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Sample records for preoperative ct volume

  1. Diagnostic performance of whole brain volume perfusion CT in intra-axial brain tumors: Preoperative classification accuracy and histopathologic correlation

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    Xyda, Argyro, E-mail: argyro.xyda@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Department of Radialogy, University Hospital of Heraklion, Voutes, 71110 Heraklion, Crete (Greece); Haberland, Ulrike, E-mail: ulrike.haberland@siemens.com [Siemens AG Healthcare Sector, Computed Tomography, Siemensstr. 1, 91301 Forchheim (Germany); Klotz, Ernst, E-mail: ernst.klotz@siemens.com [Siemens AG Healthcare Sector, Computed Tomography, Siemensstr. 1, 91301 Forchheim (Germany); Jung, Klaus, E-mail: kjung1@uni-goettingen.de [Department of Medical Statistics, Georg-August University, Humboldtallee 32, 37073 Goettingen (Germany); Bock, Hans Christoph, E-mail: cbock@gmx.de [Department of Neurosurgery, Johannes Gutenberg University Hospital of Mainz, Langenbeckstraße 1, 55101 Mainz (Germany); Schramm, Ramona, E-mail: ramona.schramm@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Knauth, Michael, E-mail: michael.knauth@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Schramm, Peter, E-mail: p.schramm@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany)

    2012-12-15

    Background: To evaluate the preoperative diagnostic power and classification accuracy of perfusion parameters derived from whole brain volume perfusion CT (VPCT) in patients with cerebral tumors. Methods: Sixty-three patients (31 male, 32 female; mean age 55.6 ± 13.9 years), with MRI findings suspected of cerebral lesions, underwent VPCT. Two readers independently evaluated VPCT data. Volumes of interest (VOIs) were marked circumscript around the tumor according to maximum intensity projection volumes, and then mapped automatically onto the cerebral blood volume (CBV), flow (CBF) and permeability Ktrans perfusion datasets. A second VOI was placed in the contra lateral cortex, as control. Correlations among perfusion values, tumor grade, cerebral hemisphere and VOIs were evaluated. Moreover, the diagnostic power of VPCT parameters, by means of positive and negative predictive value, was analyzed. Results: Our cohort included 32 high-grade gliomas WHO III/IV, 18 low-grade I/II, 6 primary cerebral lymphomas, 4 metastases and 3 tumor-like lesions. Ktrans demonstrated the highest sensitivity, specificity and positive predictive value, with a cut-off point of 2.21 mL/100 mL/min, for both the comparisons between high-grade versus low-grade and low-grade versus primary cerebral lymphomas. However, for the differentiation between high-grade and primary cerebral lymphomas, CBF and CBV proved to have 100% specificity and 100% positive predictive value, identifying preoperatively all the histopathologically proven high-grade gliomas. Conclusion: Volumetric perfusion data enable the hemodynamic assessment of the entire tumor extent and provide a method of preoperative differentiation among intra-axial cerebral tumors with promising diagnostic accuracy.

  2. Single minimum incision endoscopic radical nephrectomy for renal tumors with preoperative virtual navigation using 3D-CT volume-rendering

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    Shioyama Yasukazu

    2010-04-01

    Full Text Available Abstract Background Single minimum incision endoscopic surgery (MIES involves the use of a flexible high-definition laparoscope to facilitate open surgery. We reviewed our method of radical nephrectomy for renal tumors, which is single MIES combined with preoperative virtual surgery employing three-dimensional CT images reconstructed by the volume rendering method (3D-CT images in order to safely and appropriately approach the renal hilar vessels. We also assessed the usefulness of 3D-CT images. Methods Radical nephrectomy was done by single MIES via the translumbar approach in 80 consecutive patients. We performed the initial 20 MIES nephrectomies without preoperative 3D-CT images and the subsequent 60 MIES nephrectomies with preoperative 3D-CT images for evaluation of the renal hilar vessels and the relation of each tumor to the surrounding structures. On the basis of the 3D information, preoperative virtual surgery was performed with a computer. Results Single MIES nephrectomy was successful in all patients. In the 60 patients who underwent 3D-CT, the number of renal arteries and veins corresponded exactly with the preoperative 3D-CT data (100% sensitivity and 100% specificity. These 60 nephrectomies were completed with a shorter operating time and smaller blood loss than the initial 20 nephrectomies. Conclusions Single MIES radical nephrectomy combined with 3D-CT and virtual surgery achieved a shorter operating time and less blood loss, possibly due to safer and easier handling of the renal hilar vessels.

  3. Comparison of cerebral blood volume and permeability in preoperative grading of intracranial glioma using CT perfusion imaging

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    Ding, Bei; Ling, Hua Wei; Chen, Ke Min [Shanghai Jiaotong University, Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai (China); Jiang, Hong [Shanghai Jiaotong University, Department of Pathology, Ruijin Hospital, School of Medicine, Shanghai (China); Zhu, Yan Bo [Shanghai Jiaotong University, Department of Neurosurgery, Ruijin Hospital, School of Medicine, Shanghai (China)

    2006-10-15

    Regional cerebral blood volume (rCBV) and permeability surfaces (rPS) permit in vivo assessment of glioma microvasculature, which provides quite important pathophysiological information in grading gliomas. The aim of our study was to simultaneously examine rCBV and rPS in glioma patients to determine their correlation with histological grade using CT perfusion imaging. A total of 22 patients with gliomas underwent multislice CT perfusion imaging preoperatively. Low-grade and high-grade groups were categorized corresponding to WHO grade II gliomas and WHO grade III or IV gliomas, respectively, as determined by histopathological examination. rCBVs and rPSs were obtained from regions of maximal abnormality in tumor parenchyma on CBV and PS color perfusion maps. Perfusion parameters were compared using the Kruskal-Wallis test in order to evaluate the differences in relation to tumor grade. The Pearson coefficients of rCBV and rPS for each tumor grade were assessed using SPSS 13.0 software. (orig.)

  4. Preoperative volume calculation of the hepatic venous draining areas with multi-detector row CT in adult living donor liver transplantation: impact on surgical procedure

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    Frericks, Bernd B.J. [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); University of Berlin, Department of Radiology, Berlin (Germany); Charite - University Medicine Berlin, Department of Radiology and Nuclear Medicine, Berlin (Germany); Kirchhoff, Timm D.; Shin, Hoen-Oh; Stamm, Georg; Merkesdal, Sonja; Abe, Takehiko; Galanski, Michael [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Diagnostic Radiology, Hannover (Germany); Schenk, Andrea; Peitgen, Heinz-Otto [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); MeVis - Center for Medical Diagnostic Systems and Visualization, Bremen (Germany); Klempnauer, Juergen [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Nashan, Bjoern [Hanover Medical School, Departments of Radiology and Surgery, Hannover (Germany); Hanover Medical School, Department of Visceral- and Transplantation Surgery, Hannover (Germany); Dalhousie University, Multi Organ Transplant Program, Halifax, Nova Scotia (Canada)

    2006-12-15

    The purpose was to assess the volumes of the different hepatic territories and especially the drainage of the right paramedian sector in adult living donor liver transplantation (ALDLT). CT was performed in 40 potential donors of whom 28 underwent partial living donation. Data sets of all potential donors were postprocessed using dedicated software for segmentation, volumetric analysis and visualization of liver territories. During an initial period, volumes and shapes of liver parts were calculated based on the individual portal venous perfusion areas. After partial hepatic congestion occurring in three grafts, drainage territories with special regard to MHV tributaries from the right paramedian sector, and the IRHV were calculated additionally. Results were visualized three-dimensionally and compared to the intraoperative findings. Calculated graft volumes based on hepatic venous drainage and graft weights correlated significantly (r=0.86,P<0.001). Mean virtual graft volume was 930 ml and drained as follows: RHV: 680 ml, IRHV: 170 ml (n=11); segment 5 MHV tributaries: 100 ml (n=16); segment 8 MHV tributaries: 110 ml (n=20). When present, the mean aberrant venous drainage fraction of the right liver lobe was 28%. The evaluated protocol allowed a reliable calculation of the hepatic venous draining areas and led to a change in the hepatic venous reconstruction strategy at our institution. (orig.)

  5. Preoperative PET/CT in early-stage breast cancer

    DEFF Research Database (Denmark)

    Bernsdorf, M; Berthelsen, A K; Wielenga, V T;

    2012-01-01

    The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

  6. Assessment of spiral CT pneumocolon in preoperative colorectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Can-Hui Sun; Zi-Ping Li; Quan-Fei Meng; Shen-Ping Yu; Da-Sheng Xu

    2005-01-01

    AIM: To investigate the value of spiral CT pneumocolon in preoperative colorectal carcinoma.METHODS: Spiral CT pneumocolon was performed prior to surgery in 64 patients with colorectal carcinoma. Spiral CT images were compared to specimens from the resected tumor.RESULTS: Spiral CT depicted the tumor in all patients.Comparison of spiral CT and histologic results showed that the sensitivity and specificity were 95.2%, 40.9% in detection of local invasion, and 75.0%, 90.9% in detection of lymph node metastasis. Compared to the Dukes classification,the disease was correctly staged as A in 6 of 18 patients,as B in 18 of 23, as C in 10 of 15, and as D in 7 of 8. Overall,spiral CT correctly staged 64.1% of patients.CONCLUSION: Spiral CT pneumocolon may be useful in the preoperative assessment of patients with colorectal carcinoma as a means for assisting surgical planning.

  7. Preoperative assessment of vascular anatomy of inferior mesenteric artery by volume-rendered 3D-CT for laparoscopic lymph node dissection with left colic artery preservation in lower sigmoid and rectal cancer

    Institute of Scientific and Technical Information of China (English)

    Michiya Kobayashi; Satoshi Morishita; Takehiro Okabayashi; Kana Miyatake; Ken Okamoto; Tsutomu Namikawa; Yasuhiro Ogawa; Keijiro Araki

    2006-01-01

    AIM: To determine the distance between the branching point of the left colic artery (LCA) and the inferior mesenteric artery (IMA) by computed tomography (CT) scanning, for preoperative evaluation before laparoscopic colorectal operation.METHODS: From February 2004 to May 2005, 100patients (63 men, 37 women) underwent angiography performed with a 16-scanner multi-detector row CT unit (Toshiba, Aquilion 16). All images were analyzed on a workstation (AZE Ltd, Virtual Place Advance 300). The distance from the root of the IMA to the bifurcation of the LCA was measured by curved multi-planar reconstruction on a workstation.RESULTS: The IMA could be visualized in all the cases,but the LCA was missing in two patients. The mean distance from the root of the IMA to the root of the LCA was 42.0 mm (range, 23.2-75.0 mm). There were no differences in gender, arterial branching types, body weight, height, and body mass index.CONCLUSION: Volume-rendered 3D-CT is helpful to assess the vascular branching anatomy for laparoscopic surgery.

  8. Fenestral otosclerosis: significance of preoperative CT evaluation

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    Swartz, J.D.; Faerber, E.N.; Wolfson, R.J.; Marlowe, F.I.

    1984-06-01

    Thirty-five consecutive patients with the clinical diagnosis of fenestral otosclerosis were evaluated with high-resolution computed tomography (CT). Twenty-six were diagnosed as having this disorder by CT evidence of abnormal bony excrescences at or adjacent to the oval window. Sections were also evaluated for evidence of plaque formation elsewhere in the lateral wall of the labyrinth and for surgical obstacles such as an abnormally wide cochlear aqueduct, a high jugular vein, and a dehiscent facial nerve. It is concluded that fenestral otosclerosis may be accurately diagnosed with proper CT techniques.

  9. CT two-dimensional reformation versus three-dimensional volume rendering with regard to surgical findings in the preoperative assessment of the ossicular chain in chronic suppurative otitis media

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    Guo, Yong, E-mail: guoyong27@hotmail.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Liu, Yang, E-mail: liuyangdoc@sina.com [Department of Otorhinolaryngology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Lu, Qiao-hui, E-mail: Luqiaohui465@126.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Zheng, Kui-hong, E-mail: zhengkuihong1971@sina.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Shi, Li-jing, E-mail: Shilijing2003@yahoo.com.cn [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China); Wang, Qing-jun, E-mail: wangqingjun77@163.com [Department of Radiology, Navy General Hospital, 6# Fucheng Road, Beijing 100048 (China)

    2013-09-15

    Purpose: To assess the role of three-dimensional volume rendering (3DVR) in the preoperative assessment of the ossicular chain in chronic suppurative otitis media (CSOM). Materials and methods: Sixty-six patients with CSOM were included in this prospective study. Temporal bone was scanned with a 128-channel multidetector row CT and the axial data was transferred to the workstation for multiplanar reformation (MPR) and 3DVR reconstructions. Evaluation of the ossicular chain according to a three-point scoring system on two-dimensional reformation (2D) and 3DVR was performed independently by two radiologists. The evaluation results were compared with surgical findings. Results: 2D showed over 89% accuracy in the assessment of segmental absence of the ossicular chain in CSOM, no matter how small the segmental size was. 3DVR was as accurate as 2D for the assessment of segmental absence. However, 3DVR was found to be more accurate than 2D in the evaluation of partial erosion of segments. Conclusion: Both 3DVR and 2D are accurate and reliable for the assessment of the ossicular chain in CSOM. The inclusion of 3DVR images in the imaging protocol improves the accuracy of 2D in detecting ossicular erosion from CSOM.

  10. Prognostic significance of preoperative metabolic tumour volume and total lesion glycolysis measured by {sup 18}F-FDG PET/CT in squamous cell carcinoma of the oral cavity

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    Ryu, In Sun; Roh, Jong-Lyel; Choi, Seung-Ho; Nam, Soon Yuhl [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Center, Seoul (Korea, Republic of); Kim, Jae Seung [University of Ulsan College of Medicine, Department of Nuclear Medicine, Asan Medical Center, Seoul (Korea, Republic of); Cho, Kyung-Ja [University of Ulsan College of Medicine, Department of Pathology, Asan Medical Center, Seoul (Korea, Republic of); Kim, Sang Yoon [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Center, Seoul (Korea, Republic of); Biomedical Research Institute, Korean Institute of Science and Technology, Seoul (Korea, Republic of)

    2014-03-15

    Metabolic tumour volume (MTV) and total lesion glycolysis (TLG) from {sup 18}F-FDG PET/CT are emerging prognostic biomarkers in human solid cancers; yet few studies have investigated their clinical and prognostic significance in oral cavity squamous cell carcinoma (OSCC). The present retrospective study evaluated the utility of pretreatment MTV and TLG measured by {sup 18}F-FDG PET/CT to predict survival and occult metastasis (OM) in OSCC. Of 162 patients with OSCC evaluated preoperatively by {sup 18}F-FDG PET/CT, 105 who underwent definitive surgery with or without adjuvant therapy were eligible. Maximum standardized uptake value (SUV{sub max}), MTV and TLG were measured. For calculation of MTV, 3-D regions of interest were drawn and a SUV threshold of 2.5 was used for defining regions. Univariate and multivariate analyses identified clinicopathological and imaging variables associated with OM, disease-free survival (DFS) and overall survival (OS). The median (range) SUV{sub max}, MTV and TLG were 7.3 (0.7-41.9), 4.5 ml (0.7-115.1 ml) and 18.3 g (2.4-224.1 g), respectively. Of 53 patients with clinically negative lymph nodes, OM was detected in 19 (36 %). By univariate and multivariate analyses, MTV (P = 0.018) and TLG (P = 0.011) were both independent predictive factors for OM, although they were not independent of each other. The 4-year DFS and OS rates were 53.0 % and 62.0 %, respectively. Univariate and multivariate analyses revealed that MTV (P = 0.001) and TLG (P = 0.006), with different cut-off levels, were both independent predictive factors for DFS, although they were not independent of each other, and MTV (P = 0.001), TLG (P = 0.002) and the involved resection margin (P = 0.007) were independent predictive factors for OS. Pretreatment MTV and TLG may be useful in stratifying the likelihood of survival and predicting OM in OSCC. (orig.)

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

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

    1992-05-01

    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).

  12. Usefulness of CT in preoperative examinations for middle ear surgery

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    Kobayashi, Toshimitsu; Okitsu, Takuji; Sakurai, Tokio; Ikeda, Katsuhisa; Taniguchi, Kazuhiko; Takahashi, Kuniaki; Kusakari, Jun

    1985-02-01

    The usefulness of CT in preoperative examinations for middle ear surgery was evaluated on the basis of whether or not it can provide a surgon with useful information not available from the other preoperative examinations, such as microscopic examination, pure tone audiometry, impedance audiometry, equilibrium tests, conventional X-ray films, etc. The findings of CT were compared with those obatained during operations and the following conclusions were reached: CT is especially useful for the three purposes indicated below. (1) to determine the patency of the attic air route to the mastoid antrum. (2) to make differential diagnoses of middle ear diseases in the presence of obstructive pathology of the external auditory meatus. (3) to make a rough estimate of the extent of cholesteatoma growth in the middle ear cleft, and to diagnose labyrinthine fistulae. CT proved less effective or useless for the following three purposes. (1) to secure detailed information on the status of the ossicular chain. (2) to determine the precise extent of the growth of cholesteatoma. (3) to evaluate the postoperative status of the ear. (author).

  13. Preoperative staging of lung cancer with combined PET-CT

    DEFF Research Database (Denmark)

    Fischer, Barbara; Lassen, Ulrik; Mortensen, Jann

    2009-01-01

    BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC...... one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause...

  14. Preoperative CT planning of screw length in arthroscopic Latarjet.

    Science.gov (United States)

    Hardy, Alexandre; Gerometta, Antoine; Granger, Benjamin; Massein, Audrey; Casabianca, Laurent; Pascal-Moussellard, Hugues; Loriaut, Philippe

    2016-08-25

    The Latarjet procedure has shown its efficiency for the treatment of anterior shoulder dislocation. The success of this technique depends on the correct positioning and fusion of the bone block. The length of the screws that fix the bone block can be a problem. They can increase the risk of non-union if too short or be the cause of nerve lesion or soft tissue discomfort if too long. Suprascapular nerve injuries have been reported during shoulder stabilisation surgery up to 6 % of the case. Bone block non-union depending on the series is found around 20 % of the cases. The purpose of this study was to evaluate the efficiency of this CT preoperative planning to predict optimal screws length. The clinical importance of this study lies in the observation that it is the first study to evaluate the efficiency of CT planning to predict screw length. Inclusion criteria were patients with chronic anterior instability of the shoulder with an ISIS superior to 4. Exclusion criteria were patients with multidirectional instability or any previous surgery on this shoulder. Thirty patients were included prospectively, 11 of them went threw a CT planning, before their arthroscopic Latarjet. Optimal length of both screws was calculated, adding the size of the coracoid at 5 and 15 mm from the tip to the glenoid. Thirty-two-mm screws were used for patients without planning. On a post-operative CT scan with 3D reconstruction, the distance between the screw tip and the posterior cortex was measured. A one-sample Wilcoxon test was used to compare the distance from the tip of the screw to an acceptable positioning of ±2 mm from the posterior cortex. In the group without planning, screw 1 tended to differ from the acceptable positioning: mean 3.44 mm ± 3.13, med 2.9 mm, q1; q3 [0.6; 4.75] p = 0.1118, and screw 2 differed significantly from the acceptable position: mean 4.83 mm ± 4.11, med 3.7 mm, q1; q3 [1.7; 5.45] p = 0.0045. In the group with planning, position of

  15. Tumor Volume Reduction Rate After Preoperative Chemoradiotherapy as a Prognostic Factor in Locally Advanced Rectal Cancer

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    Yeo, Seung-Gu [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Department of Radiation Oncology, Soonchunhyang University College of Medicine, Cheonan (Korea, Republic of); Kim, Dae Yong, E-mail: radiopiakim@hanmail.net [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Park, Ji Won; Oh, Jae Hwan; Kim, Sun Young; Chang, Hee Jin; Kim, Tae Hyun; Kim, Byung Chang; Sohn, Dae Kyung; Kim, Min Ju [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    2012-02-01

    Purpose: To investigate the prognostic significance of tumor volume reduction rate (TVRR) after preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC). Methods and Materials: In total, 430 primary LARC (cT3-4) patients who were treated with preoperative CRT and curative radical surgery between May 2002 and March 2008 were analyzed retrospectively. Pre- and post-CRT tumor volumes were measured using three-dimensional region-of-interest MR volumetry. Tumor volume reduction rate was determined using the equation TVRR (%) = (pre-CRT tumor volume - post-CRT tumor volume) Multiplication-Sign 100/pre-CRT tumor volume. The median follow-up period was 64 months (range, 27-99 months) for survivors. Endpoints were disease-free survival (DFS) and overall survival (OS). Results: The median TVRR was 70.2% (mean, 64.7% {+-} 22.6%; range, 0-100%). Downstaging (ypT0-2N0M0) occurred in 183 patients (42.6%). The 5-year DFS and OS rates were 77.7% and 86.3%, respectively. In the analysis that included pre-CRT and post-CRT tumor volumes and TVRR as continuous variables, only TVRR was an independent prognostic factor. Tumor volume reduction rate was categorized according to a cutoff value of 45% and included with clinicopathologic factors in the multivariate analysis; ypN status, circumferential resection margin, and TVRR were significant prognostic factors for both DFS and OS. Conclusions: Tumor volume reduction rate was a significant prognostic factor in LARC patients receiving preoperative CRT. Tumor volume reduction rate data may be useful for tailoring surgery and postoperative adjuvant therapy after preoperative CRT.

  16. Preoperative RFA simulation for liver cancer using a CT virtual ultrasound system

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    Kudo, Kosei [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Moriyasu, Fuminori [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan)]. E-mail: moriyasu@tokyo-med.ac.jp; Mine, Yoshitaka [R and D, Toshiba Medical Systems Co., Tokyo (Japan); Miyata, Yuki [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Sugimoto, Katsutoshi [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Metoki, Ryou [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Kamamoto, Hiroyuki [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Suzuki, Shirou [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Shimizu, Masafumi [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Miyahara, Takeo [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Yokoi, Masato [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Horibe, Toshiya [Fourth Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku-ku, Tokyo 160-0023 (Japan); Yamagata, Hitoshi [R and D, Toshiba Medical Systems Co., Tokyo (Japan)

    2007-02-15

    We developed a computed tomography (CT) virtual ultrasound system (CVUS) as an imaging system to support treatment under percutaneous ultrasound (US) guidance. This prototype clinical system, produced in collaboration with Tokyo Medical University, uses display software developed by Toshiba Medical Systems. We examined the utility of this system by scheduling treatment plans preoperatively and simulating puncture and radiofrequency ablation (RFA) for liver cancer. The study enrolled 51 liver cancer patients with 66 nodules 0.8-8 cm in diameter in which RFA was performed between June 2004 and December 2004. Virtual US and multiplanar reconstruction (MPR) images were constructed on the basis of DICOM CT data and puncture and ablation of liver cancer were simulated. The following were evaluated: (1) how to avoid complications and determine an appropriate puncture route by simulating puncture with C-mode MPR images; (2) determination of the three-dimensional location of the tumor for ablation, as well as the adjacent organs and vessels, by MPR rotation 360{sup o} around the center of the tumor (center lock); and (3) how to determine the center and volume of ablation and avoid injuries to nearby organs and vessels by simulating ablation procedures. C -mode MPR images were effective for (1) determining and modifying the puncture route in 35 of 51 cases (69.6%) and (2) determining the spatial location of vessels and nearby organs in 50 of 51 cases (98.0%) by the center lock; and (3) simulating the ablation helped determine the center and volume of ablation by avoiding injuries to vessels and nearby organs in 45 or 51 cases (88.2%). Taken together, the CVUS allowed easy simulation of local treatment of liver cancer under US guidance using CT data alone and the preoperative simulation predicted an improvement in the safety of local therapy of liver cancer.

  17. Influence of the Alveolar Cleft Type on Preoperative Estimation Using 3D CT Assessment for Alveolar Cleft

    Directory of Open Access Journals (Sweden)

    Hang Suk Choi

    2012-09-01

    Full Text Available BackgroundThe bone graft for the alveolar cleft has been accepted as one of the essential treatments for cleft lip patients. Precise preoperative measurement of the architecture and size of the bone defect in alveolar cleft has been considered helpful for increasing the success rate of bone grafting because those features may vary with the cleft type. Recently, some studies have reported on the usefulness of three-dimensional (3D computed tomography (CT assessment of alveolar bone defect; however, no study on the possible implication of the cleft type on the difference between the presumed and actual value has been conducted yet. We aimed to evaluate the clinical predictability of such measurement using 3D CT assessment according to the cleft type.MethodsThe study consisted of 47 pediatric patients. The subjects were divided according to the cleft type. CT was performed before the graft operation and assessed using image analysis software. The statistical significance of the difference between the preoperative estimation and intraoperative measurement was analyzed.ResultsThe difference between the preoperative and intraoperative values were -0.1±0.3 cm3 (P=0.084. There was no significant intergroup difference, but the groups with a cleft palate showed a significant difference of -0.2±0.3 cm3 (P<0.05.ConclusionsAssessment of the alveolar cleft volume using 3D CT scan data and image analysis software can help in selecting the optimal graft procedure and extracting the correct volume of cancellous bone for grafting. Considering the cleft type, it would be helpful to extract an additional volume of 0.2 cm3 in the presence of a cleft palate.

  18. Reliability of CT in preoperative evaluation of bladder carcinoma

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    Nurmi, M.; Puntala, P. (Univ. of Turku (Finland). Dept. of Surgery); Katevuo, K. (Univ. of Turku (Finland). Dept. of Radiology)

    1988-01-01

    Sixty patients with bladder carcinoma were examined by CT prior to radical cystectomy. CT indicated perivesical tumor growth or extension to neighboring organs correctly in 60 % of the cases. Overstaging was observed in 23% and understaging in 8 % of the cases. Most of the difficulties concerned assessment of tumors in the anterior bladder wall and identification of the plane between the bladder and the seminal vesicle. In most instances CT provided no supplementary information to clinical staging, but was useful when obesity or previous irradiation impeded clinical staging. (authors).

  19. Influence of the Alveolar Cleft Type on Preoperative Estimation Using 3D CT Assessment for Alveolar Cleft

    Directory of Open Access Journals (Sweden)

    Hang Suk Choi

    2012-09-01

    Full Text Available Background The bone graft for the alveolar cleft has been accepted as one of the essentialtreatments for cleft lip patients. Precise preoperative measurement of the architecture andsize of the bone defect in alveolar cleft has been considered helpful for increasing the successrate of bone grafting because those features may vary with the cleft type. Recently, somestudies have reported on the usefulness of three-dimensional (3D computed tomography(CT assessment of alveolar bone defect; however, no study on the possible implication of thecleft type on the difference between the presumed and actual value has been conducted yet.We aimed to evaluate the clinical predictability of such measurement using 3D CT assessmentaccording to the cleft type.Methods The study consisted of 47 pediatric patients. The subjects were divided according tothe cleft type. CT was performed before the graft operation and assessed using image analysissoftware. The statistical significance of the difference between the preoperative estimationand intraoperative measurement was analyzed.Results The difference between the preoperative and intraoperative values were -0.1±0.3cm3 (P=0.084. There was no significant intergroup difference, but the groups with a cleftpalate showed a significant difference of -0.2±0.3 cm3 (P<0.05.Conclusions Assessment of the alveolar cleft volume using 3D CT scan data and image analysissoftware can help in selecting the optimal graft procedure and extracting the correct volumeof cancellous bone for grafting. Considering the cleft type, it would be helpful to extract anadditional volume of 0.2 cm3 in the presence of a cleft palate.

  20. Preoperative localization of hyperfunctioning parathyroid glands with 4D-CT.

    Science.gov (United States)

    Lundstroem, Anke Katrin; Trolle, Waldemar; Soerensen, Christian Hjort; Myschetzky, Peter Sand

    2016-05-01

    Primary hyperparathyroidism (pHPT) is almost exclusively the result of a solitary parathyroid adenoma. In most cases, the affected gland can be surgically removed, but precise preoperative imaging is essential for adenoma localization prior to surgical intervention. In this study, we evaluated the diagnostic value of four-dimensional computed tomography (4D-CT) as a preoperative imaging tool in relation to the localization of pathologic parathyroid glands in patients with pHPT and negative sestamibi scans. This study included 43 consecutive patients with pHPT referred for parathyroidectomy at the Department of Head and Neck Surgery of Copenhagen University Hospital Rigshospitalet in 2011 and 2012. All patients had a 4D-CT performed prior to parathyroidectomy. CT localization of the suspected adenoma was correlated to the actual surgical findings and subsequent histological diagnosis was also available as references for the accuracy of this imaging tool. Hyperfunctioning parathyroid glands were found in 40 patients. 4D-CT identified 32 solitary hyperfunctioning parathyroid glands located on the correct side of the neck (PPV 76 %) and 21 located within the correct quadrant (PPV 49 %). Unilateral resection was performed in 72 % of patients due to the localization findings of preoperative imaging. 4D-CT can, therefore, be considered an effective method for the preoperative localization of parathyroid adenomas and is an important tool in surgical intervention for patients referred to parathyroidectomy.

  1. Preoperative staging of lung cancer with PET/CT

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Fischer, Barbara Malene B; Mortensen, Jann

    2011-01-01

    thoracotomy. All monetary estimates were inflated to 2010 . RESULTS: The incremental cost of the PET/CT-based regimen was estimated at 3,927 [95% confidence interval (CI) -3,331; 10,586] and the NNT at 4.92 (95% CI 3.00; 13.62). These resulted in an average incremental cost-effectiveness ratio...

  2. Reassessment of CT images to improve diagnostic accuracy in patients with suspected acute appendicitis and an equivocal preoperative CT interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won [Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of); Park, Seong Jin [Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of)

    2012-06-15

    To identify CT features that discriminate individuals with and without acute appendicitis in patients with equivocal CT findings, and to assess whether knowledge of these findings improves diagnostic accuracy. 53 patients that underwent appendectomy with an indeterminate preoperative CT interpretation were selected and allocated to an acute appendicitis group or a non-appendicitis group. The 53 CT examinations were reviewed by two radiologists in consensus to identify CT findings that could aid in the discrimination of those with and without appendicitis. In addition, two additional radiologists were then requested to evaluate independently the 53 CT examinations using a 4-point scale, both before and after being informed of the potentially discriminating criteria. CT findings found to be significantly different in the two groups were; the presence of appendiceal wall enhancement, intraluminal air in appendix, a coexistent inflammatory lesion, and appendiceal wall thickening (P < 0.05). Areas under the curves of reviewers 1 and 2 significantly increased from 0.516 and 0.706 to 0.677 and 0.841, respectively, when reviewers were told which CT variables were significant (P = 0.0193 and P = 0.0397, respectively). Knowledge of the identified CT findings was found to improve diagnostic accuracy for acute appendicitis in patients with equivocal CT findings. circle Numerous patients with clinically equivocal appendicitis do not have acute appendicitis circle Computed tomography (CT) helps to reduce the negative appendectomy rate circle CT is not always infallible and may also demonstrate indeterminate findings circle However knowledge of significant CT variables can further reduce negative appendectomy rate circle An equivocal CT interpretation of appendicitis should be reassessed with this knowledge. (orig.)

  3. The diagnostic utility of ultrasonography, CT and PET/CT for the preoperative evaluation of cervical lymph node metastasis inpapillary thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim Young Sang; Lee, Tae Hyun; Park, Dong Hee [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2016-08-15

    To compare the diagnostic utility of ultrasonography (US), CT and positron emission tomography/CT (PET/CT) in the preoperative evaluation of cervical lymph node metastasis in patients with papillary thyroid carcinoma. The study population consisted of 300 patients with pathologically diagnosed papillary thyroid carcinoma after thyroidectomy and neck dissection. Preoperative US, CT, and PET/CT findings were compared with pathologic outcomes after thyroidectomy and neck dissection. Sensitivity in detecting central lymph node metastasis (US 29.9%, CT 27.9%, PET/CT 18.8%) was lower than that for lateral lymph node metastasis (US 56.3%, CT 66.2%, PET/CT 43.7%). Specificity in detecting central lymph node metastasis (US 80.6%, CT 77.7%, PET/CT 83.0%) was lower than that for lateral lymph node metastasis (US 96.8%, CT 80.6%, PET/CT 95.2%). The combination of US and CT had higher specificity (77.3%) and higher sensitivity (33.1%) than US alone. PET/CT has no significant additional benefit over the combination of US and CT. In preoperative evaluations of neck lymph node metastasis, US and CT and PET/CT are more useful in lateral lymph node areas than in central lymph node areas. The combination of US and CT has higher sensitivity than US alone.

  4. CT detection of thyroid pyramidal lobe in preoperative patients with thyroid tumors

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Gi Won; Kim, Dong Won [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2013-10-15

    Thyroid pyramidal lobe (TPL) is a normal variant of the thyroid gland, but few imaging studies of TPL have been published. The purpose of this study is to investigate the frequency, location, size (length, maximal AP diameter, maximal transverse diameter), and upper end level of TPL with its separation from the main thyroid gland on preoperative neck CT and to compare them with operative findings in order to assess the diagnostic accuracy of neck CT for detection TPL. 46 patients, who underwent preoperative neck CT before thyroidectomy, were included in the study. The frequency, location, size, and upper end level of TPL with its separation from the main thyroid gland on the neck CT was analyzed by a single radiologist. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of neck CT for detecting TPL was 77.8%, 89.5%, 91.3%, 73.9% and 82.6%. There was a significant difference in maximal AP diameter, location, upper end level, and its separation from main thyroid gland between CT and operative findings (p < 0.05), but there was no significant difference in the length and maximal transverse diameter of TPL (p > 0.05). Diagnostic accuracy of neck CT for detecting TPL was high, and the neck CT may be useful for evaluating TPL in the suprahyoid neck.

  5. State-of-the-art on cone beam CT imaging for preoperative planning of implant placement.

    NARCIS (Netherlands)

    Guerrero, M.E.; Jacobs, R.; Loubele, M.; Schutyser, F.A.C.; Suetens, P.; Steenberghe, D van

    2006-01-01

    Orofacial diagnostic imaging has grown dramatically in recent years. As the use of endosseous implants has revolutionized oral rehabilitation, a specialized technique has become available for the preoperative planning of oral implant placement: cone beam computed tomography (CT). This imaging techno

  6. High-resolution CT: pre-operative assessment of chronic and recurrent rhinosinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Ferrie, J.C. [Dept. of Radiology A, University Hospital, 86 Poitiers (France); Vandermarcq, P. [Dept. of Radiology A, University Hospital, 86 Poitiers (France); Azais, O. [Dept. of Radiology A, University Hospital, 86 Poitiers (France); Klossek, J.M. [Dept. of Oto-Rhino-Laryngology, University Hospital, 86 Poitiers (France); Drouineau, J. [Dept. of Radiology A, University Hospital, 86 Poitiers (France)

    1993-04-01

    The better understanding of chronic and recurrent rhinosinusitis and the advance in endoscopic endonasal surgery have modified the radiological pre-operative investigation of this condition. The ethmoid labyrinth, not accessible to the endoscope, may be explored by axial and coronal high-resolution thin section (2 mm) CT. We have reviewed 100 CT scans with endoscopic correlation in order to assess the accuracy of this pre-operative method. This anatomical study reveals the presence and extent of parasinus diseases which are usually concentrated in the area of the ostiomeatal unit. The anatomic variations of the lateral nasal wall that have been reporded as predisposing to sinusitis and the morphologic variations altering the relationships of the ethmoid with the orbits and the brain were also studied. This pre-operative radiological assessment is currently necessary for functional and safe surgery. (orig.)

  7. Application of Preoperative CT/MRI Image Fusion in Target Positioning for Deep Brain Stimulation

    Institute of Scientific and Technical Information of China (English)

    Yu Wang; Zi-yuan Liu; Wan-chen Dou; Wen-bin Ma; Ren-zhi Wang; Yi Guo

    2016-01-01

    Objective To explore the efficacy of target positioning by preoperative CT/MRI image fusion technique in deep brain stimulation. Methods We retrospectively analyzed the clinical data and images of 79 cases (68 with Parkinson’s disease, 11 with dystonia) who received preoperative CT/MRI image fusion in target positioning of subthalamic nucleus in deep brain stimulation. Deviation of implanted electrodes from the target nucleus of each patient were measured. Neurological evaluations of each patient before and after the treatment were performed and compared. Complications of the positioning and treatment were recorded. Results The mean deviations of the electrodes implanted on X, Y, and Z axis were 0.5 mm, 0.6 mm, and 0.6 mm, respectively. Postoperative neurologic evaluations scores of unified Parkinson’s disease rating scale (UPDRS) for Parkinson’s disease and Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) for dystonia patients improved significantly compared to the preoperative scores (P<0.001); Complications occurred in 10.1% (8/79) patients, and main side effects were dysarthria and diplopia. Conclusion Target positioning by preoperative CT/MRI image fusion technique in deep brain stimulation has high accuracy and good clinical outcomes.

  8. CT virtual reality in the preoperative workup of malunited distal radius fractures: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Rieger, Michael; Gruber, Hannes; Jaschke, Werner R. [Innsbruck University Hospital, Department of Radiology I, Innsbruck (Austria); Gabl, Markus [Innsbruck University Hospital, Department of Trauma Surgery, Innsbruck (Austria); Mallouhi, Ammar [Innsbruck University Hospital, Department of Radiology II, Innsbruck (Austria)

    2005-04-01

    Our objective was to evaluate the usefulness of CT virtual preoperative planning in the surgical repositioning of malunited distal radius fracture. Eleven patients with malunited distal radius fracture underwent multislice CT of both wrists. A preoperative workup was performed in a virtual reality environment created from the CT data sets. Virtual planning comprised three main procedures, carrying out the virtual osteotomy of the radius, prediction of the final position of the distal radius after osteotomy and computer-assisted manufacturing of a repositioning device, which was later placed at the surgical osteotomy site to reposition objectively the distal radius fragment before fixation with the osteosynthesis. All patients tolerated the surgical procedure well. During surgery, the orthopedic surgeons were not required in any of the cases to alter the position of the distal radius that was determined by the repositioning device. At postoperative follow-up, the anatomic relationship of the distal radius was restored (radial inclination, 21.4 ; volar tilt, 10.3 ; ulnar variance, 0.5 mm). Clinically, a significant improvement of pronation (P=0.012), supination (P=0.01), flexion (P=0.001) and extension (P=0.006) was achieved. Pain decreased from 54 to 7 points. CT virtual reality is a valuable adjunct for the preoperative workup and surgical reposition of malunited distal radius fractures. (orig.)

  9. 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

    1994-01-01

    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).

  10. 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)

    2016-06-15

    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.)

  11. Preoperative localization of hyperfunctioning parathyroid glands with 4D-CT

    DEFF Research Database (Denmark)

    Lundstroem, Anke Katrin; Trolle, Waldemar; Soerensen, Christian Hjort

    2016-01-01

    the diagnostic value of four-dimensional computed tomography (4D-CT) as a preoperative imaging tool in relation to the localization of pathologic parathyroid glands in patients with pHPT and negative sestamibi scans. This study included 43 consecutive patients with pHPT referred for parathyroidectomy...... available as references for the accuracy of this imaging tool. Hyperfunctioning parathyroid glands were found in 40 patients. 4D-CT identified 32 solitary hyperfunctioning parathyroid glands located on the correct side of the neck (PPV 76 %) and 21 located within the correct quadrant (PPV 49 %). Unilateral...

  12. Preoperative CT versus diffusion weighted magnetic resonance imaging of the liver in patients with rectal cancer

    DEFF Research Database (Denmark)

    Achiam, Michael P; Løgager, Vibeke B; Skjoldbye, Bjørn;

    2016-01-01

    Introduction. Colorectal cancer is one of the most frequent cancers in the world and liver metastases are seen in up to 19% of patients with colorectal cancers. Detection of liver metastases is not only vital for sufficient treatment and survival, but also for a better estimation of prognosis....... The aim of this study was to evaluate the feasibility of diffusion weighted MRI of the liver as part of a combined MR evaluation of patients with rectal cancers and compare it with the standard preoperative evaluation of the liver with CT. Methods. Consecutive patients diagnosed with rectal cancers were....... The current standard preoperative evaluation with CT-scan results in disadvantages like missed metastases and futile operations. We recommend that patients with rectal cancer, who are scheduled for MR of the rectum, should have a DWMR of the liver performed at the same time....

  13. Comparison between CT volume measurement and histopathological assessment of response to neoadjuvant therapy in rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pomerri, Fabio, E-mail: fabio.pomerri@unipd.it [Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padua (Italy); Department of Medicine, University of Padua, via Giustiniani 2, 35128 Padua (Italy); Pucciarelli, Salvatore, E-mail: puc@unipd.it [Department of Oncological and Surgical Sciences, University of Padua, via Giustiniani 2, 35128 Padua (Italy); Gennaro, Gisella, E-mail: gisella.gennaro@pd.infn.it [Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padua (Italy); Maretto, Isacco, E-mail: isac77@gmail.com [Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padua (Italy); Nitti, Donato, E-mail: donato.nitti@unipd.it [Department of Oncological and Surgical Sciences, University of Padua, via Giustiniani 2, 35128 Padua (Italy); Muzzio, Pier Carlo, E-mail: pcmuzzio@unipd.it [Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128 Padua (Italy)

    2012-12-15

    Objectives: The aim of this study was to compare volume measurements on computed tomography (CT) images with histopathological assessments of chemoradiotherapy (CRT)-induced tumor regression in locally advanced rectal cancer (RC). Methods: In 25 patients (13 males, 12 females; median age, 63 years; age range, 44–79 years) with locally advanced RC treated with preoperative CRT and surgery, two radiologists measured tumor volume on CT images before and after CRT. CT-based tumor volumetry and the modified response evaluation criteria in solid tumors (mRECISTs) were compared with T and N downstaging after CRT, and with the tumor regression grade (TRG). Results: Tumor volumes were significantly smaller on CT images after CRT. The tumors regressed in 52% (13/25), 36% (9/25) and 40% (10/25) of patients, based on T downstaging, TRG and mRECIST findings, respectively. In terms of T downstaging, the pre- and post-CRT tumor volumes of responders and non-responders to the treatment differed statistically, while their tumor volume reduction rates and volume reductions according to the 65% mRECIST threshold did not. In terms of N downstaging and TRG, the differences between the responders’ and the non-responders’ pre- and post-CRT tumor volumes, tumor volume reduction rates, and mRECIST thresholds were never statistically significant. Conclusion: Measuring tumor size on CT images is of limited value in predicting the histopathological response to preoperative CRT in RC patients, so it may be unwise to select surgical treatment strategies based on CT volumetry.

  14. CT-guided preoperative needle localization of MRI-detected breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Giagounidis, Elektra M. E-mail: giagounjdis@online.de; Markus, Ruwe; Josef, Luetzeler; Wemer, Audretsch; Mahdi, Rezai; Bernward, Kurtz

    2001-08-01

    To assess the value of accurate preoperative CT-guided needle localization of occult breast lesions, we reviewed a total of 39 needle-directed biopsies of breast tumors in 24 women. The average age was 52.9 years (range 31-67). All lesions were nonpalpable and mammographically, as well as sonographically occult. They were solely seen on MR-images. After demonstrating the suspicious region on CT scans, a hookwire was inserted. The correct position was confirmed by a control scan. The subsequent histopathological examination showed that 28 of the lesions (71.8%) were benign, among them mastopathy, fibrosis, fibroadenoma, papilloma, intramammary lymph node, liponecrosis and epitheliosis. Eleven lesions (28%) were malignant and showed either lobular, ductal or tubular cancer. Our results endorse that CT guided needle localization is a helpful method that allows a precise surgical excision of the suspect area with the removal of a minimal amount of breast tissue.

  15. Effect of routine preoperative fasting on residual gastric volume and ...

    African Journals Online (AJOL)

    2016-02-10

    Feb 10, 2016 ... Nigerian Journal of Clinical Practice • Nov‑Dec 2016 • Vol 19 • Issue 6 induction of ... disorder, receiving antacids, or H2 receptor blockers, or those who ... The patients' preoperative anxiety states were graded using the ...

  16. Coronary artery imaging during preoperative CT staging: preliminary experience with 64-slice multidetector CT in 99 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Delhaye, Damien; Remy-Jardin, Martine; Rozel, Celine; Remy, Jacques [University Center of Lille, Boulevard Jules Leclerc, Department of Thoracic Imaging, Hospital Calmette, Lille cedex (France); Dusson, Catherine; Wurtz, Alain [University Center of Lille, Department of Thoracic Surgery, Hospital Calmette, Lille cedex (France); Delannoy-Deken, Valerie; Duhamel, Alain [University of Lille, Department of Medical Statistics, Lille cedex (France)

    2007-03-15

    The purpose of this study was to evaluate the clinical feasibility of coronary artery imaging during routine preoperative 64-slice MDCT scans of the chest. Ninety-nine consecutive patients in sinus rhythm underwent a biphasic multidetector-row spiral CT examination of the chest without the administration of beta-blockers, including an ECG-gated acquisition over the cardiac cavities, followed by a non-gated examination of the upper third of the thorax. Data were reconstructed to evaluate coronary arteries and to obtain presurgical staging of the underlying disease. The percentage of assessable segments ranged from 65.4% (972/1,485) when considering all coronary artery segments to 88% (613/693) for the proximal and mid segments, reaching 98% (387/396) for proximal coronary artery segments. The 387 interpretable proximal segments included 97 (97%) LM, 99 (100%) LAD, 96 (97%) LCX and 95 (96%) RCA with a mean attenuation of 280.70{+-}52.93 HU. The mean percentage of assessable segments was significantly higher in patients with a heart rate {<=}80 bpm (n=48) than in patients with a heart rate greater than 80 bpm (n=35) (80{+-}11% vs. 72{+-}13%; P=0.0008). Diagnostic image quality was achieved in all patients for preoperative staging of the underlying disorder. The mean estimated effective dose was 12.06{+-}3.25 mSv for ECG-gated scans and 13.88{+-}3.49 mSv for complete chest examinations. Proximal and mid-coronary artery segments can be adequately evaluated during presurgical CT examinations of the chest obtained with 64-slice MDCT without the administration of {beta}-blockers. (orig.)

  17. An augmented reality navigation system for pediatric oncologic surgery based on preoperative CT and MRI images.

    Science.gov (United States)

    Souzaki, Ryota; Ieiri, Satoshi; Uemura, Munenori; Ohuchida, Kenoki; Tomikawa, Morimasa; Kinoshita, Yoshiaki; Koga, Yuhki; Suminoe, Aiko; Kohashi, Kenichi; Oda, Yoshinao; Hara, Toshiro; Hashizume, Makoto; Taguchi, Tomoaki

    2013-12-01

    In pediatric endoscopic surgery, a limited view and lack of tactile sensation restrict the surgeon's abilities. Moreover, in pediatric oncology, it is sometimes difficult to detect and resect tumors due to the adhesion and degeneration of tumors treated with multimodality therapies. We developed an augmented reality (AR) navigation system based on preoperative CT and MRI imaging for use in endoscopic surgery for pediatric tumors. The patients preoperatively underwent either CT or MRI with body surface markers. We used an optical tracking system to register the reconstructed 3D images obtained from the CT and MRI data and body surface markers during surgery. AR visualization was superimposed with the 3D images projected onto captured live images. Six patients underwent surgery using this system. The median age of the patients was 3.5 years. Two of the six patients underwent laparoscopic surgery, two patients underwent thoracoscopic surgery, and two patients underwent laparotomy using this system. The indications for surgery were local recurrence of a Wilms tumor in one case, metastasis of rhabdomyosarcoma in one case, undifferentiated sarcoma in one case, bronchogenic cysts in two cases, and hepatoblastoma in one case. The average tumor size was 22.0±14.2 mm. Four patients were treated with chemotherapy, three patients were treated with radiotherapy before surgery, and four patients underwent reoperation. All six tumors were detected using the AR navigation system and successfully resected without any complications. The AR navigation system is very useful for detecting the tumor location during pediatric surgery, especially for endoscopic surgery. Crown Copyright © 2013. All rights reserved.

  18. Preoperative CT versus diffusion weighted magnetic resonance imaging of the liver in patients with rectal cancer; a prospective randomized trial

    Directory of Open Access Journals (Sweden)

    Michael P. Achiam

    2016-01-01

    Full Text Available Introduction. Colorectal cancer is one of the most frequent cancers in the world and liver metastases are seen in up to 19% of patients with colorectal cancers. Detection of liver metastases is not only vital for sufficient treatment and survival, but also for a better estimation of prognosis. The aim of this study was to evaluate the feasibility of diffusion weighted MRI of the liver as part of a combined MR evaluation of patients with rectal cancers and compare it with the standard preoperative evaluation of the liver with CT.Methods. Consecutive patients diagnosed with rectal cancers were asked to participate in the study. Preoperative CT and diffusion weighted MR (DWMR were compared to contrast enhanced laparoscopic ultrasound (CELUS.Results. A total of 35 patients were included, 15 patients in Group-1 having the standard CT evaluation of the liver and 20 patients in Group-2 having the standard CT evaluation of the liver and DWMR of the liver. Compared with CELUS, the per-patient sensitivity/specificity was 50/100% for CT, and for DWMR: 100/94% and 100/100% for Reader 1 and 2, respectively. The per-lesion sensitivity of CT and DWMR were 17% and 89%, respectively compared with CELUS. Furthermore, one patient had non-resectable metastases after DWMR despite being diagnosed with resectable metastases after CT. Another patient was diagnosed with multiple liver metastases during CELUS, despite a negative CT-scan.Discussion. DWMR is feasible for preoperative evaluation of liver metastases. The current standard preoperative evaluation with CT-scan results in disadvantages like missed metastases and futile operations. We recommend that patients with rectal cancer, who are scheduled for MR of the rectum, should have a DWMR of the liver performed at the same time.

  19. 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)

    2012-03-15

    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

  20. Preoperative staging of non-small cell lung cancer: prospective comparison of PET/MR and PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Min [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Goo, Jin Mo; Park, Chang Min [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Cancer Research Institute, Seoul (Korea, Republic of); Yoon, Soon Ho [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Paeng, Jin Chul; Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kim, Young Tae [Seoul National University College of Medicine, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea, Republic of); Park, Young Sik [Seoul National University Hospital, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Internal Medicine, Seoul (Korea, Republic of)

    2016-11-15

    To prospectively compare the accuracies of PET/MR and PET/CT in the preoperative staging of non-small cell lung cancer (NSCLC). Institutional review board approval and patients' informed consents were obtained. 45 patients with proven or radiologically suspected lung cancer which appeared to be resectable on CT were enrolled. PET/MR was performed for the preoperative staging of NSCLC followed by PET/CT without contrast enhancement on the same day. Dedicated MR images including diffusion weighted images were obtained. Readers assessed PET/MR and PET/CT with contrast-enhanced CT. Accuracies of PET/MR and PET/CT for NSCLC staging were compared. Primary tumour stages (n = 40) were correctly diagnosed in 32 patients (80.0 %) on PET/MR and in 32 patients (80.0 %) on PET/CT (P = 1.0). Node stages (n = 42) were correctly determined in 24 patients (57.1 %) on PET/MR and in 22 patients (52.4 %) on PET/CT (P = 0.683). Metastatic lesions in the brain, bone, liver, and pleura were detected in 6 patients (13.3 %). PET/MR missed one patient with pleural metastasis while PET/CT missed one patient with solitary brain metastasis and two patients with pleural metastases (P = 0.480). This study demonstrated that PET/MR in combination with contrast-enhanced CT was comparable to PET/CT in the preoperative staging of NSCLC while reducing radiation exposure. (orig.)

  1. Flat-panel volume CT: fundamental principles, technology, and applications.

    Science.gov (United States)

    Gupta, Rajiv; Cheung, Arnold C; Bartling, Soenke H; Lisauskas, Jennifer; Grasruck, Michael; Leidecker, Christianne; Schmidt, Bernhard; Flohr, Thomas; Brady, Thomas J

    2008-01-01

    Flat-panel volume computed tomography (CT) systems have an innovative design that allows coverage of a large volume per rotation, fluoroscopic and dynamic imaging, and high spatial resolution that permits visualization of complex human anatomy such as fine temporal bone structures and trabecular bone architecture. In simple terms, flat-panel volume CT scanners can be thought of as conventional multidetector CT scanners in which the detector rows have been replaced by an area detector. The flat-panel detector has wide z-axis coverage that enables imaging of entire organs in one axial acquisition. Its fluoroscopic and angiographic capabilities are useful for intraoperative and vascular applications. Furthermore, the high-volume coverage and continuous rotation of the detector may enable depiction of dynamic processes such as coronary blood flow and whole-brain perfusion. Other applications in which flat-panel volume CT may play a role include small-animal imaging, nondestructive testing in animal survival surgeries, and tissue-engineering experiments. Such versatility has led some to predict that flat-panel volume CT will gain importance in interventional and intraoperative applications, especially in specialties such as cardiac imaging, interventional neuroradiology, orthopedics, and otolaryngology. However, the contrast resolution of flat-panel volume CT is slightly inferior to that of multidetector CT, a higher radiation dose is needed to achieve a comparable signal-to-noise ratio, and a slower scintillator results in a longer scanning time.

  2. The role of FDG-PET/CT in preoperative staging of sentinel lymph node biopsy-positive melanoma patients

    DEFF Research Database (Denmark)

    Frary, Charles; Gad, Dorte; Bastholt, Lars;

    2016-01-01

    BACKGROUND: On April 1, 2015, Odense University Hospital (OUH) began a new diagnostic strategy, wherein all malignant melanoma (MM) patients in the Region of Southern Denmark with a positive sentinel lymph node biopsy (SLNB) underwent FDG-PET/CT preoperatively prior to lymph node dissection (LND...

  3. Role of multislice CT and magnetic resonance cholangiography in preoperative evaluation of potential donor in living related liver transplantation

    Directory of Open Access Journals (Sweden)

    Hossam M. Abdel-Rahman

    2016-03-01

    Conclusion: Multislice CT is a valuable tool in the evaluation of potential living liver donors that provides complete information on the hepatic vascular anatomy, the liver parenchyma, and volumetric measurements. MRC with a 3.0-T MR system demonstrates the preoperative biliary evaluation very well with a high accuracy rate.

  4. MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - a multicenter prospective comparative study

    DEFF Research Database (Denmark)

    Antonsen, Sofie Leisby; Jensen, Lisa Neerup; Loft, Annika;

    2013-01-01

    OBJECTIVES: The aim of this prospective multicenter study was to evaluate and compare the diagnostic performance of PET/CT, MRI and transvaginal two-dimensional ultrasound (2DUS) in the preoperative assessment of endometrial cancer (EC). METHODS: 318 consecutive women with EC were included when...... referred to three Danish tertiary gynecological centers for surgical treatment. Preoperatively they were PET/CT-, MRI-, and 2DUS scanned. The imaging results were compared to the final pathological findings. This study was approved by the National Committee on Health Research Ethics. RESULTS......: For predicting myometrial invasion, we found sensitivity, specificity, PPV, NPV, and accuracy for PET/CT to be 93%, 49%, 41%, 95% and 61%, for MRI to be 87%, 57%, 44%, 92%, and 66% and for 2DUS to be 71%, 72%, 51%, 86% and 72%. For predicting cervical invasion, the values were 43%, 94%, 69%, 85% and 83...

  5. CT- and MRI-based volumetry of resected liver specimen: Comparison to intraoperative volume and weight measurements and calculation of conversion factors

    Energy Technology Data Exchange (ETDEWEB)

    Karlo, C., E-mail: christoph.karlo@usz.c [Institute of Diagnostic Radiology, Department of Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Reiner, C.S.; Stolzmann, P. [Institute of Diagnostic Radiology, Department of Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Breitenstein, S. [Department of Visceral Surgery, University Hospital of Zurich (Switzerland); Marincek, B. [Institute of Diagnostic Radiology, Department of Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Weishaupt, D. [Institute for Radiology and Radiodiagnostics, City Hospital Triemli, Zurich (Switzerland); Frauenfelder, T. [Institute of Diagnostic Radiology, Department of Radiology, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2010-07-15

    Objective: To compare virtual volume to intraoperative volume and weight measurements of resected liver specimen and calculate appropriate conversion factors to reach better correlation. Methods: Preoperative (CT-group, n = 30; MRI-group, n = 30) and postoperative MRI (n = 60) imaging was performed in 60 patients undergoing partial liver resection. Intraoperative volume and weight of the resected liver specimen was measured. Virtual volume measurements were performed by two readers (R1,R2) using dedicated software. Conversion factors were calculated. Results: Mean intraoperative resection weight/volume: CT: 855 g/852 mL; MRI: 872 g/860 mL. Virtual resection volume: CT: 960 mL(R1), 982 mL(R2); MRI: 1112 mL(R1), 1115 mL(R2). Strong positive correlation for both readers between intraoperative and virtual measurements, mean of both readers: CT: R = 0.88(volume), R = 0.89(weight); MRI: R = 0.95(volume), R = 0.92(weight). Conversion factors: 0.85(CT), 0.78(MRI). Conclusion: CT- or MRI-based volumetry of resected liver specimen is accurate and recommended for preoperative planning. A conversion of the result is necessary to improve intraoperative and virtual measurement correlation. We found 0.85 for CT- and 0.78 for MRI-based volumetry the most appropriate conversion factors.

  6. Preoperative risk stratification using metabolic parameters of {sup 18}F-FDG PET/CT in patients with endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro [Kobe University School of Medicine, Department of Radiology, Kobe (Japan); Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Suenaga, Yuko; Ueno, Yoshiko; Maeda, Tetsuo; Sofue, Keitarou; Sugimura, Kazuro [Kobe University School of Medicine, Department of Radiology, Kobe (Japan); Ebina, Yasuhiko; Yamada, Hideto [Kobe University School of Medicine, Department of Obstetrics and Gynecology, Kobe (Japan); Okunaga, Takashi; Kubo, Kazuhiro [Kobe University Hospital, Department of Radiology Division, Kobe (Japan); Kanda, Tomonori [Teikyo University School of Medicine, Department of Radiology, Tokyo (Japan); Tamaki, Yukihisa [Shimane University School of Medicine, Department of Radiation Oncology, Shimane (Japan)

    2015-07-15

    To evaluate the usefulness of metabolic parameters obtained by {sup 18}F-FDG PET/CT for preoperative stratification of high-risk and low-risk endometrial carcinomas. Preoperative {sup 18}F-FDG PET/CT was performed in 56 women with endometrial cancer. Maximum standardized uptake values (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) of primary tumours were compared with clinicopathological features of surgical specimens. Diagnostic performance in terms of differentiation of low-risk disease (endometrioid histology, histological grade 1 or 2, invasion of less than half of the myometrium, and FIGO stage I) from high-risk disease was assessed. MTV and TLG were significantly higher in patients with higher histological grade (p = 0.0026 and p = 0.034), larger tumour size (p = 0.002 and p = 0.0017), lymphovascular space involvement (LVSI; p = 0.012 and p = 0.0051), myometrial invasion (p = 0.027 and p = 0.031), cervical stromal invasion (p = 0.023 and p = 0.014), ovarian metastasis (p = 0.00022 and p = 0.00034), lymph node metastasis (p < 0.0001 and p < 0.0001), and higher FIGO stage (p = 0.0011 and p = 0.00048). SUVmax was significantly higher in patients with larger tumour size (p = 0.0025), LVSI (p = 0.00023) and myometrial invasion (p < 0.0001). The areas under the ROC curves (AUCs) for distinguishing high-risk from low-risk carcinoma were 0.625, 0.829 and 0.797 for SUVmax, MTV and TLG, respectively. AUCs for both MTV and TLG were significantly larger than that for SUVmax (p = 0.0049 and p = 0.021). The optimal TLG cut-off value of 70.2, determined by ROC analysis, was found to have 72.0 % sensitivity and 74.2 % specificity for risk stratification. MTV and TLG of primary endometrial cancer show better correlations with clinicopathological features and are more useful for differentiating high-risk from low-risk carcinoma than SUVmax. (orig.)

  7. Preoperative FDG-PET/CT Is an Important Tool in the Management of Patients with Thick (T4) Melanoma.

    Science.gov (United States)

    Arrangoiz, Rodrigo; Papavasiliou, Pavlos; Stransky, Carrie A; Yu, Jian Q; Tianyu, Li; Sigurdson, Elin R; Berger, Adam C; Farma, Jeffrey M

    2012-01-01

    The yield of preoperative PET/CT (PET/CT) for regional and distant metastases for thin/intermediate thickness melanoma is low. Objective of this study is to determine if PET/CT performed for T4 melanomas helps guide management and alter treatment plans. Methods. Retrospective cohort of 216 patients with T4 melanomas treated at two tertiary institutions. Fifty-six patients met our inclusion criteria (T4 lesion, PET/CT and no clinical evidence of metastatic disease). Results. Fifty-six patients (M: 32, F: 24) with median tumor thickness of 6 mm were identified. PET/CT recognized twelve with regional and four patients with metastatic disease. Melanoma-related treatment plan was altered in 11% of the cases based on PET/CT findings. PET/CT was negative 60% of the time, in 35% of the cases; it identified incidental findings that required further evaluation. Conclusion. Patients with T4 lesions, PET/CT changed the treatment plan 18% of the time. Regional findings changed the surgical treatment plan in 11% and the adjuvant plan in 7% of our cases due to the finding of metastatic disease. Additionally 20 patients had incidental findings that required further workup. In this subset of patients, we feel there is a benefit to PET/CT, and further studies should be performed to validate our findings.

  8. Preoperative FDG-PET/CT Is an Important Tool in the Management of Patients with Thick (T4 Melanoma

    Directory of Open Access Journals (Sweden)

    Rodrigo Arrangoiz

    2012-01-01

    Full Text Available The yield of preoperative PET/CT (PET/CT for regional and distant metastases for thin/intermediate thickness melanoma is low. Objective of this study is to determine if PET/CT performed for T4 melanomas helps guide management and alter treatment plans. Methods. Retrospective cohort of 216 patients with T4 melanomas treated at two tertiary institutions. Fifty-six patients met our inclusion criteria (T4 lesion, PET/CT and no clinical evidence of metastatic disease. Results. Fifty-six patients (M: 32, F: 24 with median tumor thickness of 6 mm were identified. PET/CT recognized twelve with regional and four patients with metastatic disease. Melanoma-related treatment plan was altered in 11% of the cases based on PET/CT findings. PET/CT was negative 60% of the time, in 35% of the cases; it identified incidental findings that required further evaluation. Conclusion. Patients with T4 lesions, PET/CT changed the treatment plan 18% of the time. Regional findings changed the surgical treatment plan in 11% and the adjuvant plan in 7% of our cases due to the finding of metastatic disease. Additionally 20 patients had incidental findings that required further workup. In this subset of patients, we feel there is a benefit to PET/CT, and further studies should be performed to validate our findings.

  9. Estimation of Carrying Angle Based on CT Images in Preoperative Surgical Planning for Cubitus Deformities

    Directory of Open Access Journals (Sweden)

    Kim,Eugene

    2009-12-01

    Full Text Available Conventionally, the carrying angle of the elbow is measured using simple two-dimensional radiography or goniometry, which has questionable reliability. This study proposes a novel method for estimating carrying angles using computed tomography that can enhance the reliability of the angle measurement. Data of CT scans from 25 elbow joints were processed to build segmented three-dimensional models. The cross-sectional centerlines of the ulna and the humerus were traced from the 3D models, and the angle between 2 vectors formed from the centerlines of the humerus and the ulna was defined as the "three-dimensional carrying angle." These angles were compared with those measured by simple radiograph. Two cases of angular deformity were underwent surgery based on this preoperative surgical planning, and the postoperative 3D carrying angles were evaluated using the proposed method. The mean value of the calculated three-dimensional carrying angle was 20.7 degrees +/-3.61, while it was 16.3 degrees +/-3.21 based on simple radiography without statistical difference. Based on the 3D carrying angle estimations, 2 surgical cases of cubitus deformities were planned by comparison with the normal contra-lateral elbow. Postoperative angle estimations confirmed that the corrected angles were nearly identical to the planned angles for both cases. The results of this study showed that the carrying angle can be accurately estimated using three-dimensional CT and that the proposed method is useful in evaluating deformities of the elbow with high reliability.

  10. Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography.

    Science.gov (United States)

    Ciolina, F; Sedati, P; Zaccagna, F; Galea, N; Noce, V; Miraldi, F; Cavarretta, E; Francone, M; Carbone, I

    2015-10-01

    In patients affected by aortic valve stenosis (AS) it is mandatory to rule out coronary artery disease (CAD). The role of retrospectively ECG-gated 64-slice CT angiography (64-SCTA) was assessed in patients with AS referred for surgical valve replacement. Forty-two patients with AS underwent ECG-gated 64-SCTA of thoracic aorta, including the heart and coronary arteries, before surgical valve replacement. Images were evaluated by two independent readers and compared with surgical findings in terms of aortic valve calcification grading, valvular morphology, aortic valve annulus and sino-tubular junction diameters, and valvular area planimetry. Quantitative evaluation of cusps opening was also performed. Finally, the presence of CAD, thoracic aortic aneurysm and left ventricle hypertrophy were assessed. Visualization of the aortic valve without motion artefacts was possible in 38 patients (90.5%). Valvular morphology was correctly assessed in all cases (100%). 64-SCTA correctly determined aortic valve calcification grading and the aortic valve annulus and sinotubular junction diameters in 100% of cases. The aortic valve planimetric area was assessed in 38 cases (90.5%). Ascending aortic aneurysms requiring surgical replacement were detected in 12 patients (28.6%). Significant left ventricle hypertrophy was found in 30 patients (71%). Preoperative evaluation of patients undergoing surgical replacement for AS with 64-SCTA is feasible. 64-SCTA can rule out CAD and evaluate the status of the aortic valve and thoracic aorta in the same examination, obtaining relevant information for surgical planning.

  11. Reliability of a CT reconstruction for preoperative surgical planning in the arthroscopic Latarjet procedure.

    Science.gov (United States)

    Hardy, Alexandre; Loriaut, Philippe; Granger, Benjamin; Neffati, Ahmed; Massein, Audrey; Casabianca, Laurent; Pascal-Moussellard, Hugues; Gerometta, Antoine

    2016-10-12

    The arthroscopic Latarjet procedure has provided reliable results in the treatment of anterior shoulder instability. However, this procedure remains technically challenging and is related to several complications. The morphology of the coracoid and the glenoid are inconsistent. Inadequate coracoid and glenoid preparing may lead to mismatching between their surfaces. Inadequate screws lengthening and orientation are a major concern. Too long screws can lead to suprascapular nerve injuries or hardware irritation, whereas too short screws can lead to nonunions, fibrous unions or migration of the bone block. The purpose of the study was to investigate the application of virtual surgical planning and digital technology in preoperative assessment and planning of the Latarjet procedure. Twelve patients planned for an arthroscopic Latarjet had a CT scan evaluation with multi-two-dimensional reconstruction performed before surgery. Interobserver and intraobserver reliability were evaluated. The shape of the anterior rim of the glenoid and the undersurface of the coracoid were classified. Coracoid height was measured, respectively, at 5 mm (C1) and 10 mm (C2) from the tip of the coracoid process, corresponding to the drilling zone. Measurements of the glenoid width were then taken in the axial view at 25 % (G1) and 50 % (G2) of the glenoid height with various α angles (5°, 10°, 15°, 20°, 25°, 30°) 7 mm from the anterior glenoid rim. Shapes of the undersurface of the coracoid and the anterior rim of the glenoid were noted during the surgical procedure. Post-operative measurements included the α angle. Concerning coracoid height measurements, there was an almost perfect to substantial intra- and inter-reliability, with values ranging from ICC = 0.75-0.97. For the shape of the coracoid, concordances were, respectively, perfect (ICC = 1) and almost perfect (0.87 [0.33; 1]) for the intra- and interobserver reliabilities. Concerning the glenoid, concordance was

  12. 3D CT modeling of hepatic vessel architecture and volume calculation in living donated liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Frericks, Bernd B. [Medizinische Hochschule Hannover, Diagnostische Radiologie, Hannover (Germany); Klinik und Poliklinik fuer Radiologie und Nuklearmedizin, Universitaetsklinikum Benjamin Franklin, Freie Universitaet Berlin, Hindenburgdamm 30, 12200, Berlin (Germany); Caldarone, Franco C.; Savellano, Dagmar Hoegemann; Stamm, Georg; Kirchhoff, Timm D.; Shin, Hoen-Oh; Galanski, Michael [Medizinische Hochschule Hannover, Diagnostische Radiologie, Hannover (Germany); Nashan, Bjoern; Klempnauer, Juergen [Medizinische Hochschule Hannover, Viszeral und Transplantationschirurgie, Hannover (Germany); Schenk, Andrea; Selle, Dirk; Spindler, Wolf; Peitgen, Heinz-Otto [Centrum fuer Medizinische Diagnosesysteme und Visualisierung, Bremen (Germany)

    2004-02-01

    The aim of this study was to evaluate a software tool for non-invasive preoperative volumetric assessment of potential donors in living donated liver transplantation (LDLT). Biphasic helical CT was performed in 56 potential donors. Data sets were post-processed using a non-commercial software tool for segmentation, volumetric analysis and visualisation of liver segments. Semi-automatic definition of liver margins allowed the segmentation of parenchyma. Hepatic vessels were delineated using a region-growing algorithm with automatically determined thresholds. Volumes and shapes of liver segments were calculated automatically based on individual portal-venous branches. Results were visualised three-dimensionally and statistically compared with conventional volumetry and the intraoperative findings in 27 transplanted cases. Image processing was easy to perform within 23 min. Of the 56 potential donors, 27 were excluded from LDLT because of inappropriate liver parenchyma or vascular architecture. Two recipients were not transplanted due to poor clinical conditions. In the 27 transplanted cases, preoperatively visualised vessels were confirmed, and only one undetected accessory hepatic vein was revealed. Calculated graft volumes were 1110{+-}180 ml for right lobes, 820 ml for the left lobe and 270{+-}30 ml for segments II+III. The calculated volumes and intraoperatively measured graft volumes correlated significantly. No significant differences between the presented automatic volumetry and the conventional volumetry were observed. A novel image processing technique was evaluated which allows a semi-automatic volume calculation and 3D visualisation of the different liver segments. (orig.)

  13. Preoperative (18)F-FDG-PET/CT vs Contrast-Enhanced CT to Identify Regional Nodal Metastasis among Patients with Head and Neck Squamous Cell Carcinoma.

    Science.gov (United States)

    Cho, Joshua K; Ow, Thomas J; Lee, Andrew Y; Smith, Richard V; Schlecht, Nicolas F; Schiff, Bradley A; Tassler, Andrew B; Lin, Juan; Moadel, Renee M; Valdivia, Ana; Abraham, Tony; Gulko, Edwin; Neimark, Matthew; Ustun, Berrin; Bello, Jacqueline A; Shifteh, Keivan

    2017-09-01

    Objective Our objective was to compare the accuracy of preoperative positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced CT (CECT) in detecting cervical nodal metastases in patients treated with neck dissection and to scrutinize the ability of each modality to determine nodal stage. Study Design Case series with chart review. Setting Montefiore Medical Center, Bronx, New York. Subjects and Methods Patients who underwent neck dissection at our institution for primary treatment of head and neck squamous cell carcinoma (HNSCC) and had received preoperative PET/CT and CECT were included in this study. Imaging studies were reinterpreted by 3 specialists within the field and compared for interreader agreement. Concordance between radiology and histopathology was measured using neck levels and sides, along with patient nodal stage. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and agreement coefficients were calculated. Results Seventy-three patients were included in the study. Sensitivity was 0.69 and 0.94 (level and side) for PET/CT vs 0.53 and 0.66 for CECT ( P = .056, P = .001). Specificity was 0.86 and 0.56 for PET/CT vs 0.91 and 0.76 for CECT ( P = .014, P = .024). No significant difference was found in overall accuracy ( P = .33, P = .88). The overall agreement percentages between N stage called by imaging modality and pathology were 52% and 55% for PET/CT and CECT, respectively. Conclusion No significant difference in sensitivity was found between PET/CT and CECT. CECT was found to have superior specificity compared with PET/CT. The information gleaned from each modality in the pretreatment evaluation of HNSCC appears to be complementary.

  14. Prediction of recurrence after HCC resection. Faint oily deposits in preoperative Lipiodol-CT of remnant liver tissue

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, M. (First Dept. of Surgery, Depts. of Pathology and Radiology, Yamanashi Medical Coll. (Japan)); Iimuro, Y. (First Dept. of Surgery, Depts. of Pathology and Radiology, Yamanashi Medical Coll. (Japan)); Mogaki, M. (First Dept. of Surgery, Depts. of Pathology and Radiology, Yamanashi Medical Coll. (Japan)); Kachi, K. (First Dept. of Surgery, Depts. of Pathology and Radiology, Yamanashi Medical Coll. (Japan)); Fujii, H. (First Dept. of Surgery, Depts. of Pathology and Radiology, Yamanashi Medical Coll. (Japan)); Matsumoto, Y. (First Dept. of Surgery, Depts. of Pathology and Radiology, Yamanashi Medical Coll. (Japan))

    1994-07-01

    In trying to clarify the high recurrence rate after removal of small hepatocellular carconoma (HCC), we assessed the postoperative evolution of minute hepatic Lipiodol deposits which had been diagnosed as artifacts on the preoperative Lipiodol-CT. Of 27 patients with solitary HCC less than 5 cm in diameter, 14 had such Lipiodol deposits in the preoperative CT and 9 of them (64%) developed recurrent tumors. On the other hand, 6 of the 13 patients without deposits (46%) suffered recurrence, but in 5 of these 6 patients the HCC was metachronous multicentric. The cumulative survival rate of the non-deposit group was better than that of the deposit group (p<0.1). The present study suggested that, even in patients with small HCC, minute concomitant tumors invisible by conventional imaging techniques may exist at the time of surgery. Some of these lesions without sufficient tumor vasculature showing a hypervascular blush on angiography appear to retain small, vague Lipiodol deposits. (orig.).

  15. Preoperative [{sup 18}F]FDG PET/CT maximum standardized uptake value predicts recurrence of uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hyun Hoon; Kim, Jae Weon; Park, Noh-Hyun; Song, Yong-Sang; Kang, Soon-Beom [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea); Nam, Byung-Ho [National Cancer Center, Division of Cancer Epidemiology and Management, Research Institute, Seoul (Korea); Kang, Keon Wook; Chung, June-Key [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea)

    2010-08-15

    To determine if preoperative [{sup 18}F]FDG-PET/CT imaging has prognostic significance in patients with uterine cervical cancer. Patients with FIGO stage IB to IIA cervical cancer were imaged with integrated FDG PET/CT before radical surgery. The relationship between the maximum standardized uptake value (SUV{sub max}) of FDG in the primary tumour during PET/CT and recurrence was examined. Included in the study were 75 patients. Medical records including clinical data, treatment modalities, and treatment results were retrospectively reviewed. The median duration of follow-up was 13 months (range 3 to 58 months) after treatment. Median preoperative SUV{sub max} values in the primary tumours were significantly higher in patients with higher FIGO stages (p = 0.0149), pelvic lymph node metastasis (p = 0.0068), parametrial involvement (p = 0.0002), large (>4 cm) tumour size (p = 0.0022), presence of lymphovascular space invasion (p = 0.0055), and deep cervical stromal invasion (p < 0.0001). In univariate analysis, lymph node metastasis, parametrial invasion, presence of lymphovascular space invasion, and preoperative SUV{sub max} (uncategorized values) in the primary tumour were significantly associated with recurrence. However, in multivariate analysis, preoperative SUV{sub max} (p = 0.014, HR 1.178, 95% CI 1.034-1.342), age (p = 0.021, HR 0.87, 95% CI 0.772-0.980), and parametrial involvement (p = 0.040, HR 27.974, 95% CI 1.156-677.043) by primary tumour were significantly associated with recurrence. Preoperative FDG uptake by the primary tumour showed a significant association with recurrence in patients with uterine cervical cancer. (orig.)

  16. Diagnostic performance of 64-section CT using CT gastrography in preoperative T staging of gastric cancer according to 7th edition of AJCC cancer staging manual

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woong [Chonnam National University Hwasun Hospital, Department of Radiology, Hwasun-gun, Jeollanam-do (Korea, Republic of); Shin, Sang Soo [Chonnam National University Medical School, Department of Radiology, Gwangju (Korea, Republic of); Chonnam National University Medical School, Center for Aging and Geriatrics, Gwangju (Korea, Republic of); Heo, Suk Hee; Lim, Hyo Soon; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Medical School, Department of Radiology, Gwangju (Korea, Republic of); Choi, Yoo Duk [Chonnam National University Medical School, Department of Pathology, Gwangju (Korea, Republic of); Park, Young Kyu [Chonnam National University Medical School, Department of Surgery, Gwangju (Korea, Republic of); Park, Chang Hwan [Chonnam National University Medical School, Department of Internal Medicine, Gwangju (Korea, Republic of)

    2012-03-15

    To evaluate the accuracy of 64-section multidetector CT with CT gastrography for determining the depth of mural invasion in patients with gastric cancer according to the 7th edition of the AJCC cancer staging manual. A total of 127 patients with gastric cancer and who had undergone both esophago-gastro-duodenoscopy and 64-section CT were included in this study. Two radiologists independently reviewed the preoperative CT images with respect to the detectability and T-staging of the gastric cancers. The sensitivity, specificity, accuracy and overall accuracy of each reviewer for the T staging of gastric cancer were calculated. Overall, gastric cancer was detected in 123 (96.9%) of the 127 cancers on the CT images. Reviewer 1 correctly staged 98 gastric cancers, and reviewer 2 correctly classified 105 gastric cancers. The overall diagnostic accuracy of the T staging was 77.2% (98/127) for reviewer 1 and 82.7% (105/127) for reviewer 2. 64-section CT using CT gastrography showed a reasonable diagnostic performance for determining the T staging in patients with gastric cancer according to the 7th edition of the AJCC cancer staging manual. (orig.)

