CT scan was highly useful in the diagnosis of this disease and the follow-up of the healing mechanism of the intrahepatic hemorrhagic lesion.

  13. Reversible bone pain and symmetric bone scan uptake in a dialysis patient treated with cinacalcet: a case report

    Directory of Open Access Journals (Sweden)

    Bottino Carla


    Full Text Available Abstract Introduction The medical management of secondary hyperparathyroidism in patients with end-stage renal disease involves a combination of dietary restrictions, phosphate binders, active vitamin D analogs, and calcimimetics. Case presentation We report the case of a 36-year-old Hispanic dialysis patient, originally from Cuba and now residing in the USA, who developed severe bone pain and muscle twitching after starting low dose cinacalcet, despite normal pre-dialysis ionized calcium and elevated parathyroid hormone. The clinical symptoms correlated with increased symmetrical uptake on bone scan that resolved rapidly upon discontinuation of cinacalcet. Conclusion Cinacalcet may induce severe bone pain and a unique bone scan uptake pattern in hemodialysis patients.

  14. Reversible bone pain and symmetric bone scan uptake in a dialysis patient treated with cinacalcet: a case report (United States)


    Introduction The medical management of secondary hyperparathyroidism in patients with end-stage renal disease involves a combination of dietary restrictions, phosphate binders, active vitamin D analogs, and calcimimetics. Case presentation We report the case of a 36-year-old Hispanic dialysis patient, originally from Cuba and now residing in the USA, who developed severe bone pain and muscle twitching after starting low dose cinacalcet, despite normal pre-dialysis ionized calcium and elevated parathyroid hormone. The clinical symptoms correlated with increased symmetrical uptake on bone scan that resolved rapidly upon discontinuation of cinacalcet. Conclusion Cinacalcet may induce severe bone pain and a unique bone scan uptake pattern in hemodialysis patients. PMID:20576153

  15. SPECT/spiral CT and bone scintigraphy in cancer patients: Impact of a low dose CT acquisitions in indeterminate or suspicious solitary focus; TEMP/TDM et scintigraphie osseuse en cancerologie: impact d'une acquisition scannographique basse dose chez les patients avec foyer isole suspect ou de nature indeterminee

    Energy Technology Data Exchange (ETDEWEB)

    Franson, T.; Bardet, S.; Switsers, O.; Aide, N. [CRLCC Francois-Baclesse, 14 - Caen (France); CHU Lyon-Sud, Pierre-Benite, Service de Medecine Nucleaire, 69 - Lyon (France); Loiseau, C. [CRLCC Francois-Baclesse, Unite de Biophysique, 14 - Caen (France); Allouache, D.; Gunzer, K. [CRLCC Francois-Baclesse, Oncologie Medicale, 14 - Caen (France); Allouache, N. [CRLCC Francois-Baclesse, Radiotherapie, 14 - Caen (France)


    Aim: To evaluate the usefulness of a low dose SPECT/CT and the added value of an additional 'diagnostic' centred CT-scan in cancer patients with a solitary focus observed on planar whole-body bone scintigraphy (P.W.B.S.) and classified as indeterminate or suspicious. Material and methods Sixty consecutive patients underwent a low dose SPECT/CT acquisition (120 kV, 30 m As, 3 mm slice thickness) followed by a 'diagnostic' CT-scan (120 kV, 100 m As, 1.25 mm slice thickness) centred on the focus. The first observer considered prospectively W.B.S., low-dose SPECT/CT and finally the centred SPECT/CT. A blinded review was performed by a second observer. Results P.W.B.S. depicted solitary indeterminate or suspicious foci in 38 and 22 patients, respectively. SPECT/CT acquisitions clarified 73% (44/60) of the foci. Additional diagnostic CT-scan altered low-dose SPECT/CT results in nine patients. Additional foci (not found by P.W.B.S.) located outside the scanning area of the centred diagnostic CT-scan were found in 20 patients. Inter observer agreement for P.W.B.S., low-dose SPECT/CT and diagnostic SPECT/CT was equal to 0.542, 0.68 and 0.694, respectively. R.O.C. analysis showed no difference between low-dose SPECT/CT and diagnostic SPECT/CT for observer 1 and observer 2. Conclusion This study shows that a conventional low-dose SPECT/CT in patients presenting with a solitary focus on P.W.B.S. is sufficient to improve both accuracy and inter observer variability of bone scanning. A CT volume session should not be limited to the area of the solitary focus since additional foci located outside the centred CT-scan frequently occurred. (authors)

  16. Reduction of Cone-Beam CT scan time without compromising the accuracy of the image registration in IGRT

    DEFF Research Database (Denmark)

    Westberg, Jonas; Jensen, Henrik R; Bertelsen, Anders;


    In modern radiotherapy accelerators are equipped with 3D cone-beam CT (CBCT) which is used to verify patient position before treatment. The verification is based on an image registration between the CBCT acquired just before treatment and the CT scan made for the treatment planning. The purpose...... of this study is to minimise the scan time of the CBCT without compromising the accuracy of the image registration in IGRT....

  17. Comparison of bone scan with carbohydrate antigen 15-3 for evaluation of bone metastasis of brest cancer. (United States)

    Mohammadzadeh, M; Alikhah, H; Zareh, A G A


    This study aimed at comparing the bone scan and CA15-3 titer in patients with breast cancer for evaluation of bone metastasis. Thirty five patients with definite diagnosis of breast cancer were evaluated in Tabriz Imam Khomeini Hospital from 2007 to 2008. Bone scan (99 mTc-MDP) performed in all patients. The serum CA15-3 was measured by ECLIA method. The increased level was considered as >30 U mL(-1). The serum level of CA15-3 was compared between the patients with and without bone metastasis, as well as its correlation with the extent of bone involvement. Thirty five patients with the mean age of 51.69 +/- 10.77 (34-81) years were enrolled in the study. According to bone scan results, 24 (68.8%) patients revealed bone metastasis. The mean level of serum CA15-3 was significantly higher in patents with bone metastasis than patients without metastasis (26.37 +/- 4.74 U mL(-1) vs. 19.09 +/- 1.99 U mL(-1); p 21.8 U mL(-1) for the serum level of CA15-3 in our patients, with a sensitivity and specificity of 91.7 and 91%, respectively. Serum level of CA15-3 is higher in the patients with bone metastatic breast cancer; however, the recommended cut-off point might not be suitable for Iranian patients. Further studies with large sample sizes are recommended.

  18. FDG PET/CT for the detection of bone marrow involvement in diffuse large B-cell lymphoma: systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A.; Kwee, Thomas C.; Keizer, Bart de; Nievelstein, Rutger A.J. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Fijnheer, Rob [Meander Medical Center, Department of Hematology, Amersfoort (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands)


    To systematically review and meta-analyse published data on the diagnostic performance of {sup 18}F-FDG PET/CT in detecting bone marrow involvement in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). PubMed/MEDLINE and Embase were systematically searched for relevant studies. The methodological quality of each study was assessed. Sensitivities and specificities of FDG PET/CT in individual studies were calculated and meta-analysed with a random effects model. A summary receiver operating characteristic curve (sROC) was constructed with the Moses-Shapiro-Littenberg method. Weighted summary proportions of discrepancies between the FDG PET/CT and (blind) bone marrow biopsy (BMB) results among all patients were calculated. Seven studies, with a total of 654 patients with newly diagnosed DLBCL, were included. Overall, the quality of the included studies was moderate. The sensitivity and specificity of FDG PET/CT for detecting bone marrow involvement ranged from 70.8 % to 95.8 % and from 99.0 % to 100 %, with pooled estimates of 88.7 % (95 % confidence interval, CI, 82.5 - 93.3 %) and 99.8 % (95 % CI 98.8 - 100 %), respectively. The area under the sROC curve was 0.9983. The weighted summary proportion of FDG PET/CT-negative patients with positive BMB findings among all patients was 3.1 % (95 % CI 1.8 - 5.0 %) and the weighted summary proportion of FDG PET/CT-positive patients with negative BMB findings among all patients was 12.5 % (95 % CI 8.4 - 17.3 %). FDG PET/CT is accurate and complementary to BMB for detecting bone marrow involvement in patients with newly diagnosed DLBCL. A negative FDG PET/CT scan cannot rule out the presence of bone marrow involvement, but positive FDG PET/CT findings obviate the need for BMB for the detection of bone marrow involvement in these patients. (orig.)

  19. Observation on local and/or unilateral pathologic changes in renal cortex by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Isao; Shinoda, Akira (Kanazawa Medical Univ. (Japan)); Onouchi, Zengoro; Saito, Yasuhito; Matsuura, Hajime


    Renal cortex visualization after bolus injection of contrast medium using computed tomography (CT), was obtained in 132 consecutive patients with renal disease. Local pathological changes in the functioning cortex of the kidney were easily recognized in 37 cases and unilateral cortical thinning was found in 17 cases. Unilateral poor enhancement of the cortex with bilateral equal cortex thickness was noted in 4 cases. Several representative cases are reported with CT scans. The cortex at the posterior aspect of the renal graft compressed on psoas muscle was thinner than that at the anterior aspect in renal transplant cases. The macroscopic observation on the renal cortex presented here is far superior to the nephrogram or pyelogram seen through conventional radiographic examination. In vivo cortex visualization will correlate renal biopsy findings with the state of the whole kidney.

  20. Initial experience with optical-CT scanning of RadBall Dosimeters

    Energy Technology Data Exchange (ETDEWEB)

    Oldham, M; Clift, C; Thomas, A; Farfan, E; Foley, T; Jannik, T; Adamovics, J; Holmes, C; Stanley, S, E-mail: Mark.Oldham@Duke.ed


    The RadBall dosimeter is a novel device for providing 3-D information on the magnitude and distribution of contaminant sources of unknown radiation in a given hot cell, glovebox, or contaminated room. The device is presently under evaluation by the National Nuclear Lab (NNL, UK) and the Savannah River National Laboratory (SRNL, US), for application as a diagnostic device for such unknown contaminants in the nuclear industry. A critical component of the technique is imaging the dose distribution recorded in the RadBall using optical-CT scanning. Here we present our initial investigations using the Duke Mid-sized Optical-CT Scanner (DMOS) to image dose distributions deposited in RadBalls exposed to a variety of radiation treatments.

  1. CT Scan Features of Presumptive Haemorrhagic Stroke in a Dog with Cushing’s Disease

    Directory of Open Access Journals (Sweden)

    A. Liotta


    Full Text Available A 9-year-old, intact male, Brie’s shepherd dog, with a 10-day history of depression and tachypnoea developed signs of central neurological dysfunction. 16 Multislice Computed Tomography (CT pre- and postcontrast studies of the brain revealed a single intra-axial homogeneous well-circumscribed hyperattenuating (+/− 62 HU and noncontrast-enhancing area, 5 mm in diameter, in the caudal part of the mesencephalon. This finding was highly suggestive of a haemorrhagic event. A pituitary-dependent hyperadrenocorticism (PDH was identified and is considered likely to be the underlying cause. A repeat CT scan examination, 2 months later, showed almost complete resolution of the brain lesion. The present case describes a solitary 5 mm diameter lesion: the result of intracranial haemorrhage in a dog with presumed PDH.

  2. Automated Detection of Healthy and Diseased Aortae from Images Obtained by Contrast-Enhanced CT Scan

    Directory of Open Access Journals (Sweden)

    Michael Gayhart


    Full Text Available Purpose. We developed the next stage of our computer assisted diagnosis (CAD system to aid radiologists in evaluating CT images for aortic disease by removing innocuous images and highlighting signs of aortic disease. Materials and Methods. Segmented data of patient’s contrast-enhanced CT scan was analyzed for aortic dissection and penetrating aortic ulcer (PAU. Aortic dissection was detected by checking for an abnormal shape of the aorta using edge oriented methods. PAU was recognized through abnormally high intensities with interest point operators. Results. The aortic dissection detection process had a sensitivity of 0.8218 and a specificity of 0.9907. The PAU detection process scored a sensitivity of 0.7587 and a specificity of 0.9700. Conclusion. The aortic dissection detection process and the PAU detection process were successful in removing innocuous images, but additional methods are necessary for improving recognition of images with aortic disease.

  3. Giant aneurysm of the distal anterior cerebral artery simulating brain tumor on CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Shigemori, Minoru; Kawaba, Tomoyuki; Kuramoto, Shinken (Kurume Univ., Fukuoka (Japan). School of Medicine); Ogata, Takeyuki; Yoshimura, Kyoko


    A successfully treated case with a giant aneurysm of the distal anterior cerebral artery which simulated brain tumor on computerized tomography (CT) is reported. In a 69-year-old woman suffering with a mild headache and a weakness in the left leg, a plain skull film revealed a ballooning of the sella turcica and an erosion of the dorsum. A CT scan showed a round or oval high-density area at the medial site of the right frontal lobe which was associated with an extensive low-density area. Curviliner calcification was also noted. A marked attenuation of the medial site of the mass lesion was demonstrated with contrast enhancement. A left-carotid angiogram demonstrated a large aneurysm at the distal-branching point of the anterior cerebral artery. Radical treatment for the aneurysm was performed. The postoperative course was uneventful, and the low-density area around the aneurysm disappeared within 6 weeks after the operation.

  4. A multicenter, randomized controlled trial of immediate total-body CT scanning in trauma patients (REACT-2

    Directory of Open Access Journals (Sweden)

    Sierink Joanne C


    Full Text Available Abstract Background Computed tomography (CT scanning has become essential in the early diagnostic phase of trauma care because of its high diagnostic accuracy. The introduction of multi-slice CT scanners and infrastructural improvements made total-body CT scanning technically feasible and its usage is currently becoming common practice in several trauma centers. However, literature provides limited evidence whether immediate total-body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scanning in trauma patients. The aim of the REACT-2 trial is to determine the value of immediate total-body CT scanning in trauma patients. Methods/design The REACT-2 trial is an international, multicenter randomized clinical trial. All participating trauma centers have a multi-slice CT scanner located in the trauma room or at the Emergency Department (ED. All adult, non-pregnant, severely injured trauma patients according to predefined criteria will be included. Patients in whom direct scanning will hamper necessary cardiopulmonary resuscitation or who require an immediate operation because of imminent death (both as judged by the trauma team leader are excluded. Randomization will be computer assisted. The intervention group will receive a contrast-enhanced total-body CT scan (head to pelvis during the primary survey. The control group will be evaluated according to local conventional trauma imaging protocols (based on ATLS guidelines supplemented with selective CT scanning. Primary outcome will be in-hospital mortality. Secondary outcomes are differences in mortality and morbidity during the first year post trauma, several trauma work-up time intervals, radiation exposure, general health and quality of life at 6 and 12 months post trauma and cost-effectiveness. Discussion The REACT-2 trial is a multicenter randomized clinical trial that will provide evidence on the value of immediate total-body CT scanning

  5. Construction and analysis of a head CT-scan database for craniofacial reconstruction. (United States)

    Tilotta, Françoise; Richard, Frédéric; Glaunès, Joan; Berar, Maxime; Gey, Servane; Verdeille, Stéphane; Rozenholc, Yves; Gaudy, J F


    This paper is devoted to the construction of a complete database which is intended to improve the implementation and the evaluation of automated facial reconstruction. This growing database is currently composed of 85 head CT-scans of healthy European subjects aged 20-65 years old. It also includes the triangulated surfaces of the face and the skull of each subject. These surfaces are extracted from CT-scans using an original combination of image-processing techniques which are presented in the paper. Besides, a set of 39 referenced anatomical skull landmarks were located manually on each scan. Using the geometrical information provided by triangulated surfaces, we compute facial soft-tissue depths at each known landmark positions. We report the average thickness values at each landmark and compare our measures to those of the traditional charts of [J. Rhine, C.E. Moore, Facial Tissue Thickness of American Caucasoïds, Maxwell Museum of Anthropology, Albuquerque, New Mexico, 1982] and of several recent in vivo studies [M.H. Manhein, G.A. Listi, R.E. Barsley, et al., In vivo facial tissue depth measurements for children and adults, Journal of Forensic Sciences 45 (1) (2000) 48-60; S. De Greef, P. Claes, D. Vandermeulen, et al., Large-scale in vivo Caucasian facial soft tissue thickness database for craniofacial reconstruction, Forensic Science International 159S (2006) S126-S146; R. Helmer, Schödelidentifizierung durch elektronische bildmischung, Kriminalistik Verlag GmbH, Heidelberg, 1984].

  6. Atypical bisphosphonate-associated subtrochanteric and femoral shaft stress fractures: diagnostic features on bone scan. (United States)

    Probst, Stephan; Rakheja, Rajan; Stern, Jerry


    A 69-year-old woman presented with a spontaneous right subtrochanteric hip fracture. Pan-imaging following orthopedic repair failed to identify a primary malignancy to explain the presumed pathologic basis for this fracture. The patient then underwent bone scintigraphy and SPECT/CT which showed mild uptake in multifocal endosteal thickening of the lateral left femoral diaphysis, diagnostic of bisphosphonate-associated femoral shaft stress fractures, but no evidence of metastatic bone disease. Atypical bisphosphonate-associated subtrochanteric and femoral shaft stress fractures have a fairly specific appearance on bone scintigraphy, and nuclear medicine physicians should be aware of this relatively infrequent emerging pathology.

  7. A novel framework for the temporal analysis of bone mineral density in metastatic lesions using CT images of the femur (United States)

    Knoop, Tom H.; Derikx, Loes C.; Verdonschot, Nico; Slump, Cornelis H.