  17. Brain volume perfusion CT performed with 128-detector row CT system in patients with cerebral gliomas: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Xyda, Argyro [University Hospital of Goettingen, Department of Neuroradiology, Georg-August University, Goettingen (Germany); University Hospital of Heraklion, Department of Radiology, Crete (Greece); Haberland, Ulrike; Klotz, Ernst [Computed Tomography, Siemens AG Healthcare Sector, Forchheim (Germany); Bock, Hans Christoph [University Hospital of Goettingen, Department of Neurosurgery, Georg-August University, Goettingen (Germany); Jung, Klaus [University Hospital of Goettingen, Department of Medical Statistics, Georg-August University, Goettingen (Germany); Knauth, Michael; Schramm, Ramona; Psychogios, Marios Nikos; Schramm, Peter [University Hospital of Goettingen, Department of Neuroradiology, Georg-August University, Goettingen (Germany); Erb, Gunter [Bracco Imaging Deutschland GmbH, Konstanz (Germany)

    2011-09-15

    Validation of the feasibility and efficacy of volume perfusion computed tomography (VPCT) in the preoperative assessment of cerebral gliomas by applying a 128-slice CT covering the entire tumour. Forty-six patients (25 men, 21 women; mean age 52.8 years) with cerebral gliomas were evaluated with VPCT. Two readers independently evaluated VPCT data, drawing volumes of interest (VOIs) around the tumour according to maximum intensity projection volumes, which were mapped automatically onto the cerebral blood volume (CBV), flow (CBF) and permeability (Ktrans) perfusion datasets. As control, a second VOI was placed in the contralateral healthy cortex. Correlation among perfusion parameters, tumour grade, hemisphere and VOIs was assessed. The diagnostic power of perfusion parameters was analysed by receiver operating characteristics curve analyses. VPCT was feasible in the assessment of the entire tumour extent. Mean values of Ktrans, CBV, CBF in high-grade gliomas were significantly higher compared with low-grade (p < 0.01). Ktrans demonstrated the highest diagnostic (97% sensitivity), positive (100%) and negative (94%) prognostic values. VPCT was feasible in all subjects. All areas of different perfusion characteristics are depicted and quantified in colour-coded 3D maps. The derived parameters correlate well with tumour histopathology, differentiating low- from high-grade gliomas. (orig.)

  18. Prognostic value of total lesion glycolysis on preoperative {sup 18}F-FDG PET/CT in patients with uterine carcinosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong-Won [Sungkyunkwan University School of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of); Sungkyunkwan University School of Medicine, Samsung Advanced Institute for Health Sciences and Technology, Seoul (Korea, Republic of); Heo, Eun Jin [Sungkyunkwan University School of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of); Moon, Seung Hwan [Sungkyunkwan University School of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Lee, Hyunjong; Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Lee, Maria; Kim, Hee Seung; Chung, Hyun Hoon [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of)

    2016-11-15

    To investigate the relationship between functional tumour parameters measured during preoperative {sup 18}F-FDG PET/CT and clinical outcomes in patients with uterine carcinosarcoma. For patients with pathologically proven uterine carcinosarcoma, we determined the maximal and average standardized uptake values, cumulative total lesion glycolysis (TLG) and sum of all metabolic tumour volumes (MTVs). Their predictive value for recurrence and the effects of pretreatment functional tumour activity on patient survival were compared. Clinicopathological data from 28 eligible patients were reviewed. The median duration of progression-free survival was 18.6 months (range 6.1-84.5 months), and 10 (35.7 %) patients experienced recurrences. Univariate analyses showed significant associations between recurrence and tumour size, lymph node metastasis, high TLG and MTV values, and ovarian invasion. Multivariate analysis identified high TLG value as an independent risk factor for recurrence (p = 0.048, hazard ratio 115.261, 95 % confidence interval 1.041-12,765.483). Kaplan-Meier survival curves showed that progression-free survival significantly differed in groups categorized according to TLG (p = 0.007, log-rank test). Preoperative TLG measured with {sup 18}F-FDG PET/CT was statistically significantly associated with uterine carcinosarcoma recurrence. Metabolic parameters can provide useful quantitative criteria for disease prognostication in patients with uterine carcinosarcoma before treatment. (orig.)

  19. Heterotopic Pancreas of the Jejunum Incidentally Detected by Preoperative Abdominal CT: Report of Two Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Manabu Watanabe

    2012-09-01

    Full Text Available Heterotopic pancreas (HP is typically an asymptomatic malformation that can present anywhere along the gastrointestinal tract. It is often detected incidentally on surgery for other diseases or autopsy. We encountered 2 patients with jejunal HP incidentally detected by computed tomography (CT performed for close evaluation of other diseases. In a 57-year-old woman diagnosed with reactive lymphoid hyperplasia on the dorsal portion of the pancreas head, CT detected a 15 mm oval-shaped submucosal lesion at the jejunum. In an 87-year-old woman diagnosed with type 2 adenocarcinoma occupying the sigmoid colon, CT detected a round-shaped submucosal tumor 15 mm in diameter in the jejunum. Both cases were histologically diagnosed as type 1 HP according to the classification by Heinrich. Contrast-enhanced CT revealed that the CT analyses of HP and pancreatic parenchyma were nearly identical in the arterial phase, but in the equilibrium phase, contrast enhancement persisted longer in HP than in the pancreatic parenchyma. There has been no report of asymptomatic jejunal HP preoperatively diagnosed by CT. These cases are presented with a review of the literature, particularly focusing on CT findings.

  20. Breast volume estimation from systematic series of CT scans using the Cavalieri principle and 3D reconstruction.

    Science.gov (United States)

    Erić, Mirela; Anderla, Andraš; Stefanović, Darko; Drapšin, Miodrag

    2014-01-01

    Preoperative breast volume estimation is very important for the success of the breast surgery. In the present study, two different breast volume determination methods, Cavalieri principle and 3D reconstruction were compared. Consecutive sections were taken in slice thickness of 5 mm. Every 2nd breast section in a set of consecutive sections was selected. We marked breast tissue with blue line on each selected section, and so prepared CT scans used for breast volume estimation. The volumes of the 60 breasts were estimated using the Cavalieri principle and 3D reconstruction. The mean breast volume value was established to be 467.79 ± 188.90 cm(3) with Cavalieri method and 465.91 ± 191.41 cm(3) with 3D reconstruction. The mean CE for the estimates in this study was calculated as 0.25%. Skin-sparing volume was about 91.64% of the whole breast volume. Both methods are very accurate and have a strong linear association. Our results suggest that the calculation of breast volume or its part in vivo from systematic series of CT scans using the Cavalieri principle or 3D breast reconstruction is accurate enough to have a significant clinical benefit in planning reconstructive breast surgery. These methods can help the surgeon guide the choice of the most appropriate implant or/and flap preoperatively. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  1. Not All Hip Dysplasias are the Same: Preoperative CT Version Study and the Need for Reverse Bernese Periacetabular Osteotomy.

    Science.gov (United States)

    Thawrani, Dinesh P; Feldman, David S; Sala, Debra A

    2017-01-01

    Dysplastic hip may present with acetabular retroversion with or without femoral retroversion. This retroversion, if not accounted for when performing a periacetabular osteotomy (PAO), will lead to anterior hip pain and early osteoarthritis. A reverse PAO involves anteverting the acetabulum while still obtaining lateral coverage. The purpose of this study was to investigate the relationship between rotational malalignment of acetabulum and femur on 2-dimensional computed tomographic (CT) scans of hips that underwent Bernese PAO and its role in the surgical decision making. This retrospective, case-control study examined and compared preoperative 2-dimensional CT scans of hips that underwent reverse PAO to the hips that underwent traditional PAO. Twelve hips underwent reverse PAO from 2005 to 2010. Twelve hips were randomly selected from a cohort of 52 hips that underwent traditional PAO during same time period. Hips that underwent reverse PAO showed crossover sign on preoperative radiographs, but not on postoperative radiographs. Crossover sign was negative preoperatively and postoperatively on hips that underwent traditional PAO. The 2 groups were similar in regards to preoperative lateral center-edge angle, acetabular index, and anterior center-edge angle on plain radiographs and showed significant improvement after surgery.On preoperative CT scans both acetabulae and femurs were retroverted in reverse PAO group. Comparison of the 2 groups demonstrated that acetabular version (16.5±4.9 degrees vs. 25.3±5.6 degrees, P=0.001), femoral version (12.8±10.4 degrees vs. 31.9±8 degrees, P<0.001), and McKibbins Instability Index (29.3±11.9 degrees vs. 57.1±9.8 degrees, P<0.001) were significantly lower for the reverse PAO than the traditional PAO group. Anterior Acetabular Sector Angle (determines anterior coverage) was significantly higher in reverse PAO group, 53.1±13.7 degrees versus 39.7±10.4 degrees (P=0.013). Retroverted acetabulae seem to be associated with

  2. A 20-year retrospective analysis of CT-based pre-operative identification of pulmonary metastases in patients with osteosarcoma: A single-center review.

    Science.gov (United States)

    Heaton, Todd E; Hammond, William J; Farber, Benjamin A; Pallos, Valerie; Meyers, Paul A; Chou, Alexander J; Price, Anita P; LaQuaglia, Michael P

    2017-01-01

    Cooperative studies support complete metastasectomy in osteosarcoma (OS). Pre-operative CT is used to identify and quantify metastases and can facilitate minimally invasive techniques. Here we assess the accuracy of pre-operative CT compared to findings at thoracotomy and its change over time. We reviewed OS thoracotomies performed at our institution from 1996 to 2015. The number of metastases identified on pre-operative chest CT was compared to the number of metastases seen on pathology (both metastases with viable cells and non-viable, osteoid-only metastases). Eighty-eight patients underwent 161 thoracotomies with a median of 14days (range, 1-85) between CT and surgery, a median of 2 CT-identified lesions (range, 0-15), and a median of 4 resected lesions (range, 1-25). In 56 (34.8%) cases, more metastases were found surgically than were seen on CT, and among these, 34 (21.1%) had a greater number of viable metastases. There was poor overall correlation between CT and pathology findings (Kendall Tau-b=0.506), regardless of CT slice thickness, decade of thoracotomy, or total number of CT-identified lesions. CT accuracy in pre-operatively quantifying OS pulmonary metastases has not improved in recent decades. Consequently, we recommend an open technique with direct lung palpation for complete identification and resection of OS pulmonary metastases. Level IV, retrospective study with no comparison group. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Rheumatoid arthritis bone erosion volumes on CT and MRI: reliability and correlations with erosion scores on CT, MRI and radiography

    DEFF Research Database (Denmark)

    Møller Døhn, Uffe; Ejbjerg, Bo J; Hasselquist, Maria;

    2007-01-01

    controls underwent unilateral CT, MRI and radiography of second to fifth MCP joints in one hand. Erosion volumes (using OSIRIS software) and scores were determined from CT, MRI and radiography (scores only). RESULTS: CT, MRI and radiography detected 77, 62 and 12 erosions, respectively. On CT, the mean...

  4. The role of FDG-PET/CT in preoperative staging of sentinel lymph node biopsy-positive melanoma patients

    DEFF Research Database (Denmark)

    Frary, Evan C; Gad, Dorte; Bastholt, Lars;

    2016-01-01

    BACKGROUND: On April 1, 2015, Odense University Hospital (OUH) began a new diagnostic strategy, wherein all malignant melanoma (MM) patients in the Region of Southern Denmark with a positive sentinel lymph node biopsy (SLNB) underwent FDG-PET/CT preoperatively prior to lymph node dissection (LND...... cohort study which included all patients with MM from all hospitals in the Region of Southern Denmark from April 1, 2015 to April 1, 2016 found to be SLNB-positive who subsequently underwent FDG-PET/CT. Patient information was acquired from the Danish Melanoma Database and was cross-referenced with OUH...... or uncover anything else of relevance. FDG-PET/CT did, however, provide false positive findings in 13 % (6/46) of these patients. These scans triggered additional, predominantly invasive, procedures, which did not ultimately have an impact on the therapeutic strategy. Thus, these findings indicate a need...

  5. Preoperative TRAM free flap volume estimation for breast reconstruction in lean patients.

    Science.gov (United States)

    Minn, Kyung Won; Hong, Ki Yong; Lee, Sang Woo

    2010-04-01

    To obtain pleasing symmetry in breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) free flap, a large amount of abdominal flap is elevated and remnant tissue is trimmed in most cases. However, elevation of abundant abdominal flap can cause excessive tension in donor site closure and increase the possibility of hypertrophic scarring especially in lean patients. The TRAM flap was divided into 4 zones in routine manner; the depth and dimension of the 4 zones were obtained using ultrasound and AutoCAD (Autodesk Inc., San Rafael, CA), respectively. The acquired numbers were then multiplied to obtain an estimate of volume of each zone and the each zone volume was added. To confirm the relation between the estimated volume and the actual volume, authors compared intraoperative actual TRAM flap volumes with preoperative estimated volumes in 30 consecutive TRAM free flap breast reconstructions. The estimated volumes and the actual elevated volumes of flap were found to be correlated by regression analysis (r = 0.9258, P AutoCAD (Autodesk Inc.) allow the authors to attain the precise volume desired for elevation. This method provides advantages in terms of minimal flap trimming, easier closure of donor sites, reduced scar widening and symmetry, especially in lean patients.

  6. Analysis of the abdominal musculo-aponeurotic anatomy in rectus diastasis: comparison of CT scanning and preoperative clinical assessment with direct measurement intraoperatively.

    Science.gov (United States)

    Emanuelsson, P; Dahlstrand, U; Strömsten, U; Gunnarsson, U; Strigård, K; Stark, B

    2014-08-01

    To evaluate and compare the consistency of agreement of two methods for measuring abdominal rectus diastasis (ARD), preoperative computed tomography (CT) scanning and preoperative clinical assessment were compared with direct measurement intraoperatively. Fifty-five consecutive patients were retrieved from an ongoing prospective randomised trial comparing two operative techniques for the repair of ARD. All patients underwent a preoperative clinical assessment and CT scan, and the results were compared with intraoperative measurement of the ARD width. Agreement between methods was described with Bland-Altman plots (BA plots) and calculated using Lin's Concordance Correlation Coefficient (CCC). The median width of the diastasis was 4.0 cm in the upper midline and 3.0 cm in the lower midline for the intraoperative measurement. BA plots showed that measurements on CT and intraoperatively are not in agreement in the lower midline, whereas the agreement was stronger between the clinical and the intraoperative method. The CCC was higher for clinical vs. intraoperative measurement (0.479) than for CT vs. intraoperative measurement (-0.002) in the lower midline, although the agreement was over all low. CT scanning underestimated the width of the ARD when compared to 87 % of preoperative clinical assessments, and 83 % of intraoperative measurements. Preoperative clinical assessment overestimated ARD in 35 % when compared with intraoperative measurements. Clinical assessment prior to surgery provides more accurate information than CT scanning in the assessment of ARD width. CT scanning underestimates ARD width when compared with intraoperative measurement.

  7. Spleen volume on CT and the effect of abdominal trauma.

    Science.gov (United States)

    Cruz-Romero, Cinthia; Agarwal, Sheela; Abujudeh, Hani H; Thrall, James; Hahn, Peter F

    2016-08-01

    The aim of this study is to determine the magnitude of change in spleen volume on CT in subjects sustaining blunt abdominal trauma without hemorrhage relative to patients without disease and how the spleen volumes are distributed. Sixty-seven subjects with blunt abdominal trauma and 101 control subjects were included in this retrospective single-center, IRB-approved, and HIPAA-compliant study. Patients with an injured spleen were excluded. Using a semiautomatic segmentation program, two readers computed spleen volumes from CT. Spleen volume distribution in male and female trauma and control cohorts were compared nonparametrically. Spleen volume plotted against height, weight, and age were analyzed by linear regression. The number of females and males are, respectively, 35 and 32 in trauma subjects and 69 and 32 among controls. Female trauma patients (49.6 years) were older than males (39.8 years) (p = 0.02). Distributions of spleen volume were not normal, skewed above their means, requiring a nonparametric comparison. Spleen volumes in trauma patients were smaller than those in controls with medians of 230 vs 294 mL in males(p volume correlated positively with weight in females and with height in male controls, and negatively with age in male controls (p volume in controls was 245 mL, the largest ever reported. Spleen volume decreases in response to blunt abdominal trauma. Spleen volumes are not normally distributed. Our population has the largest spleen volume reported in the literature, perhaps a consequence of the obesity epidemic.

  8. Feasibility of Preoperative FDG PET/CT Total Hepatic Glycolysis in the Remnant Liver for the Prediction of Postoperative Liver Function.

    Science.gov (United States)

    Cho, Arthur; Chung, Yong Eun; Choi, Jin Sub; Kim, Kyung Sik; Choi, Gi Hong; Park, Young Nyun; Kim, Myeong-Jin

    2017-03-01

    The objective of our study was to investigate the prognostic value of total glycolysis of the remnant liver, which reflects both metabolic and anatomic liver function, for predicting postoperative hepatic insufficiency. Patients who underwent (18)F-FDG PET/CT and abdominal CT within 1 month of major hepatectomy were retrospectively analyzed. Total liver volume, remnant liver volume, the ratio of the remnant hepatic volume to the preoperative hepatic volume (RFRHV), and mean standardized uptake value (SUVmean) were measured, and total glycolysis of the remnant liver was calculated. Clinical hepatic function reserve values, including the indocyanine green retention rate at 15 minutes, the model for end-stage liver disease (MELD) score, and aspartate aminotransferase to platelet ratio index (APRI), were calculated. Univariate and multivariate analyses were performed, and an optimal model for predicting hepatic insufficiency was developed. ROC curves were used to compare diagnostic performance. Of 149 patients, seven patients had hepatic insufficiency. The SUVmean showed the highest sensitivity (100%; specificity, 31.7%) for predicting hepatic insufficiency, and total glycolysis of the remnant liver showed the highest specificity (96.5%; sensitivity, 57.1%) for predicting hepatic insufficiency. On multivariate analysis, the odds ratio of APRI (> 5.4) and total glycolysis of the remnant liver (≤ 625.6) was 46.3 and 82.9, respectively, for predicting hepatic insufficiency. On ROC curve analysis, a new model composed of APRI and total glycolysis of the remnant liver showed a higher area under the ROC curve (Az) value (Az = 0.899) than SUVmean (0.659), MELD score (0.618), APRI (0.693), RFRHV (0.797), and remnant liver volume (0.762). The total glycolysis of the remnant liver has moderate sensitivity and high specificity for predicting hepatic insufficiency. Combining the total glycolysis of the remnant liver and APRI yielded the best diagnostic performance for predicting

  9. Image analysis of the inner ear with CT and MR imaging; Pre-operative assessment for cochlear implant surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kumakawa, Kohzoh; Takeda, Hidehiko; Mutoh, Naoko; Miyakawa, Kohichi (Toranomon Hospital, Tokyo (Japan)); Yukawa, Kumiko; Funasaka, Sohtaro

    1992-06-01

    Recent progress in magnetic resonance imaging (MRI) has made it possible to obtain detailed images of the inner ear by delineating the lymphatic fluid within the labyrinth. We analyzed CT scans and MR imaging in 70 ears manifesting profound deafness owing to inner ear lesions and compared their detective ability for inner ear lesions. The following results were obtained. CT scan examination showed slight to extensive ossification of the labyrinth in six ears (9%), whereas MRI examination revealed low to absent signal intensity of the inner ear in nine ears (13%). Therefore, it was concluded that MRI is more sensitive in detecting abnormalities of the inner ear than CT scan. MRI provided useful information as to whether the cochlear turn is filled with lymphatic fluid or obstructed. This point was one of the greatest advantages of MRI over CT scan. Abnormal findings in either or both the CT scan and the MRI were detected in suppurative labyrinthitis occurring secondary to chronic otitis media, bacterial meningitis and in inner ear trauma. However, such abnormal findings were not detected in patients with idiopathic progressive sensorineural hearing loss, ototoxity or sudden deafness. These findings should be taken into consideration in pre-operative assessment of cochlear implant candidates. (author).

  10. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

    Energy Technology Data Exchange (ETDEWEB)

    Seeters, Tom van; Schaaf, Irene C. van der; Dankbaar, Jan Willem; Horsch, Alexander D.; Niesten, Joris M.; Luitse, Merel J.A.; Mali, Willem P.T.M.; Velthuis, Birgitta K. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Biessels, Geert Jan; Kappelle, L.J. [University Medical Center Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht (Netherlands); Majoie, Charles B.L.M. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Vos, Jan Albert [St. Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Schonewille, Wouter J. [St. Antonius Hospital, Department of Neurology, Nieuwegein (Netherlands); Walderveen, Marianne A.A. van [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Wermer, Marieke J.H. [Leiden University Medical Center, Department of Neurology, Leiden (Netherlands); Duijm, Lucien E.M. [Catharina Hospital, Department of Radiology, Eindhoven (Netherlands); Keizer, Koos [Catharina Hospital, Department of Neurology, Eindhoven (Netherlands); Bot, Joseph C.J. [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Visser, Marieke C. [VU University Medical Center, Department of Neurology, Amsterdam (Netherlands); Lugt, Aad van der [Erasmus MC University Medical Center, Department of Radiology, Rotterdam (Netherlands); Dippel, Diederik W.J. [Erasmus MC University Medical Center, Department of Neurology, Rotterdam (Netherlands); Kesselring, F.O.H.W. [Rijnstate Hospital, Department of Radiology, Arnhem (Netherlands); Hofmeijer, Jeannette [Rijnstate Hospital, Department of Neurology, Arnhem (Netherlands); Lycklama a Nijeholt, Geert J. [Medical Center Haaglanden, Department of Radiology, The Hague (Netherlands); Boiten, Jelis [Medical Center Haaglanden, Department of Neurology, The Hague (Netherlands); Rooij, Willem Jan van [St. Elisabeth Hospital, Department of Radiology, Tilburg (Netherlands); Kort, Paul L.M. de [St. Elisabeth Hospital, Department of Neurology, Tilburg (Netherlands); Roos, Yvo B.W.E.M. [Academic Medical Center, Department of Neurology, Amsterdam (Netherlands); Meijer, Frederick J.A. [Radboud University Medical Center, Department of Radiology, Nijmegen (Netherlands); Pleiter, C.C. [St. Franciscus Hospital, Department of Radiology, Rotterdam (Netherlands); Graaf, Yolanda van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Collaboration: Dutch acute stroke study (DUST) investigators

    2016-04-15

    We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging. We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R{sup 2} was assessed to determine the additional value of CTA and CTP. At follow-up, 612 patients (67.5 %) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8-69.6). Regarding infarct presence, the AUC of 0.82 (95 % confidence interval (CI) 0.79-0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95 % CI 0.82-0.87); p < 0.001) and was even higher after addition of CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001) and combined CTA/CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001). For infarct volume, adding combined CTA/CTP measures (R{sup 2} = 0.58) was superior to patient characteristics and non-contrast CT alone (R{sup 2} = 0.44) and to addition of CTA alone (R{sup 2} = 0.55) or CTP alone (R{sup 2} = 0.54; all p < 0.001). In the acute stage, CTA and CTP have additional value over patient characteristics and non-contrast CT for predicting infarct presence and infarct volume on follow-up imaging. These findings could be applied for patient selection in future trials on ischemic stroke treatment. (orig.)

  11. Development of automated quantification of visceral and subcutaneous adipose tissue volumes from abdominal CT scans

    Science.gov (United States)

    Mensink, Sanne D.; Spliethoff, Jarich W.; Belder, Ruben; Klaase, Joost M.; Bezooijen, Roland; Slump, Cornelis H.

    2011-03-01

    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.

  12. MRI in preoperative evaluation of chronic paranasal sinusitis - a comparison with CT; MRT in der praeoperativen Diagnostik der chronischen Sinusitis im Vergleich mit der CT

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, F.; Habermann, C.R.; Welger, J.; Steiner, P.; Rozeh, B.; Buecheler, E. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Radiologie; Knaape, A.; Metternich, F. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde; Schoder, V. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Inst. fuer Mathematik und Datenverarbeitung in der Medizin

    2001-04-01

    Purpose: To determine the value of MRI in the preoperative evaluation of chronic paranasal sinusitis and to compare the results with CT and intraoperative findings. Method/Materials: 42 patients with clinical signs of chronic paranasal sinusitis underwent MRI after CT evaluation on one day, with subsequent functional endoscopic sinus surgery on the next day. Coronary CT was obtained with 5-mm slices and table-feed in the prone position, while MRI was performed in the supine position with coronary T{sub 2}-TSE+pd and coronary and transverse HASTE, each with 5-mm slice thickness. Aquisition time in MRI was less than 8 minutes. Two radiologists reviewed the CT and MRI scans for signs of sinusitis and detection of anatomical landmarks. The results were correlated with the intraoperative findings. Results: MRI offered no artifacts of dental work and showed more often high quality pictures than CT. CT and MRI demonstrated a good correlation in the detection of mucosal pathologies ({kappa}=0.46-0.87) and anatomic variants ({kappa}=0.55-0.86). All important anatomical structures could be evaluated sufficiently with MRI for preoperative management. Both diagnostic tools showed an unsatisfactory correlation with intraoperative findings in the ethmoidal complex and maxillary sinus ({tau}=-0.08-0.3). (orig.) [German] Zielsetzung: Einschaetzung des Stellenwertes der MRT in der Beurteilung der praeoperativen Diagnostik der chronischen Sinusitis und Vergleich mit koronarer CT und intraoperativem Befund. Material und Methodik: 42 Patientinnen mit klinischen Zeichen einer chronischen Sinusitis wurden jeweils innerhalb eines Tages mittels CT und MRT untersucht. Am Folgetag wurde eine transnasale endoskopische Operation an den Nasennebenhoehlen durchgefuehrt. Die CT erfolgte in Bauchlage und koronarer Schichtfuehrung (5 mm Schichtdicke und Tischvorschub). Die MRT wurde an einem 1,5 T-Geraet in Rueckenlage mittels Kopfspule durchgefuehrt. Eingesetzt wurden koronare Protonen-w-, T

  13. The influence of respiratory motion on CT image volume definition

    Energy Technology Data Exchange (ETDEWEB)

    Rodríguez-Romero, Ruth, E-mail: rrromero@salud.madrid.org; Castro-Tejero, Pablo, E-mail: pablo.castro@salud.madrid.org [Servicio de Radiofísica y Protección Radiológica, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid (Spain)

    2014-04-15

    Purpose: Radiotherapy treatments are based on geometric and density information acquired from patient CT scans. It is well established that breathing motion during scan acquisition induces motion artifacts in CT images, which can alter the size, shape, and density of a patient's anatomy. The aim of this work is to examine and evaluate the impact of breathing motion on multislice CT imaging with respiratory synchronization (4DCT) and without it (3DCT). Methods: A specific phantom with a movable insert was used. Static and dynamic phantom acquisitions were obtained with a multislice CT. Four sinusoidal breath patterns were simulated to move known geometric structures longitudinally. Respiratory synchronized acquisitions (4DCT) were performed to generate images during inhale, intermediate, and exhale phases using prospective and retrospective techniques. Static phantom data were acquired in helical and sequential mode to define a baseline for each type of respiratory 4DCT technique. Taking into account the fact that respiratory 4DCT is not always available, 3DCT helical image studies were also acquired for several CT rotation periods. To study breath and acquisition coupling when respiratory 4DCT was not performed, the beginning of the CT image acquisition was matched with inhale, intermediate, or exhale respiratory phases, for each breath pattern. Other coupling scenarios were evaluated by simulating different phantom and CT acquisition parameters. Motion induced variations in shape and density were quantified by automatic threshold volume generation and Dice similarity coefficient calculation. The structure mass center positions were also determined to make a comparison with their theoretical expected position. Results: 4DCT acquisitions provided volume and position accuracies within ±3% and ±2 mm for structure dimensions >2 cm, breath amplitude ≤15 mm, and breath period ≥3 s. The smallest object (1 cm diameter) exceeded 5% volume variation for the breath

  14. The influence of respiratory motion on CT image volume definition.

    Science.gov (United States)

    Rodríguez-Romero, Ruth; Castro-Tejero, Pablo

    2014-04-01

    Radiotherapy treatments are based on geometric and density information acquired from patient CT scans. It is well established that breathing motion during scan acquisition induces motion artifacts in CT images, which can alter the size, shape, and density of a patient's anatomy. The aim of this work is to examine and evaluate the impact of breathing motion on multislice CT imaging with respiratory synchronization (4DCT) and without it (3DCT). A specific phantom with a movable insert was used. Static and dynamic phantom acquisitions were obtained with a multislice CT. Four sinusoidal breath patterns were simulated to move known geometric structures longitudinally. Respiratory synchronized acquisitions (4DCT) were performed to generate images during inhale, intermediate, and exhale phases using prospective and retrospective techniques. Static phantom data were acquired in helical and sequential mode to define a baseline for each type of respiratory 4DCT technique. Taking into account the fact that respiratory 4DCT is not always available, 3DCT helical image studies were also acquired for several CT rotation periods. To study breath and acquisition coupling when respiratory 4DCT was not performed, the beginning of the CT image acquisition was matched with inhale, intermediate, or exhale respiratory phases, for each breath pattern. Other coupling scenarios were evaluated by simulating different phantom and CT acquisition parameters. Motion induced variations in shape and density were quantified by automatic threshold volume generation and Dice similarity coefficient calculation. The structure mass center positions were also determined to make a comparison with their theoretical expected position. 4DCT acquisitions provided volume and position accuracies within ± 3% and ± 2 mm for structure dimensions >2 cm, breath amplitude ≤ 15 mm, and breath period ≥ 3 s. The smallest object (1 cm diameter) exceeded 5% volume variation for the breath patterns of higher

  15. Anatomic and Quantitative Temporal Bone CT for Preoperative Assessment of Branchio-Oto-Renal Syndrome.

    Science.gov (United States)

    Ginat, D T; Ferro, L; Gluth, M B

    2016-12-01

    We describe the temporal bone computed tomography (CT) findings of an unusual case of branchio-oto-renal syndrome with ectopic ossicles that are partially located in the middle cranial fossa. We also describe quantitative temporal bone CT assessment pertaining to cochlear implantation in the setting of anomalous cochlear anatomy associated with this syndrome.

  16. Obscure gastrointestinal bleeding: preoperative CT-guided percutaneous needle localization of the bleeding small bowel segment.

    Science.gov (United States)

    Heiss, Peter; Feuerbach, Stefan; Iesalnieks, Igors; Rockmann, Felix; Wrede, Christian E; Zorger, Niels; Schlitt, Hans J; Schölmerich, Jürgen; Hamer, Okka W

    2009-04-01

    A 57-year-old woman presented with obscure gastrointestinal bleeding. Double balloon enteroscopy, angiography, and surgery including intraoperative enteroscopy failed to identify the bleeding site. Multidetector computed tomography (CT) depicted active bleeding of a small bowel segment. The bleeding segment was localized by CT-guided percutaneous needle insertion and subsequently removed surgically.

  17. Impacted teeth in the maxilla: usefulness of 3D Dental-CT for preoperative evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Sawamura, Tsuyoshi E-mail: tsuyo@den.hokudai.ac.jp; Minowa, Kazuyuki; Nakamura, Motoyasu

    2003-09-01

    Objective: To compare the shapes of roots of impacted teeth shown in three-dimensional computed tomographic images (3D Dental-computed tomography (CT) images) and plain radiographs and to determine whether 3D Dental-CT images are useful for examination before performing an operation for extraction of a maxillary impacted tooth. Methods and patients: Images obtained from patients who had impacted teeth in the maxilla, including impacted mesial supernumerary teeth in 13 patients, impacted incisors in two patients, impacted canines in 11 patients, impacted premolars in four patients and impacted molars in three patients, were used in this study. In all patients, plain radiographs and 3D Dental-CT images were retrospectively reviewed by an oral radiologist for evidence of root dilaceration before operations to extract the impacted teeth were performed. The findings in the images were compared with intraoperative findings in all cases. Results: The mean specificity and sensitivity of plain radiographs were 95 and 8%, respectively, while those of 3D Dental-CT images were 100 and 77%, respectively. There was a statistically significant (P<0.01) difference between the depiction capabilities of plain radiographs and 3D Dental-CT images with regard to dilacerations of roots of impacted teeth. Discussion and conclusion: CT may enable radiologists to make a quick and accurate diagnosis of tooth impaction. 3D Dental-CT images are useful for determining the root shape of an impacted tooth in the maxilla.

  18. Preoperative CT-Angiography Predicts Ex Vivo Vein Length for Right Kidneys After Laparoscopic Donor Nephrectomy

    NARCIS (Netherlands)

    Özdemir-van Brunschot, D.M.D.; Rottier, S.J.; Ouden, J.E. den; Jagt, M.F.P. van der; D'Ancona, F.C.H.; Kloke, H.J.; Vliet, D. van der; Schultze Kool, L.J.; Warle, M.C.

    2015-01-01

    BACKGROUND Implantation of a kidney with a short renal vein is technically more challenging and therefore prone for technique-related complications. It remains unclear whether pre-operative computed tomography angiography (CTA), to assess vascular anatomy of the donor kidney, can be used to predict

  19. PET/CT and histopathologic response to preoperative chemoradiation therapy in locally advanced rectal cancer

    DEFF Research Database (Denmark)

    Kristiansen, C.; Loft, A.; Berthelsen, Anne Kiil;

    2008-01-01

    PURPOSE: The objective of this study was to investigate the possibility of using positron emission tomography/computer tomography to predict the histopathologic response in locally advanced rectal cancer treated with preoperative chemoradiation. METHODS: The study included 30 patients with locall...

  20. Comparison of Volume Rendering CT cholangiography and Minimum intensity projection CT cholangiography in patients with obstructive biliary disease

    OpenAIRE

    牛見, 尚史; 佃, 俊二; 平敷, 淳子

    2002-01-01

     We compared the detectability and conspicuity of minimum intensity projection CT cholangiography (Min-IP CTC)with volume rendering CT cholangiography (VRCTC).The subjects were ten patients (6 men, 4 women, mean age 64.7) who clinically suspected obstructive biliary truct disease. They underwent enhanced helical CT. Volume data of delayed phase that reconstructed by 2 or 1 mm thickness was transferred to work station (Advantage Windows) and data processing by Minimum Intensity Projection (Min...

  1. Preoperative visualization of the trajectory for CT-guided stereotactic surgery; A technical note

    Energy Technology Data Exchange (ETDEWEB)

    Ohira, Takayuki; Toya, Shigeo; Momoshima, Hirotaka; Shiga, Hayao (Keio Univ., Tokyo (Japan). School of Medicine)

    1989-04-01

    A method is reported for confirming the entire trajectory on CT images using Komai's CT stereotactic apparatus and a GE 8800 CT scanner. For this purpose, we used the 'oblique reformation software with a parameter mode' contained in the GE 8800 CT scanner and made a 'Y-angle ring' for Komai's stereotactic apparatus. The value of the angle between the axial plane and the arc (Y angle) was put on the scale of the ring during operation. Pseudo-coronal and pseudo-sagittal images containing the entire trajectory were re-formed by this software using 6 values of the X, Y, and Z coordinates for the target and trephination points. This method allows the quick visualization of various potential routes, thus aiding the optimal selection of the best actual surgical paths. (author).

  2. Clinical utility of ultrasound and {sup 99m}Tc sestamibi SPECT/CT for preoperative localization of parathyroid adenoma in patients with primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Patel, C.N., E-mail: chirag_patel@totalise.co.u [Department of Radiology and Nuclear Medicine, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Salahudeen, H.M. [Department of Radiology and Nuclear Medicine, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Lansdown, M. [Department of Endocrine Surgery, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Scarsbrook, A.F. [Department of Radiology and Nuclear Medicine, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom)

    2010-04-15

    Aim: To evaluate the accuracy of ultrasound and parathyroid scintigraphy using single photon-emission computed tomography/computed tomography (SPECT/CT) for the preoperative localization of solitary parathyroid adenomas in patients with primary hyperparathyroidism who would be suitable for minimally invasive parathyroid surgery. Materials and methods: Retrospective study of 63 consecutive patients with biochemical evidence of primary hyperparathyroidism referred for preoperative localization of parathyroid adenoma that proceeded to surgery in the same institution. All patients underwent high-resolution ultrasound and Technetium-99m sestamibi scintigraphy with planar and SPECT/CT imaging. The accuracy of preoperative imaging was compared to surgical and histological findings as the reference standard. Results: Fifty-nine patients had solitary parathyroid adenomas, three patients had multiglandular hyperplasia, and one patient had multiple parathyroid adenomas confirmed at surgery and histology. Thirty-five solitary parathyroid adenomas were identified preoperatively with ultrasound (64%) and 53 with SPECT-CT (90%). Concordant ultrasound and SPECT/CT findings were found in 35 cases (59%). An additional three adenomas were found with ultrasound alone and 18 adenomas with SPECT/CT alone. Fifty-one of the 56 adenomas localized using combined ultrasound and SPECT/CT were found at the expected sites during surgery. Combined ultrasound and SPECT/CT has an overall sensitivity of 95% and accuracy of 91% for the preoperative localization of solitary parathyroid adenomas. Conclusions: The combination of ultrasound and SPECT/CT has incremental value in accurately localizing solitary parathyroid adenomas over either technique alone, and allows selection of patients with primary hyperparathyroidism who would be suitable for minimally invasive surgery.

  3. Preoperative diagnosis of the thoracic aortic aneurysm by three-dimensional CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Hideo; Ino, Takashi; Ide, Hirofumi; Mizuhara, Akihiro; Yamaguchi, Atsushi; Kawahito, Koji; Kobayashi, Yasuyuki; Nagai, Jun (Jichi Medical School, Minamikawachi, Tochigi (Japan))

    1993-09-01

    Serial eight patients with thoracic aortic aneurysms were evaluated by a newly developed three-dimensional CT angiography (3D-CT) from December 1992 to January 1993. The patients include 3 aortic dissections, 3 aortic arch aneurysms, one descending aortic aneurysm and one thoraco-abdominal aortic aneurysm. The surgical treatment was performed after the evaluation of 3D-CT, and the operative findings were compared to the three-dimensional images reconstructed by 3D-CT in all patients. Three-dimensional displays were achieved using the unique method of data collection of the helical (spinal) scanner with continuous tube rotation and continuous table feed. An intravenous contrast material was used to image the thoracic aorta and major aortic branches with the single-breath-hold technique. Two and three-dimensional images reconstructed by 3D-CT were displayed within 10-20 minutes after the scanning. These three-dimensional images of the aortic lesions could be displayed in any angle we chose. Three-dimensional structures of the thoracic aorta and major aortic branches were clearly visualized and easily recognized by 3D-CT. These images were similar to the intraoperative findings and were quite useful to determine the operative procedure. The successful repair of thoracic aortic aneurysm was achieved in all cases. 3D-CT is a new and attractive modality to assess the vascular system. Although our experience is limited, 3D-CT may be a useful and powerful diagnostic method for the surgical treatment of thoracic aortic aneurysm. (author).

  4. [Imaging techniques in the preoperative diagnosis of soft tissue tumors. A comparison of MRT, CT, sonography, angiography and conventional x-rays].

    Science.gov (United States)

    Roeren, T; Gindele, A; Grosspietsch, C; Dueck, M; Kauffmann, G W

    1992-12-01

    In a study on 51 patients with histologically confirmed soft tissue tumors (STT), we retrospectively evaluated the preoperative use of imaging procedures (MRI, CT, ultrasound, angiography, plain film) for identification of tumor size, delineation, and determination of malignancy and tissue type. The findings were correlated with intraoperative findings and histological diagnosis. The overall diagnostic method of choice for preoperative imaging of STT is MRI, followed by CT. Ultrasound, although sensitive, lacks the required specificity. Angiography and plain film can only be used for specific indications, as they generally do not make it possible to stage the tumor. Combining our results with those from the more recent literature, we propose a diagnostic algorithm according to which MRI would generally be performed for preoperative staging of STT. CT and plain film should only be used if bony infiltration is suspected; angiography is indicated for planning intraarterial chemotherapy or embolization or if vascular infiltration is probable.

  5. A combination of preoperative CT findings and postoperative serum CEA levels improves recurrence prediction for stage I lung adenocarcinoma.

    Science.gov (United States)

    Yamazaki, Motohiko; Ishikawa, Hiroyuki; Kunii, Ryosuke; Tasaki, Akiko; Sato, Suguru; Ikeda, Yohei; Yoshimura, Norihiko; Hashimoto, Takehisa; Tsuchida, Masanori; Aoyama, Hidefumi

    2015-01-01

    To assess the prognostic value of combined evaluation of preoperative CT findings and pre/postoperative serum carcinoembryonic antigen (CEA) levels for pathological stage I lung adenocarcinoma. This retrospective study included 250 consecutive patients who underwent complete resection for ≤ 3-cm pathological stage I (T1-2aN0M0) adenocarcinomas (132 men, 118 women; mean age, 67.8 years). Radiologists evaluated following CT findings: maximum tumor diameter, percentage of solid component (%solid), air bronchogram, spiculation, adjacency of bullae or interstitial pneumonia (IP) around the tumor, notch, and pleural indent. These CT findings, pre/postoperative CEA levels, age, gender, and Brinkman index were assessed by Cox proportional hazards model to determine the best prognostic model. Prognostic accuracy was examined using the area under the receiver operating characteristic curve (AUC). Median follow-up period was 73.2 months. In multivariate analysis, high %solid, adjacency of bullae or IP around the tumor, and high postoperative CEA levels comprised the best combination for predicting recurrence (Psensitivity of 85.7% and a specificity of 74.3% at the optimal threshold. The best cut-off values of %solid and postoperative CEA levels for predicting high-risk patients were ≥ 48% and ≥ 3.7 ng/mL, respectively. Compared to %solid alone, combined evaluation of %solid, adjacency of bullae or IP change around the tumor, and postoperative CEA levels improves recurrence prediction for stage I lung adenocarcinoma. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Computer-assisted preoperative planning for reduction of proximal femoral fracture using 3-D-CT data.

    Science.gov (United States)

    Okada, Toshiyuki; Iwasaki, Yuta; Koyama, Tsuyoshi; Sugano, Nobuhiko; Chen, Yen-Wei; Yonenobu, Kazuo; Sato, Yoshinobu

    2009-03-01

    This paper describes procedures for repositioning calculations of fractured bone fragments using 3-D-computed tomography (CT), aimed at preoperative planning for computer-guided fracture reduction of the proximal femur. Fracture boundaries of the bone fragments, as "fracture lines (FLs)," and the mirror-transformed contralateral femur shape extracted from 3-D-CT were used for repositioning of the fragments. We first describe a method for extracting FLs based on 3-D curvature analysis and then formulate repositioning methods based on registration of bone fragments using the following three constraints: 1) contralateral (CL) femur shape; 2) FLs; and 3) both CL femur shape and fracture lines, as "both constraints". We performed experiments using CT datasets from five simulated and four real patients with proximal femoral fracture. We evaluated the rotation error in reposition calculations and the contact ratio between repositioned fragment boundaries, which are crucial for the recovery of proper functional axes and bone adhesion of fragments, respectively. Experimental results showed that good accuracy and stability were attainable when registration using both constraints was performed after registration using the fracture-line constraint. On average, 6.0 degrees +/-0.8 degrees in rotation error and 89%+/-3 % in contact ratio were obtained without providing precise initial values.

  7. Multi-slice CT angiography by triple-phase enhancement in preoperative evaluation of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    XIAO Xi-gang; HAN Xue; SHAN Wei-dong; LI An-yuan

    2005-01-01

    Background Triple-phase enhancement of multi-slice computed tomography (MSCT) has markedly improved the diagnostic accuracy of hepatocellular carcinoma (HCC), and MSCT angiography (MSCTA) has been proved useful in detecting vascular anatomy noninvasively. This study aimed to explore the value of MSCTA by triple-phase enhancement in preoperative evaluation of HCC.Methods Fifty-six consecutive cases of primary HCC scheduled for resection were studied with MSCTA by triple-phase enhancement. The raw data images were processed on a workstation for multiplanar reconstruction (MPR) and three-dimensional (3D) reconstruction. The findings after processing of the data were compared with those after surgery or intraoperative sonography. Results The false positive rate of MSCTA by triple-phase enhancement was 10.1% and its false negative rate was 4.3% in detecting HCC. No significant difference was observed in MSCTA and surgery or intraoperative sonography in detecting vascular anatomy anomalies and pathologic variations, whereas significant difference was found in detecting bile duct invasion with MSCT compared to intraoperative sonography.Conclusions MSCTA by triple-phase enhancement not only improves the detection of HCC, but also provides valuable preoperative information about hepatic vascular architecture and parenchyma. MSCTA by triple-phase enhancement is worthy of application as a non-invasive method in preoperative evaluation of HCC.

  8. Preoperative determination of prostate cancer tumor volume: analysis through biopsy fragments

    Directory of Open Access Journals (Sweden)

    Alberto A. Antunes

    2007-08-01

    Full Text Available OBJECTIVE: Preoperative determination of prostate cancer (PCa tumor volume (TV is still a big challenge. We have assessed variables obtained in prostatic biopsy aiming at determining which is the best method to predict the TV in radical prostatectomy (RP specimens. MATERIALS AND METHODS: Biopsy findings of 162 men with PCa submitted to radical prostatectomy were revised. Preoperative characteristics, such as PSA, the percentage of positive fragments (PPF, the total percentage of cancer in the biopsy (TPC, the maximum percentage of cancer in a fragment (MPC, the presence of perineural invasion (PNI and the Gleason score were correlated with postoperative surgical findings through an univariate analysis of a linear regression model. RESULTS: The TV correlated significantly to the PPF, TPC, MPC, PSA and to the presence of PNI (p < 0.001. However, the Pearson correlation analysis test showed an R2 of only 24%, 12%, 17% and 9% for the PPF, TPC, MPC, and PSA respectively. The combination of the PPF with the PSA and the PNI analysis showed to be a better model to predict the TV (R2 of 32.3%. The TV could be determined through the formula: Volume = 1.108 + 0.203 x PSA + 0.066 x PPF + 2.193 x PNI. CONCLUSIONS: The PPF seems to be better than the TPC and the MPC to predict the TV in the surgical specimen. Due to the weak correlation between those variables and the TV, the PSA and the presence of PNI should be used together.

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

    DEFF Research Database (Denmark)

    Nørgaard, Anne; Dam, Claus; Jakobsen, Anders

    2014-01-01

    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...

  10. Preoperative multidetector CT manifestations of perigastric lymph nodes in patients with early gastric cancer and pN0

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jung Hyun; Yu, Jeong Sik; Chung, Jae Joon; Lim, Joo Hee; Cho, Eun Suk; Kim, Ki Whang [Dept. of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2013-11-15

    To find the determinant of lymph node (LN) manifestations on preoperative multidetector CT (MDCT) in early gastric cancer (EGC) patients with pN0. One hundred and eighty-six consecutive patients with pT1pN0, the largest perigastric LN on preoperative MDCT, were categorized into two groups according to 8 different parameters [short (SD) and long diameter (LD) 4/6/8 mm, average attenuation 100 Hounsfield unit, short-to-long diameter-ratio (SLR) 0.7], and correlated with the size, gross type, depth of invasion and microscopic type of their primary lesions by the chi-square test and multiple logistic regression analysis. When the primary lesion was larger than 3 cm, the LNs were larger in 4 parameters (SD or LD, 4/6 mm; p < 0.05); gross type IIb patients showed smaller LNs in 5 parameters (SD 4/6 mm, LD 4/6/8 mm; p < 0.05); and patients with microscopically-undifferentiated lesions showed larger LNs in SD 4 mm or LD 8 mm by the chi-square test and multiple logistic regression analysis. The depth of invasion showed no significant difference in LN size. No factors revealed significant difference in LN attenuation or SLR. Benign regional LN enlargement is more frequent in EGC patients with larger size primary lesions or lesion with poor microscopic differentiation. However, this condition is less frequent in gross type IIb patients.

  11. Dedicated breast CT: Fibroglandular volume measurements in a diagnostic population

    Energy Technology Data Exchange (ETDEWEB)

    Vedantham, Srinivasan; Shi Linxi; Karellas, Andrew; O' Connell, Avice M. [Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts 01655 (United States); Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York 14642 (United States)

    2012-12-15

    Purpose: To determine the mean and range of volumetric glandular fraction (VGF) of the breast in a diagnostic population using a high-resolution flat-panel cone-beam dedicated breast CT system. This information is important for Monte Carlo-based estimation of normalized glandular dose coefficients and for investigating the dependence of VGF on breast dimensions, race, and pathology. Methods: Image data from a clinical trial investigating the role of dedicated breast CT that enrolled 150 women were retrospectively analyzed to determine the VGF. The study was conducted in adherence to a protocol approved by the institutional human subjects review boards and written informed consent was obtained from all study participants. All participants in the study were assigned BI-RADS{sup Registered-Sign} 4 or 5 as per the American College of Radiology assessment categories after standard diagnostic work-up and underwent dedicated breast CT exam prior to biopsy. A Gaussian-kernel based fuzzy c-means algorithm was used to partition the breast CT images into adipose and fibroglandular tissue after segmenting the skin. Upon determination of the accuracy of the algorithm with a phantom, it was applied to 137 breast CT volumes from 136 women. VGF was determined for each breast and the mean and range were determined. Pathology results with classification as benign, malignant, and hyperplasia were available for 132 women, and were used to investigate if the distributions of VGF varied with pathology. Results: The algorithm was accurate to within {+-}1.9% in determining the volume of an irregular shaped phantom. The study mean ({+-} inter-breast SD) for the VGF was 0.172 {+-} 0.142 (range: 0.012-0.719). VGF was found to be negatively correlated with age, breast dimensions (chest-wall to nipple length, pectoralis to nipple length, and effective diameter at chest-wall), and total breast volume, and positively correlated with fibroglandular volume. Based on pathology, pairwise statistical

  12. The value of MRI and CT in the pre-operative diagnosis of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Hirabayashi, Shigeru; Kumano, Kiyoshi; Takahashi, Soichiro; Ishii, Jun (Kanto Rosai Hospital, Kawasaki, Kanagawa (Japan))

    1991-05-01

    A prospective analysis of computed tomography (CT) and magnetic resonance imaging (MRI) scans in 51 patients with lumbar disc herniation was made to determine the height of hernia for operation and, if impossible, the indications of myelography. Among the 51 patients, 40 (78%) received surgery based on these imaging modalities (Group A); and the remaining 11 (22%) underwent myelography for the confirmation of the height of hernia or detailed examination (Group B). Satisfactory or excellent surgical outcome was achieved in 95% in Group A and in 91% in Group B. Twenty seven patients had multiple disc herniation on CT and MRI; in 17 patients surgery was performed for one disc hernia that was radiologically found to compress the spinal nerve root; and in the other 10 hernia-related disc was not determined by either radiological or neurological manifestations. Satisfactory or excellent surgical outcome could, however, be achieved in 26 patients (96%). Myelography should be indicated when there is no neurological radicular sign in the lower extremities, and when there is no radiological evidence of the compressed spinal nerve root in spite of the presence of multiple disc herniation. The height of hernia may be determined when compression of the spinal nerve root is visualized on CT or MRI. (N.K.).

  13. Cost-effectiveness of preoperative SPECT/CT combined with lymphoscintigraphy vs. lymphoscintigraphy for sentinel lymph node excision in patients with cutaneous malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Stoffels, Ingo; Leyh, Julia; Schadendorf, Dirk; Klode, Joachim [University of Duisburg-Essen, Department of Dermatology, Venerology and Allergology, University-Hospital Essen, Essen (Germany); Mueller, Markus [University of Duisburg-Essen, Department of Medical controlling, University-Hospital Essen, Essen (Germany); Geisel, Marie Henrike [University of Duisburg-Essen, Institute for Medical Informatics, Biometry and Epidemiology, University-Hospital Essen, Essen (Germany); Poeppel, Thorsten [University of Duisburg-Essen, Department of Nuclear Medicine, University-Hospital Essen, Essen (Germany)

    2014-09-15

    Malignant melanoma has become a major growing interdisciplinary problem in public health worldwide. Sentinel lymph node excision (SLNE) in conjunction with preoperative SPECT/CT is considered the most sensitive and specific staging test for the detection of micrometastatic melanoma in regional lymph nodes. Among patients with clinically lymph node-negative melanoma, the use of SPECT/CT-aided SLNE compared with SLNE alone has been found to be associated with a higher frequency of metastatic involvement and a higher rate of disease-free survival. The aim of this study was to analyse the cost-effectiveness of SLNE with preoperative SPECT/CT for detecting sentinel lymph nodes versus that of standard SLNE with preoperative lymphoscintigraphy from a single-institution database. Cost-effectiveness analysis of two surgical approaches for SLNE for malignant melanoma at the University Hospital Essen, Skin Cancer Center in Essen, Germany. Between March 2003 and April 2011 464 patients eligible for SLNE were identified. Of these patients, 403 with clinically negative lymph nodes who underwent SLNE with or without preoperative SPECT/CT qualified for subsequent analysis. Between March 2003 and October 2008, 254 patients were operated upon with the standard technique. From November 2008, 149 patients underwent the SPECT/CT technique. Cost analysis showed a mean cost saving of EUR 710.50 when SPECT/CT was added to preoperative imaging. This was achieved by a reduction in operative time (median, Q1;Q3, 40 min, 40;50 min, vs. 45 min, 35;60 min; p = 0.002), hospital stay duration (5 days, 3;8 days, vs. 8 days, 4.5;14.5 days; p < 0.001) and more frequent use of local anaesthesia (90.6 % vs. 70.5 %; p < 0.001). The median cost of SLNE using SPECT/CT was EUR 1,619.7 (Q1;Q3 EUR 1,317.0;2,603.4) and of SLNE without SPECT/CT was EUR 2,330.2 (EUR 1,468.3;4,058.1; p < 0.001), a cost saving of 30.5 %. In patients with cutaneous melanoma, the use of preoperative SPECT/CT-aided SLNE compared

  14. Preoperative evaluation of the artery of adamkiewicz by MR angiography and CT angiography in patients with a thoracic aortic aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Niinuma, Hiroyuki; Ohira, Atsushi; Makita, Shinji; Moriai, Yoshiteru; Hiramori, Katsuhiko [Iwate Medical Univ., Morioka (Japan). School of Medicine; Yoshioka, Kunihiro; Nakajima, Takayuki; Kawazoe, Kohei [Iwate Medical Univ., Morioka (Japan). Memorial Heart Center

    2002-08-01

    Paraplegia is known as an extremely serious and important complication of surgical repair in patients with a thoraco-abdominal aortic aneurysm. It is important to evaluate the artery of Adamkiewicz (AdA) before surgical repair to prevent paraplegia. But the AdA is difficult to visualize by the invasive and hazardous, conventional selective angiography. The aim of this study was to visualize AdA by MR angiography (MRA) and CT angiography (CTA). Twenty-one consecutive patients with a thoracic aortic aneurysm underwent both gadolinium-enhanced, three-dimensional MRA and CTA using multislice helical CT. The AdA was successfully visualized in 15 of the 21 patients (71.4%) by MRA, and in 17 of those 21 patients (80.9%) by CTA. Its continuity was depicted in 12 of 15 patients (80%) by MRA, and in 9 of 17 patients (47%) by CTA. AdA was visualized at 85.7% by MRA or CTA, respectively. This study shows that CTA is a much more sensitive method to detect AdA than MRA. On the other hand, MRA is better to evaluate the continuity of AdA from the descending aorta to the anterior spinal artery, than CTA. Therefore, MRA and CTA are both useful for a preoperative evaluation of AdA and its detailed vascular anatomy from the aorta to the anterior spinal artery. (author)

  15. PET/CT and Histopathologic Response to Preoperative Chemoradiation Therapy in Locally Advanced Rectal Cancer

    DEFF Research Database (Denmark)

    Kristiansen, Charlotte; Loft, Annika; Berthelsen, Anne K

    2008-01-01

    PURPOSE: The objective of this study was to investigate the possibility of using positron emission tomography/computer tomography to predict the histopathologic response in locally advanced rectal cancer treated with preoperative chemoradiation. METHODS: The study included 30 patients with locally...... advanced rectal adenocarcinoma treated with a combination of radiotherapy and concurrent Uftoral(R) (uracil, tegafur) and leucovorine. All patients were evaluated by positron emission tomography/computer tomography scan seven weeks after end of chemoradiation, and the results were compared...... of chemoradiation is not able to predict the histopathologic response in locally advanced rectal cancer. There is an obvious need for other complementary methods especially with respect to the low sensitivity of positron emission tomography/computer tomography....

  16. Prediction of nodal involvement in primary rectal carcinoma without invasion to pelvic structures: accuracy of preoperative CT, MR, and DWIBS assessments relative to histopathologic findings.

    Directory of Open Access Journals (Sweden)

    Jun Zhou

    Full Text Available OBJECTIVE: To investigate the accuracy of preoperative computed tomography (CT, magnetic resonance (MR imaging and diffusion-weighted imaging with background body signal suppression (DWIBS in the prediction of nodal involvement in primary rectal carcinoma patients in the absence of tumor invasion into pelvic structures. METHODS AND MATERIALS: Fifty-two subjects with primary rectal cancer were preoperatively assessed by CT and MRI at 1.5 T with a phased-array coil. Preoperative lymph node staging with imaging modalities (CT, MRI, and DWIBS were compared with the final histological findings. RESULTS: The accuracy of CT, MRI, and DWIBS were 57.7%, 63.5%, and 40.4%. The accuracy of DWIBS with higher sensitivity and negative predictive value for evaluating primary rectal cancer patients was lower than that of CT and MRI. Nodal staging agreement between imaging and pathology was fairly strong for CT and MRI (Kappa value = 0.331 and 0.348, P<0.01 but was relatively weaker for DWIBS (Kappa value = 0.174, P<0.05. The accuracy was 57.7% and 59.6%, respectively, for CT and MRI when the lymph node border information was used as the criteria, and was 57.7% and 61.5%, respectively, for enhanced CT and MRI when the lymph node enhancement pattern was used as the criteria. CONCLUSION: MRI is more accurate than CT in predicting nodal involvement in primary rectal carcinoma patients in the absence of tumor invasion into pelvic structures. DWIBS has a great diagnostic value in differentiating small malignant from benign lymph nodes.

  17. A combination of preoperative CT findings and postoperative serum CEA levels improves recurrence prediction for stage I lung adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Motohiko, E-mail: xackey2001@gmail.com [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Ishikawa, Hiroyuki [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Kunii, Ryosuke [Division of Cellular and Molecular Pathology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Tasaki, Akiko; Sato, Suguru; Ikeda, Yohei; Yoshimura, Norihiko [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Hashimoto, Takehisa; Tsuchida, Masanori [Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences (Japan); Aoyama, Hidefumi [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan)

    2015-01-15

    Objectives: To assess the prognostic value of combined evaluation of preoperative CT findings and pre/postoperative serum carcinoembryonic antigen (CEA) levels for pathological stage I lung adenocarcinoma. Methods: This retrospective study included 250 consecutive patients who underwent complete resection for ≤3-cm pathological stage I (T1–2aN0M0) adenocarcinomas (132 men, 118 women; mean age, 67.8 years). Radiologists evaluated following CT findings: maximum tumor diameter, percentage of solid component (%solid), air bronchogram, spiculation, adjacency of bullae or interstitial pneumonia (IP) around the tumor, notch, and pleural indent. These CT findings, pre/postoperative CEA levels, age, gender, and Brinkman index were assessed by Cox proportional hazards model to determine the best prognostic model. Prognostic accuracy was examined using the area under the receiver operating characteristic curve (AUC). Results: Median follow-up period was 73.2 months. In multivariate analysis, high %solid, adjacency of bullae or IP around the tumor, and high postoperative CEA levels comprised the best combination for predicting recurrence (P < 0.05). A combination of these three findings had a greater accuracy in predicting 5-year disease-free survival than did %solid alone (AUC = 0.853 versus 0.792; P = 0.023), with a sensitivity of 85.7% and a specificity of 74.3% at the optimal threshold. The best cut-off values of %solid and postoperative CEA levels for predicting high-risk patients were ≥48% and ≥3.7 ng/mL, respectively. Conclusion: Compared to %solid alone, combined evaluation of %solid, adjacency of bullae or IP change around the tumor, and postoperative CEA levels improves recurrence prediction for stage I lung adenocarcinoma.

  18. Feasibility of contrast material volume reduction in coronary artery imaging using 320-slice volume CT

    Energy Technology Data Exchange (ETDEWEB)

    Hein, Patrick A.; May, Juliane; Rogalla, Patrik; Hamm, Bernd; Lembcke, Alexander [Charite-University Hospital, Department of Radiology, Berlin (Germany); Butler, Craig [Charite-University Hospital, Department of Radiology, Berlin (Germany); University of Alberta, Department of Cardiology, Edmonton, Alberta (Canada)

    2010-06-15

    To assess reduced volumes of contrast agent on image quality for coronary computed tomography angiography (CCTA) by using single-beat cardiac imaging with 320-slice CT. Forty consecutive male patients (mean age: 55.8 years) undergoing CCTA with body weight {<=}85 kg, heart rate {<=}65 bpm, and ejection fraction {>=}55% were included. Image acquisition protocol was standardized (120 kV, 400 mA, and prospective ECG-triggered single-beat nonspiral CCTA). Patients were randomly assigned to one of four groups (G1: received 40 ml, G2: 50 ml, G3: 60 ml, G4: 70 ml). Groups were compared with respect to aortic attenuation, image noise, and image quality. CT values (mean {+-} standard deviation) in the aortic root were measured as 423 {+-} 38 HU in G1, and 471 {+-} 68, 463 {+-} 60, and 476 {+-} 78 HU in G2-4, respectively. There were no statistically significant differences in attenuation among the groups (P > 0.068). All 40 CT datasets were rated diagnostic, and image noise and image quality were not statistically different among groups. Using 320-slice volume CT, diagnostic image quality can be achieved with 40 ml of contrast material in CCTA in patients with normal body weight, cardiac function, and low heart rate. (orig.)

  19. Accuracy of single phase contrast enhanced multidetector CT colonography in the preoperative staging of colo-rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mainenti, Pier Paolo [IBB CNR, Via Pansini 5, 80131 Naples (Italy) and Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy)]. E-mail: pierpamainenti@hotmail.com; Cirillo, Luigi Carlo [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Hospital ' dei Pellegrini' , ASLNA 1, Via Portamedina 41, 80100 Naples (Italy); Camera, Luigi [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Persico, Francesco [Department of General Surgery, Geriatry and Endoscopy, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Cantalupo, Teresa [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Pace, Leonardo [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Palma, Giovanni Domenico De [Department of General Surgery, Geriatry and Endoscopy, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Persico, Giovanni [Department of General Surgery, Geriatry and Endoscopy, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy); Salvatore, Marco [Department of Biomorphological and Functional Sciences, University of Naples ' Federico II' , Via Pansini 5, 80131 Naples (Italy)

    2006-12-15

    Aim: The optimal acquisition time for staging colo-rectal carcinoma with a contrast enhanced multidetector CT colonography (CE CTC) has not yet been established. A dual phase with both arterial and portal venous acquisition has been proposed. The purpose of our study is to assess the value of single portal venous phase CE CTC in the preoperative staging of colo-rectal carcinoma. Materials and methods: Fifty two (30 M, 22 F; aged 35-82 years) consecutive patients with a histologically proven diagnosis of colo-rectal adenocarcinoma or a highly suspected colo-rectal cancer on conventional colonoscopy underwent a four-slice CE CTC. The procedure was performed 70 s (portal phase) after the intravenous bolus (3 ml/s) administration of 120 ml iodinated non-ionic contrast agent (370 mg iodine/ml). Scans were performed using the following parameters: 2.5 mm beam collimation, pitch 1.25, 120 kV, 200 mAs, rotation time 0.75 s. Images were reconstructed with an effective thickness of 3.2 mm at intervals of 1.6 mm. Two radiologists independently evaluated the depth of tumour invasion into the colo-rectal wall (T), regional lymph node involvement (N), and extracolonic metastases (M). Disagreement was resolved by means of a consensus decision. The pathological results served as the standard of reference. Assessment was made of sensitivity, specificity and accuracy, as well as positive and negative predictive values were assessed. Results: CE CTC correctly staged the pT of 52/56 (93%) and the N of 40/56 (71%) lesions, as well as properly identifying 13/14 (93%) extracolonic findings. Conclusion: The single portal venous phase CE CTC scanning protocol enables satisfactory preoperative assessment of T, N and M staging in patients with colo-rectal cancer.

  20. Correlation between abdominal perforator vessels identified with preoperative CT angiography and intraoperative fluorescent angiography in the microsurgical breast reconstruction patient.

    Science.gov (United States)

    Pestana, Ivo A; Zenn, Michael R

    2014-01-01

    CT angiography (CTA) has become a reliable method of perforator vessel identification. Indocyanine green fluorescent angiography (ICGLA) produces a real-time image of large- and small-caliber blood vessels. The aim of this prospective study was to compare ICGLA with CTA to evaluate its reliability of vessel identification and correlation to perforator vessel size and number determined preoperatively by CTA. The effect of both imaging techniques on flap design or intraoperative plan was also evaluated. Over a 1-year period, patients presenting for free-tissue transfer breast reconstruction underwent preoperative CTA mapping of abdominal perforators followed by intraoperative ICGLA. Using visualization software, scaling factors were calculated so CTA and ICGLA data could be compared. Eighteen patients (24 breast reconstructions) were included. Larger CTA perforator size was associated with larger actual size (P = 0.04). The largest CTA perforator or largest actual perforator was used 78% of the time. Increasing body mass index was not associated with larger CTA perforator size (P = 0.67) or more intense ICGLA blushes (P = 0.13). No significant correlation was found between CTA perforator location and ICGLA skin blush location, size, or intensity. CTA or SPY guided intraoperative procedure adjustments in 72% of patients. ICGLA identified poor soft-tissue perfusion and guided flap resection in 46% of patients. ICGLA skin blush location, size, and intensity do not correlate with CTA-identified perforating vessel location or actual perforating vessel size. Despite this, the ICGLA information was useful for evaluation of soft-tissue perfusion and flap design.

  1. Comparison of low-dose sequences of dual-source CT and echocardiography for preoperative evaluation of aortic valve disease

    Institute of Scientific and Technical Information of China (English)

    FENG Juan; WANG Xi-ming; JI Xiao-peng; LI Hai-ou; LI Qiao; GUO Wen-bin; WANG Zheng-jun

    2013-01-01

    Background Accurate evaluation of coronary artery,aortic valve annulus diameter (AVAD),and cardiac function in patients with aortic valve disease is of great significance for surgical strategy.In this study,we explored the preoperative evaluation of low-dose sequence (MinDose sequence) scan of dual-source CT (DSCT) for those patients.Methods Forty patients suspected for aortic valve disease (the experimental group) underwent MinDose sequence of DSCT to observe coronary artery,AVAD,and left ventricular ejection fraction (LVEF).Another 33 subjects suspected for coronary artery disease (the control group) underwent conventional retrospective electrocardiographically-gated sequence of DSCT.Two-dimensional transthoracic echocardiography (2D-TTE) and four-dimensional transthoracic echocardiography (4D-TTE) were applied in the experimental group to measure AVAD and LVEF and compared with MinDose-DSCT.Results There was a strong correlation between LVEFs measured by 2D-TTE and MinDose-DSCT (r=0.87,P <0.01),as well as between 4D-TTE and MinDose-DSCT (r=0.90,P <0.01).AVAD measured by MinDose-DSCT was in good agreement with corresponding measurements by 2D-TTE (r=0.90,P <0.01).The effective dose in the experimental group was 63.54% lower than that in the control group.Conclusions MinDose sequence of DSCT with a low radiation dose serving as a one-stop preoperative evaluation makes effective assessment of the coronary artery,AVAD,and LVEF for patients with aortic valve disease.

  2. Detection of Preoperative Wilms Tumor Rupture with CT: A Report from the Children’s Oncology Group

    Science.gov (United States)

    Naranjo, Arlene; Hoffer, Fredric; Mullen, Elizabeth; Geller, James; Gratias, Eric J.; Ehrlich, Peter F.; Perlman, Elizabeth J.; Rosen, Nancy; Grundy, Paul; Dome, Jeffrey S.

    2013-01-01

    Purpose: To retrospectively determine the diagnostic performance of computed tomography (CT) in identifying the presence or absence of preoperative Wilms tumor rupture. Materials and Methods: The cohort was derived from the AREN03B2 study of the Children’s Oncology Group. The study was approved by the institutional review board and was compliant with HIPAA. Written informed consent was obtained before enrollment. The diagnosis of Wilms tumor rupture was established by central review of notes from surgery and/or pathologic examination. Seventy Wilms tumor cases with rupture were matched to 70 Wilms tumor controls without rupture according to age and tumor weight (within 6 months and 50 g, respectively). CT scans were independently reviewed by two radiologists, and the following CT findings were assessed: poorly circumscribed mass, perinephric fat stranding, peritumoral fat planes obscured, retroperitoneal fluid (subcapsular vs extracapsular), ascites beyond the cul-de-sac, peritoneal implants, ipsilateral pleural effusion, and intratumoral hemorrhage. All fluids were classified as hemorrhagic or nonhemorrhagic by using a cutoff of 30 HU. The relationship between CT findings and rupture was assessed with logistic regression models. Results: The sensitivity and specificity for detecting Wilms tumor rupture were 54% (36 of 67 cases) and 88% (61 of 69 cases), respectively, for reviewer 1 and 70% (47 of 67 cases) and 88% (61 of 69 cases), respectively, for reviewer 2. Interobserver agreement was substantial (ĸ = 0.76). All imaging signs tested, except peritoneal implants, intratumoral hemorrhage, and subcapsular fluid, showed a significant association with rupture (P ≤ .02). The attenuation of ascitic fluid did not have a significant correlation with rupture (P = .9990). Ascites beyond the cul-de-sac was the single best indicator of rupture for both reviewers, followed by perinephric fat stranding and retroperitoneal fluid for reviewers 1 and 2, respectively (P cul

  3. Artifacts in conventional computed tomography (CT) and free breathing four-dimensional CT induce uncertainty in gross tumor volume determination

    DEFF Research Database (Denmark)

    Persson, Gitte Fredberg; Nygaard, Ditte Eklund; Af Rosenschöld, Per Munck;

    2011-01-01

    PURPOSE: Artifacts impacting the imaged tumor volume can be seen in conventional three-dimensional CT (3DCT) scans for planning of lung cancer radiotherapy but can be reduced with the use of respiration-correlated imaging, i.e., 4DCT or breathhold CT (BHCT) scans. The aim of this study...... was to compare delineated gross tumor volume (GTV) sizes in 3DCT, 4DCT, and BHCT scans of patients with lung tumors. METHODS AND MATERIALS: A total of 36 patients with 46 tumors referred for stereotactic radiotherapy of lung tumors were included. All patients underwent positron emission tomography (PET)/CT, 4DCT......, and BHCT scans. GTVs in all CT scans of individual patients were delineated during one session by a single physician to minimize systematic delineation uncertainty. The GTV size from the BHCT was considered the closest to true tumor volume and was chosen as the reference. The reference GTV size...

  4. Preoperative planning for endovascular aortic repair of abdominal aortic aneurysms: feasibility of nonenhanced MR angiography versus contrast-enhanced CT angiography.

    Science.gov (United States)

    Goshima, Satoshi; Kanematsu, Masayuki; Kondo, Hiroshi; Kawada, Hiroshi; Kojima, Toshihisa; Sakurai, Kota; Watanabe, Haruo; Shimabukuro, Katsuya; Matsuno, Yukihiro; Ishida, Narihiro; Takemura, Hirofumi; Bae, Kyongtae T

    2013-06-01

    To compare vascular measurements to determine stent types and configurations for abdominal endovascular aneurysm repair (EVAR) by comparing results of contrast material-enhanced computed tomographic (CT) angiography and nonenhanced magnetic resonance (MR) angiography. This prospective study was institutional review board approved, and all patients provided written informed consent. Fifty patients (45 men and five women; mean age, 76.0 years) admitted for elective abdominal EVAR underwent preoperative abdominal CT angiography (triplanar reformatted images; section thickness of 1-3 mm) and nonenhanced MR angiography (triplanar two-dimensional single-shot turbo field-echo images; section thickness of 6 mm). Two observers independently completed standard measurement and device selection forms for endovascular stent planning for CT and MR angiography. Pearson and intraclass correlation coefficients were calculated to evaluate intermodality and interobserver differences. No significant difference was found in aortic neck diameter (observer 1: CT, 18.5 mm; MR, 19.0 mm; P = .43) (observer 2: CT, 19.6 mm; MR, 19.3 mm; P = .59), aortic neck diameter 15 mm distal to the lowest renal artery (observer 1: CT, 19.2 mm; MR, 19.2 mm; P = .38) (observer 2: CT, 19.6 mm; MR, 19.6 mm; P = .91), aortic neck length (observer 1: CT, 43.6 mm; MR, 43.6 mm; P = .85) (observer 2: CT, 44.4 mm; MR, 44.0 mm; P = .93), or other key vascular measurements (P = .23-.99) for preoperative planning. These included aneurysm diameter, lowest renal artery to aortic bifurcation length, aortic bifurcation diameter, common iliac artery diameters, external iliac artery diameters, length between orifices of lower renal and internal iliac arteries, and iliac artery sealing length. CT and MR angiography measurements showed very strong correlation (r = 0.92-0.99). Intraclass correlation coefficients between observers ranged from 0.90 to 0.98. Stent types and configurations determined with CT measurements remained

  5. 'Orbital volume restoration rate after orbital fracture'; a CT-based orbital volume measurement for evaluation of orbital wall reconstructive effect.

    Science.gov (United States)

    Wi, J M; Sung, K H; Chi, M

    2017-01-13

    PurposeTo evaluate the effect of orbital reconstruction and factors related to the effect of orbital reconstruction by assessing of orbital volume using orbital computed tomography (CT) in cases of orbital wall fracture.MethodsIn this retrospective study, 68 patients with isolated blowout fractures were evaluated. The volumes of orbits and herniated orbital tissues were determined by CT scans using a three-dimensional reconstruction technique (the Eclipse Treatment Planning System). Orbital CT was performed preoperatively, immediately after surgery, and at final follow ups (minimum of 6 months). We evaluated the reconstructive effect of surgery making a new formula, 'orbital volume reconstruction rate' from orbital volume differences between fractured and contralateral orbits before surgery, immediately after surgery, and at final follow up.ResultsMean volume of fractured orbits before surgery was 23.01±2.60 cm(3) and that of contralateral orbits was 21.31±2.50 cm(3) (P=0.005). Mean volume of the fractured orbits immediately after surgery was 21.29±2.42 cm(3), and that of the contralateral orbits was 21.33±2.52 cm(3) (P=0.921). Mean volume of fractured orbits at final follow up was 21.50±2.44 cm(3), and that of contralateral orbits was 21.32±2.50 cm(3) (P=0.668). The mean orbital volume reconstruction rate was 100.47% immediately after surgery and 99.17% at final follow up. No significant difference in orbital volume reconstruction rate was observed with respect to fracture site or orbital implant type. Patients that underwent operation within 14 days of trauma had a better reconstruction rate at final follow up than patients who underwent operation over 14 days after trauma (P=0.039).ConclusionComputer-based measurements of orbital fracture volume can be used to evaluate the reconstructive effect of orbital implants and provide useful quantitative information. Significant reduction of orbital volume is observed immediately after orbital wall

  6. Quantitative estimation of a ratio of intracranial cerebrospinal fluid volume to brain volume based on segmentation of CT images in patients with extra-axial hematoma.

    Science.gov (United States)

    Nguyen, Ha Son; Patel, Mohit; Li, Luyuan; Kurpad, Shekar; Mueller, Wade

    2017-02-01

    Background Diminishing volume of intracranial cerebrospinal fluid (CSF) in patients with space-occupying masses have been attributed to unfavorable outcome associated with reduction of cerebral perfusion pressure and subsequent brain ischemia. Objective The objective of this article is to employ a ratio of CSF volume to brain volume for longitudinal assessment of space-volume relationships in patients with extra-axial hematoma and to determine variability of the ratio among patients with different types and stages of hematoma. Patients and methods In our retrospective study, we reviewed 113 patients with surgical extra-axial hematomas. We included 28 patients (age 61.7 +/- 17.7 years; 19 males, nine females) with an acute epidural hematoma (EDH) ( n = 5) and subacute/chronic subdural hematoma (SDH) ( n = 23). We excluded 85 patients, in order, due to acute SDH ( n = 76), concurrent intraparenchymal pathology ( n = 6), and bilateral pathology ( n = 3). Noncontrast CT images of the head were obtained using a CT scanner (2004 GE LightSpeed VCT CT system, tube voltage 140 kVp, tube current 310 mA, 5 mm section thickness) preoperatively, postoperatively (3.8 ± 5.8 hours from surgery), and at follow-up clinic visit (48.2 ± 27.7 days after surgery). Each CT scan was loaded into an OsiriX (Pixmeo, Switzerland) workstation to segment pixels based on radiodensity properties measured in Hounsfield units (HU). Based on HU values from -30 to 100, brain, CSF spaces, vascular structures, hematoma, and/or postsurgical fluid were segregated from bony structures, and subsequently hematoma and/or postsurgical fluid were manually selected and removed from the images. The remaining images represented overall brain volume-containing only CSF spaces, vascular structures, and brain parenchyma. Thereafter, the ratio between the total number of voxels representing CSF volume (based on values between 0 and 15 HU) to the total number of voxels

  7. Brain perfusion CT for acute stroke using a 256-slice CT: improvement of diagnostic information by large volume coverage

    Energy Technology Data Exchange (ETDEWEB)

    Dorn, F. [Technical University, Department of Radiology, Klinikum rechts der Isar, Munich (Germany); Institut fuer Radiologie, Klinikum rechts der Isar der Technischen Universitaet Muenchen, Muenchen (Germany); Muenzel, D.; Meier, R.; Rummeny, E.J.; Huber, A. [Technical University, Department of Radiology, Klinikum rechts der Isar, Munich (Germany); Poppert, H. [Technical University, Department of Neurology, Klinikum rechts der Isar, Munich (Germany)

    2011-09-15

    To compare a 256-slice CT with a simulated standard CT for brain CT perfusion (CTP). CTP was obtained in 51 patients using a 256-slice CT (128 detector rows, flying z-focus, 8-cm detector width, 80 kV, 120mAs, 20 measurements, 1 CT image/2.5 s). Signal-to-noise ratios (SNR) were compared in grey and white matter. Perfusion maps were evaluated for cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) in hypoperfused areas and corresponding contralateral regions. Two reconstructed 10-mm slices for simulation of a standard CT (SDCT) were compared with the complete data sets (large-volume CT, LVCT). Adequate image quality was achieved in 50/51 cases. SNR were significantly different in grey and white matter. A perfusion deficit was present in 27 data sets. Differences between the hypoperfusions and the control regions were significant for MTT and CBF, but not for CBV. Three lesions were missed by SDCT but detected by LVCT; 24 lesions were covered incompletely by SDCT, and 6 by LVCT. 21 lesions were detected completely by LVCT, but none by SDCT. CTP imaging of the brain using an increased detector width can detect additional ischaemic lesions and cover most ischaemic lesions completely. (orig.)

  8. The potential of positron emission tomography/computerized tomography (PET/CT) scanning as a detector of high-risk patients with oral infection during preoperative staging.

    Science.gov (United States)

    Yamashiro, Keisuke; Nakano, Makoto; Sawaki, Koichi; Okazaki, Fumihiko; Hirata, Yasuhisa; Takashiba, Shogo

    2016-08-01

    It is sometimes difficult to determine during the preoperative period whether patients have oral infections; these patients need treatment to prevent oral infection-related complications from arising during medical therapies, such as cancer therapy and surgery. One of the reasons for this difficulty is that basic medical tests do not identify oral infections, including periodontitis and periapical periodontitis. In this report, we investigated the potential of positron emission tomography/computerized tomography (PET/CT) as a diagnostic tool in these patients. We evaluated eight patients during the preoperative period. All patients underwent PET/CT scanning and were identified as having the signs of oral infection, as evidenced by (18)F-fludeoxyglucose (FDG) localization in the oral regions. Periodontal examination and orthopantomogram evaluation showed severe infection or bone resorption in the oral regions. (18)F-FDG was localized in oral lesions, such as severe periodontitis, apical periodontitis, and pericoronitis of the third molar. The densities of (18)F-FDG were proportional to the degree of inflammation. PET/CT is a potential diagnostic tool for oral infections. It may be particularly useful in patients during preoperative staging, as they frequently undergo scanning at this time, and those identified as having oral infections at this time require treatment before cancer therapy or surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. A bronchoscopic navigation system using bronchoscope center calibration for accurate registration of electromagnetic tracker and CT volume without markers

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Xiongbiao, E-mail: xiongbiao.luo@gmail.com [Robarts Research Institute, Western University, London, Ontario N6A 5K8 (Canada)

    2014-06-15

    Purpose: Various bronchoscopic navigation systems are developed for diagnosis, staging, and treatment of lung and bronchus cancers. To construct electromagnetically navigated bronchoscopy systems, registration of preoperative images and an electromagnetic tracker must be performed. This paper proposes a new marker-free registration method, which uses the centerlines of the bronchial tree and the center of a bronchoscope tip where an electromagnetic sensor is attached, to align preoperative images and electromagnetic tracker systems. Methods: The chest computed tomography (CT) volume (preoperative images) was segmented to extract the bronchial centerlines. An electromagnetic sensor was fixed at the bronchoscope tip surface. A model was designed and printed using a 3D printer to calibrate the relationship between the fixed sensor and the bronchoscope tip center. For each sensor measurement that includes sensor position and orientation information, its corresponding bronchoscope tip center position was calculated. By minimizing the distance between each bronchoscope tip center position and the bronchial centerlines, the spatial alignment of the electromagnetic tracker system and the CT volume was determined. After obtaining the spatial alignment, an electromagnetic navigation bronchoscopy system was established to real-timely track or locate a bronchoscope inside the bronchial tree during bronchoscopic examinations. Results: The electromagnetic navigation bronchoscopy system was validated on a dynamic bronchial phantom that can simulate respiratory motion with a breath rate range of 0–10 min{sup −1}. The fiducial and target registration errors of this navigation system were evaluated. The average fiducial registration error was reduced from 8.7 to 6.6 mm. The average target registration error, which indicates all tracked or navigated bronchoscope position accuracy, was much reduced from 6.8 to 4.5 mm compared to previous registration methods. Conclusions: An

  10. Comparison of pirenzepine, ranitidine, and pirenzepine-ranitidine combination for reducing preoperative gastric fluid acidity and volume in children.

    Science.gov (United States)

    Maekawa, N; Nishina, K; Mikawa, K; Shiga, M; Obara, H

    1998-01-01

    We conducted a two-part controlled study to evaluate the efficacy of preoperative oral pirenzepine (muscarinic receptor antagonist known to inhibit gastric secretion), ranitidine, and the combination pirenzepine-ranitidine in controlling gastric fluid pH and volume in 210 ASA I children, aged 2-14 yr, undergoing elective surgery. In the first part of the study (n = 90), the proportion of children considered at risk for aspiration pneumonitis was reduced with pirenzepine 25 mg (P pirenzepine 25 mg with placebo; ranitidine 75 mg with placebo; pirenzepine 25 mg with ranitidine 75 mg; and placebo and placebo. These medications were administered 1 h before anaesthesia. After tracheal intubation, volume and pH of the gastric fluid aspiration via a multiorifice orogastric tube were measured. Pirenzepine 25 mg decreased gastric fluid volume (P pirenzepine-ranitidine combination reduced gastric fluid acidity and volume (P < 0.05).

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

    DEFF Research Database (Denmark)

    Ding, Ming; Odgaard, A; Hvid, I

    1999-01-01

    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...

  12. Preoperative PET/CT standardized FDG uptake values of pelvic lymph nodes as a significant prognostic factor in patients with endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hyun Hoon; Kim, Hee Seung; Kim, Jae Weon; Park, Noh-Hyun [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, 101 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, 101 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Seoul National University, WCU Biomodulation Major, Department of Agricultural Biotechnology, College of Agriculture and Life Sciences, Seoul (Korea, Republic of)

    2014-09-15

    Using integrated PET/CT, we evaluated the prognostic relevance of preoperative pelvic lymph node (LN) {sup 18}F-FDG uptake in endometrioid endometrial cancer. We retrospectively reviewed patients with pathologically proven endometrial cancer who underwent preoperative {sup 18}F-FDG PET/CT scans to evaluate the prognostic significance of PET/CT parameters and other clinicopathological variables. We used Cox proportional hazards regression to examine the relationship between recurrence and the maximum standardized uptake value (SUV{sub max}) in pelvic LNs (SUV{sub LN}) on FDG PET/CT. Clinical data, treatment modalities and results were reviewed in 70 eligible patients. The median postsurgical follow-up was 29 months (range 6 to 95 months). Receiver-operating characteristic analysis identified the significant SUV{sub LN} cut-off value as 15. The SUV{sub LN} correlated with FIGO stage (P < 0.001), LN metastasis (P < 0.001), lymphovascular space invasion (P < 0.001), SUV{sub tumour} (P = 0.001), metastatic LN size (P = 0.004), primary tumour size (P = 0.012), tumour grade (P = 0.015) and depth of tumour invasion (P = 0.035). Regression analysis showed a statistically significant association between recurrence and SUV{sub LN} (P = 0.002). Recurrence differed significantly (P < 0.001) between patients with SUV{sub LN} >15 and those with SUV{sub LN} ≤15. Preoperative pelvic LN FDG uptake exhibited a strong significant association with recurrence of endometrioid endometrial cancer. (orig.)

  13. Focused parathyroidectomy without intraoperative parathormone testing is safe after pre-operative localization with (18)F-Fluorocholine PET/CT.

    Science.gov (United States)

    Hocevar, M; Lezaic, L; Rep, S; Zaletel, K; Kocjan, T; Sever, M J; Zgajnar, J; Peric, B

    2017-01-01

    A focused surgical approach based on pre-operative localization replaced the classical four-gland exploration in patients with primary hyperparathyroidism (PHP). Sestamibi scanning and ultrasound are most often used localization modalities with reported sensitivity of 54-100% for identification of single gland disease. The aim of this study was to analyze the results of pre-operative localization with (18)F-Fluorocholine PET/CT (FCh-PET) in patients with PHP. A retrospective review of 151 patients with PHP who underwent surgery after pre-operative localization with FCh-PET was performed. Only a focused parathyroidectomy without ioPTH testing had been done in patients with single adenoma on FCh-PET. Primary outcome was operative failure, defined as persistent PHP. According to pre-operative FCh-PET 126 (83,4%) patients had single adenoma, 22 (14,5%) multiglandular disease and the test was negative in only two patients. Intraoperative failure experienced 4/126 patients (3,3%) with single adenoma. Removed parathyroid glands were normal in three and hyperplastic in one patient with intraoperative failure. A limited bilateral neck exploration with ioPTH testing was used in 14/22 patients with double adenoma and a classical four-gland exploration without ioPTH testing was used in 8/22 patients with more than two pathological glands according to pre-operative FCh-PET. Intraoperative failure experienced 2/22 patients (9,1%). In two patients with negative FCh-PET a classical four-gland exploration without ioPTH testing was used and one experienced intraoperative failure. A preoperative localization with FCh-PET is a reliable test in patients with PHP. Patients with a single adenoma on FCh-PET can safely undergo a focused parathyroidectomy without ioPTH testing.

  14. Anatomical-based Partial Volume Correction for Low-dose Dedicated Cardiac SPECT/CT

    OpenAIRE

    Liu, Hui; Chan, Chung; Grobshtein, Yariv; Ma, Tianyu; Liu, Yaqiang; Wang, Shi; Stacy, Mitchel R.; Sinusas, Albert J.; Liu, Chi

    2015-01-01

    Due to the limited spatial resolution, partial volume effect (PVE) has been a major degrading factor on quantitative accuracy in emission tomography systems. This study aims to investigate the performance of several anatomical-based partial volume correction (PVC) methods for a dedicated cardiac SPECT/CT system (GE Discovery NM/CT 570c) with focused field-of-view (FOV) over a clinically relevant range of high and low count levels for two different radiotracer distributions. These PVC methods ...

  15. Quantification of respiratory depression during pre-operative administration of midazolam using a non-invasive respiratory volume monitor

    Science.gov (United States)

    Gonzalez Castro, Luis N.; Mehta, Jaideep H.; Brayanov, Jordan B.; Mullen, Gary J.

    2017-01-01

    Background Pre-operative administration of benzodiazepines can cause hypoventilation—a decrease in minute ventilation (MV)—commonly referred to as “respiratory compromise or respiratory depression.” Respiratory depression can lead to hypercarbia and / or hypoxemia, and may heighten the risk of other respiratory complications. Current anesthesia practice often places patients at risk for respiratory complications even before surgery, as respiratory monitoring is generally postponed until the patient is in the operating room. In the present study we examined and quantified the onset of respiratory depression following the administration of a single dose of midazolam in pre-operative patients, using a non-invasive respiratory volume monitor that reports MV, tidal volume (TV), and respiratory rate (RR). Methods Impedance-based Respiratory Volume Monitor (RVM) data were collected and analyzed from 30 patients prior to undergoing orthopedic or general surgical procedures. All patients received 2.0 mg of midazolam intravenously at least 20 minutes prior to the induction of anesthesia and the effects of midazolam on the patient's respiratory function were analyzed. Results Within 15 minutes of midazolam administration, we noted a significant decrease in both MV (average decrease of 14.3% ± 5.9%, pbenzodiazepines affect primarily TV rather than RR. Such respiratory monitoring data provide the opportunity for individualizing dosing and adjustment of clinical interventions, especially important in elderly patients. With additional respiratory data, clinicians may be able to better identify and quantify respiratory depression, reduce adverse effects, and improve overall patient safety. PMID:28235069

  16. CT false-profile view of the hip: a reproducible method of measuring anterior acetabular coverage using volume CT data

    Energy Technology Data Exchange (ETDEWEB)

    Needell, Steven D.; Borzykowski, Ross M. [Boca Radiology Group, Boca Raton, FL (United States); Carreira, Dominic S.; Kozy, John [Broward Health Orthopedics and Sports Medicine, Fort Lauderdale, FL (United States)

    2014-11-15

    To devise a simple, reproducible method of using CT data to measure anterior acetabular coverage that results in values analogous to metrics derived from false-profile radiographs. Volume CT images were used to generate simulated false-profile radiographs and cross-sectional false-profile views by angling a multiplanar reformat 115 through the affected acetabulum relative to a line tangential to the posterior margin of the ischial tuberosities. The anterolateral margin of the acetabulum was localized on the CT false-profile view corresponding with the cranial opening of the acetabular roof. Anterior center edge angle (CEA) was measured between a vertical line passing through the center of the femoral head and a line connecting the center of the femoral head with the anterior edge of the condensed line of the acetabulum (sourcil). Anterior CEA values measured on CT false-profile views of 38 symptomatic hips were compared with values obtained on simulated and projection false-profile radiographs. The CT false-profile view produces a cross-sectional image in the same obliquity as false-profile radiographs. Anterior CEA measured on CT false-profile views were statistically similar to values obtained with false-profile radiographs. CT technologists quickly mastered the technique of generating this view. Inter-rater reliability indicated this method to be highly reproducible. The CT false-profile view is simple to generate and anterior CEA measurements derived from it are similar to those obtained using well-positioned false-profile radiographs. Utilization of CT to assess hip geometry enables precise control of pelvic inclination, eliminates projectional errors, and minimizes limitations of image quality inherent to radiography. (orig.)

  17. Predictive Role of Functional Visceral Fat Activity Assessed by Preoperative F-18 FDG PET/CT for Regional Lymph Node or Distant Metastasis in Patients with Colorectal Cancer.

    Directory of Open Access Journals (Sweden)

    Kisoo Pahk

    Full Text Available To investigate the role of functional visceral fat activity assessed by preoperative F-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT in colorectal cancer (CRC for predicting regional lymph node (LN or distant metastasis.We evaluated 131 patients with newly diagnosed CRC. They all underwent pre-operative 18F-FDG PET/CT and surgery. Functional fat activity was measured by maximum standardized uptake value (SUVmax using 18F-FDG PET/CT. Functional visceral fat activity was measured by SUVmax of visceral fat/SUVmax of subcutaneous fat (V/S ratio. Mann-Whitney U test, χ2 test, Fisher's exact test, receiver-operating characteristic (ROC analysis, Spearrman's correlation coefficient, and uni- and multivariate logistic regression statistical analyses were done.Patients with higher V/S ratio displayed a significantly higher rate of regional LN (p = 0.004 and distant metastasis (p<0.001. In addition, V/S ratio was the only factor that was significantly associated with distant metastasis. An optimal cut-off V/S ratio of 1.88 was proposed for predicting distant metastasis with a sensitivity of 84.6% and specificity of 78.8% (area under the curve: 0.86; p<0.0001.Functional visceral fat activity is significantly associated with distant metastasis in CRC patients. Furthermore, V/S ratio can be useful as a complementary factor in predicting distant metastasis.

  18. Stroke risk after abrupt internal carotid artery sacrifice: Accuracy of preoperative assessment with balloon test occlusion and stable xenon-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Linskey, M.E.; Jungreis, C.A.; Yonas, H.; Hirsch, W.L. Jr.; Sekhar, L.N.; Horton, J.A.; Janosky, J.E. [Univ. of Pittsburgh School of Medicine, PA (United States)

    1994-05-01

    To evaluate stable xenon-enhanced CT cerebral blood flow with balloon test occlusion as a predictor of stroke risk in internal carotid artery sacrifice. Abrupt internal carotid artery occlusion was performed by surgical or endovascular means below the origin of the ophthalmic artery in 31 normotensive patients who were assessed preoperatively by a 15-minute clinical balloon test occlusion followed by an internal carotid artery-occluded xenon CT cerebral blood flow study. One patient, who passed the clinical test occlusion but exhibited regions of cerebral blood flow less than 30 mL/100 g per minute on the occlusion xenon CT cerebral blood flow study went on to have a fatal stroke corresponding exactly to the region of assessment. Neuroimaging demonstrated possible flow-related infarctions, which subsequently developed in three patients. Two patients were asymptomatic, and one patient was left with a mild residual hemiparesis. Our protocol provided a statistically significant reduction in subsequent infarction rate and infarction-related death rate when compared with a control group of normotensive abrupt internal carotid artery occlusion patients who did not undergo any preoperative stroke-risk assessment (reported in the literature). The estimated false-negative rate for our preoperative assessment protocol ranged from 3.3% to 10% depending on the assessment of the cause of the three potentially flow-related infarctions. Although life-threatening major vascular territory infarctions have been avoided, our protocol is less sensitive to changes predicting smaller, often minimally symptomatic, vascular border zone infarctions and does not predict postoperative thromboembolic strokes. 94 refs., 5 figs., 4 tabs.

  19. Linear and volume measurements of pulmonary nodules at different CT dose levels. Interscan and interscan analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hein, P.A.; Romano, V.C.; Rogalla, P.; Klessen, C.; Lembcke, A.; Bauknecht, H.C. [Charite-Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie; Dicken, V.; Bornemann, L. [MeVis Research, Bremen (Germany)

    2009-01-15

    Purpose: To compare the interobserver variability of the unidimensional diameter and volume measurements of pulmonary nodules in an intrascan and interscan analysis using semi-automated segmentation software on ultra-low-dose computed tomography (ULD-CT) and standard dose CT (SD-CT) data. Materials and Methods: In 33 patients with pulmonary nodules, two chest multi-slice CT (MSCT) datasets (1 mm slice thickness; 20 % reconstruction overlap) had been consecutively acquired with an ultra-low dose (120 kV, 5 mAs) and standard dose technique (120 kV, 75 mAs). MSCT data was retrospectively analyzed using the segmentation software OncoTREAT (MeVis, Bremen, Germany, version 1.3). The volume of 229 solid pulmonary nodules included in the analysis as well as the largest diameter according to RECIST (Response Evaluation Criteria for Solid Tumors) were measured by two radiologists. Interobserver variability was calculated and SD-CT and ULD-CT data compared in an intrascan and interscan analysis. Results: The median nodule diameter (n = 229 nodules) was registered with 8.2 mm (range: 2.8 to 43.6 mm, mean: 10.8 mm). The nodule volume ranged between 0.01 and 49.1 ml (median 0.1 ml, mean 1.5 ml). With respect to interobserver variability, the intrascan analysis did not reveal statistically significant differences (p > 0.05) between ULD-CT and SD-CT with broader limits of agreement for relative differences of RECIST measurements (-31.0 % + 27.0 % mean -2.0 % for SD-CT; -27.0 % + 38.6 %, mean 5.8 % for ULD-CT) than for volume measurements (-9.4 %, 8.0 %, mean 0.7 % for SD-CT; -13 %, 13 %, mean 0.0 % for ULD-CT). The interscan analysis showed broadened 95 % confidence intervals for volume measurements (-26.5 % 29.1 % mean 1.3 %, and -25.2 %, 29.6 %, mean 2.2 %) but yielded comparable limits of agreement for RECIST measurements. Conclusion: The variability of nodule volumetry assessed by semi-automated segmentation software as well as nodule size determination by RECIST appears to be

  20. Is [F-18]-fluorodeoxyglucose FDG-PET/CT better than CT alone for the preoperative lymph node staging of muscle invasive bladder cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Uttam, Mete; Pravin, Nayak; Anish, Bhattacharya; Nandita, Kakkar; Arup, Mandal, E-mail: uttam_mete@yahoo.com [PGIMER, Chandigarh, (India)

    2016-03-15

    Objective: To evaluate whether the use of [F-18]-FDG-PET/CT can accurately predict pelvic lymph node metastasis in patients with muscle invasive TCC of the bladder undergoing radical cystectomy. Materials and methods: Fifteen patients with muscle invasive bladder cancer had undergone FDG-PET/CT scan from the skull base to the mid-thighs after IV injection of 6.5MBq (Mega-Becquerel)/Kg of FDG. After intravenous hydration IV furosemide was given to overcome the difficulties posed by urinary excretion of {sup 18}F-FDG. PET/ CT data were analyzed as PET and CT images studied separately as well as fused PET/ CT images. The imaging findings were correlated with the histopathology of the nodes (gold standard). Results: CT and FDG-PET had demonstrated positive lymph nodes in 9 & 8 patients respectively. Among the 15 patients 3 had documented metastasis on histopathology. Both CT and PET could detect the nodes in all these 3 patients (100% sensitivity). Nodes were histologically negative amongst 6&5 patients who had node involvement by CT and PET respectively. Therefore, specificity, positive predictive value (PPV) & negative predictive value (NPV) for CT and PET/CT were 50%, 33.3%, 100% and 58.3%, 37.5%, 100% respectively. Conclusion: The theoretical advantage of this cutting edge technology for whole body imaging has not been translated into clinical practice as we found minimal advantage of combined FDG-PET/CT over CT alone for nodal staging of muscle invasive bladder cancer. This may be due to substantial overlap between standardized uptake values (SUVs) from active inflammatory processes with those of malignant lesion. (author)

  1. Feasibility of low contrast media volume in CT angiography of the aorta

    NARCIS (Netherlands)

    Seehofnerová, Anna; Kok, Madeleine; Mihl, Casper; Douwes, Dave; Sailer, Anni; Nijssen, Estelle; de Haan, Michiel J W; Wildberger, Joachim E; Das, Marco

    2015-01-01

    OBJECTIVES: Using smaller volumes of contrast media (CM) in CT angiography (CTA) is desirable in terms of cost reduction and prevention of contrast-induced nephropathy (CIN). The purpose was to evaluate the feasibility of low CM volume in CTA of the aorta. METHODS: 77 patients referred for CTA of th

  2. Pre-operative ⁶⁸Ga-DOTANOC somatostatin receptor PET/CT imaging demonstrating multiple synchronous lesions in a patient with head and neck paraganglioma.

    Science.gov (United States)

    Naswa, N; Karunanithi, S; Sharma, P; Soundararajan, R; Bal, C; Kumar, R

    2014-01-01

    Paragangliomas, or glomus tumors, are neoplasms arising from extra-adrenal chromaffin tissue. They frequently cause symptoms by over-production of catecholamines with known predilection to multicentricity. We describe the case of a patient with bilateral carotid body tumor who underwent a preoperative ⁶⁸Gallium labeled [1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid]-1-NaI3-Octreotide (⁶⁸Ga-DOTANOC) positron emission tomography/computed tomography (PET/CT) imaging for staging. This is a unique case in which multiple paraganglioma and pheochromocytoma were demonstrated in a single patient using ⁶⁸Ga-DOTANOC PET/CT. Copyright © 2013 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  3. Three-dimensional CT angiography with volume rendering for the dignosis of multiple intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    FANG Bing; LI Tie-lin; ZHANG Jian-min; DUAN Chuan-zhi; WANG Qiu-jing; ZAO Qing-ping

    2004-01-01

    Objective:To evaluate the importance of 3D-CTA with volume rendering for the diagnosis of multiple intracranial aneurysms. Methods: Axial source images were obtained by helical CT scanning and reconstruction of 3D-CTA images was done by volume rendering technique in conjunction with multiplanar reformation. Results: In the past one year,there were 10 patients diagnosed as having multiple intracranial aneurysms by 3D-CTA and altogether 24 aneurysms were visualized,including 10 small aneurysms(≤5mm.Three dimensional CT angiography with volume rendering demonstrated aneurysms very well and provided useful information concerning the site,shape,size and spatial relationship with the surrounding vessels and bone anatomy. Conclusion: Three-dimensional CT angiography with volume rendering is a quick,reliable,and relatively noninvasive method for diagnosing multiple intracranial aneurysms.It delineates detailed aneurysmal morphology,and provides useful information for planning microsurgical approaches.

  4. Effects of preoperative inspiratory muscle training in obese women undergoing open bariatric surgery: respiratory muscle strength, lung volumes, and diaphragmatic excursion

    OpenAIRE

    Marcela Cangussu Barbalho-Moulim; Gustavo Peixoto Soares Miguel; Eli Maria Pazzianotto Forti; Flavio do Amaral Campos; Dirceu Costa

    2011-01-01

    OBJECTIVE: To determine whether preoperative inspiratory muscle training is able to attenuate the impact of surgical trauma on the respiratory muscle strength, in the lung volumes, and diaphragmatic excursion in obese women undergoing open bariatric surgery. DESIGN: Randomized controlled trial. SETTING: Meridional Hospital, Cariacica/ES, Brazil. SUBJECTS: Thirty-two obese women undergoing elective open bariatric surgery were randomly assigned to receive preoperative inspiratory muscle trainin...

  5. Prediction of Long-term Post-operative Testosterone Replacement Requirement Based on the Pre-operative Tumor Volume and Testosterone Level in Pituitary Macroadenoma

    OpenAIRE

    Cheng-Chi Lee; Chung-Ming Chen; Shih-Tseng Lee; Kuo-Chen Wei; Ping-Ching Pai; Cheng-Hong Toh; Chi-Cheng Chuang

    2015-01-01

    Non-functioning pituitary macroadenomas (NFPAs) are the most prevalent pituitary macroadenomas. One common symptom of NFPA is hypogonadism, which may require long-term hormone replacement. This study was designed to clarify the association between the pre-operative tumor volume, pre-operative testosterone level, intraoperative resection status and the need of long-term post-operative testosterone replacement. Between 2004 and 2012, 45 male patients with NFPAs were enrolled in this prospective...

  6. Quantification of respiratory depression during pre-operative administration of midazolam using a non-invasive respiratory volume monitor.

    Science.gov (United States)

    Gonzalez Castro, Luis N; Mehta, Jaideep H; Brayanov, Jordan B; Mullen, Gary J

    2017-01-01

    Pre-operative administration of benzodiazepines can cause hypoventilation-a decrease in minute ventilation (MV)-commonly referred to as "respiratory compromise or respiratory depression." Respiratory depression can lead to hypercarbia and / or hypoxemia, and may heighten the risk of other respiratory complications. Current anesthesia practice often places patients at risk for respiratory complications even before surgery, as respiratory monitoring is generally postponed until the patient is in the operating room. In the present study we examined and quantified the onset of respiratory depression following the administration of a single dose of midazolam in pre-operative patients, using a non-invasive respiratory volume monitor that reports MV, tidal volume (TV), and respiratory rate (RR). Impedance-based Respiratory Volume Monitor (RVM) data were collected and analyzed from 30 patients prior to undergoing orthopedic or general surgical procedures. All patients received 2.0 mg of midazolam intravenously at least 20 minutes prior to the induction of anesthesia and the effects of midazolam on the patient's respiratory function were analyzed. Within 15 minutes of midazolam administration, we noted a significant decrease in both MV (average decrease of 14.3% ± 5.9%, pmidazolam administration on clinically significant respiratory parameters (MV, TV and RR) using a non-invasive RVM, uncovering that the respiratory depressive effect of benzodiazepines affect primarily TV rather than RR. Such respiratory monitoring data provide the opportunity for individualizing dosing and adjustment of clinical interventions, especially important in elderly patients. With additional respiratory data, clinicians may be able to better identify and quantify respiratory depression, reduce adverse effects, and improve overall patient safety.

  7. Nonpalpable supraclavicular lymph nodes in lung cancer patients: preoperative characterization with 18F-FDG PET/CT.

    Science.gov (United States)

    Sung, Yon Mi; Lee, Kyung Soo; Kim, Byung-Tae; Kim, Seonwoo; Kwon, O Jung; Choi, Joon Young; Yang, Seoung-Oh

    2008-01-01

    Our purpose was to evaluate the usefulness of integrated 18F-FDG PET/CT in the detection and characterization of nonpalpable supraclavicular lymph node metastasis in patients with the initial diagnosis of lung cancer. This study was conducted from May 2005 to May 2006 and included 32 consecutively registered lung cancer patients in whom supraclavicular lymph nodes were not palpable but were identified on contrast-enhanced CT or exhibited increased FDG uptake on integrated PET/CT. Three patients had bilateral nodes, for a total of 35 nodes in the 32 patients. Results of cytologic analysis of a specimen obtained with sonographically guided fine-needle aspiration (n = 27), normal initial and follow-up sonographic findings (n = 3), and no change in the size of supraclavicular lymph nodes on follow-up sonography (n = 2) were the reference standards. The presence of supraclavicular lymph node metastasis was determined with integrated PET/CT (uptake greater than that of surrounding tissue) and contrast-enhanced CT (node short-axis diameter of 5 mm or more). The diagnostic efficacies of these methods in the detection of supraclavicular lymph node metastasis were compared. Supraclavicular lymph node metastasis was diagnosed cytologically in 12 (34%) of 35 lesions. The diagnostic accuracies of integrated PET/CT and contrast-enhanced CT in the detection of supraclavicular lymph node metastasis were 71% and 66%, respectively; the difference was not statistically significant. Although the difference was not statistically significant, the sensitivity (92%) and negative predictive value (93%) of integrated PET/CT were higher than those of contrast-enhanced CT. Because of its high sensitivity and negative predictive value, integrated PET/CT is useful in the detection and characterization of nonpalpable supraclavicular lymph nodes in lung cancer patients.

  8. Multimodality imaging with CT, MR and FDG-PET for radiotherapy target volume delineation in oropharyngeal squamous cell carcinoma

    OpenAIRE

    Bird, David; Scarsbrook, Andrew F.; Sykes, Jonathan; Ramasamy, Satiavani; Subesinghe, Manil; Carey, Brendan; Wilson, Daniel J.; Roberts, Neil; McDermott, Gary; KARAKAYA, Ebru; BAYMAN, Evrim; Sen, Mehmet; Speight, Richard; Prestwich, Robin J. D.

    2015-01-01

    Background This study aimed to quantify the variation in oropharyngeal squamous cell carcinoma gross tumour volume (GTV) delineation between CT, MR and FDG PET-CT imaging. Methods A prospective, single centre, pilot study was undertaken where 11 patients with locally advanced oropharyngeal cancers (2 tonsil, 9 base of tongue primaries) underwent pre-treatment, contrast enhanced, FDG PET-CT and MR imaging, all performed in a radiotherapy treatment mask. CT, MR and CT-MR GTVs were contoured by ...

  9. The role of three-dimensional multidetector CT gastrography in the preoperative imaging of stomach cancer: Emphasis on detection and localization of the tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woong; Shin, Sang Soo; Heo, Suk Hee; Lim, Hyo Soon; Park, Young Kyu; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Medical School, Gwangju (Korea, Republic of); Lim, Nam Yeol [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2015-02-15

    Multidetector CT (MDCT) gastrography has been regarded as a promising technique for the preoperative imaging of gastric cancer. It has the ability to produce various three-dimensional (3D) images. Because 3D reconstruction images are more effective and intuitive for recognizing abnormal changes in the gastric folds and subtle mucosal nodularity than two-dimensional images, 3D MDCT gastrography can enhance the detection rate of early gastric cancer, which, in turn, contributes to the improvement of the accuracy of preoperative tumor (T) staging. In addition, shaded surface display and tissue transition projection images provide a global view of the stomach, with the exact location of gastric cancer, which may replace the need for barium studies. In this article, we discuss technical factors in producing high-quality MDCT gastrographic images and present cases demonstrating the usefulness of MDCT gastrography for the detection and T staging of gastric cancer while emphasizing the significance of preoperative localization of gastric cancer in terms of surgical margin.

  10. Navigation of a robot-integrated fluorescence laparoscope in preoperative SPECT/CT and intraoperative freehand SPECT imaging data: a phantom study

    Science.gov (United States)

    van Oosterom, Matthias Nathanaël; Engelen, Myrthe Adriana; van den Berg, Nynke Sjoerdtje; KleinJan, Gijs Hendrik; van der Poel, Henk Gerrit; Wendler, Thomas; van de Velde, Cornelis Jan Hadde; Navab, Nassir; van Leeuwen, Fijs Willem Bernhard

    2016-08-01

    Robot-assisted laparoscopic surgery is becoming an established technique for prostatectomy and is increasingly being explored for other types of cancer. Linking intraoperative imaging techniques, such as fluorescence guidance, with the three-dimensional insights provided by preoperative imaging remains a challenge. Navigation technologies may provide a solution, especially when directly linked to both the robotic setup and the fluorescence laparoscope. We evaluated the feasibility of such a setup. Preoperative single-photon emission computed tomography/X-ray computed tomography (SPECT/CT) or intraoperative freehand SPECT (fhSPECT) scans were used to navigate an optically tracked robot-integrated fluorescence laparoscope via an augmented reality overlay in the laparoscopic video feed. The navigation accuracy was evaluated in soft tissue phantoms, followed by studies in a human-like torso phantom. Navigation accuracies found for SPECT/CT-based navigation were 2.25 mm (coronal) and 2.08 mm (sagittal). For fhSPECT-based navigation, these were 1.92 mm (coronal) and 2.83 mm (sagittal). All errors remained below the robot-integrated fluorescence laparoscope is feasible and may aid fluorescence-guided surgery procedures.

  11. Diagnostic pitfalls in the preoperative 18F-FDG PET/CT evaluation of a case of giant malignant solitary fibrous tumor of the pleura.

    Science.gov (United States)

    Lococo, F; Rapicetta, C; Ricchetti, T; Cavazza, A; Filice, A; Treglia, G; Tenconi, S; Paci, M; Sgarbi, G

    2014-01-01

    Solitary fibrous tumor of the pleura (SFTP) is an uncommon entity, generally with an indolent behavior. Nevertheless, some malignant forms have been rarely reported. These, often have an aggressive biological behavior with pathological findings of invasiveness. The preoperative diagnosis and evaluation of the grade of malignancy are extremely challenging. Herein we report a case of a 64-year-old man who presented with a left giant intra-thoracic mass imaged with fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG/PET-CT) and sampled via fine-needle aspiration biopsy (FNAB). Imaging and FNAB findings showed suspicion of a benign form of SFTP. Surgical radical resection of the giant mass was performed. The definitive histological diagnosis showed a malignant SFTP. Based on this report, we take the opportunity to briefly discuss the insidious pitfalls concerning the radiological and (18)F-FDG/PET-CT features as well as cyto/histological findings in the pre-operative diagnostic work-up examination of this rare entity. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  12. Fused 99m-Tc-GSA SPECT/CT imaging for the preoperative evaluation of postoperative liver function: can the liver uptake index predict postoperative hepatic functional reserve?

    Science.gov (United States)

    Yoshida, Morikatsu; Shiraishi, Shinya; Sakaguchi, Fumi; Utsunomiya, Daisuke; Tashiro, Kuniyuki; Tomiguchi, Seiji; Okabe, Hirohisa; Beppu, Toru; Baba, Hideo; Yamashita, Yasuyuki

    2012-04-01

    To evaluate the role of hepatic asialoglycoprotein receptor analysis in the preoperative estimation of postoperative hepatic functional reserve. We obtained technetium-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin (99mTc-GSA) SPECT/CT fusion images in 256 patients with liver disease scheduled for hepatic resection. The liver uptake value corrected for body surface area [LUV(BSA)] and liver uptake ratio (LUR) of the remnant were preoperatively estimated based on the fused images. These values were compared with the postoperative hepatic functional reserve. Significant correlations were observed between LUV(BSA), LUR, and most conventional indicators of hepatic functional reserve. Postoperatively, nonpreserved liver functional reserve was observed in 15 of the 256 patients (5.8%). Remnant LUV(BSA) showed better correlation than remnant LUR or the other indicators. No patients with remnant LUV(BSA) above 28.0 manifested poor nonpreserved functional reserve. Using a LUV(BSA) of 27.0, it was possible to predict postoperative poor hepatic functional reserve at a sensitivity of 91%, specificity of 81%, and accuracy of 81% postoperatively. According to multivariate analysis, a low remnant LUV(BSA) was the only significant independent predictor of poor hepatic functional reserve. Our 99mTc-GSA SPECT/CT fusion imaging method was clinically useful for evaluating regional hepatic function and for predicting postoperative hepatic functional reserve.

  13. Prediction of Long-term Post-operative Testosterone Replacement Requirement Based on the Pre-operative Tumor Volume and Testosterone Level in Pituitary Macroadenoma.

    Science.gov (United States)

    Lee, Cheng-Chi; Chen, Chung-Ming; Lee, Shih-Tseng; Wei, Kuo-Chen; Pai, Ping-Ching; Toh, Cheng-Hong; Chuang, Chi-Cheng

    2015-11-05

    Non-functioning pituitary macroadenomas (NFPAs) are the most prevalent pituitary macroadenomas. One common symptom of NFPA is hypogonadism, which may require long-term hormone replacement. This study was designed to clarify the association between the pre-operative tumor volume, pre-operative testosterone level, intraoperative resection status and the need of long-term post-operative testosterone replacement. Between 2004 and 2012, 45 male patients with NFPAs were enrolled in this prospective study. All patients underwent transsphenoidal surgery. Hypogonadism was defined as total serum testosterone levels of testosterone to patients with defined hypogonadism or clinical symptoms of hypogonadism. Hormone replacement for longer than 1 year was considered as long-term therapy. The need for long-term post-operative testosterone replacement was significantly associated with larger pre-operative tumor volume (p = 0.0067), and lower pre-operative testosterone level (p = 0.0101). There was no significant difference between the gross total tumor resection and subtotal resection groups (p = 0.1059). The pre-operative tumor volume and testosterone level impact post-operative hypogonadism. By measuring the tumor volume and the testosterone level and by performing adequate tumor resection, surgeons will be able to predict post-operative hypogonadism and the need for long-term hormone replacement.

  14. Potential advantage of preoperative three-dimensional mapping of sentinel nodes in breast cancer by a hybrid single photon emission CT (SPECT)/CT system

    OpenAIRE

    Ibusuki, Mutsuko; Yamamoto, Yutaka; Kawasoe, Teru; Shiraishi, Shinya; Tomiguchi, Seiji; Yamashita, Yasuyuki; Honda, Yumi; Iyama, Kenichi; Iwase, Hirotaka; イブスキ, ムツコ; ヤマモト, ユタカ; カワソエ, テル; シライシ, シンヤ; トミグチ, セイジ; ヤマシタ, ヤスユキ

    2010-01-01

    Objective: This study aims to assess the role of three dimensional single-photon emissioncomputed tomography (3D-SPECT/CT) in sentinel node (SN) identification, and toanalyze the impact of such information on estimating metastases to SNs.Background: Nodal status is a key factor for breast cancer. SN biopsy has beenestablished as the alternative to routine axillary dissection these days. We investigatedboth the anatomical location of SNs demonstrated by our 3D-SPECT/CT system and thecorrelatio...

  15. Estimation of adipose compartment volumes in CT images of a mastectomy specimen

    Science.gov (United States)

    Imran, Abdullah-Al-Zubaer; Pokrajac, David D.; Maidment, Andrew D. A.; Bakic, Predrag R.

    2016-03-01

    Anthropomorphic software breast phantoms have been utilized for preclinical quantitative validation of breast imaging systems. Efficacy of the simulation-based validation depends on the realism of phantom images. Anatomical measurements of the breast tissue, such as the size and distribution of adipose compartments or the thickness of Cooper's ligaments, are essential for the realistic simulation of breast anatomy. Such measurements are, however, not readily available in the literature. In this study, we assessed the statistics of adipose compartments as visualized in CT images of a total mastectomy specimen. The specimen was preserved in formalin, and imaged using a standard body CT protocol and high X-ray dose. A human operator manually segmented adipose compartments in reconstructed CT images using ITK-SNAP software, and calculated the volume of each compartment. In addition, the time needed for the manual segmentation and the operator's confidence were recorded. The average volume, standard deviation, and the probability distribution of compartment volumes were estimated from 205 segmented adipose compartments. We also estimated the potential correlation between the segmentation time, operator's confidence, and compartment volume. The statistical tests indicated that the estimated compartment volumes do not follow the normal distribution. The compartment volumes are found to be correlated with the segmentation time; no significant correlation between the volume and the operator confidence. The performed study is limited by the mastectomy specimen position. The analysis of compartment volumes will better inform development of more realistic breast anatomy simulation.

  16. Quantitative CT: technique dependence of volume estimation on pulmonary nodules.

    Science.gov (United States)

    Chen, Baiyu; Barnhart, Huiman; Richard, Samuel; Colsher, James; Amurao, Maxwell; Samei, Ehsan

    2012-03-07

    Current estimation of lung nodule size typically relies on uni- or bi-dimensional techniques. While new three-dimensional volume estimation techniques using MDCT have improved size estimation of nodules with irregular shapes, the effect of acquisition and reconstruction parameters on accuracy (bias) and precision (variance) of the new techniques has not been fully investigated. To characterize the volume estimation performance dependence on these parameters, an anthropomorphic chest phantom containing synthetic nodules was scanned and reconstructed with protocols across various acquisition and reconstruction parameters. Nodule volumes were estimated by a clinical lung analysis software package, LungVCAR. Precision and accuracy of the volume assessment were calculated across the nodules and compared between protocols via a generalized estimating equation analysis. Results showed that the precision and accuracy of nodule volume quantifications were dependent on slice thickness, with different dependences for different nodule characteristics. Other parameters including kVp, pitch, and reconstruction kernel had lower impact. Determining these technique dependences enables better volume quantification via protocol optimization and highlights the importance of consistent imaging parameters in sequential examinations.

  17. Preoperative PET/CT FDG standardized uptake value of pelvic lymph nodes as a significant prognostic factor in patients with uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hyun Hoon [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of); Cheon, Gi Jeong; Kang, Keon Wook [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kim, Jae Weon; Park, Noh-Hyun [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University, WCU Biomodulation Major, Department of Agricultural Biotechnology, College of Agriculture and Life Sciences, Seoul (Korea, Republic of)

    2014-04-15

    Using integrated PET/CT, we evaluated the prognostic relevance in uterine cervical cancer of preoperative pelvic lymph node (LN) [{sup 18}F]FDG uptake. Patients with FIGO stage IB to IIA uterine cervical cancer were imaged with FDG PET/CT before radical surgery. We used Cox proportional hazards regression to examine the relationship between recurrence and the FDG maximum standardized uptake value (SUV{sub max}) in the pelvic LN (SUV{sub LN}) on PET/CT. Clinical data, treatment modalities, and results in 130 eligible patients were reviewed. The median postsurgical follow-up was 34 months (range 6 to 109 months). Receiver operating characteristic analysis identified SUV{sub LN} 2.36 as the most significant cut-off value for predicting recurrence. SUV{sub LN} was correlated with SUV{sub tumour} (P = 0.002), primary tumour size (P = 0.004), and parametrial invasion (P = 0.013). Univariate analyses showed significant associations between recurrence and SUV{sub LN} (P = 0.001), SUV{sub tumour} (P = 0.007), pelvic LN metastasis (P = 0.002), parametrial invasion (P < 0.001), primary tumour size (P = 0.007), suspected LN metastasis on MRI (P = 0.024), and FIGO stage (P = 0.026). Multivariate analysis identified SUV{sub LN} (P = 0.013, hazard ratio, HR, 4.447, 95 % confidence interval, CI, 1.379 - 14.343) and parametrial invasion (P = 0.013, HR 6.728, 95 % CI 1.497 - 30.235) as independent risk factors for recurrence. Patients with SUV{sub LN} ≥2.36 and SUV{sub LN} <2.36 differed significantly in terms of recurrence (HR 15.20, P < 0.001). Preoperative pelvic LN FDG uptake showed a strong significant association with uterine cervical cancer recurrence. (orig.)

  18. Wide coverage by volume CT: benefits for cardiac imaging

    Science.gov (United States)

    Sablayrolles, Jean-Louis; Cesmeli, Erdogan; Mintandjian, Laura; Adda, Olivier; Dessalles-Martin, Diane

    2005-04-01

    With the development of new technologies, computed tomography (CT) is becoming a strong candidate for non-invasive imaging based tool for cardiac disease assessment. One of the challenges of cardiac CT is that a typical scan involves a breath hold period consisting of several heartbeats, about 20 sec with scanners having a longitudinal coverage of 2 cm, and causing the image quality (IQ) to be negatively impacted since beat to beat variation is high likely to occur without any medication, e.g. beta blockers. Because of this and the preference for shorter breath hold durations, a CT scanner with a wide coverage without the compromise in the spatial and temporal resolution of great clinical value. In this study, we aimed at determining the optimum scan duration and the delay relative to beginning of breath hold, to achieve high IQ. We acquired EKG data from 91 consecutive patients (77 M, 14 F; Age: 57 +/- 14) undergoing cardiac CT exams with contrast, performed on LightSpeed 16 and LightSpeed Pro16. As an IQ metric, we adopted the standard deviation of "beat-to-beat variation" (stdBBV) within a virtual scan period. Two radiologists evaluated images by assigning a score of 1 (worst) to 4 best). We validated stdBBV with the radiologist scores, which resulted in a population distribution of 9.5, 9.5, 31, and 50% for the score groups 1, 2, 3, and 4, respectively. Based on the scores, we defined a threshold for stdBBV and identified an optimum combination of virtual scan period and a delay. With the assumption that the relationship between the stdBBV and diagnosable scan IQ holds, our analysis suggested that the success rate can be improved to 100% with scan durations equal or less than 5 sec with a delay of 1 - 2 sec. We confirmed the suggested conclusion with LightSpeed VCT (GE Healthcare Technologies, Waukesha, WI), which has a wide longitudinal coverage, fine isotropic spatial resolution, and high temporal resolution, e.g. 40 mm coverage per rotation of 0.35 sec

  19. Maximum standardized uptake value on PET/CT in preoperative assessment of lymph node metastasis from thoracic esophageal squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Amos JM Ela Bella; Ya-Rui Zhang; Wei Fan; Kong-Jia Luo; Tie-Hua Rong; Peng Lin; Hong Yang; Jian-Hua Fu

    2014-01-01

    The presence of lymph node metastasis is an important prognostic factor for patients with esophageal cancer. Accurate assessment of lymph nodes in thoracic esophageal carcinoma is essential for selecting appropriate treatment and forecasting disease progression. Positron emission tomography combined with computed tomography (PET/CT) is becoming an important tool in the workup of esophageal carcinoma. Here, we evaluated the effectiveness of the maximum standardized uptake value (SUVmax) in assessing lymph node metastasis in esophageal squamous cell carcinoma (ESCC) prior to surgery. Fifty-nine surgical patients with pathologically confirmed thoracic ESCC were retrospectively studied. These patients underwent radical esophagectomy with pathologic evaluation of lymph nodes. They al had 18F-FDG PET/CT scans in their preoperative staging procedures. None had a prior history of cancer. The pathologic status and PET/CT SUVmax of lymph nodes were col ected to calculate the receiver operating characteristic (ROC) curve and to determine the best cutoff value of the PET/CT SUVmax to distinguish benign from malignant lymph nodes. Lymph node data from 27 others were used for the validation. A total of 323 lymph nodes including 39 metastatic lymph nodes were evaluated in the training cohort, and 117 lymph nodes including 32 metastatic lymph nodes were evaluated in the validation cohort. The cutoff point of the SUVmax for lymph nodes was 4.1, as calculated by ROC curve (sensitivity, 80%; specificity, 92%;accuracy, 90%). When this cutoff value was applied to the validation cohort, a sensitivity, a specificity, and an accuracy of 81%, 88%, and 86%, respectively, were obtained. These results suggest that the SUVmax of lymph nodes predicts malignancy. Indeed, when an SUVmax of 4.1 was used instead of 2.5, FDG-PET/CT was more accurate in assessing nodal metastasis.

  20. Sensitivity and specificity of eight CT signs in the preoperative diagnosis of internal mesenteric hernia following Roux-en-Y gastric bypass surgery

    Energy Technology Data Exchange (ETDEWEB)

    Iannuccilli, J.D. [Department of Diagnostic Imaging, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island (United States)], E-mail: jiannuccilli@lifespan.org; Grand, D.; Murphy, B.L.; Evangelista, P. [Department of Diagnostic Imaging, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island (United States); Roye, G.D. [Department of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island (United States); Mayo-Smith, W. [Department of Diagnostic Imaging, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island (United States)

    2009-04-15

    Aim: To evaluate the sensitivity and specificity of eight previously reported computed tomography (CT) signs in diagnosing internal mesenteric hernia following Roux-en-Y gastric bypass surgery. Materials and methods: Preoperative CT images of nine patients with surgically proven internal mesenteric hernia as a complication of gastric bypass surgery and 10 matched control patients were reviewed in a blinded fashion by three radiologists. The presence of eight previously reported signs of internal mesenteric hernia was assessed: mesenteric swirl sign, hurricane eye sign, mushroom sign, small bowel obstruction, clustered small bowel loops, small bowel other than duodenum located behind the superior mesenteric artery (SMA), presence of the jejunal anastomosis to the right of the midline, and engorged mesenteric lymph nodes. The sensitivity and specificity were calculated for each sign, as well as inter-observer reliability in recognizing these signs. Results: Mesenteric swirl was the most predictive sign of internal hernia (sensitivity 78-100%, specificity 80-90%). Other CT signs showed good specificity (70-100%), but sensitivities were low (0-44%). The presence of a small-bowel obstruction and engorged mesenteric nodes was found to be 100% specific in predicting the presence of an underlying hernia. There was substantial inter-observer agreement in detecting mesenteric swirl sign ({kappa} = 0.48-0.79), but agreement was relatively poor for all other signs. Conclusion: Mesenteric swirl is an easily recognized CT sign, and is the best indicator of internal hernia following Roux-en-Y gastric bypass surgery. Other reported CT signs are diagnostically insensitive. The presence of small-bowel obstruction with engorged mesenteric nodes is highly specific in diagnosing internal mesenteric hernia.

  1. Measurement of four chambers' volumes and ventricular masses by cardiac CT examination

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Motomasa; Naito, Hiroaki; Ohta, Mitsushige; Kozuka, Takahiro; Kito, Yoshitsugu (National Cardiovascular Center, Suita, Osaka (Japan))

    1983-09-01

    Using cardiac computed tomography (CT), the ''mean'' volume of each cardiac chamber and both ventricular masses were calculated from summation of a sliced volume by ungated scans obtained using rapid sequential scanning covering the whole heart. 1. Estimation of a normal value of each chamber's volume was attempted in 20 patients with ischemic heart disease and with normal heart function. The ''mean'' volume of the right atrium (RAMV), right ventricle (RVMV), and left atrium (LAMV) was 22.3 +- 6.5, 40.3 +- 6.5 and 28.7 +- 8.2ml/m/sup 2/, respectively. 2. In 54 patients with valvular heart diseases, each chamber's volume obrained by CT was compared with the grade of tricuspid regurgitation (TR) estimated by ultrasonic Doppler technique or the grade of mitral regurgitation (MR) by left ventriculography (LVG). The RAMV (234 +- 119 ml/m/sup 2/) and the RVMV (101 +- 39 ml/m/sup 2/) were markedly increased in patients with severe TR (grade 3 to 4) (p<0.01). The LAMV (487 +- 231 ml/m/sup 2/) was also increased in patients with severe mitral regurgitation (grade 3 to 4) (p<0.01). 3. In 46 patients with valvular heart diseases, the LVMV by CT was well correlated with end-diastolic volume (EDV) obtained by LVG (r=0.92), and the LVEDVs by ECG gated CT and by LVG showed a fairly good correlation (r=0.95). 4. CT examination was performed before and after surgery in 17 patients with MR or TR for evaluation of the change of chamber volumes. The mean reduction ratio (MRR) of the RAMV after tricuspid annuloplasty, the LVMV after mitral valve plasty, and the LAMV after left atrial plication was 44%, 41%, and 60%, respectively.

  2. Automatic registration between 3D intra-operative ultrasound and pre-operative CT images of the liver based on robust edge matching

    Science.gov (United States)

    Nam, Woo Hyun; Kang, Dong-Goo; Lee, Duhgoon; Lee, Jae Young; Ra, Jong Beom

    2012-01-01

    The registration of a three-dimensional (3D) ultrasound (US) image with a computed tomography (CT) or magnetic resonance image is beneficial in various clinical applications such as diagnosis and image-guided intervention of the liver. However, conventional methods usually require a time-consuming and inconvenient manual process for pre-alignment, and the success of this process strongly depends on the proper selection of initial transformation parameters. In this paper, we present an automatic feature-based affine registration procedure of 3D intra-operative US and pre-operative CT images of the liver. In the registration procedure, we first segment vessel lumens and the liver surface from a 3D B-mode US image. We then automatically estimate an initial registration transformation by using the proposed edge matching algorithm. The algorithm finds the most likely correspondences between the vessel centerlines of both images in a non-iterative manner based on a modified Viterbi algorithm. Finally, the registration is iteratively refined on the basis of the global affine transformation by jointly using the vessel and liver surface information. The proposed registration algorithm is validated on synthesized datasets and 20 clinical datasets, through both qualitative and quantitative evaluations. Experimental results show that automatic registration can be successfully achieved between 3D B-mode US and CT images even with a large initial misalignment.

  3. Comparison between FDG Uptake and Pathologic or Immunohistochemical Parametersin Pre-operative PET/CT Scan of Patient with Primary Colorectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Na, Sae Jung; Chung, Yong An; Maeng, Lee So; Kim, Ki Jun; Sohn, Kyung Myung; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2009-12-15

    To evaluate the relationship between F-18 FDG uptake of tumor in PET/CT scan and pathological or immunohistochemial parameters of colorectal cancer. 147 colorectal cancer patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The pathologic results such as site, size, depth of invasion (T stage), growth pattern, differentiation of primary tumor, lymph node metastasis and Dukes-Astler and Coller stage and immunohistochemical markers such as expression of EGFR, MLH1, MSH2 and Ki-67 index were reviewed. 146 out of 147 PET/CT scans with colorectal cancer showed perceptible focal FDG uptake. SUVmax showed mild positive linear correlation with size of primary tumor (r=0.277, p=0.001) and Ki-67 index (r=0.226, p=0.019). No significant difference in F-18 FDG uptake was found according to site, depth of invasion (T stage), growth pattern, differentiation of primary tumor, presence of lymph node metastasis, Dukes-Astler and Coller stage and expression of EGFR. The degree of F-18 FDG uptake in colorectal cancer was associated with the size and the degree of Ki-67 index of primary tumor. It could be thought that FDG uptake of primary tumor has a correlation with macroscopic and microscopic tumor growth.

  4. Comments on 'Ionization chamber volume determination and quality assurance using micro-CT imaging'.

    Science.gov (United States)

    Ross, C K

    2009-03-21

    The authors of a recent paper (McNiven et al 2008 Phys. Med. Biol. 53 5029-43) measured the volume of a particular type of a small ionization chamber using CT images. Using four Exradin A1SL chambers, they find that the volume measured using CT imaging is, on average, 4.3% larger than the value derived from the chamber calibration coefficient. Although they point out that the effective chamber volume is defined by electric field lines between the collector and the chamber body, they do not estimate how the mechanical volume might differ from the effective volume. We have used a commercial software package to calculate the electric field in the cavity and we show that the field lines define a volume that is about 11% smaller than the mechanical volume. We also show that the effective volume is very sensitive to small changes in the chamber geometry near the base of the collector. We conclude that simply determining the mechanical volume without careful consideration of the electric field lines within the cavity is not a useful dosimetric technique.

  5. Does the addition of oxaliplatin to preoperative chemoradiation benefit cT4 or fixed cT3 rectal cancer treatment? A subgroup analysis from a prospective study.

    Science.gov (United States)

    Wiśniowska, K; Nasierowska-Guttmejer, A; Polkowski, W; Michalski, W; Wyrwicz, L; Pietrzak, L; Rutkowski, A; Malinowska, M; Kryński, J; Kosakowska, E; Zwoliński, J; Winiarek, M; Olędzki, J; Kuśnierz, J; Zając, L; Bednarczyk, M; Szczepkowski, M; Tarnowski, W; Paśnik, K; Radziszewski, J; Partycki, M; Bęczkowska, K; Styliński, R; Wierzbicki, R; Bury, P; Jankiewicz, M; Paprota, K; Lewicka, M; Ciseł, B; Skórzewska, M; Mielko, J; Danek, A; Nawrocki, G; Sopyło, R; Kępka, L; Bujko, K

    2016-12-01

    Whether there is any benefit derived from adding oxaliplatin to fluoropyrimidine-based preoperative chemoradiation is currently unknown in cases of advanced cT3 or cT4 tumours. Our aim was to evaluate this issue by analysing a randomized trial, which compared two schedules of preoperative treatment (chemoradiation vs. 5 × 5 Gy with 3 cycles of consolidation chemotherapy) for cT4 or fixed cT3 rectal cancer. Delivery of oxaliplatin was mandatory to the first part of the study. For the second part, its delivery in both treatment-assigned groups was left to the discretion of the local investigator. We analysed a subgroup of 272 patients (136 in the oxaliplatin group and 136 in the fluorouracil-only group) from institutions that had omitted oxaliplatin in the second part of the study. Circumferential resection margin negative (CRM-) status rate was 68% in the oxaliplatin group and 70% in the fluorouracil-only group, p = 0.72. The pathological complete response rate (pCR) was correspondingly 14% vs. 7%, p = 0.10. Following multivariable analysis, when comparing the CRM- status in the oxaliplatin group to the fluorouracil-only group, the odds ratio was 0.79 (95 CI 0.35-1.74), p = 0.54; there being no interaction between concomitant chemoradiation and 5 × 5 Gy with consolidation chemotherapy; pinteraction = 0.073. For pCR, the corresponding results were 0.47 (95 CI 0.19-1.16), p = 0.10, pinteraction = 0.84. No benefit was found of adding oxaliplatin in terms of CRM nor pCR rates for either concomitant or sequential settings in preoperative radiochemotherapy for very advanced rectal cancer. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  6. Potential advantage of preoperative three-dimensional mapping of sentinel nodes in breast cancer by a hybrid single photon emission CT (SPECT)/CT system.

    Science.gov (United States)

    Ibusuki, Mutsuko; Yamamoto, Yutaka; Kawasoe, Teru; Shiraishi, Shinya; Tomiguchi, Seiji; Yamashita, Yasuyuki; Honda, Yumi; Iyama, Kenichi; Iwase, Hirotaka

    2010-06-01

    This study aims to assess the role of three-dimensional single-photon emission computed tomography (3D-SPECT/CT) in sentinel node (SN) identification, and to analyze the impact of such information on estimating metastases to SNs. Nodal status is a key factor for breast cancer. SN biopsy has been established as the alternative to routine axillary dissection these days. We investigated both the anatomical location of SNs demonstrated by our 3D-SPECT/CT system and the correlation to SN positivity. Two hundred and twenty-three clinically node-negative patients underwent SN biopsy. All of the axillary structures, including SNs, were visualized by a SPECT/CT combined system after subcutaneous injection of (99m)Tc-phytate. By plotting the visualized SNs, the most frequent SN location 'Pedestal area (PA)' was designated. SPECT/CT detected (99m)Tc uptake in 217 cases (97.3%). 3D-SPECT/CT images visualized the accurate location of SNs in each case. In patients whose SNs were histopathologically negative (SN-), 228 (98.3%) SNs were found in the PA, and 4 (1.7%) were in other zones. In those with histopathologically positive SNs (SN+), 65 (78.3%) SNs were in the PA and 18 (21.7%) were outside it. The difference in SN distribution (i.e., in or out of the PA) between SN+ and SN- patients was statistically significant (pSNs in patients with breast cancer. Atypical distribution of SNs out of the PA may suggest SN positivity, reflecting failure of the lymphatic drainage systems.

  7. [18F]-fluorocholine PET/CT for preoperative lymph node staging of Prostate Cancer.study

    DEFF Research Database (Denmark)

    Poulsen, Mads Hvid; Bouchelouche, Kirsten; Gerke, Oke

    and method A prospective planned registered consecutive study has begun and the first 25 patients have been evaluated. From 1th January to 30th July 2008 the patients have been FCH PET/CT scanned prior to standard regional bilateral lymphadenectomy in fossa obturatoria. Following the lymphadenectomy...

  8. Volumetry of human molars with flat panel-based volume CT in vitro

    NARCIS (Netherlands)

    Hannig, C.; Krieger, E.; Dullin, C.; Merten, H.A.; Attin, T.; Grabbe, E.; Heidrich, G.

    2006-01-01

    The flat panel-based volume computed tomography (fpVCT) is a new CT device applicable for experimental, three-dimensional evaluation of teeth at a resolution of about 150 microm in the high contrast region. The aim of this study was to investigate whether fpVCT was suitable for quantification of the

  9. Assessment of hepatic functional reserve by cirrhosis grading and liver volume measurement using CT

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To explore a method for quantitative assessment of hepatic functional reserve by combining computed tomography (CT) volumetry with CT grading of liver cirrhosis before liver resection in patients with hepatocellular carcinoma.METHODS: CT images of 55 patients undergoing liver resection were studied prospectively. The degree of liver cirrhosis was referred as "CT grade" and the percentage of remnant liver volume (PRLV) [PRLV = predicted RLV/predicted total liver volume (PTLV) × 100%;PTLV (mL) = 121.75 + 16.49 × body mass (kg)] were calculated by adding slice by slice of CT liver images.The postoperative RLV, pathologic stages of liver fibrosis in non-tumor area and survival time in these cases were analyzed.RESULTS: There was a significant difference in survival time between the group with PRLV ≤ 50% and the group with PRLV > 50% (χ2= 4.988, P = 0.026), and between the group with CT grade 0/1 and the group with CT grade 2/3 (χ2= 5.429, P = 0.026). With combination of the both parameters, an oblique line was identified according to the distribution of 32 survivors versus 23 deceased subjects. The mortality rate above the line was 7.1% (1/14), and that below the line was 53.7% (22/41),indicating a significant difference between the two rates (χ2 = 9.281, P = 0.002, P < 0.05).CONCLUSION: PRLV and CT grades are significantly correlated with hepatic functional reserve. The predicted line using these two parameters is useful in candidates undergoing liver resection for judging hepatic functional reserve.

  10. Connection method of separated luminal regions of intestine from CT volumes

    Science.gov (United States)

    Oda, Masahiro; Kitasaka, Takayuki; Furukawa, Kazuhiro; Watanabe, Osamu; Ando, Takafumi; Hirooka, Yoshiki; Goto, Hidemi; Mori, Kensaku

    2015-03-01

    This paper proposes a connection method of separated luminal regions of the intestine for Crohn's disease diagnosis. Crohn's disease is an inflammatory disease of the digestive tract. Capsule or conventional endoscopic diagnosis is performed for Crohn's disease diagnosis. However, parts of the intestines may not be observed in the endoscopic diagnosis if intestinal stenosis occurs. Endoscopes cannot pass through the stenosed parts. CT image-based diagnosis is developed as an alternative choice of the Crohn's disease. CT image-based diagnosis enables physicians to observe the entire intestines even if stenosed parts exist. CAD systems for Crohn's disease using CT volumes are recently developed. Such CAD systems need to reconstruct separated luminal regions of the intestines to analyze intestines. We propose a connection method of separated luminal regions of the intestines segmented from CT volumes. The luminal regions of the intestines are segmented from a CT volume. The centerlines of the luminal regions are calculated by using a thinning process. We enumerate all the possible sequences of the centerline segments. In this work, we newly introduce a condition using distance between connected ends points of the centerline segments. This condition eliminates unnatural connections of the centerline segments. Also, this condition reduces processing time. After generating a sequence list of the centerline segments, the correct sequence is obtained by using an evaluation function. We connect the luminal regions based on the correct sequence. Our experiments using four CT volumes showed that our method connected 6.5 out of 8.0 centerline segments per case. Processing times of the proposed method were reduced from the previous method.

  11. Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases

    NARCIS (Netherlands)

    Meijerink, Martijn; Waesberghe, van Jan; Weide, van der Lineke; Tol, van den Petrousjka; Meijer, Sybren; Kuijk, van Cornelis

    2008-01-01

    The purpose of this study was to evaluate the feasibility of a totalliver- volume perfusion CT (CTP) technique for the detection and characterization of livermetastases. Twenty patients underwent helical CT of the total liver volume before and 11 times after intravenous contrast-material injection.

  12. Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases

    NARCIS (Netherlands)

    Meijerink, Martijn; Waesberghe, van Jan; Weide, van der Lineke; Tol, van den Petrousjka; Meijer, Sybren; Kuijk, van Cornelis

    2008-01-01

    The purpose of this study was to evaluate the feasibility of a totalliver- volume perfusion CT (CTP) technique for the detection and characterization of livermetastases. Twenty patients underwent helical CT of the total liver volume before and 11 times after intravenous contrast-material injection.

  13. Preoperative oxaliplatin, capecitabine, and external beam radiotherapy in patients with newly diagnosed, primary operable, cT3NxMo, low rectal cancer. A phase II study

    Energy Technology Data Exchange (ETDEWEB)

    Oefner, Dietmar [Paracelsus Private Medical Univ., Salzburg (Austria). Dept. of Surgery; Innsbruck Medical Univ. (Austria). Dept. of Visceral, Transplant and Thoracic Surgery; DeVries, Alexander F. [Feldkirch Hospital (Austria). Dept. of Radio-Oncology; Schaberl-Moser, Renate [Medical Univ. Graz (AT). Div. of Oncology] (and others)

    2011-02-15

    Purpose: In patients with locally advanced rectal cancer (LARC), preoperative chemoradiation is known to improve local control, and down-staging of the tumor serves as a surrogate for survival. Intensification of the systemic therapy may lead to higher downstaging rates and, thus, enhance survival. This phase II study investigated the efficacy and safety of preoperative capecitabine and oxaliplatin in combination with radiotherapy. Patients and Methods: Patients with LARC of the mid and lower rectum, T3NxM0 staged by MRI received radiotherapy (total dose 45 Gy) in combination with oral capecitabine (825 mg/m{sup 2} twice a day on radiotherapy days; weeks 1-4) and oxaliplatin 50 mg/m{sup 2} intravenously (days 1, 8, 15, and 22). Efficacy was evaluated as rate of tumor down-categorization at the T level. Results: A total of 59 patients were enrolled (19 women, 40 men; median age of 61 years) and all were evaluable for efficacy and toxicity. Down-categorization at the T level was observed in 53% with pathological complete response in 6 patients (10%). Actual total radiotherapy, oxaliplatin and capecitabine doses received were 97%, 90%, and 93% of the protocol-specified preplanned doses, respectively. Grade 3/4 toxicity was observed in 15 patients (25%). The most frequent was diarrhea (12%). Conclusions: Preoperative chemoradiation with capecitabine and oxaliplatin is feasible in patients with MRI-proven cT3 LARC. The only clinically relevant toxicity was diarrhea. Overall, efficacy of the multimodality treatment was good, but not markedly exceeding that of 5-FU- or capecitabine-based chemoradiation approaches. (orig.)

  14. Abdominal fat volume estimation by stereology on CT: a comparison with manual planimetry

    Energy Technology Data Exchange (ETDEWEB)

    Manios, G.E.; Mazonakis, M.; Damilakis, J. [University of Crete, Department of Medical Physics, Faculty of Medicine, Heraklion, Crete (Greece); Voulgaris, C.; Karantanas, A. [University of Crete, Department of Radiology, Faculty of Medicine, Heraklion, Crete (Greece)

    2016-03-15

    To deploy and evaluate a stereological point-counting technique on abdominal CT for the estimation of visceral (VAF) and subcutaneous abdominal fat (SAF) volumes. Stereological volume estimations based on point counting and systematic sampling were performed on images from 14 consecutive patients who had undergone abdominal CT. For the optimization of the method, five sampling intensities in combination with 100 and 200 points were tested. The optimum stereological measurements were compared with VAF and SAF volumes derived by the standard technique of manual planimetry on the same scans. Optimization analysis showed that the selection of 200 points along with the sampling intensity 1/8 provided efficient volume estimations in less than 4 min for VAF and SAF together. The optimized stereology showed strong correlation with planimetry (VAF: r = 0.98; SAF: r = 0.98). No statistical differences were found between the two methods (VAF: P = 0.81; SAF: P = 0.83). The 95 % limits of agreement were also acceptable (VAF: -16.5 %, 16.1 %; SAF: -10.8 %, 10.7 %) and the repeatability of stereology was good (VAF: CV = 4.5 %, SAF: CV = 3.2 %). Stereology may be successfully applied to CT images for the efficient estimation of abdominal fat volume and may constitute a good alternative to the conventional planimetric technique. (orig.)

  15. Jejunal GIST causing acute massive gastrointestinal bleeding: role of multidetector row helical CT in the preoperative diagnosis and management.

    Science.gov (United States)

    Daldoul, Sami; Moussi, Amir; Triki, Wissem; Baraket, Rym Bennaceur; Zaouche, Abdeljelil

    2012-09-01

    In this report, we describe a 34-year-old man with a jejunal gastrointestinal stromal tumour (GIST) accompanied by an unusual severe haemorrhage. Because oesophagogastroduodenoscopy proved inconclusive in determining the source of the bleeding and also because of gradually dropping haemoglobin levels and persistence of the melena not allowing colonic preparation, colonoscopy was cancelled and a mesenteric angio-computed tomography (angio-CT) was deemed necessary. The results of this analysis showed a 5-cm heterogeneous mass located in the jejunal loop surrounded by abnormal arterial structures. This multidetector computed tomography (MDCT) appearance was highly suggestive of GIST. The patient then underwent an urgent laparotomy and, peroperative findings being compatible with angio-CT descriptions, a small-bowel resection was performed. The results of the histopathological examination confirmed the diagnosis of GIST. Angio-CT helps define the size of GIST as well as its range and location and can be used as the primary routine test for patients suffering from lower-GI bleeding.

  16. CT-pro-AVP as a tool for assessment of intravascular volume depletion in severe hyponatremia.

    Science.gov (United States)

    Boursier, Guilaine; Alméras, Marion; Buthiau, Delphine; Jugant, Sébastien; Daubin, Delphine; Kuster, Nils; Dupuy, Anne-Marie; Ribstein, Jean; Klouche, Kada; Cristol, Jean-Paul

    2015-07-01

    Assessment of volume status is essential to best manage hyponatremic patients but is not always accurate in clinical practice. The aim of this study was to evaluate the reliability of C-terminal portion of pro-arginine-vasopressin (CT-pro-AVP), a surrogate biomarker of vasopressin release, in assessing intravascular volume (IVV) depletion in hypoosmolar hyponatremic patients. Plasma CT-pro-AVP and urea-to-creatinine ratio (Ur/Cr) were performed in 131 hospitalized patients presenting chronic severe hypoosmolar hyponatremia. At hospital discharge, their IVV was evaluated regardless of CT-pro-AVP concentrations. All patients were then classified as decreased or as normal/expanded IVV group. Plasma CT-pro-AVP levels were higher in patients with decreased IVV (34.6 vs. 11.3 pmol/L, ppro-AVP and Ur/Cr resulted in an improved ROC AUC up to 0.787 (95% CI 0.709-0.866). Our findings support the hypothesis that CT-pro-AVP plasma level may reflect IVV and would be a tool for its assessment. This performance has been magnified by its combination with Ur/Cr. A dual-marker strategy may help clinicians to optimize the management of severe hyponatremia especially in case of confusing clinical presentations. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  17. Application of 16-detector row CT in the diagnosis and preoperative assessment of pulmonary sequestration%16排CT在肺隔离症诊断和术前评估中的价值

    Institute of Scientific and Technical Information of China (English)

    朱石柱

    2011-01-01

    目的 评估16排CT在肺隔离症(PS)诊断和术前评估中的价值.方法 经手术和病理证实的年龄为1个月~39岁的PS患者32例,纳入本研究,其中2005年3月前收治的22例采用X线胸片、超声、MR或血管造影等方法检查;2005年3月后收治的10例患者行16排CT检查生成多平面重建(MPVR)、最大密度投影(MIP)和容量再现图像(VR).软组织和肺窗设置中观察轴像以评估实质改变.结果 应用16排CT检查前,22例PS中漏诊10例(45.5%),误诊7例(31.8%),术中操作发生大出血11例(50.0%);而应用16排CT检查后,10例PS中仅有漏诊1例(10.0%),无误诊病例,术中大出血1例(10.0%),应用16排CT前后比较差异均有统计学意义(P<0.05).结论 16排CT血管成像能准确显示异常动脉血供和静脉回流,在PS的诊断和术前评估中具有极大价值.%Objective To evaluate the role of 16-detector row CT in the diagnosis and preoperative assessment in pulnonary sequestration( PS ).Methods 32 patients with age range from 1 month to 39 years with PS proved with operation and pathology were included in this study.22 of those patients who were collected before March 2005 underwent chest X-ray film, ultrasound, magnetic resonance or angiography.10 of those patients who were collected after March 2005 underwent 16-detector row CT, and MPVR, MIP and 3D volume rendered images were used for diagnosis.The axial images were also reviewed at soft tissue and lung window settings to evaluate the parenchyma changes.Results The number of missed diagnosis for PS patients, misdiagnosed as PS and occurrence of intra-operative bleeding were 10( 45.5% ),7( 31.8% )and 11( 50.0% )cases separately before application of 16-detector row CT.After usage of 16-detector row CT, only 1 case were missed( 10.0% )in these 10 patients, no misdiagnosed cases were found and intra-operative bleeding were ole case( 10.0% ).Data between before and after application of 16-detector row CT were

  18. CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax

    Energy Technology Data Exchange (ETDEWEB)

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Kanazawa, Susumu [Okayama University Medical School, Departments of Radiology, Okayama (Japan); Miyoshi, Shinichiro [Okayama University Medical School, General Thoracic Surgery, Okayama (Japan)

    2016-01-15

    To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P = 0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. (orig.)

  19. Automated mass detection in contrast-enhanced CT colonography: an approach based on contrast and volume

    Energy Technology Data Exchange (ETDEWEB)

    Luboldt, W. [University Hospital Essen, Clinic and Policlinic of Angiology, Essen (Germany); Multiorgan Screening Foundation (Germany); Tryon, C. [Philips Medical Systems, Best (Netherlands); Kroll, M.; Vogl, T.J. [University Hospital Frankfurt, Department of Radiology, Frankfurt (Germany); Toussaint, T.L. [Multiorgan Screening Foundation (Germany); Holzer, K. [University Hospital Frankfurt, Department of Visceral and Vascular Surgery, Frankfurt (Germany); Hoepffner, N. [University Hospital Frankfurt, Department of Gastroenterology, Frankfurt (Germany)

    2005-02-01

    The purpose of this feasibility study was to design and test an algorithm for automating mass detection in contrast-enhanced CT colonography (CTC). Five patients with known colorectal masses underwent a pre-surgical contrast-enhanced (120 ml volume 1.6 g iodine/s injection rate, 60 s scan delay) CTC in high spatial resolution (16-slice CT: collimation: 16 x 0.75 mm, tablefeed: 24 mm/0.5 s, reconstruction increment: 0.5 mm). A CT-density- and volume-based algorithm searched for masses in the colonic wall, which was extracted before by segmenting and dilating the colonic air lumen and subtracting the inner air. A radiologist analyzed the detections and causes of false positives. All masses were detected, and false positives were easy to identify. Combining CT density with volume as a cut-off is a promising approach for automating mass detection that should be further refined and also tested in contrast-enhanced MR colonography. (orig.)