    In the progressive stages of cancer, metastatic lesions in often develop in the femur. The accompanying pain and risk of fracture dramatically affect the quality of life of the patient. Radiotherapy is often administered as palliative treatment to relieve pain and restore the bone around the lesion. It is thought to affect the bone mineralization of the treated region, but the quantitative relation between radiation dose and femur remineralization remains unclear. A new framework for the longitudinal analysis of CT-scans of patients receiving radiotherapy is presented to investigate this relationship. The implemented framework is capable of automatic calibration of Hounsfield Units to calcium equivalent values and the estimation of a prediction interval per scan. Other features of the framework are temporal registration of femurs using elastix, transformation of arbitrary Regions Of Interests (ROI), and extraction of metrics for analysis. Build in Matlab, the modular approach aids easy adaptation to the pertinent questions in the explorative phase of the research. For validation purposes, an in-vitro model consisting of a human cadaver femur with a milled hole in the intertrochanteric region was used, representing a femur with a metastatic lesion. The hole was incrementally stacked with plates of PMMA bone cement with variable radiopaqueness. Using a Kolmogorov-Smirnov (KS) test, changes in density distribution due to an increase of the calcium concentration could be discriminated. In a 21 cm3 ROI, changes in 8% of the volume from 888 ± 57mg • ml-1 to 1000 ± 80mg • ml-1 could be statistically proven using the proposed framework. In conclusion, the newly developed framework proved to be a useful and flexible tool for the analysis of longitudinal CT data.

  8. Intravenous contrast injection significantly affects bone mineral density measured on CT

    NARCIS (Netherlands)

    Pompe, Esther; Willemink, Martin J.; Dijkhuis, Gawein R.; Verhaar, Harald J. J.; Mohamed Hoesein, Firdaus A A; de Jong, Pim A.


    OBJECTIVE: The objective is to evaluate the effect of intravenous contrast media on bone mineral density (BMD) assessment by comparing unenhanced and contrast-enhanced computed tomography (CT) examinations performed for other indications. METHODS: One hundred and fifty-two patients (99 without and 5

  9. Sacral pseudotumor complicating iliac bone harvest: radiographic, CT and MRI appearances

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, E.; Roth, C.; O' Connell, M.; Eustace, S. [Dept. of Radiology, Mater Misericordiae Hospital, Dublin (Ireland)


    We present the imaging appearances of a lytic pseudotumor in the right sacral ala presenting with referred pain to the right thigh. Subsequent imaging revealed the presence of a cystic lesion arising at the site of previous bone graft harvest; CT-guided aspiration yielded synovial fluid presumed to arise from the contiguous sacroiliac joint. (orig.)

  10. Semi-automated method to measure pneumonia severity in mice through computed tomography (CT) scan analysis (United States)

    Johri, Ansh; Schimel, Daniel; Noguchi, Audrey; Hsu, Lewis L.


    Imaging is a crucial clinical tool for diagnosis and assessment of pneumonia, but quantitative methods are lacking. Micro-computed tomography (micro CT), designed for lab animals, provides opportunities for non-invasive radiographic endpoints for pneumonia studies. HYPOTHESIS: In vivo micro CT scans of mice with early bacterial pneumonia can be scored quantitatively by semiautomated imaging methods, with good reproducibility and correlation with bacterial dose inoculated, pneumonia survival outcome, and radiologists' scores. METHODS: Healthy mice had intratracheal inoculation of E. coli bacteria (n=24) or saline control (n=11). In vivo micro CT scans were performed 24 hours later with microCAT II (Siemens). Two independent radiologists scored the extent of airspace abnormality, on a scale of 0 (normal) to 24 (completely abnormal). Using the Amira 5.2 software (Mercury Computer Systems), a histogram distribution of voxel counts between the Hounsfield range of -510 to 0 was created and analyzed, and a segmentation procedure was devised. RESULTS: A t-test was performed to determine whether there was a significant difference in the mean voxel value of each mouse in the three experimental groups: Saline Survivors, Pneumonia Survivors, and Pneumonia Non-survivors. It was found that the voxel count method was able to statistically tell apart the Saline Survivors from the Pneumonia Survivors, the Saline Survivors from the Pneumonia Non-survivors, but not the Pneumonia Survivors vs. Pneumonia Non-survivors. The segmentation method, however, was successfully able to distinguish the two Pneumonia groups. CONCLUSION: We have pilot-tested an evaluation of early pneumonia in mice using micro CT and a semi-automated method for lung segmentation and scoring system. Statistical analysis indicates that the system is reliable and merits further evaluation.

  11. A Look from the Inside: MicroCT Analysis of Burned Bones

    Directory of Open Access Journals (Sweden)

    Francesco Boschin


    Full Text Available MicroCT imaging is increasingly used in paleoanthropological and zooarchaeological research to analyse the internal microstructure of bone, replacing comparatively invasive and destructive methods. Consequently the analytical potential of this relatively new 3D imaging technology can be enhanced by developing discipline specific protocols for archaeological analysis. Here we examine how the microstructure of mammal bone changes after burning and explore if X-ray computed microtomography (microCT can be used to obtain reliable information from burned specimens. We subjected domestic pig, roe deer, and red fox bones to burning at different temperatures and for different periods using an oven and an open fire. We observed significant changes in the three-dimensional microstructure of trabecular bone, suggesting that biomechanical studies or other analyses (for instance, determination of age-at-death can be compromised by burning. In addition, bone subjected to very high temperatures (600°C or more became cracked, posing challenges for quantifying characteristics of bone microstructure. Specimens burned at 600°C or greater temperatures, exhibit a characteristic criss-cross cracking pattern concentrated in the cortical region of the epiphyses. This feature, which can be readily observed on the surface of whole bone, could help the identification of heavily burned specimens that are small fragments, where color and surface texture are altered by diagenesis or weathering.

  12. CT-MR image data fusion for computer assisted navigated neurosurgery of temporal bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Nemec, Stefan Franz [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria)]. E-mail:; Donat, Markus Alexander [Department of Neurosurgery, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Mehrain, Sheida [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Friedrich, Klaus [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Krestan, Christian [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Matula, Christian [Department of Neurosurgery, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Imhof, Herwig [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Czerny, Christian [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria)


    Purpose: To demonstrate the value of multi detector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the preoperative work up of temporal bone tumors and to present, especially, CT and MR image fusion for surgical planning and performance in computer assisted navigated neurosurgery of temporal bone tumors. Materials and methods: Fifteen patients with temporal bone tumors underwent MDCT and MRI. MDCT was performed in high-resolution bone window level setting in axial plane. The reconstructed MDCT slice thickness was 0.8 mm. MRI was performed in axial and coronal plane with T2-weighted fast spin-echo (FSE) sequences, un-enhanced and contrast-enhanced T1-weighted spin-echo (SE) sequences, and coronal T1-weighted SE sequences with fat suppression and with 3D T1-weighted gradient-echo (GE) contrast-enhanced sequences in axial plane. The 3D T1-weighted GE sequence had a slice thickness of 1 mm. Image data sets of CT and 3D T1-weighted GE sequences were merged utilizing a workstation to create CT-MR fusion images. MDCT and MR images were separately used to depict and characterize lesions. The fusion images were utilized for interventional planning and intraoperative image guidance. The intraoperative accuracy of the navigation unit was measured, defined as the deviation between the same landmark in the navigation image and the patient. Results: Tumorous lesions of bone and soft tissue were well delineated and characterized by CT and MR images. The images played a crucial role in the differentiation of benign and malignant pathologies, which consisted of 13 benign and 2 malignant tumors. The CT-MR fusion images supported the surgeon in preoperative planning and improved surgical performance. The mean intraoperative accuracy of the navigation system was 1.25 mm. Conclusion: CT and MRI are essential in the preoperative work up of temporal bone tumors. CT-MR image data fusion presents an accurate tool for planning the correct surgical procedure and is a

  13. Development of 1-year-old computational phantom and calculation of organ doses during CT scans using Monte Carlo simulation. (United States)

    Pan, Yuxi; Qiu, Rui; Gao, Linfeng; Ge, Chaoyong; Zheng, Junzheng; Xie, Wenzhang; Li, Junli


    With the rapidly growing number of CT examinations, the consequential radiation risk has aroused more and more attention. The average dose in each organ during CT scans can only be obtained by using Monte Carlo simulation with computational phantoms. Since children tend to have higher radiation sensitivity than adults, the radiation dose of pediatric CT examinations requires special attention and needs to be assessed accurately. So far, studies on organ doses from CT exposures for pediatric patients are still limited. In this work, a 1-year-old computational phantom was constructed. The body contour was obtained from the CT images of a 1-year-old physical phantom and the internal organs were deformed from an existing Chinese reference adult phantom. To ensure the organ locations in the 1-year-old computational phantom were consistent with those of the physical phantom, the organ locations in 1-year-old computational phantom were manually adjusted one by one, and the organ masses were adjusted to the corresponding Chinese reference values. Moreover, a CT scanner model was developed using the Monte Carlo technique and the 1-year-old computational phantom was applied to estimate organ doses derived from simulated CT exposures. As a result, a database including doses to 36 organs and tissues from 47 single axial scans was built. It has been verified by calculation that doses of axial scans are close to those of helical scans; therefore, this database could be applied to helical scans as well. Organ doses were calculated using the database and compared with those obtained from the measurements made in the physical phantom for helical scans. The differences between simulation and measurement were less than 25% for all organs. The result shows that the 1-year-old phantom developed in this work can be used to calculate organ doses in CT exposures, and the dose database provides a method for the estimation of 1-year-old patient doses in a variety of CT examinations.

  14. Improved image quality and radiation dose reduction in liver dynamic CT scan with the protocol change

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Yu Jin; Cho, Pyong Kon [Radiological Science, Catholic University of Daegu, Daegu (Korea, Republic of)


    The purpose is reducing radiation dose while maintaining of image quality in liver dynamic CT(LDCT) scan, by protocols generally used and the tube voltage set at a low level protocol compared to the radiation dose and image quality. The target is body mass index, 18.5-24 patients out of 40 patients who underwent the ACT(abdominal CT). Group A(tube voltage : 120 kVp, SAFIRE strength 1) of 20 people among 40 people, to apply the general abdominal CT scan protocol, group B(tube voltage : 100 kVp, apply SAFIRE strength 0-5) was 20 people, set a lower tube voltage. Image quality evaluation was setting a region of interest(ROI) in the liver parenchyma, aorta, superior mesenteric artery (SMA), celiac trunk, visceral fat of arterial phase. In the ROI were compared by measuring the noise, signal to noise ratio(SNR), contrast to noise ratio(CNR), CT number. In addition, qualitative assessments to evaluate two people in the rich professional experience in Radiology by 0-3 points. We compared the total radiation dose, dose length product(DLP) and effective dose, volume computed tomography dose index(CTDIvol). The higher SAFIRE in the tube voltage 100 kVp, noise is reduced, CT number was increased. Thus, SNR and CNR was increased higher the SAFIRE step. Compared with the tube voltage 120 kVp, noise, SNR, CNR was most similar in SAFIRE strength 2 and 3. Qualitative assessment SAFIRE strength 2 is the most common SAFIRE strength 2 the most common qualitative assessment, if the tube voltage of 100 kVp when the quality of the images better evaluated was SAFIRE strength 1. Dose was reduced from 21.69%, in 100 kVp than 120 kVp. In the case of a relatively high BMI is not LDCT scan, When it is shipped from the factory tube voltage is set higher, unnecessary radiation exposure when considering the reality that is concerned, when according to the results of this study, set a lower tube voltage and adjust the SAFIRE strength to 1 or 2, the radiation without compromising image quality


    Directory of Open Access Journals (Sweden)

    Arun Kumar


    Full Text Available BACKGROUND: Sinus headache secondary to Chronic Rhinosinusitis refers to episode of pain over the sinus area of the face and is often associated with nasal congestion, rhinorrhea, facial pressure, lacrimation, nausea and sensory sensitivity. Any small lesions or anatomical variations over lateral wall of nose may giv e rise to sinus headache. CT scan play a vital role in accurate assessment of osteomeatal complex area and anatomical variations at this site. AIM: To study anatomical variations of osteomeatal complex area and deviated septum in cases of chronic sinus hea dache secondary to Chronic Rhinosinusitis. MATERIALS AND METHODS : This study was conducted in Jhalawar Medical College, ENT Department between Sept. 2012 to Dec. 2014. In this study 75 patients withchronic sinus headache was selected who had chronic headac he for more than 3 months duration not responding to medical line of treatment and who were willing to undergo function endoscopic sinus surgery. All patients underwent for CT scan para nasal sinus. RESULT: In this study deviated nasal septum was found in 77.33% patients, apart from that it was observed that 54.66% of the sinus headache cases had two or more anatomical variations and 28% had single anatomical variations, out of them commonest finding is concha bullosa followed by enlarge bulla ethmoid, para doxical middle turbinate, medialiseduncinate process, lateraliseduncinate process, prominent aggar nasi cells, haller cells and onodi cells in decreasing order . CONCLUSION: The study of CT scan PNS conclude that Deviated Nasal Septum and anatomical variati ons at lateral wall of nose causes narrowing of osteomeatal complex area which predisposed patients to sino nasal disease and sinus headache

  16. Development of automated quantification of visceral and subcutaneous adipose tissue volumes from abdominal CT scans (United States)

    Mensink, Sanne D.; Spliethoff, Jarich W.; Belder, Ruben; Klaase, Joost M.; Bezooijen, Roland; Slump, Cornelis H.


    This contribution describes a novel algorithm for the automated quantification of visceral and subcutaneous adipose tissue volumes from abdominal CT scans of patients referred for colorectal resection. Visceral and subcutaneous adipose tissue volumes can accurately be measured with errors of 1.2 and 0.5%, respectively. Also the reproducibility of CT measurements is good; a disadvantage is the amount of radiation. In this study the diagnostic CT scans in the work - up of (colorectal) cancer were used. This implied no extra radiation. For the purpose of segmentation alone, a low dose protocol can be applied. Obesity is a well known risk factor for complications in and after surgery. Body Mass Index (BMI) is a widely accepted indicator of obesity, but it is not specific for risk assessment of colorectal surgery. We report on an automated method to quantify visceral and subcutaneous adipose tissue volumes as a basic step in a clinical research project concerning preoperative risk assessment. The outcomes are to be correlated with the surgery results. The hypothesis is that the balance between visceral and subcutaneous adipose tissue together with the presence of calcifications in the major bloodvessels, is a predictive indicator for post - operatieve complications such as anastomotic leak. We start with four different computer simulated humanoid abdominal volumes with tissue values in the appropriate Hounsfield range at different dose levels. With satisfactory numerical results for this test, we have applied the algorithm on over a 100 patient scans and have compared results with manual segmentations by an expert for a smaller pilot group. The results are within a 5% difference. Compared to other studies reported in the literature, reliable values are obtained for visceral and subcutaneous adipose tissue areas.

  17. Is there a role of whole-body bone scan in patients with esophageal squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Li Shau-Hsuan


    Full Text Available Abstract Background Correct detection of bone metastases in patients with esophageal squamous cell carcinoma is pivotal for prognosis and selection of an appropriate treatment regimen. Whole-body bone scan for staging is not routinely recommended in patients with esophageal squamous cell carcinoma. The aim of this study was to investigate the role of bone scan in detecting bone metastases in patients with esophageal squamous cell carcinoma. Methods We retrospectively evaluated the radiographic and scintigraphic images of 360 esophageal squamous cell carcinoma patients between 1999 and 2008. Of these 360 patients, 288 patients received bone scan during pretreatment staging, and sensitivity, specificity, positive predictive value, and negative predictive value of bone scan were determined. Of these 360 patients, surgery was performed in 161 patients including 119 patients with preoperative bone scan and 42 patients without preoperative bone scan. Among these 161 patients receiving surgery, 133 patients had stages II + III disease, including 99 patients with preoperative bone scan and 34 patients without preoperative bone scan. Bone recurrence-free survival and overall survival were compared in all 161 patients and 133 stages II + III patients, respectively. Results The diagnostic performance for bone metastasis was as follows: sensitivity, 80%; specificity, 90.1%; positive predictive value, 43.5%; and negative predictive value, 97.9%. In all 161 patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence-free survival (P = 0.009, univariately. In multivariate comparison, absence of preoperative bone scan (P = 0.012, odds ratio: 5.053 represented the independent adverse prognosticator for bone recurrence-free survival. In 133 stages II + III patients receiving surgery, absence of preoperative bone scan was significantly associated with inferior bone recurrence

  18. CT Scan and Pulmonary Sequestration%CT扫描与肺隔离症

    Institute of Scientific and Technical Information of China (English)



    目的:分析CT增强扫描对肺隔离症的价值。方法回顾性分析经手术病理证实的17例肺隔离症患者。结果手术病理证实2例为叶外型,15例为叶内型,均位于两肺下叶。呈实性肿块的4例,呈囊性的5例(其中2例可见气液平面),呈囊实性肿块的7例。CT增强扫描均可见异常的供血动脉。结论 CT增强扫描清晰显示肺隔离症的异常体动脉血供,在鉴别诊断中具有重大价值。%Objective To analyse the value of constrast-enhanced Routine CT in pulmonary sequestration.Methods The contrast-enhanced Routine CT of 17 patients of pulmonary sequestration were retrospectively studied. They were al proved by surgery.Results There were 2 extra-lober sequestration and 15 intra-lober sequestration in the 17 patients. The lesions of the17 cases located in both lower lobar. 4 of them were solid and 5 were cystic,(2 of 5 cases had air fluid level.),and 7 were cystic and soild.contrast-enhanced Routine CT successfuly delineated abnormal systemic artery.Conclusion Contrast-enhanced Routine CT scan display abnormal systemic artery. Contrast-enhanced Routine CT have important evalution in the distinguish of pulmonary sequestration.