  20. Automated CT-based segmentation and quantification of total intracranial volume

    Energy Technology Data Exchange (ETDEWEB)

    Aguilar, Carlos; Wahlund, Lars-Olof; Westman, Eric [Karolinska Institute, Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Stockholm (Sweden); Edholm, Kaijsa; Cavallin, Lena; Muller, Susanne; Axelsson, Rimma [Karolinska Institute, Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology, Stockholm (Sweden); Karolinska University Hospital in Huddinge, Department of Radiology, Stockholm (Sweden); Simmons, Andrew [King' s College London, Institute of Psychiatry, London (United Kingdom); NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia, London (United Kingdom); Skoog, Ingmar [Gothenburg University, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Gothenburg (Sweden); Larsson, Elna-Marie [Uppsala University, Department of Surgical Sciences, Radiology, Akademiska Sjukhuset, Uppsala (Sweden)

    2015-11-15

    To develop an algorithm to segment and obtain an estimate of total intracranial volume (tICV) from computed tomography (CT) images. Thirty-six CT examinations from 18 patients were included. Ten patients were examined twice the same day and eight patients twice six months apart (these patients also underwent MRI). The algorithm combines morphological operations, intensity thresholding and mixture modelling. The method was validated against manual delineation and its robustness assessed from repeated imaging examinations. Using automated MRI software, the comparability with MRI was investigated. Volumes were compared based on average relative volume differences and their magnitudes; agreement was shown by a Bland-Altman analysis graph. We observed good agreement between our algorithm and manual delineation of a trained radiologist: the Pearson's correlation coefficient was r = 0.94, tICVml[manual] = 1.05 x tICVml[automated] - 33.78 (R{sup 2} = 0.88). Bland-Altman analysis showed a bias of 31 mL and a standard deviation of 30 mL over a range of 1265 to 1526 mL. tICV measurements derived from CT using our proposed algorithm have shown to be reliable and consistent compared to manual delineation. However, it appears difficult to directly compare tICV measures between CT and MRI. (orig.)

  1. Volume calculation of CT lung lesions based on Halton low-discrepancy sequences

    Science.gov (United States)

    Li, Shusheng; Wang, Liansheng; Li, Shuo

    2017-03-01

    Volume calculation from the Computed Tomography (CT) lung lesions data is a significant parameter for clinical diagnosis. The volume is widely used to assess the severity of the lung nodules and track its progression, however, the accuracy and efficiency of previous studies are not well achieved for clinical uses. It remains to be a challenging task due to its tight attachment to the lung wall, inhomogeneous background noises and large variations in sizes and shape. In this paper, we employ Halton low-discrepancy sequences to calculate the volume of the lung lesions. The proposed method directly compute the volume without the procedure of three-dimension (3D) model reconstruction and surface triangulation, which significantly improves the efficiency and reduces the complexity. The main steps of the proposed method are: (1) generate a certain number of random points in each slice using Halton low-discrepancy sequences and calculate the lesion area of each slice through the proportion; (2) obtain the volume by integrating the areas in the sagittal direction. In order to evaluate our proposed method, the experiments were conducted on the sufficient data sets with different size of lung lesions. With the uniform distribution of random points, our proposed method achieves more accurate results compared with other methods, which demonstrates the robustness and accuracy for the volume calculation of CT lung lesions. In addition, our proposed method is easy to follow and can be extensively applied to other applications, e.g., volume calculation of liver tumor, atrial wall aneurysm, etc.

  2. Use of multidetector row CT with volume renderings in right lobe living liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Ishifuro, Minoru; Akiyama, Yuji; Kushima, Toshio [Department of Radiology, Hiroshima University Medical Hospital, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima 734-8551 (Japan); Horiguchi, Jun; Nakashige, Aya; Tamura, Akihisa; Marukawa, Kazushi; Fukuda, Hiroshi; Ono, Chiaki; Ito, Katsuhide [Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Science, Hiroshima University, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima 734-8551 (Japan)

    2002-10-01

    Multidetector row CT is a feasible diagnostic tool in pre- and postoperative liver partial transplantation. We can assess vascular anatomy and liver parenchyma as well as volumetry, which provide useful information for both donor selection and surgical planning. Disorders of the vascular and biliary systems are carefully observed in recipients. In addition, we evaluate liver regeneration of both the donor and the recipient by serial volumetry. We present how multidetector row CT with state-of-the-art three-dimensional volume renderings may be used in right lobe liver transplantation. (orig.)

  3. Effects of preoperative inspiratory muscle training in obese women undergoing open bariatric surgery: respiratory muscle strength, lung volumes, and diaphragmatic excursion

    Directory of Open Access Journals (Sweden)

    Marcela Cangussu Barbalho-Moulim

    2011-01-01

    Full Text Available OBJECTIVE: To determine whether preoperative inspiratory muscle training is able to attenuate the impact of surgical trauma on the respiratory muscle strength, in the lung volumes, and diaphragmatic excursion in obese women undergoing open bariatric surgery. DESIGN: Randomized controlled trial. SETTING: Meridional Hospital, Cariacica/ES, Brazil. SUBJECTS: Thirty-two obese women undergoing elective open bariatric surgery were randomly assigned to receive preoperative inspiratory muscle training (inspiratory muscle training group or usual care (control group. MAIN MEASURES: Respiratory muscle strength (maximal static respiratory pressure - maximal inspiratory pressure and maximal expiratory pressure, lung volumes, and diaphragmatic excursion. RESULTS: After training, there was a significant increase only in the maximal inspiratory pressure in the inspiratory muscle training group. The maximal expiratory pressure, the lung volumes and the diaphragmatic excursion did not show any significant change with training. In the postoperative period there was a significant decrease in maximal inspiratory pressure in both the groups. However, there was a decrease of 28% in the inspiratory muscle training group, whereas it was 47% in the control group. The decrease in maximal expiratory pressure and in lung volumes in the postoperative period was similar between the groups. There was a significant reduction in the measures of diaphragmatic excursion in both the groups. CONCLUSION: The preoperative inspiratory muscle training increased the inspiratory muscle strength (maximal inspiratory pressure and attenuated the negative postoperative effects of open bariatric surgery in obese women for this variable, though not influencing the lung volumes and the diaphragmatic excursion.

  4. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years' experience in a tertiary trauma center

    Energy Technology Data Exchange (ETDEWEB)

    Yeung, Tsz Wai; Chan, Chung Yan Grace; Chan, Wun Cheung Samuel; Yuen, Ming Keung [Tuen Mun Hospital, Department of Radiology, Tuen Mun (China); Yeung, Yuk Nam [Tune Mun Hospital, Department of Orthopaedics and Traumatology, Tuen Mun (China)

    2015-06-01

    The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. From July 2006 to June 2013, 123 patients presented to a single tertiary hospital who received pre-operative CT for ankle fractures were retrospectively reviewed. All patients underwent open reduction and internal fixation for fractures and intra-operative syndesmosis integrity tests. The morphology of incisura fibularis was categorized as deep or shallow. The tibiofibular distance (TFD) between the medial border of the fibula and the nearest point of the lateral border of tibia were measured at anterior (aTFD), middle (mTFD), posterior (pTFD), and maximal (maxTFD) portions across the syndesmosis on axial CT images at 10 mm proximal to the tibial plafond. Statistical analysis was performed with independent samples t test and ROC curve analysis. Intraobserver reproducibility and inter-observers agreement were also evaluated. Of the 123 patients, 39 (31.7 %) were operatively diagnosed with syndesmosis instability. No significant difference of incisura fibularis morphology (deep or shallow) and TFDs was demonstrated respective to genders. The axial CT measurements were significantly higher in ankles diagnosed with syndesmosis instability than the group without (maxTFD means 7.2 ± 2.96 mm vs. 4.6 ± 1.4 mm, aTFD mean 4.9 ± 3.7 mm vs. 1.8 ± 1.4 mm, mTFD mean 5.3 ± 2.4 mm vs. 3.2 ± 1.6 mm, pTFD mean 5.3 ± 1.8 mm vs. 4.1 ± 1.3 mm, p < 0.05). Their respective cutoff values with best sensitivity and specificity were calculated; the aTFD (AUC 0.798) and maxTFD (AUC 0.794) achieved the highest diagnostic accuracy. The optimal cutoff levels were aTFD = 4 mm (sensitivity, 56.4 %; specificity, 91.7 %) and maxTFD = 5.65 mm (sensitivity, 74.4 %; specificity, 79.8 %). The inter-observer agreement was good for all aTFD, mTFD, pTFD, and maxTFD measurements (ICC 0.959, 0.799, 0.783, and 0.865). The ICC

  5. Comparison between FDG Uptake and Clinicopathologic and Immunohistochemical Parameters in Pre-operative PET/CT Scan of Primary Gastric Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Han, Eun Ji; Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Maeng, Lee So; Sohn, Kyung Myung; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2009-02-15

    The purpose of this study was to find out what clinicopathologic or immunohistochemical parameter that may affect FDG uptake of primary tumor in PET/CT scan of the gastric carcinoma patient. Eighty-nine patients with stomach cancer who underwent pre-operative FDG PET/CT scans were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The clinicopathologic results such as depth of invasion (T stage), tumor size, lymph node metastasis, tumor differentiation and Lauren's classification and immunohistochemical markers such as Ki-67 index, expression of p53, EGFR, Cathepsin D, c-erb-B2 and COX-2 were reviewed. Nineteen out of 89 gastric carcinomas showed imperceptible FDG uptake on PET/CT images. In cases with perceptible FDG uptake in primary tumor, SUVmax was significantly higher in T2, T3 and T4 tumors than T1 tumors (5.8{+-}3.1 vs. 3.7{+-}2.1, p=0.002). SUVmax of large tumors (above or equal to 3 cm) was also significantly higher than SUVmax of small ones (less than 3 cm) (5.7{+-}3.2 vs. 3.7{+-}2.0, p=0.002). The intestinal types of gastric carcinomas according to Lauren showed higher FDG uptake compared to the non-intestinal types (5.4{+-}2.8 vs. 3.7{+-}1.3, p=0.003). SUVmax between p53 positive group and negative group was significantly different (6.0{+-}2.8 vs. 4.4{+-}3.0, p=0.035). No significant difference was found in presence of LN metastasis, tumor differentiation, Ki-67 index, and expression of EGFR, Cathepsin D, c-erb-B2 and COX-2. T stage of gastric carcinoma influenced the detectability of gastric cancer on FDG PET/CT scan. When gastric carcinoma was perceptible on PET/CT scan, T stage, size of primary tumor, Lauren's classification and p53 expression were related to degree of FDG uptake in primary tumor.

  6. Iterative reconstruction technique with reduced volume CT dose index: diagnostic accuracy in pediatric acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Didier, Ryne A. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Vajtai, Petra L. [Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States); Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Hopkins, Katharine L. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States)

    2014-07-05

    Iterative reconstruction technique has been proposed as a means of reducing patient radiation dose in pediatric CT. Yet, the effect of such reductions on diagnostic accuracy has not been thoroughly evaluated. This study compares accuracy of diagnosing pediatric acute appendicitis using contrast-enhanced abdominopelvic CT scans performed with traditional pediatric weight-based protocols and filtered back projection reconstruction vs. a filtered back projection/iterative reconstruction technique blend with reduced volume CT dose index (CTDI{sub vol}). Results of pediatric contrast-enhanced abdominopelvic CT scans done for pain and/or suspected appendicitis were reviewed in two groups: A, 192 scans performed with the hospital's established weight-based CT protocols and filtered back projection reconstruction; B, 194 scans performed with iterative reconstruction technique and reduced CTDI{sub vol}. Reduced CTDI{sub vol} was achieved primarily by reductions in effective tube current-time product (mAs{sub eff}) and tube peak kilovoltage (kVp). CT interpretation was correlated with clinical follow-up and/or surgical pathology. CTDI{sub vol}, size-specific dose estimates (SSDE) and performance characteristics of the two CT techniques were then compared. Between groups A and B, mean CTDI{sub vol} was reduced by 45%, and mean SSDE was reduced by 46%. Sensitivity, specificity and diagnostic accuracy were 96%, 97% and 96% in group A vs. 100%, 99% and 99% in group B. Accuracy in diagnosing pediatric acute appendicitis was maintained in contrast-enhanced abdominopelvic CT scans that incorporated iterative reconstruction technique, despite reductions in mean CTDI{sub vol} and SSDE by nearly half as compared to the hospital's traditional weight-based protocols. (orig.)

  7. Automated pericardium delineation and epicardial fat volume quantification from noncontrast CT.

    Science.gov (United States)

    Ding, Xiaowei; Terzopoulos, Demetri; Diaz-Zamudio, Mariana; Berman, Daniel S; Slomka, Piotr J; Dey, Damini

    2015-09-01

    The authors aimed to develop and validate an automated algorithm for epicardial fat volume (EFV) quantification from noncontrast CT. The authors developed a hybrid algorithm based on initial segmentation with a multiple-patient CT atlas, followed by automated pericardium delineation using geodesic active contours. A coregistered segmented CT atlas was created from manually segmented CT data and stored offline. The heart and pericardium in test CT data are first initialized by image registration to the CT atlas. The pericardium is then detected by a knowledge-based algorithm, which extracts only the membrane representing the pericardium. From its initial atlas position, the pericardium is modeled by geodesic active contours, which iteratively deform and lock onto the detected pericardium. EFV is automatically computed using standard fat attenuation range. The authors applied their algorithm on 50 patients undergoing routine coronary calcium assessment by CT. Measurement time was 60 s per-patient. EFV quantified by the algorithm (83.60 ± 32.89 cm(3)) and expert readers (81.85 ± 34.28 cm(3)) showed excellent correlation (r = 0.97, p < 0.0001), with no significant differences by comparison of individual data points (p = 0.15). Voxel overlap by Dice coefficient between the algorithm and expert readers was 0.92 (range 0.88-0.95). The mean surface distance and Hausdorff distance in millimeter between manually drawn contours and the automatically obtained contours were 0.6 ± 0.9 mm and 3.9 ± 1.7 mm, respectively. Mean difference between the algorithm and experts was 9.7% ± 7.4%, similar to interobserver variability between 2 readers (8.0% ± 5.3%, p = 0.3). The authors' novel automated method based on atlas-initialized active contours accurately and rapidly quantifies EFV from noncontrast CT.

  8. Precise segmentation of multiple organs in CT volumes using learning-based approach and information theory.

    Science.gov (United States)

    Lu, Chao; Zheng, Yefeng; Birkbeck, Neil; Zhang, Jingdan; Kohlberger, Timo; Tietjen, Christian; Boettger, Thomas; Duncan, James S; Zhou, S Kevin

    2012-01-01

    In this paper, we present a novel method by incorporating information theory into the learning-based approach for automatic and accurate pelvic organ segmentation (including the prostate, bladder and rectum). We target 3D CT volumes that are generated using different scanning protocols (e.g., contrast and non-contrast, with and without implant in the prostate, various resolution and position), and the volumes come from largely diverse sources (e.g., diseased in different organs). Three key ingredients are combined to solve this challenging segmentation problem. First, marginal space learning (MSL) is applied to efficiently and effectively localize the multiple organs in the largely diverse CT volumes. Second, learning techniques, steerable features, are applied for robust boundary detection. This enables handling of highly heterogeneous texture pattern. Third, a novel information theoretic scheme is incorporated into the boundary inference process. The incorporation of the Jensen-Shannon divergence further drives the mesh to the best fit of the image, thus improves the segmentation performance. The proposed approach is tested on a challenging dataset containing 188 volumes from diverse sources. Our approach not only produces excellent segmentation accuracy, but also runs about eighty times faster than previous state-of-the-art solutions. The proposed method can be applied to CT images to provide visual guidance to physicians during the computer-aided diagnosis, treatment planning and image-guided radiotherapy to treat cancers in pelvic region.

  9. A simplified CT-based definition of the supraclavicular and infraclavicular nodal volumes in breast cancer.

    Science.gov (United States)

    Atean, I; Pointreau, Y; Ouldamer, L; Monghal, C; Bougnoux, A; Bera, G; Barillot, I

    2013-02-01

    The available contouring guidelines for the supraclavicular and infraclavicular lymph nodes appeared to be inadequate for their delineation on non-enhanced computed tomography (CT) scans. For this purpose, we developed delineation guidelines for the clinical target volumes (CTV) of these lymph nodes on non-enhanced CT-slices performed in the treatment position of breast cancer. A fresh female cadaver study as well as delineation and an anatomical descriptions review were performed to propose a simplified definition of the supra- and infraclavicular lymph nodes using readily identifiable anatomical structures. This definition was developed jointly by breast radiologists, breast surgeons, and radiation oncologists. To validate these guidelines, the primary investigator and seven radiation oncologists (observers) independently delineated 10 different nodal CTVs. The primary investigator contours were considered to be the gold standard contours. Contour accuracy and concordance were evaluated. Written guidelines for the delineation of supra- and infraclavicular lymph nodes CTVs were developed. Consistent contours with minimal variability existed between the delineated volumes; the mean kappa index was 0.83. The mean common contoured and additional contoured volumes were 84.6% and 18.5%, respectively. The mean overlap volume ratio was 0.71. Simplified CT-based atlas for delineation of the supra- and infraclavicular lymph nodes for locoregional irradiation of the breast on non-enhanced CT-scan, have been developed in this study. This atlas provides a consistent set of guidelines for delineating these volumes. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  10. Evaluation of bone substitute materials: comparison of flat-panel based volume CT to conventional multidetector CT.

    Science.gov (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

    2013-10-01

    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.

  11. Dose cone-beam CT alter treatment plans? Comparison of preoperative implant planning using panoramic versus cone-beam CT images

    Energy Technology Data Exchange (ETDEWEB)

    Guerrero, Maria Eugenia; Jacobs, Reinhilde [Dept. of Oral and Maxillofacial Surgery, University Hospitals, Leuven (Belgium); Norge, Jorge; Castro, Carmen [Master of Periodontology, Universidad San Martin de Porres, Lima (Peru)

    2014-06-15

    The present study was performed to compare the planning of implant placement based on panoramic radiography (PAN) and cone-beam computed tomography (CBCT) images, and to study the impact of the image dataset on the treatment planning. One hundred five partially edentulous patients (77 males, 28 females, mean age: 46 years, range: 26-67 years) seeking oral implant rehabilitation were referred for presurgical imaging. Imaging consisted of PAN and CBCT imaging. Four observers planned implant treatment based on the two-dimensional (2D) image datasets and at least one month later on the three-dimensional (3D) image dataset. Apart from presurgical diagnostic and dimensional measurement tasks, the observers needed to indicate the surgical confidence levels and assess the image quality in relation to the presurgical needs. All observers confirmed that both imaging modalities (PAN and CBCT) gave similar values when planning implant diameter. Also, the results showed no differences between both imaging modalities for the length of implants with an anterior location. However, significant differences were found in the length of implants with a posterior location. For implant dimensions, longer lengths of the implants were planned with PAN, as confirmed by two observers. CBCT provided images with improved scores for subjective image quality and surgical confidence levels. Within the limitations of this study, there was a trend toward PAN-based preoperative planning of implant placement leading towards the use of longer implants within the posterior jaw bone.

  12. Comparing Gross Tumor Volume of Delineation between CT and MRI for Nasopharyngeal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    TANGXi; HUGuoqing; QIUHong; CUIWei

    2005-01-01

    Objective: To study the accuracy between CT and MRI in delineating gross tumor volume (GTV) of nasopharyngeal carcinoma (NPC) in making radiotherapy plan. Methods: The clinical data of 39 cases pathologically proven as nasopharyngeal carcinoma selected from April 2003 to September 2004 were retrospectively analyzed. All were subjected to CT and MR examination one week before treatment.CT scanning was performed with GE Light speed 16, and axial scan was parallel to the OM line routinely from soft palate to the suprasellar cistern. MR scanning was performed by GE Signa super-conducting magnetic resonance imaging system (1.5 Tesla). The standard quadrature head coil was used. Routine axial, sagittal and coronal image with SE sequence were obtained, and FLAIR was used in 10 of 21 cases.Scanned field ranged from the soft palate to the suprasellar cistern. Part of all cases underwent enhanced scanned with Ultravist in CT group or/and GD-DTPA in MR group. All data were analyzed by using the paired-samples t test. Results: The media primary tumor volume (cm3) in CT group and MR group was 32.49±19.91, 29.06±18.75, respectively, and the difference between the two groups were significant (t=5.268, P=0.000). There was significant difference between the two groups in early stage (T1+T2) and advanced stage (T3+T4) by Fuzhou Staging System (t=5.677, P=0.000; t=3.310, P=0.005, respectively).There was significant difference in stage T1, T2, T3 (P=0.005, P=0.001, P=0.004, respectively), and not in stage T4 (P=0.146) between the two groups. Conclusion: MR was more accurate than CT in delineating GTV of NPC, so, is more valuable in making radiotherapy plan.

  13. CT-measured regional specific volume change reflects regional ventilation in supine sheep.

    Science.gov (United States)

    Fuld, Matthew K; Easley, R Blaine; Saba, Osama I; Chon, Deokiee; Reinhardt, Joseph M; Hoffman, Eric A; Simon, Brett A

    2008-04-01

    Computer tomography (CT) imaging techniques permit the noninvasive measurement of regional lung function. Regional specific volume change (sVol), determined from the change in lung density over a tidal breath, should correlate with regional ventilation and regional lung expansion measured with other techniques. sVol was validated against xenon (Xe)-CT-specific ventilation (sV) in four anesthetized, intubated, mechanically ventilated sheep. Xe-CT used expiratory gated axial scanning during the washin and washout of 55% Xe. sVol was measured from the tidal changes in tissue density (H, houndsfield units) of lung regions using the relationship sVol = [1,000(Hi - He)]/[He(1,000 + Hi)], where He and Hi are expiratory and inspiratory regional density. Distinct anatomical markings were used to define corresponding lung regions of interest between inspiratory, expiratory, and Xe-CT images, with an average region of interest size of 1.6 +/- 0.7 ml. In addition, sVol was compared with regional volume changes measured directly from the positions of implanted metal markers in an additional animal. A linear relationship between sVol and sV was demonstrated over a wide range of regional sV found in the normal supine lung, with an overall correlation coefficient (R(2)) of 0.66. There was a tight correlation (R(2) = 0.97) between marker-measured volume changes and sVol. Regional sVol, which involves significantly reduced exposure to radiation and Xe gas compared with the Xe-CT method, represents a safe and efficient surrogate for measuring regional ventilation in experimental studies and patients.

  14. Target volume definition in high-risk prostate cancer patients using sentinel node SPECT/CT and 18 F-choline PET/CT

    Directory of Open Access Journals (Sweden)

    Vees Hansjörg

    2012-08-01

    Full Text Available Abstract Background To assess the influence of sentinel lymph nodes (SNs SPECT/CT and 18 F-choline (18 F-FCH PET/CT in radiotherapy (RT treatment planning for prostate cancer patients with a high-risk for lymph node (LN involvement. Methods Twenty high-risk prostate cancer patients underwent a pelvic SPECT acquisition following a transrectal ultrasound guided injection of 99mTc-Nanocoll into the prostate. In all patients but one an 18 F-FCH PET/CT for RT treatment planning was performed. SPECT studies were coregistered with the respective abdominal CTs. Pelvic SNs localized on SPECT/CT and LN metastases detected by 18 F-FCH PET/CT were compared to standard pelvic clinical target volumes (CTV. Results A total of 104 pelvic SNs were identified on SPECT/CT (mean 5.2 SNs/patient; range 1–10. Twenty-seven SNs were located outside the standard pelvic CTV, 17 in the proximal common iliac and retroperitoneal regions above S1, 9 in the pararectal fat and 1 in the inguinal region. SPECT/CT succeeded to optimize the definition of the CTV and treatment plans in 6/20 patients due to the presence of pararectal SNs located outside the standard treatment volume. 18 F-FCH PET/CT identified abnormal tracer uptake in the iliac LN region in 2/19 patients. These abnormal LNs were negative on SPECT/CT suggesting a potential blockade of lymphatic drainage by metastatic LNs with a high tumour burden. Conclusions Multimodality imaging which combines SPECT/CT prostate lymphoscintigraphy and 18 F-FCH PET/CT identified SNs outside standard pelvic CTVs or highly suspicious pelvic LNs in 40% of high-risk prostate cancer patients, highlighting the potential impact of this approach in RT treatment planning.

  15. Automated volume of interest delineation and rendering of cone beam CT images in interventional cardiology

    Science.gov (United States)

    Lorenz, Cristian; Schäfer, Dirk; Eshuis, Peter; Carroll, John; Grass, Michael

    2012-02-01

    Interventional C-arm systems allow the efficient acquisition of 3D cone beam CT images. They can be used for intervention planning, navigation, and outcome assessment. We present a fast and completely automated volume of interest (VOI) delineation for cardiac interventions, covering the whole visceral cavity including mediastinum and lungs but leaving out rib-cage and spine. The problem is addressed in a model based approach. The procedure has been evaluated on 22 patient cases and achieves an average surface error below 2mm. The method is able to cope with varying image intensities, varying truncations due to the limited reconstruction volume, and partially with heavy metal and motion artifacts.

  16. GPU-Based 3D Cone-Beam CT Image Reconstruction for Large Data Volume

    Directory of Open Access Journals (Sweden)

    Xing Zhao

    2009-01-01

    Full Text Available Currently, 3D cone-beam CT image reconstruction speed is still a severe limitation for clinical application. The computational power of modern graphics processing units (GPUs has been harnessed to provide impressive acceleration of 3D volume image reconstruction. For extra large data volume exceeding the physical graphic memory of GPU, a straightforward compromise is to divide data volume into blocks. Different from the conventional Octree partition method, a new partition scheme is proposed in this paper. This method divides both projection data and reconstructed image volume into subsets according to geometric symmetries in circular cone-beam projection layout, and a fast reconstruction for large data volume can be implemented by packing the subsets of projection data into the RGBA channels of GPU, performing the reconstruction chunk by chunk and combining the individual results in the end. The method is evaluated by reconstructing 3D images from computer-simulation data and real micro-CT data. Our results indicate that the GPU implementation can maintain original precision and speed up the reconstruction process by 110–120 times for circular cone-beam scan, as compared to traditional CPU implementation.

  17. Volume rendering versus maximum intensity projection in CT angiography: what works best, when, and why.

    Science.gov (United States)

    Fishman, Elliot K; Ney, Derek R; Heath, David G; Corl, Frank M; Horton, Karen M; Johnson, Pamela T

    2006-01-01

    The introduction and widespread availability of 16-section multi-detector row computed tomographic (CT) technology and, more recently, 64-section scanners, has greatly advanced the role of CT angiography in clinical practice. CT angiography has become a key component of state-of-the-art imaging, with applications ranging from oncology (eg, staging of pancreatic or renal cancer) to classic vascular imaging (eg, evaluation of aortic aneurysms and renal artery stenoses) as well as newer techniques such as coronary artery imaging and peripheral runoff studies. With an average of 400-1000 images in each volume data set, three-dimensional postprocessing is crucial to volume visualization. Radiologists now have workstations that provide capabilities for evaluation of these data sets by using a range of software programs and processing tools. Although different systems have unique capabilities and functionality, all provide the options of volume rendering and maximum intensity projection for image display and analysis. These two postprocessing techniques have different advantages and disadvantages when used in clinical practice, and it is important that radiologists understand when and how each technique should be used. Copyright RSNA, 2006.

  18. Volume-monitored chest CT: a simplified method for obtaining motion-free images near full inspiratory and end expiratory lung volumes

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Kathryn S. [The Ohio State University College of Medicine, Columbus, OH (United States); Long, Frederick R. [Nationwide Children' s Hospital, The Children' s Radiological Institute, Columbus, OH (United States); Flucke, Robert L. [Nationwide Children' s Hospital, Department of Pulmonary Medicine, Columbus, OH (United States); Castile, Robert G. [The Research Institute at Nationwide Children' s Hospital, Center for Perinatal Research, Columbus, OH (United States)

    2010-10-15

    Lung inflation and respiratory motion during chest CT affect diagnostic accuracy and reproducibility. To describe a simple volume-monitored (VM) method for performing reproducible, motion-free full inspiratory and end expiratory chest CT examinations in children. Fifty-two children with cystic fibrosis (mean age 8.8 {+-} 2.2 years) underwent pulmonary function tests and inspiratory and expiratory VM-CT scans (1.25-mm slices, 80-120 kVp, 16-40 mAs) according to an IRB-approved protocol. The VM-CT technique utilizes instruction from a respiratory therapist, a portable spirometer and real-time documentation of lung volume on a computer. CT image quality was evaluated for achievement of targeted lung-volume levels and for respiratory motion. Children achieved 95% of vital capacity during full inspiratory imaging. For end expiratory scans, 92% were at or below the child's end expiratory level. Two expiratory exams were judged to be at suboptimal volumes. Two inspiratory (4%) and three expiratory (6%) exams showed respiratory motion. Overall, 94% of scans were performed at optimal volumes without respiratory motion. The VM-CT technique is a simple, feasible method in children as young as 4 years to achieve reproducible high-quality full inspiratory and end expiratory lung CT images. (orig.)

  19. Automated detection of fiducial screws from CT/DVT volume data for image-guided ENT surgery.

    Science.gov (United States)

    Zheng, Guoyan; Gerber, Nicolas; Widmer, Daniel; Stieger, Christof; Caversaccio, Marco; Nolte, Lutz-Peter; Weber, Stefan

    2010-01-01

    This paper presents an automated solution for precise detection of fiducial screws from three-dimensional (3D) Computerized Tomography (CT)/Digital Volume Tomography (DVT) data for image-guided ENT surgery. Unlike previously published solutions, we regard the detection of the fiducial screws from the CT/DVT volume data as a pose estimation problem. We thus developed a model-based solution. Starting from a user-supplied initialization, our solution detects the fiducial screws by iteratively matching a computer aided design (CAD) model of the fiducial screw to features extracted from the CT/DVT data. We validated our solution on one conventional CT dataset and on five DVT volume datasets, resulting in a total detection of 24 fiducial screws. Our experimental results indicate that the proposed solution achieves much higher reproducibility and precision than the manual detection. Further comparison shows that the proposed solution produces better results on the DVT dataset than on the conventional CT dataset.

  20. The role of metabolic tumor volume and total lesion glycolysis on {sup 18}F-FDG PET/CT in the prognosis of epithelial ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won; Cho, Arthur; Lee, Jae-Hoon; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun [Yonsei University College of Medicine, Department of Nuclear Medicine, 134 Shinchon-dong, Seodaemoon-gu, Seoul (Korea, Republic of); Kim, Young Tae [Yonsei University College of Medicine, Department of Obstetrics and Gynecology, 134 Shinchon-dong, Seodaemoon-gu, Seoul (Korea, Republic of)

    2014-10-15

    This study assessed the prognostic value of pre-operative 2-[{sup 18}F] fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) positron emission tomography/computed tomography (PET/CT) volumetric parameters, including metabolic tumor volume (MTV) and total lesion glycolysis (TLG), in patients with epithelial ovarian cancer. A total of 175 patients with epithelial ovarian cancer who underwent {sup 18} F-FDG PET/CT and subsequent cytoreductive surgery were retrospectively enrolled. Maximum standardized uptake value (SUVmax) on {sup 18}F-FDG PET/CT was measured for all patients. Because nine patients showed low tumor-to-background uptake ratios, MTV and TLG were measured in 166 patients. Univariate and multivariate analyses were performed to evaluate the prognostic significance of SUVmax, MTV, TLG, and clinicopathological factors for disease progression-free survival. Disease progressed in 78 (44.6 %) of the 175 patients, and the 2-year disease progression-free survival rate was 57.5 %. Univariate analysis showed that tumor stage, histopathological type, presence of regional lymph node metastasis, residual tumor after cytoreductive surgery, pre-operative serum carbohydrate antigen 125 (CA125) level, SUVmax, MTV, and TLG were significant prognostic factors (p < 0.05). Among these variables, tumor stage (p = 0.0006) and TLG (p = 0.008) independently correlated with disease progression-free survival on multivariate analysis. The disease progression rate was only 2.3 % in stage I-II patients with low TLG (≤100.0), compared to 80.0 % in stage III-IV patients with high TLG (>100.0). Along with tumor stage, TLG is an independent prognostic factor for disease progression after cytoreductive surgery in patients with epithelial ovarian cancer. By combining tumor stage and TLG, one can further stratify the risk of disease progression for patients undergoing cytoreductive surgery. (orig.)

  1. Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging

    Directory of Open Access Journals (Sweden)

    Juliana Muniz Miziara

    2011-01-01

    predictive values of 67.7% and 91.2%, respectively. CONCLUSION: Single-photon emission computed tomography/computed tomography with 99mTc-sestamibi showed very low sensitivity and accuracy for the nodal staging of patients with non-small cell lung cancer, despite its high level of specificity. In addition, the performance of single-photon emission computed tomography/computed tomography added no relevant information compared to computed tomography that would justify its use in the routine preoperative staging of non-small cell lung carcinoma.

  2. Perfusion analysis using a wide coverage flat-panel volume CT: feasibility study

    Science.gov (United States)

    Grasruck, M.; Gupta, R.; Reichardt, B.; Klotz, E.; Schmidt, B.; Flohr, T.

    2007-03-01

    We developed a Flat-panel detector based Volume CT (VCT) prototype scanner with large z-coverage. In that prototype scanner a Varian 4030CB a-Si flat-panel detector was mounted in a multi slice CT-gantry (Siemens Medical Solutions) which provides a 25 cm field of view with 18 cm z-coverage at isocenter. The large volume covered in one rotation can be used for visualization of complete organs of small animals, e.g. rabbits. By implementing a mode with continuous scanning, we are able to reconstruct the complete volume at any point in time during the propagation of a contrast bolus. Multiple volumetric reconstructions over time elucidate the first pass dynamics of a bolus of contrast resulting in 4-D angiography and potentially allowing whole organ perfusion analysis. We studied to which extent pixel based permeability and blood volume calculation with a modified Patlak approach was possible. Experimental validation was performed by imaging evolution of contrast bolus in New Zealand rabbits. Despite the short circulation time of a rabbit, the temporal resolution was sufficient to visually resolve various phases of the first pass of the contrast bolus. Perfusion imaging required substantial spatial smoothing but allowed a qualitative discrimination of different types of parenchyma in brain and liver. If a true quantitative analysis is possible, requires further studies.

  3. Utility of the iodine overlay technique and virtual nonenhanced images for the preoperative T staging of colorectal cancer by dual-energy CT with tin filter technology.

    Science.gov (United States)

    Chen, Chiao-Yun; Hsu, Jui-Sheng; Jaw, Twei-Shiun; Wu, Deng-Chyang; Shih, Ming-Chen Paul; Lee, Chien-Hung; Kuo, Chao-Hung; Chen, Yi-Ting; Lai, Ming-Lai; Liu, Gin-Chung

    2014-01-01

    To evaluate the diagnostic accuracy and the potential radiation dose reduction of dual-energy CT (DECT) for tumor (T) staging of colorectal cancer (CRC) using iodine overlay (IO) and virtual nonenhanced (VNE) images. This retrospective study included 103 consecutive patients who underwent nonenhanced CT and enhanced DECT for preoperative CRC staging. Enhanced weighted-average (WA), IO and VNE images were reconstructed from enhanced 80 kVp and Sn140 kVp scans. Two radiologists assessed image qualities of the true nonenhanced (TNE) and VNE images. For T-staging, another two radiologists independently interpreted all scans in two separate reading sessions: in the first session, only images derived from the single phase DECT acquisition (IO and VNE images) were read. In the second reading session after 30 to 50 (average:42) days, the same assessment was again performed with the TNE and enhanced WA images thereby simulating conventional dual-phase single-energy CT. The tumor node metastasis (TNM) system was used for staging with histopathologic reports as gold standard. Analysis of variance was used for statistical analysis. The signal-to-noise ratios (SNRs) of the tumors and normal reference tissues showed significant correlation between the TNE and VNE images (Poverlay value (48.4 HU±12.2) and enhancement (49.4 HU±11.8) value of CRCs had no significant difference (P = 0.52).The mean image noise on TNE (5.0±1.1) and VNE (5.3±1.1) images were similar (P = 0.07). The quantitative qualities of the VNE images were mildly inferior to the TNE images. Overall accuracy of T-stage CRC when using single-phase acquisition was slightly better than the dual-phase acquisition (90.3% vs 87.4%) (P = 0.51). The mean dose of the single-phase DECT acquisition was 6.2 mSv comparing with 14.3 mSv of dual-phase. Single-phase DECT using IO and VNE images yields a high accuracy in T-staging of CRCs. Thereby, the radiation exposure of the patients can be reduced.

  4. Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ah Young; Choi, Su Jung; Jung, Kyung Pyo; Park, Ji Sun; Lee, Seok Mo; Bae, Sang Kyun [Inje Univ. College of Medicine, Gimhae (Korea, Republic of)

    2014-03-15

    The aim of this study was to evaluate the characteristics of PET and CT features of mediastinal metastatic lymph nodes on F-18 FDG PET/CT and to determine the diagnostic criteria in nodal staging of non-small cell lung cancer. One hundred four non-small cell lung cancer patients who had preoperative F-18 FDG PET/CT were included. For quantitative analysis, the maximum SUV of the primary tumor, maximum SUV of the lymph nodes (SUVmax), size of the lymph nodes, and average Hounsfield units (aHUs) and maximum Hounsfield units (mHUs) of the lymph nodes were measured. The SUVmax, SUV ratio of the lymph node to blood pool (LN SUV/blood pool SUV), SUV ratio of the lymph node to primary tumor (LN SUV/primary tumor SUV), size, aHU, and mHU were compared between the benign and malignant lymph nodes. Among 372 dissected lymph node stations that were pathologically diagnosed after surgery, 49 node stations were malignant and 323 node stations benign. SUVmax, LN SUV/blood pool SUV, and size were significantly different between the malignant and benign lymph node stations (P <0.0001). However, there was no significant difference in LN SUV/primary tumor SUV (P =0.18), mHU (P =0.42), and aHU (P =0.98). Using receiver-operating characteristic curve analyses, there was no significant difference among these three variables (SUVmax, LN SUV/blood pool SUV, and size). The optimal cutoff values were 2.9 for SUVmax, 1.4 for LN SUV/blood pool SUV, and 5 mm for size. When the cutoff value of SUVmax≥2.9 and size≥5 mm were used in combination, the positive predictive value was 44.2%, and the negative predictive value was 90.9 %. When we evaluated the results based on the histology of the primary tumor, the negative predictive value was 92.3 % in adenocarcinoma (cutoff values of SUVmax≥2.3 and size≥5 mm) and 97.2 % in squamous cell carcinoma (cutoff values of SUVmax≥3.6 and size≥8 mm), separately. In the lymph node staging of non-small cell lung cancer, SUVmax, LN SUV/blood pool SUV

  5. Utility of the iodine overlay technique and virtual nonenhanced images for the preoperative T staging of colorectal cancer by dual-energy CT with tin filter technology.

    Directory of Open Access Journals (Sweden)

    Chiao-Yun Chen

    Full Text Available OBJECTIVES: To evaluate the diagnostic accuracy and the potential radiation dose reduction of dual-energy CT (DECT for tumor (T staging of colorectal cancer (CRC using iodine overlay (IO and virtual nonenhanced (VNE images. MATERIALS AND METHODS: This retrospective study included 103 consecutive patients who underwent nonenhanced CT and enhanced DECT for preoperative CRC staging. Enhanced weighted-average (WA, IO and VNE images were reconstructed from enhanced 80 kVp and Sn140 kVp scans. Two radiologists assessed image qualities of the true nonenhanced (TNE and VNE images. For T-staging, another two radiologists independently interpreted all scans in two separate reading sessions: in the first session, only images derived from the single phase DECT acquisition (IO and VNE images were read. In the second reading session after 30 to 50 (average:42 days, the same assessment was again performed with the TNE and enhanced WA images thereby simulating conventional dual-phase single-energy CT. The tumor node metastasis (TNM system was used for staging with histopathologic reports as gold standard. Analysis of variance was used for statistical analysis. RESULTS: The signal-to-noise ratios (SNRs of the tumors and normal reference tissues showed significant correlation between the TNE and VNE images (P<0.01. The mean iodine overlay value (48.4 HU±12.2 and enhancement (49.4 HU±11.8 value of CRCs had no significant difference (P = 0.52.The mean image noise on TNE (5.0±1.1 and VNE (5.3±1.1 images were similar (P = 0.07. The quantitative qualities of the VNE images were mildly inferior to the TNE images. Overall accuracy of T-stage CRC when using single-phase acquisition was slightly better than the dual-phase acquisition (90.3% vs 87.4% (P = 0.51. The mean dose of the single-phase DECT acquisition was 6.2 mSv comparing with 14.3 mSv of dual-phase. CONCLUSION: Single-phase DECT using IO and VNE images yields a high accuracy in T-staging of CRCs

  6. Utility of 18 fludeoxyglucose in preoperative positon-emission tomography-computed tomography (PET-CT) in the early diagnosis of exocrine pancreatic cancer: A study of 139 resected cases.

    Science.gov (United States)

    Sánchez-Bueno, Francisco; García-Pérez, Rocío; Claver Valderas, María Antonia; de la Peña Moral, Jesús; Frutos Esteban, Laura; Ortiz Ruiz, Eduardo; Fuster Quiñonero, Matilde; Parrilla Paricio, Pascual

    2016-11-01

    In pancreatic ductal adenocarcinoma (PDA), surgical resection is the only curative treatment, but due to its late clinical presentation only 15-25% patients are candidates for curative resection. The aim of this prospective, single-center study is to determine the diagnostic utility of preoperative PET-CT for early detection of PDA and early panIN lesions. We studied the histopathological features of PDA and different panIN lesions in 139 surgical samples from patients undergoing pancreatic resection (from 2010-2014), comparing these results with preoperative PET-CT and MDCT study. For tumor diagnosis in PET-CT maximum standard SUV 2.5 was used. Pancreatic baseline SUVmax is the maximum uptake of the radiotracer 18-2FDG on the ROI curve determined for the area of the normal pancreas after pathological reassessment with areas not affected by tumours or preneoplastic lesions. Tumour Uptake Index is the ratio between the tumour SUVmax and pancreatic baseline SUVmax. Using an standard maximum SUV value of 2.5, PET-CT sensitivity was 77.7% (108 of the 139 cases) against 75.5% (105 of the 139 cases) of MDCT. But when we combined this value with maximum SUV of normal pancreatic tissue from each patient, PET-CT sensitivity improved its value to 94.9%. A combination of studies of PET-CT in tumor and non-tumor tissue of each patient might be a very useful diagnostic tool not only for preoperative diagnosis of PDA, but also for early panIN lesions. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Advanced Primary Epithelial Ovarian and Peritoneal Carcinoma-Does Diagnostic Accuracy of Preoperative CT Scan for Detection of Peritoneal Metastatic Sites Reflect into Prediction of Suboptimal Debulking? A Prospective Study.

    Science.gov (United States)

    Bagul, Kiran; Vijaykumar, D K; Rajanbabu, Anupama; Antony, Mitchelle Aline; Ranganathan, Venkatesan

    2017-06-01

    Ovarian cancer is the seventh most common cancer in females worldwide. Optimal debulking is the standard treatment but possible only in 30-85% of advanced stages. Knowing exactly the disease extent preoperatively may predict suboptimal debulking. We analyzed diagnostic accuracy of preoperative CT scan in disease mapping and prediction of suboptimal debulking in a prospective observational study from March 2013 to May 2015 in a tertiary hospital. Adults below the age of 75 years with ECOG PS-0, 1, 2, clinically/radiologically newly diagnosed stage IIIc epithelial ovarian (EOC), and primary peritoneal carcinoma (PPC) were included. Neoadjuvant chemotherapy recipients were excluded. Preoperative multidetector CT (MDCT) scan showing deposits at 19 predetermined abdominopelvic sites were compared with the same sites seen at laparotomy and corresponding accuracies of CT scan calculated. Primary debulking surgery was done to achieve debulking to nil or less than 1-cm residual disease. Stepwise logistic regression models were used to determine the frequent suboptimal debulking sites and the predictive performance of the clinical and CT scan findings. A total of 36 patients were enrolled. The optimal debulking rate was 50%. The CT scan could detect the disease-bearing sites with overall sensitivity of 68.29%, specificity of 89%, accuracy of 78.07%, and positive and negative predictive values of 99 and 50.1%, respectively. Upon multivariate analysis, bowel mesentery (p 0.011) and omental extension (p 0.025) were associated with suboptimal debulking. CT scan accuracy at these sites (predictive performance) was 86.1%. We identified small bowel mesentery and omental extension (to spleen/stomach/colon) as sites associated with suboptimal debulking. MDCT accurately depicts peritoneal metastases, although sensitivity is reduced in certain areas of significance for optimal debulking. Further validation with more number of patients is warranted.

  8. A Hybrid 3D Learning-and-Interaction-based Segmentation Approach Applied on CT Liver Volumes

    Directory of Open Access Journals (Sweden)

    M. Danciu

    2013-04-01

    Full Text Available Medical volume segmentation in various imaging modalities using real 3D approaches (in contrast to slice-by-slice segmentation represents an actual trend. The increase in the acquisition resolution leads to large amount of data, requiring solutions to reduce the dimensionality of the segmentation problem. In this context, the real-time interaction with the large medical data volume represents another milestone. This paper addresses the twofold problem of the 3D segmentation applied to large data sets and also describes an intuitive neuro-fuzzy trained interaction method. We present a new hybrid semi-supervised 3D segmentation, for liver volumes obtained from computer tomography scans. This is a challenging medical volume segmentation task, due to the acquisition and inter-patient variability of the liver parenchyma. The proposed solution combines a learning-based segmentation stage (employing 3D discrete cosine transform and a probabilistic support vector machine classifier with a post-processing stage (automatic and manual segmentation refinement. Optionally, an optimization of the segmentation can be achieved by level sets, using as initialization the segmentation provided by the learning-based solution. The supervised segmentation is applied on elementary cubes in which the CT volume is decomposed by tilling, thus ensuring a significant reduction of the data to be classified by the support vector machine into liver/not liver. On real volumes, the proposed approach provides good segmentation accuracy, with a significant reduction in the computational complexity.

  9. The value of MPR and VRT reconstruction with helical CT enhanced images in the diagnosis and pre-operative evaluation of hypopharyneal carcinoma%MSCT增强扫描MPR和VR重建对下咽癌评估的价值

    Institute of Scientific and Technical Information of China (English)

    曹汉海; 孙敬武; 别远志

    2013-01-01

    目的 探讨螺旋CT增强扫描及二维多平面重建(Multi-Planar Reconstruction,MPR)、三维VRT (Volume Rendering Technique)后处理技术对下咽癌病情术前评估的价值.方法 回顾性分析25例经病理证实的下咽癌患者,所有病例术前均行64排螺旋CT平扫、三期增强扫描及MPR、VRT后处理,并与喉镜及手术所见进行对照分析,比较CT横轴位图像、MRP及VRT图像在下咽癌诊断及周围结构侵犯、颈淋巴结转移评估的价值.结果 25例患者中,包括梨状隐窝癌18例,环后区癌4例,下咽后壁癌3例.螺旋CT平扫、增强扫描及其MPR、VRT图像对下咽癌的诊断和颈部淋巴结转移诊断的准确度分别是94.4%和98%.其中,增强图像有助干肿瘤病灶的显示及其侵犯范围的判断,增强扫描静脉期冠状位MPR图像对于颈部淋巴结转移的显示明显优于横轴位图像.结论 螺旋CT横轴位图像结合MPR、VRT后处理技术,能清楚显示下咽癌病灶及其侵袭范围、颈部淋巴结转移情况,并能直观显示气道狭窄程度,有利于更好地制定手术计划.%Objective To evaluate the clinical implications of MRP and VRT post-prcessing technique on the images of MSCT in the diagnosis and staging of hypopharyneal cancers as carried out preoperatively based on a clinical trial.Methods A retrospective study was carried out among 25 patients with hypopharyngeal cancer diagnosed histopathologically.All these cases received 64-slice spiral CT regular scanning,phase Ⅲ enhanced scanning and multiplannar reconstruction (MPR) and volume rendering technique (VRT) post-precessing on the images.Then,a comparative analysis was made to evaluate the correlation of images with the findings obtained from laryngoscopy and during the operation in order to compare the value of axial CT,MPR and VRT images in the diagnosis of hypopharyngeal cancers and in the evaluation of its invasive extent and neck node metastasis.Results Of the 25 cases,18

  10. SU-F-207-06: CT-Based Assessment of Tumor Volume in Malignant Pleural Mesothelioma

    Energy Technology Data Exchange (ETDEWEB)

    Qayyum, F; Armato, S; Straus, C; Husain, A; Vigneswaran, W; Kindler, H [The University of Chicago, Chicago, IL (United States)

    2015-06-15

    Purpose: To determine the potential utility of computed tomography (CT) scans in the assessment of physical tumor bulk in malignant pleural mesothelioma patients. Methods: Twenty-eight patients with malignant pleural mesothelioma were used for this study. A CT scan was acquired for each patient prior to surgical resection of the tumor (median time between scan and surgery: 27 days). After surgery, the ex-vivo tumor volume was measured by a pathologist using a water displacement method. Separately, a radiologist identified and outlined the tumor boundary on each CT section that demonstrated tumor. These outlines then were analyzed to determine the total volume of disease present, the number of sections with outlines, and the mean volume of disease per outlined section. Subsets of the initial patient cohort were defined based on these parameters, i.e. cases with at least 30 sections of disease with a mean disease volume of at least 3mL per section. For each subset, the R- squared correlation between CT-based tumor volume and physical ex-vivo tumor volume was calculated. Results: The full cohort of 28 patients yielded a modest correlation between CT-based tumor volume and the ex-vivo tumor volume with an R-squared value of 0.66. In general, as the mean tumor volume per section increased, the correlation of CT-based volume with the physical tumor volume improved substantially. For example, when cases with at least 40 CT sections presenting a mean of at least 2mL of disease per section were evaluated (n=20) the R-squared correlation increased to 0.79. Conclusion: While image-based volumetry for mesothelioma may not generally capture physical tumor volume as accurately as one might expect, there exists a set of conditions in which CT-based volume is highly correlated with the physical tumor volume. SGA receives royalties and licensing fees through the University of Chicago for computer-aided diagnosis technology.

  11. Are positron emission tomography-computed tomography (PET-CT) scans useful in preoperative assessment of patients with peritoneal disease before cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)?

    Science.gov (United States)

    Wang, Weining; Tan, Grace Hwei Ching; Chia, Claramae Shulyn; Skanthakumar, Thakshayeni; Soo, Khee Chee; Teo, Melissa Ching Ching

    2017-08-31

    CRS and HIPEC confer survival benefit in selected patients with peritoneal metatases (PM). Accurate preoperative assessment of disease burden and exclusion of distant metastases are crucial in selecting the appropriate patient. We evaluate the utility of PET-CT scans in comparison with CT and MRI scans in patients considered for CRS and HIPEC. Data were retrospectively collected from patients who had been discussed for CRS and HIPEC between January 2011 and December 2015, at our institutional multidisciplinary tumour board. Patients who underwent PET-CT scan were included. Results of PET-CT were compared against traditional imaging. Patient and tumour factors were analysed to identify those who were most likely to benefit from PET imaging. Four hundred and seven patients were considered for CRS and HIPEC. PET-CT was performed for 128(31.4%) patients: being the only imaging modality in 37 and used as an adjunct in 91. In the latter group, it was not beneficial in 58 patients as it provided no additional information (n = 33) or showed lesions of minimal FDG uptake (n = 25). In 33 patients, PET-CT provided definitive answers for indeterminate lesions seen on CT and MRI, confirmed the diagnosis of peritoneal disease in 10 patients (30.3%), identified extra-peritoneal disease and/or nodal metastases in 15 (45.5%) and excluded peritoneal disease in 8 (24.2%). The usefulness of PET-CT was predicted by tumour histology (p = .009), with non-mucinous tumours benefitting the most. Our results suggest that PET-CT can be used as an adjunct to CT and/or MRI scans, when lesions on the CT/MRI scans are indeterminate, and that it is most useful in patients with non-mucinous tumours.

  12. The role of volume perfusion CT in the diagnosis of pathologies of the pancreas; Die Rolle des Volumenperfusions-CT in der Diagnostik von Pankreaspathologika

    Energy Technology Data Exchange (ETDEWEB)

    Groezinger, G.; Groezinger, A.; Horger, M. [Universitaetsklinik Tuebingen (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie

    2014-12-15

    The review discusses the potential role of volume perfusion CT (VPCT) in the diagnosis and follow-up of different pathologies of the pancreas. VPCT enables a differentiation of different pancreatic tumors like adenocarcinoma or neuroendocrine tumors based on functional parameters like blood flow, blood volume and permeability. Furthermore, the article discusses the potential indications for VPCT imaging of inflammatory diseases of the pancreas such as acute or chronic pancreatitis and autoimmune pancreatitis.

  13. Volume-of-change cone-beam CT for image-guided surgery

    Science.gov (United States)

    Lee, Junghoon; Webster Stayman, J.; Otake, Yoshito; Schafer, Sebastian; Zbijewski, Wojciech; Khanna, A. Jay; Prince, Jerry L.; Siewerdsen, Jeffrey H.

    2012-08-01

    C-arm cone-beam CT (CBCT) can provide intraoperative 3D imaging capability for surgical guidance, but workflow and radiation dose are the significant barriers to broad utilization. One main reason is that each 3D image acquisition requires a complete scan with a full radiation dose to present a completely new 3D image every time. In this paper, we propose to utilize patient-specific CT or CBCT as prior knowledge to accurately reconstruct the aspects of the region that have changed by the surgical procedure from only a sparse set of x-rays. The proposed methods consist of a 3D-2D registration between the prior volume and a sparse set of intraoperative x-rays, creating digitally reconstructed radiographs (DRRs) from the registered prior volume, computing difference images by subtracting DRRs from the intraoperative x-rays, a penalized likelihood reconstruction of the volume of change (VOC) from the difference images, and finally a fusion of VOC reconstruction with the prior volume to visualize the entire surgical field. When the surgical changes are local and relatively small, the VOC reconstruction involves only a small volume size and a small number of projections, allowing less computation and lower radiation dose than is needed to reconstruct the entire surgical field. We applied this approach to sacroplasty phantom data obtained from a CBCT test bench and vertebroplasty data with a fresh cadaver acquired from a C-arm CBCT system with a flat-panel detector. The VOCs were reconstructed from a varying number of images (10-66 images) and compared to the CBCT ground truth using four different metrics (mean squared error, correlation coefficient, structural similarity index and perceptual difference model). The results show promising reconstruction quality with structural similarity to the ground truth close to 1 even when only 15-20 images were used, allowing dose reduction by the factor of 10-20.

  14. Volume change determination of metastatic lung tumors in CT images using 3-D template matching

    Science.gov (United States)

    Ambrosini, Robert D.; Wang, Peng; O'Dell, Walter G.

    2009-02-01

    The ability of a clinician to properly detect changes in the size of lung nodules over time is a vital element to both the diagnosis of malignant growths and the monitoring of the response of cancerous lesions to therapy. We have developed a novel metastasis sizing algorithm based on 3-D template matching with spherical tumor appearance models that were created to match the expected geometry of the tumors of interest while accounting for potential spatial offsets of nodules in the slice thickness direction. The spherical template that best-fits the overall volume of each lung metastasis was determined through the optimization of the 3-D normalized cross-correlation coefficients (NCCC) calculated between the templates and the nodules. A total of 17 different lung metastases were extracted manually from real patient CT datasets and reconstructed in 3-D using spherical harmonics equations to generate simulated nodules for testing our algorithm. Each metastasis 3-D shape was then subjected to 10%, 25%, 50%, 75% and 90% scaling of its volume to allow for 5 possible volume change combinations relative to the original size per each reconstructed nodule and inserted back into CT datasets with appropriate blurring and noise addition. When plotted against the true volume change, the nodule volume changes calculated by our algorithm for these 85 data points exhibited a high degree of accuracy (slope = 0.9817, R2 = 0.9957). Our results demonstrate that the 3-D template matching method can be an effective, fast, and accurate tool for automated sizing of metastatic tumors.

  15. Accurate tracking of tumor volume change during radiotherapy by CT-CBCT registration with intensity correction

    Science.gov (United States)

    Park, Seyoun; Robinson, Adam; Quon, Harry; Kiess, Ana P.; Shen, Colette; Wong, John; Plishker, William; Shekhar, Raj; Lee, Junghoon

    2016-03-01

    In this paper, we propose a CT-CBCT registration method to accurately predict the tumor volume change based on daily cone-beam CTs (CBCTs) during radiotherapy. CBCT is commonly used to reduce patient setup error during radiotherapy, but its poor image quality impedes accurate monitoring of anatomical changes. Although physician's contours drawn on the planning CT can be automatically propagated to daily CBCTs by deformable image registration (DIR), artifacts in CBCT often cause undesirable errors. To improve the accuracy of the registration-based segmentation, we developed a DIR method that iteratively corrects CBCT intensities by local histogram matching. Three popular DIR algorithms (B-spline, demons, and optical flow) with the intensity correction were implemented on a graphics processing unit for efficient computation. We evaluated their performances on six head and neck (HN) cancer cases. For each case, four trained scientists manually contoured the nodal gross tumor volume (GTV) on the planning CT and every other fraction CBCTs to which the propagated GTV contours by DIR were compared. The performance was also compared with commercial image registration software based on conventional mutual information (MI), VelocityAI (Varian Medical Systems Inc.). The volume differences (mean±std in cc) between the average of the manual segmentations and automatic segmentations are 3.70+/-2.30 (B-spline), 1.25+/-1.78 (demons), 0.93+/-1.14 (optical flow), and 4.39+/-3.86 (VelocityAI). The proposed method significantly reduced the estimation error by 9% (B-spline), 38% (demons), and 51% (optical flow) over the results using VelocityAI. Although demonstrated only on HN nodal GTVs, the results imply that the proposed method can produce improved segmentation of other critical structures over conventional methods.

  16. SU-E-I-84: Accuracy Comparison of Multi-Modality Image-Based Volumes of Rodent Solid Tumors Using In-Air Micro-CT Image Volume

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y [University of Kansas Hospital, Kansas City, KS (United States); Fullerton, G; Goins, B [University of Texas Health Science Center at San Antonio, San Antonio, TX (United States)

    2015-06-15

    Purpose: Tumor volume is considered as a better predictor for therapy response monitoring and tumor staging over Response Evaluation Criteria In Solid Tumors (RECIST) or World Health Organization (WHO) criteria. In this study, the accuracy of subcutaneous rodent tumor volumes using preclinical magnetic resonance imaging (MRI), micro-computed tomography (micro-CT) and ultrasound (US) equipment and with an external caliper was compared using in-air micro-CT image volume of excised tumors determined as reference tumor volume in our prior study. Methods: MR, US and micro-CT images of subcutaneous SCC4 head and neck tumor xenografts were acquired 4, 6, 9, 11 and 13 days after tumor cell inoculation. Before MR and US scans, caliper measurements were made. After tumors were excised, in-air micro-CT imaging and ex vivo caliper measurements were performed. Tumor volumes were calculated using formula V = (π/6)*a*b*c where a, b and c are the maximum diameters in three perpendicular dimensions determined by the three image modalities and caliper, and compared with reference tumor volume by linear regression analysis as well as Bland-Altman plots. A one-way Analysis of Variance (ANOVA) test was also performed to compare volumes among caliper measurements. Results: The correlation coefficients (R2) of the regression lines for tumor volumes measured by the three imaging modalities and caliper were 0.9939, 0.9669, 0.9806, 0.9274, 0.9619 and 0.9819 for MRI, US and micro-CT, caliperbeforeMRI, caliperbeforeUS and ex vivo caliper respectively. In Bland-Altman plots, the average of tumor volume difference from reference tumor volume (bias) was significant for caliper and micro- CT, but not for MRI and US. Comparison of caliper measurements showed a significant difference (p < 0.05). Conclusion: Using the in-air micro-CT image volume, tumor volume measured by MRI was the most accurate among the three imaging modalities. In vivo caliper volume measurements showed unreliability while ex

  17. Dynamic volume perfusion CT in patients with lung cancer: Baseline perfusion characteristics of different histological subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Jingyun, E-mail: shijingyun89179@126.com [Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine (China); Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Schmid-Bindert, Gerald, E-mail: gerald.schmid-bindert@medma.uni-heidelberg.de [Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Fink, Christian, E-mail: Christian.Fink@akh-celle.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Sudarski, Sonja, E-mail: sonja_sudarski@gmx.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Apfaltrer, Paul, E-mail: Paul.Apfaltrer@medma.uni-heidelberg.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Pilz, Lothar R., E-mail: Lothar.Pilz@medma.uni-heidelberg.de [Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1, 68167 Mannheim (Germany); Liu, Bo, E-mail: bo.liu@siemens.com [Siemens Healthcare, No. 278, Zhouzhu Road, Shanghai, 201318 (China); Haberland, Ulrike, E-mail: ulrike.haberland@siemens.com [Siemens Healthcare Sector, H IM CR R and D PA SC, Siemensstraße 1, 91301 Forchheim (Germany); Klotz, Ernst, E-mail: ernst.klotz@siemens.com [Siemens Healthcare Sector, H IM CR R and D PA SC, Siemensstraße 1, 91301 Forchheim (Germany); and others

    2013-12-01

    Objective: To evaluate dynamic volume perfusion CT (dVPCT) tumor baseline characteristics of three different subtypes of lung cancer in untreated patients. Materials and methods: 173 consecutive patients (131 men, 42 women; mean age 61 ± 10 years) with newly diagnosed lung cancer underwent dVPCT prior to biopsy. Tumor permeability, blood flow (BF), blood volume (BV) and mean transit time (MTT) were quantitatively assessed as well as tumor diameter and volume. Tumor subtypes were histologically determined and compared concerning their dVPCT results. dVPCT results were correlated to tumor diameter and volume. Results: Histology revealed adenocarcinoma in 88, squamous cell carcinoma in 54 and small cell lung cancer (SCLC) in 31 patients. Tumor permeability was significantly differing between adenocarcinoma, squamous cell carcinoma and SCLC (all p < 0.05). Tumor BF and BV were higher in adenocarcinomathan in SCLC (p = 0.001 and p = 0.0002 respectively). BV was also higher in squamous cell carcinoma compared to SCLC (p = 0.01). MTT was not differing between tumor subtypes. Regarding all tumors, tumor diameter did not correlate with any of the dVPCT parameters, whereas tumor volume was negatively associated with permeability, BF and BV (r = −0.22, −0.24, −0.24, all p < 0.05). In squamous cell carcinoma, tumor diameter und volume correlated with BV (r = 0.53 and r = −0.40, all p < 0.05). In SCLC, tumor diameter und volume correlated with MTT (r = 0.46 and r = 0.39, all p < 0.05). In adenocarcinoma, no association between morphological and functional tumor characteristics was observed. Conclusions: dVPCT parameters are only partially related to tumor diameter and volume and are significantly differing between lung cancer subtypes.

  18. Improvement of internal tumor volumes of non-small cell lung cancer patients for radiation treatment planning using interpolated average CT in PET/CT.

    Directory of Open Access Journals (Sweden)

    Yao-Ching Wang

    Full Text Available Respiratory motion causes uncertainties in tumor edges on either computed tomography (CT or positron emission tomography (PET images and causes misalignment when registering PET and CT images. This phenomenon may cause radiation oncologists to delineate tumor volume inaccurately in radiotherapy treatment planning. The purpose of this study was to analyze radiology applications using interpolated average CT (IACT as attenuation correction (AC to diminish the occurrence of this scenario. Thirteen non-small cell lung cancer patients were recruited for the present comparison study. Each patient had full-inspiration, full-expiration CT images and free breathing PET images by an integrated PET/CT scan. IACT for AC in PET(IACT was used to reduce the PET/CT misalignment. The standardized uptake value (SUV correction with a low radiation dose was applied, and its tumor volume delineation was compared to those from HCT/PET(HCT. The misalignment between the PET(IACT and IACT was reduced when compared to the difference between PET(HCT and HCT. The range of tumor motion was from 4 to 17 mm in the patient cohort. For HCT and PET(HCT, correction was from 72% to 91%, while for IACT and PET(IACT, correction was from 73% to 93% (*p<0.0001. The maximum and minimum differences in SUVmax were 0.18% and 27.27% for PET(HCT and PET(IACT, respectively. The largest percentage differences in the tumor volumes between HCT/PET and IACT/PET were observed in tumors located in the lowest lobe of the lung. Internal tumor volume defined by functional information using IACT/PET(IACT fusion images for lung cancer would reduce the inaccuracy of tumor delineation in radiation therapy planning.

  19. Groin sentinel node biopsy and (18)F-FDG PET/CT-supported preoperative lymph node assessment in cN0 patients with vulvar cancer currently unfit for minimally invasive inguinal surgery: The GroSNaPET study.

    Science.gov (United States)

    Garganese, G; Collarino, A; Fragomeni, S M; Rufini, V; Perotti, G; Gentileschi, S; Evangelista, M T; Ieria, F P; Zagaria, L; Bove, S; Giordano, A; Scambia, G

    2017-09-01

    The study aims were: 1) to verify the role of sentinel node biopsy (SNB) in a subset of patients with clinical N0 (cN0) invasive vulvar cancer (VC) who were still candidates for radical inguinal surgery according to the current guidelines; 2) to investigate whether a preoperative (18)F-FDG PET/CT (PET/CT) evaluation could improve the selection of node negative patients. From July 2013 to July 2016, all patients with VC admitted to our Division were evaluated by standard imaging and clinical exam. Among the patients assessed as cN0 we enrolled those unsuitable for SNB, due to: T > 4 cm, multifocal tumors, complete tumor diagnostic excision, contralateral nodal involvement and local recurrence. A preoperative PET/CT was performed. For each patient surgery included SNB, performed using a combined technique (radiotracer plus blue dye), followed by standard inguino-femoral lymphadenectomy. The reference standard was histopathology. Forty-seven patients entered the study for a total of 73 groins. Histopathology revealed 12 metastatic SNs in 9 groins. No false negative SNs were found (NPV 100%). PET/CT showed a negative predictive value of 93%. Our data suggest that SNB is accurate and safe even in cN0 patients currently excluded from this procedure, providing that a careful preoperative selection is performed. PET/CT allows a reliable assessment of LN status and may be an effective support for the selection of patients who are safe candidates for SNB. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  20. Prognostic significance of metabolic tumor volume measured by {sup 18}F FDG PET/CT in operable primary breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jahae; Yoo, Su Woong; Kang, Sae Ryung; Cho, Sang Geon; Oh, Jong Ryool; Chong, Ari; Min, Jung Joon; Bom, Hee Seung; Yoon, Jung Han; Song, Ho Chun [Chonnam National Univ. Medical School and Hospital, Gwangju (Korea, Republic of)

    2012-12-15

    We investigated whether PET indices measured by {sup 18}F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) can predict prognosis in patients with operable primary breast cancer. We reviewed 53 patients with operable primary breast cancer who underwent pretreatment FDG PET/CT. PET indices, maximum standardized uptake value (SUV) and metabolic tumor volume (MTV), were measured in the primary breast tumor (P), metastatic lymph nodes (N) and total tumor (T). The cox proportional hazards model was used with age, tumor size, clinical lymph node status, method od of surgery, presence or absence of neoadjuvant chemo therapy, histological type, histological grade, hormone grade, hormone receptors and HER2 status to predict disease free survival (DFS) and overall survival (OS). Median follow up period was 50 months (range, 17 73 months), during which 17 patients had recurrent disease and nine of whom died. The univariate analysis showed that high SUV of N (N{sup SUV,} =0.011), MTV of N (N{sup MTV,} =0.011) and MTV of T (T{sup MTV,} =0.045) as well as high histological grade (=0.008), negative estrogen ( =0.045) and negative progesterone ( =0.029) receptor status were associated with shorter DFS. High N{sup SUV(}=0.035) and N{sup MTV(} =0.035) and T{sup MTV(}=0.035)as well as high histological grade (=0.012) and negative estrogen receptor status ( =0.009)were associated with shorted OS. N{sup SUV,} N{sup MTVa}nd T{sup MTw}ere found to be significantly associated with high histological grade ( =0.005). However, those failed to be statistically significant prognostic factors on multivariate analysis PET indices seem to be useful in the preoperative evaluation of prognosis in patients with operable primary breast cancer, N{sup SUV,} N{sup MTVa}nd T{sup MTVm}ight be considerable factors associated with patient outcome in operable breast cancer.

  1. Early prediction of histopathological response of rectal tumors after one week of preoperative radiochemotherapy using 18 F-FDG PET-CT imaging. A prospective clinical study

    Directory of Open Access Journals (Sweden)

    Goldberg Natalia

    2012-08-01

    Full Text Available Abstract Background Preoperative radiochemotherapy (RCT is standard in locally advanced rectal cancer (LARC. Initial data suggest that the tumor’s metabolic response, i.e. reduction of its 18 F-FDG uptake compared with the baseline, observed after two weeks of RCT, may correlate with histopathological response. This prospective study evaluated the ability of a very early metabolic response, seen after only one week of RCT, to predict the histopathological response to treatment. Methods Twenty patients with LARC who received standard RCT regimen followed by radical surgery participated in this study. Maximum standardized uptake value (SUV-MAX, measured by PET-CT imaging at baseline and on day 8 of RCT, and the changes in FDG uptake (ΔSUV-MAX, were compared with the histopathological response at surgery. Response was classified by tumor regression grade (TRG and by achievement of pathological complete response (pCR. Results Absolute SUV-MAX values at both time points did not correlate with histopathological response. However, patients with pCR had a larger drop in SUV-MAX after one week of RCT (median: -35.31% vs −18.42%, p = 0.046. In contrast, TRG did not correlate with ΔSUV-MAX. The changes in FGD-uptake predicted accurately the achievement of pCR: only patients with a decrease of more than 32% in SUV-MAX had pCR while none of those whose tumors did not show any decrease in SUV-MAX had pCR. Conclusions A decrease in ΔSUV-MAX after only one week of RCT for LARC may be able to predict the achievement of pCR in the post-RCT surgical specimen. Validation in a larger independent cohort is planned.

  2. Left ventricle endocardium segmentation for cardiac CT volumes using an optimal smooth surface

    Science.gov (United States)

    Zheng, Yefeng; Georgescu, Bogdan; Vega-Higuera, Fernando; Comaniciu, Dorin

    2009-02-01

    We recently proposed a robust heart chamber segmentation approach based on marginal space learning. In this paper, we focus on improving the LV endocardium segmentation accuracy by searching for an optimal smooth mesh that tightly encloses the whole blood pool. The refinement procedure is formulated as an optimization problem: maximizing the surface smoothness under the tightness constraint. The formulation is a convex quadratic programming problem, therefore has a unique global optimum and can be solved efficiently. Our approach has been validated on the largest cardiac CT dataset (457 volumes from 186 patients) ever reported. Compared to our previous work, it reduces the mean point-to-mesh error from 1.13 mm to 0.84 mm (22% improvement). Additionally, the system has been extensively tested on a dataset with 2000+ volumes without any major failure.

  3. Low tube voltage and low contrast material volume cerebral CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Song [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Xuzhou Medical College, School of Medical Imaging, Xuzhou, Jiangsu (China); Zhang, Long Jiang; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Meinel, Felix G.; McQuiston, Andrew D. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Zhou, Chang Sheng; Qi, Li [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

    2014-07-15

    To evaluate the image quality, radiation dose and diagnostic accuracy of low kVp and low contrast material volume cerebral CT angiography (CTA) in intracranial aneurysm detection. One hundred twenty patients were randomly divided into three groups (n = 40 for each): Group A, 70 ml iodinated contrast agent/120 kVp; group B, 30 ml/100 kVp; group C, 30 ml/80 kVp. The CT numbers, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured in the internal carotid artery (ICA) and middle cerebral artery (MCA). Subjective image quality was evaluated. For patients undergoing DSA, diagnostic accuracy of CTA was calculated with DSA as reference standard and compared. CT numbers of ICA and MCA were higher in groups B and C than in group A (P < 0.01). SNR and CNR in groups A and B were higher than in group C (both P < 0.05). There was no difference in subjective image quality among the three groups (P = 0.939). Diagnostic accuracy for aneurysm detection among these groups had no statistical difference (P = 1.00). Compared with group A, the radiation dose of groups B and C was decreased by 45 % and 74 %. Cerebral CTA at 100 or 80 kVp using 30 ml contrast agent can obtain diagnostic image quality with a low radiation dose while maintaining the same diagnostic accuracy for aneurysm detection. (orig.)

  4. Cerebral blood volume imaging by flat detector computed tomography in comparison to conventional multislice perfusion CT.

    Science.gov (United States)

    Struffert, Tobias; Deuerling-Zheng, Yu; Kloska, Stephan; Engelhorn, Tobias; Boese, Jan; Zellerhoff, Michael; Schwab, Stefan; Doerfler, Arnd

    2011-04-01

    We tested the hypothesis that Flat Detector computed tomography (FD-CT) with intravenous contrast medium would allow the calculation of whole brain cerebral blood volume (CBV) mapping (FD-CBV) and would correlate with multislice Perfusion CT (PCT). Twenty five patients were investigated with FD-CBV and PCT. Correlation of the CBV maps of both techniques was carried out with measurements from six anatomical regions from both sides of the brain. Mean values of each region and the correlation coefficient were calculated. Bland-Altman analysis was performed to compare the two different imaging techniques. The image and data quality of both PCT and FD-CBV were suitable for evaluation in all patients. The mean CBV values of FD-CBV and PCT showed only minimal differences with overlapping standard deviation. The correlation coefficient was 0.79 (p < 0.01). Bland-Altman analysis showed a mean difference of -0.077 ± 0.48 ml/100 g between FD-CBV and PCT CBV measurements, indicating that FD-CBV values were only slightly lower than those of PCT. CBV mapping with intravenous contrast medium using Flat Detector CT compared favourably with multislice PCT. The ability to assess cerebral perfusion within the angiographic suite may improve the management of ischaemic stroke and evaluation of the efficacy of dedicated therapies.

  5. A comparison study between gross tumor volumes defined by preoperative magnetic resonance imaging, postoperative specimens, and tumor bed for radiotherapy after breast-conserving surgery

    Science.gov (United States)

    Zhang, Aiping; Li, Jianbin; Wang, Wei; Wang, Yongsheng; Mu, Dianbin; Chen, Zhaoqiu; Shao, Qian; Li, Fengxiang

    2017-01-01

    Abstract Background: The identification and contouring of target volume is important for breast-conserving therapy. The aim of the study was to compare preoperative magnetic resonance imaging (MRI), postoperative pathology, excised specimens’ (ES) size, and tumor bed (TB) delineation as methods for determining the gross tumor volume (GTV) for radiotherapy after breast-conserving surgery (BCS). Methods: Thirty-three patients with breast cancer who underwent preoperative MRI and radiotherapy after BCS were enrolled. The GTVs determined by MRI, pathology, and the ES were defined as GTVMRI, GTVPAT, and GTVES, respectively. GTVMRI+1 was defined as a 1.0-cm margin around the GTVMRI. The radiation oncologist delineated GTV of the TB (GTVTB) using planning computed tomography according to ≥5 surgical clips placed in the lumpectomy cavity (LC). Results: The median GTVMRI, GTVMRI+1, GTVPAT, GTVES, and GTVTB were 0.97 cm3 (range, 0.01–6.88), 12.58 cm3 (range, 3.90–34.13), 0.97 cm3 (range, 0.01–6.36), 15.46 cm3 (range, 1.15–70.69), and 19.24 cm3 (range, 4.72–54.33), respectively. There were no significant differences between GTVMRI and GTVPAT, GTVMRI+1 and GTVES, GTVES and GTVTB (P = 0.188, 0.070, and 0.264, respectively). GTVMRI is positively related with GTVPAT. However, neither GTVES nor GTVTB correlated with GTVMRI (P = 0.071 and 0.378, respectively). Furthermore, neither GTVES nor GTVTB correlated with GTVMRI+1 (P = 0.068 and 0.375, respectively). Conclusion: When ≥5 surgical clips were placed in the LC for BCS, the volume of TB was consistent with the volume of ES. Neither the volume of TB nor the volume of ES correlated significantly with the volume of tumor defined by preoperative MRI. PMID:28079816

  6. 2D-3D Registration of CT Vertebra Volume to Fluoroscopy Projection: A Calibration Model Assessment

    Directory of Open Access Journals (Sweden)

    Allen R

    2010-01-01

    Full Text Available This study extends a previous research concerning intervertebral motion registration by means of 2D dynamic fluoroscopy to obtain a more comprehensive 3D description of vertebral kinematics. The problem of estimating the 3D rigid pose of a CT volume of a vertebra from its 2D X-ray fluoroscopy projection is addressed. 2D-3D registration is obtained maximising a measure of similarity between Digitally Reconstructed Radiographs (obtained from the CT volume and real fluoroscopic projection. X-ray energy correction was performed. To assess the method a calibration model was realised a sheep dry vertebra was rigidly fixed to a frame of reference including metallic markers. Accurate measurement of 3D orientation was obtained via single-camera calibration of the markers and held as true 3D vertebra position; then, vertebra 3D pose was estimated and results compared. Error analysis revealed accuracy of the order of 0.1 degree for the rotation angles of about 1 mm for displacements parallel to the fluoroscopic plane, and of order of 10 mm for the orthogonal displacement.

  7. Automatic extraction of forward stroke volume using dynamic PET/CT

    DEFF Research Database (Denmark)

    Harms, Hans; Tolbod, Lars Poulsen; Hansson, Nils Henrik;

    Background: Dynamic PET can be used to extract forward stroke volume (FSV) by the indicator dilution principle. The technique employed can be automated and is in theory independent on the tracer used and may therefore be added to any dynamic cardiac PET protocol. The aim of this study was to vali......Background: Dynamic PET can be used to extract forward stroke volume (FSV) by the indicator dilution principle. The technique employed can be automated and is in theory independent on the tracer used and may therefore be added to any dynamic cardiac PET protocol. The aim of this study...... was to validate automated methods for extracting FSV directly from dynamic PET studies for two different tracers and to examine potential scanner hardware bias. Methods: 21 subjects underwent a dynamic 27 min 11C-acetate PET scan on a Siemens Biograph TruePoint 64 PET/CT scanner (scanner I). In addition, 8...... subjects underwent a dynamic 6 min 15O-water PET scan followed by a 27 min 11C-acetate PET scan on a GE Discovery ST PET/CT scanner (scanner II). The LV-aortic time-activity curve (TAC) was extracted automatically from dynamic PET data using cluster analysis. The first-pass peak was isolated by automatic...

  8. Influence of technical parameters on epicardial fat volume quantification at cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Bucher, Andreas M. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt (Germany); Joseph Schoepf, U., E-mail: schoepf@musc.edu [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States); Krazinski, Aleksander W.; Silverman, Justin; Spearman, James V. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); De Cecco, Carlo N. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiological Sciences, Oncology and Pathology, University of Rome “Sapienza” – Polo Pontino, Latina (Italy); Meinel, Felix G. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich (Germany); Vogl, Thomas J. [Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Frankfurt (Germany); Geyer, Lucas L. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich (Germany)

    2015-06-15

    Highlights: • Upper threshold levels and contrast enhancement influence epicardial fat volumetry. • Cardiac cycle does not significantly influence epicardial fat volumetry. • Adjustments of upper threshold can lead to comparable volumetry results. - Abstract: Objectives: To systematically analyze the influence of technical parameters on quantification of epicardial fat volume (EATV) at cardiac CT. Methods: 153 routine cardiac CT data sets were analyzed using three-dimensional pericardial border delineation. Three image series were reconstructed per patient: (a) CTA{sub D}: coronary CT angiography (CTA), diastolic phase; (b) CTA{sub S}: coronary CTA, systolic phase; (c) CaSc{sub D}: non-contrast CT, diastolic phase. EATV was calculated using three different upper thresholds (−15HU, −30HU, −45HU). Repeated measures ANOVA, Spearman's rho, and Bland Altman plots were used. Results: Mean EATV differed between all three image series at a −30HU threshold (CTA{sub D} 87.2 ± 38.5 ml, CTA{sub S} 90.9 ± 37.7 ml, CaSc{sub D} 130.7 ± 49.5 ml, P < 0.001). EATV of diastolic and systolic CTA reconstructions did not differ significantly (P = 0.225). Mean EATV for contrast enhanced CTA at a −15HU threshold (CTA{sub D15} 102.4 ± 43.6 ml, CTA{sub S15} 105.3 ± 42.3 ml) could be approximated most closely by non-contrast CT at −45HU threshold (CaSc{sub D45} 105.3 ± 40.8 ml). The correlation was excellent: CTA{sub S15}–CTA{sub D15}, rho = 0.943; CTA{sub D15}–CaSc{sub D45}, rho = 0.905; CTA{sub S15}–CaSc{sub D45}, rho = 0.924; each P < 0.001). Bias values from Bland Altman Analysis were: CTA{sub S15}–CTA{sub D15}, 4.9%; CTA{sub D15}–CaSc{sub D45}, −4.3%; CTA{sub S15}–CaSc{sub D45}, 0.6%. Conclusions: Measured EATV can differ substantially between contrast enhanced and non-contrast CT studies, which can be reconciled by threshold modification. Heart cycle phase does not significantly influence EATV measurements.

  9. Measurement of tumor volumes of hepatocellular carcinoma (HCC) by computed tomography (CT). Correlation with several tumor markers

    Energy Technology Data Exchange (ETDEWEB)

    Yoneshima, Manabu; Sawabu, Norio; Toya, Daishu

    1984-09-01

    Tumor volumes of HCC were measured by CT using planimeter and the clinical value of this measurement was evaluated by comparing several tumor markers. Tumor volumes measured by CT roughly agreed with those measured by angiography. In some cases, volumes from ultrasonography were smaller than those from CT and angiography. Tumor volumes measured by CT correlated significantly with the levels of ..cap alpha..-fetoprotein (AFP) but didn't relate to the presence of hepatoma specific ..gamma..-GTP isoenzyme (novel ..gamma..-GTP) nor to the values and positivities of LAI assay. In small HCCs (<=30 cm/sup 3/), the presence of novel ..gamma..-GTP and the levels of AFP were significantly lower than for larger tumors of HCC, but LAI assay wasn't lower. The non-tumorous volumes and the ratio of the non-tumorous volume to the whole liver volume didn't relate to the tests of liver function except for the presence of ascites.

  10. Detection and Characterization of Parathyroid Adenoma/Hyperplasia for Preoperative Localization: Comparison Between {sup 11}C-Methionine PET/CT and {sup 99m}Tc-Sestamibi Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Chun, In Kook; Cheon, Gi Jeong; Paeng, Jin Chul; Kang, Keon Wook; Chung, Junekey; Lee, Dong Soo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2013-09-15

    {sup 11}C-Methionine PET/CT (Met-PET/CT) is a useful imaging method for detection of parathyroid adenoma; however, the reported detection rate has been variable. The current study was intended to investigate detection sensitivity and preoperative localization of parathyroid adenoma (PA) or parathyroid hyperplasia (PH) on Met-PET/CT compared with {sup 99m}Tc-sestamibi (MIBI) scintigraphy in patients with primary hyperparathyroidism (HPT) or suspected PA. Met-PET/CT and MIBI scintigraphy images were reviewed by two nuclear medicine physicians unaware of pathologic results. Detection sensitivities and preoperative localization of detected parathyroid tissues into five predefined segments were evaluated by visual assessment and semiquantitative analysis with ratio of standardized uptake values (SUVR) between parathyroid tissue and normal lung as reference. Linear regression analysis with SUVR and serum parathyroid hormone (sPTH) was performed for characterization of PA or PH. Predicted PTH (pPTH) was calculated and compared with sPTH in PH and PA. Each pPTH was obtained for a calculated SUVR by using linear regression model from the result of previous linear regression analysis between SUVR and sPTH. In 16 patients, detection sensitivities of Met-PET/CT and MIBI scintigraphy were 91.7 % (11/12) and 41.7 % (5/12) for PA and PH including both biopsy-confirmed and clinically-suspected cases, and 100 % (8/8) and 50 % (4/8) for pathologically confirmed PA and PH cases only, respectively. Met-PET/CT showed higher performance than MIBI scintigraphy in localization of parathyroid tissues; correct localization rate was 87.5 % (7/8) on Met-PET/CT and 50 % (4/8) on MIBI scintigraphy. In semi-quantitative analysis, SUVR was linearly associated with sPTH by linear regression analysis (sPTH=39.53ΧSUVR-89.84, p=0.0383). There was a borderline significant difference in pPTH between PH and PA (35.1 vs 204.7±164.0, p=0.052),while there was no significant difference in sPTH between PH

  11. Changes in computed tomography features following preoperative chemotherapy for nephroblastoma: relation to histopathological classification

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, Oeystein E.; Jeanes, Annmarie C.; Roebuck, Derek J.; Owens, Catherine M. [Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, WC1N 3JH, London (United Kingdom); Sebire, Neil J.; Risdon, Rupert A. [Department Histopathology, Great Ormond Street Hospital for Children NHS Trust, London (United Kingdom); Michalski, Anthony J. [Department Haematology and Oncology, Great Ormond Street Hospital for Children NHS Trust, London (United Kingdom)

    2004-06-01

    The objective of this study is to assess computed tomography (CT) changes, both volume estimates and subjective features, following preoperative chemotherapy for nephroblastoma (Wilms' tumour) in patients treated on the United Kingdom Children's Cancer Study Group Wilms' Tumour Study-3 (UKW-3) protocol and to compare CT changes and histopathological classification. Twenty-one nephroblastomas in 15 patients treated on UKW-3 were included. All patients were examined by CT before and after preoperative chemotherapy treatment. CT images were reviewed (estimated volume change and subjectively assessed features). CT changes were compared to histopathological classification. Of the 21 tumours, all five high-risk tumours decreased in volume following chemotherapy (median -79%; range -37 to -91%). The sole low-risk tumour decreased in volume by 98%. Ten intermediate-risk tumours decreased in volume (median -72%; range -6 to -98%) and five intermediate-risk tumours increased (median +110%; range +11 to +164%). None of the five high-risk tumours, compared to 15/16 intermediate or low-risk tumours, became less dense and/or more homogeneous, or virtually disappeared, following chemotherapy. Volume change following chemotherapy did not relate to histopathological risk group. Changes in subjectively assessed qualitative CT features were more strongly related to histopathological risk group. (orig.)

  12. Automated localization and segmentation of lung tumor from PET-CT thorax volumes based on image feature analysis.

    Science.gov (United States)

    Cui, Hui; Wang, Xiuying; Feng, Dagan

    2012-01-01

    Positron emission tomography - computed tomography (PET-CT) plays an essential role in early tumor detection, diagnosis, staging and treatment. Automated and more accurate lung tumor detection and delineation from PET-CT is challenging. In this paper, on the basis of quantitative analysis of contrast feature of PET volume in SUV (standardized uptake value), our method firstly automatically localized the lung tumor. Then based on analysing the surrounding CT features of the initial tumor definition, our decision strategy determines the tumor segmentation from CT or from PET. The algorithm has been validated on 20 PET-CT studies involving non-small cell lung cancer (NSCLC). Experimental results demonstrated that our method was able to segment the tumor when adjacent to mediastinum or chest wall, and the algorithm outperformed the other five lung segmentation methods in terms of overlapping measure.

  13. Low dose four-dimensional computerized tomography with volume rendering reconstruction for primary hyperparathyroidism: How I do it?

    Institute of Scientific and Technical Information of China (English)

    Timothy; A; Platz; Moshim; Kukar; Rania; Elmarzouky; William; Cance; Ahmed; Abdelhalim

    2014-01-01

    Abstract Modification of 4-dimensional computed tomography(4D-CT)technique with volume rendering reconstruc-tions and significant dose reduction is a safe and ac-curate method of pre-operative localization for primary hyperparathyroidism.Modified low dose 4D-CT with volume rendering reconstructions provides precise preoperative localization and is associated with a sig-nificant reduction in radiation exposure compared to classic preoperative localizing techniques.It should be considered the preoperative localization study of choice for primary hyperparathyroidism.

  14. Advanced NSCLC First Pass Perfusion at 64-slice CT: Reproducibility of Volume-based Quantitative Measurement

    Directory of Open Access Journals (Sweden)

    Jie HU

    2010-05-01

    Full Text Available Background and objective The aim of this study is to explore the reproducibility of volume-based quantitative measurement of non-small cell lung cancer (NSCLC perfusion at 64-slice CT. Methods Fourteen patients with proved advanced NSCLC were enrolled in this dynamic first pass volume-based CT perfusion (CTP study (8×5 mm collimation, and they underwent the second scan within 24 h. According to the longest diameters, those patients were classified to ≤3 cm and >3 cm groups, and each group had 7 patients. Intraclass correlation coefficient (ICC and Bland-Altman statistics were used to evaluate the reproducibility of CTP imaging. Results In both groups of advanced NSCLC, the reproducibility with BF, BV, and PS values were good (ICC >0.75 for all, but mean transit time (MTT values. For advanced NSCLC (≤3 cm, repeatability coefficient (RC values with blood flow (BF, blood volume (BV, MTT and permeability surface area product (PS values were 56%, 45%, 114%, and 78%, respectively, and the 95% change intervals of RC were -39%-53%, -29%-62%, -83%-145%, and -57%-98%, respectively. For advanced NSCLC (>3 cm, those values were 46%, 30%, 59%, and 33%, respectively, and the 95% change intervals of RC were -48%-45%, -33%-26%, -54%-64%, and -18%-48%. Conclusion There is greater reproducibility of tumor size >3 cm than that of ≤3 cm. BF and BV could be addressed for reliable clinical application in antiangiogenesis therapeutic monitoring with advanced NSCLC patients.

  15. Analysis of 64-row multidetector CT images for preoperative angiographic evaluation of potential living kidney donors; Analyse der mehrphasigen 64-Zeilen-Multidetektor-Computertomographie zur praeoperativen angiographischen Evaluation potenzieller Lebendnierenspender

    Energy Technology Data Exchange (ETDEWEB)

    Blondin, D.; Andersen, K.; Kroepil, P.; Cohnen, M.; Moedder, U.; Jung, G. [Universitaetsklinikum Duesseldorf, Institut fuer Diagnostische Radiologie, Duesseldorf (Germany); Sandmann, W. [Universitaetsklinikum Duesseldorf, Klinik fuer Gefaesschirurgie und Nierentransplantation, Duesseldorf (Germany); Ivens, K. [Universitaetsklinikum Duesseldorf, Klinik fuer Nephrologie, Duesseldorf (Germany)

    2008-07-15

    Anatomical imaging and the ascertainment of any anomalies in the renal vessels and the ureters are essential in the planning of a kidney donation. The aim of the present study was to assess the value of 64-row multidetector CT in noninvasive examination of the renal vessels and ureters of potential living kidney donors. The evaluation embraced 63 living renal donors (LNS) who underwent preoperative CT examination from December 2004 to January 2007. The examinations were all carried out using a Somatom Sensation -Cardiac 64 (Siemens Medical Solutions, Germany). As well as CT angiography (CTA), a venous phase of the abdomen and a late phase after 15 min using low-dose technique were performed for CT urography (CTU). The radiological findings were compared with the surgical results, or with the angiograms in 2 cases. Sensitivity, specificity and both negative and positive predictive value were calculated. In the 63 (31 female, 32 male) donors CTA had a sensitivity of 100% in examination of the main and accessory renal arteries and of 98.3% when the venous and ureteric anatomy were assessed. The sensitivity of low-dose CTU was also 100%. The findings recorded in this study indicate that noninvasive preoperative planning with 64-row multidetector CTA and CTU is a reliable 'one-stop shopping' method of examination for potential living kidney donors. (orig.) [German] Die anatomische Darstellung und Erfassung moeglicher Anomalien der Nierengefaesse und Ureteren ist fuer die Planung einer Lebendnierenspende von essenzieller Bedeutung. Die vorliegende Untersuchung soll die Wertigkeit der nichtinvasiven Evaluation mit der 64-Zeilen-Multidetektor-CT untersuchen. In die Auswertung wurden 63 Lebendnierenspender (LNS) eingeschlossen, die im Zeitraum 12.2004 bis 01.2007 mit der CT praeoperativ untersucht wurden. Die Untersuchungen erfolgten mit einem Somatom-Sensation-Cardiac-64 (Siemens Medical Solutions, Deutschland). Neben einer CT-Angiographie (CTA) wurden eine

  16. Intraobserver and interobserver agreement of volume perfusion CT (VPCT) measurements in patients with lung lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sauter, Alexander W., E-mail: alexander.sauter@klinikum.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Merkle, Anne, E-mail: anne_merkle@web.de [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Schulze, Maximilian, E-mail: maximilian.schulze@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Spira, Daniel, E-mail: daniel.spira@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Hetzel, Juergen, E-mail: juergen.hetzel@med.uni-tuebingen.de [Departments of Oncology, Hematology, Immunology, Rheumatology and Pulmonology, University Hospital of Tuebingen, Otfried-Mueller-Str. 10, 72076 Tuebingen (Germany); Claussen, Claus D., E-mail: claus.claussen@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Horger, Marius S., E-mail: marius.horger@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)

    2012-10-15

    Objectives: To evaluate intraobserver and interobserver agreement of manually encompassed lung lesions for perfusion measurements using volume-perfusion computed tomography (VPCT). Materials and methods: Institutional review board approval and informed consent were obtained. HIPAA guidelines were followed. A 65-s dynamic study was acquired with scan parameters 80 kV, 60 mA s (80 mA s for patients ≥70 kg), 128 × 0.6 mm collimation. Blood flow (BF), blood volume (BV) and K{sup trans} parameters were determined by syngo volume perfusion CT body with 88 lesions analyzed retrospectively. Results: Within-subject coefficients of variation for intraobserver agreement (range 6.59–12.82%) were superior to those for interobserver agreement (range 21.75–38.30%). Size-dependent analysis revealed lower agreements for lesions <4 cm as compared to larger lesions. Additionally, agreements of the upper, middle and lower lung zones were different. Conclusions: Intraobserver agreement was substantial for VPCT lung cancer perfusion measurements encouraging the use for tumor characterization and therapy response monitoring. Interobserver agreement is limited and unexperienced readers should be trained before using this new method.

  17. Effect of Fixed-Volume and Weight-Based Dosing Regimens on the Cost and Volume of Administered Iodinated Contrast Material at Abdominal CT.

    Science.gov (United States)

    Davenport, Matthew S; Parikh, Kushal R; Mayo-Smith, William W; Israel, Gary M; Brown, Richard K J; Ellis, James H

    2017-03-01

    To determine the magnitude of subject-level and population-level cost savings that could be realized by moving from fixed-volume low-osmolality iodinated contrast material administration to an effective weight-based dosing regimen for contrast-enhanced abdominopelvic CT. HIPAA-compliant, institutional review board-exempt retrospective cohort study of 6,737 subjects undergoing contrast-enhanced abdominopelvic CT from 2014 to 2015. Subject height, weight, lean body weight (LBW), and body surface area (BSA) were determined. Twenty-six volume- and weight-based dosing strategies with literature support were compared with a fixed-volume strategy used at the study institution: 125 mL 300 mgI/mL for routine CT, 125 mL 370 mgI/mL for multiphasic CT (single-energy, 120 kVp). The predicted population- and subject-level effects on cost and contrast material utilization were calculated for each strategy and sensitivity analyses were performed. Most subjects underwent routine CT (91% [6,127/6,737]). Converting to lesser-volume higher-concentration contrast material had the greatest effect on cost; a fixed-volume 100 mL 370 mgI/mL strategy resulted in $132,577 in population-level savings with preserved iodine dose at routine CT (37,500 versus 37,000 mgI). All weight-based iodine-content dosing strategies (mgI/kg) with the same maximum contrast material volume (125 mL) were predicted to contribute mean savings compared with the existing fixed-volume algorithm ($4,053-$116,076/strategy in the overall study population, $1-$17/strategy per patient). Similar trends were observed in all sensitivity analyses. Large cost and material savings can be realized at abdominopelvic CT by adopting a weight-based dosing strategy and lowering the maximum volume of administered contrast material. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Feasibility of Commercially Available, Fully Automated Hepatic CT Volumetry for Assessing Both Total and Territorial Liver Volumes in Liver Transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Cheong Il; Kim, Se Hyung; Rhim, Jung Hyo; Yi, Nam Joon; Suh, Kyung Suk; Lee, Jeong Min; Han, Joon Koo; Choi, Byung Ihn [Seoul National University Hospital, Seoul (Korea, Republic of)

    2013-02-15

    To assess the feasibility of commercially-available, fully automated hepatic CT volumetry for measuring both total and territorial liver volumes by comparing with interactive manual volumetry and measured ex-vivo liver volume. For the assessment of total and territorial liver volume, portal phase CT images of 77 recipients and 107 donors who donated right hemiliver were used. Liver volume was measured using both the fully automated and interactive manual methods with Advanced Liver Analysis software. The quality of the automated segmentation was graded on a 4-point scale. Grading was performed by two radiologists in consensus. For the cases with excellent-to-good quality, the accuracy of automated volumetry was compared with interactive manual volumetry and measured ex-vivo liver volume which was converted from weight using analysis of variance test and Pearson's or Spearman correlation test. Processing time for both automated and interactive manual methods was also compared. Excellent-to-good quality of automated segmentation for total liver and right hemiliver was achieved in 57.1% (44/77) and 17.8% (19/107), respectively. For both total and right hemiliver volumes, there were no significant differences among automated, manual, and ex-vivo volumes except between automate volume and manual volume of the total liver (p = 0.011). There were good correlations between automate volume and ex-vivo liver volume ({gamma}= 0.637 for total liver and {gamma}= 0.767 for right hemiliver). Both correlation coefficients were higher than those with manual method. Fully automated volumetry required significantly less time than interactive manual method (total liver: 48.6 sec vs. 53.2 sec, right hemiliver: 182 sec vs. 244.5 sec). Fully automated hepatic CT volumetry is feasible and time-efficient for total liver volume measurement. However, its usefulness for territorial liver volumetry needs to be improved.

  19. Digital forensic osteology: morphological sexing of skeletal remains using volume-rendered cranial CT scans.

    Science.gov (United States)

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

    2010-02-25

    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.

  20. Effects of Propranolol on the Left Ventricular Volume of Normal Subjects During CT Coronary Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Mo, Yuan Heng; Jaw, Fu Shan [National Taiwan University, Taipei, Taiwan (China); Wang, Yung Cheng; Jeng, Chin Ming [Fu Jen Catholic University, Taipei, Taiwan (China); Peng, Shinn Forng [National Taiwan University Hospital, Taipei, Taiwan (CN)

    2011-06-15

    The purpose of this study is to determine the effects of propranolol on the left ventricular (LV) volume during CT coronary angiography. The LV volume of 252 normal Chinese subjects (126 subjects with propranolol medication and 126 age- and gender-matched Chinese subjects without medication) was estimated using 64 slices multi-detector CT (MDCT). The heart rate difference was analyzed by the logistic linear regression model with variables that included gender, age, body height, body weight, systolic blood pressure (SBP), diastolic blood pressure (DBP) and the dosage of propranolol. The following global LV functional parameters were calculated: the real-end diastolic volume (EDV), the real-end systolic volume (ESV) and the real-ejection fraction (EF). The female subjects had a greater decrease of heart rate after taking propranolol. The difference of heart rate was negatively correlated with the dosage of propranolol. The real-EDV, the real-ESV and the real-EF ranged from 48.1 to 109 mL/m2, 6.1 to 57.1 mL/m2 and 41% to 88%, respectively. There was no significant difference in the SBP and DBP between the groups without and with propranolol medication (123 {+-} 17 and 80 {+-} 10 mmHg; 120 {+-} 14 and 80 {+-} 11 mmHg, respectively). The real-EDV showed no significant difference between these two groups, but the real-ESV and real-EF showed significant differences between these two groups (69.4 {+-} 9.3 and 70.6 {+-} 8.9 mL/m2; 23.5 {+-} 5.7 and 25.6 {+-} 3.7 mL/m2, 66.5 {+-} 5.1% and 63.5 {+-} 4.6%, respectively). The difference of heart rate is significantly influenced by gender and the dosage of propranolol. Propranolol will also increase the ESV, which contributes to a decreased EF, while the SBP, DBP and EDV are not statistically changed.

  1. The Value of Preoperative CT Angiography for Splenic Artery Steal Syndrome in Liver Transplantation%术前CT血管成像对肝移植脾动脉盗血综合征的预估

    Institute of Scientific and Technical Information of China (English)

    高海军; 陈光; 祁吉

    2011-01-01

    Objective To estimate the value of preoperative CT angiography( CTA ) in predicting the splenic artery steal syndrome (SASS) in liver transplantation. Methods 8 cases with SASS ( group A) and 8 healthy control subjects (group B) underwent CTA. The diameters of splenic artery and hepatic artery,the volume of liver and spleen, the ratio of splenic artery to hepatic artery (SA/HA) ,the ratio of hepatic volume to splenic volume( HV/SV) in both group A and B were measured before the transplantation of liver using GE ADW4. 2 at workstation and analysed statistically using SPSS 13. 0 statistic software. Results There were significant differences statistically between group A and B in the diameters of splenic artery( P= 0. 008 , P<0. 05 ) and SA/HA( P = 0. 015 ,P<0. 05). While there were no significant statistically differences between group A and B in hepatic artery diameter, spleen volume,liver volume and HV/SV ( P= 0. 364 , 0. 78 , 0. 624 and 0. 172 , respectively, P>0. 05 ). Conclusion The splenic artery diameter and HV/SV have important symptomatic significance for the happening of SASS whether or not. And it is to hint that the possibility of SASS is high when splenic artery diameter exceeds 7. 5 mm and SA/HA cxcecds 1. 2.%目的 评价术前CT血管成像对肝移植术后脾动脉盗血综合征的预估价值.方法 脾动脉盗血组(A组)及正常对照组(B组)各8例行CT血管成像.应用GE ADW4.2工作站,测量脾动脉盗血组和正常组病人肝移植术前肝动脉直径,脾动脉直径,肝脏体积,脾体积及其比值.使用SPSS 13统计软件,对2组数据进行统计分析.结果 脾动脉盗血组和正常组脾动脉直径在统计学上有显著的差别(P=0.008,P0.05).结论 脾动脉直径、脾动脉直径/肝动脉直径对术后是否发生盗血具有重要提示意义,并且脾动脉直径>7.5 mm、脾动脉直径/肝动脉直径>1.2提示发生盗血的概率较大.

  2. The effect of late-phase contrast enhancement on semi-automatic software measurements of CT attenuation and volume of part-solid nodules in lung adenocarcinomas

    NARCIS (Netherlands)

    Cohen, J.G.; Goo, J.M.; Yoo, R.E.; Park, S.B.; Ginneken, B. van; Ferretti, G.R.; Lee, C.H.; Park, C.M.

    2016-01-01

    OBJECTIVES: To evaluate the differences in semi-automatic measurements of CT attenuation and volume of part-solid nodules (PSNs) between unenhanced and enhanced CT scans. MATERIALS AND METHODS: CT scans including unenhanced and enhanced phases (slice thickness 0.625 and 1.25mm, respectively) for 53

  3. Development of automated extraction method of biliary tract from abdominal CT volumes based on local intensity structure analysis

    Science.gov (United States)

    Koga, Kusuto; Hayashi, Yuichiro; Hirose, Tomoaki; Oda, Masahiro; Kitasaka, Takayuki; Igami, Tsuyoshi; Nagino, Masato; Mori, Kensaku

    2014-03-01

    In this paper, we propose an automated biliary tract extraction method from abdominal CT volumes. The biliary tract is the path by which bile is transported from liver to the duodenum. No extraction method have been reported for the automated extraction of the biliary tract from common contrast CT volumes. Our method consists of three steps including: (1) extraction of extrahepatic bile duct (EHBD) candidate regions, (2) extraction of intrahepatic bile duct (IHBD) candidate regions, and (3) combination of these candidate regions. The IHBD has linear structures and intensities of the IHBD are low in CT volumes. We use a dark linear structure enhancement (DLSE) filter based on a local intensity structure analysis method using the eigenvalues of the Hessian matrix for the IHBD candidate region extraction. The EHBD region is extracted using a thresholding process and a connected component analysis. In the combination process, we connect the IHBD candidate regions to each EHBD candidate region and select a bile duct region from the connected candidate regions. We applied the proposed method to 22 cases of CT volumes. An average Dice coefficient of extraction result was 66.7%.

  4. Anatomical-based partial volume correction for low-dose dedicated cardiac SPECT/CT

    Science.gov (United States)

    Liu, Hui; Chan, Chung; Grobshtein, Yariv; Ma, Tianyu; Liu, Yaqiang; Wang, Shi; Stacy, Mitchel R.; Sinusas, Albert J.; Liu, Chi

    2015-09-01

    Due to the limited spatial resolution, partial volume effect has been a major degrading factor on quantitative accuracy in emission tomography systems. This study aims to investigate the performance of several anatomical-based partial volume correction (PVC) methods for a dedicated cardiac SPECT/CT system (GE Discovery NM/CT 570c) with focused field-of-view over a clinically relevant range of high and low count levels for two different radiotracer distributions. These PVC methods include perturbation geometry transfer matrix (pGTM), pGTM followed by multi-target correction (MTC), pGTM with known concentration in blood pool, the former followed by MTC and our newly proposed methods, which perform the MTC method iteratively, where the mean values in all regions are estimated and updated by the MTC-corrected images each time in the iterative process. The NCAT phantom was simulated for cardiovascular imaging with 99mTc-tetrofosmin, a myocardial perfusion agent, and 99mTc-red blood cell (RBC), a pure intravascular imaging agent. Images were acquired at six different count levels to investigate the performance of PVC methods in both high and low count levels for low-dose applications. We performed two large animal in vivo cardiac imaging experiments following injection of 99mTc-RBC for evaluation of intramyocardial blood volume (IMBV). The simulation results showed our proposed iterative methods provide superior performance than other existing PVC methods in terms of image quality, quantitative accuracy, and reproducibility (standard deviation), particularly for low-count data. The iterative approaches are robust for both 99mTc-tetrofosmin perfusion imaging and 99mTc-RBC imaging of IMBV and blood pool activity even at low count levels. The animal study results indicated the effectiveness of PVC to correct the overestimation of IMBV due to blood pool contamination. In conclusion, the iterative PVC methods can achieve more accurate quantification, particularly for low

  5. Random forest classification of large volume structures for visuo-haptic rendering in CT images

    Science.gov (United States)

    Mastmeyer, Andre; Fortmeier, Dirk; Handels, Heinz

    2016-03-01

    For patient-specific voxel-based visuo-haptic rendering of CT scans of the liver area, the fully automatic segmentation of large volume structures such as skin, soft tissue, lungs and intestine (risk structures) is important. Using a machine learning based approach, several existing segmentations from 10 segmented gold-standard patients are learned by random decision forests individually and collectively. The core of this paper is feature selection and the application of the learned classifiers to a new patient data set. In a leave-some-out cross-validation, the obtained full volume segmentations are compared to the gold-standard segmentations of the untrained patients. The proposed classifiers use a multi-dimensional feature space to estimate the hidden truth, instead of relying on clinical standard threshold and connectivity based methods. The result of our efficient whole-body section classification are multi-label maps with the considered tissues. For visuo-haptic simulation, other small volume structures would have to be segmented additionally. We also take a look into these structures (liver vessels). For an experimental leave-some-out study consisting of 10 patients, the proposed method performs much more efficiently compared to state of the art methods. In two variants of leave-some-out experiments we obtain best mean DICE ratios of 0.79, 0.97, 0.63 and 0.83 for skin, soft tissue, hard bone and risk structures. Liver structures are segmented with DICE 0.93 for the liver, 0.43 for blood vessels and 0.39 for bile vessels.

  6. Comparison of partial volume effects in arterial and venous contrast curves in CT brain perfusion imaging.

    Directory of Open Access Journals (Sweden)

    Alan J Riordan

    Full Text Available PURPOSE: In brain CT perfusion (CTP, the arterial contrast bolus is scaled to have the same area under the curve (AUC as the venous outflow to correct for partial volume effects (PVE. This scaling is based on the assumption that large veins are unaffected by PVE. Measurement of the internal carotid artery (ICA, usually unaffected by PVE due to its large diameter, may avoid the need for partial volume correction. The aims of this work are to examine i the assumptions behind PVE correction and ii the potential of selecting the ICA obviating correction for PVE. METHODS: The AUC of the ICA and sagittal sinus were measured in CTP datasets from 52 patients. The AUCs were determined by i using commercial CTP software based on a Gaussian curve-fitting to the time attenuation curve, and ii by simple integration of the time attenuation curve over a time interval. In addition, frames acquired up to 3 minutes after first bolus passage were used to examine the ratio of arterial and venous enhancement. The impact of selecting the ICA without PVE correction was illustrated by reporting cerebral blood volume (CBV measurements. RESULTS: In 49 of 52 patients, the AUC of the ICA was significantly larger than that of the sagittal sinus (p = 0.017. Measured after the first pass bolus, contrast enhancement remained 50% higher in the ICA just after the first pass bolus, and 30% higher 3 minutes later. CBV measurements were significantly lowered when the ICA was used without PVE correction. CONCLUSIONS: Contradicting the assumptions underlying PVE correction, contrast in the ICA was significantly higher than in the sagittal sinus, even 3 minutes after the first pass of the contrast bolus. PVE correction might lead to overestimation of CBV if the CBV is calculated using the AUC of the time attenuation curves.

  7. Segmentation of organs at risk in CT volumes of head, thorax, abdomen, and pelvis

    Science.gov (United States)

    Han, Miaofei; Ma, Jinfeng; Li, Yan; Li, Meiling; Song, Yanli; Li, Qiang

    2015-03-01

    Accurate segmentation of organs at risk (OARs) is a key step in treatment planning system (TPS) of image guided radiation therapy. We are developing three classes of methods to segment 17 organs at risk throughout the whole body, including brain, brain stem, eyes, mandible, temporomandibular joints, parotid glands, spinal cord, lungs, trachea, heart, livers, kidneys, spleen, prostate, rectum, femoral heads, and skin. The three classes of segmentation methods include (1) threshold-based methods for organs of large contrast with adjacent structures such as lungs, trachea, and skin; (2) context-driven Generalized Hough Transform-based methods combined with graph cut algorithm for robust localization and segmentation of liver, kidneys and spleen; and (3) atlas and registration-based methods for segmentation of heart and all organs in CT volumes of head and pelvis. The segmentation accuracy for the seventeen organs was subjectively evaluated by two medical experts in three levels of score: 0, poor (unusable in clinical practice); 1, acceptable (minor revision needed); and 2, good (nearly no revision needed). A database was collected from Ruijin Hospital, Huashan Hospital, and Xuhui Central Hospital in Shanghai, China, including 127 head scans, 203 thoracic scans, 154 abdominal scans, and 73 pelvic scans. The percentages of "good" segmentation results were 97.6%, 92.9%, 81.1%, 87.4%, 85.0%, 78.7%, 94.1%, 91.1%, 81.3%, 86.7%, 82.5%, 86.4%, 79.9%, 72.6%, 68.5%, 93.2%, 96.9% for brain, brain stem, eyes, mandible, temporomandibular joints, parotid glands, spinal cord, lungs, trachea, heart, livers, kidneys, spleen, prostate, rectum, femoral heads, and skin, respectively. Various organs at risk can be reliably segmented from CT scans by use of the three classes of segmentation methods.

  8. Interobserver and Intraobserver Reproducibility with Volume Dynamic Contrast Enhanced Computed Tomography (DCE-CT in Gastroesophageal Junction Cancer

    Directory of Open Access Journals (Sweden)

    Martin Lundsgaard Hansen

    2016-02-01

    Full Text Available The purpose of this study was to assess inter- and intra-observer reproducibility of three different analytic methods to evaluate quantitative dynamic contrast-enhanced computed tomography (DCE-CT measures from gastroesophageal junctional cancer. Twenty-five DCE-CT studies with gastroesophageal junction cancer were selected from a previous longitudinal study. Three radiologists independently reviewed all scans, and one repeated the analysis eight months later for intraobserver analysis. Review of the scans consisted of three analysis methods: (I Four, fixed small sized regions of interest (2-dimensional (2D fixed ROIs placed in the tumor periphery, (II 2-dimensional regions of interest (2D-ROI along the tumor border in the tumor center, and (III 3-dimensional volumes of interest (3D-VOI containing the entire tumor volume. Arterial flow, blood volume and permeability (ktrans were recorded for each observation. Inter- and intra-observer variability were assessed by Intraclass Correlation Coefficient (ICC and Bland-Altman statistics. Interobserver ICC was excellent for arterial flow (0.88, for blood volume (0.89 and for permeability (0.91 with 3D-VOI analysis. The 95% limits of agreement were narrower for 3D analysis compared to 2D analysis. Three-dimensional volume DCE-CT analysis of gastroesophageal junction cancer provides higher inter- and intra-observer reproducibility with narrower limits of agreement between readers compared to 2D analysis.

  9. Interobserver and Intraobserver Reproducibility with Volume Dynamic Contrast Enhanced Computed Tomography (DCE-CT) in Gastroesophageal Junction Cancer.

    Science.gov (United States)

    Lundsgaard Hansen, Martin; Fallentin, Eva; Axelsen, Thomas; Lauridsen, Carsten; Norling, Rikke; Svendsen, Lars Bo; Nielsen, Michael Bachmann

    2016-02-01

    The purpose of this study was to assess inter- and intra-observer reproducibility of three different analytic methods to evaluate quantitative dynamic contrast-enhanced computed tomography (DCE-CT) measures from gastroesophageal junctional cancer. Twenty-five DCE-CT studies with gastroesophageal junction cancer were selected from a previous longitudinal study. Three radiologists independently reviewed all scans, and one repeated the analysis eight months later for intraobserver analysis. Review of the scans consisted of three analysis methods: (I) Four, fixed small sized regions of interest (2-dimensional (2D) fixed ROIs) placed in the tumor periphery, (II) 2-dimensional regions of interest (2D-ROI) along the tumor border in the tumor center, and (III) 3-dimensional volumes of interest (3D-VOI) containing the entire tumor volume. Arterial flow, blood volume and permeability (k(trans)) were recorded for each observation. Inter- and intra-observer variability were assessed by Intraclass Correlation Coefficient (ICC) and Bland-Altman statistics. Interobserver ICC was excellent for arterial flow (0.88), for blood volume (0.89) and for permeability (0.91) with 3D-VOI analysis. The 95% limits of agreement were narrower for 3D analysis compared to 2D analysis. Three-dimensional volume DCE-CT analysis of gastroesophageal junction cancer provides higher inter- and intra-observer reproducibility with narrower limits of agreement between readers compared to 2D analysis.

  10. Observation on the Accuracy of Perfusion Imaging and CT Enhanced Scan in Determining Preoperative Grading of Gliomas%灌注成像与CT增强扫描对脑胶质瘤术前分级的判断准确性观察

    Institute of Scientific and Technical Information of China (English)

    杨磊; 杨元山; 张海燕

    2016-01-01

    目的:观察并分析灌注成像与CT增强扫描对脑胶质瘤术前分级的判断准确性。方法对2009年1月至2012年12月来我院就诊并治疗的76例脑胶质瘤患者作回顾性分析,进行灌注扫描与CT增强扫描,以两种诊断方法的影像学资料为基础,灌注成像参考脑血容量(CBV)、脑血流量(CBF)和脑血管表面通透性(PS)和相对脑血容量(rCBV)值进行术前分级, CT增强扫描以影像学图片为判断依据,对比术后病理结果,比较两组术前分级准确率。结果以术后病理结果为标准,灌注成像中,两级别组病灶区域的CBF、PS、CBV、rCBV值均大于对侧正常区域的对应值(P<0.05),高级别组各灌注参数显著大于低级别组对应值(P<0.05)。灌注成像在低级别组、高级别组的判断准确率分别为90.24%、91.43%,均显著高于CT增强扫描的准确率73.17%、71.43%(P<0.05)。结论灌注成像对脑胶质瘤术前分级准确性均高于CT增强扫描,是一种有效的胶质瘤术前诊断技术。%Objective To observe and analyze the accuracy of perfusion imaging and CT scan in determining preoperative grading of gliomas.Methods 76 cases of patients with gliomas who were treated in our hospital between January 2009 and December 2012 were retrospectively analyzed. All underwent perfusion scan and CT enhanced scan. Based on the imaging data of the two kinds of diagnostic methods, preoperative grading of perfusion imaging was performed with reference to cerebral blood volume (CBV), cerebral blood flow (CBF), cerebrovascular permeability surface (PS) and relative cerebral blood volume (rCBV) values.Results The postoperative pathological results were taken as the standard. In terms of perfusion imaging, the values of CBF, PS, CBV and rCBV of lesion areas in the two different grade of groups were greater than the corresponding values of the contralateral normal areas (P<0.05). The perfusion parameters of high grade

  11. Interobserver and Intraobserver Reproducibility with Volume Dynamic Contrast Enhanced Computed Tomography (DCE-CT) in Gastroesophageal Junction Cancer

    DEFF Research Database (Denmark)

    Lundsgaard Hansen, Martin; Fallentin, Eva; Axelsen, Thomas;

    2016-01-01

    The purpose of this study was to assess inter- and intra-observer reproducibility of three different analytic methods to evaluate quantitative dynamic contrast-enhanced computed tomography (DCE-CT) measures from gastroesophageal junctional cancer. Twenty-five DCE-CT studies with gastroesophageal ...... were narrower for 3D analysis compared to 2D analysis. Three-dimensional volume DCE-CT analysis of gastroesophageal junction cancer provides higher inter- and intra-observer reproducibility with narrower limits of agreement between readers compared to 2D analysis.......The purpose of this study was to assess inter- and intra-observer reproducibility of three different analytic methods to evaluate quantitative dynamic contrast-enhanced computed tomography (DCE-CT) measures from gastroesophageal junctional cancer. Twenty-five DCE-CT studies with gastroesophageal...... for each observation. Inter- and intra-observer variability were assessed by Intraclass Correlation Coefficient (ICC) and Bland-Altman statistics. Interobserver ICC was excellent for arterial flow (0.88), for blood volume (0.89) and for permeability (0.91) with 3D-VOI analysis. The 95% limits of agreement...

  12. Preoperative staging of perforated diverticulitis by computed tomography scanning

    NARCIS (Netherlands)

    M.P.M. Gielens; I.M. Mulder (Irene); E. van der Harst (Erwin); M.P. Gosselink (Martijn Pieter); K.J. Kraal; H.T. Teng; J.F. Lange (Johan); J. Vermeulen (Jefrey)

    2012-01-01

    textabstractBackground: Treatment of perforated diverticulitis depends on disease severity classified according to Hinchey's preoperative classification. This study assessed the accuracy of preoperative staging of perforated diverticulitis by computerized tomography (CT) scanning. Methods: All patie

  13. FDG PET/CT for rectal carcinoma radiotherapy treatment planning: comparison of functional volume delineation algorithms and clinical challenges.

    Science.gov (United States)

    Withofs, Nadia; Bernard, Claire; Van der Rest, Catherine; Martinive, Philippe; Hatt, Mathieu; Jodogne, Sebastien; Visvikis, Dimitris; Lee, John A; Coucke, Philippe A; Hustinx, Roland

    2014-09-08

    PET/CT imaging could improve delineation of rectal carcinoma gross tumor volume (GTV) and reduce interobserver variability. The objective of this work was to compare various functional volume delineation algorithms. We enrolled 31 consecutive patients with locally advanced rectal carcinoma. The FDG PET/CT and the high dose CT (CTRT) were performed in the radiation treatment position. For each patient, the anatomical GTVRT was delineated based on the CTRT and compared to six different functional/metabolic GTVPET derived from two automatic segmentation approaches (FLAB and a gradient-based method); a relative threshold (45% of the SUVmax) and an absolute threshold (SUV > 2.5), using two different commercially available software (Philips EBW4 and Segami OASIS). The spatial sizes and shapes of all volumes were compared using the conformity index (CI). All the delineated metabolic tumor volumes (MTVs) were significantly different. The MTVs were as follows (mean ± SD): GTVRT (40.6 ± 31.28ml); FLAB (21.36± 16.34 ml); the gradient-based method (18.97± 16.83ml); OASIS 45% (15.89 ± 12.68 ml); Philips 45% (14.52 ± 10.91 ml); OASIS 2.5 (41.6 2 ± 33.26 ml); Philips 2.5 (40 ± 31.27 ml). CI between these various volumes ranged from 0.40 to 0.90. The mean CI between the different MTVs and the GTVCT was algorithms and the software products. The manipulation of PET/CT images and MTVs, such as the DICOM transfer to the Radiation Oncology Department, induced additional volume variations.

  14. A global CT to US registration of the lumbar spine

    Science.gov (United States)

    Nagpal, Simrin; Hacihaliloglu, Ilker; Ungi, Tamas; Rasoulian, Abtin; Osborn, Jill; Lessoway, Victoria A.; Rohling, Robert N.; Borschneck, Daniel P.; Abolmaesumi, Purang; Mousavi, Parvin

    2014-03-01

    During percutaneous lumbar spine needle interventions, alignment of the preoperative computed tomography (CT) with intraoperative ultrasound (US) can augment anatomical visualization for the clinician. We propose an approach to rigidly align CT and US data of the lumbar spine. The approach involves an intensity-based volume registration step, followed by a surface segmentation and a point-based registration of the entire lumbar spine volume. A clinical feasibility study resulted in mean registration error of approximately 3 mm between CT and US data.

  15. Three-dimensional whole-brain perfused blood volume imaging with multimodal CT for evaluation of acute ischaemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Lu, J.; Zhang, M.; Cao, Y. [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing (China); Ma, Q. [Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing (China); Chen, J. [Healthcare, Siemens Ltd. China, Beijing (China); Ji, X. [Department of Neurosurgery Xuanwu Hospital, Capital Medical University, Beijing (China); Li, K., E-mail: imaging@yeah.ne [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing (China)

    2011-06-15

    Aim: To determine the diagnostic value of integrating three-dimensional perfused blood volume (3D PBV) with multimodal computed tomography (CT) [non-enhanced CT (NECT), CT perfusion (CTP), and CT angiography (CTA)] in acute ischaemic stroke. Materials and methods: NECT, CTP, and CTA were performed in 25 acute ischaemic stroke patients. The ischaemia detection rate of 3D PBV was compared with the results of baseline NECT and CTP. The correlation of ischaemic lesion volume between 3D PBV, CTP images, and follow-up NECT were analysed. Results: NECT demonstrated ischaemic signs in 12 of 25 patients with proven infarction. CTP maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and time to peak (TTP) all demonstrated perfusion deficits in 21 of 25 patients. However, 3D PBV demonstrated perfusion deficits in all of the 25 patients. Among the 25 patients, a strong correlation was found between PBV and the follow-up NECT infarct (r = 0.858). The correlation between CTP and the follow-up NECT infarct as following: CBF (r = 0.718), CBV (r = 0.785), and TTP (r = 0.569). In 14 thrombolytic patients, strong correlation was found between the ischaemic volume on 3D PBV and follow-up NECT (r = 0.798). Conclusion: In acute stroke patients, the combination of 3D PBV and multimodal CT (NECT, CTP, and CTA) can improve the detection rate of ischaemia and enable assessment of the full extent of ischaemia, which correlates well with follow-up NECT.

  16. Volume perfusion CT imaging of cerebral vasospasm: diagnostic performance of different perfusion maps

    Energy Technology Data Exchange (ETDEWEB)

    Othman, Ahmed E. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Radiology, Tuebingen (Germany); Afat, Saif; Nikoubashman, Omid; Mueller, Marguerite; Wiesmann, Martin; Brockmann, Carolin [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Schubert, Gerrit Alexander [RWTH Aachen University, Department of Neurosurgery, Aachen (Germany); Bier, Georg [Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Brockmann, Marc A. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); University Hospital Mainz, Department of Neuroradiology, Mainz (Germany)

    2016-08-15

    In this study, we aimed to evaluate the diagnostic performance of different volume perfusion CT (VPCT) maps regarding the detection of cerebral vasospasm compared to angiographic findings. Forty-one datasets of 26 patients (57.5 ± 10.8 years, 18 F) with subarachnoid hemorrhage and suspected cerebral vasospasm, who underwent VPCT and angiography within 6 h, were included. Two neuroradiologists independently evaluated the presence and severity of vasospasm on perfusion maps on a 3-point Likert scale (0 - no vasospasm, 1 - vasospasm affecting <50 %, 2 - vasospasm affecting >50 % of vascular territory). A third neuroradiologist independently assessed angiography for the presence and severity of vasospasm on a 3-point Likert scale (0 - no vasospasm, 1 - vasospasm affecting < 50 %, 2 - vasospasm affecting > 50 % of vessel diameter). Perfusion maps of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to drain (TTD) were evaluated regarding diagnostic accuracy for cerebral vasospasm with angiography as reference standard. Correlation analysis of vasospasm severity on perfusion maps and angiographic images was performed. Furthermore, inter-reader agreement was assessed regarding findings on perfusion maps. Diagnostic accuracy for TTD and MTT was significantly higher than for all other perfusion maps (TTD, AUC = 0.832; MTT, AUC = 0.791; p < 0.001). TTD revealed higher sensitivity than MTT (p = 0.007). The severity of vasospasm on TTD maps showed significantly higher correlation levels with angiography than all other perfusion maps (p ≤ 0.048). Inter-reader agreement was (almost) perfect for all perfusion maps (kappa ≥ 0.927). The results of this study indicate that TTD maps have the highest sensitivity for the detection of cerebral vasospasm and highest correlation with angiography regarding the severity of vasospasm. (orig.)

  17. 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: andre.gahleitner@univie.ac.at; Podesser, Birgit; Schick, Susanne; Watzek, Georg; Imhof, Herwig

    2004-09-01

    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.

  18. Prostate cancer volume associates with preoperative plasma levels of testosterone that independently predicts high grade tumours which show low densities (quotient testosterone/tumour volume

    Directory of Open Access Journals (Sweden)

    Antonio B. Porcaro

    2016-01-01

    Conclusion: The investigation shows that TT relates to volume and grade of PCa; moreover, the density of TT relative to TV inversely associates with rate of increase of cancer that depends on the grade of the tumour.

  19. Semiautomated three-dimensional segmentation software to quantify carpal bone volume changes on wrist CT scans for arthritis assessment.

    Science.gov (United States)

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

    2008-06-01

    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.

  20. Effects of radiation dose reduction in Volume Perfusion CT imaging of acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Othman, Ahmed E. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Radiology, Tuebingen (Germany); Brockmann, Carolin; Afat, Saif; Pjontek, Rastislav; Nikobashman, Omid; Brockmann, Marc A.; Wiesmann, Martin [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Yang, Zepa; Kim, Changwon [Seoul National University, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Suwon (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kim, Jong Hyo [Seoul National University, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Suwon (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Center for Medical-IT Convergence Technology Research, Advanced Institute of Convergence Technology, Suwon (Korea, Republic of)

    2015-12-15

    To examine the influence of radiation dose reduction on image quality and sensitivity of Volume Perfusion CT (VPCT) maps regarding the detection of ischemic brain lesions. VPCT data of 20 patients with suspected ischemic stroke acquired at 80 kV and 180 mAs were included. Using realistic reduced-dose simulation, low-dose VPCT datasets with 144 mAs, 108 mAs, 72 mAs and 36 mAs (80 %, 60 %, 40 % and 20 % of the original levels) were generated, resulting in a total of 100 datasets. Perfusion maps were created and signal-to-noise-ratio (SNR) measurements were performed. Qualitative analyses were conducted by two blinded readers, who also assessed the presence/absence of ischemic lesions and scored CBV and CBF maps using a modified ASPECTS-score. SNR of all low-dose datasets were significantly lower than those of the original datasets (p <.05). All datasets down to 72 mAs (40 %) yielded sufficient image quality and high sensitivity with excellent inter-observer-agreements, whereas 36 mAs datasets (20 %) yielded poor image quality in 15 % of the cases with lower sensitivity and inter-observer-agreements. Low-dose VPCT using decreased tube currents down to 72 mAs (40 % of original radiation dose) produces sufficient perfusion maps for the detection of ischemic brain lesions. (orig.)

  1. A framework of whole heart extracellular volume fraction estimation for low-dose cardiac CT images.

    Science.gov (United States)

    Chen, Xinjian; Nacif, Marcelo S; Liu, Songtao; Sibley, Christopher; Summers, Ronald M; Bluemke, David A; Yao, Jianhua

    2012-09-01

    Cardiac CT (CCT) is widely available and has been validated for the detection of focal myocardial scar using a delayed enhancement technique in this paper. CCT, however, has not been previously evaluated for quantification of diffuse myocardial fibrosis. In our investigation, we sought to evaluate the potential of low-dose CCT for the measurement of myocardial whole heart extracellular volume (ECV) fraction. ECV is altered under conditions of increased myocardial fibrosis. A framework consisting of three main steps was proposed for CCT whole heart ECV estimation. First, a shape-constrained graph cut (GC) method was proposed for myocardium and blood pool segmentation on postcontrast image. Second, the symmetric demons deformable registration method was applied to register precontrast to postcontrast images. So the correspondences between the voxels from precontrast to postcontrast images were established. Finally, the whole heart ECV value was computed. The proposed method was tested on 20 clinical low-dose CCT datasets with precontrast and postcontrast images. The preliminary results demonstrated the feasibility and efficiency of the proposed method.

  2. A framework of whole heart extracellular volume fraction estimation for low dose cardiac CT images

    Science.gov (United States)

    Chen, Xinjian; Summers, Ronald M.; Nacif, Marcelo Souto; Liu, Songtao; Bluemke, David A.; Yao, Jianhua

    2012-02-01

    Cardiac magnetic resonance imaging (CMRI) has been well validated and allows quantification of myocardial fibrosis in comparison to overall mass of the myocardium. Unfortunately, CMRI is relatively expensive and is contraindicated in patients with intracardiac devices. Cardiac CT (CCT) is widely available and has been validated for detection of scar and myocardial stress/rest perfusion. In this paper, we sought to evaluate the potential of low dose CCT for the measurement of myocardial whole heart extracellular volume (ECV) fraction. A novel framework was proposed for CCT whole heart ECV estimation, which consists of three main steps. First, a shape constrained graph cut (GC) method was proposed for myocardium and blood pool segmentation for post-contrast image. Second, the symmetric Demons deformable registrations method was applied to register pre-contrast to post-contrast images. Finally, the whole heart ECV value was computed. The proposed method was tested on 7 clinical low dose CCT datasets with pre-contrast and post-contrast images. The preliminary results demonstrated the feasibility and efficiency of the proposed method.

  3. Effect of tumor volume on the enhancement pattern of parathyroid adenoma on parathyroid four-dimensional CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Kyoung [Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Dongguk University Ilsan Hospital, Department of Radiology, Goyang-si (Korea, Republic of); Yun, Tae Jin; Kim, Ji-hoon; Kang, Koung Mi; Choi, Seung Hong; Sohn, Chul-Ho [Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University Hospital, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Lee, Kyu Eun; Kim, Su-jin [Seoul National University Hospital, Department of Surgery, Seoul (Korea, Republic of); Won, Jae-Kyung [Seoul National University Hospital, Department of Pathology, Seoul (Korea, Republic of)

    2016-05-15

    The purpose of this study is to assess the effect of tumor volume on the enhancement pattern of parathyroid adenoma (PTA) on four-dimensional computed tomography (4D-CT). We analyzed the enhancement patterns of PTA on four-phase 4D-CT in 44 patients. Dependency of the changes of Hounsfield unit values (ΔHU) on the tumor volumes and clinical characteristics was evaluated using linear regression analyses. In addition, an unpaired t test was used to compare ΔHU of PTAs between PTA volume ≥1 cm{sup 3} and <1 cm{sup 3}, thyroid gland, and lymph node. PTA volume based on CT was the strongest factor on the ΔHU{sub Pre} {sub to} {sub Arterial} and ΔHU{sub Arterial} {sub to} {sub Venous} and ΔHU{sub Arterial} {sub to} {sub Delayed} (R {sup 2} = 0.34, 0.25, and 0.32, respectively, P < 0.001 for both). PTA ≥1 cm {sup 3} had statistically significant greater enhancement between the unenhanced phase and the arterial phase than PTA <1 cm {sup 3} (mean values ± standard deviations (SDs) of ΔHU{sub Pre} {sub to} {sub Arterial}, 102.7 ± 33.7 and 57.5 ± 28.8, respectively, P < 0.001). PTA ≥1 cm {sup 3} showed an early washout pattern on the venous phase, whereas PTA <1 cm {sup 3} showed a progressive enhancement pattern on the venous phase (mean values ± SDs of ΔHU{sub Arterial} {sub to} {sub Venous}, -13.2 ± 31.6 and 14.4 ± 32.7, respectively; P = 0.009). The enhancement pattern of PTA on 4D-CT is variable with respect to PTA volume based on CT. Therefore, the enhancement pattern of PTA on 4D-CT requires careful interpretation concerning the tumor volume, especially in cases of PTA <1 cm {sup 3}. (orig.)

  4. Volume of sealer in the apical region of teeth filled by different techniques: a micro-CT analysis

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    Araujo, Vanessa Lessa; Souza-Gabriel, Aline Evangelista; Cruz Filho, Antonio Miranda da; Pecora, Jesus Djalma; Silva, Ricardo Gariba, E-mail: vanessalessa@usp.br [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Escola de Odontologia. Departamento de Odontologia Restauradora

    2016-05-01

    The volume of sealer in the apical 1 mm of teeth filled using different techniques was evaluated by micro-commuted tomography (micro-CT). Sixty-four maxillary central incisors were prepared using NiTi rotary instruments. Teeth were randomly distributed into four groups according to root canal sealers (AH Plus, Endofill, Sealapex, and Sealer 26) and subdivided into two subgroups according to the filling techniques (active and passive lateral condensation; n = 8 each). Subsequently, teeth were examined using the 1174 SkyScan micro-CT device. Images were reconstructed using the NRecon software, and the sealer volume (mm{sup 3}) in the apical region was analyzed using the two-way ANOVA and post-hoc Student-Newman-Keuls test (α = 0.05). The lowest volume of sealer was observed in teeth filled with Sealapex (0.100 ± 0.009) and Endofill (0.103 ± 0.010). The highest volume was observed in teeth filled with AH Plus (0.112 ± 0.008) and Sealer 26 (0.109 ± 0.018) (p > 0.05). Regarding the filling technique, a lower sealer volume was observed using the active lateral condensation technique compared with that using the passive lateral condensation technique (0.100 ± 0.010 vs. 0.111 ± 0.012) (p < 0.05). Therefore, the lowest volume of sealer was observed in teeth filled with Sealapex and Endofill using the active lateral condensation technique. (author)

  5. Characterization of hepatocellular carcinoma (HCC) lesions using a novel CT-based volume perfusion (VPCT) technique

    Energy Technology Data Exchange (ETDEWEB)

    Kaufmann, S., E-mail: sascha.kaufmann@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Horger, T., E-mail: horger@ma.tum.de [Technische Universität München, Boltzmannstraße 3, 85748 Garching (Germany); Oelker, A., E-mail: oelker@ma.tum.de [Technische Universität München, Boltzmannstraße 3, 85748 Garching (Germany); Kloth, C., E-mail: christopher.kloth@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Nikolaou, K., E-mail: Konstantin.Nikolaou@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Schulze, M., E-mail: maximilian.schulze@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Horger, M., E-mail: marius.horger@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany)

    2015-06-15

    Highlights: • Quantification of perfusion with VPCT has great potential for functional imaging. • We present our preliminary results of perfusion parameters (Blood Flow, Blood Volume and kk-trans) of hepatocellular carcinoma (HCC) in terms of using VPCT and two different calculation methods, compare their results and look for correlation between tumor arterialization and lesion size. • VPCT can measure tumor volume perfusion non-invasively and enables quantification of the degree of HCC arterialization. Results are dependent on the technique used with best inter-method correlation for Blood Flow. • Tumor arterialization did not proved size-dependent. - Abstract: Objective: To characterize hepatocellular carcinoma (HCC) in terms of perfusion parameters using volume perfusion CT (VPCT) and two different calculation methods, compare their results, look for interobserver agreement of measurements and correlation between tumor arterialization and lesion size. Material and methods: This study was part of a prospective monitoring study in patients with HCC undergoing TACE, which was approved by the local Institutional Review Board. 79 HCC-patients (mean age, 64.7) with liver cirrhosis were enrolled. VPCT was performed for 40 s covering the involved liver (80 kV, 100/120 mAs) using 64 mm × 0.6 mm collimation, 26 consecutive volume measurements, 50 mL iodinated contrast IV and 5 mL/s flow rate. Mean/maximum blood flow (BF; ml/100 mL/min), blood volume (BV) and k-trans were determined both with the maximum slope + Patlak vs. deconvolution method. Additionally, the portal venous liver perfusion (PVP), the arterial liver perfusion (ALP) and the hepatic perfusion index (HPI) were determined for each tumor including size measurements. Interobserver agreement for all perfusion parameters was calculated using intraclass correlation coefficients (ICC). Results: The max. slope + Patlak method yielded: BFmean/max = 37.8/57 mL/100 g-tissue/′, BVmean/max = 9.8/11.1 mL/100 g

  6. Segmental analysis of cochlea on three-dimensional MR imaging and high-resolution CT. Application to pre-operative assessment of cochlear implant candidates

    Energy Technology Data Exchange (ETDEWEB)

    Akiba, Hidenari; Himi, Tetsuo; Hareyama, Masato [Sapporo Medical Coll. (Japan). School of Medicine

    2002-12-01

    High-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) have recently become standard pre-operative examinations for cochlear implant candidates. HRCT can demonstrate ossification and narrowing of the cochlea, but subtle calcification or soft tissue obstruction may not be detected by this method alone, and so conventional T2 weighted image (T2WI) on MRI has been recommended to disclose them. In this study, segmental analyses of the cochlea were made on three-dimensional MRI (3DMRI) and HRCT in order to predict cochlear implant difficulties. The study involved 59 consecutive patients with bilateral profound sensorineural hearing loss who underwent MRI and HRCT from November 1992 to February 1998. Etiologies of deafness were meningogenic labyrinthitis (n=9), tympanogenic labyrinthitis (n=12), and others (n=38). Pulse sequence of heavy T2WI was steady state free precession and 3DMRI was reconstructed by maximum intensity projection method. HRCT was reconstructed by bone algorithm focusing on the temporal bone. For alternative segmental analysis, cochleas were anatomically divided into five parts and each of them was classified by three ranks of score depending on 3DMRI or HRCT findings. There was a close correlation by ranks between the total score of the five parts on 3DMRI and HRCT (rs=0.86, P<0.001), and a statistically significant difference was identified between causes of deafness in the total score on 3DMRI or HRCT (P<0.001, respectively). There was a significant difference in the score among the five parts on each examination (P<0.001, respectively), and abnormal findings were more frequent in the inferior horizontal part (IHP) of the basal turn. Of the 35 patients who underwent cochlear implantation, no one had ossification in the IHP on HRCT and only one patient had an obstacle to implantation. When no signal void in the IHP on 3DMRI and no ossification in the IHP on HRCT were assumed to be the criteria for candidacy for cochlear

  7. Definition of optimal percentage threshold of SUVmax by comparison of 18F-FDG PET/CT metabolism volume with pathological volume of cervical cancer

    Directory of Open Access Journals (Sweden)

    Sheng-jun WANG

    2013-09-01

    Full Text Available Objective To define an optimal maximum standardized uptake value(SUVmaxthreshold of 18F-fluorodeoxygluose(18F-FDG in delineating metabolic tumor volume of cervical cancer by comparing positron emission tomography and computed tomography(PET/CT with pathological volume of the tumor. Methods Twelve patients with cervical cancer prospectively underwent a PET/CT scan. Different SUVmax thresholds, including10%, 15%, 20%, 25%, 30%, 35%, 40%, 45% and 50%, were screened from PET images to obtain the corresponding PET metabolism gross tumor volume(GTV. Pathological slices were prepared after the operation for determination of the edge and area of the tumor. Pathological tumor volumes were measured from each slice, and they were then combined to derive the pathological GTV. An optimal PET GTV wasdefined when PET GTV was closest to the pathological tumor volume, and SUVmax threshold corresponding to the optimal PET GTV was named as the optimal SUVmax threshold. Results The optimal SUVmax threshold was between 30% and 50% with an mean value of40.83%±6.07%in all the 12patients. There was no significant statistical difference between the pathological GTV and PET GTV with aSUVmax threshold of 41%(P=0.352, and they were well correlated with each other with a coefficient of 0.99(P=0.000. Conclusions PET optimal SUVmax thresholdderivedby comparison with pathological GTV is of great significance in improving the curative effect of intensified modulated radiation herapy(IMRT.

  8. Utility of Quantitative 99mTc-MAA SPECT/CT for 90yttrium-Labelled Microsphere Treatment Planning: Calculating Vascularized Hepatic Volume and Dosimetric Approach

    Directory of Open Access Journals (Sweden)

    Etienne Garin

    2011-01-01

    Full Text Available Objectives. The aim of this study was to assess the effectiveness of SPECT/CT for volume measurements and to report a case illustrating the major impact of SPECT/CT in calculating the vascularized liver volume and dosimetry prior to injecting radiolabelled yttrium-90 microspheres (Therasphere. Materials and Methods. This was a phantom study, involving volume measurements carried out by two operators using SPECT and SPECT/CT images. The percentage of error for each method was calculated, and interobserver reproducibility was evaluated. A treatment using Therasphere was planned in a patient with three hepatic arteries, and the quantitative analysis of SPECT/CT for this patient is provided. Results. SPECT/CT volume measurements proved to be accurate (mean error <6% for volumes ≥16 cm3 and reproductive (interobserver agreement = 0.9. In the case report, 99mTc-MAA SPECT/CT identified a large liver volume, not previously identified with angiography, which was shown to be vascularized after selective MAA injection into an arterial branch, resulting in a large modification in the activity of Therasphere used. Conclusions. MAA SPECT/CT is accurate for vascularized liver volume measurements, providing a valuable contribution to the therapeutic planning of patients with complex hepatic vascularization.

  9. Effect of Scanning and Reconstruction Parameters on Three Dimensional Volume and CT Value Measurement of Pulmonary Nodules: A Phantom Study

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    Datong SU

    2017-08-01

    Full Text Available Background and objective The computed tomography (CT follow-up of indeterminate pulmonary nodules aiming to evaluate the change of the volume and CT value is the common strategy in clinic. The CT dose needs to considered on serious CT scans in addition to the measurement accuracy. The purpose of this study is to quantify the precision of pulmonary nodule volumetric measurement and CT value measurement with various tube currents and reconstruction algorithms in a phantom study with dual-energy CT. Methods A chest phantom containing 9 artificial spherical solid nodules with known diameter (D=2.5 mm, 5 mm, 10 mm and density (-100 HU, 60 HU and 100 HU was scanned using a 64-row detector CT canner at 120 Kilovolt & various currents (10 mA, 20 mA, 50 mA, 80 mA,100 mA, 150 mA and 350 mA. Raw data were reconstructed with filtered back projection and three levels of adaptive statistical iterative reconstruction algorithm (FBP, ASIR; 30%, 50% and 80%. Automatic volumetric measurements were performed using commercially available software. The relative volume error (RVE and the absolute attenuation error (AAE between the software measures and the reference-standard were calculated. Analyses of the variance were performed to evaluate the effect of reconstruction methods, different scan parameters, nodule size and attenuation on the RPE. Results The software substantially overestimated the very small (D=2.5 mm nodule's volume [mean RVE: (100.8%±28%] and underestimated it attenuation [mean AAE: (-756±80 HU]. The mean RVEs of nodule with diameter as 5 mm and 10 mm were small [(-0.9%±1.1% vs (0.9%±1.4%], however, the mean AAEs [(-243±26 HU vs (-129±7 HU] were large. The ANOVA analysis for repeated measurements showed that different tube current and reconstruction algorithm had no significant effect on the volumetric measurements for nodules with diameter of 5 mm and 10 mm (F=5.60, P=0.10 vs F=11.13, P=0.08, but significant effects on the measurement of CT

  10. Role of quantitative CT in predicting postoperative FEV1 and chronic dyspnea in patients undergoing lung resection

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    Papageorgiou Chrysovalantis V

    2010-06-01

    Full Text Available Abstract Lung resection is the mainstay of treatment in patients with early stage non-small cell lung cancer. However, lung cancer patients often suffer from comorbidities and the respiratory reserve should be carefully evaluated preoperatively in order to avoid postoperative complications. Forced expiratory volume in 1 second (FEV1 is considered to be an index that depicts the patient's respiratory efficacy and its prediction has a key role in the preoperative evaluation of lung cancer patients with impaired lung function. Prediction of postoperative FEV1 is currently possible with the use of perfusion radionuclide lung scanning. Quantitative CT is the analysis of data acquired during normal chest CT scan using the system's software. By applying a dual threshold of -500 to -910 Hounsfield Units, functional lung volumes are estimated and postoperative FEV1 can be predicted by reducing the preoperative measurement by the fraction of the part to be resected. Studies have shown that preoperative predictions correlate well with the actual postoperative measurements. Additionally, quantitative CT results are in good agreement with perfusion scintigraphy predictions. Newer radiological techniques such as perfusion MRI and co-registered SPECT/CT have also been used in the preoperative evaluation with similar results. In conclusion, chest CT which is obligatory for staging, can be used for quantitative analysis of the already available data. It is technically simple, providing an accurate prediction of postoperative FEV1. Thus, quantitative CT appears to be a useful tool in the preoperative evaluation of lung cancer patients undergoing lung resection.

  11. Tumor volume in subcutaneous mouse xenografts measured by microCT is more accurate and reproducible than determined by 18F-FDG-microPET or external caliper

    DEFF Research Database (Denmark)

    Jensen, Mette Munk; Jørgensen, Jesper Tranekjaer; Binderup, Tina;

    2008-01-01

    and reproducible measures of tumor size in mice compared with caliper measurements. Furthermore, we evaluated the accuracy of tumor volume determined from 18F-fluorodeoxyglucose (18F-FDG) PET. METHODS: Subcutaneously implanted human breast adenocarcinoma cells in NMRI nude mice served as tumor model. Tumor volume...... systematic bias compared to reference volume. Coefficients of variation for intra-observer variation were 7% and 14% for microCT and caliper measurements, respectively. Regression coefficients between observers were 0.97 for microCT and 0.91 for caliper measurements. CONCLUSION: MicroCT was more accurate...

  12. Automatic segmentation of airway tree based on local intensity filter and machine learning technique in 3D chest CT volume.

    Science.gov (United States)

    Meng, Qier; Kitasaka, Takayuki; Nimura, Yukitaka; Oda, Masahiro; Ueno, Junji; Mori, Kensaku

    2017-02-01

    Airway segmentation plays an important role in analyzing chest computed tomography (CT) volumes for computerized lung cancer detection, emphysema diagnosis and pre- and intra-operative bronchoscope navigation. However, obtaining a complete 3D airway tree structure from a CT volume is quite a challenging task. Several researchers have proposed automated airway segmentation algorithms basically based on region growing and machine learning techniques. However, these methods fail to detect the peripheral bronchial branches, which results in a large amount of leakage. This paper presents a novel approach for more accurate extraction of the complex airway tree. This proposed segmentation method is composed of three steps. First, Hessian analysis is utilized to enhance the tube-like structure in CT volumes; then, an adaptive multiscale cavity enhancement filter is employed to detect the cavity-like structure with different radii. In the second step, support vector machine learning will be utilized to remove the false positive (FP) regions from the result obtained in the previous step. Finally, the graph-cut algorithm is used to refine the candidate voxels to form an integrated airway tree. A test dataset including 50 standard-dose chest CT volumes was used for evaluating our proposed method. The average extraction rate was about 79.1 % with the significantly decreased FP rate. A new method of airway segmentation based on local intensity structure and machine learning technique was developed. The method was shown to be feasible for airway segmentation in a computer-aided diagnosis system for a lung and bronchoscope guidance system.

  13. Study of 320-slice dynamic volume CT perfusion in different pathologic types of kidney tumor: preliminary results.

    Directory of Open Access Journals (Sweden)

    Chao Chen

    Full Text Available OBJECTIVE: To investigate microcirculatory differences between pathologic types of kidney tumor using 320-slice dynamic volume CT perfusion. METHODS: Perfusion imaging with 320-slice dynamic volume CT was prospectively performed in 85 patients with pathologically proven clear cell renal cell carcinoma (RCC (n = 66, papillary RCC (n = 7, chromophobe RCC (n = 5, angiomyolipoma (AML with minimal fat (n = 7, or RCC (n = 78. Equivalent blood volume (Equiv BV, permeability surface-area product (PS; clearance/unit volume = permeability, and blood flow (BF of tumor and normal renal cortex were measured and analyzed. Effective radiation dose was calculated. RESULTS: There was a significant difference in all three parameters between tumor and normal renal cortex (P<0.001. Equiv BV was significantly different between RCC and AML with minimal fat (P = 0.038 and between clear cell RCC and AML with minimal fat (P<0.001. Mean Equiv BV and BF were significantly higher in clear cell RCC than in papillary RCC (P<0.001 for both and mean Equiv BV was higher in clear cell RCC than in chromophobe RCC (P<0.001. The effective radiation dose of the CT perfusion protocol was 18.5 mSv. CONCLUSION: Perfusion imaging using 320-slice dynamic volume CT can be used to evaluate hemodynamic features of the whole kidney and kidney tumors, which may be useful in the differential diagnosis of these four pathologic types of kidney tumor.

  14. Technique for bone volume measurement from human femur head samples by classification of micro-CT image histograms

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    Franco Marinozzi

    2013-09-01

    Full Text Available INTRODUCTION: Micro-CT analysis is a powerful technique for a non-invasive evaluation of the morphometric parameters of trabecular bone samples. This elaboration requires a previous binarization of the images. A problem which arises from the binarization process is the partial volume artifact. Voxels at the external surface of the sample can contain both bone and air so thresholding operates an incorrect estimation of volume occupied by the two materials. AIM: The aim of this study is the extraction of bone volumetric information directly from the image histograms, by fitting them with a suitable set of functions. METHODS: Nineteen trabecular bone samples were extracted from femoral heads of eight patients subject to a hip arthroplasty surgery. Trabecular bone samples were acquired using micro-CT Scanner. Hystograms of the acquired images were computed and fitted by Gaussian-like functions accounting for: a gray levels produced by the bone x-ray absorption, b the portions of the image occupied by air and c voxels that contain a mixture of bone and air. This latter contribution can be considered such as an estimation of the partial volume effect. RESULTS: The comparison of the proposed technique to the bone volumes measured by a reference instrument such as by a helium pycnometer show the method as a good way for an accurate bone volume calculation of trabecular bone samples.

  15. Tumor volume in subcutaneous mouse xenografts measured by microCT is more accurate and reproducible than determined by 18F-FDG-microPET or external caliper

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    Jørgensen Jesper

    2008-10-01

    Full Text Available Abstract Background In animal studies tumor size is used to assess responses to anticancer therapy. Current standard for volumetric measurement of xenografted tumors is by external caliper, a method often affected by error. The aim of the present study was to evaluate if microCT gives more accurate and reproducible measures of tumor size in mice compared with caliper measurements. Furthermore, we evaluated the accuracy of tumor volume determined from 18F-fluorodeoxyglucose (18F-FDG PET. Methods Subcutaneously implanted human breast adenocarcinoma cells in NMRI nude mice served as tumor model. Tumor volume (n = 20 was determined in vivo by external caliper, microCT and 18F-FDG-PET and subsequently reference volume was determined ex vivo. Intra-observer reproducibility of the microCT and caliper methods were determined by acquiring 10 repeated volume measurements. Volumes of a group of tumors (n = 10 were determined independently by two observers to assess inter-observer variation. Results Tumor volume measured by microCT, PET and caliper all correlated with reference volume. No significant bias of microCT measurements compared with the reference was found, whereas both PET and caliper had systematic bias compared to reference volume. Coefficients of variation for intra-observer variation were 7% and 14% for microCT and caliper measurements, respectively. Regression coefficients between observers were 0.97 for microCT and 0.91 for caliper measurements. Conclusion MicroCT was more accurate than both caliper and 18F-FDG-PET for in vivo volumetric measurements of subcutaneous tumors in mice.18F-FDG-PET was considered unsuitable for determination of tumor size. External caliper were inaccurate and encumbered with a significant and size dependent bias. MicroCT was also the most reproducible of the methods.

  16. 3D SPECT/CT fusion using image data projection of bone SPECT onto 3D volume-rendered CT images: feasibility and clinical impact in the diagnosis of bone metastasis.

    Science.gov (United States)

    Ogata, Yuji; Nakahara, Tadaki; Ode, Kenichi; Matsusaka, Yohji; Katagiri, Mari; Iwabuchi, Yu; Itoh, Kazunari; Ichimura, Akira; Jinzaki, Masahiro

    2017-05-01

    We developed a method of image data projection of bone SPECT into 3D volume-rendered CT images for 3D SPECT/CT fusion. The aims of our study were to evaluate its feasibility and clinical usefulness. Whole-body bone scintigraphy (WB) and SPECT/CT scans were performed in 318 cancer patients using a dedicated SPECT/CT systems. Volume data of bone SPECT and CT were fused to obtain 2D SPECT/CT images. To generate our 3D SPECT/CT images, colored voxel data of bone SPECT were projected onto the corresponding location of the volume-rendered CT data after a semi-automatic bone extraction. Then, the resultant 3D images were blended with conventional volume-rendered CT images, allowing to grasp the three-dimensional relationship between bone metabolism and anatomy. WB and SPECT (WB + SPECT), 2D SPECT/CT fusion, and 3D SPECT/CT fusion were evaluated by two independent reviewers in the diagnosis of bone metastasis. The inter-observer variability and diagnostic accuracy in these three image sets were investigated using a four-point diagnostic scale. Increased bone metabolism was found in 744 metastatic sites and 1002 benign changes. On a per-lesion basis, inter-observer agreements in the diagnosis of bone metastasis were 0.72 for WB + SPECT, 0.90 for 2D SPECT/CT, and 0.89 for 3D SPECT/CT. Receiver operating characteristic analyses for the diagnostic accuracy of bone metastasis showed that WB + SPECT, 2D SPECT/CT, and 3D SPECT/CT had an area under the curve of 0.800, 0.983, and 0.983 for reader 1, 0.865, 0.992, and 0.993 for reader 2, respectively (WB + SPECT vs. 2D or 3D SPECT/CT, p < 0.001; 2D vs. 3D SPECT/CT, n.s.). The durations of interpretation of WB + SPECT, 2D SPECT/CT, and 3D SPECT/CT images were 241 ± 75, 225 ± 73, and 182 ± 71 s for reader 1 and 207 ± 72, 190 ± 73, and 179 ± 73 s for reader 2, respectively. As a result, it took shorter time to read 3D SPECT/CT images than 2D SPECT/CT (p < 0.0001) or WB

  17. Risk scores to facilitate preoperative prediction of transfusion and large volume blood transfusion associated with adult cardiac surgery.