  19. Sigmoid sinus diverticulum and pulsatile tinnitus - Analysis of CT scans from 15 cases

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    Liu, Zhaohui; Wang, Zhenchang; Xian, Junfang; Wang, Yongzhe; Liang, Xihong [Dept. of Radiology, Capital Medical Univ., Beijing Tongren Hospital, Beijing (China); Chen, Chengfang; Gong, Shusheng; Ma, Xiaobo; Li, Yi [Dept. of Otolaryngology Head and Neck Surgery, Capital Medical Univ., Beijing Tongren Hospital, Beijing (China)], e-mail:


    Background: Although the imaging features of sigmoid sinus diverticulum induced pulsatile tinnitus (PT) have been presented in some extent, detailed imaging findings still have not been systematically evaluated and precise diagnostic radiographic criteria has not been established. Purpose: To examine the computed tomography (CT) characteristics of sigmoid sinus diverticulum accompanied with PT. Material and Methods: Fifteen PT patients with sigmoid sinus diverticula proven by surgery were recruited after consenting. CT images of 15 patients were obtained and analyzed, including features of diverticula, brain venous systems, integrity of the sigmoid plate, and the degree of temporal bone pneumatization. Results: Sigmoid sinus diverticulum was located on the same side of PT in 15 patients. Diverticula originated at the superior curve of the sigmoid sinus in 11 patients and the descending segment of the sigmoid sinus in four patients. Sigmoid sinus diverticula focally eroded into the adjacent mastoid air cells in 12 patients and mastoid cortex in three patients. Among eight patients with unilateral dominant brain venous systems, the diverticula were seen on the dominant side in seven patients and non-dominant side in one patient. In contrast, the other seven patients showed co-dominant brain venous systems, with three presenting diverticula on the right side and four on the left. More notably, dehiscent sigmoid plate on the PT side was demonstrated in all patients. In addition, temporal bone hyper-pneumatization was found in nine patients, good and moderate pneumatization in three patients, respectively. Conclusion: Dehiscent sigmoid plate and extensive temporal bone pneumatization are two important imaging characteristics of the PT induced by sigmoid sinus diverticulum.

  20. SPECT/spiral-CT hybrid imaging in unclear foci of increased bone metabolism: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Roemer, W.; Kuwert, T. [Nuklearmedizinische Klinik, Friedrich-Alexander-Univ. Erlangen/Nuernberg (Germany); Beckmann, M.W. [Frauenklinik, Friedrich-Alexander-Univ. Erlangen/Nuernberg (Germany); Forst, R. [Lehrstuhl fuer Orthopaedie mit Orthopaedischer Chirurgie, Friedrich-Alexander Univ. Erlangen/Nuernberg (Germany); Bautz, W. [Radiologisches Inst., Friedrich-Alexander-Univ. Erlangen/Nuernberg (Germany)


    In bone scintigraphy, the differentiation between degenerative processes and bone metastases is still difficult. Therefore, additional radiological studies are regularly needed after bone scintigraphy. The now introduced hybrid-cameras combining single-photon emission computed tomography (SPECT) and spiral-CT are unique in the sense that they offer the opportunity to correlate the functional information with morphology in one session. We herein present two patients in whom this technological setup allowed a definite diagnosis in scintigraphically unclear vertebral lesions. In a patient with breast cancer, hypermetabolic lesions were clearly correlated with osteolyses. In another patient with synovial carcinoma, spondylosis and spondylarthrosis caused focal tracer uptake in the lumbar spine. In addition to an improved diagnostic accuracy, SPECT/Spiral-CT will considerably abbreviate the diagnostic process. (orig.)

  1. Fibrous dysplasia mimicking bone metastasis on both bone scintigraphy and {sup 18}F FDG PET CT: Diagnostic dilemma in a patient with breast cancer

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    KC, Sud Hir Suman; Sharma, Punit; Singh, Har Man Deep; Bal, Chand Rasekhar; Kumar, Rake Sh [India Institute of Medical Sciences, New Delhi (India)


    Bone is the most common distant site to which breast cancer metastasizes. Commonly used imaging modalities for imaging bone metastasis are bone scintigraphy, plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). Although bone scintigraphy gas high sensitivity for detecting bone metastasis, its specificity is low. This is because of the fact that bone scintigraphy images secondary changes in bone rather than just tumor cells {sup 18}F fluorodeoxyglucose ({sup 18}F FDG) PET CT, on the other hand, directly images the tumor cells' glucose metabolism. Unfortunately, similar to bone scintigraphy, benign bone conditions can also show increased {sup 18}F FDG uptake on PET CT, and PET positive asymptomatic fibrous dysplasia can be misinterpreted as a metastasis. Fibrous dysplasia of bone has wide skeletal distribution, with variability of {sup 18}F FDG uptake and CT appearance. It is therefore important to recognize the characteristics of this skeletal dysplasia, to allow differentiation from skeletal metastasis. Bone lesions with {sup 18}F FDG uptake need to be carefully interpreted when evaluating patients with known malignancy. In doubtful cases, fibrous dysplasia should be given as a differential diagnosis and histopathological diagnosis may be warranted, as highlighted in the present case.

  2. The pros and cons of intraoperative CT scan in evaluation of deep brain stimulation lead implantation: A retrospective study (United States)

    Servello, Domenico; Zekaj, Edvin; Saleh, Christian; Pacchetti, Claudio; Porta, Mauro


    Background: Deep brain stimulation (DBS) is an established therapy for movement disorders, such as Parkinson's disease (PD), dystonia, and tremor. The efficacy of DBS depends on the correct lead positioning. The commonly adopted postoperative radiological evaluation is performed with computed tomography (CT) scan and/or magnetic resonance imaging (MRI). Methods: We conducted a retrospective study on 202 patients who underwent DBS from January 2009 to October 2013. DBS indications were PD, progressive supranuclear palsy, tremor, dystonia, Tourette syndrome, obsessive compulsive disorder, depression, and Huntington's disease. Preoperatively, all patients underwent brain MRI and brain CT scan with the stereotactic frame positioned. The lead location was confirmed intraoperatively with CT. The CT images were subsequently transferred to the Stealth Station Medtronic and merged with the preoperative planning. On the first or second day after, implantation we performed a brain MRI to confirm the correct position of the lead. Results: In 14 patients, leads were in suboptimal position after intraoperative CT scan positioning. The cases with alteration in the Z-axis were corrected immediately under fluoroscopic guidance. In all the 14 patients, an immediate repositioning was done. Conclusions: Based on our data, intraoperative CT scan is fast, safe, and a useful tool in the evaluation of the position of the implanted lead. It also reduces the patient's discomfort derived from the transfer of the patient from the operating room to the radiological department. However, intraoperative CT should not be considered as a substitute for postoperative MRI. PMID:27583182

  3. Clinical significance of multislice spiral CT scans in hepatic veins occlusion in Budd-Chiari syndrome

    Institute of Scientific and Technical Information of China (English)

    MENG Xiao-chun; ZHU Kang-shun; QIN Jie; ZHANG Jian-sheng; WANG Xiao-hong; ZOU Yan; ZHANG Ya-qin; SHAN Hong


    Background Budd-Chiari syndrome with hepatic vein occlusion (HVBCS) can induce severe portal hypertension and liver damage. We retrospectively analyzed hepatic CT features of HVBCS and evaluated the usefulness of triphasic enhancement of CT examinations and CT angiography (CTA) in its diagnosis.Methods Twenty-five cases with HVBCS, confirmed by digital subtraction angiography (DSA), received a triphasic enhancement CT scan within one week before DSA. The CTA images of the relevant blood vessels were reconstructed with maximum intensity projection, volume rendering and oblique reformat techniques.Results Compared with DSA, the detection rate of transverse CT and CTA images for abnormal hepatic vein were 81.7% (58/71) and 95.8% (68/71) (χ2=7.044, P=0.008), for membranous obstruction were 47.4% (9/19) and 84.2% (16/19) respectively (χ2 =5.729, P=0.017 ), for segmental obstruction were 88.0% (22/25) and 100% (25/25) respectively (χ2=1.418, P=0.234). The detection rates for hepatic vein stenosis were 100% with each method. Diffuse hepatomegaly was found in all 6 cases in acute phase and 3 of 19 cases in chronic phase who had severe obstruction of three hepatic veins without patent intrahepatic collaterals. The other 16 cases in chronic phase had hepatatrophia to different extents related to the obstructed hepatic vein. All in acute phase and 15 in chronic phase presented typical patchy enhancement initially in caudate lobe and perihilar areas and enlarged with time delay. In all cases, parenchyma areas with atrophy, necrosis and congestion demonstrated lower and later enhancement. In all the parts, which had normal enhancement at least one patent outflow hepatic vein, accessory hepatic vein or collateral vessel was detected. Conclusion Dynamic enhancement CT examination by multislice spiral CT not only could improve the diagnosis of HVBCS by CTA technique, but also could noninvasively provide anatomical information and reveal damage to the hepatic parenchyma.

  4. Whole spine CT for evaluation of scoliosis in children - Feasibility of sub-milli Sievert scanning protocol

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    Kalra, Mannudeep K. [Center for Medical Image Science and Visualization (CMIV), Linkoeping Univ., Linkoeping Univ. Hospital, Linkoeping (Sweden); Massachusetts General Hospital Imaging, Massachusetts General Hospital, Boston (United States); Quick, Petter; Persson, Anders [Center for Medical Image Science and Visualization (CMIV), Linkoeping Univ., Linkoeping Univ. Hospital, Linkoeping (Sweden)], e-mail:; Singh, Sarabjeet [Massachusetts General Hospital Imaging, Massachusetts General Hospital, Boston (United States); Sandborg, Michael [Center for Medical Image Science and Visualization (CMIV), Linkoeping Univ., Linkoeping Univ. Hospital, Linkoeping (Sweden); Department of Radiophysics, Linkoeping Univ. Hospital, Linkoeping (Sweden)


    Background: Optimization of CT radiation dose is important for children due to their higher risk of radiation-induced adverse effects. Anatomical structures with high inherent contrast, such as bones can be imaged at very low radiation doses by optimizing scan parameters. Purpose: To assess feasibility of sub-milli Sievert whole spine CT scanning protocol for evaluation of scoliosis in children. Material and Methods: With approval of the ethical board, we performed whole spine CT for evaluation of scoliosis in 22 children (age range, 3-18 years; mean age, 13 years; 13 girls, 9 boys) on a 128-slice dual source multidetector-row CT scanner. Lowest possible quality reference mAs value (image quality factor for xy-z automatic exposure control or xyz-AEC, CARE Dose 4D) was selected on a per patient basis. Remaining parameters were held constant at 3.0:1 pitch, 128 X 0.6 mm detector collimation, 115.2 mm table feed per gantry rotation, 100 kVp, and 1 and 3 mm reconstructed sections. Average mAs, projected estimated dose savings with AEC, computed tomography dose index volume (CTDI vol), and dose length product (DLP) were recorded. Artifacts were graded on a four-point scale (1, no artifacts; 4, severe artifacts). Ability to identify vertebral and pedicular contours, and measure pedicular width and degree of vertebral rotation was graded on a three-point scale (1, unacceptable; 3, excellent). Results: All CT examinations were deemed as reliable for identifying vertebral and pedicular contours as well as for measuring pedicular width (5.9 {+-} 1.6 mm) and degree of vertebral rotation (28.7{+-} 23.4 deg). Mean objective image noise and signal to noise ratio (SNR) were 57.5 {+-} 21.5 {+-} 4.7 2.3, respectively. With a mean quality reference mAs of 13, the scanner employed an average actual effective mAs of 10 {+-} 3.8 (range, 6-18 mAs) with an estimated radiation dose saving of 43.5 {+-} 16.3% with xyz-AEC compared with fixed mAs. The mean CTDI, DLP, and estimated effective

  5. Nerve canals at the fundus of the internal auditory canal on high-resolution temporal bone CT

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    Ji, Yoon Ha; Youn, Eun Kyung; Kim, Seung Chul [Sungkyunkwan Univ., School of Medicine, Seoul (Korea, Republic of)


    To identify and evaluate the normal anatomy of nerve canals in the fundus of the internal auditory canal which can be visualized on high-resolution temporal bone CT. We retrospectively reviewed high-resolution (1 mm thickness and interval contiguous scan) temporal bone CT images of 253 ears in 150 patients who had not suffered trauma or undergone surgery. Those with a history of uncomplicated inflammatory disease were included, but those with symptoms of vertigo, sensorineural hearing loss, or facial nerve palsy were excluded. Three radiologists determined the detectability and location of canals for the labyrinthine segment of the facial, superior vestibular and cochlear nerve, and the saccular branch and posterior ampullary nerve of the inferior vestibular nerve. Five bony canals in the fundus of the internal auditory canal were identified as nerve canals. Four canals were identified on axial CT images in 100% of cases; the so-called singular canal was identified in only 68%. On coronal CT images, canals for the labyrinthine segment of the facial and superior vestibular nerve were seen in 100% of cases, but those for the cochlear nerve, the saccular branch of the inferior vestibular nerve, and the singular canal were seen in 90.1%, 87.4% and 78% of cases, respectiveIy. In all detectable cases, the canal for the labyrinthine segment of the facial nerve was revealed as one which traversed anterolateralIy, from the anterosuperior portion of the fundus of the internal auditory canal. The canal for the cochlear nerve was located just below that for the labyrinthine segment of the facial nerve, while that canal for the superior vestibular nerve was seen at the posterior aspect of these two canals. The canal for the saccular branch of the inferior vestibular nerve was located just below the canal for the superior vestibular nerve, and that for the posterior ampullary nerve, the so-called singular canal, ran laterally or posteolateralIy from the posteroinferior aspect of

  6. CT and MRI assessment and characterization using segmentation and 3D modeling techniques: applications to muscle, bone and brain

    Directory of Open Access Journals (Sweden)

    Paolo Gargiulo


    Full Text Available This paper reviews the novel use of CT and MRI data and image processing tools to segment and reconstruct tissue images in 3D to determine characteristics of muscle, bone and brain.This to study and simulate the structural changes occurring in healthy and pathological conditions as well as in response to clinical treatments. Here we report the application of this methodology to evaluate and quantify: 1. progression of atrophy in human muscle subsequent to permanent lower motor neuron (LMN denervation, 2. muscle recovery as induced by functional electrical stimulation (FES, 3. bone quality in patients undergoing total hip replacement and 4. to model the electrical activity of the brain. Study 1: CT data and segmentation techniques were used to quantify changes in muscle density and composition by associating the Hounsfield unit values of muscle, adipose and fibrous connective tissue with different colors. This method was employed to monitor patients who have permanent muscle LMN denervation in the lower extremities under two different conditions: permanent LMN denervated not electrically stimulated and stimulated. Study 2: CT data and segmentation techniques were employed, however, in this work we assessed bone and muscle conditions in the pre-operative CT scans of patients scheduled to undergo total hip replacement. In this work, the overall anatomical structure, the bone mineral density (BMD and compactness of quadriceps muscles and proximal femoral was computed to provide a more complete view for surgeons when deciding which implant technology to use. Further, a Finite element analysis provided a map of the strains around the proximal femur socket when solicited by typical stresses caused by an implant press fitting. Study 3 describes a method to model the electrical behavior of human brain using segmented MR images. The aim of the work is to use these models to predict the electrical activity of the human brain under normal and pathological

  7. Evaluation of bone-marrow scanning with technetium-99m sulfur colloid in pediatric oncology. (United States)

    Siddiqui, A R; Oseas, R S; Wellman, H N; Doerr, D R; Baehner, R L


    Eighty-six technetium-99m sulfur colloid (Tc-SC) bone-marrow scans in 56 pediatric oncology patients were reviewed. The distribution of the sulfur colloid was similar to that in adult bone marrow in normal children older than 10 yr, and involved progressively more marrow of the extremities in normal children under 10 years of age. After irradiation or chemotherapy there was an extension of the Tc-SC to peripheral marrow sites. There was also diminished uptake of the tracer in sites corresponding to irradiated areas. In most patients there was recovery of these defects by 6 mo after completion of therapy. Tumor replacement of the marrow was reflected in the scans, and the extent of the scan defect paralleled the course of the disease. In four patients, despite normal bone scans and radiographs, marrow-scan abnormalities due to tumor replacement were present and confirmed by needle aspiration and/or biopsy. In two other patients, the marrow-scan abnormality preceded radiographic and histologic evidence of tumor metastasis. Two patients who responded clinically showed persistent defects; biopsy in one revealed fibrosis. Technetium-99m sulfur colloid bone-marrow scanning appears to be a sensitive monitor of marrow alteration caused by metastases, irradiation damage, or tissue fibrosis in children receiving treatment for cancer.

  8. Image-based compensation for involuntary motion in weight-bearing C-arm cone-beam CT scanning of knees (United States)

    Unberath, Mathias; Choi, Jang-Hwan; Berger, Martin; Maier, Andreas; Fahrig, Rebecca


    We previously introduced four fiducial marker-based strategies to compensate for involuntary knee-joint motion during weight-bearing C-arm CT scanning of the lower body. 2D methods showed significant reduction of motion- related artifacts, but 3D methods worked best. However, previous methods led to increased examination times and patient discomfort caused by the marker attachment process. Moreover, sub-optimal marker placement may lead to decreased marker detectability and therefore unstable motion estimates. In order to reduce overall patient discomfort, we developed a new image-based 2D projection shifting method. A C-arm cone-beam CT system was used to acquire projection images of five healthy volunteers at various flexion angles. Projection matrices for the horizontal scanning trajectory were calibrated using the Siemens standard PDS-2 phantom. The initial reconstruction was forward projected using maximum-intensity projections (MIP), yielding an estimate of a static scan. This estimate was then used to obtain the 2D projection shifts via registration. For the scan with the most motion, the proposed method reproduced the marker-based results with a mean error of 2.90 mm +/- 1.43 mm (compared to a mean error of 4.10 mm +/- 3.03 mm in the uncorrected case). Bone contour surrounding modeling clay layer was improved. The proposed method is a first step towards automatic image-based, marker-free motion-compensation.