    Science.gov (United States)

    Goudie, R; Sterne, J A C; Verheyden, V; Bhabra, M; Ranucci, M; Murphy, G J

    2015-05-01

    The aim of this study was to develop two novel risk prediction scores for transfusion and bleeding that would be used to inform treatment decisions, quality assurance, and clinical trial design in cardiac surgery. Clinical data prospectively collected from 26 UK cardiac surgical centres and a single European centre were used to develop two risk prediction models: one for any red blood cell (RBC) transfusion, and the other for large volume blood transfusion (≥4 RBC units; LVBT), an index of severe blood loss. 'Complete case' data were available for 24 749 patients. Multiple imputation was used for missing covariate data (typically data set containing 39 970 patients. Risk models were developed in the complete case data set, with internal validation using leave-one-centre-out cross-validation. The final selected models were fitted to the imputed data set. Final risk scores were then compared with the performance of three existing scores: the Transfusion Risk and Clinical Knowledge score (TRACK), the Transfusion Risk Understanding Scoring Tool (TRUST), and the Papworth Bleeding Risk Score (BRiSc). The area under the receiver operating characteristic curve (AUC) was 0.77 (95% confidence interval 0.77-0.77) for the any RBC transfusion score and AUC 0.80 (0.79-0.80) for the LVBT score in the imputed data set. The LVBT model also showed excellent discrimination (Hosmer-Lemeshow P=0.32). In the imputed data set, the AUCs for the TRACK and TRUST scores for any RBC transfusion were 0.71 and 0.71, respectively, and for LVBT the AUC for the BRiSc score was 0.69. Two new risk scores for any RBC transfusion or LVBT among cardiac surgery patients have excellent discrimination, and could inform clinical decision making. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Preoperative lymph node staging in patients with primary prostate cancer: comparison and correlation of quantitative imaging parameters in diffusion-weighted imaging and 11C-choline PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Vag, Tibor; Beer, Ambros J.; Souvatzoglou, Michael; Schwaiger, Markus [Technical University Munich, Clinic of Nuclear Medicine, Klinikum Rechts der Isar, Munich (Germany); Heck, Matthias M. [Technical University Munich, Clinic of Urology, Klinikum Rechts der Isar, Munich (Germany); Weirich, Gregor [Technical University Munich, Institute of Pathology, Klinikum Rechts der Isar, Munich (Germany); Holzapfel, Konstantin; Eiber, Matthias; Rummeny, Ernst J. [Technical University Munich, Institute of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Munich (Germany); Krause, Bernd Joachim [University Hospital Rostock, Clinic of Nuclear Medicine, Rostock (Germany)

    2014-08-15

    To compare the diagnostic performance of DWI and 11C-choline PET/CT in the assessment of preoperative lymph node status in patients with primary prostate cancer. Thirty-three patients underwent DWI and 11C-choline PET/CT prior to prostatectomy and extended pelvic lymph node dissection. Mean standardised uptake value (SUV{sub mean}) and mean apparent diffusion coefficient (ADC) of 76 identified lymph nodes (LN) were measured and correlated with histopathology. ADC values and SUVs were compared using linear regression analysis. A significant difference between benign and malignant LN was observed for ADC values (1.17 vs. 0.96 x 10{sup -3} mm{sup 2}/s; P < 0.001) and SUV{sub mean} (1.61 vs. 3.20; P < 0.001). ROC analysis revealed an optimal ADC threshold of 1.01 x 10{sup -3} mm{sup 2}/s for differentiating benign from malignant LN with corresponding sensitivity/specificity of 69.70 %/78.57 % and an area under the curve (AUC) of 0.785. The optimal threshold for SUV{sub mean} was 2.5 with corresponding sensitivity/specificity of 69.72 %/90.48 % and with an AUC of 0.832. ADC values and SUV{sub mean} showed a moderate significant inverse correlation (r = -0.63). Both modalities reveal similar moderate diagnostic performance for preoperative lymph node staging of prostate cancer, not justifying their application in routine clinical practice at this time. The only moderate inverse correlation between ADC values and SUV{sub mean} suggests that both imaging parameters might provide complementary information on tumour biology. (orig.)

  19. Standard Splenic Volume Estimation in North Indian Adult Population: Using 3D Reconstruction of Abdominal CT Scan Images

    Directory of Open Access Journals (Sweden)

    Adil Asghar

    2011-01-01

    Full Text Available A prospective study was carried out to establish normative data for splenic dimensions in North Indian population and their correlation with physical standard on abdominal CT of 21 patients aged between 20 and 70 years having no splenic disorders. Splenic volume was measured by two methods—volume and surface rendering technique of Able 3D doctor software and prolate ellipsoid formula. Volumes measured by both the techniques were correlated with their physical standards. Mean splenic volume was 161.57±90.2 cm3 and range 45.7–271.46 cm3. The volume of spleen had linear correlation with body height (r=0.512, P<.05. Splenic volume (cm3 = 7 × height (cm − 961 can be used to generate normal standard volume of spleen as a function of body height in North Indian population (with 95% confidence interval. This formula can be used to objectively measure the size of the spleen in adults who have clinically suspected splenomegaly.

  20. 18F-Fluorodeoxyglucose-PET/CT in locally advanced head and neck cancer can influence the stage migration and nodal radiation treatment volumes.

    Science.gov (United States)

    Mazzola, Rosario; Alongi, Pierpaolo; Ricchetti, Francesco; Fiorentino, Alba; Fersino, Sergio; Giaj-Levra, Niccolò; Salgarello, Matteo; Alongi, Filippo

    2017-08-28

    To analyze the impact of 18F-fluorodeoxyglucose-PET/CT (PET/CT) in the radiotherapy (RT) planning strategy in HNC, correlating CT-scan and PET/CT performances. Inclusion criteria were: age >18 years old, histologically proven head and neck cancer (HNC), patients candidate to definitive RT ± chemotherapy, stage of disease by means of PET/TC and CT-scan performed at our Cancer Care Center. Sixty patients were analyzed. The following primary tumor sites were investigated: nasopharynx (13%), oropharynx (42%), oral cavity (32%) and larynx non-glottic (13%). Globally, PET/CT findings caused changes on nodal radiation treatment volumes in 10% of all the population of study. Specifically, in 5 cases out of 19 oral cavity tumors (26%), PET/CT detected neck-nodes positive (not detected at CT-scan). These findings have allowed to change the patients management, including PET/CT neck-nodes positive in the high-risk RT volumes. In the RT planning strategy, the present findings support the use of PET/CT to improve upfront regional staging of HNC disease, particularly for oral cavity tumors. Further investigations are advocated to evaluate if this strategy could impact on long-term outcomes in terms of local control and overall survival.

  1. The development and validation of a CT-based radiomics signature for the preoperative discrimination of stage I-II and stage III-IV colorectal cancer

    Science.gov (United States)

    He, Lan; Chen, Xin; Ma, Zelan; Dong, Di; Tian, Jie; Liang, Changhong; Liu, Zaiyi

    2016-01-01

    Objectives To investigative the predictive ability of radiomics signature for preoperative staging (I-IIvs.III-IV) of primary colorectal cancer (CRC). Methods This study consisted of 494 consecutive patients (training dataset: n=286; validation cohort, n=208) with stage I–IV CRC. A radiomics signature was generated using LASSO logistic regression model. Association between radiomics signature and CRC staging was explored. The classification performance of the radiomics signature was explored with respect to the receiver operating characteristics(ROC) curve. Results The 16-feature-based radiomics signature was an independent predictor for staging of CRC, which could successfully categorize CRC into stage I-II and III-IV (p <0.0001) in training and validation dataset. The median of radiomics signature of stage III-IV was higher than stage I-II in the training and validation dataset. As for the classification performance of the radiomics signature in CRC staging, the AUC was 0.792(95%CI:0.741-0.853) with sensitivity of 0.629 and specificity of 0.874. The signature in the validation dataset obtained an AUC of 0.708(95%CI:0.698-0.718) with sensitivity of 0.611 and specificity of 0.680. Conclusions A radiomics signature was developed and validated to be a significant predictor for discrimination of stage I-II from III-IV CRC, which may serve as a complementary tool for the preoperative tumor staging in CRC. PMID:27120787

  2. Best single-slice location to measure visceral adipose tissue on paediatric CT scans and the relationship between anthropometric measurements, gender and VAT volume in children

    OpenAIRE

    2015-01-01

    Objective: Visceral adipose tissue (VAT) is a significant risk factor for obesity-related metabolic diseases. This study investigates (1) the best single CT slice location for predicting total abdominal VAT volume in paediatrics and (2) the relationship between waist circumference (WC), sagittal diameter (SD), gender and VAT volume. Methods: A random sample of 130 paediatric abdomen CT scans, stratified according to age and gender, was collected. Three readers measured VAT area at each interv...

  3. Relationship between flow volume curve and CT findings in non-smoking patients with long histories of bronchial asthma

    Energy Technology Data Exchange (ETDEWEB)

    Kawamoto, Hitoshi; Kambe, Masayuki; Yamagata, Mitsunori; Nakajima, Hidekatsu [Hiroshima Univ. (Japan). School of Medicine; Yamane, Kousuke; Kuraoka, Toshihiko; Miyamura, Isao

    2001-08-01

    This study was conducted to verify whether bronchial asthma (BA) alone causes pulmonary emphysema (PE), and to examine the computed tomography (CT) findings in non-smokers with BA demonstrating the flow volume curve (FV curve) characteristic of PE. Non-smoking patients with a history of BA for more than 20 years were divided into 2 groups: the dogleg pattern group (n=5), with an FV curve characteristic of PE, and the concave pattern group (n=16) with an FV curve characteristic of BA. CT scans was performed using CT values (level, 900 H.U.; width, 400 H.U.) that facilitate detection of a low attenuation area (LAA), and using conventional CT values (level, 700 H.U.; width, 1,300 H.U.). LAA (including air trapping), thickness of the bronchial wall, and partial atelectasis were compared between the 2 groups. PE was not detected, although air trapping was found in all subjects. The thickness of the airway was greater in the dogleg pattern than in the concave pattern. The incidences of air trapping and partial atelectasis were higher in the former than in the latter. BA alone may not cause PE. Some BA patients without PE show the FV curve characteristic of PE, reflecting an increase in the thickness of the airway wall and a decrease in the pulmonary ventilation probably due to the air trapping and the partial atelectasis. (author)

  4. Fully automatic multi-atlas segmentation of CTA for partial volume correction in cardiac SPECT/CT

    Science.gov (United States)

    Liu, Qingyi; Mohy-ud-Din, Hassan; Boutagy, Nabil E.; Jiang, Mingyan; Ren, Silin; Stendahl, John C.; Sinusas, Albert J.; Liu, Chi

    2017-05-01

    Anatomical-based partial volume correction (PVC) has been shown to improve image quality and quantitative accuracy in cardiac SPECT/CT. However, this method requires manual segmentation of various organs from contrast-enhanced computed tomography angiography (CTA) data. In order to achieve fully automatic CTA segmentation for clinical translation, we investigated the most common multi-atlas segmentation methods. We also modified the multi-atlas segmentation method by introducing a novel label fusion algorithm for multiple organ segmentation to eliminate overlap and gap voxels. To evaluate our proposed automatic segmentation, eight canine 99mTc-labeled red blood cell SPECT/CT datasets that incorporated PVC were analyzed, using the leave-one-out approach. The Dice similarity coefficient of each organ was computed. Compared to the conventional label fusion method, our proposed label fusion method effectively eliminated gaps and overlaps and improved the CTA segmentation accuracy. The anatomical-based PVC of cardiac SPECT images with automatic multi-atlas segmentation provided consistent image quality and quantitative estimation of intramyocardial blood volume, as compared to those derived using manual segmentation. In conclusion, our proposed automatic multi-atlas segmentation method of CTAs is feasible, practical, and facilitates anatomical-based PVC of cardiac SPECT/CT images.

  5. Axially extended-volume C-arm CT using a reverse helical trajectory in the interventional room.

    Science.gov (United States)

    Yu, Zhicong; Maier, Andreas; Lauritsch, Gunter; Vogt, Florian; Schonborn, Manfred; Kohler, Christoph; Hornegger, Joachim; Noo, Frederic

    2015-01-01

    C-arm computed tomography (CT) is an innovative technique that enables a C-arm system to generate 3-D images from a set of 2-D X-ray projections. This technique can reduce treatment-related complications and may improve interventional efficacy and safety. However, state-of-the-art C-arm systems rely on a circular short scan for data acquisition, which limits coverage in the axial direction. This limitation was reported as a problem in hepatic vascular interventions. To solve this problem, as well as to further extend the value of C-arm CT, axially extended-volume C-arm CT is needed. For example, such an extension would enable imaging the full aorta, the peripheral arteries or the spine in the interventional room, which is currently not feasible. In this paper, we demonstrate that performing long object imaging using a reverse helix is feasible in the interventional room. This demonstration involved developing a novel calibration method, assessing geometric repeatability, implementing a reconstruction method that applies to real reverse helical data, and quantitatively evaluating image quality. Our results show that: 1) the reverse helical trajectory can be implemented and reliably repeated on a multiaxis C-arm system; and 2) a long volume can be reconstructed with satisfactory image quality using reverse helical data.

  6. 漏斗胸术前 CT 肺容量测算结果与肺功能检查结果的相关性分析%Preoperative CT-based pulmonary volumetric evaluation in patients with pectus excavatum:comparison with pulmonary function test

    Institute of Scientific and Technical Information of China (English)

    于洁; 张娜; 陈诚豪; 曹隽; 曾骐

    2014-01-01

    目的:通过对比 CT 的肺容量测算结果与常规肺功能检查结果之间的相关性,评估 CT 测量肺容量法的可靠性和临床意义。方法选取首都医科大学附属北京儿童医院胸外科入院治疗的共计49例漏斗胸患者,术前行肺功能检查和 CT 检查。应用手绘-分层测量求和法测量患者肺容量并计算其与预计值之间比例。将结果与患者常规肺功能结果进行对比。结果基于CT 肺容量结果平均值低于肺功能检查结果,但与常规肺功能结果的相关性具有统计学意义:最大肺活量(maximal ventilatory capacity, VCmax)(P<0.001)、用力肺活量(forced vital capacity,FVC)(P<0.001)、肺总量(total lung capacity,TLC)(P<0.001);基于 CT 的肺容量实测值/预计值比例与肺功能结果相关性均有统计学意义: VCmax%(P<0.001)、FVC%(P<0.001)、TLC%(P<0.001)。结论 CT 测算的肺容积结果与常规肺功能结果高度相关,CT 肺容积测算法可作为临床评估漏斗胸患者肺脏容积的一种有效方法。%Objective To access the reliability of CT-based pulmonary volumetric evaluation by analyzing the correlation between lung volume calculated by CT-based pulmonary volumetric evaluation method and pulmonary function test(PFT) results. Methods This study enrolled 49 patients with pectus excavatum seen in Beijing Children' s Hospital. All patients had CT scan and pulmonary function test data. The CT-scan data were used to calculate lung's volume by handdrawn-layers summation method. The lung volume and PFT result were compared. Results The lung volume calculated by CT-based pulmonary volumetric evaluation underestimated from the PFT result of VCmax, FVC and TLC. However, the correlation between lung's volume and PFT result of VCmax(P<0. 001), FVC(P<0. 001), TLC (P < 0. 001) was significant. The correlation between value of actuality/ anticipated between lung volume and PFT results was also significant. Conclusion The lung volume

  7. MSCT血管成像对肝移植受体术前血管结构的评价%The evalution of the vascular structure of preoperative liver transplantation recipients using 64-slice spiral CT angiography

    Institute of Scientific and Technical Information of China (English)

    李妙玲; 刘雯雁; 袁会军; 强永乾; 孙兴旺; 赵婷婷

    2011-01-01

    Objective To evaluate the clinical significance of 64-slice spiral CT angiography for vascular structures of preoperative liver transplantation recipients. Methods Tri-phase enhanced CT scan were performed in 32 cases, All cases were post-processing with maximum intensity projection(MIP) , volume rendering(VR) ,and all reformation images with axial images were analyzed. Results In all 32 cases, 1 case with absence of celiac artery, 3 cases with stenosis of celiac artery caused by plaque, 12 cases with dilated splenic artery, 2 cases with splenic artery aneurysm, 7 cases with variation of hepatic artery. 3 cases with extrahepatic portal vein thrombosis, 2 cases with intrahepatic portal vein thrombosis, 1 case with thrombosis in superior mesenteric vein, 1 case with muti-ple thrombosis in portal vein and superior mesenteric vein. In all 32 cases, 25 cases with good images of hepatic vein, 14 cases with standard hepatic vein, 11 cases with common drainage of the middle and the left hepatic vein into the inferior vena cava, and 1 case with inferior hepatic vein respectively,? Cases with poor images. In all 32 cases,30 cases with normal inferior vena cava, 1 case with embolism in inferior vena cava and 1 case with embolism near the right atrium. In all 32 cases, 24 cases received liver transplantation successfully, the other 8 cases had the contraindications of liver transplantation and gave up operation,of 8 cases, 3 cases with total diameter of cancer nodules were more than 8 cm,l case with mutiple thrombosis, 4 cases with extrohepatic metastasis(including 1 case with total diameter of cancer nodules were more than 8 cm) , 1 case with Michels MD had narrowing hepatic artery and the diameter was less than 3 mm separately. Conclusion 64-slice spiral CT tri-phase angiography could overall evaluate structural changes of the hepatic vessels and choose the cases suitable for surgery,it has an important value for surgery program.%目的 探讨64排螺旋CT血管成像对肝

  8. Respiratory-gated (4D) contrast-enhanced FDG PET-CT for radiotherapy planning of lower oesophageal carcinoma: feasibility and impact on planning target volume.

    Science.gov (United States)

    Scarsbrook, Andrew; Ward, Gillian; Murray, Patrick; Goody, Rebecca; Marshall, Karen; McDermott, Garry; Prestwich, Robin; Radhakrishna, Ganesh

    2017-10-04

    To assess the feasibility and potential impact on target delineation of respiratory-gated (4D) contrast-enhanced (18)Fluorine fluorodeoxyglucose (FDG) positron emission tomography - computed tomography (PET-CT), in the treatment planning position, for a prospective cohort of patients with lower third oesophageal cancer. Fifteen patients were recruited into the study. Imaging included 4D PET-CT, 3D PET-CT, endoscopic ultrasound and planning 4D CT. Target volume delineation was performed on 4D CT, 4D CT with co-registered 3D PET and 4D PET-CT. Planning target volumes (PTV) generated with 4D CT (PTV4DCT), 4D CT co-registered with 3D PET-CT (PTV3DPET4DCT) and 4D PET-CT (PTV4DPETCT) were compared with multiple positional metrics. Mean PTV4DCT, PTV3DPET4DCT and PTV4DPETCT were 582.4 ± 275.1 cm(3), 472.5 ± 193.1 cm(3) and 480.6 ± 236.9 cm(3) respectively (no significant difference). Median DICE similarity coefficients comparing PTV4DCT with PTV3DPET4DCT, PTV4DCT with PTV4DPETCT and PTV3DPET4DCT with PTV4DPETCT were 0.85 (range 0.65-0.9), 0.85 (range 0.69-0.9) and 0.88 (range 0.79-0.9) respectively. The median sensitivity index for overlap comparing PTV4DCT with PTV3DPET4DCT, PTV4DCT with PTV4DPETCT and PTV3DPET4DCT with PTV4DPETCT were 0.78 (range 0.65-0.9), 0.79 (range 0.65-0.9) and 0.89 (range 0.68-0.94) respectively. Planning 4D PET-CT is feasible with careful patient selection. PTV generated using 4D CT, 3D PET-CT and 4D PET-CT were of similar volume, however, overlap analysis demonstrated that approximately 20% of PTV3DPETCT and PTV4DPETCT are not included in PTV4DCT, leading to under-coverage of target volume and a potential geometric miss. Additionally, differences between PTV3DPET4DCT and PTV4DPETCT suggest a potential benefit for 4D PET-CT. ClinicalTrials.gov Identifier - NCT02285660 (Registered 21/10/2014).

  9. Correlation between [{sup 18}F]FDG PET/CT and volume perfusion CT in primary tumours and mediastinal lymph nodes of non-small-cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sauter, Alexander W.; Spira, Daniel; Schulze, Maximilian; Pfannenberg, Christina; Claussen, Claus D.; Horger, Marius S. [Eberhard Karls University, Diagnostic and Interventional Radiology, Department of Radiology, Tuebingen (Germany); Hetzel, Juergen [Eberhard Karls University, Department of Oncology, Hematology, Immunology, Rheumatology and Pulmonology, Tuebingen (Germany); Reimold, Matthias [Eberhard Karls University, Nuclear Medicine, Department of Radiology, Tuebingen (Germany); Klotz, Ernst [Siemens Healthcare, Computed Tomography, Forchheim (Germany)

    2013-05-15

    The aim of this study was to investigate correlations between glucose metabolism as determined by [{sup 18}F]FDG PET/CT and tumour perfusion as quantified by volume perfusion CT in primary tumours and mediastinal lymph nodes (MLN) of patients with non-small-cell lung cancer (NSCLC). Enrolled in the study were 17 patients with NSCLC. [{sup 18}F]FDG uptake was quantified in terms of SUV{sub max} and SUV{sub avg}. Blood flow (BF), blood volume (BV) and flow extraction product (K{sup trans}) were determined as perfusion parameters. The correlations between the perfusion parameters and [{sup 18}F]FDG uptake values were subsequently evaluated. For the primary tumours, no correlations were found between perfusion parameters and [{sup 18}F]FDG uptake. In MLN, there were negative correlations between BF and SUV{sub avg} (r = -0.383), BV and SUV{sub avg} (r = -0.406), and BV and SUV{sub max} (r = -0.377), but not between BF and SUV{sub max}, K{sup trans} and SUV{sub avg}, or K{sup trans} and SUV{sub max}. Additionally, in MLN with SUV{sub max} >2.5 there were negative correlations between BF and SUV{sub avg} (r = -0.510), BV and SUV{sub avg} (r = -0.390), BF and SUV{sub max} (r = -0.536), as well as BV and SUV{sub max} (r = -0.346). Perfusion and glucose metabolism seemed to be uncoupled in large primary tumours, but an inverse correlation was observed in MLN. This information may help improve therapy planning and response evaluation. (orig.)

  10. Accuracy and reliability of thyroid volumetry using spiral CT and thyroid volume in a healthy, non-iodine-deficient Chinese adult population

    Energy Technology Data Exchange (ETDEWEB)

    Shu Jian, E-mail: shujiannc@163.com [Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010 (China); Zhao Jiannong, E-mail: zhaojiannong@tom.com [Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010 (China); Guo Dajing, E-mail: guodaj@163.com [Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010 (China); Luo Yindeng, E-mail: yindengluo_1019@163.com [Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010 (China); Zhong Weijia, E-mail: zhongweijia2003@eyou.com [Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010 (China); Xie Weibo, E-mail: radiologycq@163.com [Department of Radiology, Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010 (China)

    2011-02-15

    Objective: The purpose of this study was to assess the accuracy and reliability of thyroid volumetry using spiral CT and to investigate thyroid volumes for a healthy, non-iodine-deficient adult population in southwestern region of China. Materials and methods: Spiral CT was performed in phantoms and adult subjects with normal thyroid, and the volumes were measured by observers with 5 years or more of CT experience. The phantom volumes and the thyroid volumes of all subjects were noted. Results: For the thyroid phantoms, there was no significant difference between the true and CT calculated volumes (t = 0.862, P = 0.399), and the correlation was excellent (ICC = 0.9995, P = 0.000). In the subjects for reliability analysis, the intraobserver or interobserver differences for CT volumetric measurement of thyroid were not significant (P > 0.05). The intraobserver or interobserver correlations were very high (ICC > 0.99, P < 0.001). In the subjects for population analysis, the median of the thyroid volumes was 11.45 cm{sup 3}. The nonparametric Mann-Whitney U-test showed no significant difference for the thyroid volume between sexes (U = 4388.00, Z = -1.118, P = 0.264). The nonparametric Kruskall-Wallis test showed no significant difference in all age groups ({chi}{sup 2} = 13.466, P = 0.062). There was a slight negative correlation between the thyroid volume and age (r{sub s} = -0.166, P = 0.019). Conclusion: The accuracy and reliability of multi-slice spiral CT in measuring thyroid volume are very high. The thyroid volumes are not significantly difference between genders or among decades for the healthy, non-iodine-deficient adult population in southwestern region of China.

  11. NOTE Thyroid volume measurement in external beam radiotherapy patients using CT imaging: correlation with clinical and anthropometric characteristics

    Science.gov (United States)

    Veres, C.; Garsi, J. P.; Rubino, C.; Pouzoulet, F.; Bidault, F.; Chavaudra, J.; Bridier, A.; Ricard, M.; Ferreira, I.; Lefkopoulos, D.; de Vathaire, F.; Diallo, I.

    2010-11-01

    The aim of this study is to define criteria for accurate representation of the thyroid in human models used to represent external beam radiotherapy (EBRT) patients and evaluate the relationship between the volume of this organ and clinical and anthropometric characteristics. From CT images, we segmented the thyroid gland and calculated its volume for a population of 188 EBRT patients of both sexes, with ages ranging from 1 to 89 years. To evaluate uncertainties linked to measured volumes, experimental studies on the Livermore anthropomorphic phantom were performed. For our population of EBRT patients, we observed that in children, thyroid volume increased rapidly with age, from about 3 cm3 at 2 years to about 16 cm3 at 20. In adults, the mean thyroid gland volume was 23.5 ± 9 cm3 for males and 17.5 ± 8 cm3 for females. According to anthropometric parameters, the best fit for children was obtained by modeling the log of thyroid volume as a linear function of body surface area (BSA) (p < 0.0001) and age (p = 0.04) and for adults, as a linear function of BSA (p < 0.0001) and gender (p = 0.01). This work enabled us to demonstrate that BSA was the best indicator of thyroid volume for both males and females. These results should be taken into account when modeling the volume of the thyroid in human models used to represent EBRT patients for dosimetry in retrospective studies of the relationship between the estimated dose to the thyroid and long-term follow-up data on EBRT patients.

  12. Thyroid volume measurement in external beam radiotherapy patients using CT imaging: correlation with clinical and anthropometric characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Veres, C; Garsi, J P; Rubino, C; De Vathaire, F; Diallo, I [Inserm, CESP Centre for research in Epidemiology and Population Health, U1018, Radiation Epidemiology Team, F 94807, Villejuif (France); Pouzoulet, F; Bidault, F; Chavaudra, J; Bridier, A; Ricard, M; Ferreira, I; Lefkopoulos, D, E-mail: ibrahim.diallo@igr.f [Institut Gustave Roussy, F-94805, Villejuif (France)

    2010-11-07

    The aim of this study is to define criteria for accurate representation of the thyroid in human models used to represent external beam radiotherapy (EBRT) patients and evaluate the relationship between the volume of this organ and clinical and anthropometric characteristics. From CT images, we segmented the thyroid gland and calculated its volume for a population of 188 EBRT patients of both sexes, with ages ranging from 1 to 89 years. To evaluate uncertainties linked to measured volumes, experimental studies on the Livermore anthropomorphic phantom were performed. For our population of EBRT patients, we observed that in children, thyroid volume increased rapidly with age, from about 3 cm{sup 3} at 2 years to about 16 cm{sup 3} at 20. In adults, the mean thyroid gland volume was 23.5 {+-} 9 cm{sup 3} for males and 17.5 {+-} 8 cm{sup 3} for females. According to anthropometric parameters, the best fit for children was obtained by modeling the log of thyroid volume as a linear function of body surface area (BSA) (p < 0.0001) and age (p = 0.04) and for adults, as a linear function of BSA (p < 0.0001) and gender (p = 0.01). This work enabled us to demonstrate that BSA was the best indicator of thyroid volume for both males and females. These results should be taken into account when modeling the volume of the thyroid in human models used to represent EBRT patients for dosimetry in retrospective studies of the relationship between the estimated dose to the thyroid and long-term follow-up data on EBRT patients. (note)

  13. CT检查对变应性真菌性鼻窦炎术前诊断的价值%The value of CT scan in preoperative diagnosis of allergic fungal rhinosinusitis

    Institute of Scientific and Technical Information of China (English)

    李颖; 金焰

    2014-01-01

    Objective To study the CT scan features and preoperative diagnosis value of allergic fungal rhinosinusitis, to enhance imaging cognition of allergic fungal rhinosinusitis, and to improve the curative effect of endoscopic sinus surgery and decrease complications. Methods Clinical and imaging date of 33 patients with allergic fungal, who received endoscopic sinus surgery and confirmed by histopathological examination were summarized. Histopathological results were used as standards for analysis of the preoperative diagnosis value of CT scan in allergic fungal rhinosinusitis. Results Among the 33 cases of allergic fungal rhinosinusitis, there were 28 cases with all involved sinuses, and 5 cases with half involved sinuses. CT scan showed that 33 cases all had soft tissue shadow filling in sinus cavity, and some cases had multiple patch and strip high density shadow with clear border, while other cases had cloud high density shadow with vague border. There were 27 cases with involved sinuses expansion, 26 cases with sinuses wall sclerotin attenuation, 5 cases with sinuses wall sclerotin erosion, and 5 cases with extended lesion on close structure. Conclusion CT scan plays an important role in the diagnosis of allergic fungal rhinosinusitis. CT scan can show the nidus and involved range and degree, it also can provide information for clinical stages and treatment plan.%目的:探讨变应性真菌性鼻窦炎的CT表现及术前诊断价值,增进对该病的影像学认识,提高鼻窦内窥镜手术的疗效,降低并发症。方法行鼻内镜手术治疗并经组织病理学检查证实为变应性真菌性鼻窦炎的33例患者,对其临床资料及影像学资料进行总结,并以组织病理学结果作为标准分析评价CT检查对变应性真菌性鼻窦炎的术前诊断价值。结果变应性真菌性鼻窦炎累及全组鼻窦者28例,累及半组鼻窦者5例;CT扫描33例表现为窦腔内充满软组织影,有的伴有多发条状、斑片状高

  14. Evaluation of the partial volume effect in the activity quantification in PET/CT images; Avaliacao do efeito de volume parcial na quantificacao de atividade em imagens de PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Krempser, Alexandre R., E-mail: krempser@peb.ufrj.br [Coordenacao dos Programas de Pos-Graduacao de Engenharia (COPPE/UFRJ), RJ (Brazil). Instituto Alberto Luiz Coimbra. Programa de Engenharia Biomedica; Oliveira, Silvia M. Velasques de [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Almeida, Sergio A. de [Hospital Samaritano, Rio de Janeiro, RJ (Brazil). Centro de Imagens PET/CT

    2012-08-15

    The aim of this work was to evaluate the influence of partial volume effect (PVE) in the quantification of activity in images of a PET-CT scanner and its ability to identify lesions. Recovery coefficients were calculated using a phantom containing 12 cylinders with diameters between 4 and 30 mm and a National Electrical Manufactures Association scattering phantom, both fillable with known concentrations of {sup 18}F. The images were acquired for acquisition time of 3 and 5 minutes, and cylinder to background ratio of n=8:1 and n=4:1. The recovery coefficients were calculated between 0.01 and 0.91 depending on the diameter. Significant variations were not found in function of image acquisition parameters. Errors in the activity quantification above 70% were found for cylinders with diameters smaller than 10 mm. The cylinders with diameters smaller than 8 mm were not identified in the images. The phantoms were adequate for PVE evaluation in the PET/CT images. The PVE had the greatest impact on the cylinders with diameters of 6 and 4 mm. It's necessary to use partial volume correction techniques in the images in order to increase the quantitative accuracy of the studied equipment. (author)

  15. Modelling capillary trapping using finite-volume simulation of two-phase flow directly on micro-CT images

    Science.gov (United States)

    Raeini, Ali Q.; Bijeljic, Branko; Blunt, Martin J.

    2015-09-01

    We study capillary trapping in porous media using direct pore-scale simulation of two-phase flow on micro-CT images of a Berea sandstone and a sandpack. The trapped non-wetting phase saturations are predicted by solving the full Navier-Stokes equations using a volume-of-fluid based finite-volume framework to simulate primary drainage followed by water injection. Using these simulations, we analyse the effects of initial non-wetting-phase saturation, capillary number and flow direction on the residual saturation. The predictions from our numerical method are in agreement with published experimental measurements of capillary trapping curves. This shows that our direct simulation method can be used to elucidate the effect of pore structure and flow pattern of capillary trapping and provides a platform to study the physics of multiphase flow at the pore scale.

  16. A comparative study of the target volume definition in radiotherapy with «Slow CT Scan» vs. 4D PET/CT Scan in early stages non-small cell lung cancer.

    Science.gov (United States)

    Molla, M; Anducas, N; Simó, M; Seoane, A; Ramos, M; Cuberas-Borros, G; Beltran, M; Castell, J; Giralt, J

    To evaluate the use of 4D PET/CT to quantify tumor respiratory motion compared to the «Slow»-CT (CTs) in the radiotherapy planning process. A total of 25 patients with inoperable early stage non small cell lung cancer (NSCLC) were included in the study. Each patient was imaged with a CTs (4s/slice) and 4D PET/CT. The adequacy of each technique for respiratory motion capture was evaluated using the volume definition for each of the following: Internal target volume (ITV) 4D and ITVslow in relation with the volume defined by the encompassing volume of 4D PET/CT and CTs (ITVtotal). The maximum distance between the edges of the volume defined by each technique to that of the total volume was measured in orthogonal beam's eye view. The ITV4D showed less differences in relation with the ITVtotal in both the cranio-caudal and the antero-posterior axis compared to the ITVslow. The maximum differences were 0.36mm in 4D PET/CTand 0.57mm in CTs in the antero-posterior axis. 4D PET/CT resulted in the definition of more accurate (ITV4D/ITVtotal 0.78 vs. ITVs/ITVtotal 0.63), and larger ITVs (19.9 cc vs. 16.3 cc) than those obtained with CTs. Planning with 4D PET/CT in comparison with CTs, allows incorporating tumor respiratory motion and improving planning radiotherapy of patients in early stages of lung cancer. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  17. The evolution of the cerebral blood volume abnormality in patients with ischemic stroke: a CT perfusion study

    Energy Technology Data Exchange (ETDEWEB)

    D' Esterre, Christopher D.; Lee, Ting Yim (Lawson Health Research Inst., London (Canada); Robarts Research Inst., London (Canada)), email: tlee@robarts.ca; Aviv, Richard I. (Sunnybrook Health Sciences Centre, Toronto (Canada))

    2012-05-15

    Background: Accurate identification of the acute infarct core abnormality is important for guiding acute stroke treatment. Abnormality volumes from diffusion-weighted MRI (DWI) and CT perfusion (CTP)-cerebral blood volume (CBV) are highly correlated. DWI lesions have been shown to be reversible at 24 h. Purpose: To examine the temporal profile of the CT perfusion (CTP)-derived CBV abnormality out to 7 days post ischemic stroke. Material and Methods: Twenty-six patients were included. Group A (n = 13) underwent a noncontrast CT (NCCT), CTP/CT angiography (CTA) within 6 h of stroke onset, CTP/CTA at 24 h, and CTP/NCCT at 5-7 days post stroke. Group B (n = 13) underwent a NCCT, CTP/CTA within 6 h of stroke onset, and NCCT at 5-7 days. Recanalization status was established in all patients. For both groups, infarct volumes were traced on 5-7 day NCCT images and superimposed onto all CTP-CBV functional maps to determine CBV. Group B (n = 13) admission images were used to define CBV infarct thresholds for gray and white matter. CBV-lesion overestimation was determined for Group A using the thresholds from Group B. Results: CBV (ml x 100g- 1; mean +- stdev) for gray/white matter, within confirmed infarcted regions (CBVI) at admission, 24 h, and 5-7 days were 1.82 +- 0.56, 1.56 +- 0.42, 1.75 +- 0.31, and 1.38 +- 0.65, 1.13 +- 0.31, 1.32 +- 0.44, respectively, when averaged over all patients (P > 0.05). Four patients had tissue time-density curves from ischemic lesions (TDCi) with an incomplete contrast medium wash-out phase (truncation) at admission and/or 24 h. Compared to admission, gray matter CBVI was higher at 5-7 days for patients with TDCi truncation (P < 0.05). There were no significant CBVI increases for the eight patients without truncation (P > 0.05). Over-estimation of acute CBV lesion was present in 3/4 (75%) and 1/9 (11%) of patients with/without TDCi truncation, respectively. Conclusion: CTP-derived CBV lesion reversal is associated with TDCi truncation

  18. Z-score-based semi-quantitative analysis of the volume of the temporal horn of the lateral ventricle on brain CT images.

    Science.gov (United States)

    Takahashi, Noriyuki; Kinoshita, Toshibumi; Ohmura, Tomomi; Lee, Yongbum; Matsuyama, Eri; Toyoshima, Hideto; Tsai, Du-Yih

    2016-01-01

    The volume of the temporal horn of the lateral ventricle (THLV) on brain computed tomography (CT) images is important for neurologic diagnosis. Our purpose in this study was to develop a z-score-based semi-quantitative analysis for estimation of the THLV volume by using voxel-based morphometry. The THLV volume was estimated by use of a z-score mapping method that consisted of four main steps: anatomic standardization, construction of a normal reference database, calculation of the z score, and calculation of the mean z score in a volume of interest (VOI). A mean z score of the CT value obtained from a VOI around the THLV was used as an index for the THLV volume. CT scans from 50 subjects were evaluated. For evaluation of the accuracy of this method for estimating the THLV volume, the THLV volume was determined manually by neuroradiologists (serving as the reference volume). A mean z score was calculated from the VOI for each THLV of the 50 subjects by use of the proposed method. The accuracy of this method was evaluated by use of the relationship between the mean z score and the reference volume. The quadratic polynomial regression equation demonstrated a statistically significant correlation between the mean z score and the reference volume of the THLV (R (2) = 0.94; P z score captured the reference volume of the THLV. The z-score-based semi-quantitative analysis has the potential quantitatively to estimate the THLV volume on CT images.

  19. Dose efficiency consideration for volume-of-interest breast imaging using x-ray differential phase-contrast CT

    Science.gov (United States)

    Cai, Weixing; Ning, Ruola

    2009-02-01

    The newly developed differential phase-contrast (DPC) imaging technique has attracted increasing interest among researchers. In a DPC system, the self-imaging effect and the phase-stepping method are implemented through three gratings to manifest phase contrast, and differentiated phase images can be obtained. An important advantage of this technique is that hospital-grade x-ray tubes can be used, allowing much higher x-ray output power and faster image processing than with micro-focus in-line phase-contrast imaging. A DPC-CT system can acquire images from different view angles along a circular orbit, and tomographic images can be reconstructed. However, the principle of DPC imaging requires multiple exposures to compute any differentiated phase image at each view angle, which raises concerns about radiation exposure via x-ray dose. Computer simulations are carried out to study the dose efficiency for DPC-CT for volume-of-interest breast imaging. A conceptual CBCT/DPC-CT hybrid imaging system and a numerical breast phantom are designed for this study. A FBP-type reconstruction algorithm is optimized for the VOI reconstruction. Factors including the x-ray flux and detector pixel size are considered and their effects on reconstruction image quality in terms of noise level and contrast-to-noise ratio are investigated. The results indicate that with a pixel size of 20 microns and a dose level of 5.7mGy, which is equivalent to the patient dose of a two-view mammography screening or a dedicated CBCT breast imaging scan, much better tissue contrast and spatial resolution can be achieved using the DPC-CT technique. It is very promising for possible application at pathology-level in vivo study for human breasts.

  20. Whole-brain 320-detector row dynamic volume CT perfusion detected crossed cerebellar diaschisis after spontaneous intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Fu, Jun; Chen, Wei-jian; Wang, Mei-hao; Li, Jian-ce; Zhang, Qian; Xia, Neng-zhi; Yang, Yun-jun [Wenzhou Medical University, Department of Radiology, First Affiliated Hospital, Wenzhou (China); Wu, Gui-yun [Cleveland Clinics Foundation, Department of Nuclear Medicine, Imaging Institute, Cleveland, OH (United States); Cheng, Jing-liang; Zhang, Yong [Zhengzhou University, Department of Radiology, First Affiliated Hospital, Zhengzhou (China); Zhuge, Qichuan [Wenzhou Medical University, Department of Neurosurgery, First Affiliated Hospital, Wenzhou (China)

    2014-11-09

    The purpose of this study was to evaluate the value of 320-detector row CT used to detect crossed cerebellar diaschisis (CCD) in patients with unilateral supratentorial spontaneous intracerebral hemorrhage (SICH). We investigated 62 of 156 patients with unilateral supratentorial SICH using 320-detector row CT scanning. Regional cerebral blood flow (rCBF), cerebral blood volume (rCBV), mean transit time (rMTT), and time to peak (rTTP) levels were measured in different regions of interest (ROIs) that were manually outlined on computed tomography perfusion (CTP) for the cerebrum, including normal-appearing brain tissue that surrounded the perilesional low-density area (NA) and the perihematomal low-density area (PA) in all patients and the cerebellum (ipsilateral and contralateral) in CCD-positive patients. Of 62 cases, a total of 14 met the criteria for CCD due to cerebellar perfusion asymmetry on CTP maps. In the quantitative analysis, significant differences were found in the perfusion parameters between the contralateral and ipsilateral cerebellum in CCD-positive cases. No significant differences were found between the CCD-positive group and the CCD-negative group according to the hematoma volume, NIHSS scores, and cerebral perfusion abnormality (each P > 0.05). The correlation analysis of the degree of NA, PA perfusion abnormality, and the degree of CCD severity showed negative and significant linear correlations (R, -0.66∝-0.56; P < 0.05). 320-detector row CT is a robust and practicable method for the comprehensive primary imaging work-up of CCD in unilateral supratentorial SICH patients. (orig.)

  1. Contribution of {sup 68}Ga-DOTATOC PET/CT to Target Volume Delineation of Skull Base Meningiomas Treated With Stereotactic Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Graf, Reinhold, E-mail: reinhold.graf@charite.de [Department of Radiation Oncology, Charite Universitaetsmedizin Berlin, Berlin (Germany); Nyuyki, Fonyuy; Steffen, Ingo G.; Michel, Roger; Fahdt, Daniel [Department of Nuclear Medicine, Charite Universitaetsmedizin Berlin, Berlin (Germany); Wust, Peter; Brenner, Winfried; Budach, Volker [Department of Radiation Oncology, Charite Universitaetsmedizin Berlin, Berlin (Germany); Wurm, Reinhard [Department of Radiation Oncology, Klinikum Frankfurt (Oder) (Germany); Plotkin, Michail [Department of Nuclear Medicine, Charite Universitaetsmedizin Berlin, Berlin (Germany)

    2013-01-01

    Purpose: To investigate the potential impact of {sup 68}Ga-DOTATOC positron emission tomography ({sup 68}Ga-DOTATOC-PET) in addition to magnetic resonance imaging (MRI) and computed tomography (CT) for retrospectively assessing the gross tumor volume (GTV) delineation of meningiomas of the skull base in patients treated with fractionated stereotactic radiation therapy (FSRT). Methods and Materials: The study population consisted of 48 patients with 54 skull base meningiomas, previously treated with FSRT. After scans were coregistered, the GTVs were first delineated with MRI and CT data (GTV{sub MRI/CT}) and then by PET (GTV{sub PET}) data. The overlapping regions of both datasets resulted in the GTV{sub common}, which was enlarged to the GTV{sub final} by adding volumes defined by only one of the complementary modalities (GTV{sub MRI/CT-added} or GTV{sub PET-added}). We then evaluated the contribution of conventional imaging modalities (MRI, CT) and {sup 68}Ga-DOTATOC-PET to the GTV{sub final}, which was used for planning purposes. Results: Forty-eight of the 54 skull base lesions in 45 patients showed increased {sup 68}Ga-DOTATOC uptake and were further analyzed. The mean GTV{sub MRI/CT} and GTV{sub PET} were approximately 21 cm{sup 3} and 25 cm{sup 3}, with a common volume of approximately 15 cm{sup 3}. PET contributed a mean additional GTV of approximately 1.5 cm{sup 3} to the common volume (16% {+-} 34% of the GTV{sub common}). Approximately 4.5 cm{sup 3} of the GTV{sub MRI/CT} was excluded from the contribution to the common volume. The resulting mean GTV{sub final} was significantly smaller than both the GTV{sub MRI/CT} and the GTV{sub PET}. Compared with the initial GTV{sub MRI/CT}, the addition of {sup 68}Ga-DOTATOC-PET resulted in more than 10% modification of the size of the GTV{sub final} in 32 (67%) meningiomas Conclusions: {sup 68}Ga-DOTATOC-PET/CT seems to improve the target volume delineation in skull base meningiomas, often leading to a reduction of

  2. 多层螺旋CT多模式重组在复杂髋臼骨折术前检查中的应用%The preoperative application of multi slice CT with three-dimensional reconstruction in complex acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    陈木养; 黄伟坚; 余洪希; 王东

    2016-01-01

    Objective To evaluate the value of volume scanning method, multiplanar reconstruction (MPR), surface shaded display (SSD), and volume reconstruction (VR) techniques in the preoperative examination of complex acetabular fractures. Methods Fifty-eight cases with ancetabular fractures were all accepted CT volume scanning , and MPR were done in all cases. In addition, case-control analysis were done with conventional acetabular CT imagings. Results Coronal plane of MPR, surface shaded display (SSD) combined with VR imaging, could display the acetabular fractures clearly, in accordance with the operations, and its diagnostic accuracy was significantly higher than conventional CT scan. The two sets of data had significances difference (P<0.05) in displaying fracture type, the length of the fracture lines, the shapes and direction of the fracture, the sizes of fracture pieces, the spatial location, the degree of fracture displacement and the joint dislocation classification. Conclusion Multi slice CT (MSCT) volume scanning, MPR, SSD and VR techniques have good display abilities of acetabular fractures , their performance are close to the pathological anatomy. They are considered to be the ideal imaging methods to know about the complex acetabular fractures and its microscopic structures.%目的:利用多层螺旋CT的容积扫描方法和多平面重建(MPR)、表面遮盖法(SSD)及容积再现(VR)技术,评价其在复杂性髋臼骨折术前检查中的应用价值。方法选取58例患者的损伤髋臼进行多层螺旋CT容积扫描,所得原始数据做数字化三维重组处理,并与常规髋臼CT平扫图像进行对照分析。结果 MPR冠状面、SSD重建结合VR成像,能清晰显示58例髋臼骨折情况,与手术相符,诊断正确率明显高于常规CT平扫。在显示骨折分型、骨折线的长短、形态、走向,骨折片大小、空间位置以及骨折移位程度和关节脱位分类征象方面,2组

  3. Demons Registration of CT Volume and CBCT Projections for Adaptive Radiotherapy: Avoiding CBCT Reconstruction

    DEFF Research Database (Denmark)

    Bjerre, Troels; Aznar, M.; Munck af Rosenschöld, P.

    2012-01-01

    . CBCT scans, are typically reconstructed using the filtered back-projection algorithm, which introduces significant artefacts, causing deteriorated image quality and registration results. We study the feasibility of performing demons registration without tomographic reconstruction of the CBCT...... and registered image was 1.4·10-3 HU2. The mean absolute difference between the Jacobian determinant of the true and estimated deformation field was 4.0·10- 4. Time consumption was 11 min. using 8 2.3 GHz AMD Opteron cores. Conclusions: In this feasibility study, using a known deformation and synthetic noise......Purpose/Objective: In adaptive radiotherapy, the dose plan is adapted throughout the fractionation schedule to accommodate for anatomical changes. This can be achieved by deformable image registration of the planning PET-CT scan with segmented tumor and organs to daily cone beam CT (CBCT) scans...

  4. Automatic extraction of forward stroke volume using dynamic 11C-acetate PET/CT

    DEFF Research Database (Denmark)

    Harms, Hans; Tolbod, Lars Poulsen; Hansson, Nils Henrik

    was then calculated as the injected dose divided by the product of heart rate and the area under the curve of the first-pass peak. Gold standard FSV was measured in the left ventricular outflow tract by cardiovascular magnetic resonance using phase-contrast velocity mapping within two weeks of PET imaging. Results...... TruePoint 64 PET/CT scanner after bolus injection of 399±27 MBq of 11C-acetate. The LV-aortic time-activity curve (TAC) was extracted automatically from dynamic PET data using cluster analysis. The first-pass peak was derived by automatic extrapolation of the down-slope of the TAC. FSV...... = 0.001). Conclusions: FSV can be obtained automatically and reliably using dynamic 11C-acetate PET/CT and cluster analysis, although a small overestimation is observed when compared to FSV determined from MRI. This method could potentially be generalized to other tracers, although this requires...

  5. Preoperative nodal staging of non-small cell lung cancer using {sup 99m}Tc-sestamibi SPECT/CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Miziara, Juliana Muniz; Rocha, Euclides Timoteo da; Miziara, Jose Elias Abrao; Garcia, Gustavo Fabene; Simoes, Maria Izilda Previato; Lopes, Marco Antonio; Kerr, Ligia Maria [Hospital de Cancer de Barretos, Barretos, SP (Brazil); Buchpiguel, Carlos Alberto, E-mail: julimiziara@ig.com.br [Faculdade de Medicina da Universidade da Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, SP (Brazil)

    2011-07-01

    predictive values of 67.7% and 91.2%, respectively. Conclusion: Single-photon emission computed tomography/computed tomography with {sup 99m}Tc-sestamibi showed very low sensitivity and accuracy for the nodal staging of patients with non-small cell lung cancer, despite its high level of specificity. In addition, the performance of single-photon emission computed tomography/computed tomography added no relevant information compared to computed tomography that would justify its use in the routine preoperative staging of non-small cell lung carcinoma. (author)

  6. Tumour 18 F-FDG Uptake on preoperative PET/CT may predict axillary lymph node metastasis in ER-positive/HER2-negative and HER2-positive breast cancer subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin You; Lee, Suck Hong; Kim, Suk [Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Department of Radiology, Seo-gu, Busan (Korea, Republic of); Kang, Taewoo [Pusan National University Hospital, Busan Cancer Center, Busan (Korea, Republic of); Bae, Young Tae [Pusan National University Hospital, Department of Surgery, Busan (Korea, Republic of)

    2015-04-01

    To evaluate the association between tumour FDG uptake on preoperative PET/CT and axillary lymph node metastasis (ALNM) according to breast cancer subtype. The records of 671 patients with invasive breast cancer who underwent {sup 18} F-FDG PET/CT and surgery were reviewed. Using immunohistochemistry, tumours were divided into three subtypes: oestrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, HER2-positive, and triple-negative. Tumour FDG uptake, expressed as maximum standardized uptake value (SUV{sub max}), and clinicopathological variables were analysed. ALNM was present in 187 of 461 ER-positive/HER2-negative, 54 of 97 HER2-positive, and 38 of 113 triple-negative tumours. On multivariate analysis, high tumour SUV{sub max} (≥4.25) (P < 0.001), large tumour size (>2 cm) (P = 0.003) and presence of lymphovascular invasion (P < 0.001) were independent variables associated with ALNM. On subset analyses, tumour SUV{sub max} maintained independent significance for predicting ALNM in ER-positive/HER2-negative (adjusted odds ratio: 3.277, P < 0.001) and HER2-positive tumours (adjusted odds ratio: 14.637, P = 0.004). No association was found for triple-negative tumours (P = 0.161). Tumour SUV{sub max} may be an independent prognostic factor for ALNM in patients with invasive breast cancer, especially in ER-positive/HER2-negative and HER2-positive subtypes, but not in those with triple-negative subtype. (orig.)

  7. Automatic extraction of forward stroke volume using dynamic PET/CT

    DEFF Research Database (Denmark)

    Harms, Hans; Tolbod, Lars Poulsen; Hansson, Nils Henrik Stubkjær

    2015-01-01

    from PET data using cluster analysis. The first-pass peak was isolated by automatic extrapolation of the downslope of the TAC. FSV was calculated as the injected dose divided by the product of heart rate and the area under the curve of the first-pass peak. Gold standard FSV was measured using phase-contrast...... a dynamic 11 C-acetate PET scan on a Siemens Biograph TruePoint-64 PET/CT (scanner I). In addition, 10 subjects underwent both dynamic 15 O-water PET and 11 C-acetate PET scans on a GE Discovery-ST PET/CT (scanner II). The left ventricular (LV)-aortic time-activity curve (TAC) was extracted automatically.......001 for all). FSV based on 11 C-acetate and 15 O-water correlated highly (r = 0.99, slope = 1.03) with no significant difference between FSV estimates (p = 0.14). Conclusions FSV can be obtained automatically using dynamic PET/CT and cluster analysis. Results are almost identical for 11 C-acetate and 15 O...

  8. SU-E-J-123: Assessing Segmentation Accuracy of Internal Volumes and Sub-Volumes in 4D PET/CT of Lung Tumors Using a Novel 3D Printed Phantom

    Energy Technology Data Exchange (ETDEWEB)

    Soultan, D [University of California-San Diego, San Diego State University, La Jolla, CA (United States); Murphy, J; James, C; Hoh, C; Moiseenko, V; Cervino, L [University of California, San Diego, La Jolla, CA (United States); Gill, B [British Columbia Cancer Agency, Windsor, ON (Canada)

    2015-06-15

    Purpose: To assess the accuracy of internal target volume (ITV) segmentation of lung tumors for treatment planning of simultaneous integrated boost (SIB) radiotherapy as seen in 4D PET/CT images, using a novel 3D-printed phantom. Methods: The insert mimics high PET tracer uptake in the core and 50% uptake in the periphery, by using a porous design at the periphery. A lung phantom with the insert was placed on a programmable moving platform. Seven breathing waveforms of ideal and patient-specific respiratory motion patterns were fed to the platform, and 4D PET/CT scans were acquired of each of them. CT images were binned into 10 phases, and PET images were binned into 5 phases following the clinical protocol. Two scenarios were investigated for segmentation: a gate 30–70 window, and no gating. The radiation oncologist contoured the outer ITV of the porous insert with on CT images, while the internal void volume with 100% uptake was contoured on PET images for being indistinguishable from the outer volume in CT images. Segmented ITVs were compared to the expected volumes based on known target size and motion. Results: 3 ideal breathing patterns, 2 regular-breathing patient waveforms, and 2 irregular-breathing patient waveforms were used for this study. 18F-FDG was used as the PET tracer. The segmented ITVs from CT closely matched the expected motion for both no gating and gate 30–70 window, with disagreement of contoured ITV with respect to the expected volume not exceeding 13%. PET contours were seen to overestimate volumes in all the cases, up to more than 40%. Conclusion: 4DPET images of a novel 3D printed phantom designed to mimic different uptake values were obtained. 4DPET contours overestimated ITV volumes in all cases, while 4DCT contours matched expected ITV volume values. Investigation of the cause and effects of the discrepancies is undergoing.

  9. An evaluation of the feasibility of assessment of volume perfusion for the whole lung by 128-slice spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Haitao [Imaging Center of Taian Central Hospital, Taian, Shandong (China); Gao, Fei; Li, Ning; Liu, Cheng [Shandong Univ., Shandong Medical Imaging Research Inst., CT Room, Shandong (China)], e-mail: liucheng491025@sina.com

    2013-10-15

    Background: Lung perfusion based on dynamic scanning cannot provide a quantitative assessment of the whole lung because of the limited coverage of the current computed tomography (CT) detector designs. Purpose: To evaluate the feasibility of dynamic volume perfusion CT (VPCT) of the whole lung using a 128-slice CT for the quantitative assessment and visualization of pulmonary perfusion. Material and Methods: Imaging was performed in a control group of 17 subjects who had no signs of disturbance of pulmonary function or diffuse lung disease, and 15 patients (five patients with acute pulmonary embolism and 10 with emphysema) who constituted the abnormal lung group. Dynamic VPCT was performed in all subjects, and pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time (MTT) were calculated from dynamic contrast images with a coverage of 20.7 cm. Regional and volumetric PBF, PBV, and MTT were statistically evaluated and comparisons were made between the normal and abnormal lung groups. Results: Regional PBF (94.2{+-}36.5, 161.8 {+-}29.6, 185.7 {+-}38.1 and 125.5 {+-}46.1, 161.9 {+-}31.4, 169.3 {+-}51.7), PBV (6.7 {+-}2.8, 10.9 {+-}3.0, 12.9 {+-}4.5 and 9.9 {+-}4.6, 10.3 {+-}2.9, 11.9 {+-}4.5), and MTT (5.8 {+-}2.4, 4.5 {+-}1.3, 4.7 {+-}2.1 and 5.6 {+-}2.3, 4.3 {+-}1.5, 4.9 {+-}1.5) demonstrated significant differences in the gravitational and isogravitational directions in the normal lung group (P < 0.05). The PBF (154.2 {+-}30.6 vs. 94.9 {+-}15.9) and PBV (11.1 {+-}4.0 vs. 6.6 {+-}1.7) by dynamic VPCT showed significant differences between normal and abnormal lungs (P < 0.05), notwithstanding the four large lungs that had coverage > 20.7 cm. Conclusion: Dynamic VPCT of the whole lung is feasible for the quantitative assessment of pulmonary perfusion by 128-slice CT, and may in future permit the evaluation of both morphological and functional features of the whole lung in a single examination.

  10. Liver SULmean at FDG PET/CT: interreader agreement and impact of placement of volume of interest.

    Science.gov (United States)

    Viner, Maya; Mercier, Gustavo; Hao, Frank; Malladi, Ashish; Subramaniam, Rathan M

    2013-05-01

    To evaluate how interreader agreement and the site of the volume of interest (VOI) affect the agreement and variability of liver mean standardized uptake value normalized to lean body mass (SUL(mean)) at fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT). Institutional review board approval was obtained for this HIPAA-compliant retrospective review of PET/CT images and patient records. PET/CT images were reviewed in 116 randomly selected patients who had undergone a baseline PET/CT examination and who had normal livers according to imaging and biochemical test results. A 30-mm-diameter spherical VOI was placed within the right lobe of the liver above, below, and at the level of the main portal vein. Two readers performed all measurements independently. Analysis of variance, intraclass correlation coefficient (ICC) analysis, and Bland-Altman analysis were performed. The mean SUL(mean) was between 2.11 and 2.17 at the upper, portal, and lower levels of the right lobe of the liver. The coefficient of variance was between 21.0% and 23.1%, without significant differences for location, with the least variance in the upper level. The ICC of the two readers varied between 0.98 and 0.99 (95% confidence interval [CI]: 0.97, 0.99; P = .0001) at each level. The greatest precision (narrowest CI) was also in the upper level. Bias was 0.025 ± 0.10 (standard deviation) at the upper level, was 0.004 ± 0.14 at the lower level, and was 0.047 ± 0.10 at the portal vein (P = .02). For each reader, there was almost perfect reliability between the SUL(mean) measurements made at the three levels, with an ICC of 0.98 (95% CI: 0.98, 0.99; P = .0001). Liver SUL(mean) at FDG PET/CT has excellent interreader agreement, with similar values and variance whether measured at the upper, lower, or portal vein levels within the right lobe of the liver. © RSNA, 2013.

  11. Impact of 18-fluorodeoxyglucose positron emission tomography on computed tomography defined target volumes in radiation treatment planning of esophageal cancer: reduction in geographic misses with equal inter-observer variability: PET/CT improves esophageal target definition.

    Science.gov (United States)

    Schreurs, L M A; Busz, D M; Paardekooper, G M R M; Beukema, J C; Jager, P L; Van der Jagt, E J; van Dam, G M; Groen, H; Plukker, J Th M; Langendijk, J A

    2010-08-01

    Target volume definition in modern radiotherapy is based on planning computed tomography (CT). So far, 18-fluorodeoxyglucose positron emission tomography (FDG-PET) has not been included in planning modality in volume definition of esophageal cancer. This study evaluates fusion of FDG-PET and CT in patients with esophageal cancer in terms of geographic misses and inter-observer variability in volume definition. In 28 esophageal cancer patients, gross, clinical and planning tumor volumes (GTV; CTV; PTV) were defined on planning CT by three radiation oncologists. After software-based emission tomography and computed tomography (PET/CT) fusion, tumor delineations were redefined by the same radiation-oncologists. Concordance indexes (CCI's) for CT and PET/CT based GTV, CTV and PTV were calculated for each pair of observers. Incorporation of PET/CT modified tumor delineation in 17/28 subjects (61%) in cranial and/or caudal direction. Mean concordance indexes for CT-based CTV and PTV were 72 (55-86)% and 77 (61-88)%, respectively, vs. 72 (47-99)% and 76 (54-87)% for PET/CT-based CTV and PTV. Paired analyses showed no significant difference in CCI between CT and PET/CT. Combining FDG-PET and CT may improve target volume definition with less geographic misses, but without significant effects on inter-observer variability in esophageal cancer.

  12. 28例儿童漏斗胸术前多层螺旋CT的诊断与评估%Preoperative diagnosis and assessment of 28 children with pectus excavatum Multi-Slice CT

    Institute of Scientific and Technical Information of China (English)

    白林; 彭泽华; 梁洪; 高燕

    2012-01-01

    Objective To evaluate the preoperative diagnosis of multi-slice CT (MSCT) in children with pectus excavatum. Methods We retrospectively analyzed 28 cases of funnel chest diagnosed by MSCT examination. All the cases were divided into three groups with pathogenetic condition in mild, moderate, serious degree respectively according to the depression of the chest diagnosed by CT. We measured the degree of sternal depression, CT depression index, the angle of sternal depression, cardiac rotation angle, Haller index,compare those five indicators among the three groups,and analyzed the correlation between cardiac rotation angle and the other four indices. Results Varying degrees of pectus excavatum were found in the 28 cases including 14 cases of mild depression,9 cases of moderrate depression, and 5 cases of serious depression. The five indicators between each of the two groups were significantly different ( P < 0.01). Cardiac rotation angle was positively correlated to sternal depression depth, CT depression index and Haller index ( rs = 0. 736,0. 873,0. 881 ,P < 0.01) ,and was negative correlated to sternal depression angle (rt = -0.731 ,P < 0.01). Conclusion MSCT can accurately display the deformity of funnel chest and the rotation of cardiac compression, to provide effective help for clinical treatment.%目的 评价多层螺旋CT(MSCT)在儿童漏斗胸术前诊断中的价值.方法 回顾性分析28例经MSCT检查并诊断为漏斗胸患儿的CT资料,根据CT凹陷指数,将其分为轻、中、重度三组,测量并比较三组患儿胸骨凹陷深度、CT凹陷指数、胸骨凹陷角度、心脏旋转角度及Haller指数五项指标的差异,分析心脏旋转角与其它四项指标的相关性.结果 ①28例均有不同程度胸骨凹陷,其中轻度凹陷14例,中度凹陷9例,重度凹陷5例;②胸骨凹陷深度、CT凹陷指数、胸骨凹陷角度、心脏旋转角度及Haller指数五项指标在轻、中、重度三组间差异均有统计学

  13. Prognostic impact of tumour burden assessed by metabolic tumour volume on FDG PET/CT in anal canal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gauthe, Mathieu [Institut Curie, Medecine Nucleaire, Saint-Cloud (France); Hopital Tenon, Medecine Nucleaire, Paris (France); Richard-Molard, Marion [Institut Curie, Radiotherapie, Saint-Cloud (France); Fayard, Juliette; Cacheux, Wulfran [Institut Curie, Oncologie Medicale, Saint-Cloud (France); Alberini, Jean-Louis [Institut Curie, Medecine Nucleaire, Saint-Cloud (France); Lievre, Astrid [Institut Curie, Oncologie Medicale, Saint-Cloud (France); CHU Pontchaillou, Service des Maladies de l' Appareil Digestif, Rennes (France); Universite Rennes 1, Rennes (France)

    2017-01-15

    The aim of this study was to confirm the prognostic value of metabolic tumour volume (MTV) at the primary site on initial work-up FDG PET/CT in patients with squamous cell carcinoma (SCC) of the anal canal. Patients with a recent diagnosis of SCC of the anal canal without metastases undergoing PET/CT for initial work-up and treated with (chemo)radiotherapy were retrospectively reviewed. Computer-aided MTV and SUVmax were determined. Survival rates were estimated using the Kaplan-Meier method. Cox regression analysis was used to evaluate prognostic variables of progression-free survival and overall survival (OS). The study group comprised 75 patients who had an initial work-up PET/CT. Five patients (6.7 %) had stage I disease, 22 (29.3 %) stage II disease, 20 (26.7 %) stage IIIA disease, and 28 (37.3 %) stage IIIB disease. Median follow-up was 51 months (range 10 - 117 months). Global 4-year OS was 82.7 %, ranging from 100 % in patients with stage I disease to 75 % in patients with stage IIIB disease. MTV at the primary site was significantly and independently correlated with OS (p < 0.05), as patients with MTV less than 7 cm{sup 3} had a better prognosis. SUVmax was not correlated with survival parameters. Metabolic involvement of the inguinal lymph nodes was also correlated with a poor outcome in the univariate analysis (p < 0.05). MTV at the primary site is a prognostic biomarker in anal canal cancer. Hypermetabolic inguinal lymph nodes also appear to be correlated with survival. (orig.)

  14. Added value of lung perfused blood volume images using dual-energy CT for assessment of acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Munemasa, E-mail: radokada@yamaguchi-u.ac.jp [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Kunihiro, Yoshie [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Nakashima, Yoshiteru [Department of Radiology, Yamaguchi Grand Medical Center, Oosaki 77, Hofu, Yamaguchi 747-8511 (Japan); Nomura, Takafumi [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Kudomi, Shohei; Yonezawa, Teppei [Department of Radiology, Yamaguchi University Hospital, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Suga, Kazuyoshi [Department of Radiology, St. Hills Hospital, Imamurakita 3-7-18, Ube, Yamaguchi 755-0155 (Japan); Matsunaga, Naofumi [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan)

    2015-01-15

    Purpose: To investigate the added value of lung perfused blood volume (LPBV) using dual-energy CT for the evaluation of intrapulmonary clot (IPC) in patients suspected of having acute pulmonary embolism (PE). Materials and methods: Institutional review board approval was obtained for this retrospective study. Eighty-three patients suspected of having PE who underwent CT pulmonary angiography (CTPA) using a dual-energy technique were enrolled in this study. Two radiologists who were blinded retrospectively and independently reviewed CTPA images alone and the combined images with color-coded LPBV over a 4-week interval, and two separate sessions were performed with a one-month interval. Inter- and intraobserver variability and diagnostic accuracy were evaluated for each reviewer with receiver operating characteristic (ROC) curve analysis. Results: Values for inter- and intraobserver agreement, respectively, were better for CTPA combined with LPBV (ICC = 0.847 and 0.937) than CTPA alone (ICC = 0.748 and 0.861). For both readers, diagnostic accuracy (area under the ROC curve [A{sub z}]) were also superior, when CTPA alone (A{sub z} = 0.888 [reader 1] and 0.912 [reader 2]) was compared with that after the combination with LPBV images (A{sub z} = 0.966 [reader 1] and 0.959 [reader 2]) (p < 0.001). However, A{sub z} values of both images might not have significant difference in statistics, because A{sub z} value of CTPA alone was high and 95% confidence intervals overlapped in both images. Conclusion: Addition of dual-energy perfusion CT to CTPA improves detection of peripheral IPCs with better interobserver agreement.

  15. Use of combined maximum and minimum intensity projections to determine internal target volume in 4-dimensional CT scans for hepatic malignancies

    Directory of Open Access Journals (Sweden)

    Liu Jin

    2012-01-01

    Full Text Available Abstract Background To evaluate the accuracy of the combined maximum and minimum intensity projection-based internal target volume (ITV delineation in 4-dimensional (4D CT scans for liver malignancies. Methods 4D CT with synchronized IV contrast data were acquired from 15 liver cancer patients (4 hepatocellular carcinomas; 11 hepatic metastases. We used five approaches to determine ITVs: (1. ITVAllPhases: contouring gross tumor volume (GTV on each of 10 respiratory phases of 4D CT data set and combining these GTVs; (2. ITV2Phase: contouring GTV on CT of the peak inhale phase (0% phase and the peak exhale phase (50% and then combining the two; (3. ITVMIP: contouring GTV on MIP with modifications based on physician's visual verification of contours in each respiratory phase; (4. ITVMinIP: contouring GTV on MinIP with modification by physician; (5. ITV2M: combining ITVMIP and ITVMinIP. ITVAllPhases was taken as the reference ITV, and the metrics used for comparison were: matching index (MI, under- and over-estimated volume (Vunder and Vover. Results 4D CT images were successfully acquired from 15 patients and tumor margins were clearly discernable in all patients. There were 9 cases of low density and 6, mixed on CT images. After comparisons of metrics, the tool of ITV2M was the most appropriate to contour ITV for liver malignancies with the highest MI of 0.93 ± 0.04 and the lowest proportion of Vunder (0.07 ± 0.04. Moreover, tumor volume, target motion three-dimensionally and ratio of tumor vertical diameter over tumor motion magnitude in cranio-caudal direction did not significantly influence the values of MI and proportion of Vunder. Conclusion The tool of ITV2M is recommended as a reliable method for generating ITVs from 4D CT data sets in liver cancer.

  16. Spine segmentation from C-arm CT data sets: application to region-of-interest volumes for spinal interventions

    Science.gov (United States)

    Buerger, C.; Lorenz, C.; Babic, D.; Hoppenbrouwers, J.; Homan, R.; Nachabe, R.; Racadio, J. M.; Grass, M.

    2017-03-01

    Spinal fusion is a common procedure to stabilize the spinal column by fixating parts of the spine. In such procedures, metal screws are inserted through the patients back into a vertebra, and the screws of adjacent vertebrae are connected by metal rods to generate a fixed bridge. In these procedures, 3D image guidance for intervention planning and outcome control is required. Here, for anatomical guidance, an automated approach for vertebra segmentation from C-arm CT images of the spine is introduced and evaluated. As a prerequisite, 3D C-arm CT images are acquired covering the vertebrae of interest. An automatic model-based segmentation approach is applied to delineate the outline of the vertebrae of interest. The segmentation approach is based on 24 partial models of the cervical, thoracic and lumbar vertebrae which aggregate information about (i) the basic shape itself, (ii) trained features for image based adaptation, and (iii) potential shape variations. Since the volume data sets generated by the C-arm system are limited to a certain region of the spine the target vertebra and hence initial model position is assigned interactively. The approach was trained and tested on 21 human cadaver scans. A 3-fold cross validation to ground truth annotations yields overall mean segmentation errors of 0.5 mm for T1 to 1.1 mm for C6. The results are promising and show potential to support the clinician in pedicle screw path and rod planning to allow accurate and reproducible insertions.

  17. Preoperative evaluation of oesophageal adenocarcinoma.

    Science.gov (United States)

    Khanna, Lauren G; Gress, Frank G

    2015-02-01

    The preoperative evaluation of oesophageal adenocarcinoma involves endoscopic ultrasound (EUS), computed tomography (CT), and positron emission tomography (PET). With routine Barrett's oesophagus surveillance, superficial cancers are often identified. EUS, CT and PET have a limited role in the staging of superficial tumours. Standard EUS has limited accuracy, but high frequency ultrasound miniprobes are valuable for assessing tumour stage in superficial tumours. However, the best method for determining depth of invasion, and thereby stage of disease, is endoscopic mucosal resection. In contrast, in advanced oesophageal cancers, a multi-modality approach is crucial. Accurate tumour staging is very important since the treatment of advanced cancers involves a combination of chemotherapy, radiation, and surgery. EUS is very useful for staging of the tumour and nodes. High frequency ultrasound miniprobes provide the ability to perform staging when the lesion is obstructing the oesophageal lumen. CT and PET provide valuable information regarding node and metastasis staging.

  18. Evaluation of liver functional reserve by combining D-sorbitol clearance rate and CT measured liver volume

    Institute of Scientific and Technical Information of China (English)

    Yi-Ming Li; Fan Lv; Xin Xu; Hong Ji; Wen-Tao Gao; Tuan-Jie Lei; Gui-Bing Ren; Zhi-Lan Bai; Qiang Li

    2003-01-01

    AIM: Our research attempted to evaluate the overall functional reserve of cirrhotic liver by combination of hepatic functional blood flow, liver volume, and ChildPugh′s classification, and to discuss its value of clinical application.METHODS: Ninety two patients with portal hypertension due to hepatic cirrhosis were investigated. All had a historyof haematemesis and hematochezia, esophageal and gastric fundus varices, splenomegaly and hypersplenia.A 2-year follow-up was routinely performed and no one was lost. Twenty two healthy volunteers were used as control group. Blood and urine samples were collected 4times before and after intravenous D-sorbitol infusion.The hepatic clearance (CLH) of D-sorbitol was then calculated according to enzymatic spectrophotometric method while the total blood flow (QToTAL) and intrahepatic shunt (RINs) were detected by multicolor Doppler ultrasound, and the liver volume was measured by spiral CT. Data were estimated by t-test, variance calculation and chi-squared test. The relationships between all these parameters and different groups were investigated according to Child-Pugh classification and postoperative complications respectively.RESULTS: Steady blood concentration was achieved 120 mins after D-sorbitol intravenous infusion, which was (0.358±0.064) mmoⅠ@L-1 in cirrhotic group and (0.189±0.05)mmol@L-1 in control group (P<0.01). CLH=(812.7±112.4) ml@min-1,QTOTAL=(1280.6±131.4) ml@min-1, and RINS=(36.54±10.65)%in cirrhotic group and CLH=(1248.3±210.5) ml.min-1, QTOTAL=(1362.4-±126.9) ml@min-1, and RINS=(8.37±3.32) % in control group (P<0.01). The liver volume of cirrhotic group was 1057±249 cm3, 851±148 cm3 and 663±77 cm3 in Child A, B and C group respectively with significant difference (P<0.001).The average volume of cirrhotic liver in Child B, C group was significantly reduced in comparison with that in control group (P<0.001). The patient, whose liver volume decreased by 40 % with the CLH below 600 ml

  19. High-pitch dual-source CT coronary angiography with low volumes of contrast medium

    Energy Technology Data Exchange (ETDEWEB)

    Lembcke, Alexander; Hein, Patrick A.; Knobloch, Gesine; Durmus, Tahir; Hamm, Bernd [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); Schwenke, Carsten [SCO:SSiS - Schwenke Consulting, Berlin (Germany); Huppertz, Alexander [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); ISI - Imaging Science Institute Charite, Berlin (Germany)

    2014-01-15

    To assess the effect of lower volumes of contrast medium (CM) on image quality in high-pitch dual-source computed tomography coronary angiography (CTCA). One-hundred consecutive patients (body weight 65-85 kg, stable heart rate ≤65 bpm, cardiac index ≥2.5 L/min/m{sup 2}) referred for CTCA were prospectively enrolled. Patients were randomly assigned to one of five groups of different CM volumes (G{sub 30}, 30 mL; G{sub 40}, 40 mL; G{sub 50}, 50 mL; G{sub 60}, 60 mL; G{sub 70}, 70 mL; flow rate 5 mL/s each, iodine content 370 mg/mL). Attenuation within the proximal and distal coronary artery segments was analysed. Mean attenuation for men and women ranged from 345.0 and 399.1 HU in G{sub 30} to 478.2 and 571.8 HU in G{sub 70}. Mean attenuation values were higher in groups with higher CM volumes (P < 0.0001) and higher in women than in men (P < 0.0001). The proportions of segments with attenuation of at least 300 HU in G{sub 30}, G{sub 40}, G{sub 50}, G{sub 60} and G{sub 70} were 89 %, 95 %, 98 %, 98 % and 99 %. CM volume of 30 mL in women and 40 mL in men proved to be sufficient to guarantee attenuation of at least 300 HU. In selected patients high-pitch dual-source CTCA can be performed with CM volumes of 40 mL in men or 30 mL in women. (orig.)

  20. Automatic extraction of forward stroke volume using dynamic 11C-acetate PET/CT

    DEFF Research Database (Denmark)

    Harms, Hans; Tolbod, Lars Poulsen; Hansson, Nils Henrik;

    , potentially introducing bias if measured with a separate modality. The aim of this study was to develop and validate methods for automatically extracting FSV directly from the dynamic PET used for measuring oxidative metabolism. Methods: 16 subjects underwent a dynamic 27 min PET scan on a Siemens Biograph...... TruePoint 64 PET/CT scanner after bolus injection of 399±27 MBq of 11C-acetate. The LV-aortic time-activity curve (TAC) was extracted automatically from dynamic PET data using cluster analysis. The first-pass peak was derived by automatic extrapolation of the down-slope of the TAC. FSV...... was then calculated as the injected dose divided by the product of heart rate and the area under the curve of the first-pass peak. Gold standard FSV was measured in the left ventricular outflow tract by cardiovascular magnetic resonance using phase-contrast velocity mapping within two weeks of PET imaging. Results...

  1. Influence of volumes of prostate, rectum, and bladder on treatment planning CT on interfraction prostate shifts during ultrasound image-guided IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Nandanuri M. S.; Nori, Dattatreyudu; Sartin, William; Maiorano, Samuel; Modena, Jennifer; Mazur, Andrej; Osian, Adrian; Sood, Brijmohan; Ravi, Akkamma; Sampath, Seshadri; Lange, Christopher S. [Department of Radiation Oncology, New York Hospital Queens, Flushing, New York 11355 (United States); Department of Radiation Oncology, New York Hospital Queens, Flushing, New York 11355 and Department of Radiation Oncology, New York Presbyterian Hospital Weill-Cornell Medical Center, New York, New York 10021 (United States); Department of Radiation Oncology, New York Hospital Queens, Flushing, New York 11355 (United States); Department of Radiation Oncology, New York Hospital Queens, Flushing, New York 11355 and Department of Radiation Oncology, New York Presbyterian Hospital Weill-Cornell Medical Center, New York, New York 10021 (United States); Department of Radiation Oncology, New York Hospital Queens, Flushing, New York 11355 (United States); Department of Radiation Oncology, State University of New York, Brooklyn, New York 11203 (United States)

    2009-12-15

    Purpose: The purpose of this study was to analyze the relationship between prostate, bladder, and rectum volumes on treatment planning CT day and prostate shifts in the XYZ directions on treatment days. Methods: Prostate, seminal vesicles, bladder, and rectum were contoured on CT images obtained in supine position. Intensity modulated radiation therapy plans was prepared. Contours were exported to BAT-ultrasound imaging system. Patients were positioned on the couch using skin marks. An ultrasound probe was used to obtain ultrasound images of prostate, bladder, and rectum, which were aligned with CT images. Couch shifts in the XYZ directions as recommended by BAT system were made and recorded. 4698 couch shifts for 42 patients were analyzed to study the correlations between interfraction prostate shifts vs bladder, rectum, and prostate volumes on planning CT. Results: Mean and range of volumes (cc): Bladder: 179 (42-582), rectum: 108 (28-223), and prostate: 55 (21-154). Mean systematic prostate shifts were (cm, {+-}SD) right and left lateral: -0.047{+-}0.16 (-0.361-0.251), anterior and posterior: 0.14{+-}0.3 (-0.466-0.669), and superior and inferior: 0.19{+-}0.26 (-0.342-0.633). Bladder volume was not correlated with lateral, anterior/posterior, and superior/inferior prostate shifts (P>0.2). Rectal volume was correlated with anterior/posterior (P<0.001) but not with lateral and superior/inferior prostate shifts (P>0.2). The smaller the rectal volume or cross sectional area, the larger was the prostate shift anteriorly and vice versa (P<0.001). Prostate volume was correlated with superior/inferior (P<0.05) but not with lateral and anterior/posterior prostate shifts (P>0.2). The smaller the prostate volume, the larger was prostate shift superiorly and vice versa (P<0.05). Conclusions: Prostate and rectal volumes, but not bladder volumes, on treatment planning CT influenced prostate position on treatment fractions. Daily image-guided adoptive radiotherapy would be

  2. Volume-based predictive biomarkers of sequential FDG-PET/CT for sunitinib in cancer of unknown primary: identification of the best benefited patients

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Yifei [Second Military Medical University, Department of Orthorpedic Oncology, Changzheng Hospital, Shanghai (China); Second Military Medical University, Department of Pathology, Changzheng Hospital, Shanghai (China); Xu, Wei; Xiao, Jianru [Second Military Medical University, Department of Orthorpedic Oncology, Changzheng Hospital, Shanghai (China); Bai, Ruojing [Geriatrics Institute, Department of Geriatrics, Tianjin Medical University General Hospital, Laboratory of Neuro-Trauma and Neurodegenerative Disorder, Tianjin (China); Li, Yiming [Neurosurgery Institute, Department of Neuro-oncology, Beijing (China); Yu, Hongyu [Second Military Medical University, Department of Pathology, Changzheng Hospital, Shanghai (China); Yang, Chunshan [Panorama Medical Imaging Center, Department of PET/CT Radiology, Shanghai (China); Department of PET/CT Radiology Center, Shanghai (China); Shi, Huazheng; Zhang, Jian [Department of PET/CT Radiology Center, Shanghai (China); Li, Jidong [The First People' s Hospital of Shangqiu, Department of Stomatology, Shangqiu, Henan Province (China); Wang, Chenguang [Second Military Medical University, Department of Radiology, Changzheng Hospital, Shanghai (China)

    2017-02-15

    To test the performance of sequential {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting survival after sunitinib therapies in patients with cancer of unknown primary (CUP). CUP patients were enrolled for sequential PET/CT scanning for sunitinib and a control group. Univariate and multivariate analysis were applied to test the efficacy of sunitinib therapy in CUP patients. Next, sequential analyses involving PET/CT parameters were performed to identify and validate sensitive PET/CT biomarkers for sunitinib therapy. Finally, time-dependent receiver operating characteristic (TDROC) analyses were performed to compare the predictive accuracy. Multivariate analysis proved that sunitinib group had significantly improved survival (p < 0.01) as compared to control group. After cycle 2 of therapy, multivariate analysis identified volume-based PET/CT parameters as sensitive biomarkers for sunitinib (p < 0.01). TDROC curves demonstrated whole-body total lesion glycolysis reduction (Δ WTLG) and follow-up WTLG to have good accuracy for efficacy prediction. This evidence was validated after cycle 4 of therapy with the same method. Sunitinib therapy proved effective in treatment of CUP. PET/CT volume-based parameters may help predict outcome of sunitinib therapy, in which Δ WTLG and follow-up WTLG seem to be sensitive biomarkers for sunitinib efficacy. Patients with greater reduction and lower WTLG at follow-up seem to have better survival outcome. (orig.)

  3. Intraprocedural blood volume measurement using C-arm CT as a predictor for treatment response of malignant liver tumours undergoing repetitive transarterial chemoembolization (TACE)

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J.; Schaefer, Patrik; Lehnert, Thomas; Mbalisike, Emmanuel; Hammerstingl, Renate; Eichler, Katrin; Zangos, Stephan [Johann Wolfgang Goethe-University Frankfurt, Institute for Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Nour-Eldin, Nour-Eldin A. [Johann Wolfgang Goethe-University Frankfurt, Institute for Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Cairo University, Department of Radiology, Faculty of Medicine (Kasr Al-Ainy), Cairo (Egypt); Ackermann, Hanns [Johann Wolfgang Goethe-University Frankfurt, Department of Biomedical Statistics, Frankfurt am Main (Germany); Naguib, Nagy N.N. [Johann Wolfgang Goethe-University Frankfurt, Institute for Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Alexandria University, Department of Radiology, Faculty of Medicine, Alexandria (Egypt)

    2016-03-15

    To evaluate feasibility of measuring parenchymal blood volume (PBV) of malignant hepatic tumours using C-arm CT, test the changes in PBV following repeated transarterial chemoembolization (TACE) and correlate these changes with the change in tumour size in MRI. 111 patients with liver malignancy were included. Patients underwent MRI and TACE in a 4- to 6-week interval. During intervention C-arm CT was performed. Images were post-processed to generate PBV maps. Blood volume data in C-arm CT and change in size in MRI were evaluated. The correlation between PBV and size was tested using Spearman rank test. Pre-interventional PBV maps showed a mean blood volume of 84.5 ml/1000 ml ± 62.0, follow-up PBV maps after multiple TACE demonstrated 61.1 ml/1000 ml ± 57.5. The change in PBV was statistically significant (p = 0.02). Patients with initial tumour blood volume >100 ml/1000 ml dropped 7.1 % in size and 47.2 % in blood volume; 50-100 ml/1000 ml dropped 4.6 % in size and 25.7 % in blood volume; and <50 ml/1000 ml decreased 2.8 % in size and increased 82.2 % in blood volume. PBV measurement of malignant liver tumours using C-arm CT is feasible. Following TACE PBV decreased significantly. Patients with low initial PBV show low local response rates and further increase in blood volume, whereas high initial tumour PBV showed better response to TACE. (orig.)

  4. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    OpenAIRE

    Rozie, S.; de Weert, T. T.; de Monyé, C.; Homburg, P. J.; Tanghe, H L J; Dippel, D W J; van der Lugt, A

    2009-01-01

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic a...

  5. High-resolution dynamic angiography using flat-panel volume CT: feasibility demonstration for neuro and lower limb vascular applications

    Energy Technology Data Exchange (ETDEWEB)

    Mehndiratta, Amit [Massachusetts General Hospital, Department of Radiology, Harvard Medical School, Boston, MA (United States); University of Oxford, Institute of Biomedical Engineering and Keble College, Oxford (United Kingdom); Indian Institute of Technology Delhi and All India Institute of Medical Science, Centre for Biomedical Engineering, New Delhi (India); Rabinov, James D. [Massachusetts General Hospital, Interventional Neuroradiology, Harvard Medical School, Boston, MA (United States); Grasruck, Michael [Siemens Medical Solutions, Forchheim (Germany); Liao, Eric C. [Massachusetts General Hospital, Department of Plastic and Reconstructive Surgery and Center for Regenerative Medicine, Harvard Medical School, Boston, MA (United States); Crandell, David [Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA (United States); Gupta, Rajiv [Massachusetts General Hospital, Department of Radiology, Harvard Medical School, Boston, MA (United States)

    2015-07-15

    This paper evaluates a prototype flat-panel volume CT (fpVCT) for dynamic in vivo imaging in a variety of neurovascular and lower limb applications. Dynamic CTA was performed on 12 patients (neuro = 8, lower limb = 4) using an fpVCT with 120 kVp, 50 mA, rotation time varying from 8 to 19 s, and field of view of 25 x 25 x 18 cm{sup 3}. Four-dimensional data sets (i.e. 3D images over time) were reconstructed and reviewed. Dynamic CTA demonstrated sufficient spatio-temporal resolution to elucidate first-pass and recirculation dynamics of contrast bolus through neurovasclar pathologies and phasic blood flow though lower-limb vasculature and grafts. The high spatial resolution of fpVCT resulted in reduced partial volume and metal beam-hardening artefacts. This facilitated assessment of vascular lumen in the presence of calcified plaque and evaluation of fractures, especially in the presence of fixation hardware. Evaluation of arteriovenous malformation using dynamic fpVCT angiography was of limited utility. Dynamic CTA using fpVCT can visualize time-varying phenomena in neuro and lower limb vascular applications and has sufficient diagnostic imaging quality to evaluate a number of pathologies affecting these regions. (orig.)

  6. Accuracy of renal volume assessment in children by three-dimensional sonography; Nierenvolumetrie im Kindesalter: Genauigkeit der dreidimensionalen Sonographie im Vergleich zur konventionellen Sonographie und CT/MRT

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, G.A.; Riccabona, M.; Bohdal, G. [Klinik fuer Radiologie, Universitaetsklinikum Graz (Austria); Quehenberger, F. [Inst. fuer medizinische Informatik, Statistik und Dokumentation, Universitaetsklinikum Graz (Austria)

    2003-04-01

    Purpose: Prospective evaluation of the accuracy of three-dimensional ultrasound (3DUS) to assess the renal parenchymal volume. Materials and Methods: CT, MRI, 2DUS and 3DUS were used to measure the renal volume in 40 patients (range: neonate to 17 years; mean age: 8.95 years). The 3DUS was determined with a Voluson 730 (Kretztechnik, GE) or an external 3D-system (EchoTech, GE) using electromagnetic positioning sensors attached to conventional 2DUS-equipment. The 2DUS volume was calculated with the ellipsoid equation and the 3DUS volume computed with the system integrated software. For CT and MRI, planimetric analysis was used to determine the renal parenchymal volume, whereby the dilated collecting system of a hydronephrosis was subtracted to obtain the real renal parenchymal volume. The results of 2DUS and 3DUS were compared to the results of CT and MRI, and inter- and intraobserver variabilities were calculated. Results: In 74 of 77 kidneys, the 3DUS study was of diagnostic quality. The accuracy of the 3DUS volumes compared well to the CT and MRI volumes with a mean difference of -1.8 {+-} 4.6% versus a mean difference of -2.4 {+-} 15.4% for 2DUS. In normal kidneys, the accuracy was -2.6 {+-} 4.4% for 3DUS and -3.8 {+-} 14.7% for 2DUS. In hydronephrosis, the accuracy was +4.0 {+-} 5.9% and +9.6 {+-} 21.3%, respectively, indicating that 3DUS is more accurate than 2DUS, particularly in kidneys with a dilated collecting system. Inter- and intraobserver variabilities were {+-} 7.3% and {+-} 5.3%. Conclusion: For assessing the renal parenchymal volume in children, 3DUS is feasible and comparable to CT and MRI. (orig.) [German] Studienziel: Prospektive Evaluation der Genauigkeit des drei-dimensionalen Ultraschalls (3DUS) bei der Volumetrie der kindlichen Niere im Vergleich zur CT/MRT. Methode: Bei 40 Patienten (Alter: 0 - 17 Jahre) mit einer klinisch indizierten CT/MRT des Abdomens oder des Harntrakts wurde zusaetzlich ein 2D- und 3DUS inklusive Volumetrie des

  7. Impact of PET - CT motion correction in minimising the gross tumour volume in non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Michael Masoomi

    2013-10-01

    Full Text Available AbstractObjective: To investigate the impact of respiratory motion on localization, and quantification lung lesions for the Gross Tumour Volume utilizing an in-house developed Auto3Dreg programme and dynamic NURBS-based cardiac-torso digitised phantom (NCAT. Methods: Respiratory motion may result in more than 30% underestimation of the SUV values of lung, liver and kidney tumour lesions. The motion correction technique adopted in this study was an image-based motion correction approach using, an in-house developed voxel-intensity-based and a multi-resolution multi-optimisation (MRMO algorithm. All the generated frames were co-registered to a reference frame using a time efficient scheme. The NCAT phantom was used to generate CT attenuation maps and activity distribution volumes for the lung regions. Quantitative assessment including Region of Interest (ROI, image fidelity and image correlation techniques, as well as semi-quantitative line profile analysis and qualitatively overlaying non-motion and motion corrected image frames were performed. Results: the largest transformation was observed in the Z-direction. The greatest translation was for the frame 3, end inspiration, and the smallest for the frame 5 which was closet frame to the reference frame at 67% expiration. Visual assessment of the lesion sizes, 20-60mm at 3 different locations, apex, mid and base of lung showed noticeable improvement for all the foci and their locations. The maximum improvements for the image fidelity were from 0.395 to 0.930 within the lesion volume of interest. The greatest improvement in activity concentration underestimation, post motion correction, was 7% below the true activity for the 20 mm lesion. The discrepancies in activity underestimation were reduced with increasing the lesion sizes. Overlay activity distribution on the attenuation map showed improved localization of the PET metabolic information to the anatomical CT images. Conclusion: The respiratory

  8. Influence of 320-detector-row volume scanning and AAPM report 111 CT dosimetry metrics on size-specific dose estimate: a Monte Carlo study.

    Science.gov (United States)

    Haba, Tomonobu; Koyama, Shuji; Kinomura, Yutaka; Ida, Yoshihiro; Kobayashi, Masanao

    2016-09-01

    The American Association of Physicists in Medicine (AAPM) task group 204 has recommended the use of size-dependent conversion factors to calculate size-specific dose estimate (SSDE) values from volume computed tomography dose index (CTDIvol) values. However, these conversion factors do not consider the effects of 320-detector-row volume computed tomography (CT) examinations or the new CT dosimetry metrics proposed by AAPM task group 111. This study aims to investigate the influence of these examinations and metrics on the conversion factors reported by AAPM task group 204, using Monte Carlo simulations. Simulations were performed modelling a Toshiba Aquilion ONE CT scanner, in order to compute dose values in water for cylindrical phantoms with 8-40-cm diameters at 2-cm intervals for each scanning parameter (tube voltage, bow-tie filter, longitudinal beam width). Then, the conversion factors were obtained by applying exponential regression analysis between the dose values for a given phantom diameter and the phantom diameter combined with various scanning parameters. The conversion factors for each scanning method (helical, axial, or volume scanning) and CT dosimetry method (i.e., the CTDI100 method or the AAPM task group 111 method) were in agreement with those reported by AAPM task group 204, within a percentage error of 14.2 % for phantom diameters ≥11.2 cm. The results obtained in this study indicate that the conversion factors previously presented by AAPM task group 204 can be used to provide appropriate SSDE values for 320-detector-row volume CT examinations and the CT dosimetry metrics proposed by the AAPM task group 111.

  9. 3D volume assessment techniques and computer-aided design and manufacturing for preoperative fabrication of implants in head and neck reconstruction.

    Science.gov (United States)

    Patel, Ashish; Otterburn, David; Saadeh, Pierre; Levine, Jamie; Hirsch, David L

    2011-11-01

    Cases in subdisciplines of craniomaxillofacial surgery--corrective jaw surgery, maxillofacial trauma, temporomandibular joint/skull base, jaw reconstruction, and postablative reconstruction-illustrate the ease of use, cost effectiveness, and superior results that can be achieved when using computer-assisted design and 3D volumetric analysis in preoperative surgical planning. This article discusses the materials and methods needed to plan cases, illustrates implementation of guides and implants, and describes postoperative analysis in relation to the virtually planned surgery.

  10. Computer-aided measurement of liver volumes in CT by means of geodesic active contour segmentation coupled with level-set algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Kenji; Kohlbrenner, Ryan; Epstein, Mark L.; Obajuluwa, Ademola M.; Xu Jianwu; Hori, Masatoshi [Department of Radiology, University of Chicago, 5841 South Maryland Avenue, Chicago, Illinois 60637 (United States)

    2010-05-15

    Purpose: Computerized liver extraction from hepatic CT images is challenging because the liver often abuts other organs of a similar density. The purpose of this study was to develop a computer-aided measurement of liver volumes in hepatic CT. Methods: The authors developed a computerized liver extraction scheme based on geodesic active contour segmentation coupled with level-set contour evolution. First, an anisotropic diffusion filter was applied to portal-venous-phase CT images for noise reduction while preserving the liver structure, followed by a scale-specific gradient magnitude filter to enhance the liver boundaries. Then, a nonlinear grayscale converter enhanced the contrast of the liver parenchyma. By using the liver-parenchyma-enhanced image as a speed function, a fast-marching level-set algorithm generated an initial contour that roughly estimated the liver shape. A geodesic active contour segmentation algorithm coupled with level-set contour evolution refined the initial contour to define the liver boundaries more precisely. The liver volume was then calculated using these refined boundaries. Hepatic CT scans of 15 prospective liver donors were obtained under a liver transplant protocol with a multidetector CT system. The liver volumes extracted by the computerized scheme were compared to those traced manually by a radiologist, used as ''gold standard.''Results: The mean liver volume obtained with our scheme was 1504 cc, whereas the mean gold standard manual volume was 1457 cc, resulting in a mean absolute difference of 105 cc (7.2%). The computer-estimated liver volumetrics agreed excellently with the gold-standard manual volumetrics (intraclass correlation coefficient was 0.95) with no statistically significant difference (F=0.77; p(F{<=}f)=0.32). The average accuracy, sensitivity, specificity, and percent volume error were 98.4%, 91.1%, 99.1%, and 7.2%, respectively. Computerized CT liver volumetry would require substantially less

  11. Variability of Gross Tumor Volume in Nasopharyngeal Carcinoma Using 11C-Choline and 18F-FDG PET/CT.

    Directory of Open Access Journals (Sweden)

    Jun Jiang

    Full Text Available This study was conducted to evaluate the variability of gross tumor volume (GTV using 11C-Choline and 18F-FDG PET/CT images for nasopharyngeal carcinomas boundary definition. Assessment consisted of inter-observer and inter-modality variation analysis. Four radiation oncologists were invited to manually contour GTV by using PET/CT fusion obtained from a cohort of 12 patients with nasopharyngeal carcinoma (NPC and who underwent both 11C-Choline and 18F-FDG scans. Student's paired-sample t-test was performed for analyzing inter-observer and inter-modality variability. Semi-automatic segmentation methods, including thresholding and region growing, were also validated against the manual contouring of the two types of PET images. We observed no significant variation in the results obtained by different oncologists in terms of the same type of PET/CT volumes. Choline fusion volumes were significantly larger than the FDG volumes (p < 0.0001, mean ± SD = 18.21 ± 8.19. While significantly consistent results were obtained between the oncologists and the standard references in Choline volumes compared with those in FDG volumes (p = 0.0025. Simple semi-automatic delineation methods indicated that 11C-Choline PET images could provide better results than FDG volumes (p = 0.076, CI = [-0.29, 0.025]. 11C-Choline PET/CT may be more advantageous in GTV delineation for the radiotherapy of NPC than 18F-FDG. Phantom simulations and clinical trials should be conducted to prove the possible improvement of the treatment outcome.

  12. Comparison and Consensus Guidelines for Delineation of Clinical Target Volume for CT- and MR-Based Brachytherapy in Locally Advanced Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Viswanathan, Akila N., E-mail: aviswanathan@lroc.harvard.edu [Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Erickson, Beth [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Gaffney, David K. [University of Utah Huntsman Cancer Hospital, Salt Lake City, Utah (United States); Beriwal, Sushil [University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Bhatia, Sudershan K. [University of Iowa, Iowa City, Iowa (United States); Lee Burnett, Omer [University of Alabama, Birmingham, Alabama (United States); D' Souza, David P.; Patil, Nikhilesh [London Health Sciences Centre and Western University, London, Ontario (Canada); Haddock, Michael G. [Mayo Medical Center, Rochester, Minnesota (United States); Jhingran, Anuja [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jones, Ellen L. [University of North Carolina, Chapel Hill, North Carolina (United States); Kunos, Charles A. [Case Western Reserve University, Cleveland, Ohio (United States); Lee, Larissa J. [Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Lin, Lilie L. [University of Pennsylvania, Philadelphia, Pennsylvania (United States); Mayr, Nina A. [University of Washington, Seattle, Washington (United States); Petersen, Ivy [Mayo Medical Center, Rochester, Minnesota (United States); Petric, Primoz [Division of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana (Slovenia); Department of Radiation Oncology, National Center for Cancer Care and Research, Doha (Qatar); Portelance, Lorraine [University of Miami Miller School of Medicine, Miami, Florida (United States); Small, William [Loyola University Strich School of Medicine, Chicago, Illinois (United States); Strauss, Jonathan B. [The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois (United States); and others

    2014-10-01

    Objective: To create and compare consensus clinical target volume (CTV) contours for computed tomography (CT) and 3-Tesla (3-T) magnetic resonance (MR) image-based cervical-cancer brachytherapy. Methods and Materials: Twenty-three experts in gynecologic radiation oncology contoured the same 3 cervical cancer brachytherapy cases: 1 stage IIB near-complete response (CR) case with a tandem and ovoid, 1 stage IIB partial response (PR) case with tandem and ovoid with needles, and 1 stage IB2 CR case with a tandem and ring applicator. The CT contours were completed before the MRI contours. These were analyzed for consistency and clarity of target delineation using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE), with κ statistics as a measure of agreement between participants. The conformity index was calculated for each of the 6 data sets. Dice coefficients were generated to compare the CT and MR contours of the same case. Results: For all 3 cases, the mean tumor volume was smaller on MR than on CT (P<.001). The κ and conformity index estimates were slightly higher for CT, indicating a higher level of agreement on CT. The Dice coefficients were 89% for the stage IB2 case with a CR, 74% for the stage IIB case with a PR, and 57% for the stage IIB case with a CR. Conclusion: In a comparison of MR-contoured with CT-contoured CTV volumes, the higher level of agreement on CT may be due to the more distinct contrast medium visible on the images at the time of brachytherapy. MR at the time of brachytherapy may be of greatest benefit in patients with large tumors with parametrial extension that have a partial or complete response to external beam. On the basis of these results, a 95% consensus volume was generated for CT and for MR. Online contouring atlases are available for instruction at (http://www.nrgoncology.org/Resources/ContouringAtlases/GYNCervicalBrachytherapy.aspx)

  13. Myocardial Extracellular Volume Fraction with Dual-Energy Equilibrium Contrast-enhanced Cardiac CT in Nonischemic Cardiomyopathy: A Prospective Comparison with Cardiac MR Imaging.

    Science.gov (United States)

    Lee, Hye-Jeong; Im, Dong Jin; Youn, Jong-Chan; Chang, Suyon; Suh, Young Joo; Hong, Yoo Jin; Kim, Young Jin; Hur, Jin; Choi, Byoung Wook

    2016-07-01

    Purpose To evaluate the feasibility of equilibrium contrast material-enhanced dual-energy cardiac computed tomography (CT) to determine extracellular volume fraction (ECV) in nonischemic cardiomyopathy (CMP) compared with magnetic resonance (MR) imaging. Materials and Methods This study was approved by the institutional review board; informed consent was obtained. Seven healthy subjects and 23 patients (six with hypertrophic CMP, nine with dilated CMP, four with amyloidosis, and four with sarcoidosis) (mean age ± standard deviation, 57.33 years ± 14.82; 19 male participants [63.3%]) were prospectively enrolled. Twelve minutes after contrast material injection (1.8 mL/kg at 3 mL/sec), dual-energy cardiac CT was performed. ECV was measured by two observers independently. Hematocrit levels were compared between healthy subjects and patients with the Mann-Whitney U test. In per-subject analysis, interobserver agreement for CT was assessed with the intraclass correlation coefficient (ICC), and intertest agreement between MR imaging and CT was assessed with Bland-Altman analysis. In per-segment analysis, Student t tests in the linear mixed model were used to compare ECV on CT images between healthy subjects and patients. Results Hematocrit level was 43.44% ± 1.80 for healthy subjects and 41.23% ± 5.61 for patients with MR imaging (P = .16) and 43.50% ± 1.92 for healthy subjects and 41.35% ± 5.92 for patients with CT (P = .15). For observer 1 in per-subject analysis, ECV was 34.18% ± 8.98 for MR imaging and 34.48% ± 8.97 for CT. For observer 2, myocardial ECV was 34.42% ± 9.03 for MR imaging and 33.98% ± 9.05 for CT. Interobserver agreement for ECV at CT was excellent (ICC = 0.987). Bland-Altman analysis between MR imaging and CT showed a small bias (-0.06%), with 95% limits of agreement of -1.19 and 1.79. Compared with healthy subjects, patients with hypertrophic CMP, dilated CMP, amyloidosis, and sarcoidosis had significantly higher myocardial ECV at dual

  14. Effectiveness of quantitative MAA SPECT/CT for the definition of vascularized hepatic volume and dosimetric approach: phantom validation and clinical preliminary results in patients with complex hepatic vascularization treated with yttrium-90-labeled microspheres.

    Science.gov (United States)

    Garin, Etienne; Lenoir, Laurence; Rolland, Yan; Laffont, Sophie; Pracht, Marc; Mesbah, Habiba; Porée, Philippe; Ardisson, Valérie; Bourguet, Patrick; Clement, Bruno; Boucher, Eveline

    2011-12-01

    The goal of this study was to assess the use of quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) analysis for vascularized volume measurements in the use of the yttrium-90-radiolabeled microspheres (TheraSphere). A phantom study was conducted for the validation of SPECT/CT volume measurement. SPECT/CT quantitative analysis was used for the measurement of the volume of distribution of the albumin macroaggregates (MAA; i.e., the vascularized volume) in the liver and the tumor, and the total activity contained in the liver and the tumor in four consecutive patients presenting with a complex liver vascularization referred for a treatment with TheraSphere. SPECT/CT volume measurement proved to be accurate (mean error data, instead of angiography and CT data, results in modifying the activity injected for three treatments of eight. Moreover, quantitative analysis of SPECT/CT allows us to calculate the absorbed dose in the tumor and in the healthy liver, leading to doubling of the injected activity for one treatment of eight. MAA SPECT/CT is accurate for volume measurements. It provides a valuable contribution to the therapeutic planning of patients presenting with complex hepatic vascularization, in particular for calculating the vascularized liver volume, the activity to be injected and the absorbed doses. Studies should be conducted to assess the role of quantitative MAA/SPECT CT in therapeutic planning.

  15. Liver volume measurement: reason of the difference between in vivo CT-volumetry and intraoperative ex vivo determination and how to cope it

    Directory of Open Access Journals (Sweden)

    Niehues SM

    2010-08-01

    Full Text Available Abstract Purpose Volumetric assessment of the liver regularly yields discrepant results between pre- and intraoperatively determined volumes. Nevertheless, the main factor responsible for this discrepancy remains still unclear. The aim of this study was to systematically determine the difference between in vivo CT-volumetry and ex vivo volumetry in a pig animal model. Material and Methods Eleven pigs were studied. Liver density assessment, CT-volumetry and water displacement volumetry was performed after surgical removal of the complete liver. Known possible errors of volume determination like resection or segmentation borders were eliminated in this model. Regression analysis was performed and differences between CT-volumetry and water displacement determined. Results Median liver density was 1.07 g/ml. Regression analysis showed a high correlation of r2 = 0.985 between CT-volumetry and water displacement. CTvolumetry was found to be 13% higher than water displacement volumetry (p Conclusion In this study the only relevant factor leading to the difference between in vivo CT-volumetry and ex vivo water displacement volumetry seems to be blood perfusion of the liver. The systematic difference of 13 percent has to be taken in account when dealing with those measures.

  16. The effect of CT scanner parameters and 3D volume rendering techniques on the accuracy of linear, angular, and volumetric measurements of the mandible

    Science.gov (United States)

    Whyms, B.J.; Vorperian, H.K.; Gentry, L.R.; Schimek, E.M.; Bersu, E.T.; Chung, M.K.

    2013-01-01

    Objectives This study investigates the effect of scanning parameters on the accuracy of measurements from three-dimensional multi-detector computed tomography (3D-CT) mandible renderings. A broader range of acceptable parameters can increase the availability of CT studies for retrospective analysis. Study Design Three human mandibles and a phantom object were scanned using 18 combinations of slice thickness, field of view, and reconstruction algorithm and three different threshold-based segmentations. Measurements of 3D-CT models and specimens were compared. Results Linear and angular measurements were accurate, irrespective of scanner parameters or rendering technique. Volume measurements were accurate with a slice thickness of 1.25 mm, but not 2.5 mm. Surface area measurements were consistently inflated. Conclusions Linear, angular and volumetric measurements of mandible 3D-CT models can be confidently obtained from a range of parameters and rendering techniques. Slice thickness is the primary factor affecting volume measurements. These findings should also apply to 3D rendering using cone-beam-CT. PMID:23601224

  17. Efficacy evaluation of retrospectively applying the Varian normal breathing predictive filter for volume definition and artifact reduction in 4D CT lung patients.

    Science.gov (United States)

    Malone, Ciaran; Rock, Luke; Skourou, Christina

    2014-05-08

    Phase-based sorting of four-dimensional computed tomography (4D CT) datasets is prone to image artifacts due to patient's breathing irregularities that occur during the image acquisition. The purpose of this study is to investigate the effect of the Varian normal breathing predictive filter (NBPF) as a retrospective phase-sorting parameter in 4D CT. Ten 4D CT lung cancer datasets were obtained. The volumes of all tumors present, as well as the total lung volume, were calculated on the maximum intensity projection (MIP) images as well as each individual phase image. The NBPF was varied retrospectively within the available range, and changes in volume and image quality were recorded. The patients' breathing trace was analysed and the magnitude and location of any breathing irregularities were correlated to the behavior of the NBPF. The NBPF was found to have a considerable effect on the quality of the images in MIP and single-phase datasets. When used appropriately, the NBPF is shown to have the ability to account for and correct image artifacts. However, when turned off (0%) or set above a critical level (approximately 40%), it resulted in erroneous volume reconstructions with variations in tumor volume up to 26.6%. Those phases associated with peak inspiration were found to be more susceptible to changes in the NBPF. The NBPF settings selected prior to exporting the breathing trace for patients evaluated using 4D CT directly affect the accuracy of the targeting and volume estimation of lung tumors. Recommendations are made to address potential errors in patient anatomy introduced by breathing irregularities, specifically deep breath or cough irregularities, by implementing the proper settings and use of this tool.

  18. Capability of differentiating smokers with normal pulmonary function from COPD patients: a comparison of CT pulmonary volume analysis and MR perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fan, Li; Xia, Yi; Guan, Yu; Yu, Hong; Liu, Shi-yuan [Changzheng Hospital of the Second Military Medical University, Department of Radiology, Shanghai (China); Zhang, Tie-feng; Li, Bing [Changzheng Hospital of the Second Military Medical University, Department of Respiration Medicine, Shanghai (China)

    2013-05-15

    To compare CT volume analysis with MR perfusion imaging in differentiating smokers with normal pulmonary function (controls) from COPD patients. Sixty-two COPD patients and 17 controls were included. The total lung volume (TLV), total emphysema volume (TEV) and emphysema index (EI) were quantified by CT. MR perfusion evaluated positive enhancement integral (PEI), maximum slope of increase (MSI), maximum slope of decrease (MSD), signal enhancement ratio (SER) and signal intensity ratio (R{sub SI}) of perfusion defects to normal lung. There were 19 class I, 17 class II, 14 class III and 12 class IV COPD patients. No differences were observed in TLV, TEV and EI between control and class I COPD. The control was different from class II, III and IV COPD in TEV and EI. The control was different from each class of COPD in R{sub SI,} MSI, PEI and MSD. Differences were found in R{sub SI} between class I and III, I and IV, and II and IV COPD. Amongst controls, MR detected perfusion defects more frequently than CT detected emphysema. Compared with CT, MR perfusion imaging shows higher potential to distinguish controls from mild COPD and appears more sensitive in identifying abnormalities amongst smokers with normal pulmonary function (controls). (orig.)

  19. Study of optimal exposure windows using 320-Detector rows dynamic volume CT

    Directory of Open Access Journals (Sweden)

    Gang Sun

    2010-12-01

    Full Text Available Gang Sun1, Min Li1, Li Li1, Guo-ying Li1, Zhi-wei Jing21Departments of Medical Imaging, 2Medical Statistics, Jinan Military General Hospital, Shandong Province, ChinaAbstract: The purpose of this study was to determine the optimal electrocardiographic (ECG pulsing windows and evaluate the effect on reduced dose and accuracy using 320-detector rows dynamic volume computed tomography (DVCT. A total of 170 patients were prospectively studied. The optimal reconstruction windows were analyzed in 76 patients scanned using retrospective ECG gating. Forty-seven patients were scanned by the predicted triggering windows. The optimal positions of exposure intervals according to different heart rates were evaluated. Optimal image quality, radiation dose, and diagnostic accuracy were then investigated by applying optimal triggering windows. The optimal ECG pulsing windows were determined as follows: when heart rate was <70 beats per minute, the exposure windows should be preset at 60%–80%; for a heart rate 70–90 beats per minute at 70%–90%; and for a heart rate ≥90 beats per minute at 30%–50%. The radiation dose for patients scanned with prospective ECG gating was significantly lower (5.9 versus 12.9 mSv, P < 0.001. However, because two or three heart beats were needed when heart rate was >70 beats per minute, the radiation dose increased with increasing heart rate for both retrospective and prospective ECG gating (r = 0.64, P < 0.001 and r = 0.59, P < 0.001, respectively. On the basis of a per segment analysis, overall sensitivity was 98.0% (49/50, specificity was 99.2% (602/607, the positive predictive value was 90.7% (49/54, and the negative predictive value was 99.8% (602/603. In conclusion, DVCT has the potential to provide high image quality across a wide range of heart rates using an optimized ECG pulsing window. However, it is recommended to control heart rate below 70 beats per minute, if possible, to decrease the radiation dose

  20. Automatic LV volume measurement in low dose multi-phase CT by shape tracking

    Science.gov (United States)

    von Berg, Jens; Begemann, Philipp; Stahmer, Felix; Adam, Gerhard; Lorenz, Cristian

    2006-03-01

    Functional assessment of cardiac ventricular function requires time consuming manual interaction. Some automated methods have been presented that predominantly used cardiac magnet resonance images. Here, an automatic shape tracking approach is followed to estimate left ventricular blood volume from multi-slice computed tomography image series acquired with retrospective ECG-gating. A deformable surface model method was chosen that utilized both shape and local appearance priors to determine the endocardial surface and to follow its motion through the cardiac cycle. Functional parameters like the ejection fraction could be calculated from the estimated shape deformation. A clinical validation was performed in a porcine model with 60 examinations on eight subjects. The functional parameters showed a good correlation with those determined by clinical experts using a commercially available semi-automatic short axes delineation tool. The correlation coefficient for the ejection fraction (EF) was 0.89. One quarter of these acquisitions were done with a low dose protocol. All of these degraded images could be processed well. Their correlation slightly decreases when compared to the normal dose cases (EF: 0.87 versus 0.88).

  1. Crack surface extraction of industrial CT volume data using FPIT and planelet.

    Science.gov (United States)

    Li, Zongjian; Zeng, Li; Zou, Xiaobing; Xiang, Caibing

    2011-01-01

    As an advanced nondestructive testing (NDT) technology, industrial computed tomography (ICT) has been widely applied to diversified areas. In modern industry, ICT is especially useful for analyzing inner defects of complex and close work pieces. The common defects of work pieces include gas cavities, slag inclusions, cracks and shrinking cavities. Only cracks are often caused by fatigue usage. Precisely extracting a crack is important to estimate the remaining secure service time of the work piece. This paper presents a crack surface extraction method of ICT volume data based on finite plane integral transform (FPIT) and planelet. FPIT and planelet, as new methods of multiscale geometric analysis (MGA), have distinct discrimination for different plane singularities. Within the paper, firstly the definitions of FPIT and planelet are introduced. Secondly, after analyzing the components and relationship of planelet at monoscale, a fast performance of planelet transform is designed. Thirdly, the steps of the proposed crack surface extraction method are described. In numeric experiment, compared with the method of 3D facet model, C-V model and 3D wavelet respectively, the proposed method can extract the crack surface full and continuously, which,is robust to noise.

  2. Fast reconstruction of 3D volumes from 2D CT projection data with GPUs.

    Science.gov (United States)

    Leeser, Miriam; Mukherjee, Saoni; Brock, James

    2014-08-30

    Biomedical image reconstruction applications require producing high fidelity images in or close to real-time. We have implemented reconstruction of three dimensional conebeam computed tomography(CBCT) with two dimensional projections. The algorithm takes slices of the target, weights and filters them to backproject the data, then creates the final 3D volume. We have implemented the algorithm using several hardware and software approaches and taken advantage of different types of parallelism in modern processors. The two hardware platforms used are a Central Processing Unit (CPU) and a heterogeneous system with a combination of CPU and GPU. On the CPU we implement serial MATLAB, parallel MATLAB, C and parallel C with OpenMP extensions. These codes are compared against the heterogeneous versions written in CUDA-C and OpenCL. Our results show that GPUs are particularly well suited to accelerating CBCT. Relative performance was evaluated on a mathematical phantom as well as on mouse data. Speedups of up to 200x are observed by using an AMD GPU compared to a parallel version in C with OpenMP constructs. In this paper, we have implemented the Feldkamp-Davis-Kress algorithm, compatible with Fessler's image reconstruction toolbox and tested it on different hardware platforms including CPU and a combination of CPU and GPU. Both NVIDIA and AMD GPUs have been used for performance evaluation. GPUs provide significant speedup over the parallel CPU version.

  3. HipMatch: an object-oriented cross-platform program for accurate determination of cup orientation using 2D-3D registration of single standard X-ray radiograph and a CT volume.

    Science.gov (United States)

    Zheng, Guoyan; Zhang, Xuan; Steppacher, Simon D; Murphy, Stephen B; Siebenrock, Klaus A; Tannast, Moritz

    2009-09-01

    The widely used procedure of evaluation of cup orientation following total hip arthroplasty using single standard anteroposterior (AP) radiograph is known inaccurate, largely due to the wide variability in individual pelvic orientation relative to X-ray plate. 2D-3D image registration methods have been introduced for an accurate determination of the post-operative cup alignment with respect to an anatomical reference extracted from the CT data. Although encouraging results have been reported, their extensive usage in clinical routine is still limited. This may be explained by their requirement of a CAD model of the prosthesis, which is often difficult to be organized from the manufacturer due to the proprietary issue, and by their requirement of either multiple radiographs or a radiograph-specific calibration, both of which are not available for most retrospective studies. To address these issues, we developed and validated an object-oriented cross-platform program called "HipMatch" where a hybrid 2D-3D registration scheme combining an iterative landmark-to-ray registration with a 2D-3D intensity-based registration was implemented to estimate a rigid transformation between a pre-operative CT volume and the post-operative X-ray radiograph for a precise estimation of cup alignment. No CAD model of the prosthesis is required. Quantitative and qualitative results evaluated on cadaveric and clinical datasets are given, which indicate the robustness and the accuracy of the program. HipMatch is written in object-oriented programming language C++ using cross-platform software Qt (TrollTech, Oslo, Norway), VTK, and Coin3D and is transportable to any platform.

  4. The clinical value on the pre-operation of styloid process syndrome diagnosed by 128-slice spiral CT%128层螺旋 CT 在茎突综合征术前诊断中的临床价值

    Institute of Scientific and Technical Information of China (English)

    左开荣

    2014-01-01

    目的:探讨128层螺旋 CT 在茎突综合征术前诊断中的临床价值。方法回顾性分析50例(100侧)正常成人(对照组)和48例(96侧)经手术证实的茎突综合征患者(SPS 组)的临床及影像资料,并对两组患者的茎突长度和倾角分布的差异进行统计分析。结果对照组中,茎突过长(长度>30mm)8侧(8%),前倾角过大(角度>25°)2侧(2%),内倾角过大(角度>25°)4侧(4%);而 SPS 组中,茎突过长56侧(58.3%),前倾角过大14侧(14.6%),内倾角过大18侧(18.8%),茎突过长伴倾角异常10侧(10.4%)。经统计学分析,SPS 组的茎突过长及倾角过大的检出率明显高于对照组,差异具有统计学意义(P<0.05)。结论茎突综合征在影像学上主要表现为茎突过长和(或)倾角过大,128层螺旋 CT 三维重建技术能为临床提供可靠的影像学依据,在茎突综合征术前诊断中具有重要临床价值。%Objective To explore the clinical value on the pre-operation of styloid process syndrome diagnosed by 128-slice spiral CT. Methods Retrospectively analyzed 50 cases (100sides) of normal adult (control group) and 48 cases(96 sides) of styloid process syndrome diagnosed by operation (SPS group). The differences between two groups in the length and angle distribution of the styloid process were analyzed statistically. Results Eight sides of control group (8%) had the elon-gated styloid process (the lenght was more than 30mm),two sides (2%) had the larger anteversion angle (the angle was more than 25°),four sides (4%) had the larger inclination angle (more than 25°);48 cases of SPS group, 56 sides (58.3%) had the elongated styloid process,14 sides (14.6%) had the larger anteversion angle, 18 sides (18.8%) had the larger inclination an-gle,10 sides (10.4%) had the elongated styloid process coupled with abnormal inclination. Analyzed by statistics, the detection

  5. SU-E-T-143: Effect of X-Ray and Cone Beam CT Reconstruction Parameters On Estimation of Bone Volume of Mice Used in Aging Research

    Energy Technology Data Exchange (ETDEWEB)

    Russ, M; Pang, M; Troen, B; Rudin, S; Ionita, C [University at Buffalo, Buffalo, NY (United States)

    2014-06-01

    Purpose: To investigate the variations in bone volume calculations in mice involved in aging research when changing cone beam micro-CT x-ray and reconstruction parameters. Methods: Mouse spines were placed on an indexed turn table that rotated 0.5° per projection and imaged by a self-built micro CT machine containing a CCD-based high-resolution x-ray detector. After the full 360° rotation data set of object images was obtained, a standard filtered back-projection cone beam reconstruction was performed. Four different kVp's between 40–70 kVp in 10kVp increments were selected. For each kVp two mAs settings were used. Each acquisition was reconstructed using two voxel sizes (12 and 25μm) and two step angles, 0.5° and 1°, respectively. A LabView program was written to determine the total bone volume contained in the mouse's total spine volume (bone plus gaps) as a measure of spine health. First, the user selected the desired 512×512 reconstruction to view the whole spine volume which was then used to select a gray-level threshold that allowed for viewing of the bone structure, then another threshold to include gaps. The program returned bone volume, bone × gap volume, and their ratio, BVF. Results: The calculated bone volume fractions were compared as a function of tube potential. Cases with 25μm slice thickness showed trials with lower kVp's had greater image contrast, which resulted in higher calculated bone volume fractions. Cases with 12μm reconstructed slice thickness were significantly noisier, and showed no clear maximum BVF. Conclusion: Using the projection images and reconstructions acquired from the micro CT, it can be shown that the micro-CT x-ray and reconstruction parameters significantly affect the total bone volume calculations. When comparing mice cohorts treated with different therapies researchers need to be aware of such details and use volumes which were acquired and processed in identical conditions.

  6. PET-CT在乳腺癌术前诊断与分期中的临床应用%The clinical application of PET-CT in preoperative diagnosing and staging for breast cancer

    Institute of Scientific and Technical Information of China (English)

    汪世存; 方雷; 潘博; 展凤麟; 谢强; 谢吉奎

    2011-01-01

    Aim To evaluate the clinical application of PET-CT in preoperative diagnosing and staging for breast cancer. Methods The 56 patients who were presumed by clinical manifestation and physical examination as breast cancer in our hospital underwent PET-CT examination which included primary breast lesion , area lymphaden and other organs of the whole body. After complete routine scanning , we should rescan breast by particular scanning mode and carry out PET projection collection and CT thin slice scanning. Then, both the results of PET-CT examination should be analyzed and contrasted with pathology results of after operation or paracentesis. Results There were 4 cases of Phase Ⅰ ,31 cases of phase Ⅱ .6 cases of phase Ⅲ were and 15 cases of phase Ⅳ in 56 patients. In the 35 cases of.there were 34 cases of Axillary lymph nodes metastasis .4 cases of homonymy internal mammary lymph nodes metastasis and 1 case of supraclavicular lymph nodes metastasis. Meanwhile.in the 21 cases of phase JII ancl lV .there were 8 cases of pulmonary metastasis.8 cases of hepatic metastasis , bony 11 cases of metastasis( including 5 cases of osteogenesis and 6 cases of mixed type) and 1 case of brain metastases.The pathology results of afteroperation or paracentesis can prompt that there were 2 cases of carcinoma in situ.21 cases of ductal carcinoma in situ with local micro invasion.33 cases of invasive ductal carcinoma and 31 cases of axillary lymph nodes metastasis( 31/34) . The diagnostic accuracy was 91. 2% . Conclusion PET-CT imaging has higher sensitivity and specificity in diagnosing breast cancer, especially in diagnosing area lymphaden and metastasis ,which can guide us to choose therapy way%目的 探讨PET-CT在乳腺癌术前诊断与分期中的临床价值.方法 对该院临床表现和体格检查提示为乳腺癌的56例患者行PET-CT检查,检查范围包括乳腺癌原发病灶、区域淋巴结及全身脏器;完成常规扫描后,再应用特殊的乳腺扫

  7. Color-coded perfused blood volume imaging using multidetector CT: initial results of whole-brain perfusion analysis in acute cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kloska, Stephan P.; Fischer, Tobias; Fischbach, Roman; Heindel, Walter [University of Muenster, Department of Clinical Radiology, Muenster (Germany); Nabavi, Darius G.; Dittrich, Ralf; Ringelstein, E.B. [University of Muenster, Department of Neurology, Muenster (Germany); Ditt, Hendrik; Klotz, Ernst [Siemens AG, Medical Solutions, Forchheim (Germany)

    2007-09-15

    Computed tomography (CT) is still the primary imaging modality following acute stroke. To evaluate a prototype of software for the calculation of color-coded whole-brain perfused blood volume (PBV) images from CT angiography (CTA) and nonenhanced CT (NECT) scans, we studied 14 patients with suspected acute ischemia of the anterior cerebral circulation. PBV calculations were performed retrospectively. The detection rate of ischemic changes in the PBV images was compared with NECT. The volume of ischemic changes in PBV was correlated with the infarct volume on follow-up examination taking potential vessel recanalization into account. PBV demonstrated ischemic changes in 12/12 patients with proven infarction and was superior to NECT (8/12) in the detection of early ischemia. Moreover, PBV demonstrated the best correlation coefficient with the follow-up infarct volume (Pearson's R = 0.957; P = 0.003) for patients with proven recanalization of initially occluded cerebral arteries. In summary, PBV appears to be more accurate in the detection of early infarction compared to NECT and mainly visualizes the irreversibly damaged ischemic tissue. (orig.)

  8. Prognostic value of preoperative intratumoral FDG uptake heterogeneity in patients with epithelial ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Maria; Kim, Hee Seung; Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Hyunjong; Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Cancer Research Institute, Seoul (Korea, Republic of)

    2017-01-15

    To investigate the prognostic value of intratumoral FDG uptake heterogeneity (IFH) derived from PET/CT in patients with epithelial ovarian cancer (EOC). We retrospectively reviewed patients with pathologically proven epithelial ovarian cancer who underwent preoperative {sup 18}F-FDG PET/CT scans. PET/CT parameters such as maximum and average standardized uptake values (SUV{sub max} and SUV{sub avg}), sum of all metabolic tumour volume (MTV), cumulative total lesion glycolysis (TLG) and IFH were assessed. Regression analyses were used to identify clinicopathological and imaging variables associated with disease-free survival (DFS). Clinicopathological data were reviewed for 61 eligible patients. The median duration of DFS was 13 months (range, 6-26 months), and 18 (29.5 %) patients experienced recurrence. High IFH values were associated with tumour recurrence (P = 0.005, hazard ratio 4.504, 95 % CI 1.572-12.902). The Kaplan-Meier survival graphs showed that DFS significantly differed in groups categorized based on IFH (P = 0.002, log-rank test). Moreover, there were significant differences in DFS (P = 0.009) and IFH (P = 0.040) between patients with and without recurrence. Preoperative IFH measured by {sup 18}F-FDG PET/CT was significantly associated with EOC recurrence. FDG-based heterogeneity could be a useful and potential predicator of EOC recurrence before treatment. (orig.)

  9. Volumetric analysis of lung nodules in computed tomography (CT): comparison of two different segmentation algorithm softwares and two different reconstruction filters on automated volume calculation.

    Science.gov (United States)

    Christe, Andreas; Brönnimann, Alain; Vock, Peter

    2014-02-01

    A precise detection of volume change allows for better estimating the biological behavior of the lung nodules. Postprocessing tools with automated detection, segmentation, and volumetric analysis of lung nodules may expedite radiological processes and give additional confidence to the radiologists. To compare two different postprocessing software algorithms (LMS Lung, Median Technologies; LungCARE®, Siemens) in CT volumetric measurement and to analyze the effect of soft (B30) and hard reconstruction filter (B70) on automated volume measurement. Between January 2010 and April 2010, 45 patients with a total of 113 pulmonary nodules were included. The CT exam was performed on a 64-row multidetector CT scanner (Somatom Sensation, Siemens, Erlangen, Germany) with the following parameters: collimation, 24x1.2 mm; pitch, 1.15; voltage, 120 kVp; reference tube current-time, 100 mAs. Automated volumetric measurement of each lung nodule was performed with the two different postprocessing algorithms based on two reconstruction filters (B30 and B70). The average relative volume measurement difference (VME%) and the limits of agreement between two methods were used for comparison. At soft reconstruction filters the LMS system produced mean nodule volumes that were 34.1% (P filters (B30) was significantly larger than with hard filters (B70); 11.2% for LMS and 1.6% for LungCARE®, respectively (both with P filters, 13.6% for soft and 3.8% for hard filters, respectively (P  0.05). There is a substantial inter-software (LMS/LungCARE®) as well as intra-software variability (B30/B70) in lung nodule volume measurement; therefore, it is mandatory to use the same equipment with the same reconstruction filter for the follow-up of lung nodule volume.

  10. Multidetector-row computed tomography in the preoperative diagnosis of intestinal complications caused by clinically unsuspected ingested dietary foreign bodies: a case series emphasizing the use of volume rendering techniques

    Energy Technology Data Exchange (ETDEWEB)

    Teixeira, Augusto Cesar Vieira; Torres, Ulysses dos Santos; Oliveira, Eduardo Portela de; Gual, Fabiana; Bauab Junior, Tufik, E-mail: usantor@yahoo.com.br [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Hospital de Base. Serv. de Radiologia e Diagnostico por Imagem; Westin, Carlos Eduardo Garcia [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Hospital de Base. Cirurgia Geral; Cardoso, Luciana Vargas [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Hospital de Base. Setor de Tomografia Computadorizada

    2013-11-15

    Objective: the present study was aimed at describing a case series where a preoperative diagnosis of intestinal complications secondary to accidentally ingested dietary foreign bodies was made by multidetector-row computed tomography (MDCT), with emphasis on complementary findings yielded by volume rendering techniques (VRT) and curved multiplanar reconstructions (MPR). Materials and Methods: The authors retrospectively assessed five patients with surgically confirmed intestinal complications (perforation and/or obstruction) secondary to unsuspected ingested dietary foreign bodies, consecutively assisted in their institution between 2010 and 2012. Demographic, clinical, laboratory and radiological data were analyzed. VRT and curved MPR were subsequently performed. Results: preoperative diagnosis of intestinal complications was originally performed in all cases. In one case the presence of a foreign body was not initially identified as the causal factor, and the use of complementary techniques facilitated its retrospective identification. In all cases these tools allowed a better depiction of the entire foreign bodies on a single image section, contributing to the assessment of their morphology. Conclusion: although the use of complementary techniques has not had a direct impact on diagnostic performance in most cases of this series, they may provide a better depiction of foreign bodies' morphology on a single image section. (author)

  11. Discussion on Low Tension of Air of 16 Slice Spiral CT Three Phases Enhanced Images on the Application of Preoperative TNM Staging of Gastric Cancer%探讨低张充气16层螺旋CT三期增强扫描对胃癌术前TNM分期的应用

    Institute of Scientific and Technical Information of China (English)

    纪忠杰

    2014-01-01

    目的:探讨低张充气16层螺旋CT三期增强扫描对胃癌术前TNM分期的应用。方法选取我院82例胃癌患者,对其术前TNM分期进行低张充气16层螺旋CT三期增强扫描,并结合原始图像,分析其应用效果。结果82例患者在T分期的扫描准确率是63.42%,N分期扫描结果准确率是52.44%,M分期准确率是81.71%。结论低张充气16层螺旋CT三期增强扫描在患者术前TNM分期的诊断准确率较高,对临床确定手术方案具有重要指导意义。%Objective To investigate the 16 slice spiral CT hypotonic aeration three phase enhanced scan on the application of preoperative TNM staging of gastric cancer. Methods In our hospital in 82 cases of gastric cancer,the preoperative TNM staging of low tension of air 16 slice helical CT three phases enhanced images,and the combination of the original image,the analysis of its application effect. Results 82 patients in T stage scanning accuracy rate is 63.42%,the N staging scan results accuracy rate is 52.44%,the M staging accuracy rate is 81.71%. Conclusion 16 slice spiral CT hypotonic aeration three phase enhanced scanning in patients with preoperative TNM staging diagnosis accurate rate is higher, has the important guiding sense to the clinical determination of operation scheme.

  12. High-quality 3D correction of ring and radiant artifacts in flat panel detector-based cone beam volume CT imaging.

    Science.gov (United States)

    Anas, Emran Mohammad Abu; Kim, Jae Gon; Lee, Soo Yeol; Hasan, Md Kamrul

    2011-10-07

    The use of an x-ray flat panel detector is increasingly becoming popular in 3D cone beam volume CT machines. Due to the deficient semiconductor array manufacturing process, the cone beam projection data are often corrupted by different types of abnormalities, which cause severe ring and radiant artifacts in a cone beam reconstruction image, and as a result, the diagnostic image quality is degraded. In this paper, a novel technique is presented for the correction of error in the 2D cone beam projections due to abnormalities often observed in 2D x-ray flat panel detectors. Template images are derived from the responses of the detector pixels using their statistical properties and then an effective non-causal derivative-based detection algorithm in 2D space is presented for the detection of defective and mis-calibrated detector elements separately. An image inpainting-based 3D correction scheme is proposed for the estimation of responses of defective detector elements, and the responses of the mis-calibrated detector elements are corrected using the normalization technique. For real-time implementation, a simplification of the proposed off-line method is also suggested. Finally, the proposed algorithms are tested using different real cone beam volume CT images and the experimental results demonstrate that the proposed methods can effectively remove ring and radiant artifacts from cone beam volume CT images compared to other reported techniques in the literature.

  13. High-quality 3D correction of ring and radiant artifacts in flat panel detector-based cone beam volume CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Anas, Emran Mohammad Abu; Hasan, Md Kamrul [Department of Electrical and Electronic Engineering, Bangladesh University of Engineering and Technology, Dhaka-1000 (Bangladesh); Kim, Jae Gon; Lee, Soo Yeol, E-mail: khasan@eee.buet.ac.b [Department of Biomedical Engineering, Kyung Hee University, Kyungki 446-701 (Korea, Republic of)

    2011-10-07

    The use of an x-ray flat panel detector is increasingly becoming popular in 3D cone beam volume CT machines. Due to the deficient semiconductor array manufacturing process, the cone beam projection data are often corrupted by different types of abnormalities, which cause severe ring and radiant artifacts in a cone beam reconstruction image, and as a result, the diagnostic image quality is degraded. In this paper, a novel technique is presented for the correction of error in the 2D cone beam projections due to abnormalities often observed in 2D x-ray flat panel detectors. Template images are derived from the responses of the detector pixels using their statistical properties and then an effective non-causal derivative-based detection algorithm in 2D space is presented for the detection of defective and mis-calibrated detector elements separately. An image inpainting-based 3D correction scheme is proposed for the estimation of responses of defective detector elements, and the responses of the mis-calibrated detector elements are corrected using the normalization technique. For real-time implementation, a simplification of the proposed off-line method is also suggested. Finally, the proposed algorithms are tested using different real cone beam volume CT images and the experimental results demonstrate that the proposed methods can effectively remove ring and radiant artifacts from cone beam volume CT images compared to other reported techniques in the literature.

  14. Impact of image denoising on image quality, quantitative parameters and sensitivity of ultra-low-dose volume perfusion CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Othman, Ahmed E. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Radiology, Tuebingen (Germany); Brockmann, Carolin; Afat, Saif; Pjontek, Rastislav; Nikoubashman, Omid; Brockmann, Marc A.; Wiesmann, Martin [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Yang, Zepa; Kim, Changwon [Seoul National University, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Suwon (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Nikolaou, Konstantin [Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Radiology, Tuebingen (Germany); Kim, Jong Hyo [Seoul National University, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Suwon (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Advanced Institute of Convergence Technology, Center for Medical-IT Convergence Technology Research, Suwon (Korea, Republic of); Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of)

    2016-01-15

    To examine the impact of denoising on ultra-low-dose volume perfusion CT (ULD-VPCT) imaging in acute stroke. Simulated ULD-VPCT data sets at 20 % dose rate were generated from perfusion data sets of 20 patients with suspected ischemic stroke acquired at 80 kVp/180 mAs. Four data sets were generated from each ULD-VPCT data set: not-denoised (ND); denoised using spatiotemporal filter (D1); denoised using quanta-stream diffusion technique (D2); combination of both methods (D1 + D2). Signal-to-noise ratio (SNR) was measured in the resulting 100 data sets. Image quality, presence/absence of ischemic lesions, CBV and CBF scores according to a modified ASPECTS score were assessed by two blinded readers. SNR and qualitative scores were highest for D1 + D2 and lowest for ND (all p ≤ 0.001). In 25 % of the patients, ND maps were not assessable and therefore excluded from further analyses. Compared to original data sets, in D2 and D1 + D2, readers correctly identified all patients with ischemic lesions (sensitivity 1.0, kappa 1.0). Lesion size was most accurately estimated for D1 + D2 with a sensitivity of 1.0 (CBV) and 0.94 (CBF) and an inter-rater agreement of 1.0 and 0.92, respectively. An appropriate combination of denoising techniques applied in ULD-VPCT produces diagnostically sufficient perfusion maps at substantially reduced dose rates as low as 20 % of the normal scan. (orig.)

  15. MRI versus {sup 68}Ga-PSMA PET/CT for gross tumour volume delineation in radiation treatment planning of primary prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zamboglou, Constantinos; Kirste, Simon; Fechter, Tobias; Grosu, Anca-Ligia [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); German Cancer Consortium (DKTK), Heidelberg (Germany); Wieser, Gesche [University Medical Center Freiburg, Department of Nuclear Medicine, Freiburg (Germany); Hennies, Steffen [University Medical Center Goettingen, Department of Radiation Oncology, Goettingen (Germany); Rempel, Irene; Soschynski, Martin; Langer, Mathias [University Medical Center Freiburg, Department of Radiology, Freiburg (Germany); Rischke, Hans Christian [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); Jilg, Cordula A. [University Medical Center Freiburg, Department of Urology, Freiburg (Germany); Meyer, Philipp T. [German Cancer Consortium (DKTK), Heidelberg (Germany); University Medical Center Freiburg, Department of Nuclear Medicine, Freiburg (Germany); Bock, Michael [German Cancer Consortium (DKTK), Heidelberg (Germany); University Medical Center Freiburg, Department of Radiology, Freiburg (Germany)

    2016-05-15

    Multiparametric magnetic resonance imaging (mpMRI) is widely used in radiation treatment planning of primary prostate cancer (PCA). Focal dose escalation to the dominant intraprostatic lesions (DIPL) may lead to improved PCA control. Prostate-specific membrane antigen (PSMA) is overexpressed in most PCAs. {sup 68}Ga-labelled PSMA inhibitors have demonstrated promising results in detection of PCA with PET/CT. The aim of this study was to compare {sup 68}Ga-PSMA PET/CT with MRI for gross tumour volume (GTV) definition in primary PCA. This retrospective study included 22 patients with primary PCA analysed after {sup 68}Ga-PSMA PET/CT and mpMRI. GTVs were delineated on MR images by two radiologists (GTV-MRIrad) and two radiation oncologists separately. Both volumes were merged leading to GTV-MRIint. GTVs based on PET/CT were delineated by two nuclear medicine physicians in consensus (GTV-PET). Laterality (left, right, and left and right prostate lobes) on mpMRI, PET/CT and pathological analysis after biopsy were assessed. Mean GTV-MRIrad, GTV-MRIint and GTV-PET were 5.92, 3.83 and 11.41 cm{sup 3}, respectively. GTV-PET was significant larger then GTV-MRIint (p = 0.003). The MRI GTVs GTV-MRIrad and GTV-MRIint showed, respectively, 40 % and 57 % overlap with GTV-PET. GTV-MRIrad and GTV-MRIint included the SUVmax of GTV-PET in 12 and 11 patients (54.6 % and 50 %), respectively. In nine patients (47 %), laterality on mpMRI, PET/CT and histopathology after biopsy was similar. Ga-PSMA PET/CT and mpMRI provided concordant results for delineation of the DIPL in 47 % of patients (40 % - 54 % of lesions). GTV-PET was significantly larger than GTV-MRIint. {sup 68}Ga-PSMA PET/CT may have a role in radiation treatment planning for focal radiation to the DIPL. Exact correlation of PET and MRI images with histopathology is needed. (orig.)

  16. Determining the organ of origin of large pelvic masses in females using multidetector CT angiography and three-dimensional volume rendering CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Li, YangKang; Chen, JunWei; Chen, XueYin; Lin, JianBang; Cai, AiQun; Zhou, XiuGuo [Cancer Hospital, Shantou University Medical College, Department of Radiology, Shantou, Guangdong Province (China); Zheng, Yu [Cancer Hospital, Shantou University Medical College, Department of Clinical Pharmacology, Shantou (China)

    2015-04-01

    To study the value of tumour feeding arteries and the ovarian vein in determining the organ of origin of large pelvic tumours in females using multidetector CT. One hundred and thirty patients with 131 pathologically proven tumours (>6.5 cm) were retrospectively reviewed. Conventional CT images and CT angiography were evaluated, with focus on assessing the value of tumour feeding arteries and the ovarian vein in differentiating ovarian from non-ovarian tumours. For 97 ovarian tumours, the feeding arteries included the ovarian artery (n = 51) and the ovarian branch of uterine artery (n = 64). For 34 non-ovarian tumours, the feeding arteries included the ovarian artery (n = 2), the uterine artery (n = 21), the mesenteric artery (n = 5), and the internal iliac artery (n = 1). The ovarian vein was identified in 86 ovarian tumours and 12 non-ovarian tumours. When the feeding arteries and the ovarian vein were combined to confirm ovarian origin, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.8 %, 84.2 %, 93.8 %, 94.1 %, and 93.9 %, respectively. The accuracy was significantly higher than that of independently using the ovarian vein or the ovarian feeding arteries. Combined application of tumour feeding arteries and the ovarian vein is valuable to differentiate large ovarian from non-ovarian tumours. (orig.)

  17. Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?

    Energy Technology Data Exchange (ETDEWEB)

    Sofue, Keitaro [National Cancer Center Hospital, Division of Diagnostic Radiology, Tokyo (Japan); Kobe University, Department of Radiology, Graduate School of Medicine, Kobe (Japan); Tsurusaki, Masakatsu [National Cancer Center Hospital, Division of Diagnostic Radiology, Tokyo (Japan); Kinki University, Department of Radiology, Faculty of Medicine, Osakasayama, Osaka (Japan); Murakami, Takamichi [Kinki University, Department of Radiology, Faculty of Medicine, Osakasayama, Osaka (Japan); Onoe, Shunsuke [National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Surgery, Tokyo (Japan); Tokue, Hiroyuki; Shibamoto, Kentaro; Arai, Yasuaki [National Cancer Center Hospital, Division of Diagnostic Radiology, Tokyo (Japan); Sugimura, Kazuro [Kobe University, Department of Radiology, Graduate School of Medicine, Kobe (Japan)

    2014-10-15

    To compare diagnostic performance in the detection of colorectal liver metastases between 64-detector-row contrast-enhanced CT (CE-CT) alone and the combination of CE-CT and gadoxetic acid-enhanced MRI (EOB-MRI) at 3.0T, and to assess whether EOB-MRI in addition to CE-CT results in a change to initially planned operative strategy. A total of 39 patients (27 men, mean age 65 years) with 85 histopathologically confirmed liver metastases were included. At EOB-MRI, unenhanced (T1- and T2-weighted), dynamic, and hepatocyte-phase images were obtained. At CE-CT, four-phase dynamic contrast-enhanced images were obtained. One on-site reader and three off-site readers independently reviewed both CE-CT alone and the combination of CE-CT and EOB-MRI. Sensitivity, positive predictive value, and alternative free-response receiver operating characteristic (AFROC) method were calculated. Differences in therapeutic strategy before and after the EOB-MRI examination were also evaluated. Sensitivity and area under the AFROC curve with the combination of CE-CT and EOB-MRI were significantly superior to those with CE-CT alone. Changes in surgical therapy were documented in 13 of 39 patients. The combination of CE-CT and EOB-MRI may provide better diagnostic performance than CE-CT alone for the detection of colorectal liver metastases, and EOB-MRI in addition to CE-CT resulted in changes to the planned operative strategy in one-third of the patients. (orig.)

  18. Virtual CT laparoscopic imaging using intravenous cholangiography with helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, Masafumi; Ishibashi, Masatoshi; Nishimura, Hiroshi; Hayabuchi, Naofumi [Kurume Univ., Fukuoka (Japan). School of Medicine

    2000-08-01

    Laparoscopic cholecystectomy is a reatively new technology that allows for minimally invasive treatment of cholelithiasis. The purpose of this paper is to demonstrate the feasibility of virtual laparoscopic imaging using helical CT cholangiography with volume rendering technique. We used the technique with ten patients with suspected gallbladder abnormalities. Our imaging sets produced high quality 3D images with excellent visualization in 70% (7/10) of all cases. Virtual laparoscopic imaging was also compared with other imaging techniques and imaging using helical scans can proved useful in preoperative imaging. Furthermore, virtual laparoscopic imaging using helical scans can in surgical planning and serve as a visual aid in discussions between radiologists, surgeons, and patients. (author)

  19. Potential of right to left ventricular volume ratio measured on chest CT for the prediction of pulmonary hypertension: correlation with pulmonary arterial systolic pressure estimated by echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Heon [Soon Chun Hyang University, Department of Radiology, Bucheon (Korea, Republic of); Kim, Seok Yeon [Seoul Medical Center, Department of Cardiology, Seoul (Korea, Republic of); Lee, Soo Jeong [Terarecon Korea, Seoul (Korea, Republic of); Kim, Jae Kyun [Chung-Ang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Reddy, Ryan P.; Schoepf, U.J. [Medical University of South Carolina, Department of Radiology and Radiological Science and Division of Cardiology, Department of Medicine, Charleston, SC (United States)

    2012-09-15

    To investigate the correlation of right ventricular (RV) to left ventricular (LV) volume ratio measured by chest CT with pulmonary arterial systolic pressure (PASP) estimated by echocardiography. 104 patients (72.47 {+-} 13.64 years; 39 male) who had undergone chest CT and echocardiography were divided into two groups (hypertensive and normotensive) based upon an echocardiography-derived PASP of 25 mmHg. RV to LV volume ratios (RV{sub V}/LV{sub V}) were calculated. RV{sub V}/LV{sub V} was then correlated with PASP using regression analysis. The Area Under the Curve (AUC) for predicting pulmonary hypertension on chest CT was calculated. In the hypertensive group, the mean PASP was 46.29 {+-} 14.42 mmHg (29-98 mmHg) and there was strong correlation between the RV{sub V}/LV{sub V} and PASP (R = 0.82, p < 0.001). The intraobserver and interobserver correlation coefficients for RV{sub V}/LV{sub V} were 0.990 and 0.892. RV{sub V}/LV{sub V} was 1.01 {+-} 0.44 (0.51-2.77) in the hypertensive and 0.72 {+-} 0.14 (0.52-1.11) in the normotensive group (P <0.05). With 0.9 as the cutoff for RV{sub V}/LV{sub V}, sensitivity and specificity for predicting pulmonary hypertension over 40 mmHg were 79.5 % and 90 %, respectively. The AUC for predicting pulmonary hypertension was 0.87 RV/LV volume ratios on chest CT correlate well with PASP estimated by echocardiography and can be used to predict pulmonary hypertension over 40 mmHg with high sensitivity and specificity. (orig.)

  20. Comparison of internal target volumes defined on 3-dimensional, 4-dimensonal, and cone-beam CT images of non-small-cell lung cancer

    Directory of Open Access Journals (Sweden)

    Li F

    2016-11-01

    Full Text Available Fengxiang Li,1 Jianbin Li,1 Zhifang Ma,1 Yingjie Zhang,1 Jun Xing,1 Huanpeng Qi,1 Dongping Shang21Department of Radiation Oncology, 2Department of Big Bore CT Room, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of ChinaPurpose: The purpose of this study was to compare the positional and volumetric differences of internal target volumes defined on three-dimensional computed tomography (3DCT, four-dimensional CT (4DCT, and cone-beam CT (CBCT images of non-small-cell lung cancer (NSCLC. Materials and methods: Thirty-one patients with NSCLC sequentially underwent 3DCT and 4DCT simulation scans of the thorax during free breathing. The first CBCT was performed and registered to the planning CT using the bony anatomy registration during radiotherapy. The gross tumor volumes were contoured on the basis of 3DCT, maximum intensity projection (MIP of 4DCT, and CBCT. CTV3D (clinical target volume, internal target volumes, ITVMIP and ITVCBCT, were defined with a 7 mm margin accounting for microscopic disease. ITV10 mm and ITV5 mm were defined on the basis of CTV3D: ITV10 mm with a 5 mm margin in left–right (LR, anterior–posterior (AP directions and 10 mm in cranial–caudal (CC direction; ITV5 mm with an isotropic internal margin (IM of 5 mm. The differences in the position, size, Dice’s similarity coefficient (DSC and inclusion relation of different volumes were evaluated.Results: The median size ratios of ITV10 mm, ITV5 mm, and ITVMIP to ITVCBCT were 2.33, 1.88, and 1.03, respectively, for tumors in the upper lobe and 2.13, 1.76, and 1.1, respectively, for tumors in the middle-lower lobe. The median DSCs of ITV10 mm, ITV5 mm, ITVMIP, and ITVCBCT were 0.6, 0.66, and 0.83 for all patients. The median percentages of ITVCBCT not included in ITV10 mm, ITV5 mm, and ITVMIP were 0.1%, 1.63%, and 15.21%, respectively, while the median percentages of ITV10 mm, ITV5 mm

  1. Biomechanically constrained groupwise ultrasound to CT registration of the lumbar spine.

    Science.gov (United States)

    Gill, Sean; Abolmaesumi, Purang; Fichtinger, Gabor; Boisvert, Jonathan; Pichora, David; Borshneck, Dan; Mousavi, Parvin

    2012-04-01

    We present a groupwise US to CT registration algorithm for guiding percutaneous spinal interventions. In addition, we introduce a comprehensive validation scheme that accounts for changes in the curvature of the spine between preoperative and intraoperative imaging. In our registration methodology, each vertebra in CT is treated as a sub-volume and transformed individually. A biomechanical model is used to constrain the displacement of the vertebrae relative to one another. The sub-volumes are then reconstructed into a single volume. During each iteration of registration, an US image is simulated from the reconstructed CT volume and an intensity-based similarity metric is calculated with the real US image. Validation studies are performed on CT and US images from a sheep cadaver, five patient-based phantoms designed to preserve realistic curvatures of the spine and a sixth patient-based phantom where the curvature of the spine is changed between preoperative and intraoperative imaging. For datasets where the spine curve between two imaging modalities was artificially perturbed, the proposed methodology was able to register initial misalignments of up to 20mm with a success rate of 95%. For the phantom with a physical change in the curvature of the spine introduced between the US and CT datasets, the registration success rate was 98.5%. Finally, the registration success rate for the sheep cadaver with soft-tissue information was 87%. The results demonstrate that our algorithm allows for robust registration of US and CT datasets, regardless of a change in the patients pose between preoperative and intraoperative image acquisitions.

  2. CT of pituitary abscess

    Energy Technology Data Exchange (ETDEWEB)

    Fong, T.C.; Johns, R.D.; Long, M.; Myles, S.T.

    1985-06-01

    Pituitary abscess is a rare condition, with only 50 cases reported in the literature. Of those, 29 cases were well documented for analysis. Preoperative diagnosis of pituitary abscess is difficult. The computed tomographic (CT) appearance of pituitary abscess was first described in 1983; the abscess was depicted by axial images with coronal reconstruction. The authors recently encountered a case of pituitary abscess documented by direct coronal CT of the sella turcica.