  9. Using the fourth dimension to distinguish between structures for anisotropic diffusion filtering in 4D CT perfusion scans

    NARCIS (Netherlands)

    Mendrik, AM; Vonken, EPA; Witkamp, TD; Prokop, Mathias; Van Ginneken, Bram; Viergever, Max A.


    High resolution 4D (3D+time) cerebral CT perfusion (CTP) scans can be used to create 3D arteriograms (showing only arteries) and venograms (only veins). However, due to the low X-ray radiation dose used for acquiring the CTP scans, they are inherently noisy. In this paper, we propose a time intensit

  10. Autopsy Findings of Brainstem in Head Trauma in Comparison with CT Scan Findings in Brain Trauma Ward in Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Shakeri Bavil Moslem


    Full Text Available Computed tomography (CT is now the primary diagnostic method for head trauma because of its ability to demonstrate the nature, extent, sites, and multiplicity of brain injuries. Although there have been numerous reports on the CT findings of most types of intracranial injury, the findings in brainstem injury have not been well described. This study aimed at comparing the autopsy findings of brainstem in head trauma in comparison with CT scan results. Two hundred patients with head trauma, who expired after a period of time of hospitalization, were assessed in a diagnostic value study. Brain stem involvement was determined by autopsy as well as CT scanning of the brain during their hospitalization. The results of the two methods were compared with each other, emphasizing on the type and location of probable lesions in the brain stem. Considering the autopsy as the method of the choice, sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of CT scan in brain stem lesions of patients with head trauma were calculated. The effect of primary cause of head trauma, survival time and Glasgow Coma Scale (GCS were evaluated, as well. Brain stem lesions were detected in 39 (19.5% patients in autopsy. However, CT scan revealed brain stem lesions in 23(11.5% cases. The sensitivity, specificity, PPV and NPV of CT scan was 59%, 100%, 100% and 91% respectively. The most common lesions of the brain stem region were as contusion of pons (8.5%, medulla (5% and midbrain (4.5%. There were 6 (3% cases of ponto-medullary junction tearing and 1 (0.5% case of cervico-medullary junction tearing. CT scan is a specific method of evaluating patients with probable brain stem injuries after head trauma, but low sensitivity limits its efficacy. Our results are in conformity with the reports in the literature.

  11. Bone Micro-CT Assessments in an Orchidectomised Rat Model Supplemented with Eurycoma longifolia

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    Rosmaliza Ramli


    Full Text Available Recent studies suggested that Eurycoma longifolia, a herbal plant, may have the potential to treat osteoporosis in elderly male. This study aimed to determine the effects of Eurycoma longifolia supplementation on the trabecular bone microarchitecture of orchidectomised rats (androgen-deficient osteoporosis model. Forty-eight-aged (10–12 months old Sprague Dawley rats were divided into six groups of sham-operated (SHAM, orchidectomised control (ORX, orchidectomised + 7 mg/rat testosterone enanthate (TEN and orchidectomised + Eurycoma longifolia 30 mg/kg (EL30, orchidectomised + Eurycoma longifolia 60 mg/kg (EL60, orchidectomised + Eurycoma longifolia 90 mg/kg (EL90. Rats were euthanized following six weeks of treatment. The left femora were used to measure the trabecular bone microarchitecture using micro-CT. Orchidectomy significantly decreased connectivity density, trabecular bone volume, and trabecular number compared to the SHAM group. Testosterone replacement reversed all the orchidectomy-induced changes in the micro-CT parameters. EL at 30 and 60 mg/kg rat worsened the trabecular bone connectivity density and trabecular separation parameters of orchidectomised rats. EL at 90 mg/kg rat preserved the bone volume. High dose of EL (90 mg/kg may have potential in preserving the bone microarchitecture of orchidectomised rats, but lower doses may further worsen the osteoporotic changes.

  12. The diagnostic value of the sagittal multiplanar reconstruction CT images for nasal bone fractures

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    Kim, B.H. [Department of Radiology, Korea University Ansan Hospital, 516 Gojan1-dong, Danwon-gu, Ansan-si, Gyunggi-do, 425-707 (Korea, Republic of); Seo, H.S., E-mail: [Department of Radiology, Korea University Ansan Hospital, 516 Gojan1-dong, Danwon-gu, Ansan-si, Gyunggi-do, 425-707 (Korea, Republic of); Kim, A.-Y.; Lee, Y.S. [Department of Radiology, Dongguk University International Hospital, Gyunggi-do (Korea, Republic of); Lee, Y.H. [Department of Radiology, Korea University Ansan Hospital, 516 Gojan1-dong, Danwon-gu, Ansan-si, Gyunggi-do, 425-707 (Korea, Republic of); Suh, S.-I. [Department of Diagnostic Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of); Lee, D.H. [Department of Radiology, Seoul Medical Center, Seoul (Korea, Republic of)


    Aim: To compare the diagnostic performance of sagittal multiplanar reconstruction (MPR) images and axial images for the detection of a nasal bone fracture. Materials and methods: This prospective study included 533 consecutive patients who underwent three-dimensional images with 64-section multidetector-row CT for the evaluation of a facial bone fracture between June 2007 and May 2008 (366 males; 167 females; mean age +- standard deviation 31.1 +- 21.2 years; age range 1-92 years). Two observers independently scored the possibility of a nasal bone fracture on axial and sagittal images. Receiver operating characteristic (ROC) curve analysis was performed. Results: The Az values of the sagittal images were higher than those of the axial images for both observers (p = 0.002 and 0.010, respectively) with higher accuracy (p < 0.001 and 0.016, respectively). The sensitivities of sagittal images were superior to those of axial images, especially for type 1 simple nasal bone fractures with no or minimal displacement (observer 1, 98.6 versus 72.8%; observer 2, 84.9 versus 71%). Conclusion: Sagittal MPR facial bone CT images provided superior diagnostic performance, and their addition to axial images is useful for the evaluation of nasal bone fractures.

  13. Three-minute SPECT/CT is sufficient for the assessment of bone metastasis as add-on to planar bone scintigraphy

    DEFF Research Database (Denmark)

    Zacho, Helle D; Manresa, José A Biurrun; Aleksyniene, Ramune


    BACKGROUND: The aim of this study is to assess whether ultra-fast acquisition SPECT/CT (UF-SPECT/CT) can replace standard SPECT/CT (std-SPECT/CT) as "add-on" to whole-body bone scintigraphy (WB-BS) for the investigation of bone metastases. Consecutive cancer patients referred for WB-BS who...... diagnosis was reached by two observers for each set of images (WB-BS + standard SPECT/CT or WB-BS + UF-SPECT/CT) using a three-category evaluation scale: M0: no bone metastases; M1: bone metastases; and Me: equivocal findings. RESULTS: Among the 104 included patients, most presented with prostate cancer (n...... in observer agreement between cancer types was detected. SPECT/CT provided a definitive classification in 90 of 104 cases in which WB-BS was not entirely diagnostic. CONCLUSIONS: To investigate potential bone metastases, UF-SPECT/CT can be conducted as add-on to WB-BS to notably reduce the SPECT acquisition...

  14. Sensitivity calibration procedures in optical-CT scanning of BANG 3 polymer gel dosimeters

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Y.; Wuu, Cheng-Shie; Maryanski, Marek J. [Department of Radiation Oncology, Columbia University, New York, New York 10032 (United States); Department of Radiation Oncology, Columbia University, New York, New York 10032 and MGS Research Inc., Madison, Connecticut 06443 (United States)


    The dose response of the BANG 3 polymer gel dosimeter (MGS Research Inc., Madison, CT) was studied using the OCTOPUS laser CT scanner (MGS Research Inc., Madison, CT). Six 17 cm diameter and 12 cm high Barex cylinders, and 18 small glass vials were used to house the gel. The gel phantoms were irradiated with 6 and 10 MV photons, as well as 12 and 16 MeV electrons using a Varian Clinac 2100EX. Three calibration methods were used to obtain the dose response curves: (a) Optical density measurements on the 18 glass vials irradiated with graded doses from 0 to 4 Gy using 6 or 10 MV large field irradiations; (b) optical-CT scanning of Barex cylinders irradiated with graded doses (0.5, 1, 1.5, and 2 Gy) from four adjacent 4x4 cm{sup 2} photon fields or 6x6 cm{sup 2} electron fields; and (c) percent depth dose (PDD) comparison of optical-CT scans with ion chamber measurements for 6x6 cm{sup 2}, 12 and 16 MeV electron fields. The dose response of the BANG 3 gel was found to be linear and energy independent within the uncertainties of the experimental methods (about 3%). The slopes of the linearly fitted dose response curves (dose sensitivities) from the four field irradiations (0.0752{+-}3%, 0.0756{+-}3%, 0.0767{+-}3%, and 0.0759{+-}3% cm{sup -1} Gy{sup -1}) and the PDD matching methods (0.0768{+-}3% and 0.0761{+-}3% cm{sup -1} Gy{sup -1}) agree within 2.2%, indicating a good reproducibility of the gel dose response within phantoms of the same geometry. The dose sensitivities from the glass vial approach are different from those of the cylindrical Barex phantoms by more than 30%, owing probably to the difference in temperature inside the two types of phantoms during gel formation and irradiation, and possible oxygen contamination of the glass vial walls. The dose response curve obtained from the PDD matching approach with 16 MeV electron field was used to calibrate the gel phantom irradiated with the 12 MeV, 6x6 cm{sup 2} electron field. Three-dimensional dose distributions

  15. AIDS complicated with intestinal lymphoma: X-ray radiology,CT scan and pathological findings

    Institute of Scientific and Technical Information of China (English)

    LI Hong-jun; CHENG Jing-liang


    Background The non-Hodgkin's lymphoma is the AIDS symbol of tumor, with high incidence and poor prognosis. The purpose of this study was to investigate the radiological demonstrations of AIDS complicated by intestinal lymphoma and its pathological mechanism.Methods CT scan and pathological data of 3 cases of AIDS complicated by intestinal lymphoma were retrospectively analyzed. All the 3 cases received CT diagnostic scanning, including 2 receiving barium enema radiography after lower gastrointestinal tract cleansing, 1 receiving laporotomy to obtain partial thickened intestinal canal for histopathology and 1with autopsy for histopathological analysis.Results Intestinal canal lymphoma occurred at the left intestinal canal in 2 cases and at the right intestinal canal in the other case, with manifestations of unevenly thickened intestinal canal wall, narrowed canal lumen and filling defect. It was pathologically classified as B cell lymphoma.Conclusions AIDS complicated by B cell lymphoma has manifestations of unevenly thickened intestinal canal wall and narrowed canal lumen, which are non-specific. It should be differentiated from other tumors of intestinal canal in its diagnosis.

  16. CT scan findings in three cases of multiple sclerosis with homonymous hemianopsia

    Energy Technology Data Exchange (ETDEWEB)

    Arikado, Takuji; Ariga, Hiroko; Kase, Manabu; Nagata, Renpei; Tashiro, Kunio (Hokkaido Univ., Sapporo (Japan). School of Medicine)


    Three cases of clinically definite multiple sclerosis manifested homonymous hemianopsia. A 35-year-old female, in whom right optic neuritis developed as the initial symptom, manifested right homonymous hemianopsia 4 months later followed by cerebral symptoms another 4 months later. A 25-year-old male developed sudden brain stem and cerebellar symptoms associated with right abducens palsy and right homonymous hemianopsia. In a 26-year-old female developed right homonymous hemianopsia 13 years after the first attack of recurrent optic neuritis. CT-scan in these three cases revealed the presence of a ''plaque'' located in the white matter of the left occipital lobe in cases 1 and 2 and in the left peririgone white matter in case 3 as the causative lesion for the right homonymous hemianopsia. These findings indicate that the optic radiation may be involved in multiple sclerosis resulting in homonymous hemianopsia. CT scan is of value in determining the location of the affected intracranial lesion in multiple sclerosis.

  17. CT Scan Mapping of Splenic Flexure in Relation to Spleen and its Clinical Implications. (United States)

    Saber, Alan A; Dervishaj, Ornela; Aida, Samer S; Christos, Paul J; Dakhel, Mahmoud


    Splenic flexure mobilization is a challenging step during left colon resection. The maneuver places the spleen at risk for injury. To minimize this risk, we conducted this study for CT scan mapping of splenic flexure in relation to the spleen. One hundred and sixty CT scans of abdomen were reviewed. The level of the splenic flexure was determined in relation to hilum and lower pole of spleen. These levels were compared with patient demographics. Statistical analysis was performed using Fisher's exact test. The splenic flexure was above the hilum of the spleen in 95 patients (67.86%), at the splenic hilum level in 11 patents (7.88%), between the hilum and lower pole of the spleen in 12 (8.57%), at the lower pole of the spleen in 15 (10.7%) patients and 7 (5%) patients has a splenic flexure that lied below the lower pole of the spleen. Patient demographics showed no statistical significance in regard to splenic flexure location. Splenic flexure lies above the hilum of the spleen in majority of patients. This should be considered as part of operative strategies for left colon resection.

  18. Evaluating 3D registration of CT-scan images using crest lines (United States)

    Ayache, Nicholas; Gueziec, Andre P.; Thirion, Jean-Philippe; Gourdon, A.; Knoplioch, Jerome


    We consider the issue of matching 3D objects extracted from medical images. We show that crest lines computed on the object surfaces correspond to meaningful anatomical features, and that they are stable with respect to rigid transformations. We present the current chain of algorithmic modules which automatically extract the major crest lines in 3D CT-Scan images, and then use differential invariants on these lines to register together the 3D images with a high precision. The extraction of the crest lines is done by computing up to third order derivatives of the image intensity function with appropriate 3D filtering of the volumetric images, and by the 'marching lines' algorithm. The recovered lines are then approximated by splines curves, to compute at each point a number of differential invariants. Matching is finally performed by a new geometric hashing method. The whole chain is now completely automatic, and provides extremely robust and accurate results, even in the presence of severe occlusions. In this paper, we briefly describe the whole chain of processes, already presented to evaluate the accuracy of the approach on a couple of CT-scan images of a skull containing external markers.

  19. Angiogenesis in tissue-engineered nerves evaluated objectively using MICROFIL perfusion and micro-CT scanning

    Institute of Scientific and Technical Information of China (English)

    Hong-kui Wang; Ya-xian Wang; Cheng-bin Xue; Zhen-mei-yu Li; Jing Huang; Ya-hong Zhao; Yu-min Yang; Xiao-song Gu


    Angiogenesis is a key process in regenerative medicine generally, as well as in the speciifc ifeld of nerve regeneration. However, no conve-nient and objective method for evaluating the angiogenesis of tissue-engineered nerves has been reported. In this study, tissue-engineered nerves were constructedin vitro using Schwann cells differentiated from rat skin-derived precursors as supporting cells and chitosan nerve conduits combined with silk ifbroin ifbers as scaffolds to bridge 10-mm sciatic nerve defects in rats. Four weeks after surgery, three-di-mensional blood vessel reconstructions were made through MICROFIL perfusion and micro-CT scanning, and parameter analysis of the tissue-engineered nerves was performed. New blood vessels grew into the tissue-engineered nerves from three main directions: the prox-imal end, the distal end, and the middle. The parameter analysis of the three-dimensional blood vessel images yielded several parameters, including the number, diameter, connection, and spatial distribution of blood vessels. The new blood vessels were mainly capillaries and microvessels, with diameters ranging from 9 to 301µm. The blood vessels with diameters from 27 to 155µm accounted for 82.84% of the new vessels. The microvessels in the tissue-engineered nerves implantedin vivo were relatively well-identiifed using the MICROFIL perfusion and micro-CT scanning method, which allows the evaluation and comparison of differences and changes of angiogenesis in tis-sue-engineered nerves implantedin vivo.

  20. Risk stratification of non-contrast CT beyond the coronary calcium scan. (United States)

    Madaj, Paul; Budoff, Matthew J


    Coronary artery calcification (CAC) is a well-known marker for coronary artery disease and has important prognostic implications. CAC is able to provide clinicians with a reliable source of information related to cardiovascular atherosclerosis, which carries incremental information beyond Framingham risk. However, non-contrast scans of the heart provide additional information beyond the Agatston score. These studies are also able to measure various sources of fat, including intrathoracic (eg, pericardial or epicardial) and hepatic, both of which are thought to be metabolically active and linked to increased incidence of subclinical atherosclerosis as well as increased prevalence of type 2  diabetes. Testing for CAC is also useful in identifying extracoronary sources of calcification. Specifically, aortic valve calcification, mitral annular calcification, and thoracic aortic calcium (TAC) provide additional risk stratification information for cardiovascular events. Finally, scanning for CAC is able to evaluate myocardial scaring due to myocardial infarcts, which may also add incremental prognostic information. To ensure the benefits outweigh the risks of a scanning for CAC for an appropriately selected asymptomatic patient, the full utility of the scan should be realized. This review describes the current state of the art interpretation of non-contrast cardiac CT, which clinically should go well beyond coronary artery Agatston scoring alone.

  1. Bone bruise, lipohemarthrosis, and joint effusion in CT of non-displaced hip fracture

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, Mats (Center for Medical Imaging and Physiology, Skaane University Hospital, Lund University, Lund (Sweden)), Email:; Dunker, Dennis; Collin, David; Goethlin, Jan H. (Department of Radiology, Sahlgrenska University Hospital, Moelndal (Sweden))


    Background. A suspected occult hip fracture after normal radiography is not uncommon in an elderly person after a fall. Despite a lack of robust validation in the literature, computed tomography (CT) is often used as secondary imaging. Purpose. To assess the frequency and clinical utility of non-cortical skeletal and soft tissue lesions as ancillary fracture signs in CT diagnosis of occult hip fractures. Material and Methods. All fracture signs (cortical and trabecular fractures, bone bruise, joint effusion, and lipohemarthrosis) were recorded in 231 hip low-energy trauma cases with CT performed after normal or equivocal radiography in two trauma centers. Results. There were no fracture signs in 110 patients. Twelve of these had a joint effusion. In 121 patients with 46 cervical hip fractures and 75 trochanteric fractures one or more fracture signs were present. Cortical fractures were found in 115 patients. Bone bruise was found in 119 patients, joint effusion in 35, and lipohemarthrosis in 20 patients. Conclusion. Ancillary signs such as bone bruise and lipohemarthrosis can strengthen and sometimes indicate the diagnosis in CT of occult hip fractures. Joint effusion is a non-specific sign

  2. Case of asymmetrical arthrogryposis. A clinical study and a preliminary report on the value of CT-scanning

    Energy Technology Data Exchange (ETDEWEB)

    Hageman, G.; Vette, J.K.; Willemse, J. (University Hospital, Utrecht (Netherlands))


    Following the introduction of the conception that arthrogryposis is a symptom and not a clinical entity, a case of the very rare asymmetric form of neurogenic arthrogryposis is presented. The asymmetry of congenital contractures and weakness is associated with hemihypotrophy. The value of muscular CT-scanning prior to muscle biopsy is demonstrated. Muscular CT-scanning shows the extension of adipose tissue, which has replaced damaged muscles and therby indicates the exact site for muscle biopsy. Since orthopaedic treatment in arthrogryposis can be unrewarding due to severe muscular degeneration, preoperative scanning may provide additional important information on muscular function and thus be of benefit for surgery. The advantage of muscular CT-scanning in other forms of arthrogryposis requires further determination. The differential diagnosis with Werdnig-Hoffmann disease is discussed.

  3. Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: Head-to-head comparison with CT and bone scintigraphy

    DEFF Research Database (Denmark)

    Baun, Christina; Falch Braas, Kirsten; Gerke, Oke

    ) of the thorax and the upper abdomen is used when looking for organ and lymph node metastases and if osseous metastases is suspected, bone scintigraphy is the preferred modality. Other modalities such as magnetic resonance imaging (MRI) are often used as a supplement to confirm or refute equivocal findings......Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: Head-to-head comparison with CT and bone scintigraphy  Kirsten Falch, Christina Baun, Oke Gerke, , Ziba A. Farahani, Poul F. Høilund-Carlsen, Lisbet B. Larsen*, Marianne Ewertz**, Katrine Søe*** and Malene G. Hildebrandt...... to evaluate the diagnostic accuracy of FDG PET/CT performed one and three hours after injection compared with CT and bone scintigraphy in patients suspected of BC recurrence Methods and materials: 39 patients suspected either clinically or diagnostically of BC recurrence were included. All patients underwent...

  4. CT scanning for the detection of tuberculous mediastinal and hilar lymphadenopathy in children

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, S. [Dept. of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa); School of Child and Adolescent Health, Univ. of Cape Town, Cape Town (South Africa); Joseph, E.; Lucas, S.; Brachmeyer, S. [Dept. of Radiology, Helen Joseph Hospital, Univ. of the Witwatersrand, Johannesburg (South Africa); Toit, G. du; Zar, H.; Swingler, G. [School of Child and Adolescent Health, Univ. of Cape Town, Cape Town (South Africa); Dept. of Paediatrics, Red Cross Children' s Hospital, Cape Town (South Africa)


    Background: The diagnosis of primary pulmonary tuberculosis (PTB) in children relies heavily on the radiographic demonstration of mediastinal lymphadenopathy. Plain radiographs may be unreliable and CT is the current 'gold standard' for demonstrating this. Only two previous studies have described the CT findings of mediastinal adenopathy exclusively in children. Objective: To determine the prevalence, distribution, characteristics and effect on the bronchial tree of mediastinal lymphadenopathy using modern CT techniques, in children suspected of PTB. Materials and methods: One hundred children (54 boys, 46 girls) with clinically suspected PTB were prospectively recruited from an overnight admission ward if they met the WHO criteria for suspected PTB. CT scans were evaluated by a panel of radiologists with regard to a predetermined set of criteria. Results: Lymph nodes were present in 92 patients, and nodes greater than 1 cm were present in 46 patients. Enhancement of lymph nodes was present in 67 patients and was almost invariably 'ghost-like' ring enhancement. Calcification was present in only 9 patients. The most common location for lymphadenopathy was the subcarinal position (n = 90), followed by the hila (n = 85; left 74, right 72, bilateral 61), the anterior mediastinum (n = 79), the precarinal position (n = 64) and the right paratracheal position (n = 63). Multiple sites of involvement were present in 88 patients, and a single site for lymphadenopathy (subcarinal) was present in only 4 patients. Bronchial compression was identified in 29 patients. Most commonly, the left main bronchus was involved (n = 21), followed by the right main bronchus (n = 14) and the bronchus intermedius (n = 8), 16 right-sided compressions in total. (orig.)

  5. Survey regarding the clinical practice of cardiac CT in Germany. Indications, scanning technique and reporting

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, Marc H.; Hamm, B.; Dewey, M. [Inst. fuer Radiologie, Charite - Universitaetsmedizin Berlin (Germany)


    Purpose: to obtain an overview of the current clinical practice of cardiac computed tomography (CT) in Germany. Materials and methods: a 30-item question-naire was mailed to 149 providers of cardiac CT in Germany. The items asked about indications, scanning technique and reporting, data storage, and cost of the examination. Results: overall 45 questionnaires could be analyzed (30%). The majority of centers (76%, 34 of 45 centers) used CT scanners of the latest generation (at least 64 rows). The most common appropriate indications were exclusion of coronary artery disease (91%, 41/45), coronary anomalies (80%, 36/45), and follow-up after coronary artery bypass grafting (53%, 24/45). Each center examined on average 243 {+-} 310 patients in 2007 and the number of centers performing cardiac CT increased significantly in 2007 (p = 0.035) compared with the preceding year. Most used sublingual nitroglycerin (84%, 38/45; median of 2 sprays = 0.8 mg) and/or a beta blocker (86%, 39/44; median of 5 mg IV, median heart rate threshold: 70 beats/min). Many providers used ECG-triggered tube current modulation (65%, 29/44) and/or adjusted the tube current to the body mass index or body weight (63%, 28/44). A median slice thickness of 0.75 mm with a 0.5 mm increment and a 20 cm field-of-view was most commonly used. Source images in orthogonal planes (96%, 43/45), curved MPRs (93%, 42/45), and thin-slice MIPs (69%, 31/45) were used most frequently for interpretation. Extracardiac structures were also evaluated by 84% of the centers (38/45). The mean examination time was 16.2 min and reporting took an average of 28.8 min. (orig.)

  6. Accuracy and benefits of 3D bone surface modelling: a comparison of two methods of surface data acquisition reconstructed by laser scanning and computed tomography outputs. (United States)

    Brzobohatá, Hana; Prokop, Josef; Horák, Martin; Jancárek, Alexandr; Velemínská, Jana


    The aim of this study is to compare two different methods of frontal bone surface model acquisition. Three dimensional models acquired by laser scanning were compared with models of the same bones acquired by virtual replicas reconstructed from a sequence of computed tomography (CT) images. The influence of volumetric CT data processing (namely thresholding), which immediately preceded the generation of the three-dimensional surface model, was also considered and explored in detail in one sample. Despite identifying certain areas where both models showed deviations across all samples, their conformity can be generally classified as satisfactory, and the differences can be regarded as minimal. The average deviation of registered surface models was 0.27 mm for 90% of the data, and its value was therefore very close to the resolution of the laser scanner used.

  7. A Bone Metastasis Nude Mouse Model Created by Ultrasound Guided Intracardiac Injection of Breast Cancer Cells: the Micro-CT, MRI and Bioluminescence Imaging Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Young Jin; Song, Eun Hye; Kim, Seol Hwa; Song, Ho Taek; Suh, Jin Suck [Yonsei University College of Medicine, Seoul (Korea, Republic of); Choi, Sang Hyun [Korean Minjok Leadership Academy, Heongsung (Korea, Republic of)


    The purpose of this study was to develop a nude mouse model of bone metastasis by performing intracardiac injection of breast cancer cells under ultrasonography guidance and we wanted to evaluate the development and the distribution of metastasis in vivo using micro-CT, MRI and bioluminescence imaging. Animal experiments were performed in 6-week-old female nude mice. The animals underwent left ventricular injection of 2x105 MDA-MB-231Bo-Luc cells. After injection of the tumor cells, serial bioluminescence imaging was performed for 7 weeks. The findings of micro-CT, MRI and the histology were correlated with the 'hot' lesions seen on the bioluminescence imaging. Metastasis was found in 62.3% of the animals. Two weeks after intracardiac injection, metastasis to the brain, spine and femur was detected with bioluminescence imaging with an increasing intensity by week 7. Micro-CT scan confirmed multiple osteolytic lesions at the femur, spine and skull. MRI and the histology were able to show metastasis in the brain and extraskeletal metastasis around the femur. The intracardiac injection of cancer cells under ultrasonography guidance is a safe and highly reproducible method to produce bone metastasis in nude mice. This bone metastasis nude mouse model will be useful to study the mechanism of bone metastasis and to validate new therapeutics

  8. [Exposure to CT scans in childhood and long-term cancer risk: A review of epidemiological studies]. (United States)

    Baysson, Hélène; Journy, Neige; Roué, Tristan; Ducou-Lepointe, Hubert; Etard, Cécile; Bernier, Marie-Odile


    Amongst medical exams requiring ionizing radiation, computed tomography (CT) scans are used more frequently, including in children. These CT examinations are associated with absorbed doses that are much higher than those associated with conventional radiology. In comparison to adults, children have a greater sensitivity to radiation and a longer life span with more years at cancer risks. Five epidemiological studies on cancer risks after CT scan exposure during childhood were published between 2012 and 2015. The results of these studies are consistent and show an increase of cancer risks in children who have been exposed to several CT scans. However, methodological limits due to indication bias, retrospective assessment of radiation exposure from CT scans and lack of statistical power are to be taken into consideration. International projects such as EPI-CT (Epidemiological study to quantify risks for pediatric computerized tomography and to optimize dose), with a focus on dosimetric reconstruction and minimization of bias will provide more precise results. In the meantime, available results reinforce the necessity of justification and optimization of doses.

  9. Assessment of the impact of application of singlephoton emission computed tomography and SPECT-CT on lesion categorisation in bone scintigraphy

    Directory of Open Access Journals (Sweden)

    Garba H. Yunusa


    Full Text Available Objectives: To assess initial experience with the use of a new single-photon emission computed tomography-computed tomography (SPECT-CT in the evaluation of lesions.Methods: The folder number, radiopharmaceutical used and type of scan of patients examined with a new Siemens T6 SPECT-CT between 02 April 2016 and 31 December 2013 were retrieved. The number of 99mTc-MDP bone scans was sufficient for a detailed analysis. The scans were re-processed and reported by the observer before he was given any clinical information. Whole body planar, whole body planar plus SPECT and whole body planar plus SPECT-CT images were assessed successively in three separate sessions at least 2 weeks apart. At each session, the certainties of detection, localisation and categorisation of each lesion were recorded.Results: A total of 539 lesions were seen on the whole body, SPECT and computed tomography (CT images in 133 patients. The whole body images showed no lesions in 3 patients and 378 lesions in 130 patients. SPECT detected 122 additional lesions in 79 patients. Thirty-nine (12.2% lesions were seen only on CT in 32 (24.1% patients. For the 261 lesions seen on the planar images in the SPECT field of view, lesion detection was definite in 233 (89.3%, localisation definite in 151 (57.9% and categorisation definite in 123 (47.1% lesions. On the SPECT, definite lesion detection, localisation and categorisation were recorded, respectively, for 259 (99.2%, 228 (87.4% and 176 (67.4% of the 261 lesions. Lesion detection, localisation and categorisation certainties were definite for 100%, 99.1% and 94.7% of the SPECT-CT lesions, respectively.Conclusion: SPECT markedly improves lesion detection and localisation, and CT enhances lesion categorisation.

  10. The additional value of CT images interpretation in the differential diagnosis of benign vs. malignant primary bone lesions with 18F-FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, K.; Stumpe, K.D.M.; Hany, T.F.; Mende, K.; Veit-Haibach, P.; Schulthess, G.K. von [University Hospital Zurich, Division of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); Exner, U.E. [University Hospital Balgrist, Department of Orthopedic Surgery, Zurich (Switzerland); Bode, B. [University Hospital Zurich, Institute of Surgical Pathology, Zurich (Switzerland); Hodler, Juerg [University Hospital Balgrist, Department of Radiology, Zurich (Switzerland)


    To evaluate the value of a dedicated interpretation of the CT images in the differential diagnosis of benign vs. malignant primary bone lesions with 18fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT). In 50 consecutive patients (21 women, 29 men, mean age 36.9, age range 11-72) with suspected primary bone neoplasm conventional radiographs and 18F-FDG-PET/CT were performed. Differentiation of benign and malignant lesions was separately performed on conventional radiographs, PET alone (PET), and PET/CT with specific evaluation of the CT part. Histology served as the standard of reference in 46 cases, clinical, and imaging follow-up in four cases. According to the standard of reference, conventional 17 lesions were benign and 33 malignant. Sensitivity, specificity, and accuracy in assessment of malignancy was 85%, 65% and 78% for conventional radiographs, 85%, 35% and 68% for PET alone and 91%, 77% and 86% for combined PET/CT. Median SUV{sub max} was 3.5 for benign lesions (range 1.6-8.0) and 5.7 (range 0.8-41.7) for malignant lesions. In eight patients with bone lesions with high FDG-uptake (SUV{sub max} {>=} 2.5) dedicated CT interpretation led to the correct diagnosis of a benign lesion (three fibrous dysplasias, two osteomyelitis, one aneurysmatic bone cyst, one fibrous cortical defect, 1 phosphaturic mesenchymal tumor). In four patients with lesions with low FDG-uptake (SUV{sub max} < 2.5) dedicated CT interpretation led to the correct diagnosis of a malignant lesion (three chondrosarcomas and one leiomyosarcoma). Combined PET/CT was significantly more accurate in the differentiation of benign and malignant lesions than PET alone (p =.039). There was no significant difference between PET/CT and conventional radiographs (p =.625). Dedicated interpretation of the CT part significantly improved the performance of FDG-PET/CT in differentiation of benign and malignant primary bone lesions compared to PET alone. PET/CT more commonly

  11. The width of the incisive canal and labial alveolar bone of the incisive canal: an assessment on CT images

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Yang Gyun; Jang, Hyun Seon; Kim, Byung Ock; Kim, Jin Soo [Chosun Univ. College of Dentistry, Gwangju (Korea, Republic of)


    To assess the width of the labial alveolar bone of the incisive canal and the width of the incisive canal on spiral computed tomographic images of the anterior portion of the maxilla. Study materials included 38 CT scans taken for preoperative planning of implant placement. Axial cross-sectioned image entirely showing the incisive canal at an orifice to the oral cavity, middle portion, and an orifice to the nasal cavity and the diameter of the incisive canal at the middle portion were determined by two specialist using Digora for Windows 2.1. The statistical analyses were carried out using SPSS 12.0.1. When the maxillary central incisors remained, the mean labial alveolar bone width were 6.81{+-}1.41 mm, 6.46{+-}1.33 mm, and 7.91{+-}1.33 mm. When the maxillary central incisors were missed the mean width were 5.42{+-}2.20 mm, 6.23{+-}2.29 mm, and 7.89{+-}2.13 mm. The labial alveolar bone width at middle portion and an orifice to the nasal cavity were of no statistical significant difference according to presence of the maxillary central incisors (P>0.05). The width between oral cavity and nasal cavity, middle portion and to masal cavity revealed statistically significant difference (P<0.05)

  12. Investigation of a method for generating synthetic CT models from MRI scans of the head and neck for radiation therapy (United States)

    Hsu, Shu-Hui; Cao, Yue; Huang, Ke; Feng, Mary; Balter, James M.


    Magnetic resonance (MR) images often provide superior anatomic and functional information over computed tomography (CT) images, but generally are not used alone without CT images for radiotherapy treatment planning and image guidance. This study aims to investigate the potential of probabilistic classification of voxels from multiple MRI contrasts to generate synthetic CT (‘MRCT’) images. The method consists of (1) acquiring multiple MRI volumes: T1-weighted, T2-weighted, two echoes from a ultra-short echo time (UTE) sequence, and calculated fat and water image volumes using a Dixon method, (2) classifying tissues using fuzzy c-means clustering with a spatial constraint, (3) assigning attenuation properties with weights based on the probability of individual tissue classes being present in each voxel, and (4) generating a MRCT image volume from the sum of attenuation properties in each voxel. The capability of each MRI contrast to differentiate tissues of interest was investigated based on a retrospective analysis of ten patients. For one prospective patient, the correlation of skull intensities between CT and MR was investigated, the discriminatory power of MRI in separating air from bone was evaluated, and the generated MRCT image volume was qualitatively evaluated. Our analyses showed that one MRI volume was not sufficient to separate all tissue types, and T2-weighted images was more sensitive to bone density variation compared to other MRI image types. The short echo UTE image showed significant improvement in contrasting air versus bone, but could not completely separate air from bone without false labeling. Generated MRCT and CT images showed similar contrast between bone and soft/solid tissues. These results demonstrate the potential of the presented method to generate synthetic CT images to support the workflow of radiation oncology treatment planning and image guidance.

  13. {sup 18}F-Fluoride PET/CT is highly effective for excluding bone metastases even in patients with equivocal bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Bortot, Daniel C.; Amorim, Barbara J.; Oki, Glaucia C.; Santos, Allan O.; Lima, Mariana C.L.; Etchebehere, Elba C.S.C.; Ramos, Celso Dario [State University of Campinas (UNICAMP), Division of Nuclear Medicine, Department of Radiology, Avenue Zeferino Vaz, S/N., PO Box 6149, Campinas (Brazil); Gapski, Sergio B. [Medicina Nuclear Diagnostico e Terapia, Nuclear Medicine Clinic, Campinas (Brazil); Barboza, Marycel F.; Mengatti, Jair [Nuclear and Energy Research Institute (IPEN)-CNEN, Radiopharmacy Directory, Sao Paulo (Brazil)


    Bone scintigraphy (BS) has been used extensively for many years for the diagnosis of bone metastases despite its low specificity and significant rate of equivocal lesions. {sup 18}F-Fluoride PET/CT has been proven to have a high sensitivity and specificity in the detection of malignant bone lesions, but its effectiveness in patients with inconclusive lesions on BS is not well documented. This study evaluated the ability of {sup 18}F-fluoride PET/CT to exclude bone metastases in patients with various malignant primary tumours and nonspecific findings on BS. We prospectively studied 42 patients (34-88 years of age, 26 women) with different types of tumour. All patients had BS performed for staging or restaging purposes but with inconclusive findings. All patients underwent {sup 18}F-fluoride PET/CT. All abnormalities identified on BS images were visually compared with their appearance on the PET/CT images. All the 96 inconclusive lesions found on BS images of the 42 patients were identified on PET/CT images. {sup 18}F-Fluoride PET/CT correctly excluded bone metastases in 23 patients (68 lesions). Of 19 patients (28 lesions) classified by PET/CT as having metastases, 3 (5 lesions) were finally classified as free of bone metastases on follow-up. The sensitivity, specificity, and positive and negative predictive values of {sup 18}F-fluoride PET/CT were, respectively, 100 %, 88 %, 84 % and 100 % for the identification of patients with metastases (patient analysis) and 100 %, 82 % and 100 % for the identification of metastatic lesions (lesion analysis). The factors that make BS inconclusive do not affect {sup 18}F-fluoride PET/CT which shows a high sensitivity and negative predictive value for excluding bone metastases even in patients with inconclusive conventional BS. (orig.)


    Institute of Scientific and Technical Information of China (English)

    JIANG Lixin; XIAO Zhiwen


    severe conductive deafness, incus long process fracture or dislocation on VE and facial paralysis all received ossic-ular chain reconstruction and facial nerve decompression after 4-8 weeks of conservative treatment. The 7 cases with moderate to severe conductive deafness, dislocated or fallen incus on VE but no facial paralysis received ossicular chain reconstruction after conservative treatment. The 4 cases with mixed hearing loss, dislocated or fallen incus on VE and no facial paralysis received ossicular chain repair via the intact canal wall epitympanum approach after conservative treatment. Pharmacological therapies continued postopera-tively in these patients to treat sensorineural deafness. Although temporal bone CT scans displayed the frac-ture line and malleus/incus abnormalities, VE provided additional detailed information on dislocation of in-cudomalleal and incudostapedial joints, incus dislocation or fracture, separation between crus longum incu-dis and stapes, and incus shifting. These were all confirmed during surgery. VE results and surgery findings were 100%consistent in patients with ossicular chain disruption. Conclusion VE can provide reliable visual evidence for accurate assessment of traumatic ossicular chain disruption, timing of surgery and individualiz-ing surgical strategies and postoperative follow-up.

  15. 3D-CT of the temporal bone area with high-speed processing

    Energy Technology Data Exchange (ETDEWEB)

    Hattori, Taku [Nagoya Univ. (Japan). Branch Hospital


    Three-dimentional (3D)-CT was introduced to represent abnormal findings in the temporal bone area utilizing a SOMATOM DRH CT scanner with accessory 3D reconstruction software and an exclusive high-speed 3D processing system, VOXEL FLINGER. In a patient with eosinophilic granuloma, a defect in the squamous part of the temporal bone was demonstrated suggesting exposure of the dura mater during surgery. In a patient with a normal ear, well-developed mastoid cavity, a part of the handle and the head of the malleus, the incudomalleal joint, the short limb, body and a part of the long limb of the incus and the round window niche were demonstrated. In a case of chronic otitis media, poorly developed mastoid cavity and a possible defect of the tip of the long limb of the incus were demonstrated, in contrast to the patient with the normal ear. 3D-CT yields objective and solid images which are useful for diagnosis, treatment planning and explanation of the pathology to patients and their family. To obtain convincing 3D images, physicians themselves have to choose exact rotation angles. It is not adequate to reconstruct original CT data using a CT computer with accessory 3D software whose processing capability is not good enough for this purpose. The conclusion is as follows: (1) it is necessary and effective to transfer original CT data into the memory of the exclusive high-speed 3D processing system and (2) process the data by the voxel memory method to establish a clinically valuable 3D-CT imaging system. (author).

  16. Moving metal artifact reduction in cone-beam CT scans with implanted cylindrical gold markers

    Energy Technology Data Exchange (ETDEWEB)

    Toftegaard, Jakob, E-mail:; Fledelius, Walther; Worm, Esben S.; Poulsen, Per R. [Department of Oncology, Aarhus University Hospital, Aarhus 8000 (Denmark); Seghers, Dieter; Huber, Michael; Brehm, Marcus [Varian Medical Systems, Imaging Laboratory GmbH, Baden-Daettwil 5405 (Switzerland); Elstrøm, Ulrik V. [Department of Medical Physics, Aarhus University Hospital, Aarhus 8000 (Denmark)


    Purpose: Implanted gold markers for image-guided radiotherapy lead to streaking artifacts in cone-beam CT (CBCT) scans. Several methods for metal artifact reduction (MAR) have been published, but they all fail in scans with large motion. Here the authors propose and investigate a method for automatic moving metal artifact reduction (MMAR) in CBCT scans with cylindrical gold markers. Methods: The MMAR CBCT reconstruction method has six steps. (1) Automatic segmentation of the cylindrical markers in the CBCT projections. (2) Removal of each marker in the projections by replacing the pixels within a masked area with interpolated values. (3) Reconstruction of a marker-free CBCT volume from the manipulated CBCT projections. (4) Reconstruction of a standard CBCT volume with metal artifacts from the original CBCT projections. (5) Estimation of the three-dimensional (3D) trajectory during CBCT acquisition for each marker based on the segmentation in Step 1, and identification of the smallest ellipsoidal volume that encompasses 95% of the visited 3D positions. (6) Generation of the final MMAR CBCT reconstruction from the marker-free CBCT volume of Step 3 by replacing the voxels in the 95% ellipsoid with the corresponding voxels of the standard CBCT volume of Step 4. The MMAR reconstruction was performed retrospectively using a half-fan CBCT scan for 29 consecutive stereotactic body radiation therapy patients with 2–3 gold markers implanted in the liver. The metal artifacts of the MMAR reconstructions were scored and compared with a standard MAR reconstruction by counting the streaks and by calculating the standard deviation of the Hounsfield units in a region around each marker. Results: The markers were found with the same autosegmentation settings in 27 CBCT scans, while two scans needed slightly changed settings to find all markers automatically in Step 1 of the MMAR method. MMAR resulted in 15 scans with no streaking artifacts, 11 scans with 1–4 streaks, and 3 scans

  17. Is there a role of whole-body bone scan in patients with esophageal squamous cell carcinoma


    Li Shau-Hsuan; Huang Yung-Cheng; Huang Wan-Ting; Lin Wei-Che; Liu Chien-Ting; Tien Wan-Yu; Lu Hung-I


    Abstract Background Correct detection of bone metastases in patients with esophageal squamous cell carcinoma is pivotal for prognosis and selection of an appropriate treatment regimen. Whole-body bone scan for staging is not routinely recommended in patients with esophageal squamous cell carcinoma. The aim of this study was to investigate the role of bone scan in detecting bone metastases in patients with esophageal squamous cell carcinoma. Methods We retrospectively evaluated the radiographi...

  18. Leukemia and brain tumors among children after radiation exposure from CT scans : design and methodological opportunities of the Dutch Pediatric CT Study

    NARCIS (Netherlands)

    Meulepas, Johanna M.; Ronckers, Cecile M.; Smets, Anne M. J. B.; Nievelstein, Rutger A. J.; Jahnen, Andreas; Lee, Choonsik; Kieft, Mariette; Lameris, Johan S.; van Herk, Marcel; Greuter, Marcel J. W.; Jeukens, Cecile R. L. P. N.; van Straten, Marcel; Visser, Otto; van Leeuwen, Flora E.; Hauptmann, Michael


    Computed tomography (CT) scans are indispensable in modern medicine; however, the spectacular rise in global use coupled with relatively high doses of ionizing radiation per examination have raised radiation protection concerns. Children are of particular concern because they are more sensitive to r

  19. Quantitative assessment of bone defect healing by multidetector CT in a pig model

    Energy Technology Data Exchange (ETDEWEB)

    Riegger, Carolin; Kroepil, Patric; Lanzman, Rotem S.; Miese, Falk R.; Antoch, Gerald; Scherer, Axel [University Duesseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany); Jungbluth, Pascal; Hakimi, Mohssen; Wild, Michael [University Duesseldorf, Medical Faculty, Department of Traumatology and Hand Surgery, Duesseldorf (Germany); Hakimi, Ahmad R. [Universtity Duesseldorf, Medical Faculty, Department of Oral Surgery, Duesseldorf (Germany)


    To evaluate multidetector CT volumetry in the assessment of bone defect healing in comparison to histopathological findings in an animal model. In 16 mini-pigs, a circumscribed tibial bone defect was created. Multidetector CT (MDCT) of the tibia was performed on a 64-row scanner 42 days after the operation. The extent of bone healing was estimated quantitatively by MDCT volumetry using a commercially available software programme (syngo Volume, Siemens, Germany).The volume of the entire defect (including all pixels from -100 to 3,000 HU), the nonconsolidated areas (-100 to 500 HU), and areas of osseous consolidation (500 to 3,000 HU) were assessed and the extent of consolidation was calculated. Histomorphometry served as the reference standard. The extent of osseous consolidation in MDCT volumetry ranged from 19 to 92% (mean 65.4 {+-} 18.5%). There was a significant correlation between histologically visible newly formed bone and the extent of osseous consolidation on MDCT volumetry (r = 0.82, P < 0.0001). A significant negative correlation was detected between osseous consolidation on MDCT and histological areas of persisting defect (r = -0.9, P < 0.0001). MDCT volumetry is a promising tool for noninvasive monitoring of bone healing, showing excellent correlation with histomorphometry. (orig.)

  20. Budd-Chiari syndrome: diagnosis with ultrasound and nuclear medicine calcium colloid liver scan following non-diagnostic contrasted CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Mulholland, J.P.; Fong, S.M.; Kafaghi, F.A.; Fong, W. [Royal Brisbane Hospital, Herston, QLD (Australia)


    Budd-Chiari syndrome is a rare condition characterized by thrombosis within the hepatic veins and inferior vena cava. A case of Budd-Chiari syndrome is presented in a patient who experienced acutely 3 days following laparoscopic cholecystectomy for a calculous cholecystitis. A discussion of pathology and findings on calcium colloid scintigram, CT scan and Doppler ultrasound is provided. 5 refs., 4 figs.

  1. Usefulness of {sup 18}F fluoride PET/CT in breast cancer patients with osteosclerotic bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Ho; Kim, Ku Sang; Kang, Seok Yun; Song, Hee Sung; Jo, Kyung Sook; Lee, Su Jin; Yoon, Joon Kee; An, Young Sil [Ajou Univ., Suwon (Korea, Republic of); Choi, Bong Hoi [Gyeongsang National Univ. Hospital, Jinju (Korea, Republic of)


    Bone metastasis is an important factor for the treatment and prognosis of breast cancer patients. Whole body bone scintigraphy (WBBS) can evaluate skeletal metastases, and {sup 18}F FDG PET/CT seems to exhibit high specificity and accuracy in detecting bone metastases. However, there is a limitation of {sup 18}F FDG PET in assessing sclerotic bone metastases because some lesions may be undetectable. Recent studies showed that {sup 18}F fluoride PET/CT is more sensitive than WBBS in detecting bone metastases. This study aims to evaluate the usefulness of {sup 18}F fluoride PET/CT by comparing it with WBBS and {sup 18}F FDG PET/CT in breast cancer patients with osteosclerotic skeletal metastases. Nine breast cancer patients with suspected bone metastases (9 females; mean age {+-} SD, 55.6{+-}10.0 years) underwent {sup 99m}Tc MDP WBBS, {sup 18}F FDG PET/CT and {sup 18}F fluoride PET/CT. Lesion based analysis of five regions of the skeletons(skull, vertebral column, thoracic cage, pelvic bones and long bones of extremities) and patient based analysis were performed. {sup 18}F fluoride PET/CT, {sup 18}F FDG PET/CT and WBBS detected 49, 20 and 25 true metastases, respectively. Sensitivity, specificity, positive predictive value and negative predictive value of {sup 18}F fluoride PET/CT were 94.2%, 46.3%, 57.7% and 91.2%, respectively. Most true metastatic lesions of {sup 18}F fluoride PET/CT had osteosclerotic change (45/49, 91.8%), and only four lesions showed osteolytic change. Most lesions on {sup 18}F FDG PET/CT also demonstrated osteosclerotic change (17/20, 85.0%) with three osteolytic lesions. All true metastatic lesions detected on WBBS and {sup 18}F FDG PET/CT were identified on {sup 18}F fluoride PET/CT. {sup 18}F FDG PET/CT in detecting osteosclerotic metastatic lesions. {sup 18}F fluoride PET/CT might be useful in evaluating osteosclerotic metastases in breast cancer patients.

  2. Aggressive Ewing's sarcoma appearing as a cold lesion on bone scan; Sarcome d'Ewing agressif apparaissant comme une lesion froide sur la scintigraphie osseuse

    Energy Technology Data Exchange (ETDEWEB)

    Chatti, K.; Guezguez, M.; Maha Ben Fredj, M.; Sfar, R.; Essabbah, H. [Hopital Universitaire de Sahloul, Dept. de Medecine Nucleaire, Sahloul (Tunisia); Mtaoumi, M. [Hopital Universitaire de Sahloul, Dept. d' Orthopedie, Sousse (Tunisia); Chatti, K. [Faculte de Medecine de Monastir, Lab. de Biophysique, Monastir (Tunisia)


    Ewing's sarcoma classically presents as a hot spot on bone scan as a result of increased vascularity of the tumor and new bone formation. Purpose We report and analyze an uncommon pattern of a 'cold' lesion in Ewing's sarcoma on bone scan and its pathophysiologic significance. Case report A 15-year-old boy complaining of thigh pain. CT scan evoked Ewing's sarcoma or osteitis. MRI evoked chronic osteitis. Scintigraphy showed a fairly intense and heterogeneous uptake on the femoral lesion and no abnormal uptake elsewhere. Biopsy showed none pathologic pattern. Three months later, a second biopsy concluded to Ewing's sarcoma. Bone scan showed a larger lesion with peripheral intense uptake centered by enlarged 'cold' area in the left femoral diaphysis and no evident bone metastasis. The patient underwent chemotherapy and surgery. Three months later, bone scan showed extensive skeletal metastasis. Conclusion Ewing's sarcoma appears usually as an intense lesion on bone scan. Nevertheless, decreased radiopharmaceutical uptake or 'cold' lesion may be seen in aggressive Ewing's sarcoma with lytic tumor, growth of which is very rapid and bony reaction is minimal. (authors)

  3. Cavum septi pellucidi and cavum vergae. Incidence on CT scan and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, S.; Hojo, H.; Kataoka, K.; Yamasaki, S. (Shizuoka Children' s Hospital, Shizuoka (Japan))


    1050 CT scans of patients under 15 years were reviewed. We also investigated the clinical features of these cases and made an attempt to disclose the incidence of cavum septi pellucidi (CSP) and cavum Vergae (CV) on the CT scan and to clarify their clinical significance. As a whole, CSP was demonstrated in 23 patients (2.2%), CV in 4 (0.4%), and both CSP and CV at the same time in 31 (3.0%). The incidence of CSP and CV in each age bracket decreased with an advance in age. No sexual differences were found. The incidences of CSP and CV in the patients with convulsive disorders, developmental delay, and other disorders were 6.4%, 5.1%, and 5.2% respectively. Of 64 patients with febrile convulsion, 4 had both CSP and CV at the same time, while one had only CSP. The four patients with both CSP and CV had convulsions three or more times, while the patient with only CSP had only one. These results suggested that those patients with febrile convulsions who had both CSP and CV at the same time were liable to have recurrent convulsions. Of 32 patients with benign infantile convulsions, only one had both CSP and CV. On the other hand, of 29 patients with infantile spasms, 2 had only CSP, and another 2 had both CSP and CV. Some patients with infantile spasms had CT scans demonstrating cerebral atrophy, porencephaly, cerebral angioma, and calcification in the brain, suggesting various types of etiology. Of 187 patients with other convulsive disorders, 4 had only CSP and 6 had both CSP and CV. Of 468 patients with developmental delay, 13 had only CSP (2.8%), one had only CV (0.2%), and 10 had both (2.1%). Of these 24 patients with developmental delay who had CSP and/or CV, 14 had cerebral atrophy besides, suggesting other etiological factors. Of 270 patients with other disorders, 3 had only CSP (1.1%), other 3 had only CV (1.1%), and 8 had both (3.0%).

  4. 3D-CT evaluation of secondary alveolar bone grafts in alveolar clefts

    Energy Technology Data Exchange (ETDEWEB)

    Naitoh, Hiroshi; Nishimura, Yoshihiko [Kyoto Univ. (Japan). Graduate School of Medicine; Yamawaki, Yoshiroh [Kyoto Katsura Hospital (Japan); Morimoto, Naoki [Kobe City General Hospital (Japan)


    From 1994 to 2000, we treated 116 patients with cleft alveolus by secondary alveolar bone grafts, and 48 of them were evaluated morphologically with 3D-CT. The frequency of successful bony bridging was significantly higher in the group whose grafts were completely enveloped (including the anterior alveolar ridge) with a mucoperiosteal flap. The frequency was also significantly higher in the group who underwent bone grafts at the age of 13 or less, and canine eruptions did not influence the ratio. Some cases showed such an improved growth pattern of grafted bone that the shape of the affected maxilla resembled that of the normal side, after long-term follow-up observations. The growth increment was remarkable in anterior maxillary height. Orthodontic management guides the canine or incisor into the reconstructed area of the previous cleft. We surmise that the new occlusal position puts pressure on the grafted bone and promotes further osteogenesis. These findings show that it is important to produce sufficient bony bridge to guide the canine or incisor, not the volume of grafted bone, in secondary alveolar bone grafts. Long-term follow-up observation, after more than 2-3 years, is also necessary to evaluate secondary alveolar bone grafts. (author)

  5. Characterizing bone marrow involvement in Hodgkin's lymphoma by FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Weiler-Sagie, Michal; Kagna, Olga [Rambam Health Care Campus, Nuclear Medicine Department, Haifa (Israel); Dann, Eldad J. [Rambam Health Care Campus and B. and R. Rappaport Faculty of Medicine, Technion, Hematology Department, Haifa (Israel); Ben-Barak, Ayelet [Rambam Health Care Campus and B. and R. Rappaport Faculty of Medicine, Technion, Pediatric Hemato-Oncology Department, Haifa (Israel); Israel, Ora [Rambam Health Care Campus and B. and R. Rappaport Faculty of Medicine, Technion, Nuclear Medicine Department, Haifa (Israel)


    Fluoro-deoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is superior to iliac bone marrow biopsy (iBMB) for detection of bone marrow involvement (BMI) in staging of Hodgkin's lymphoma (HL). The present study aims to characterize the patterns and distribution of BMI in HL as determined by FDG-PET/CT. Reports of FDG-PET/CT studies performed for staging of HL were reviewed. BMI was defined as positive iBMB and/or foci of pathological FDG uptake in the skeleton that behaved in concordance with other sites of lymphoma in studies following chemotherapy. Number of FDG uptake foci, their specific location in the skeleton and the presence of corresponding lesions in the CT component of the study, and stage according to the Ann Arbor staging system, were recorded. The study included 473 patients. iBMB was performed in 336 patients. Nine patients had positive iBMB (9/336, 3 %). Seventy-three patients (73/473, 15 %) had FDG-PET/CT-defined BMI. The BM was the only extranodal site of HL in 52/473 patients (11 %). Forty-five patients had three or more foci of pathological skeletal FDG uptake (45/73, 62 %). Sixty-four patients (64/73, 88 %) had at least one uptake focus in the pelvis or vertebrae. In 60 patients (60/73, 82 %), the number of skeletal FDG uptake foci without corresponding CT lesions was equal to or higher than the number of foci with morphological abnormalities. FDG-PET/CT demonstrated BMI in 15 % of patients with newly diagnosed HL. Diagnosis of BMI in HL by FDG-PET/CT was more sensitive than iBMB with potential upstage in 11 % of patients. The most common pattern of FDG-PET/CT BMI was multifocal (at least three foci) skeletal FDG uptake, with at least one focus in the pelvis or vertebrae and no corresponding CT lesions. (orig.)

  6. A case of catastrophic antiphospholipid syndrome, which presented an acute interstitial pneumonia-like image on chest CT scan. (United States)

    Kameda, Tomohiro; Dobashi, Hiroaki; Susaki, Kentaro; Danjo, Junichi; Nakashima, Shusaku; Shimada, Hiromi; Izumikawa, Miharu; Takeuchi, Yohei; Mitsunaka, Hiroki; Bandoh, Shuji; Imataki, Osamu; Nose, Masato; Matsunaga, Takuya


    We report the case of catastrophic antiphospholipid syndrome (CAPS) complicated with mixed connective tissue disease (MCTD). A female patient was diagnosed with acute interstitial pneumonia (AIP) with MCTD by chest CT scan. Corticosteroid therapy was refractory for lung involvement, and she died due to acute respiratory failure. The autopsy revealed that AIP was compatible with lung involvement of CAPS. We therefore suggest that chest CT might reveal AIP-like findings in CAPS patients whose condition is complicated with pulmonary manifestations.

  7. The Utilization of Gleason Grade as the Primary Criterion for Ordering Nuclear Bone Scan in Newly Diagnosed Prostate Cancer Patients

    Directory of Open Access Journals (Sweden)

    Chad W. M. Ritenour


    Full Text Available Utilization of nuclear bone scans for staging newly diagnosed prostate cancer has decreased dramatically due to PSA-driven stage migration. The current criteria for performing bone scans are based on limited historical data. This study evaluates serum PSA and Gleason grade in predicting positive scans in a contemporary large series of newly diagnosed prostate cancer patients. Eight hundred consecutive cases of newly diagnosed prostate cancer over a 64-month period underwent a staging nuclear scan. All subjects had histologically confirmed cancer. The relationship between PSA, Gleason grade, and bone scan was examined by calculating series of crude, stratified, and adjusted odds ratios with corresponding 95% confidence intervals. Four percent (32/800 of all bone scans were positive. This proportion was significantly lower in patients with Gleason score ≤7 (1.9% vs. Gleason score ≥8 (18.8%, p 30 ng/ml compared to ≤30 ng/ml (p 10 ng/ml compared to ≤10 ng/ml (p = 0.002. The combination of Gleason score and PSA enhances predictability of bone scans in newly diagnosed prostate cancer patients. The PSA threshold for ordering bone scans should be adjusted according to Gleason score. For patients with Gleason scores ≤7, we recommend a bone scan if the PSA is >30 ng/ml. However, for patients with a high Gleason score (8–10, we recommend a bone scan if the PSA is >10 ng/ml.

  8. Diagnosis of temporal bone diseases using three-dimensional images with multislice CT

    Energy Technology Data Exchange (ETDEWEB)

    Toyama, Yoshihiro; Togami, Taro; Murota, Makiko; Fukunaga, Kotaro; Hino, Ichiro; Sato, Katashi; Ohkawa, Motoomi [Kagawa Medical Univ., Miki (Japan)


    We evaluated the usefulness of three-dimensional images with multislice CT in the temporal bone diseases. Fifty-nine cases (26 with medial otitis, 8 choresteatoma, 10 congenital malformation, 3 high jugular bulb, 2 otosclerosis, and 10 others) were included in this study. In the ossicular and inner ear lesions, oblique multiplanar images of the long axis of each ossicle was useful the detection of abnormality. Structural deformity of ossicles and bony labyrinth were clearly delineated by surface rendering images. (author)

  9. A study of the short- to long-phantom dose ratios for CT scanning without table translation

    Energy Technology Data Exchange (ETDEWEB)

    Li, Xinhua; Zhang, Da; Liu, Bob, E-mail: [Division of Diagnostic Imaging Physics, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114 and Webster Center for Advanced Research and Education in Radiation, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Yang, Jie [Pinnacle Health - Fox Chase Regional Cancer Center, Harrisburg, Pennsylvania 17109 (United States)


    Purpose: For CT scanning in the stationary-table modes, AAPM Task Group 111 proposed to measure the midpoint dose on the central and peripheral axes of sufficiently long phantoms. Currently, a long cylindrical phantom is usually not available in many clinical facilities. The use of a long phantom is also challenging because of the heavy weight. In order to shed light on assessing the midpoint dose in CT scanning without table movement, the authors present a study of the short- to long-phantom dose ratios, and perform a cross-comparison of CT dose ratios on different scanner models. Methods: The authors performed Geant4-based Monte Carlo simulations with a clinical CT scanner (Somatom Definition dual source CT, Siemens Healthcare), and modeled dosimetry measurements using a 0.6 cm{sup 3} Farmer type chamber and a 10-cm long pencil ion chamber. The short (15 cm) to long (90 cm) phantom dose ratios were computed for two PMMA diameters (16 and 32 cm), two phantom axes (the center and the periphery), and a range of beam apertures (3–25 cm). The results were compared with the published data of previous studies with other multiple detector CT (MDCT) scanners and cone beam CT (CBCT) scanners. Results: The short- to long-phantom dose ratios changed with beam apertures but were insensitive to beam qualities (80–140 kV, the head and body bowtie filters) and MDCT and CBCT scanner models. Conclusions: The short- to long-phantom dose ratios enable medical physicists to make dosimetry measurements using the standard CT dosimetry phantoms and a Farmer chamber or a 10 cm long pencil chamber, and to assess the midpoint dose in long phantoms. This method provides an effective approach for the dosimetry of CBCT scanning in the stationary-table modes, and is useful for perfusion and interventional CT.

  10. Incidental Visualization of Thyroid Gland on Bone Scan Caused by Graves' Hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Myung Hee; Jeong, Hwan Jeong; Kim, Dong Wook; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)


    A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism

  11. Acetabular orientation variability and symmetry based on CT scans of adults

    Energy Technology Data Exchange (ETDEWEB)

    Lubovsky, Omri; Liebergall, Meir; Khoury, Amal [Hadassah-Hebrew University Medical Center, Orthopedic Surgery Complex, Jerusalem (Israel); Peleg, Eran [Hadassah-Hebrew University Medical Center, Department of Medical Engineering, Jerusalem (Israel); Joskowicz, Leo [Hebrew University of Jerusalem, School of Engineering and Computer Science, Jerusalem (Israel)


    Understanding acetabular orientation is important in many orthopaedic procedures. Acetabular orientation, usually described by anteversion and abduction angles, has uncertain measurement variability in adult patients. The goals of this study are threefold: (1) to describe a new method for computing patient-specific abduction/anteversion angles from a single CT study based on the identification of anatomical landmarks and acetabular rim points; (2) to quantify the inaccuracies associated with landmark selection in computing the acetabular angles; and (3) to quantify the variability and symmetry of acetabular orientation. A total of 25 CT studies from adult patients scanned for non-orthopaedic indications were retrospectively reviewed. The patients were randomly selected from the hospital's database. Inclusion criteria were adults 20-65 years of age. Acetabular landmark coordinates were identified by expert observers and tabulated in a spreadsheet. Two sets of calculations were done using the data: (1) computation of the abduction and anteversion for each patient, and (2) evaluation of the variability of measurements in the same individual by the same surgeon. The results were tabulated and summary statistics computed. This retrospective study showed that acetabular abduction and anteversion angles averaged 54 and 17 , respectively, in adults. A clinically significant intra-patient variability of >20 was found. We also found that the right and left side rim plane orientation were significantly correlated, but were not always symmetric. A new method of computing patient-specific abduction and anteversion angles from a CT study of the anterior pelvic plane and the left and right acetabular rim planes was reliable and accurate. We found that the acetabular rim plane can be reliably and accurately computed from identified points on the rim. The novelty of this work is that angular measurements are performed between planes on a 3-D model rather than lines on 2-D

  12. CT scanning carcases has no detrimental effect on the colour stability of M. longissimus dorsi from beef and sheep. (United States)

    Jose, C G; Pethick, D W; Jacob, R H; Gardner, G E


    This study investigated the effect of computerised tomography imaging (CT scan), for carcase composition determination, on the oxy/metmyoglobin ratio, hue and L(∗), a(∗) and b(∗) scores of M. longissimus dorsi from both beef and lamb. Beef and lamb M. longissimus dorsi were divided into four proportions and randomly allocated to one of the following treatments; CT 30 day aged; CT fresh; control 30 day aged; control fresh. Colour measurements were made over a 96h retail display period. CT scan had little effect on the colour of both lamb and beef across all colour parameters. There was a small negative affect observed in CT aged samples (PCT. Aged M. longissimus dorsi clearly had a worse colour stability than the fresh packaged samples, while beef was a lot more colour stable than lamb. It appears that CT scan for the purpose of body composition determination will not have any commercially relevant impact on colour stability of both beef and lamb.

  13. Brain CT-scan in acute stroke patients: silent infarcts and relation to outcome. (United States)

    Corea, Francesco; Tambasco, Nicola; Luccioli, Roberto; Ciorba, Ettore; Parnetti, Lucilla; Gallai, Virgilio


    Silent infarcts (SIs) are common findings in stroke patients, but their clinical significance remains controversial. Aim of this study was to evaluate the prevalence of SI in consecutive stroke patients, characteristics, associated factors, and influence on in-hospital mortality. The population consisted of 191 patients, consecutively admitted for an acute stroke. Of 191 patients, 74 had SI on CT-scan. Silent infarcts were often multiple, right sided, lacunar. We found SI more frequently in older patients, smokers, with an ischemic stroke having small vessel disease as presumed cause. In our study SI were associated with ageing, smoke habit and lacunar stroke. Silent infarcts size influenced the rate of in-hospital mortality.

  14. Material investigation for manufacturing of reference step gauges for CT scanning verification

    DEFF Research Database (Denmark)

    Cantatore, Angela; Angel, Jais Andreas Breusch; De Chiffre, Leonardo


    This work deals with the study of stability and material investigation for manufacturing of step gauges for CT scanning verification. Four replica step gauges were fabricated using a bisacryl material for dental applications and the stability over five months was monitored using a tactile CMM....... The material was unstable, probably due to a modification of the chemical composition which lowered the hardness. New step gauges were manufactured through milling. Polyetheretherketone (PEEK) and Polyp-phenylenesulphide (PPS with 40% glass) fulfil the requirements regarding hardness and mechanical properties...... and two series of five step gauges (one series for each material) were manufactured by milling. Results show a significant improvement in terms of form stability and surface geometry quality of the new step gauges with respect to the replica step gauges in Luxabite, as reported below....

  15. Use of CT scanning for the study of posterior lumbar intervertebral articulations

    Energy Technology Data Exchange (ETDEWEB)

    Hermanus, N.; de Becker, D.; Baleriaux, D.; Hauzeur, J.P.


    CT scan is peculiarly effective in the study of architectural pathologies of the column; it appears that a number of etiological factors of low back pain are involved and they are often related. Indeed, dis herniation, for instance, is frequently associated with facetal asymmetry, the first signs of arthroses and ligamentous calcification after treatment. The three vertebral axes must be evaluated, one discal and two facetal, the slightest defect in one of which can affect the two others. Moreover, in view of the complexity of the innervation, the entire lumbar column from L1 to L5 S1 must be investigated: it is not uncommonly that low sciatica is caused by a more cranial lumbar pathology. This systematic study promotes better understanding of the etiology of low back pain and suggests a stet judicious therapeutic attitude.

  16. Semi-Quantitative Calculations of Primary Tumor Metabolic Activity Using F-18 FDG PET/CT as a Predictor of Survival in 92 Patients With High-Grade Bone or Soft Tissue Sarcoma

    DEFF Research Database (Denmark)

    Andersen, Kim Francis; Fuglo, Hanna Maria; Rasmussen, Sine Hvid;


    To assess the prognostic value of primary tumor metabolic activity in patients with high-grade bone sarcomas (BS) or soft tissue sarcomas (STS) using F-18 FDG PET/CT. A single-site, retrospective study including 92 patients with high-grade BS or STS. Pretreatment F-18 FDG PET/CT scan was performed...... metabolic activity with pretherapeutic SUVmax using F-18 FDG PET/CT demonstrates independent properties beyond histologic grading for prediction of survival in patients with high-grade STS, but not with high-grade BS....

  17. Combined 18F-Fluoride and 18F-FDG PET/CT Scanning for Evaluation of Malignancy: Results of an International Multicenter Trial

    DEFF Research Database (Denmark)

    Iagaru, Andrei; Mittra, Erik; Mosci, Camila;


    -FDG PET/CT. The 3 PET/CT scans were performed sequentially within 4 wk of one another for each patient. Results: 18F2/18FFDG PET/CT allowed for accurate interpretation of radiotracer uptake outside the skeleton, with findings similar to those of 18F-FDG PET/CT. In 19 participants, skeletal disease...... was more extensive on 18F2 PET/CT and 18F2/18F-FDG PET/CT than on 18F-FDG PET/CT. In another 29 participants, 18F2 PET/CT and 18F2/18F-FDG PET/CT showed osseous metastases where 18FFDG PET/CT was negative. The extent of skeletal lesions was similar in 18 participants on all 3 scans. Conclusion: This trial...

  18. What is a reliable CT scan for diagnosing splenosis under emergency conditions?

    Institute of Scientific and Technical Information of China (English)

    Francesco Giuseppe Garaci; Michele Grande; Massimo Villa; Stefano Mancino; Daniel Konda; Grazia Maria Attinà; Gabriele Galatà; Giovanni Simonetti


    Splenosis is a condition in which splenic tissue is present in a non-anatomical position. Implants of splenic tissue can mimic neoplasms and only specific examinations can confirm the correct diagnosis. Here we report a case of a 23-year-old male patient with a history of surgical splenectomy during childhood after trauma. He was admitted to the emergency department with acute bowel obstruction. An abdominalpelvic computed tomography (CT) scan revealed small bowel obstruction and the presence of two rounded, solid masses located in the rectal-vescical pouch. Quantitative analyses of the different density values in the arterial phase and early portal venous phase demonstrated that these lesions were highly vascularised (92 and 97 Hounsfield Units, respectively). The hypothesis of an ectopic splenic mass was made after evaluation of the CT images and clinical history. The acute bowel obstruction caused by adhesive intestinal syndrome was resolved by surgical adhesiolysis. The smallest mass adherent to the rectum was removed. Histopathologic examination confirmed the benign nature of the lesion, which consisted of splenic tissue.

  19. A navigation system for percutaneous needle interventions based on PET/CT images: design, workflow and error analysis of soft tissue and bone punctures. (United States)

    Oliveira-Santos, Thiago; Klaeser, Bernd; Weitzel, Thilo; Krause, Thomas; Nolte, Lutz-Peter; Peterhans, Matthias; Weber, Stefan


    Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well

  20. Renal varices. Diagnosis with CT scan and treatment with embolization; Varices renales. Deagnostic tomodensitometrique et traitement par embolisation

    Energy Technology Data Exchange (ETDEWEB)

    Lenoir, S.; Strauss, Ch.; Fontanelle, L.; Bouzar, N.; Veillon, B.; Vallancien, G.; Palou, R. [Institut Mutualiste Montsouris, 75 - Paris (France)


    Two cases of recurrent macroscopic Hematuria in which the diagnosis of left renal vein varices was suggested on CT are described. Bloody efflux was seen from the left ureteric orifice. On CT scans, tubulated contrast-enhanced densities in left perirenal fat were seen. Selective renal angiography was normal. Selective left renal phlebography demonstrated intra and perirenal varices. In the two cases, embolization with metallic coil was successfully performed during left renal phlebography, to stop renal varices flux. Diagnostic and therapeutic modalities of renal varices are discussed with predominant place for CT and phlebography. (authors). 13 refs.

  1. A comparative study of the diagnostic accuracy on Waters view with CT scan in detecting midface fractures

    Directory of Open Access Journals (Sweden)

    Panjnoush M.


    Full Text Available Background and Aim: In recent years, CT scan has become available as an alternative to conventional radiography. To date, the utility of Waters view in detecting midface fractures has been rarely evaluated. The aim of this study was to compare the diagnostic accuracy and reliability of Waters radiography with CT scan in detecting midface fractures. Materials and Methods: In this tests evaluation study, waters view and CT scan were performed for 42 patients with midface fracture admitted to maxillofacial surgery department of Shariati hospital. All images were observed and interpreted by an oral and maxillofacial radiologist and an oral and maxillofacial surgeon. Sensitivity, specificity and reliability for Waters view in detecting midface fractures were assessed by Cohen’s kappa test. Results: Sensitivity and specificity for Waters view in detection of midface fratures by the radiologist were 31.79% and 95.35% and by the surgeon were 29.59% and 93.75% respectively. The highest reliability in CT scan and Waters view (in nasal fractures by the radiologist was 66.67% and was 58.33% by the surgeon in buttress of zygoma. The highest agreement rate between the radiologist and the surgeon for CT scan was in zygomatic arch (78.95% and for Waters view was in nasal fracture (62.5%. Conclusion: Based on the results of this study, the specificity of Waters view is sufficient to diagnose fractures of lateral orbital wall, infraorbital rim, orbital floor, zygomatic arch, frontozygomatic suture, lateral wall of maxillary sinus and Lefort II fracture. The specificity is not sufficient to diagnose fractures of medial orbital wall and anterior, posterior and medial wall of maxillary sinus. Detection of these midface fractures needs other conventional radiographies or CT scan.

  2. Quantifying trabecular bone material anisotropy and orientation using low resolution clinical CT images: A feasibility study. (United States)

    Nazemi, S Majid; Cooper, David M L; Johnston, James D


    Accounting for spatial variation of trabecular material anisotropy and orientation can improve the accuracy of quantitative computed tomography-based finite element (FE) modeling of bone. The objective of this study was to investigate the feasibility of quantifying trabecular material anisotropy and orientation using clinical computed tomography (CT). Forty four cubic volumes of interest were obtained from micro-CT images of the human radius. Micro-FE modeling was performed on the samples to obtain orthotropic stiffness entries as well as trabecular orientation. Simulated computed tomography images (0.32, 0.37, and 0.5mm isotropic voxel sizes) were created by resampling micro-CT images with added image noise. The gray-level structure tensor was used to derive fabric eigenvalues and eigenvectors in simulated CT images. For 'best case' comparison purposes, Mean Intercept Length was used to define fabric from micro-CT images. Regression was used in combination with eigenvalues, imaged density and FE to inversely derive the constants used in Cowin and Zysset-Curnier fabric-elasticity equations, and for comparing image derived fabric-elasticity stiffness entries to those obtained using micro-FE. Image derived eigenvectors (which indicated trabecular orientation) were then compared to orientation derived using micro-FE. When using clinically available voxel sizes, gray-level structure tensor derived fabric combined with Cowin's equations was able to explain 94-97% of the variance in orthotropic stiffness entries while Zysset-Curnier equations explained 82-88% of the variance in stiffness. Image derived orientation deviated by 4.4-10.8° from micro-FE derived orientation. Our results indicate potential to account for spatial variation of trabecular material anisotropy and orientation in subject-specific finite element modeling of bone using clinically available CT.

  3. Role of technetium-99m planar bone scanning in the evaluation of low back pain

    Energy Technology Data Exchange (ETDEWEB)

    Valdez, D.C. [Texas Univ., San Antonio, TX (United States). Health Science Center]|[St. Luke`s Lutheran Hospital, San Antonio, TX (United States); Johnson, R.G. [Texas Univ., San Antonio, TX (United States). Health Science Center]|[St. Luke`s Lutheran Hospital, San Antonio, TX (United States)


    The records of 1018 patients with low back pain in a tertiary spine referral practice were reviewed. One hundred thirty-nine out of 1018 (13.6%) underwent technetium-99m planar bone scannings as part of their investigation. Seventy-three out of 139 scans (52%) showed increased uptake in some area, but only 27 out of 139 (19.4%) showed increased uptake specifically in the low back. Scans consistently yielded no findings with reference to the back when the prescan diagnosis was spinal stenosis, lumbar pain syndrome, herniated nucleus pulposus, or postlaminectomy syndrome. Some scans gave positive findings in patients with a diagnosis of degenerative disc disease, pseudoarthrosis, spondylolisthesis, fracture, infection, metabolic disorder, or tumor. Positive scans were generally obtained early after presentation (within 3 months) and negative scans obtained later (after 6 months), suggesting that clinical suspicion is still the main indication for early scanning. Planar bone scanning was helpful in both diagnosis and therapeutic decision-making in many conditions. (orig.)

  4. Cabozantinib Resolves Bone Scans in Tumor-Naïve Mice Harboring Skeletal Injuries

    Directory of Open Access Journals (Sweden)

    Michael G. Doran


    Full Text Available The receptor tyrosine kinase inhibitor cabozantinib (XL184, BMS-907351 Cometriq has displayed impressive clinical activity against several indications, culminating in its recent approval for medullary thyroid cancer. Among malignancies with tropism for the bone (prostate, breast, one striking feature of early clinical reports about this drug has been the rapid and complete resolution of bone scans, a phenomenon almost never observed even among therapies already shown to confer survival benefit. In castration-resistant prostate cancer, not all conventional response indicators change as dramatically posttreatment, raising the possibility that cabozantinib may impair the ability of bone-seeking radionuclides to integrate within the remodeling bone. To test this hypothesis, we surgically induced bone remodeling via physical insult in non–tumor-bearing mice and performed 18F-sodium fluoride (18F-NaF positron emission tomographic (PET and technetium 99m–methylene diphosphonate (99mTc-MDP single-photon emission computed tomographic (SPECT scans pre- and posttreatment with cabozantinib and related inhibitors. A consistent reduction in the accumulation of either radiotracer at the site of bone remodeling was observed in animals treated with cabozantinib. Given that cabozantinib is known to inhibit several receptor tyrosine kinases, we drugged animals with various permutations of more selective inhibitors to attempt to refine the molecular basis of bone scan resolution. Neither the vascular endothelial growth factor receptor (VEGFR inhibitor axitinib, the MET inhibitor crizotinib, nor the combination was capable of inhibiting 18F-NaF accumulation at known bioactive doses. In summary, although the mechanism by which cabozantinib suppresses radionuclide incorporation into foci undergoing bone remodeling remains unknown, that this phenomenon occurs in tumor-naïve models indicates that caution should be exercised in interpreting the clinical significance

  5. Study of fossil bones by synchrotron radiation micro-spectroscopic techniques and scanning electron microscopy. (United States)

    Zougrou, I M; Katsikini, M; Pinakidou, F; Paloura, E C; Papadopoulou, L; Tsoukala, E


    Earlymost Villafranchian fossil bones of an artiodactyl and a perissodactyl from the Milia excavation site in Grevena, Greece, were studied in order to evaluate diagenetic effects. Optical microscopy revealed the different bone types (fibro-lamellar and Haversian, respectively) of the two fragments and their good preservation state. The spatial distribution of bone apatite and soil-originating elements was studied using micro-X-ray fluorescence (µ-XRF) mapping and scanning electron microscopy. The approximate value of the Ca/P ratio was 2.2, as determined from scanning electron microscopy measurements. Bacterial boring was detected close to the periosteal region and Fe bearing oxides were found to fill bone cavities, e.g. Haversian canals and osteocyte lacunae. In the perissodactyl bone considerable amounts of Mn were detected close to cracks (the Mn/Fe weight ratio takes values up to 3.5). Goethite and pyrite were detected in both samples by means of metallographic microscopy. The local Ca/P ratio determined with µ-XRF varied significantly in metal-poor spots indicating spatial inhomogeneities in the ionic substitutions. XRF line scans that span the bone cross sections revealed that Fe and Mn contaminate the bones from both the periosteum and medullar cavity and aggregate around local maxima. The formation of goethite, irrespective of the local Fe concentration, was verified by the Fe K-edge X-ray absorption fine structure (XAFS) spectra. Finally, Sr K-edge extended XAFS (EXAFS) revealed that Sr substitutes for Ca in bone apatite without obvious preference to the Ca1 or Ca2 unit-cell site occupation.

  6. Comparison of 18F-FDG PET/CT, 99mTc-methy-isobutyl-isonitrile(MIBI) scan and radioiodine diagnostic whole body scan with I-131 post-therapeutic whole body scan in papillary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chung Ho; Park, Young Ha; Yoo, Ie Ryung; Kim, Sung Hoon; Chung, Soo Kyo [The Catholic University of Korea, Seoul (Korea, Republic of)


    To evaluate the usefulness of 18F-FDG PET/CT and 99mTc-MIBI scan in the detection of remnant thyroid tissue, recurrence or metastasis before high dose I-131 ablation therapy. Twenty-four patients (20 female, 4 male, age=52.913.2), who received 99mTc-MIBI scan, radioiodine diagnostic whole body scan (WBS) and 18F-FDG PET/CT within a week before high dose I-131 ablation therapy from May 2004 to September 2007 were retrospectively reviewed. All patients thyroid stimulating hormone, thyroglobulin (Tg) and anti-thyroglobulin level were checked before administering I-123 or I-131 for diagnostic WBS. TSH level were higher than 30 mIU/L in all patients. The radioiodine diagnostic WBS, 99mTc-MIBI scan and 18F-FDG PET/CT were compared with the post-therapeutic WBS obtain 7 days after administration of I-131 (=150 mCi). Post-therapeutic WBS of 4 patients showed distant metastases, commonly in lung, all 4 were positive on 18F-FDG PET/CT, 1 on 99mTc-MIBI scan, but none of them were detectable on radioiodine diagnostic WBS. 7 patients with cervical or supraclavicular lymph node metastases on post-therapeutic WBS, 5 were positive on 18F-FDG PET/CT, 4 on radioiodine diagnostic WBS, and 3 on 99mTc-MIBI scan. 9 patients with remnant thyroid tissue only in thyroid bed, 7 were positive on radioiodine diagnostic WBS, 5 on 18F-FDG PET/CT and 3 on 99mTc-MIBI scan. One case with high Tg level (>10ng/mI) was positive only on post-therapeutic WBS scan. 3 patients with high Tg level, all of diagnostic scans and post-therapeutic scan were negative. Compared to the post-therapeutic WBS with radioiodine diagnostic WBS, 99mTc-MIBI scan, 18F-FDG PET/CT, none of the studies were perfectly matched with post-therapeutic WBS, but can compensate each other. 18F-FDG PET/CT might be helpful, when lymph node or lung metastasis is suspected. Further evaluation with larger population is necessary.

  7. {sup 18}F-NaF PET/CT: EANM procedure guidelines for bone imaging

    Energy Technology Data Exchange (ETDEWEB)

    Beheshti, M.; Langsteger, W. [St Vincent' s Hospital, PET - CT Center LINZ, Department of Nuclear Medicine and Endocrinology, Linz (Austria); Mottaghy, F.M. [University Hospital Aachen, RWTH Aachen University, Department of Nuclear Medicine, Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Payche, F. [Louis Mourier Hospital, Department of Nuclear Medicine, Colombes (France); Behrendt, F.F.F. [University Hospital Aachen, RWTH Aachen University, Department of Nuclear Medicine, Aachen (Germany); Wyngaert, T.V. den [Antwerp University Hospital, Department of Nuclear Medicine, Edegem (Belgium); Fogelman, I. [King' s College, Department of Nuclear Medicine, London (United Kingdom); Strobel, K. [Lucerne Cantonal Hospital, Department of Radiology and Nuclear Medicine, Lucerne (Switzerland); Celli, M.; Fanti, S. [Policlinico S. Orsola-Malpighi, Department of Nuclear Medicine, PET Unit, Bologna (Italy); Giammarile, F. [Centre Hospitalier Universitaire de Lyon, Department of Nuclear Medicine, Lyon (France); Krause, B. [University Hospital Rostock, Department of Nuclear Medicine, Rostock (Germany)


    The aim of this guideline is to provide minimum standards for the performance and interpretation of {sup 18}F-NaF PET/CT scans. Standard acquisition and interpretation of nuclear imaging modalities will help to provide consistent data acquisition and numeric values between different platforms and institutes and to promote the use of PET/CT modality as an established diagnostic modality in routine clinical practice. This will also improve the value of scientific work and its contribution to evidence-based medicine. (orig.)

  8. [Importance of bone scanning and osteoscintimetry for assessing development of acute haematogenic childhood osteomyelitis (author's transl)]. (United States)

    Fotter, R; Höllwarth, M


    Bone scanning with 99m-Tc-MDP is generally used for the early diagnosis of acute haematogenic childhood osteomyelitis. The combination of this method with radionuclide osteoscintimetry and the evaluation of the relative uptake ratio supply objective criteria for assessing the development of the disease. They permit statements as to the morphological and functional aspects of the disease and thus facilitate clinical assessment.

  9. Photon-deficient bone scan lesion as a precursor of active Paget's disease

    Energy Technology Data Exchange (ETDEWEB)

    Jaspers, M.M.J.R.; Pauwels, E.K.J.; Blom, J. (Department of Diagnostic Radiology, Division of Nuclear Medicine, University Hospital Leiden (Netherlands)); Harinck, H.I.J. (Clinical Investigation Unit, Department of Endocrinology, University Hospital Leiden, Netherands)


    A case is presented in which a Pagetoid lesion was demonstrated as a photon-deficient area (cold spot) on the bone scan. This area changed into a hot spot 3 years after its discovery. Clinical and radiological observations provide evidence that a scintigraphically photon-deficient area may represent a precursor of active Paget's disease.

  10. Effective doses associated with PET-CT scans two common in pediatric patients; Dosis efectivas asociadas a dos exploraciones PET-CT habituales en pacientes pediatricos

    Energy Technology Data Exchange (ETDEWEB)

    Camacho Lopez, C.; Garcia Martinez, M. t.; Marti Vidal, J. f.; Falgas Lacuela, M.; Vercher Conejero, J. L.


    The main objective of this paper is to outline the effective dose (E) that can be given in two studies conducted PET-CT common for children, in the absence of standard protocols both at standardizing the way image acquisition in this field, as standard levels to guide us when it comes to associate a certain effective dose to pediatric PET-CT scan. These doses will be compared to an adult patient receiving the same type of examination, and consider the percentage of the total dose due to TC.

  11. Static Myocardial Perfusion Imaging using denoised dynamic Rb-82 PET/CT scans

    DEFF Research Database (Denmark)

    Petersen, Maiken N.M.; Hoff, Camilla; Harms, Hans

    to the hottest pixel) was compared in order to assess whether a correlation between original image data and denoised image data could be found. In addition to this, correlations for TPD, Extent of defect and summed defect scores (SSS, SRS and SDS) were investigated. The data was analysed using linear regression......Introduction: Relative and absolute measures of myocardial perfusion are derived from a single 82Rb PET/CT scan. However, images are inherently noising due to the short half-life of 82Rb. We have previously shown that denoising techniques can be applied to dynamic 82Rb series with excellent...... and Bland-Altman analysis. Results: For HYPR-LR, a good correlation was found for relative segmental perfusion for both stress (y=1.007x+0.313, R2=0.98) and rest (y=1.007x+ 0.421, R2=0.96) scans with negative bias of -0.79±1.44 and -0.90±1.63, respectively. Correlations for SSS (R2=0.94), SRS (R2=0.92), SDS...

  12. X-ray CT Scanning Reveals Long-Term Copper Pollution Effects on Functional Soil Structure

    DEFF Research Database (Denmark)

    Naveed, Muhammad; Møldrup, Per; Homstrup, Martin

    Soil structure plays the main role in the ability of the soil to fulfill essential soil functions such as the root growth, rate of water infiltration and retention, transport of gaseous and chemicals/pollutants through the soil. Soil structure is a dynamic soil property and affected by various...... factors such as soil type, land use, and soil contamination. In this study, we quantified the soil structure using X-ray CT scanning and revealed the effect of a long history of Copper (Cu) pollution on it. A fallow field at Hygum Denmark provides this opportunity as it had a long history of Copper...... sulphate contamination in a gradient with Cu content varies from 21 mg kg-1 to 3837 mg kg-1. Total 20 intact soil columns (diameter of 10 cm and height of 8 cm) were sampled at five locations along the Cu-gradient from a depth of 5 to 15 cm below surface level. The soil columns were scanned at a voxel...

  13. Open source deformable image registration system for treatment planning and recurrence CT scans

    DEFF Research Database (Denmark)

    Zukauskaite, Ruta; Brink, Carsten; Hansen, Christian Rønn;


    BACKGROUND: Clinical application of deformable