  3. Volume-of-interest cone-beam CT using a 2.35 MV beam generated with a carbon target.

    Science.gov (United States)

    Robar, James L; Parsons, David; Berman, Avery; Macdonald, Alex

    2012-07-01

    This is a proof-of-concept study addressing volume of interest (VOI) cone beam CT (CBCT) imaging using an x-ray beam produced by 2.35 MeV electrons incident on a carbon linear accelerator target. Methodology is presented relevant to VOI CBCT image acquisition and reconstruction. Sample image data are given to demonstrate and compare two approaches to minimizing artifacts arising from reconstruction with truncated projections. Dosimetric measurements quantify the potential dose reduction of VOI acquisition relative to full-field CBCT. The dependence of contrast-to-noise ratio (CNR) on VOI dimension is investigated. A paradigm is presented linking the treatment planning process with the imaging technique, allowing definition of an imaging VOI to be tailored to the geometry of the patient. Missing data in truncated projection images are completed using a priori information in the form of digitally reconstructed radiographs (DRRs) generated from the planning CT set. This method is compared to a simpler technique of extrapolating truncated projection data prior to reconstruction. The utility of these approaches is shown through imaging of a geometric phantom and the head-and-neck section of a lamb. The total scatter factor of the 2.35 MV∕carbon beam on field size is measured and compared to a standard therapeutic beam to estimate the comparative dose reduction inside the VOI. Thermoluminescent dosimeters and Gafchromic film measurements are used to compare the imaging dose distributions for the 2.35 MV∕carbon beam between VOI and full-field techniques. The dependence of CNR on VOI dimension is measured for VOIs ranging from 4 to 15 cm diameter. Without compensating for missing data outside of truncated projections prior to reconstruction, pronounced boundary artifacts are present, in three dimensions, within 2-3 cm of the edges of the VOI. These artifacts, as well as cupping inside the VOI, can be reduced substantially using either the DRR filling or extrapolation

  4. Dose-volume parameters and clinical outcome of CT-guided free-hand high-dose-rate interstitial brachytherapy for cervical cancer

    Science.gov (United States)

    Wang, Yi; Ye, Wei-Jun; Du, Le-Hui; Li, Ai-Ju; Ren, Yu-Feng; Cao, Xin-Ping

    2012-01-01

    Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-dose-rate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach. Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer. Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied. With a median of 5 (range, 4–7) implanted needles for each patient, the median dose of brachytherapy alone delivered to 90% of the target volume (D90) was 45 (range, 33–54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range, 20–36) Gyα/β10 for intermediate-risk clinical target volume (IR-CTV). The percentage of the CTV covered by the prescribed dose (V100) of HR-CTV with brachytherapy alone was 81.9%–99.2% (median, 96.7%). With an additional dose of external beam radiotherapy (EBRT), the median D90 was 94 (range, 83–104) Gyα/β10 for HR-CTV and 77 (range, 70–87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100) was 75 (range, 66–84) Gyα/β10 for HR-CTV and 65 (range, 57–73) Gyα/β10 for IR-CTV. The minimum dose to the most irradiated 2 cc volume (D2cc) was 73–96 (median, 83) Gyα/β3 for the bladder, 64–98 (median, 73) Gyα/β3 for the rectum, and 52–69 (median, 61) Gyα/β3 for the sigmoid colon. After a median follow-up of 15 months (range, 3–24 months), two patients experienced local failure, and 1 showed internal iliac nodal metastasis. Despite the relatively small number of needles used, CT-guided HDRISBT for cervical cancer showed favorable

  5. Dose-volume parameters and clinical outcome of CT-guided freehand high-dose-rate interstitial brachytherapy for cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Yi Wang; Wei-Jun Ye; Le-Hui Du; Ai-Ju Li; Yu-Feng Ren; Xin-Ping Cao

    2012-01-01

    Currently,image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer.In this study,we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-doserate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach.Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer.Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied.With a median of 5 (range,4-7) implanted needles for each patient,the median dose of brachytherapy alone delivered to 90% of the target volume (D90) was 45 (range,33-54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range,20-36)Gyα/β10 for intermediate-risk clinical target volume (IR-CTV).The percentage of the CTV covered by the prescribed dose (V100) of HR-CTV with brachytherapy alone was 81.9%-99.2% (median,96.7%).With an additional dose of external beam radiotherapy (EBRT),the median D90 was 94 (range,83-104) Gyα/β10 for HR-CTV and 77 (range,70-87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100) was 75 (range,66-84) Gyα/β10 for HR-CTV and 65 (range,57-73) Gyα/β10 for IR-CTV.The minimum dose to the most irradiated 2 cc volume (D2cc) was 73-96 (median,83) Gyα/β3 for the bladder,64-98 (median,73) Gyα/β3 for the rectum,and 52-69 (median,61) Gyα/β3 for the sigmoid colon.After a median follow-up of 15 months (range,3-24 months),two patients experienced local failure,and 1 showed internal lilac nodal metastasis.Despite the relatively small number of needles used,CT-guided HDRISBT for cervical cancer showed favorable DVH parameters and clinical outcome.

  6. Impact of 18FDG-PET/CT on biological target volume (BTV) definition for treatment planning for non-small cell lung cancer patients

    Science.gov (United States)

    Devic, Slobodan; Tomic, Nada; Faria, Sergio; Dean, Geoffrey; Lisbona, Robert; Parker, William; Kaufman, Chris; Podgorsak, Ervin B.

    2007-02-01

    This work represents our effort to test feasibility of FDG-based PET/CT on target volume delineation in radiotherapy treatment planning of NSCLC patients. Different methods have been developed to enable more precise target outlining using PET: Qualitative Visual Method, CTV=2.5 SUV units, linear SUV threshold function method, and CTV=40% Iso of Maximum Uptake Value. We are proposing reconstruction of three biological target volumes: necrotic BTV (same as PTV created by radiation oncologist using CT data), proliferating BTV (based on PET signal to background ratio 1:3) and hypoxic BTV (based on PET signal to background ratio of 1:19). Two IMRT plans were created and compared to the conventional treatment plan: "conservative" IMRT plan delivers 52.5 Gy to the necrotic BTV and 65 Gy to the hypoxic BTV; "radical" IMRT plan delivers 30 Gy to necrotic BTV, 52.5 Gy to proliferating BTV and 65 Gy to hypoxic BTV. Use of BTVs in IMRT plans is attractive because it increases dose to targets considered to need higher doses. It reduces considerably dose to heart and spinal cord, organs considered to limit dose escalation approaches in NSCLC treatment. "Conservative" IMRT approach can be understood as a PET/CT-based concomitant boost to the tumor expressing the highest FDG uptake. "Radical" plan implies deviation from the traditional uniform dose target coverage approach, with the intention of achieving better surrounding tissue sparing and ultimately allowing for dose escalation protocols relying on biologically based treatment planning.

  7. Effect of different segmentation algorithms on metabolic tumor volume measured on 18F-FDG PET/CT of cervical primary squamous cell carcinoma

    Science.gov (United States)

    Xu, Weina; Yu, Shupeng; Ma, Ying; Liu, Changping

    2017-01-01

    Background and purpose It is known that fluorine-18 fluorodeoxyglucose PET/computed tomography (CT) segmentation algorithms have an impact on the metabolic tumor volume (MTV). This leads to some uncertainties in PET/CT guidance of tumor radiotherapy. The aim of this study was to investigate the effect of segmentation algorithms on the PET/CT-based MTV and their correlations with the gross tumor volumes (GTVs) of cervical primary squamous cell carcinoma. Materials and methods Fifty-five patients with International Federation of Gynecology and Obstetrics stage Ia∼IIb and histologically proven cervical squamous cell carcinoma were enrolled. A fluorine-18 fluorodeoxyglucose PET/CT scan was performed before definitive surgery. GTV was measured on surgical specimens. MTVs were estimated on PET/CT scans using different segmentation algorithms, including a fixed percentage of the maximum standardized uptake value (20∼60% SUVmax) threshold and iterative adaptive algorithm. We divided all patients into four different groups according to the SUVmax within target volume. The comparisons of absolute values and percentage differences between MTVs by segmentation and GTV were performed in different SUVmax subgroups. The optimal threshold percentage was determined from MTV20%∼MTV60%, and was correlated with SUVmax. The correlation of MTViterative adaptive with GTV was also investigated. Results MTV50% and MTV60% were similar to GTV in the SUVmax up to 5 (P>0.05). MTV30%∼MTV60% were similar to GTV (P>0.05) in the 50.05) in the 100.05) in the SUVmax of at least 15 group. MTViterative adaptive was similar to GTV in both total and different SUVmax groups (P>0.05). Significant differences were observed among the fixed percentage method and the optimal threshold percentage was inversely correlated with SUVmax. The iterative adaptive segmentation algorithm led to the highest accuracy (6.66±50.83%). A significantly positive correlation was also observed between MTViterative

  8. Preoperative selective desensitization of live donor liver transplant recipients considering the degree of T lymphocyte cross-match titer, model for end-stage liver disease score, and graft liver volume.

    Science.gov (United States)

    Hong, Geun; Yi, Nam-Joon; Suh, Suk-won; Yoo, Tae; Kim, Hyeyoung; Park, Min-Su; Choi, YoungRok; Lee, Kyungbun; Lee, Kwang-Woong; Park, Myoung Hee; Suh, Kyung-Suk

    2014-05-01

    Several studies have suggested that a positive lymphocyte cross-matching (XM) is associated with low graft survival rates and a high prevalence of acute rejection after adult living donor liver transplantations (ALDLTs) using a small-for-size graft. However, there is still no consensus on preoperative desensitization. We adopted the desensitization protocol from ABO-incompatible LDLT. We performed desensitization for the selected patients according to the degree of T lymphocyte cross-match titer, model for end-stage liver disease (MELD) score, and graft liver volume. We retrospectively evaluated 230 consecutive ALDLT recipients for 5 yr. Eleven recipients (4.8%) showed a positive XM. Among them, five patients with the high titer (> 1:16) by antihuman globulin-augmented method (T-AHG) and one with a low titer but a high MELD score of 36 were selected for desensitization: rituximab injection and plasmapheresis before the transplantation. There were no major side effects of desensitization. Four of the patients showed successful depletion of the T-AHG titer. There was no mortality and hyperacute rejection in lymphocyte XM-positive patients, showing no significant difference in survival outcome between two groups (P=1.000). In conclusion, this desensitization protocol for the selected recipients considering the degree of T lymphocyte cross-match titer, MELD score, and graft liver volume is feasible and safe.

  9. Effective incorporation of spatial information in a mutual information based 3D-2D registration of a CT volume to X-ray images.

    Science.gov (United States)

    Zheng, Guoyan

    2008-01-01

    This paper addresses the problem of estimating the 3D rigid pose of a CT volume of an object from its 2D X-ray projections. We use maximization of mutual information, an accurate similarity measure for multi-modal and mono-modal image registration tasks. However, it is known that the standard mutual information measure only takes intensity values into account without considering spatial information and its robustness is questionable. In this paper, instead of directly maximizing mutual information, we propose to use a variational approximation derived from the Kullback-Leibler bound. Spatial information is then incorporated into this variational approximation using a Markov random field model. The newly derived similarity measure has a least-squares form and can be effectively minimized by a multi-resolution Levenberg-Marquardt optimizer. Experimental results are presented on X-ray and CT datasets of a plastic phantom and a cadaveric spine segment.

  10. Hepatic angiosarcoma: CT findings

    Institute of Scientific and Technical Information of China (English)

    余日胜; 章士正; 华建明

    2003-01-01

    @@ Hepatic angiosarcoma is a rare malignant vascular tumor. Accurate preoperative diagnosis of this tumor is very difficult if the patient does not have any history of exposure to specific carcinogens including thorotrast, arsenicals and vinyl chloride monomer. We describe CT findings in two cases of hepatic angiosarcoma in combination with a review of the literature.

  11. Digital volume tomography (DVT) and multislice spiral CT (MSCT). An objective examination of dose and image quality; Digitale Volumentomografie (DVT) und Mehrschicht-Spiral-CT (MSCT). Eine objektive Untersuchung von Dosis und Bildqualitaet

    Energy Technology Data Exchange (ETDEWEB)

    Kyriakou, Y.; Kolditz, D.; Langner, O.; Krause, J.; Kalender, W. [Erlangen-Nuernberg Univ. (Germany). Inst. fuer Medizinische Physik

    2011-02-15

    Purpose: In the last five years digital volume tomographs (DVT) have found their way into the diagnostic imaging of the facial skull. In this study both the image quality and dose of DVT and multislice spiral CT (MSCT) in this field of application were investigated using established physical methods for CT. Materials and Methods: Measurements on DVT scanners of various manufacturers and on a modern MSCT scanner were performed. The investigation was based on equivalent dose levels for both modalities (CT dose index, CTDI). For this purpose, the dose was measured with an ionization chamber in a cylindrical PMMA phantom. For the evaluation of image quality, the spatial resolution, contrast and noise were investigated with phantoms established for CT. Results: MSCT exhibited spatial resolution values of 1.0 to 1.6 lp/mm, while DVT provided resolution between 0.6 and 1.0 lp/mm only. Thus, MSCT offered similar or better resolution at an equivalent dose. For soft tissue resolution, DVT showed significant image artifacts. MSCT yielded higher homogeneity and no significant artifacts, and the contrast steps of the phantom were more verifiable. The different DVT devices, from image intensifiers to modern flat-detector (FD) devices, showed significant differences in favor of the FD devices. Conclusion: For medium and high contrast applications (teeth/bones), DVT scanners can be an alternative to MSCT at comparable radiation exposure. However, MSCT offers advantages in terms of constantly good and controlled image quality with significantly more flexible scan parameters at a constant or lower dose and should therefore be given preference. (orig.)

  12. Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism - correlation with D-dimer level, right heart strain and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, Ralf W.; Frellesen, Claudia; Schell, Boris; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.; Kerl, J.M. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Renker, Matthias [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States); Ackermann, Hanns [Clinic of the Goethe University, Department of Biostatistics and Mathematical Modelling, Frankfurt (Germany); Schoepf, U.J. [Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States)

    2011-09-15

    To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p < 0.003). There were 2 deaths and 1 readmission due of PE in 18 patients with >5% RelPD, while no such events were found for patients with <5% RelPD. Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study. (orig.)

  13. Modeling of Non-Small Cell Lung Cancer Volume Changes during CT-Based Image Guided Radiotherapy: Patterns Observed and Clinical Implications

    Directory of Open Access Journals (Sweden)

    Hiram A. Gay

    2013-01-01

    Full Text Available Background. To characterize the lung tumor volume response during conventional and hypofractionated radiotherapy (RT based on diagnostic quality CT images prior to each treatment fraction. Methods. Out of 26 consecutive patients who had received CT-on-rails IGRT to the lung from 2004 to 2008, 18 were selected because they had lung lesions that could be easily distinguished. The time course of the tumor volume for each patient was individually analyzed using a computer program. Results. The model fits of group L (conventional fractionation patients were very close to experimental data, with a median Δ% (average percent difference between data and fit of 5.1% (range 3.5–10.2%. The fits obtained in group S (hypofractionation patients were generally good, with a median Δ% of 7.2% (range 3.7–23.9% for the best fitting model. Four types of tumor responses were observed—Type A: “high” kill and “slow” dying rate; Type B: “high” kill and “fast” dying rate; Type C: “low” kill and “slow” dying rate; and Type D: “low” kill and “fast” dying rate. Conclusions. The models used in this study performed well in fitting the available dataset. The models provided useful insights into the possible underlying mechanisms responsible for the RT tumor volume response.

  14. Factors influencing liver and spleen volume changes after donor hepatectomy for living donor liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Ji Hee; Ryeom, Hunku; Song, Jung Hup [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2013-11-15

    To define the changes in liver and spleen volumes in the early postoperative period after partial liver donation for living-donor liver transplantation (LDLT) and to determine factors that influence liver and spleen volume changes. 27 donors who underwent partial hepatectomy for LDLT were included in this study. The rates of liver and spleen volume change, measured with CT volumetry, were correlated with several factors. The analyzed factors included the indocyanine green (ICG) retention rate at 15 minutes after ICG administration, preoperative platelet count, preoperative liver and splenic volumes, resected liver volume, resected-to-whole liver volume ratio (LV{sub R}/LV{sub W}), resected liver volume to the sum of whole liver and spleen volume ratio [LV{sub R}/(LV{sub W} + SV{sub 0})], and pre and post hepatectomy portal venous pressures. In all hepatectomy donors, the volumes of the remnant liver and spleen were increased (increased rates, 59.5 ± 50.5%, 47.9 ± 22.6%). The increment rate of the remnant liver volume revealed a positive correlation with LV{sub R}/LV{sub W} (r = 0.759, p < 0.01). The other analyzed factors showed no correlation with changes in liver and spleen volumes. The spleen and remnant liver volumes were increased at CT volumetry performed 2 weeks after partial liver donation. Among the various analyzed factors, LV{sub R}/LV{sub W} influences the increment rate of the remnant liver volume.

  15. Semiautomatic methods for segmentation of the proliferative tumour volume on sequential FLT PET/CT images in head and neck carcinomas and their relation to clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Arens, Anne I.J.; Grootjans, Willem; Oyen, Wim J.G.; Visser, Eric P. [Radboud University Medical Center, Department of Nuclear Medicine, P.O. Box 9101, Nijmegen (Netherlands); Troost, Esther G.C. [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands); Maastricht University Medical Centre, MAASTRO clinic, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Hoeben, Bianca A.W.; Bussink, Johan; Kaanders, Johannes H.A.M. [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands); Lee, John A.; Gregoire, Vincent [St-Luc University Hospital, Department of Radiation Oncology, Universite Catholique de Louvain, Brussels (Belgium); Hatt, Mathieu; Visvikis, Dimitris [Laboratoire de Traitement de l' Information Medicale (LaTIM), INSERM UMR1101, Brest (France)

    2014-05-15

    Radiotherapy of head and neck cancer induces changes in tumour cell proliferation during treatment, which can be depicted by the PET tracer {sup 18}F-fluorothymidine (FLT). In this study, three advanced semiautomatic PET segmentation methods for delineation of the proliferative tumour volume (PV) before and during (chemo)radiotherapy were compared and related to clinical outcome. The study group comprised 46 patients with 48 squamous cell carcinomas of the head and neck, treated with accelerated (chemo)radiotherapy, who underwent FLT PET/CT prior to treatment and in the 2nd and 4th week of therapy. Primary gross tumour volumes were visually delineated on CT images (GTV{sub CT}). PVs were visually determined on all PET scans (PV{sub VIS}). The following semiautomatic segmentation methods were applied to sequential PET scans: background-subtracted relative-threshold level (PV{sub RTL}), a gradient-based method using the watershed transform algorithm and hierarchical clustering analysis (PV{sub W} and {sub C}), and a fuzzy locally adaptive Bayesian algorithm (PV{sub FLAB}). Pretreatment PV{sub VIS} correlated best with PV{sub FLAB} and GTV{sub CT}. Correlations with PV{sub RTL} and PV{sub W} and {sub C} were weaker although statistically significant. During treatment, the PV{sub VIS}, PV{sub W} and {sub C} and PV{sub FLAB} significant decreased over time with the steepest decline over time for PV{sub FLAB}. Among these advanced segmentation methods, PV{sub FLAB} was the most robust in segmenting volumes in the third scan (67 % of tumours as compared to 40 % for PV{sub W} and {sub C} and 27 % for PV{sub RTL}). A decrease in PV{sub FLAB} above the median between the pretreatment scan and the scan obtained in the 4th week was associated with better disease-free survival (4 years 90 % versus 53 %). In patients with head and neck cancer, FLAB proved to be the best performing method for segmentation of the PV on repeat FLT PET/CT scans during (chemo)radiotherapy. This may

  16. Improved CT-based estimate of pulmonary gas trapping accounting for scanner and lung-volume variations in a multicenter asthmatic study.

    Science.gov (United States)

    Choi, Sanghun; Hoffman, Eric A; Wenzel, Sally E; Castro, Mario; Lin, Ching-Long

    2014-09-15

    Lung air trapping is estimated via quantitative computed tomography (CT) using density threshold-based measures on an expiration scan. However, the effects of scanner differences and imaging protocol adherence on quantitative assessment are known to be problematic. This study investigates the effects of protocol differences, such as using different CT scanners and breath-hold coaches in a multicenter asthmatic study, and proposes new methods that can adjust intersite and intersubject variations. CT images of 50 healthy subjects and 42 nonsevere and 52 severe asthmatics at total lung capacity (TLC) and functional residual capacity (FRC) were acquired using three different scanners and two different coaching methods at three institutions. A fraction threshold-based approach based on the corrected Hounsfield unit of air with tracheal density was applied to quantify air trapping at FRC. The new air-trapping method was enhanced by adding a lung-shaped metric at TLC and the lobar ratio of air-volume change between TLC and FRC. The fraction-based air-trapping method is able to collapse air-trapping data of respective populations into distinct regression lines. Relative to a constant value-based clustering scheme, the slope-based clustering scheme shows the improved performance and reduced misclassification rate of healthy subjects. Furthermore, both lung shape and air-volume change are found to be discriminant variables for differentiating among three populations of healthy subjects and nonsevere and severe asthmatics. In conjunction with the lung shape and air-volume change, the fraction-based measure of air trapping enables differentiation of severe asthmatics from nonsevere asthmatics and nonsevere asthmatics from healthy subjects, critical for the development and evaluation of new therapeutic interventions.

  17. Delay-sensitive and delay-insensitive deconvolution perfusion-CT: similar ischemic core and penumbra volumes if appropriate threshold selected for each

    Energy Technology Data Exchange (ETDEWEB)

    Man, Fengyuan [Capital Medical University, Department of Radiology, Beijing Tongren Hospital, Beijing (China); University of Virginia, Department of Radiology, Neuroradiology Division, Charlottesville, VA (United States); Patrie, James T.; Xin, Wenjun [University of Virginia, Department of Public Health Sciences, Charlottesville, VA (United States); Zhu, Guangming [University of Virginia, Department of Radiology, Neuroradiology Division, Charlottesville, VA (United States); Military General Hospital of Beijing PLA, Department of Neurology, Beijing (China); Hou, Qinghua [University of Virginia, Department of Radiology, Neuroradiology Division, Charlottesville, VA (United States); The Second Affiliated Hospital of Guangzhou Medical University, Department of Neurology, Guangzhou (China); Michel, Patrik; Eskandari, Ashraf [Centre Hospitalier Universitaire Vaudois, Department of Neurology, Lausanne (Switzerland); Jovin, Tudor [University of Pittsburgh, Department of Neurology, Pittsburgh, PA (United States); Xian, Junfang; Wang, Zhenchang [Capital Medical University, Department of Radiology, Beijing Tongren Hospital, Beijing (China); Wintermark, Max [University of Virginia, Department of Radiology, Neuroradiology Division, Charlottesville, VA (United States); Centre Hospitalier Universitaire Vaudois, Department of Radiology, Lausanne (Switzerland); Stanford University, Department of Radiology, Neuroradiology Division, Stanford, CA (United States)

    2015-03-07

    Perfusion-CT (PCT) processing involves deconvolution, a mathematical operation that computes the perfusion parameters from the PCT time density curves and an arterial curve. Delay-sensitive deconvolution does not correct for arrival delay of contrast, whereas delay-insensitive deconvolution does. The goal of this study was to compare delay-sensitive and delay-insensitive deconvolution PCT in terms of delineation of the ischemic core and penumbra. We retrospectively identified 100 patients with acute ischemic stroke who underwent admission PCT and CT angiography (CTA), a follow-up vascular study to determine recanalization status, and a follow-up noncontrast head CT (NCT) or MRI to calculate final infarct volume. PCT datasets were processed twice, once using delay-sensitive deconvolution and once using delay-insensitive deconvolution. Regions of interest (ROIs) were drawn, and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) in these ROIs were recorded and compared. Volume and geographic distribution of ischemic core and penumbra using both deconvolution methods were also recorded and compared. MTT and CBF values are affected by the deconvolution method used (p < 0.05), while CBV values remain unchanged. Optimal thresholds to delineate ischemic core and penumbra are different for delay-sensitive (145 % MTT, CBV 2 ml x 100 g{sup -1} x min{sup -1}) and delay-insensitive deconvolution (135 % MTT, CBV 2 ml x 100 g{sup -1} x min{sup -1} for delay-insensitive deconvolution). When applying these different thresholds, however, the predicted ischemic core (p = 0.366) and penumbra (p = 0.405) were similar with both methods. Both delay-sensitive and delay-insensitive deconvolution methods are appropriate for PCT processing in acute ischemic stroke patients. The predicted ischemic core and penumbra are similar with both methods when using different sets of thresholds, specific for each deconvolution method. (orig.)

  18. CT classification of acetabular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Marincek, B.; Porcellini, B.; Robotti, G.

    1984-05-01

    The contribution of computed tomography (CT) in classifying acetabular fractures was analysed retrospectively in 33 cases. CT and plain radiography classification agreed in 27 cases (82%). CT revealed more extensive fractures in 6 patients (thereof 5 patients with associated fractures). In 10 patients (thereof 9 patients with associated fractures) CT showed intraarticular fragments; radiographically intraarticular fragments were seen only in 2 patients and suspected in 4. CT is of considerable aid in defining the fracture pattern. It should be used mainly in patients with radiographically difficult interpretable associated fractures in order to assess preoperatively the weight-bearing part of the acetabulum, the degree of displacement and the presence of intraarticular fragments.

  19. Automatic extraction of forward stroke volume using dynamic PET/CT: a dual-tracer and dual-scanner validation in patients with heart valve disease

    OpenAIRE

    Harms, Hendrik Johannes; Tolbod, Lars Poulsen; Hansson, Nils Henrik Stubkjær; Kero, Tanja; Örndahl, Lovisa Holm; Kim, Won Yong; Bjerner, Tomas; Bouchelouche, Kirsten; Wiggers, Henrik; Frøkiær, Jørgen; Sörensen, Jens

    2015-01-01

    BACKGROUND: The aim of this study was to develop and validate an automated method for extracting forward stroke volume (FSV) using indicator dilution theory directly from dynamic positron emission tomography (PET) studies for two different tracers and scanners. METHODS: 35 subjects underwent a dynamic (11)C-acetate PET scan on a Siemens Biograph TruePoint-64 PET/CT (scanner I). In addition, 10 subjects underwent both dynamic (15)O-water PET and (11)C-acetate PET scans on a GE Discovery-ST PET...

  20. 高分辨率螺旋CT及X射线检查对多导人工耳蜗植入术前患者选择及术后效果评估的价值%Significance of high-resolution spiral CT and X-ray examination in the evaluation of preoperative selection and postoperative outcome of patients with multichannel cochlear implantation

    Institute of Scientific and Technical Information of China (English)

    徐学东

    2005-01-01

    BACKGROUND:Artificial electronic cochlear (AEC) is a high-tech product used as a therapeutic substitute for pathological cochlear, and the implantative state of AEC can be assessed with the aid of imaging techniques.OBJECTIVE: To investigate the significance of CT and X-ray examination in the evaluation of preoperative selection and postoperative therapeutic result of patients with AEC implantation.DESIGN: Self-control observaton.SETTING:Auditory Rebuilding Ward of Otolaryngology Department, Zhujiang Hospital, Southern Medical University.PARTICIPANTS:Forty-four patients prepared for AEC implantation because of severe sensorineural hearing loss or extremely severer sensorineural hearing loss were recruited from the Otolaryngological Department, Zhujiang Hospital, Southern Medical University from January 1999 to June 2003.Thirty-two patients were with prespeech hearing loss, aged 2.5-12 and 12patients with postspeech hearing loss, aged 10-42.METHODS: Axial high-resolution temporal bone CT and three-dimensional reconstruction of inner ear were performed on 44 patients. They lay in supine position and received bilateral symmetric scanning with view of 9.6 cm. The baseline was set at the level of upper limit of auditory frame, and temporal bone was axially scanned. The scanning parameters were:thickness of 1 mm,spiral distance of 1.0 and interval of 0.5 mm; inserting rebuilding was performed after scanning with thickness of 1mm and interval of 0.1 mm. The improved routine cochlear axial stenves-X-ray image was performed after operation, and three patients underwent spiral CT temporal volume scanning due to suspicious postoperative complications.Postoperative inner ear and the arrangement and depth of implanted AEC.RESULTS: Totally 44 patients were remained in the result analysis perstructure: Of the 32 patients with prespeech deafness, 1 case (2 ears) was diagnosed as type Ⅰ Mondini malformation and 2 cases (4 ears) as type ⅡMondini malformation. Of the 12 patients

  1. Target volume delimitation with PET-CT in radiotherapy planning: A GDCM and ROOT based software implementation

    OpenAIRE

    Amaya Espinosa, Helman Alirio

    2014-01-01

    Un algoritmo computacional basado en detector de bordes de Canny, fue desarrollado para ser utilizado en procesamiento de imágenes de PET-CT y CT. Este algoritmo es un software construído con librerías de ROOT y GDCM. GDCM y ROOT son frameworks desarrollados por el CERN, y están licenciados como software libre. El software desarrollado mostró una mejor delimitación de una región de hiper-captación simulada con un Phantom de Agar, que el método de thresholding, siendo aplicados ...

  2. CT images of gossypiboma

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hae Jeong; Lim, Jong Nam; Choi, Young Chil; Park, Jeong Hee [College of Medicine, Kon-Kuk University, Seoul (Korea, Republic of)

    1994-04-15

    Surgical sponges retained after laparotomy can cause serious problem if they were not be identified in early state. In these circumstances abdominal CT yields the accurate diagnostic images. The purpose of this report is to present highly indicative findings permitting correct preoperative diagnosis of the gossypiboma. We experienced three cases in which CT showed the images sufficiently characteristic to suggest the correct preoperative diagnosis. We evaluated retrospectively the radiological images of gossypiboma confirmed by operation. Three patients were admitted due to palpable masses. Two female patients had medical histories of cesarean sections and a male patient had been operated due to malignant fibrous histiocytoma, previously. Abdominal CT scan of one case revealed huge ovoid hypodense mass with enhanced peripheral rim. Calcific spots and whirl-like stripes were noted within the lesion. Towel was found in pathologic specimen. CT images of two patients showed well-encapsulated, mixed fluid and soft tissue density mass with several gas bubbles. Surgical sponges were found within abscesses. The authors conclude that these characteristic CT findings and careful histories of surgery are very useful for correct pre-operative diagnosis and permit the guideline for the optimal plan of the surgical treatment.

  3. Clinical significance of CT-defined minimal ascites in patients with gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Dong Kyung Chang; Ji Won Kim; Byung Kwan Kim; Kook Lae Lee; Chi Sung Song; Joon Koo Han; In Sung Song

    2005-01-01

    AIM: To study the clinical significance of minimal ascites,which was only defined by the CT and whose nature was not determined preoperatively, in the relationship with the peritoneal carcinomatosis.METHODS: The medical records and the dynamic CT films of 118 patients with gastric cancer were reviewed.Factors associated with peritoneal carcinomatosis were analyzed in 40 patients who had CT-defined ascites of which the nature was surgically confirmed.RESULTS: Only 12.5-25% of the CT-defined minimal ascites, whose volume was estimated to be less than 50 mL, were associated with peritoneal carcinomatosis.When the estimated CT-defined ascitic volume was 50 mL or more, peritoneal carcinomatosis was identified in 75-100%. When CT-defined lymph node enlargements were not found beyond the regional gastric area,perigastricinvasions were not suspected, and the size of tumor was less than 3 cm, peritoneal carcinomatosis seemed significantly less accompanied at the univariate analysis. However, except for the minimal volume of CTdefined ascites in comparison with the mild or more,other factors were not confirmed multivariately.CONCLUSION: In the patients with gastric cancer, CTdefined minimal ascites alone is rarely associated with peritoneal carcinomatosis, if it does not accompany other signs suggestive of malignant seeding. Therefore,consideration of active curative resection should not be hesitated, if CT-defined minimal ascites is the only delusive sign.

  4. Cervical CT derived neck fat tissue distribution differences in Japanese males and females and its effect on retroglossal and retropalatal airway volume

    Science.gov (United States)

    Shigeta, Yuko; Enciso, Reyes; Ogawa, Takumi; Ikawa, Tomoko; Clark, Glenn T

    2008-01-01

    Objective To investigate the difference of neck fat tissue distribution by sex and its correlation with retropalatal and retroglossal airway. Study Design 38 consecutive patients (Male:19;Female:19) who received a CT scan were compared in the retroglossal region and at the narrowest cross-section of the airway. Retroglossal fat tissue volume (FV) was segmented with Amira software and separated into subcutaneous and internal fat volume (SFV, IFV). These volumes were normalized by retroglossal neck volume (NV). Results Men had 51.9% more IFV/NV and 64.4% less SFV/NV compared to the women. Age-adjusted BMI was negatively correlated with retroglossal airway volume (normalized by NV) and with the lateral width of the smallest cross-section airway (LW) in females. In males the IFV/NV was negatively correlated with LW, after adjusting for BMI and age. Conclusion Upper airway collapsibility analysis is needed to rule out whether increased BMI or IFV causes an increase in airway collapsibility. PMID:18554948

  5. 320层容积CT心肌灌注成像对心肌灌注缺损的诊断价值%Detection of myocardial perfusion defect with 320-row volume CT myocardial perfusion imaging

    Institute of Scientific and Technical Information of China (English)

    张传臣; 张兆琪; 王蒨; 徐磊; 于薇; 焦健; 王瑞

    2012-01-01

    目的 探讨320层容积CT心肌灌注成像(CT-MPI)的可行性及其对心肌灌注缺损的诊断价值.方法 对14例经SPECT心肌灌注成像(SPECT-MPI)阳性的已知或可疑冠心病患者行静息和腺苷负荷320层容积CT-MPI检查,使用专用心肌灌注软件对CT-MPI进行分析.以心肌16节段标准分段方法(心尖除外)分别分析核素和容积CT-MPI的固定或可逆性灌注缺损.以SPECT-MPI为参考标准评价CT-MPI对心肌灌注缺损诊断的敏感度、特异度.结果 所有患者均成功完成320层容积CT-MPI.SPECT-MPI显示14例患者中共有39段心肌出现固定或可逆性灌注缺损,CT-MPI正确显示了其中12例患者的34段心肌灌注缺损.320层容积CT-MPI诊断心肌灌注缺损的敏感度、特异度分别为87.2%( 34/39)和91.4%(169/185).结论 320层容积CT-MPI对诊断心肌灌注缺损有较高的敏感度和特异度.%Objective To evaluate the feasibility of 320-row volume CT myocardial perfusion imaging (CT-MPI) in detecting myocardial perfusion defect.Methods Fourteen patients with positive single-positron emission computed tomography myocardial perfusion imaging (SPECT-MPI) findings underwent both rest and adenosine stress 320-row volume CT-MPI.Rest and stress CT perfusion images were analyzed by employing dedicated software in 320-row CT workstation.Both SPECT-MPI and CT-MPI were evaluated for fixed and reversible perfusion defects using a 16-segment model (apex was excluded).The sensitivity,specificity of 320-row volume CT-MPI in detecting myocardial perfusion defect were evaluated by taking SPECT-MPI as a reference standard.Results Both rest and stress 320-row volume CT-MPI were successfully performed in all patients.Thirty nine segments with fixed or reversible perfusion defects in all patients were depicted by SPECT-MPI,while 34 perfusion defects in 12 patients were identified by CT-MPI.The sensitivity,specificity of 320-row volume CT-MPI for detection of perfusion defects were 87.2

  6. Interscan reproducibility of quantitative coronary plaque volume and composition from CT coronary angiography using an automated method

    Energy Technology Data Exchange (ETDEWEB)

    Schuhbaeck, Annika; Achenbach, Stephan [University of Erlangen, Department of Cardiology, Erlangen (Germany); Dey, Damini [Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles (United States); Otaki, Yuka; Slomka, Piotr; Berman, Daniel S. [Cedars-Sinai Medical Center, Department of Imaging and Medicine, Los Angeles (United States); Kral, Brian G.; Lai, Shenghan [Johns Hopkins University, Department of Medicine, Devision of Cardiology, Baltimore (United States); Fishman, Elliott K.; Lai, Hong [Johns Hopkins University, Department of Medicine, Devision of Cardiology, Baltimore (United States); Johns Hopkins University, Department of Radiology, Baltimore (United States)

    2014-09-15

    Quantitative measurements of coronary plaque volume may play a role in serial studies to determine disease progression or regression. Our aim was to evaluate the interscan reproducibility of quantitative measurements of coronary plaque volumes using a standardized automated method. Coronary dual source computed tomography angiography (CTA) was performed twice in 20 consecutive patients with known coronary artery disease within a maximum time difference of 100 days. The total plaque volume (TP), the volume of non-calcified plaque (NCP) and calcified plaque (CP) as well as the maximal remodelling index (RI) were determined using automated software. Mean TP volume was 382.3 ± 236.9 mm{sup 3} for the first and 399.0 ± 247.3 mm{sup 3} for the second examination (p = 0.47). There were also no significant differences for NCP volumes, CP volumes or RI. Interscan correlation of the plaque volumes was very good (Pearson's correlation coefficients: r = 0.92, r = 0.90 and r = 0.96 for TP, NCP and CP volumes, respectively). Automated software is a time-saving method that allows accurate assessment of coronary atherosclerotic plaque volumes in coronary CTA with high reproducibility. With this approach, serial studies appear to be possible. (orig.)

  7. Analysis of Target Volume Definition Using CT, MRI and FDG-PET in Radiotherapy Treatment Planning of Anal Cancer

    DEFF Research Database (Denmark)

    Serup-Hansen, E.; Hendel, H. Westergreen; Johannesen, H. Hjorth;

    2012-01-01

    and MRI. The delineations of GTV were done twice for each imaging modality with a minimum of 3 months in between. Delineations on the CT and MRI were done by routine methods. For the PET part three different cut-off values were used: SUV 2.5, 40% and 50% of maximum SUV, respectively. The GTVs were...

  8. Assessment of dedicated low-dose cardiac micro-CT reconstruction algorithms using the left ventricular volume of small rodents as a performance measure

    Energy Technology Data Exchange (ETDEWEB)

    Maier, Joscha, E-mail: joscha.maier@dkfz.de [Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Sawall, Stefan; Kachelrieß, Marc [Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany and Institute of Medical Physics, University of Erlangen–Nürnberg, 91052 Erlangen (Germany)

    2014-05-15

    Purpose: Phase-correlated microcomputed tomography (micro-CT) imaging plays an important role in the assessment of mouse models of cardiovascular diseases and the determination of functional parameters as the left ventricular volume. As the current gold standard, the phase-correlated Feldkamp reconstruction (PCF), shows poor performance in case of low dose scans, more sophisticated reconstruction algorithms have been proposed to enable low-dose imaging. In this study, the authors focus on the McKinnon-Bates (MKB) algorithm, the low dose phase-correlated (LDPC) reconstruction, and the high-dimensional total variation minimization reconstruction (HDTV) and investigate their potential to accurately determine the left ventricular volume at different dose levels from 50 to 500 mGy. The results were verified in phantom studies of a five-dimensional (5D) mathematical mouse phantom. Methods: Micro-CT data of eight mice, each administered with an x-ray dose of 500 mGy, were acquired, retrospectively gated for cardiac and respiratory motion and reconstructed using PCF, MKB, LDPC, and HDTV. Dose levels down to 50 mGy were simulated by using only a fraction of the projections. Contrast-to-noise ratio (CNR) was evaluated as a measure of image quality. Left ventricular volume was determined using different segmentation algorithms (Otsu, level sets, region growing). Forward projections of the 5D mouse phantom were performed to simulate a micro-CT scan. The simulated data were processed the same way as the real mouse data sets. Results: Compared to the conventional PCF reconstruction, the MKB, LDPC, and HDTV algorithm yield images of increased quality in terms of CNR. While the MKB reconstruction only provides small improvements, a significant increase of the CNR is observed in LDPC and HDTV reconstructions. The phantom studies demonstrate that left ventricular volumes can be determined accurately at 500 mGy. For lower dose levels which were simulated for real mouse data sets, the

  9. Dose reduction in dynamic perfusion CT of the brain: effects of the scan frequency on measurements of cerebral blood flow, cerebral blood volume, and mean transit time

    Energy Technology Data Exchange (ETDEWEB)

    Wiesmann, Martin [University of Munich, Department of Neuroradiology, Muenchen (Germany); Klinikum der Universitaet Muenchen - Grosshadern, Abteilung fuer Neuroradiologie, Muenchen (Germany); Berg, Scott; Stoeckelhuber, B.M. [University of Luebeck, Department of Radiology, Luebeck (Germany); Bohner, G.; Klingebiel, R. [University Medicine Berlin, Department of Neuroradiology, Charite, Berlin (Germany); Schoepf, V.; Yousry, I.; Linn, J. [University of Munich, Department of Neuroradiology, Muenchen (Germany); Missler, U. [Evangelisches Krankenhaus Duisburg-Nord, Department of Neuroradiology, Duisburg (Germany)

    2008-12-15

    The influence of the frequency of computed tomography (CT) image acquistion on the diagnostic quality of dynamic perfusion CT (PCT) studies of the brain was investigated. Eight patients with clinically suspected acute ischemia of one hemisphere underwent PCT, performed on average 3.4 h after the onset of symptoms. Sixty consecutive images per slice were obtained with individual CT images obtained at a temporal resolution of two images per second. Eight additional data sets were reconstructed with temporal resolutions ranging from one image per second to one image per 5 s. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) measurements were performed in identical regions of interest. Two neuroradiologists evaluated the PCT images visually to identify areas of abnormal perfusion. Perfusion images created up to a temporal resolution of one image per 3 s were rated to be diagnostically equal to the original data. Even at one image per 4 s, all areas of infarction were identified. Quantitative differences of CBF, CBV and MTT measurements were {<=}10% up to one image per 3 s. For PCT of the brain, temporal resolution can be reduced to one image per 3 s without significant compromise in image quality. This significantly reduces the radiation dose of the patient. (orig.)

  10. Whole-organ perfusion of the pancreas using dynamic volume CT in patients with primary pancreas carcinoma: acquisition technique, post-processing and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Kandel, Sonja; Kloeters, Christian; Meyer, Henning; Hein, Patrick; Rogalla, Patrik [Charite - Universitaetsmedizin Berlin, Department of Radiology, Campus Charite Mitte, Berlin (Germany); Hilbig, Andreas [Charite - University Medicine, Medical Clinic III - Hematology and Oncology, Campus Virchow Klinikum, Berlin (Germany)

    2009-11-15

    The purpose of this study was to evaluate a whole-organ perfusion protocol of the pancreas in patients with primary pancreas carcinoma and to analyse perfusion differences between normal and diseased pancreatic tissue. Thirty patients with primary pancreatic malignancy were imaged on a 320-slice CT unit. Twenty-nine cancers were histologically proven. CT data acquisition was started manually after contrast-material injection (8 ml/s, 350 mg iodine/ml) and dynamic density measurements in the right ventricle. After image registration, perfusion was determined with the gradient-relationship technique and volume regions-of-interest were defined for perfusion measurements. Contrast time-density curves and perfusion maps were generated. Statistical analysis was performed using the Kolmogorov-Smirnov test for analysis of normal distribution and Kruskal-Wallis test (nonparametric ANOVA) with Bonferroni correction for multiple stacked comparisons. In all 30 patients the entire pancreas was imaged, and registration could be completed in all cases. Perfusion of pancreatic carcinomas was significantly lower than of normal pancreatic tissue (P < 0.001) and could be visualized on colored perfusion maps. The 320-slice CT allows complete dynamic visualization of the pancreas and enables calculation of whole-organ perfusion maps. Perfusion imaging carries the potential to improve detection of pancreatic cancers due to the perfusion differences. (orig.)

  11. Volume perfusion CT (VPCT) for the differential diagnosis of patients with suspected cerebral vasospasm: Qualitative and quantitative analysis of 3D parameter maps

    Energy Technology Data Exchange (ETDEWEB)

    Dolatowski, K., E-mail: karoline.dolatowski@gmail.com [Department of Neuroradiology, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Malinova, V., E-mail: vesna.malinova@gmail.com [Department of Neurosurgery, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Frölich, A.M.J., E-mail: a.froelich@gmail.com [Department of Neuroradiology, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Schramm, R., E-mail: ramona.schramm@med.uni-goettingen.de [Department of Neuroradiology, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Haberland, U., E-mail: ulrike.haberland@siemens.com [Siemens AG, Healthcare Sector, Computed Tomography, H IM CR R and D PA SC, Siemensstr. 1, 91301 Forchheim (Germany); Klotz, E., E-mail: ernst.klotz@siemens.com [Siemens AG, Healthcare Sector, Computed Tomography, H IM CR R and D PA SC, Siemensstr. 1, 91301 Forchheim (Germany); Mielke, D., E-mail: dorothee.wachter@med.uni-goettingen.de [Department of Neurosurgery, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Knauth, M., E-mail: michael.knauth@med.uni-goettingen.de [Department of Neuroradiology, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Schramm, P., E-mail: Peter.Schramm@uksh.de [Department of Neuroradiology, UKSH University hospital Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany)

    2014-10-15

    Object: Cerebral vasospasm (CV) following subarachnoid hemorrhage (SAH) implies high risk for secondary ischemia. It requires early diagnosis to start treatment on time. We aimed to assess the utility of “whole brain” VPCT for detecting localization and characteristics of arterial vasospasm. Methods: 23 patients received a non-enhanced CT, VPCT and CTA of the brain. The distribution of ischemic lesions was analyzed on 3D-perfusion-parameter-maps of CBF, CBV, MTT, TTS, TTP, and TTD. CT-angiographic axial and coronal maximum-intensity-projections were reconstructed to determine arterial vasospasm. CT-data was compared to DSA, if performed additionally. Volume-of-interest placement was used to obtain quantitative mean VPCT values. Results: 82% patients (n = 19) had focal cerebral hypoperfusion. 100% sensitivity and 100% specificity was found for TTS (median 1.9 s), MTT (median 5.9 s) and TTD (median 7.6 s). CBV showed no significant differences. In 78% (n = 18) focal vessel aberrations could be detected either on CTA or DSA or on both. Conclusion: VPCT is a non-invasive method with the ability to detect focal perfusion deficits almost in the whole brain. While DSA remains to be the gold standard for detection of CV, VPCT has the potential to improve noninvasive diagnosis and treatment decisions.

  12. Prognostic significance of standardized uptake value and metabolic tumour volume on {sup 18}F-FDG PET/CT in oropharyngeal squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Won; Roh, Jong-Lyel; Choi, Seung-Ho; Nam, Soon Yuhl [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Centre, Seoul (Korea, Republic of); Oh, Jungsu S.; Kim, Jae Seung [University of Ulsan College of Medicine, Department of Nuclear Medicine, Asan Medical Centre, Seoul (Korea, Republic of); Kim, Sang Yoon [University of Ulsan College of Medicine, Department of Otolaryngology, Asan Medical Centre, Seoul (Korea, Republic of); Biomedical Research Institute, Korea Institute of Science and Technology, Seoul (Korea, Republic of)

    2015-08-15

    Standardized uptake value (SUV) and metabolic tumour volume (MTV) measured by {sup 18}F-FDG PET/CT are emerging prognostic biomarkers in human solid cancers. However, their prognostic significance in oropharyngeal squamous cell carcinoma (OPSCC) has been investigated in only a few studies and with small cohorts. In the present study we evaluated the ability of SUV, MTV, and total lesion glycolysis (TLG) measured on pretreatment {sup 18}F-FDG PET/CT to predict recurrence and survival outcomes in OPSCC. The study included 221 patients with OPSCC who underwent pretreatment {sup 18}F-FDG PET/CT imaging and received definitive treatment at our tertiary referral centre. The PET imaging parameters SUV{sub max}, SUV{sub peak}, MTV and TLG were measured in primary tumours with focal {sup 18}F-FDG uptake. Clinical and imaging variables significantly associated with overall survival (OS) and disease-free survival (DFS) were identified by univariate and multivariate analyses using the Cox proportional hazards model. Overall 5-year OS and DFS rates were 72.0 % and 79.5 %, respectively, during a median follow-up of 61 months (range 18 - 122 months). The cut-off values of tumour SUV{sub max}, SUV{sub peak}, MTV and TLG for prediction of DFS were 7.55, 6.80, 11.06 mL and 78.56 g, respectively. Univariate analyses showed that age >60 years, advanced tumour stage, and high tumour SUV{sub max}, SUV{sub peak}, MTV and TLG were significantly associated with decreased OS and DFS (P < 0.05 each). Age, tumour SUV{sub max} and MTV remained independent variables for OS and DFS (P < 0.05 each) in the multivariate analyses. SUV{sub max} and MTV measured on pretreatment {sup 18}F-FDG PET/CT may be useful in predicting the clinical outcomes in OPSCC patients. This study investigated the clinical prognostic value of imaging parameters from pretreatment {sup 18}F-FDG PET/CT in 221 patients who underwent definitive treatment for oropharyngeal squamous cell carcinoma. High maximum standardized

  13. Non-destructive, preclinical evaluation of root canal anatomy of human teeth with flat-panel detector volume CT (FD-VCT); Zerstoerungsfreie praeklinische Evaluation der Wurzelkanalanatomie menschlicher Zaehne mittels Flaechendetektor-Volumen-CT (FD-VCT)

    Energy Technology Data Exchange (ETDEWEB)

    Heidrich, G.; Hassepass, F.; Dullin, C.; Grabbe, E. [Universitaetsklinikum Goettingen, Abt. Diagnostische Radiologie (Germany); Attin, T.; Hannig, C. [Universitaetsklinikum Goettingen, Abt. fuer Zahnerhaltung, Praeventive Zahnheilkunde und Paradontologie (Germany)

    2005-12-15

    Purpose: Successful endodontic diagnostics and therapy call for adequate depiction of the root canal anatomy with multimodal diagnostic imaging. The aim of the present study is to evaluate visualization of the endodont with flat-panel detector volume CT (FD-VCT). Materials and methods: 13 human teeth were examined with the prototype of a FD-VCT. After data acquisition and generation of volume data sets in volume rendering technology (VRT), the findings obtained were compared to conventional X-rays and cross-section preparations of the teeth. Results: The anatomical structures of the endodont such as root canals, side canals and communications between different root canals as well as dentricles could be detected precisely with FD-VCT. The length of curved root canals was also determined accurately. The spatial resolution of the system is around 140 {mu}m. Only around 73% of the main root canals detected with FD-VCT and 87% of the roots could be visualized with conventional dental X-rays. None of the side canals, shown with FD-VCT, was detectable on conventional X-rays. In all cases the enamel and dentin of the teeth could be well delineated. No differences in image quality could be discerned between stored and freshly extracted teeth, or between primary and adult teeth. (orig.)

  14. Semiautomatic technique for defining the internal gross tumor volume of lung tumors close to liver/spleen cupola by 4D-CT

    Energy Technology Data Exchange (ETDEWEB)

    Mancosu, Pietro; Sghedoni, Roberto; Bettinardi, Valentino; Aquilina, Mark Anthony; Navarria, Piera; Cattaneo, Giovanni Mauro; Di Muzio, Nadia; Cozzi, Luca; Scorsetti, Marta [Department of Radiotherapy, IRCCS Istituto Clinico Humanitas, Rozzano, 20089 Milano (Italy); Department of Medical Physics, Arcispedale S. Maria Nuova, Reggio, 42100 Emilia (Italy); Department of Nuclear Medicine, Scientific Institute H. S. Raffaele, 20089 Milan (Italy); Department of Radiotherapy, IRCCS Istituto Clinico Humanitas, 20089 Rozzano, Milano (Italy); Department of Medical Physics, San Raffaele Scientific Institute, 20133 Milan (Italy); Department of Radiotherapy, San Raffaele Scientific Institute, 20133 Milan (Italy); Medical Physics Unit, Oncology Institute of Southern Switzerland, 6504 Bellinzona (Switzerland); Department of Radiotherapy, IRCCS Istituto Clinico Humanitas, 20089 Rozzano, Milano (Italy)

    2010-09-15

    Purpose: It has been shown that in cases of lung tumors close to the liver cupola, the four dimensional (4D)-CT postprocessing maximum intensity projection (MIP) algorithm does not fully recover the radiotherapy internal gross tumor volume (IGTV). In this work, a semiautomatic technique was evaluated by which the residual IGTV that was not included into the IGTV by MIP algorithm was actually added. Methods: A moving phantom and five selected patients were considered. The various IGTVs produced by the semiautomatic approach were compared to those generated by 4D-CT manual contouring. Results: In all cases, the radiation oncologist qualitatively concurred with the semiautomatic IGTV. A quantitative difference in volume of 2.6% was found in the phantom study, whereas a mean difference of 0.1{+-}4.6% was obtained in the patient studies. Conclusions: A semiautomatic technique to include the residual part of IGTV covered by liver/spleen cupola when using MIP algorithm was validated on phantom and on selected patients, revealing the possibility of defining the IGTV for patients with lesions located near liver/spleen cupola by performing only the contours on the MIP series.

  15. Estimation of non-solid lung nodule volume with low-dose CT protocols: effect of reconstruction algorithm and measurement method

    Science.gov (United States)

    Gavrielides, Marios A.; DeFilippo, Gino; Berman, Benjamin P.; Li, Qin; Petrick, Nicholas; Schultz, Kurt; Siegelman, Jenifer

    2017-03-01

    Computed tomography is primarily the modality of choice to assess stability of nonsolid pulmonary nodules (sometimes referred to as ground-glass opacity) for three or more years, with change in size being the primary factor to monitor. Since volume extracted from CT is being examined as a quantitative biomarker of lung nodule size, it is important to examine factors affecting the performance of volumetric CT for this task. More specifically, the effect of reconstruction algorithms and measurement method in the context of low-dose CT protocols has been an under-examined area of research. In this phantom study we assessed volumetric CT with two different measurement methods (model-based and segmentation-based) for nodules with radiodensities of both nonsolid (-800HU and -630HU) and solid (-10HU) nodules, sizes of 5mm and 10mm, and two different shapes (spherical and spiculated). Imaging protocols included CTDIvol typical of screening (1.7mGy) and sub-screening (0.6mGy) scans and different types of reconstruction algorithms across three scanners. Results showed that radio-density was the factor contributing most to overall error based on ANOVA. The choice of reconstruction algorithm or measurement method did not affect substantially the accuracy of measurements; however, measurement method affected repeatability with repeatability coefficients ranging from around 3-5% for the model-based estimator to around 20-30% across reconstruction algorithms for the segmentation-based method. The findings of the study can be valuable toward developing standardized protocols and performance claims for nonsolid nodules.

  16. Prognostic Value of Metabolic Tumor Volume Measured by {sup 18F} FDG PET/CT in Locally Advanced Head and Neck Squamous Cell Carcinomas Treated by Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Kyu Ho; Yoo, Ie Ryung; Han, Eun Ji; Kim, Yeon Sil; Kim, Gi Wom; Na, Sea Jung; Sun, Dong Il; Jung, So Lyung; Jung, Chan Kwon; Kim, Min Sik; Lee, So Yeon; Kim, Sung Hoon [The Cathholic Univ. of Korea, Seoul (Korea, Republic of)

    2011-03-15

    We assessed the prognostic value of metabolic tumor volume (MTV) measured using {sup 18F} fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) inpatients with locally advanced head and neck squamous cell carcinoma (HNSCC). We retrospectively reviewed 56 patients (51 men, five women; mean age 56.0{+-}8.8 years) who had locally advanced HNSCC and underwent FDG PET/CT for initial evaluation. All patients had surgical resection and radiotherapy with or without concurrent chemotherapy. The peak standardized uptake (SUV{sup peak)} and MTV of the target lesion, including primary HNSCC and metastatic cervical lymph nodes, were measured SUV{sup peak,} MTV, and clinico pathologic variables such as age, Eastern Cooperative Oncology Group (ECOG) performance status, pN stage, pT stage, TNM stage, histologic grade and treatment modality to disease free survival (DFS) and overall survival (OS). On the initial FDG PET/CT scans, the median SUV{sup peakw}as 7.8 (range, 1.8-19.0) and MTV was 17.0cm{sup 3(}range, 0.1-131.0cm{sup 3)}. The estimated 2 year DFS and OS rates were 67.2% and 81.8%. The cutoff points of SUV{sup peak6}.2 and MTV 20.7cm{sup 3w}ere the best discriminative values for predicting clinical outcome. MTV and ECOG performance status were significantly related to DFS and OS on univariate and multivariate analyses (P=0.05). The MTV obtained from initial FDG PET/CT scan is a significant prognostic factor for disease recurrence and mortality in locally advanced HNSCC treated with surgery and radiotherapy with or without chemotherapy.

  17. Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Yingru; Vliegenthart, Rozemarijn; Wang, Ying; Ooijen, Peter M.A. van; Oudkerk, Matthijs [University of Groningen/University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Department of Radiology, P.O. Box 30.001, Groningen (Netherlands); Bock, Geertruida H. de [University of Groningen/University Medical Center Groningen, Department of Epidemiology, P.O. Box 30.001, Groningen (Netherlands); Klaveren, Rob J. van [Lievensberg Hospital, Department of Pulmonology, P.O. Box 135, Bergen op Zoom (Netherlands); Bogoni, Luca [CAD Group, Siemens Medical Solutions USA, Inc., Malvern, PA (United States); Jong, Pim A. de; Mali, Willem P. [University of Utrecht, Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, Utrecht (Netherlands)

    2012-10-15

    To evaluate performance of computer-aided detection (CAD) beyond double reading for pulmonary nodules on low-dose computed tomography (CT) by nodule volume. A total of 400 low-dose chest CT examinations were randomly selected from the NELSON lung cancer screening trial. CTs were evaluated by two independent readers and processed by CAD. A total of 1,667 findings marked by readers and/or CAD were evaluated by a consensus panel of expert chest radiologists. Performance was evaluated by calculating sensitivity of pulmonary nodule detection and number of false positives, by nodule characteristics and volume. According to the screening protocol, 90.9 % of the findings could be excluded from further evaluation, 49.2 % being small nodules (less than 50 mm{sup 3}). Excluding small nodules reduced false-positive detections by CAD from 3.7 to 1.9 per examination. Of 151 findings that needed further evaluation, 33 (21.9 %) were detected by CAD only, one of them being diagnosed as lung cancer the following year. The sensitivity of nodule detection was 78.1 % for double reading and 96.7 % for CAD. A total of 69.7 % of nodules undetected by readers were attached nodules of which 78.3 % were vessel-attached. CAD is valuable in lung cancer screening to improve sensitivity of pulmonary nodule detection beyond double reading, at a low false-positive rate when excluding small nodules. circle Computer-aided detection (CAD) has known advantages for computed tomography (CT). (orig.)

  18. Impact of 18FDG-PET/CT on biological target volume (BTV) definition for treatment planning for non-small cell lung cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Devic, Slobodan [Medical Physics Department, McGill University Health Centre, Montreal, Que. (Canada)]. E-mail: devic@medphys.mcgill.ca; Tomic, Nada [Medical Physics Department, McGill University Health Centre, Montreal, Que. (Canada); Faria, Sergio [Radiation Oncology Department, McGill University Health Centre, Montreal, Que. (Canada); Dean, Geoffrey [Nuclear Medicine Department, McGill University Health Centre, Montreal, Que. (Canada); Lisbona, Robert [Nuclear Medicine Department, McGill University Health Centre, Montreal, Que. (Canada); Parker, William [Medical Physics Department, McGill University Health Centre, Montreal, Que. (Canada); Kaufman, Chris [Medical Physics Department, McGill University Health Centre, Montreal, Que. (Canada); Podgorsak, Ervin B. [Medical Physics Department, McGill University Health Centre, Montreal, Que. (Canada)

    2007-02-01

    This work represents our effort to test feasibility of FDG-based PET/CT on target volume delineation in radiotherapy treatment planning of NSCLC patients. Different methods have been developed to enable more precise target outlining using PET: Qualitative Visual Method, CTV=2.5 SUV units, linear SUV threshold function method, and CTV=40% Iso of Maximum Uptake Value. We are proposing reconstruction of three biological target volumes: necrotic BTV (same as PTV created by radiation oncologist using CT data), proliferating BTV (based on PET signal to background ratio 1:3) and hypoxic BTV (based on PET signal to background ratio of 1:19). Two IMRT plans were created and compared to the conventional treatment plan: 'conservative' IMRT plan delivers 52.5 Gy to the necrotic BTV and 65 Gy to the hypoxic BTV; 'radical' IMRT plan delivers 30 Gy to necrotic BTV, 52.5 Gy to proliferating BTV and 65 Gy to hypoxic BTV. Use of BTVs in IMRT plans is attractive because it increases dose to targets considered to need higher doses. It reduces considerably dose to heart and spinal cord, organs considered to limit dose escalation approaches in NSCLC treatment. 'Conservative' IMRT approach can be understood as a PET/CT-based concomitant boost to the tumor expressing the highest FDG uptake. 'Radical' plan implies deviation from the traditional uniform dose target coverage approach, with the intention of achieving better surrounding tissue sparing and ultimately allowing for dose escalation protocols relying on biologically based treatment planning.

  19. Progressive preoperative pneumoperitoneum preparation (the Goni Moreno protocol) prior to large incisional hernia surgery: volumetric, respiratory and clinical impacts. A prospective study.

    Science.gov (United States)

    Sabbagh, C; Dumont, F; Fuks, D; Yzet, T; Verhaeghe, P; Regimbeau, J-M

    2012-02-01

    Progressive preoperative pneumoperitoneum (PPP) is used to prepare incisional hernias with loss of domain (IHLD) operations. The aim of the present study was to analyze the effect of PPP on peritoneal volume [measured using a new computed tomography (CT)-based method] and respiratory function. From July 2004 to July 2008, 19 patients were included in a prospective, observational study. The volumes of the incisional hernia (VIH), the abdominal cavity (VAC), the total peritoneal content (VP) and the VIH/VP ratio were measured before and after PPP using abdominal CT scan data. Spirometric parameters were measured before and after PPP, and postoperative clinical data were evaluated. Before and after PPP, the mean VIH was 1,420 cc and 2,110 cc (P  VIH before PPP. After PPP, the spirometric measurements revealed a restrictive syndrome. The overall postoperative morbidity rate was 37%. PPP increased the hernia and abdominal volumes. PPP induced a progressive, restrictive syndrome.

  20. Defining the Most Accurate Measurable Dimension(s of the Liver in Predicting Liver Volume Based on CT Volumetery and Reconstruction

    Directory of Open Access Journals (Sweden)

    Reza Saadat Mostafavi

    2010-05-01

    Full Text Available Background/Objective: The presence of liver volume has a great effect on diagnosis and management of different diseases such as lymphoproliferative conditions. "nPatients and Methods: Abdominal CT scan of 100 patients without any findings for liver disease (in history and imaging was subjected to volumetry and reconstruction. Along with the liver volume, in axial series, the AP diameter of the left lobe (in midline and right lobe (mid-clavicular and lateral maximum diameter of the liver in the mid-axiliary line and maximum diameter to IVC were calculated. In the coronal mid-axillary and sagittal mid-clavicular plane, maximum superior-inferior dimensions were calculated with their various combinations (multiplying. Regression analysis between dimensions and volume were performed. "nResults: The most accurate combination was the superior inferior sagittal dimension multiplied by AP diameter of the right lobe (R squared 0.78, P-value<0.001 and the most solitary dimension was the lateral dimension to IVC in the axial plane (R squared 0.57, P-value<0.001 with an interval of 9-11cm for 68% of normal. "nConclusion: We recommend the lateral maximum diameter of liver from surface to IVC in the axial plane in ultrasound for liver volume prediction with an interval of 9-11cm for 68% of normal. Out of this range is regarded as abnormal.

  1. Subtraction-multiphase-CT unbeneficial for early detection of colorectal liver metastases

    Energy Technology Data Exchange (ETDEWEB)

    Meijerink, Martijn R., E-mail: mr.meijerink@vumc.n [Department of Radiology, Vrije Universiteit Medisch Centrum, Amsterdam (Netherlands); Waesberghe, Jan Hein T.M. van; Golding, Richard P. [Department of Radiology, Vrije Universiteit Medisch Centrum, Amsterdam (Netherlands); Weide, Lineke van der [Master of Oncology Program, Vrije Universiteit Medisch Centrum, Amsterdam (Netherlands); Tol, Petrousjka van den [Department of Surgical Oncology, Vrije Universiteit Medisch Centrum, Amsterdam (Netherlands); Meijer, Sybren [Master of Oncology Program, Vrije Universiteit Medisch Centrum, Amsterdam (Netherlands); Kuijk, Cornelis van [Department of Radiology, Vrije Universiteit Medisch Centrum, Amsterdam (Netherlands)

    2010-06-15

    Purpose: To assess the value of multiphase-subtraction-CT for early detection of colorectal-liver-metastases (CRLM). Methods and materials: In 50 patients suspected of CRLM a routine pre-operative 4-phase-CT-scan of the upper abdomen was obtained. All 12 possible image subtractions between two different phases were constructed applying 3D-image-registration to decrease distortion artefacts induced by differences in inspiration volume. Two experienced radiologists initially reviewed the conventional 4-phase-CT for malignant and/or benign appearing lesions and at least 1-month hereafter the same 4-phase-CT now including the subtracted images. The results were compared to histology reports or to a combination of surgical exploration and intraoperative ultrasound together with results from pre-operative PET and follow-up examinations. Results: Although an additional number of 31 malignant appearing lesions were detected on the subtraction images, none proved to represent a true CRLM. Interobserver agreement ({kappa}) decreased from 0.627 (good) to 0.418 (fair). Conclusion: Adding linearly co-registered subtraction-CT images to a conventional 4-phase-CT protocol does not improve detection of CRLM.

  2. Rigid Registration of Freehand 3D Ultrasound and CT-Scan Kidney Images

    CERN Document Server

    Leroy, A; Payan, Y; Troccaz, J; Leroy, Antoine; Mozer, Pierre; Payan, Yohan; Troccaz, Jocelyne

    2004-01-01

    This paper presents a method to register a preoperative CT volume to a sparse set of intraoperative US slices. In the context of percutaneous renal puncture, the aim is to transfer a planning information to an intraoperative coordinate system. The spatial position of the US slices is measured by localizing a calibrated probe. Our method consists in optimizing a rigid 6 degree of freedom (DOF) transform by evaluating at each step the similarity between the set of US images and the CT volume. The images have been preprocessed in order to increase the relationship between CT and US pixels. Correlation Ratio turned out to be the most accurate and appropriate similarity measure to be used in a Powell-Brent minimization scheme. Results are compared to a standard rigid point-to-point registration involving segmentation, and discussed.

  3. Perfusion CT in Colorectal Cancer: Comparison of Perfusion Parameters with Tumor Grade and Microvessel Density

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woong; Jeong, Yong Yeon; Chang, Nam Kyu; Heo, Suk Hee; Hur, Young Hoe; Kang, Heoung Keun [Chonnam National University Hwasun Hospital, Hwasun(Korea, Republic of); Shin, Sang Soo; Lee, Jae Hyuk [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2012-02-15

    The purpose of this study was to prospectively compare pre-operative computed tomography (CT) perfusion parameters with tumor grade from colorectal adenocarcinoma (CRC) and to correlate pre-operative CT perfusion parameters with microvessel density (MVD) to evaluate angiogenesis in CRC. Pre-operative perfusion CTs were performed with a 64-channel multidetector row CT in 27 patients (17 women and 10 men; age range 32-82 years) who were diagnosed with CRC involving the sigmoid and rectum between August 2006 and November 2007. All patients underwent surgery without pre-operative chemotherapy or radiation therapy. Dynamic perfusion CTs were performed for 65 seconds after intravenous injection of contrast medium (100 mL, 300 mg of iodine per mL, 5 mL/sec). Before surgery, blood flow (BF), blood volume, mean transit time (MTT), and permeability-surface area product were measured in the tumor. After surgery, one gastrointestinal pathologist evaluated tumor grade and performed immunohistochemical staining using CD 34 to determine MVD in each tumor. The Kruskal-Wallis test was used to compare CT perfusion parameters with tumor grade, and Pearson's correlation analysis was used to correlate CT perfusion parameters with MVD. In 27 patients with CRC, tumor grading was as follows: well differentiated (n = 8); moderately differentiated (n = 15); and poorly differentiated (n = 4). BF was higher in moderately differentiated CRC than well differentiated and poorly differentiated CRCs (p = 0.14). MTT was shorter in moderately differentiated than well differentiated and poorly differentiated CRCs (p = 0.039). The MVD was greater in poorly differentiated than well differentiated and moderately differentiated CRCs (p = 0.034). There was no significant correlation between other perfusion parameters and tumor grade. There was no significant correlation between CT perfusion parameters and MVD. BF and MTT measurement by perfusion CT is effective in predicting moderately differentiated CRCs

  4. Value of retrospective image fusion of {sup 18}F-FDG PET and MRI for preoperative staging of head and neck cancer: Comparison with PET/CT and contrast-enhanced neck MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kanda, Tomonori [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Department of Radiology, Hyogo Cancer Center, Hyogo (Japan); Kitajima, Kazuhiro, E-mail: kitajima@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Suenaga, Yuko; Konishi, Jyunya [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Sasaki, Ryohei [Division of Radiation Oncology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Morimoto, Koichi; Saito, Miki; Otsuki, Naoki; Nibu, Ken-ichi [Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan)

    2013-11-01

    Purpose: To assess the clinical value of retrospective image fusion of neck MRI and {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) PET for locoregional extension and nodal staging of neck cancer. Materials and methods: Thirty patients with carcinoma of the oral cavity or hypopharynx underwent PET/CT and contrast-enhanced neck MRI for initial staging before surgery including primary tumor resection and neck dissection. Diagnostic performance of PET/CT, MRI, and retrospective image fusion of PET and MRI (fused PET/MRI) for assessment of the extent of the primary tumor (T stage) and metastasis to regional lymph nodes (N stage) was evaluated. Results: Accuracy for T status was 87% for fused PET/MRI and 90% for MRI, thus proving significantly superior to PET/CT, which had an accuracy of 67% (p = 0.041 and p = 0.023, respectively). Accuracy for N status was 77% for both fused PET/MRI and PET/CT, being superior to MRI, which had an accuracy of 63%, although the difference was not significant (p = 0.13). On a per-level basis, the sensitivity, specificity and accuracy for detection of nodal metastasis were 77%, 96% and 93% for both fused PET/MRI and PET/CT, compared with 49%, 99% and 91% for MRI, respectively. The differences for sensitivity (p = 0.0026) and accuracy (p = 0.041) were significant. Conclusion: Fused PET/MRI combining the individual advantages of MRI and PET is a valuable technique for assessment of staging neck cancer.

  5. Combined use of positron emission tomography and volume doubling time in lung cancer screening with low-dose CT scanning

    DEFF Research Database (Denmark)

    Ashraf, H; Dirksen, A; Jakobsen, Annika Loft

    2011-01-01

    In lung cancer screening the ability to distinguish malignant from benign nodules is a key issue. This study evaluates the ability of positron emission tomography (PET) and volume doubling time (VDT) to discriminate between benign and malignant nodules....

  6. Volume-Based F-18 FDG PET/CT Imaging Markers Provide Supplemental Prognostic Information to Histologic Grading in Patients With High-Grade Bone or Soft Tissue Sarcoma

    DEFF Research Database (Denmark)

    Andersen, Kim Francis; Fuglo, Hanna Maria; Rasmussen, Sine Hvid;

    2015-01-01

    The aim of the study is to assess the prognostic value of different volume-based calculations of tumor metabolic activity in the initial assessment of patients with high-grade bone sarcomas (BS) and soft tissue sarcomas (STS) using F-18 FDG PET/CT.A single-site, retrospective study from 2002...... to 2012 including 92 patients with histologically verified high-grade BS (N = 37) or STS (N = 55). All patients underwent a pretreatment F-18 FDG PET/CT scan. Clinical data were registered. Measurements of the accuracy of metabolic tumor volume with a preset threshold of 40% of the maximum standardized.......05, HR 3.37 [95% CI 1.02-11.11]). No significant results were demonstrated for MTV40%.Volume-based F-18 FDG PET/CT imaging markers in terms of pretreatment estimation of TLG provide supplemental prognostic information to histologic grading, with significant independent properties for prediction...

  7. Combined use of positron emission tomography and volume doubling time in lung cancer screening with low-dose CT scanning

    DEFF Research Database (Denmark)

    Ashraf, H; Dirksen, A; Jakobsen, Annika Loft

    2011-01-01

    In lung cancer screening the ability to distinguish malignant from benign nodules is a key issue. This study evaluates the ability of positron emission tomography (PET) and volume doubling time (VDT) to discriminate between benign and malignant nodules.......In lung cancer screening the ability to distinguish malignant from benign nodules is a key issue. This study evaluates the ability of positron emission tomography (PET) and volume doubling time (VDT) to discriminate between benign and malignant nodules....

  8. Preoperative liver functional volumetry performed by 3D-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT:a preliminary study

    Institute of Scientific and Technical Information of China (English)

    Hiroshi Yoshida; Hiroshi Makino; Tadashi Yokoyama; Hiroshi Maruyama; Atsushi Hirakata; Junji Ueda; Yasuhiro Mamada; Nobuhiko Taniai; Eiji Uchida

    2016-01-01

    Aim: The present study was designed to evaluate the feasibility of preoperative liver functional volumetry performed by 3D-technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) scintigraphy/vascular fusion imaging using SYNAPSE VINCENT and to examine the discrepancy between conventional and functional volumetry.Methods: The study group comprised 15 patients who underwent preoperative 3-dimensional (3D)-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT software before hepatectomy between July 2014 and August 2015. The diagnosis was hepatocelular carcinoma (n = 4), metastatic liver tumor (n = 10), or intrahepatic cholangiocarcinoma (n = 1). Right hepatectomy was performed in 2 patients, left hepatectomy in 3 patients, right posterior sectionectomy in 3 patients, segmentectomy in 2 patients, and partial hepatectomy in 4 patients. 99mTc-GSA scintigraphy and computed tomography (CT) were performed to construct 3D-99mTc-GSA scintigraphy/vascular fused images. The conventional volume ratio of the planned resection region without tumor (% CT), and the functional volume ratio of the planned resection region without tumor (% GSA) were calculated. The discrepancy ratio was calculated as folows: discrepancy ratio = 100 - % GSA/ % CT × 100 (%).Results: The % GSA (17.9 ± 16.7%) was signiifcantly lower than the % CT (21.5 ± 17.6%) (P < 0.036). In al except 2 patients, the % GSA was lower than the % CT. The discrepancy ratio ranged from -4% to 75% (median, 20.7%).Conclusion: 3D-99mTc-GSA scintigraphy/vascular fused images constructed using SYNAPSE VINCENT were useful for noninvasively performing functional liver volumetry in patients scheduled to undergo various patterns of hepatectomy. In planned resection regions without tumor, the functional volume ratio was about 20% lower than the conventional volume ratio.

  9. Best single-slice location to measure visceral adipose tissue on paediatric CT scans and the relationship between anthropometric measurements, gender and VAT volume in children

    Science.gov (United States)

    Ryan, John; Foley, Shane

    2015-01-01

    Objective: Visceral adipose tissue (VAT) is a significant risk factor for obesity-related metabolic diseases. This study investigates (1) the best single CT slice location for predicting total abdominal VAT volume in paediatrics and (2) the relationship between waist circumference (WC), sagittal diameter (SD), gender and VAT volume. Methods: A random sample of 130 paediatric abdomen CT scans, stratified according to age and gender, was collected. Three readers measured VAT area at each intervertebral level between T12 and S1 using ImageJ analysis (National Institute of Health, Bethesda, MD) software by thresholding −190 to −30 HU and manually segmenting VAT. Single-slice VAT measurements were correlated with total VAT volume to identify the most representative slice. WC and SD were measured at L3–L4 and L4–L5 slices, respectively. Regression analysis was used to evaluate WC, SD and gender as VAT volume predictors. Results: Interviewer and intraviewer reliability were excellent (intraclass correlation coefficient = 0.99). Although VAT measured at multiple slices correlated strongly with abdominal VAT, only one slice in females at L2–L3 and two slices in males at L1–L2 and L5–S1 were strongly correlated across all age groups. Linear regression analysis showed that WC was strongly correlated with VAT volume (beta = 0.970, p < 0.001). Conclusion: Single-slice VAT measurements are highly reproducible. Measurements performed at L2–L3 in females and L1–L2 or L5–S1 in males were most representative of VAT. WC is indicative of VAT. Advances in knowledge: VAT should be measured at L2–L3 in female children and at either L1–L2 or L5–S1 in males. WC is a strong indicator of VAT in children. PMID:26317895

  10. In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core?

    Directory of Open Access Journals (Sweden)

    William A Copen

    Full Text Available In the treatment of patients with suspected acute ischemic stroke, increasing evidence suggests the importance of measuring the volume of the irreversibly injured "ischemic core." The gold standard method for doing this in the clinical setting is diffusion-weighted magnetic resonance imaging (DWI, but many authors suggest that maps of regional cerebral blood volume (CBV derived from computed tomography perfusion imaging (CTP can substitute for DWI. We sought to determine whether DWI and CTP-derived CBV maps are equivalent in measuring core volume.58 patients with suspected stroke underwent CTP and DWI within 6 hours of symptom onset. We measured low-CBV lesion volumes using three methods: "objective absolute," i.e. the volume of tissue with CBV below each of six published absolute thresholds (0.9-2.5 mL/100 g, "objective relative," whose six thresholds (51%-60% were fractions of mean contralateral CBV, and "subjective," in which two radiologists (R1, R2 outlined lesions subjectively. We assessed the sensitivity and specificity of each method, threshold, and radiologist in detecting infarction, and the degree to which each over- or underestimated the DWI core volume. Additionally, in the subset of 32 patients for whom follow-up CT or MRI was available, we measured the proportion of CBV- or DWI-defined core lesions that exceeded the follow-up infarct volume, and the maximum amount by which this occurred.DWI was positive in 72% (42/58 of patients. CBV maps' sensitivity/specificity in identifying DWI-positive patients were 100%/0% for both objective methods with all thresholds, 43%/94% for R1, and 83%/44% for R2. Mean core overestimation was 156-699 mL for objective absolute thresholds, and 127-200 mL for objective relative thresholds. For R1 and R2, respectively, mean±SD subjective overestimation were -11±26 mL and -11±23 mL, but subjective volumes differed from DWI volumes by up to 117 and 124 mL in individual patients. Inter-rater agreement

  11. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Rozie, S.; Weert, T.T. de; Monye, C. de; Homburg, P.J.; Tanghe, H.L.J.; Lugt, A. van der [Erasmus MC, University Medical Center Rotterdam, Departments of Radiology, Rotterdam (Netherlands); Dippel, D.W.J. [Erasmus MC, University Medical Center Rotterdam, Department of Neurology, PO Box 2040, Rotterdam (Netherlands)

    2009-09-15

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk