WorldWideScience

Sample records for ultrasound-based image guidance

  1. Accuracy of Ultrasound-Based Image Guidance for Daily Positioning of the Upper Abdomen: An Online Comparison With Cone Beam CT

    International Nuclear Information System (INIS)

    Boda-Heggemann, Judit; Mennemeyer, Philipp; Wertz, Hansjoerg; Riesenacker, Nadja; Kuepper, Beate; Lohr, Frank; Wenz, Frederik

    2009-01-01

    Purpose: Image-guided intensity-modulated radiotherapy can improve protection of organs at risk when large abdominal target volumes are irradiated. We estimated the daily positioning accuracy of ultrasound-based image guidance for abdominal target volumes by a direct comparison of daily imaging obtained with cone beam computed tomography (CBCT). Methods and Materials: Daily positioning (n = 83 positionings) of 15 patients was completed by using ultrasound guidance after an initial CBCT was obtained. Residual error after ultrasound was estimated by comparison with a second CBCT. Ultrasound image quality was visually rated using a scale of 1 to 4. Results: Of 15 patients, 7 patients had good sonographic imaging quality, 5 patients had satisfactory sonographic quality, and 3 patients were excluded because of unsatisfactory sonographic quality. When image quality was good, residual errors after ultrasound were -0.1 ± 3.11 mm in the x direction (left-right; group systematic error M = -0.09 mm; standard deviation [SD] of systematic error, Σ = 1.37 mm; SD of the random error, σ = 2.99 mm), 0.93 ± 4.31 mm in the y direction (superior-inferior, M = 1.12 mm; Σ = 2.96 mm; σ = 3.39 mm), and 0.71 ± 3.15 mm in the z direction (anteroposterior; M = 1.01 mm; Σ = 2.46 mm; σ = 2.24 mm). For patients with satisfactory image quality, residual error after ultrasound was -0.6 ± 5.26 mm in the x (M = 0.07 mm; Σ = 5.67 mm; σ = 4.86 mm), 1.76 ± 4.92 mm in the y (M = 3.54 mm; Σ = 4.1 mm; σ = 5.29 mm), and 1.19 ± 4.75 mm in the z (M = 0.82 mm; Σ = 2.86 mm; σ = 3.05 mm) directions. Conclusions: In patients from whom good sonographic image quality could be obtained, ultrasound improved daily positioning accuracy. In the case of satisfactory image quality, ultrasound guidance improved accuracy compared to that of skin marks only minimally. If sonographic image quality was unsatisfactory, daily CBCT scanning improved treatment accuracy distinctly over that of ultrasound. Use of

  2. Image Guidance

    Science.gov (United States)

    Guidance that explains the process for getting images approved in One EPA Web microsites and resource directories. includes an appendix that shows examples of what makes some images better than others, how some images convey meaning more than others

  3. Ultrasound-based guidance of intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    Fung, Albert Y.C.; Ayyangar, Komanduri M.; Djajaputra, David; Nehru, Ramasamy M.; Enke, Charles A.

    2006-01-01

    In ultrasound-guided intensity-modulated radiation therapy (IMRT) of prostate cancer, ultrasound imaging ascertains the anatomical position of patients during x-ray therapy delivery. The ultrasound transducers are made of piezoelectric ceramics. The same crystal is used for both ultrasound production and reception. Three-dimensional (3D) ultrasound devices capture and correlate series of 2-dimensional (2D) B-mode images. The transducers are often arranged in a convex array for focusing. Lower frequency reaches greater depth, but results in low resolution. For clear image, some gel is usually applied between the probe and the skin contact surface. For prostate positioning, axial and sagittal scans are performed, and the volume contours from computed tomography (CT) planning are superimposed on the ultrasound images obtained before radiation delivery at the linear accelerator. The planning volumes are then overlaid on the ultrasound images and adjusted until they match. The computer automatically deduces the offset necessary to move the patient so that the treatment area is in the correct location. The couch is translated as needed. The currently available commercial equipment can attain a positional accuracy of 1-2 mm. Commercial manufacturer designs differ in the detection of probe coordinates relative to the isocenter. Some use a position-sensing robotic arm, while others have infrared light-emitting diodes or pattern-recognition software with charge-couple-device cameras. Commissioning includes testing of image quality and positional accuracy. Ultrasound is mainly used in prostate positioning. Data for 7825 daily fractions of 234 prostate patients indicated average 3D inter-fractional displacement of about 7.8 mm. There was no perceivable trend of shift over time. Scatter plots showed slight prevalence toward superior-posterior directions. Uncertainties of ultrasound guidance included tissue inhomogeneities, speckle noise, probe pressure, and inter

  4. Intra-operative ultrasound-based augmented reality guidance for laparoscopic surgery.

    Science.gov (United States)

    Singla, Rohit; Edgcumbe, Philip; Pratt, Philip; Nguan, Christopher; Rohling, Robert

    2017-10-01

    In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm 3 ( p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm ( p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

  5. Effect of body mass index on shifts in ultrasound-based image-guided intensity-modulated radiation therapy for abdominal malignancies

    International Nuclear Information System (INIS)

    Choi, Mehee; Fuller, Clifton D.; Wang, Samuel J.; Siddiqi, Ather; Wong, Adrian; Thomas, Charles R.; Fuss, Martin

    2009-01-01

    Background and purpose: We investigated whether corrective shifts determined by daily ultrasound-based image-guidance correlate with body mass index (BMI) of patients treated with image-guided intensity-modulated radiation therapy (IG-IMRT) for abdominal malignancies. The utility of daily image-guidance, particularly for patients with BMI > 25.0, is examined. Materials and methods: Total 3162 ultrasound-directed shifts were performed in 86 patients. Direction and magnitude of shifts were correlated with pretreatment BMI. Bivariate statistical analysis and analysis of set-up correction data were performed using systematic and random error calculations. Results: Total 2040 daily alignments were performed. Average 3D vector of set-up correction for all patients was 12.1 mm/fraction. Directional and absolute shifts and 3D vector length were significantly different between BMI cohorts. 3D displacement averaged 4.9 mm/fraction and 6.8mm/fraction for BMI ≤ 25.0 and BMI > 25.0, respectively. Systematic error in all axes and 3D vector was significantly greater for BMI > 25.0. Differences in random error were not statistically significant. Conclusions: Set-up corrections derived from daily ultrasound-based IG-IMRT of abdominal tumors correlated with BMI. Daily image-guidance may improve precision of IMRT delivery with benefits assessed for the entire population, particularly patients with increased habitus. Requisite PTV margins suggested in the absence of daily image-guidance are significantly greater in patients with BMI > 25.0.

  6. Temporal regularization of ultrasound-based liver motion estimation for image-guided radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    O’Shea, Tuathan P., E-mail: tuathan.oshea@icr.ac.uk; Bamber, Jeffrey C.; Harris, Emma J. [Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS foundation Trust, Sutton, London SM2 5PT (United Kingdom)

    2016-01-15

    Purpose: Ultrasound-based motion estimation is an expanding subfield of image-guided radiation therapy. Although ultrasound can detect tissue motion that is a fraction of a millimeter, its accuracy is variable. For controlling linear accelerator tracking and gating, ultrasound motion estimates must remain highly accurate throughout the imaging sequence. This study presents a temporal regularization method for correlation-based template matching which aims to improve the accuracy of motion estimates. Methods: Liver ultrasound sequences (15–23 Hz imaging rate, 2.5–5.5 min length) from ten healthy volunteers under free breathing were used. Anatomical features (blood vessels) in each sequence were manually annotated for comparison with normalized cross-correlation based template matching. Five sequences from a Siemens Acuson™ scanner were used for algorithm development (training set). Results from incremental tracking (IT) were compared with a temporal regularization method, which included a highly specific similarity metric and state observer, known as the α–β filter/similarity threshold (ABST). A further five sequences from an Elekta Clarity™ system were used for validation, without alteration of the tracking algorithm (validation set). Results: Overall, the ABST method produced marked improvements in vessel tracking accuracy. For the training set, the mean and 95th percentile (95%) errors (defined as the difference from manual annotations) were 1.6 and 1.4 mm, respectively (compared to 6.2 and 9.1 mm, respectively, for IT). For each sequence, the use of the state observer leads to improvement in the 95% error. For the validation set, the mean and 95% errors for the ABST method were 0.8 and 1.5 mm, respectively. Conclusions: Ultrasound-based motion estimation has potential to monitor liver translation over long time periods with high accuracy. Nonrigid motion (strain) and the quality of the ultrasound data are likely to have an impact on tracking

  7. Non-invasive ultrasound-based temperature imaging for monitoring radiofrequency heating-phantom results

    International Nuclear Information System (INIS)

    Daniels, M J; Varghese, T; Madsen, E L; Zagzebski, J A

    2007-01-01

    Minimally invasive therapies (such as radiofrequency ablation) are becoming more commonly used in the United States for the treatment of hepatocellular carcinomas and liver metastases. Unfortunately, these procedures suffer from high recurrence rates of hepatocellular carcinoma (∼34-55%) or metastases following ablation therapy. The ability to perform real-time temperature imaging while a patient is undergoing radiofrequency ablation could provide a significant reduction in these recurrence rates. In this paper, we demonstrate the feasibility of ultrasound-based temperature imaging on a tissue-mimicking phantom undergoing radiofrequency heating. Ultrasound echo signals undergo time shifts with increasing temperature, which are tracked using 2D correlation-based speckle tracking methods. Time shifts or displacements in the echo signal are accumulated, and the gradient of these time shifts are related to changes in the temperature of the tissue-mimicking phantom material using a calibration curve generated from experimental data. A tissue-mimicking phantom was developed that can undergo repeated radiofrequency heating procedures. Both sound speed and thermal expansion changes of the tissue-mimicking material were measured experimentally and utilized to generate the calibration curve relating temperature to the displacement gradient. Temperature maps were obtained, and specific regions-of-interest on the temperature maps were compared to invasive temperatures obtained using fiber-optic temperature probes at the same location. Temperature elevation during a radiofrequency ablation procedure on the phantom was successfully tracked to within ±0.5 0 C

  8. Organic-Inorganic Hybrid Hollow Mesoporous Organosilica Nanoparticles for Efficient Ultrasound-Based Imaging and Controlled Drug Release

    Directory of Open Access Journals (Sweden)

    Xiaoqin Qian

    2014-01-01

    Full Text Available A novel anticancer drug delivery system with contrast-enhanced ultrasound-imaging performance was synthesized by a typical hard-templating method using monodispersed silica nanoparticles as the templates, which was based on unique molecularly organic/inorganic hybrid hollow periodic mesoporous organosilicas (HPMOs. The highly dispersed HPMOs show the uniform spherical morphology, large hollow interior, and well-defined mesoporous structures, which are very beneficial for ultrasound-based theranostics. The obtained HPMOs exhibit excellent performances in contrast-enhanced ultrasonography both in vitro and in vivo and can be used for the real-time determination of the progress of lesion tissues during the chemotherapeutic process. Importantly, hydrophobic paclitaxel- (PTX- loaded HPMOs combined with ultrasound irradiation show fast ultrasound responsiveness for controlled drug release and higher in vitro and in vivo tumor inhibition rates compared with free PTX and PTX-loaded HPMOs, which is due to the enhanced ultrasound-triggered drug release and ultrasound-induced cavitation effect. Therefore, the achieved novel HPMOs-based nanoparticle systems will find broad application potentials in clinically ultrasound-based imaging and auxiliary tumor chemotherapy.

  9. First steps towards ultrasound-based motion compensation for imaging and therapy: calibration with an optical system and 4D PET imaging

    Directory of Open Access Journals (Sweden)

    Julia eSchwaab

    2015-11-01

    Full Text Available Target motion, particularly in the abdomen, due to respiration or patient movement is still a challenge in many diagnostic and therapeutic processes. Hence, methods to detect and compensate this motion are required. Diagnostic ultrasound represents a non-invasive and dose-free alternative to fluoroscopy, providing more information about internal target motion than respiration belt or optical tracking.The goal of this project is to develop an ultrasound based motion tracking for real time motion correction in radiation therapy and diagnostic imaging, notably in 4D positron emission tomography (PET. In this work, a workflow is established to enable the transformation of ultrasound tracking data to the coordinates of the treatment delivery or imaging system – even if the ultrasound probe is moving due to respiration. It is shown that the ultrasound tracking signal is equally adequate for 4D PET image reconstruction as the clinically used respiration belt and provides additional opportunities in this concern. Furthermore, it is demonstrated that the ultrasound probe being within the PET field of view generally has no relevant influence on the image quality. The accuracy and precision of all the steps in the calibration workflow for ultrasound tracking based 4D PET imaging are found to be in an acceptable range for clinical implementation. Eventually, we show in vitro that an ultrasound based motion tracking in absolute room coordinates with a moving US-transducer is feasible.

  10. Application of image guidance in pituitary surgery

    Science.gov (United States)

    de Lara, Danielle; Filho, Leo F. S. Ditzel; Prevedello, Daniel M.; Otto, Bradley A.; Carrau, Ricardo L.

    2012-01-01

    Background: Surgical treatment of pituitary pathologies has evolved along the years, adding safety and decreasing morbidity related to the procedure. Advances in the field of radiology, coupled with stereotactic technology and computer modeling, have culminated in the contemporary and widespread use of image guidance systems, as we know them today. Image guidance navigation has become a frequently used technology that provides continuous three-dimensional information for the accurate performance of neurosurgical procedures. We present a discussion about the application of image guidance in pituitary surgeries. Methods: Major indications for image guidance neuronavigation application in pituitary surgery are presented and demonstrated with illustrative cases. Limitations of this technology are also presented. Results: Patients presenting a history of previous transsphenoidal surgeries, anatomical variances of the sphenoid sinus, tumors with a close relation to the internal carotid arteries, and extrasellar tumors are the most important indications for image guidance in pituitary surgeries. The high cost of the equipment, increased time of surgery due to setup time, and registration and the need of specific training for the operating room personnel could be pointed as limitations of this technology. Conclusion: Intraoperative image guidance systems provide real-time images, increasing surgical accuracy and enabling safe, minimally invasive interventions. However, the use of intraoperative navigation is not a replacement for surgical experience and a systematic knowledge of regional anatomy. It must be recognized as a tool by which the neurosurgeon can reduce the risk associated with surgical approach and treatment of pituitary pathologies. PMID:22826819

  11. Imaging of human tooth using ultrasound based chirp-coded nonlinear time reversal acoustics

    Czech Academy of Sciences Publication Activity Database

    Dos Santos, S.; Převorovský, Zdeněk

    2011-01-01

    Roč. 51, č. 6 (2011), s. 667-674 ISSN 0041-624X Institutional research plan: CEZ:AV0Z20760514 Keywords : TR-NEWS * chirp-coded excitation * echodentography * ultrasonic imaging Subject RIV: BI - Acoustics Impact factor: 1.838, year: 2011 http://www.sciencedirect.com/science/article/pii/S0041624X11000229

  12. Fusion Imaging for Procedural Guidance.

    Science.gov (United States)

    Wiley, Brandon M; Eleid, Mackram F; Thaden, Jeremy J

    2018-05-01

    The field of percutaneous structural heart interventions has grown tremendously in recent years. This growth has fueled the development of new imaging protocols and technologies in parallel to help facilitate these minimally-invasive procedures. Fusion imaging is an exciting new technology that combines the strength of 2 imaging modalities and has the potential to improve procedural planning and the safety of many commonly performed transcatheter procedures. In this review we discuss the basic concepts of fusion imaging along with the relative strengths and weaknesses of static vs dynamic fusion imaging modalities. This review will focus primarily on echocardiographic-fluoroscopic fusion imaging and its application in commonly performed transcatheter structural heart procedures. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Copper oxide loaded PLGA nanospheres: towards a multifunctional nanoscale platform for ultrasound-based imaging and therapy

    Science.gov (United States)

    Perlman, Or; Weitz, Iris S.; Sivan, Sarit S.; Abu-Khalla, Hiba; Benguigui, Madeleine; Shaked, Yuval; Azhari, Haim

    2018-05-01

    combined imaging and therapeutic ultrasound-based procedures.

  14. Advances in imaging for oncology guidance

    International Nuclear Information System (INIS)

    Amies, Christopher J.

    2008-01-01

    Over the last 30 years major improvements in medical imaging have played a significant role to help advance the management of oncology diseases. These advances have covered the continuum of care from screening, diagnosis, staging, treatment planning and intervention. More recently image guided radiation therapy (IGRT) has placed sophisticated imaging closer to the treatment event. The opportunity to improve care seems obvious; however the clinical benefits of IGRT are at present not easily proven and yet contribute to the complexity of treatment and the rising costs of care. It is proposed that this is in part due to the present immaturity of IGRT technology development, which is predominantly determined by the challenge of achieving precise delivery of radiation in one or many episodes (fractions) for very different diseases. There is no single type or mode of imaging that will be suitable to address all radiotherapy guidance challenges whether defined by the general criteria identified for a specific disease or the unique characteristics encountered with an individual patient. Finally the wide adoption of this or any medical technology general requires the attainment of a sufficient degree of safety and efficiency. I present the challenges faced by industry as well as select interesting technology based solutions and concepts that may help advance the field of oncology guidance

  15. Image-guidance for surgical procedures

    International Nuclear Information System (INIS)

    Peters, Terry M

    2006-01-01

    Contemporary imaging modalities can now provide the surgeon with high quality three- and four-dimensional images depicting not only normal anatomy and pathology, but also vascularity and function. A key component of image-guided surgery (IGS) is the ability to register multi-modal pre-operative images to each other and to the patient. The other important component of IGS is the ability to track instruments in real time during the procedure and to display them as part of a realistic model of the operative volume. Stereoscopic, virtual- and augmented-reality techniques have been implemented to enhance the visualization and guidance process. For the most part, IGS relies on the assumption that the pre-operatively acquired images used to guide the surgery accurately represent the morphology of the tissue during the procedure. This assumption may not necessarily be valid, and so intra-operative real-time imaging using interventional MRI, ultrasound, video and electrophysiological recordings are often employed to ameliorate this situation. Although IGS is now in extensive routine clinical use in neurosurgery and is gaining ground in other surgical disciplines, there remain many drawbacks that must be overcome before it can be employed in more general minimally-invasive procedures. This review overviews the roots of IGS in neurosurgery, provides examples of its use outside the brain, discusses the infrastructure required for successful implementation of IGS approaches and outlines the challenges that must be overcome for IGS to advance further. (topical review)

  16. The vision guidance and image processing of AGV

    Science.gov (United States)

    Feng, Tongqing; Jiao, Bin

    2017-08-01

    Firstly, the principle of AGV vision guidance is introduced and the deviation and deflection angle are measured by image coordinate system. The visual guidance image processing platform is introduced. In view of the fact that the AGV guidance image contains more noise, the image has already been smoothed by a statistical sorting. By using AGV sampling way to obtain image guidance, because the image has the best and different threshold segmentation points. In view of this situation, the method of two-dimensional maximum entropy image segmentation is used to solve the problem. We extract the foreground image in the target band by calculating the contour area method and obtain the centre line with the least square fitting algorithm. With the help of image and physical coordinates, we can obtain the guidance information.

  17. Image Guidance and Assessment of Radiation Induced Gene Therapy

    National Research Council Canada - National Science Library

    Pelizzari, Charles

    2004-01-01

    Image guidance and assessment techniques are being developed for combined radiation/gene therapy, which utilizes a radiation-inducible gene promoter to cause expression of tumor necrosis factor alpha...

  18. Ultrasound-based logistic regression model LR2 versus magnetic resonance imaging for discriminating between benign and malignant adnexal masses: a prospective study.

    Science.gov (United States)

    Shimada, Kanane; Matsumoto, Koji; Mimura, Takashi; Ishikawa, Tetsuya; Munechika, Jiro; Ohgiya, Yoshimitsu; Kushima, Miki; Hirose, Yusuke; Asami, Yuka; Iitsuka, Chiaki; Miyamoto, Shingo; Onuki, Mamiko; Tsunoda, Hajime; Matsuoka, Ryu; Ichizuka, Kiyotake; Sekizawa, Akihiko

    2018-06-01

    The diagnostic performances of the International Ovarian Tumor Analysis (IOTA) ultrasound-based logistic regression model (LR2) and magnetic resonance imaging (MRI) in discriminating between benign and malignant adnexal masses have not been directly compared in a single study. Using the IOTA LR2 model and subjective interpretation of MRI findings by experienced radiologists, 265 consecutive patients with adnexal masses were preoperatively evaluated in two hospitals between February 2014 and December 2015. Definitive histological diagnosis of excised tissues was used as a gold standard. From the 265 study subjects, 54 (20.4%) tumors were histologically diagnosed as malignant (including 11 borderline and 3 metastatic tumors). Preoperative diagnoses of malignant tumors showed 91.7% total agreement between IOTA LR2 and MRI, with a kappa value of 0.77 [95% confidence interval (CI), 0.68-0.86]. Sensitivity of IOTA LR2 (0.94, 95% CI, 0.85-0.98) for predicting malignant tumors was similar to that of MRI (0.96, 95% CI, 0.87-0.99; P = 0.99), whereas specificity of IOTA LR2 (0.98, 95% CI, 0.95-0.99) was significantly higher than that of MRI (0.91, 95% CI, 0.87-0.95; P = 0.002). Combined IOTA LR2 and MRI results gave the greatest sensitivity (1.00, 95% CI, 0.93-1.00) and had similar specificity (0.91, 95% CI, 0.86-0.94) to MRI. The IOTA LR2 model had a similar sensitivity to MRI for discriminating between benign and malignant tumors and a higher specificity compared with MRI. Our findings suggest that the IOTA LR2 model, either alone or in conjunction with MRI, should be included in preoperative evaluation of adnexal masses.

  19. Image guidance improves localization of sonographically occult colorectal liver metastases

    Science.gov (United States)

    Leung, Universe; Simpson, Amber L.; Adams, Lauryn B.; Jarnagin, William R.; Miga, Michael I.; Kingham, T. Peter

    2015-03-01

    Assessing the therapeutic benefit of surgical navigation systems is a challenging problem in image-guided surgery. The exact clinical indications for patients that may benefit from these systems is not always clear, particularly for abdominal surgery where image-guidance systems have failed to take hold in the same way as orthopedic and neurosurgical applications. We report interim analysis of a prospective clinical trial for localizing small colorectal liver metastases using the Explorer system (Path Finder Technologies, Nashville, TN). Colorectal liver metastases are small lesions that can be difficult to identify with conventional intraoperative ultrasound due to echogeneity changes in the liver as a result of chemotherapy and other preoperative treatments. Interim analysis with eighteen patients shows that 9 of 15 (60%) of these occult lesions could be detected with image guidance. Image guidance changed intraoperative management in 3 (17%) cases. These results suggest that image guidance is a promising tool for localization of small occult liver metastases and that the indications for image-guided surgery are expanding.

  20. Robotic needle steering: design, modeling, planning, and image guidance

    NARCIS (Netherlands)

    Cowan, Noah J.; Goldberg, Ken; Chirikjian, Gregory S.; Fichtinger, Gabor; Alterovitz, Ron; Reed, Kyle B.; Kallem, Vinutha; Misra, Sarthak; Park, Wooram; Okamura, Allison M.; Rosen, Jacob; Hannaford, Blake; Satava, Richard M.

    2010-01-01

    This chapter describes how advances in needle design, modeling, planning, and image guidance make it possible to steer flexible needles from outside the body to reach specified anatomical targets not accessible using traditional needle insertion methods. Steering can be achieved using a variety of

  1. Space imaging infrared optical guidance for autonomous ground vehicle

    Science.gov (United States)

    Akiyama, Akira; Kobayashi, Nobuaki; Mutoh, Eiichiro; Kumagai, Hideo; Yamada, Hirofumi; Ishii, Hiromitsu

    2008-08-01

    We have developed the Space Imaging Infrared Optical Guidance for Autonomous Ground Vehicle based on the uncooled infrared camera and focusing technique to detect the objects to be evaded and to set the drive path. For this purpose we made servomotor drive system to control the focus function of the infrared camera lens. To determine the best focus position we use the auto focus image processing of Daubechies wavelet transform technique with 4 terms. From the determined best focus position we transformed it to the distance of the object. We made the aluminum frame ground vehicle to mount the auto focus infrared unit. Its size is 900mm long and 800mm wide. This vehicle mounted Ackerman front steering system and the rear motor drive system. To confirm the guidance ability of the Space Imaging Infrared Optical Guidance for Autonomous Ground Vehicle we had the experiments for the detection ability of the infrared auto focus unit to the actual car on the road and the roadside wall. As a result the auto focus image processing based on the Daubechies wavelet transform technique detects the best focus image clearly and give the depth of the object from the infrared camera unit.

  2. Active instrumental guidance in interventional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Wildermuth, S.; Erhart, P.; Leung, D.A.; Goehde, S.; Schoenenberger, A.; Debatin, J.F.

    1998-01-01

    Purpose: An active MR-based guidance system for visualisation of invasive instruments is described. Methods: The principle of MR tracking is based on the integration of a miniaturised coil into the tip of the instrument itself. A phantom experiment was designed to demonstrate the localising accuracy of this technique. In [dition, bicompatibility and warming effects were evaluated. Preliminary intravascular applications that were performed in animal experiments under MR guidance included embolisation, vascular occlusion as well as transjugular intrahepatic punctures. Percutaneous biopsies, cholecystostomies and laparoscopic applications were also evaluated with MR tracking. Results: Phantom experiments confirmed an excellent localisation accuracy of MR tracking compared to conventional r[iography. At a field strength of 0.5 T, the temperature increase remained below 2 C. Results of phantom experiments revealed a potential of significant heating dependent on the sequence parameters employed. MR tracking allowed a robust, simultaneously biplanar visualisation of the instrument tips in real time. Based on MR 'ro[ map' images, various intravascular and percutaneous interventions were successfully performed in vivo under MR guidance. Conclusions: MR tracking is a flexible concept permitting monitoring in the guidance of instruments in an MR environment. Various preliminary in vitro and in vivo experiments demonstrate safety, localisation accuracy and feasibility of this biplanar localisation technique in real time. (orig.) [de

  3. Image registration assessment in radiotherapy image guidance based on control chart monitoring.

    Science.gov (United States)

    Xia, Wenyao; Breen, Stephen L

    2018-04-01

    Image guidance with cone beam computed tomography in radiotherapy can guarantee the precision and accuracy of patient positioning prior to treatment delivery. During the image guidance process, operators need to take great effort to evaluate the image guidance quality before correcting a patient's position. This work proposes an image registration assessment method based on control chart monitoring to reduce the effort taken by the operator. According to the control chart plotted by daily registration scores of each patient, the proposed method can quickly detect both alignment errors and image quality inconsistency. Therefore, the proposed method can provide a clear guideline for the operators to identify unacceptable image quality and unacceptable image registration with minimal effort. Experimental results demonstrate that by using control charts from a clinical database of 10 patients undergoing prostate radiotherapy, the proposed method can quickly identify out-of-control signals and find special cause of out-of-control registration events.

  4. Percutaneous Thermal Ablation with Ultrasound Guidance. Fusion Imaging Guidance to Improve Conspicuity of Liver Metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Hakime, Antoine, E-mail: thakime@yahoo.com; Yevich, Steven; Tselikas, Lambros; Deschamps, Frederic [Gustave Roussy - Cancer Campus, Interventional Radiology Department (France); Petrover, David [Imagerie Médicale Paris Centre, IMPC (France); Baere, Thierry De [Gustave Roussy - Cancer Campus, Interventional Radiology Department (France)

    2017-05-15

    PurposeTo assess whether fusion imaging-guided percutaneous microwave ablation (MWA) can improve visibility and targeting of liver metastasis that were deemed inconspicuous on ultrasound (US).Materials and MethodsMWA of liver metastasis not judged conspicuous enough on US was performed under CT/US fusion imaging guidance. The conspicuity before and after the fusion imaging was graded on a five-point scale, and significance was assessed by Wilcoxon test. Technical success, procedure time, and procedure-related complications were evaluated.ResultsA total of 35 patients with 40 liver metastases (mean size 1.3 ± 0.4 cm) were enrolled. Image fusion improved conspicuity sufficiently to allow fusion-targeted MWA in 33 patients. The time required for image fusion processing and tumors’ identification averaged 10 ± 2.1 min (range 5–14). Initial conspicuity on US by inclusion criteria was 1.2 ± 0.4 (range 0–2), while conspicuity after localization on fusion imaging was 3.5 ± 1 (range 1–5, p < 0.001). Technical success rate was 83% (33/40) in intention-to-treat analysis and 100% in analysis of treated tumors. There were no major procedure-related complications.ConclusionsFusion imaging broadens the scope of US-guided MWA to metastasis lacking adequate conspicuity on conventional US. Fusion imaging is an effective tool to increase the conspicuity of liver metastases that were initially deemed non visualizable on conventional US imaging.

  5. Stereoscopic Integrated Imaging Goggles for Multimodal Intraoperative Image Guidance.

    Directory of Open Access Journals (Sweden)

    Christopher A Mela

    Full Text Available We have developed novel stereoscopic wearable multimodal intraoperative imaging and display systems entitled Integrated Imaging Goggles for guiding surgeries. The prototype systems offer real time stereoscopic fluorescence imaging and color reflectance imaging capacity, along with in vivo handheld microscopy and ultrasound imaging. With the Integrated Imaging Goggle, both wide-field fluorescence imaging and in vivo microscopy are provided. The real time ultrasound images can also be presented in the goggle display. Furthermore, real time goggle-to-goggle stereoscopic video sharing is demonstrated, which can greatly facilitate telemedicine. In this paper, the prototype systems are described, characterized and tested in surgeries in biological tissues ex vivo. We have found that the system can detect fluorescent targets with as low as 60 nM indocyanine green and can resolve structures down to 0.25 mm with large FOV stereoscopic imaging. The system has successfully guided simulated cancer surgeries in chicken. The Integrated Imaging Goggle is novel in 4 aspects: it is (a the first wearable stereoscopic wide-field intraoperative fluorescence imaging and display system, (b the first wearable system offering both large FOV and microscopic imaging simultaneously,

  6. Compton scatter imaging: A promising modality for image guidance in lung stereotactic body radiation therapy.

    Science.gov (United States)

    Redler, Gage; Jones, Kevin C; Templeton, Alistair; Bernard, Damian; Turian, Julius; Chu, James C H

    2018-03-01

    Lung stereotactic body radiation therapy (SBRT) requires delivering large radiation doses with millimeter accuracy, making image guidance essential. An approach to forming images of patient anatomy from Compton-scattered photons during lung SBRT is presented. To investigate the potential of scatter imaging, a pinhole collimator and flat-panel detector are used for spatial localization and detection of photons scattered during external beam therapy using lung SBRT treatment conditions (6 MV FFF beam). MCNP Monte Carlo software is used to develop a model to simulate scatter images. This model is validated by comparing experimental and simulated phantom images. Patient scatter images are then simulated from 4DCT data. Experimental lung tumor phantom images have sufficient contrast-to-noise to visualize the tumor with as few as 10 MU (0.5 s temporal resolution). The relative signal intensity from objects of different composition as well as lung tumor contrast for simulated phantom images agree quantitatively with experimental images, thus validating the Monte Carlo model. Scatter images are shown to display high contrast between different materials (lung, water, bone). Simulated patient images show superior (~double) tumor contrast compared to MV transmission images. Compton scatter imaging is a promising modality for directly imaging patient anatomy during treatment without additional radiation, and it has the potential to complement existing technologies and aid tumor tracking and lung SBRT image guidance. © 2018 American Association of Physicists in Medicine.

  7. Direct aperture deformation: An interfraction image guidance strategy

    International Nuclear Information System (INIS)

    Feng Yuanming; Castro-Pareja, Carlos; Shekhar, Raj; Yu, Cedric

    2006-01-01

    A new scheme, called direct aperture deformation (DAD), for online correction of interfraction geometric uncertainties under volumetric imaging guidance is presented. Using deformable image registration, the three-dimensional geometric transformation matrix can be derived that associates the planning image set and the images acquired on the day of treatment. Rather than replanning or moving the patient, we use the deformation matrix to morph the treatment apertures as a potential online correction method. A proof-of-principle study using an intensity-modulated radiation therapy plan for a prostate cancer patient was conducted. The method, procedure, and algorithm of DAD are described. The dose-volume histograms from the original plan, reoptimized plan, and rigid-body translation plan are compared with the ones from the DAD plan. The study showed the feasibility of the DAD as a general method for both target dislocation and deformation. As compared with using couch translation to move the patient, DAD is capable of correcting both target dislocation and deformations. As compared with reoptimization, online correction using the DAD scheme could be completed within a few minutes rather than tens of minutes and the speed gain would be at a very small cost of plan quality

  8. MR imaging guidance and monitoring of focal thermotherapies. A review

    International Nuclear Information System (INIS)

    Mueller-Lisse, U.G.; California Univ., San Francisco, CA; Heuck, A.F.

    1998-01-01

    Minimally invasive thermotherapies for focal tissue destruction on the basis of laser-, microwave-, focused ultrasound-, or cryogeninduced changes of tissue temperature represent an alternative to surgical tissue ablation, particularly in the treatment of tumors. The thermotherapy modalities listed necessitate indirect guidance and monitoring, since they often do not lend themselves to immediate visual control. In the brain, in head and neck tumors, in the liver, and in the prostate, MRI reliably and accurately delineates both the positions of interstitial thermotherapy applicators and - in contrast-enhanced, T1-weighted images - the perfusion defects in tissue necrosis induced by thermotherapy. The transfer of results of in-vitro and in-vivo model studies to assess interstitial temperature and lesion development during thermotherapy to the actual treatment of patients, however, is still in an initial phase. Further development of both rapid MRI sequences and MRI scanners suited for interventions will show how far treatment systems and guidance systems can be adapted to one another. (orig.) [de

  9. EPA guidance on improving the image of psychiatry.

    Science.gov (United States)

    Möller-Leimkühler, A M; Möller, H-J; Maier, W; Gaebel, W; Falkai, P

    2016-03-01

    This paper explores causes, explanations and consequences of the negative image of psychiatry and develops recommendations for improvement. It is primarily based on a WPA guidance paper on how to combat the stigmatization of psychiatry and psychiatrists and a Medline search on related publications since 2010. Furthermore, focussing on potential causes and explanations, the authors performed a selective literature search regarding additional image-related issues such as mental health literacy and diagnostic and treatment issues. Underestimation of psychiatry results from both unjustified prejudices of the general public, mass media and healthcare professionals and psychiatry's own unfavourable coping with external and internal concerns. Issues related to unjustified devaluation of psychiatry include overestimation of coercion, associative stigma, lack of public knowledge, need to simplify complex mental issues, problem of the continuum between normality and psychopathology, competition with medical and non-medical disciplines and psychopharmacological treatment. Issues related to psychiatry's own contribution to being underestimated include lack of a clear professional identity, lack of biomarkers supporting clinical diagnoses, limited consensus about best treatment options, lack of collaboration with other medical disciplines and low recruitment rates among medical students. Recommendations are proposed for creating and representing a positive self-concept with different components. The negative image of psychiatry is not only due to unfavourable communication with the media, but is basically a problem of self-conceptualization. Much can be improved. However, psychiatry will remain a profession with an exceptional position among the medical disciplines, which should be seen as its specific strength.

  10. Evaluation of a mobile augmented reality application for image guidance of neurosurgical interventions.

    Science.gov (United States)

    Kramers, Matthew; Armstrong, Ryan; Bakhshmand, Saeed M; Fenster, Aaron; de Ribaupierre, Sandrine; Eagleson, Roy

    2014-01-01

    Image guidance can provide surgeons with valuable contextual information during a medical intervention. Often, image guidance systems require considerable infrastructure, setup-time, and operator experience to be utilized. Certain procedures performed at bedside are susceptible to navigational errors that can lead to complications. We present an application for mobile devices that can provide image guidance using augmented reality to assist in performing neurosurgical tasks. A methodology is outlined that evaluates this mode of visualization from the standpoint of perceptual localization, depth estimation, and pointing performance, in scenarios derived from a neurosurgical targeting task. By measuring user variability and speed we can report objective metrics of performance for our augmented reality guidance system.

  11. Autonomous aerial vehicles : guidance, control, signal and image processing platform

    International Nuclear Information System (INIS)

    Al-Jarrah, M.; Adiansyah, S.; Marji, Z. M.; Chowdhury, M. S.

    2011-01-01

    used as fusion algorithm for position and poses estimation. Then path planning, trajectory generation and trajectory guidance alternative strategies is presented. One of the important UAV mission is target surveillance using an onboard vision system. AUS-UAV Mazari is using a gimbaled camera for target monitoring and target tracking using basic digital image processing and techniques. Successful moving target geo-location algorithms were developed and results will be presented. Future plan is to develop a cooperation strategy between several vehicles in the air and on the ground. Use of vision system to aid the vehicle in localization using ground features is also under consideration.

  12. Physics-based shape matching for intraoperative image guidance

    Energy Technology Data Exchange (ETDEWEB)

    Suwelack, Stefan, E-mail: suwelack@kit.edu; Röhl, Sebastian; Bodenstedt, Sebastian; Reichard, Daniel; Dillmann, Rüdiger; Speidel, Stefanie [Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology, Adenauerring 2, Karlsruhe 76131 (Germany); Santos, Thiago dos; Maier-Hein, Lena [Computer-assisted Interventions, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120 (Germany); Wagner, Martin; Wünscher, Josephine; Kenngott, Hannes; Müller, Beat P. [General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, Heidelberg 69120 (Germany)

    2014-11-01

    Purpose: Soft-tissue deformations can severely degrade the validity of preoperative planning data during computer assisted interventions. Intraoperative imaging such as stereo endoscopic, time-of-flight or, laser range scanner data can be used to compensate these movements. In this context, the intraoperative surface has to be matched to the preoperative model. The shape matching is especially challenging in the intraoperative setting due to noisy sensor data, only partially visible surfaces, ambiguous shape descriptors, and real-time requirements. Methods: A novel physics-based shape matching (PBSM) approach to register intraoperatively acquired surface meshes to preoperative planning data is proposed. The key idea of the method is to describe the nonrigid registration process as an electrostatic–elastic problem, where an elastic body (preoperative model) that is electrically charged slides into an oppositely charged rigid shape (intraoperative surface). It is shown that the corresponding energy functional can be efficiently solved using the finite element (FE) method. It is also demonstrated how PBSM can be combined with rigid registration schemes for robust nonrigid registration of arbitrarily aligned surfaces. Furthermore, it is shown how the approach can be combined with landmark based methods and outline its application to image guidance in laparoscopic interventions. Results: A profound analysis of the PBSM scheme based on in silico and phantom data is presented. Simulation studies on several liver models show that the approach is robust to the initial rigid registration and to parameter variations. The studies also reveal that the method achieves submillimeter registration accuracy (mean error between 0.32 and 0.46 mm). An unoptimized, single core implementation of the approach achieves near real-time performance (2 TPS, 7–19 s total registration time). It outperforms established methods in terms of speed and accuracy. Furthermore, it is shown that the

  13. Reduced rectal toxicity with ultrasound-based image guided radiotherapy using BAT trademark (B-mode acquisition and targeting system) for prostate cancer

    International Nuclear Information System (INIS)

    Bohrer, Markus; Schroeder, Peter; Welzel, Grit; Wertz, Hansjoerg; Lohr, Frank; Wenz, Frederik; Mai, Sabine Kathrin

    2008-01-01

    To evaluate the effect of image guided radiotherapy with stereotactic ultrasound BAT (B-mode acquisition and targeting system) on rectal toxicity in conformal radiotherapy of prostate cancer. Patients and Methods 42 sequential patients with prostate cancer undergoing radiotherapy before and after the introduction of BAT were included. Planning computed tomography (CT) was performed with empty rectum and moderately filled bladder. The planning target volume (PTV) included the prostate and seminal vesicles with a safety margin of 1.5 cm in anterior and lateral direction. In posterior direction the anterior 1/3 of the rectum circumference were included. Total dose was 66 Gy and a boost of 4 Gy excluding the seminal vesicles. 22 patients (BAT group) were treated with daily stereotactic ultrasound positioning, for the other 20 patients (NoBAT group) an EPID (electronic portal imaging device) was performed once a week. Acute and late genito-urinary (GU) and rectal toxicity and PSA values were evaluated after 1.5, 3, 6, 9 and 12 months. The total median follow up of toxicity was 3 years in the BAT group and 4 years in the NoBAT group. Results In the NoBAT group significant more rectal toxicity occurred, while in GU toxicity no difference was seen. Two patients in the NoBAT group showed late rectal toxicity grade 3, no toxicity > grade 2 occurred in the BAT group. There was no significant difference in PSA reduction between the groups. Conclusion Without BAT significant more acute and a trend to more late rectal toxicity was found. With regard to dose escalation this aspect is currently evaluated with a larger number of patients using intensity-modulated radiotherapy (IMRT). (orig.)

  14. Gynecologic radiation therapy. Novel approaches to image-guidance and management

    Energy Technology Data Exchange (ETDEWEB)

    Viswanathan, Akila N. [Harvard Medical School, Boston, MA (United States). Dept. of Radiation Oncology; Kirisits, Christian; Poetter, Richard (eds.) [Vienna General Hospital Medical Univ. (Austria). Dept. of Radiotherapy; Erickson, Beth E. [Medical College of Wisconsin Clinics Froedtert Hospital, Milwaukee, WI (United States). Dept. of Radiation Oncology

    2011-07-01

    Recent advances in the treatment of gynecologic malignancies led to a new worldwide consensus to introduce image guidance to gynecologic radiation therapy, particularly to brachytherapy. The book summarizes the changed practice of management: treatment planning for cervical cancer, not modified for over 60 years, has been shifted to an image-based approach, endometrial cancer management with an increase in the use of chemotherapy and vaginal brachytherapy, and vaginal cancer therapy including image guidance and high-dose delivery with IMRT. (orig.)

  15. Ultrasound-Based Guidance for Partial Breast Irradiation Therapy

    Science.gov (United States)

    2012-01-01

    displace- 0278-0062/$20.00 © IEEE Authorized licensed use limited to: IEEE Xplore . Downloaded on January 5, 2009 at 17:37 from IEEE Xplore . Restrictions...Authorized licensed use limited to: IEEE Xplore . Downloaded on January 5, 2009 at 17:37 from IEEE Xplore . Restrictions apply. RIVAZ et al...better CNR values: the Authorized licensed use limited to: IEEE Xplore . Downloaded on January 5, 2009 at 17:37 from IEEE Xplore . Restrictions apply

  16. 76 FR 51993 - Draft Guidance for Industry on Standards for Clinical Trial Imaging Endpoints; Availability

    Science.gov (United States)

    2011-08-19

    ... clinical trials of therapeutic drugs and biological products. The draft guidance describes standards... important imaging endpoint is used in a clinical trial of a therapeutic drug or biological product... Services to the Chairman of [[Page 51994

  17. Image guidance in trans-sphenoidal surgery for giant pituitary adenomas: Luxury or necessity?

    OpenAIRE

    Deepak Agrawal

    2012-01-01

    Background: In spite of availability of image guidance (neuronavigation) at major centers around the world, most trans-sphenoidal surgeries for pituitary adenomas continue to be done under fluoroscopic control. On the other hand, the high mortality and morbidity for giant pituitary adenomas is mainly due to inadequate tumor removal. Aims and Objectives: The objective of this study was to study to utility of image guidance in trans-sphenoidal surgeries for optimizing tumor removal in giant pit...

  18. Evaluation of Image-Guidance Strategies in the Treatment of Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Kupelian, Patrick A.; Lee, Choonik; Langen, Katja M.; Zeidan, Omar A.; Manon, Rafael R.; Willoughby, Twyla R.; Meeks, Sanford L.

    2008-01-01

    Purpose: To compare different image-guidance strategies in the alignment of prostate cancer patients. Using data from patients treated using daily image guidance, the remaining setup errors for several different strategies were retrospectively calculated. Methods and Materials: The alignment data from 74 patients treated with helical tomotherapy were analyzed, resulting in a data set of 2,252 fractions during which a megavoltage computed tomography image was used for image guidance with intraprostatic metallic fiducials. Given the daily positional adjustments, a variety of protocols, differing in imaging frequency and method, were retrospectively studied. The residual setup errors were determined for each protocol. Results: As expected, the systematic errors were effectively reduced with imaging. However, the random errors were unaffected. Even when image guidance was performed every other day with a running mean of the previous displacements, residual setup errors >5 mm occurred in 24% of all fractions. This frequency increased to about 40% if setup errors >3 mm were scored. Conclusion: Setup errors increased with decreasing frequency of image guidance. However, residual errors were still significant at the 5-mm level, even with imaging was performed every other day. This suggests that localizations must be performed daily in the set up of prostate cancer patients during a course of external beam radiotherapy

  19. Image guidance in trans-sphenoidal surgery for giant pituitary adenomas: Luxury or necessity?

    Directory of Open Access Journals (Sweden)

    Deepak Agrawal

    2012-01-01

    Full Text Available Background: In spite of availability of image guidance (neuronavigation at major centers around the world, most trans-sphenoidal surgeries for pituitary adenomas continue to be done under fluoroscopic control. On the other hand, the high mortality and morbidity for giant pituitary adenomas is mainly due to inadequate tumor removal. Aims and Objectives: The objective of this study was to study to utility of image guidance in trans-sphenoidal surgeries for optimizing tumor removal in giant pituitary adenomas. Materials and Methods: This was a prospective study carried out over a two years (January 2009-December 2010 in the Department of Neurosurgery, All India Institute of Medical Sciences. Patients with giant pituitary adenomas who underwent trans-sphenoidal surgery by the author were included. All surgeries were done under image-guidance only and no fluoroscopy was employed. Trajectory was defined using the image guidance and bone work done accordingly to optimize tumor removal. All patients had a contrast CT of the head done within 48 h of surgery to see for residual tumor. Observations and Results: Sixteen patients with pituitary adenomas were operated using only image-guidance in the study period. Twelve patients had virgin tumors and four patients had recurrent/residual tumors. In four patients, noncontrast MR images were used in for image guidance and contrast CT images were used in the rest. The mean set up time for image-guidance was 11 min (range 7-15 min. The mean ′′overall accuracy of registration′′ was 1.6 mm (range 1.4-2.1 mm. The mean operating time was 72 min (range 52-96 min. In all cases, midline and the relation of the carotid artery to the sella could be confirmed using the image-guidance. There were no intraoperative complications. Postoperative scans showed residual tumor in nine patients. The residual tumor was 25% in one patient (with a fibrous recurrent/residual tumor. Conclusions: Image guidance markedly improves

  20. The use of image-guidance during transsphenoidal pituitary surgery in the United States

    Science.gov (United States)

    Chung, Thomas K.; Riley, Kristen O.

    2015-01-01

    Background: Intraoperative image guidance is a useful modality for transsphenoidal pituitary surgery. However, the outcomes associated with this technology have not been systematically evaluated. Objective: The purpose of the study was to quantify complication rates with and without the use of image guidance during transsphenoidal pituitary surgery using a nationwide database with broadly applicable results. Methods: A retrospective analysis of the Nationwide Inpatient Sample was performed from 2007 to 2011. Transsphenoidal pituitary resections for adenomas were identified by International Classification of Diseases-9th Revision, Clinical Modification code. The effect of image guidance on cerebrospinal fluid (CSF) leak complications and cost-benefit was analyzed. Results: A total of 48,848 transsphenoidal pituitary resections were identified, of which 77.5% were partial resections and 22.5% were complete. Pathologic indications included benign (89.3%), malignant primary (0.6%), and malignant secondary (0.4%). Complications included same-stay death (0.4%), CSF leak (8.8%), postoperative CSF rhinorrhea (1.9%), diabetes insipidus (12.4%), and meningitis (0.4%). Image guidance was employed in 7% (n = 3401) of all cases. When analyzed by modality, computed tomography (CT)-assisted procedures had lower CSF rhinorrhea rates (1.1%) compared with cases with no image guidance (1.9%), whereas magnetic resonance (MR)-assisted procedures had the highest rates (2.7%, χ2 p surgery had significantly shorter length of stay (2.9 days) versus no image guidance (3.7 days, p surgery is associated with a lower rate of CSF leak, shorter length of stay, and lower cost compared with patients without image guidance. Further studies that control for severity and extent of disease are warranted to confirm this finding. PMID:25975254

  1. A hybrid optical system for broadband imaging in guidance and control

    Science.gov (United States)

    Wu, Xiaofang; Jiang, Yuesong; Shen, Chunyan; Zhao, Yiming

    2006-11-01

    A binary optics method has been adopted to improve upon a conventional optical system in guidance and control, and a hybrid broadband imaging system that includes a binary surface is analyzed and evaluated by optical design software ZEMAX. The practical design shows that the introduction of binary optics can simplify the structure of the imaging system and reduce the size and weight of the broadband guidance and control system. Moreover, it can help to acquire images of radiation of different wavelengths from targets; hence it will result in improved overall performance of missiles in wars.

  2. SU-E-J-06: Additional Imaging Guidance Dose to Patient Organs Resulting From X-Ray Tubes Used in CyberKnife Image Guidance System

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, A; Ding, G [Vanderbilt University, Nashville, TN (United States)

    2015-06-15

    Purpose: The use of image-guided radiation therapy (IGRT) has become increasingly common, but the additional radiation exposure resulting from repeated image guidance procedures raises concerns. Although there are many studies reporting imaging dose from different image guidance devices, imaging dose for the CyberKnife Robotic Radiosurgery System is not available. This study provides estimated organ doses resulting from image guidance procedures on the CyberKnife system. Methods: Commercially available Monte Carlo software, PCXMC, was used to calculate average organ doses resulting from x-ray tubes used in the CyberKnife system. There are seven imaging protocols with kVp ranging from 60 – 120 kV and 15 mAs for treatment sites in the Cranium, Head and Neck, Thorax, and Abdomen. The output of each image protocol was measured at treatment isocenter. For each site and protocol, Adult body sizes ranging from anorexic to extremely obese were simulated since organ dose depends on patient size. Doses for all organs within the imaging field-of-view of each site were calculated for a single image acquisition from both of the orthogonal x-ray tubes. Results: Average organ doses were <1.0 mGy for every treatment site and imaging protocol. For a given organ, dose increases as kV increases or body size decreases. Higher doses are typically reported for skeletal components, such as the skull, ribs, or clavicles, than for softtissue organs. Typical organ doses due to a single exposure are estimated as 0.23 mGy to the brain, 0.29 mGy to the heart, 0.08 mGy to the kidneys, etc., depending on the imaging protocol and site. Conclusion: The organ doses vary with treatment site, imaging protocol and patient size. Although the organ dose from a single image acquisition resulting from two orthogonal beams is generally insignificant, the sum of repeated image acquisitions (>100) could reach 10–20 cGy for a typical treatment fraction.

  3. Current Brachytherapy Quality Assurance Guidance: Does It Meet the Challenges of Emerging Image-Guided Technologies?

    International Nuclear Information System (INIS)

    Williamson, Jeffrey F.

    2008-01-01

    In the past decade, brachytherapy has shifted from the traditional surgical paradigm to more modern three-dimensional image-based planning and delivery approaches. The role of intraoperative and multimodality image-based planning is growing. Published American Association of Physicists in Medicine, American College of Radiology, European Society for Therapeutic Radiology and Oncology, and International Atomic Energy Agency quality assurance (QA) guidelines largely emphasize the QA of planning and delivery devices rather than processes. These protocols have been designed to verify compliance with major performance specifications and are not risk based. With some exceptions, complete and clinically practical guidance exists for sources, QA instrumentation, non-image-based planning systems, applicators, remote afterloading systems, dosimetry, and calibration. Updated guidance is needed for intraoperative imaging systems and image-based planning systems. For non-image-based brachytherapy, the American Association of Physicists in Medicine Task Group reports 56 and 59 provide reasonable guidance on procedure-specific process flow and QA. However, improved guidance is needed even for established procedures such as ultrasound-guided prostate implants. Adaptive replanning in brachytherapy faces unsolved problems similar to that of image-guided adaptive external beam radiotherapy

  4. Real-time image guidance in laparoscopic liver surgery

    DEFF Research Database (Denmark)

    Kenngott, Hannes G.; Wagner, Martin; Gondan, Matthias

    2014-01-01

    Background: Laparoscopic liver surgery is particularly challenging owing to restricted access, risk of bleeding and lack of haptic feedback. Navigation systems have the potential to improve information on the exact position of intrahepatic tumors, and thus facilitate oncological resection....... This study aims to evaluate the feasibility of a commercially available augmented reality (AR) guidance system employing intraoperative robotic C-arm cone-beam computed tomography (CBCT) for laparoscopic liver surgery. Methods: A human liver-like phantom with sixteen target fiducials was used to evaluate...... the Syngo iPilot® AR system. Subsequently, the system was used for the laparoscopic resection of a hepatocellular carcinoma in segment 7 of a 50-year-old male patient. Results: In the phantom experiment the AR system showed a mean target registration error of 0.96 mm ± 0.52 mm with a maximum error of 2...

  5. Near-infrared image guidance in cancer surgery

    NARCIS (Netherlands)

    Schaafsma, B.E.

    2017-01-01

    Intraoperative imaging using near-infrared (NIR) fluorescence is a fast developing imaging modality as it provides real-time visual information during surgery (Chapter 1). The ability to detect lymph nodes and tumours that need to be resected can assist the surgeon to improve surgery by reducing

  6. TU-A-201-00: Image Guidance Technologies and Management Strategies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Recent years have seen a widespread proliferation of available in-room image guidance systems for radiation therapy target localization with many centers having multiple in-room options. In this session, available imaging systems for in-room IGRT will be reviewed highlighting the main differences in workflow efficiency, targeting accuracy and image quality as it relates to target visualization. Decision-making strategies for integrating these tools into clinical image guidance protocols that are tailored to specific disease sites like H&N, lung, pelvis, and spine SBRT will be discussed. Learning Objectives: Major system characteristics of a wide range of available in-room imaging systems for IGRT. Advantages / disadvantages of different systems for site-specific IGRT considerations. Concepts of targeting accuracy and time efficiency in designing clinical imaging protocols.

  7. Optical Coherence Tomographic Imaging and Delivery for Surgical Guidance

    National Research Council Canada - National Science Library

    Fujimoto, James G

    2004-01-01

    .... OCT can thus function as a type of "optical biopsy," enabling imaging of tissue with resolution approaching conventional biopsy and histopathology, but without the need to remove and process specimens...

  8. Guidance for Methods Descriptions Used in Preclinical Imaging Papers

    Directory of Open Access Journals (Sweden)

    David Stout

    2013-10-01

    Full Text Available Preclinical molecular imaging is a rapidly growing field, where new imaging systems, methods, and biological findings are constantly being developed or discovered. Imaging systems and the associated software usually have multiple options for generating data, which is often overlooked but is essential when reporting the methods used to create and analyze data. Similarly, the ways in which animals are housed, handled, and treated to create physiologically based data must be well described in order that the findings be relevant, useful, and reproducible. There are frequently new developments for metabolic imaging methods. Thus, specific reporting requirements are difficult to establish; however, it remains essential to adequately report how the data have been collected, processed, and analyzed. To assist with future manuscript submissions, this article aims to provide guidelines of what details to report for several of the most common imaging modalities. Examples are provided in an attempt to give comprehensive, succinct descriptions of the essential items to report about the experimental process.

  9. Echocardiographic and Fluoroscopic Fusion Imaging for Procedural Guidance: An Overview and Early Clinical Experience.

    Science.gov (United States)

    Thaden, Jeremy J; Sanon, Saurabh; Geske, Jeffrey B; Eleid, Mackram F; Nijhof, Niels; Malouf, Joseph F; Rihal, Charanjit S; Bruce, Charles J

    2016-06-01

    There has been significant growth in the volume and complexity of percutaneous structural heart procedures in the past decade. Increasing procedural complexity and accompanying reliance on multimodality imaging have fueled the development of fusion imaging to facilitate procedural guidance. The first clinically available system capable of echocardiographic and fluoroscopic fusion for real-time guidance of structural heart procedures was approved by the US Food and Drug Administration in 2012. Echocardiographic-fluoroscopic fusion imaging combines the precise catheter and device visualization of fluoroscopy with the soft tissue anatomy and color flow Doppler information afforded by echocardiography in a single image. This allows the interventionalist to perform precise catheter manipulations under fluoroscopy guidance while visualizing critical tissue anatomy provided by echocardiography. However, there are few data available addressing this technology's strengths and limitations in routine clinical practice. The authors provide a critical review of currently available echocardiographic-fluoroscopic fusion imaging for guidance of structural heart interventions to highlight its strengths, limitations, and potential clinical applications and to guide further research into value of this emerging technology. Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  10. Cone beam computed tomography image guidance system for a dedicated intracranial radiosurgery treatment unit.

    Science.gov (United States)

    Ruschin, Mark; Komljenovic, Philip T; Ansell, Steve; Ménard, Cynthia; Bootsma, Gregory; Cho, Young-Bin; Chung, Caroline; Jaffray, David

    2013-01-01

    Image guidance has improved the precision of fractionated radiation treatment delivery on linear accelerators. Precise radiation delivery is particularly critical when high doses are delivered to complex shapes with steep dose gradients near critical structures, as is the case for intracranial radiosurgery. To reduce potential geometric uncertainties, a cone beam computed tomography (CT) image guidance system was developed in-house to generate high-resolution images of the head at the time of treatment, using a dedicated radiosurgery unit. The performance and initial clinical use of this imaging system are described. A kilovoltage cone beam CT system was integrated with a Leksell Gamma Knife Perfexion radiosurgery unit. The X-ray tube and flat-panel detector are mounted on a translational arm, which is parked above the treatment unit when not in use. Upon descent, a rotational axis provides 210° of rotation for cone beam CT scans. Mechanical integrity of the system was evaluated over a 6-month period. Subsequent clinical commissioning included end-to-end testing of targeting performance and subjective image quality performance in phantoms. The system has been used to image 2 patients, 1 of whom received single-fraction radiosurgery and 1 who received 3 fractions, using a relocatable head frame. Images of phantoms demonstrated soft tissue contrast visibility and submillimeter spatial resolution. A contrast difference of 35 HU was easily detected at a calibration dose of 1.2 cGy (center of head phantom). The shape of the mechanical flex vs scan angle was highly reproducible and exhibited cone beam CT image guidance system was successfully adapted to a radiosurgery unit. The system is capable of producing high-resolution images of bone and soft tissue. The system is in clinical use and provides excellent image guidance without invasive frames. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Paediatric trauma imaging: Why do we need separate guidance?

    International Nuclear Information System (INIS)

    Negus, S.; Danin, J.; Fisher, R.; Johnson, K.; Landes, C.; Somers, J.; Fitzsimmons, C.; Ashford, N.; Foster, J.

    2014-01-01

    It is often assumed that the pattern of injury in children mirrors that of the adult population, but children have different anatomical proportions and the relative elasticity of their tissues results in different injury patterns. The authors of this review are members of the British Society of Paediatric Radiologists subgroup and developed the recently published 47 paediatric trauma protocols for imaging children involved in major blunt trauma. The following article has been written to bring these guidelines to the attention of the wider community of UK radiologists, and explain the rationale behind the recommendations

  12. Three-dimensional Image Fusion Guidance for Transjugular Intrahepatic Portosystemic Shunt Placement.

    Science.gov (United States)

    Tacher, Vania; Petit, Arthur; Derbel, Haytham; Novelli, Luigi; Vitellius, Manuel; Ridouani, Fourat; Luciani, Alain; Rahmouni, Alain; Duvoux, Christophe; Salloum, Chady; Chiaradia, Mélanie; Kobeiter, Hicham

    2017-11-01

    To assess the safety, feasibility and effectiveness of image fusion guidance with pre-procedural portal phase computed tomography with intraprocedural fluoroscopy for transjugular intrahepatic portosystemic shunt (TIPS) placement. All consecutive cirrhotic patients presenting at our interventional unit for TIPS creation from January 2015 to January 2016 were prospectively enrolled. Procedures were performed under general anesthesia in an interventional suite equipped with flat panel detector, cone-beam computed tomography (CBCT) and image fusion technique. All TIPSs were placed under image fusion guidance. After hepatic vein catheterization, an unenhanced CBCT acquisition was performed and co-registered with the pre-procedural portal phase CT images. A virtual path between hepatic vein and portal branch was made using the virtual needle path trajectory software. Subsequently, the 3D virtual path was overlaid on 2D fluoroscopy for guidance during portal branch cannulation. Safety, feasibility, effectiveness and per-procedural data were evaluated. Sixteen patients (12 males; median age 56 years) were included. Procedures were technically feasible in 15 of the 16 patients (94%). One procedure was aborted due to hepatic vein catheterization failure related to severe liver distortion. No periprocedural complications occurred within 48 h of the procedure. The median dose-area product was 91 Gy cm 2 , fluoroscopy time 15 min, procedure time 40 min and contrast media consumption 65 mL. Clinical benefit of the TIPS placement was observed in nine patients (56%). This study suggests that 3D image fusion guidance for TIPS is feasible, safe and effective. By identifying virtual needle path, CBCT enables real-time multiplanar guidance and may facilitate TIPS placement.

  13. Enhanced Automated Guidance System for Horizontal Auger Boring Based on Image Processing.

    Science.gov (United States)

    Wu, Lingling; Wen, Guojun; Wang, Yudan; Huang, Lei; Zhou, Jiang

    2018-02-15

    Horizontal auger boring (HAB) is a widely used trenchless technology for the high-accuracy installation of gravity or pressure pipelines on line and grade. Differing from other pipeline installations, HAB requires a more precise and automated guidance system for use in a practical project. This paper proposes an economic and enhanced automated optical guidance system, based on optimization research of light-emitting diode (LED) light target and five automated image processing bore-path deviation algorithms. An LED light target was optimized for many qualities, including light color, filter plate color, luminous intensity, and LED layout. The image preprocessing algorithm, direction location algorithm, angle measurement algorithm, deflection detection algorithm, and auto-focus algorithm, compiled in MATLAB, are used to automate image processing for deflection computing and judging. After multiple indoor experiments, this guidance system is applied in a project of hot water pipeline installation, with accuracy controlled within 2 mm in 48-m distance, providing accurate line and grade controls and verifying the feasibility and reliability of the guidance system.

  14. Virtual and augmented medical imaging environments: enabling technology for minimally invasive cardiac interventional guidance.

    Science.gov (United States)

    Linte, Cristian A; White, James; Eagleson, Roy; Guiraudon, Gérard M; Peters, Terry M

    2010-01-01

    Virtual and augmented reality environments have been adopted in medicine as a means to enhance the clinician's view of the anatomy and facilitate the performance of minimally invasive procedures. Their value is truly appreciated during interventions where the surgeon cannot directly visualize the targets to be treated, such as during cardiac procedures performed on the beating heart. These environments must accurately represent the real surgical field and require seamless integration of pre- and intra-operative imaging, surgical tracking, and visualization technology in a common framework centered around the patient. This review begins with an overview of minimally invasive cardiac interventions, describes the architecture of a typical surgical guidance platform including imaging, tracking, registration and visualization, highlights both clinical and engineering accuracy limitations in cardiac image guidance, and discusses the translation of the work from the laboratory into the operating room together with typically encountered challenges.

  15. Visual tracking for multi-modality computer-assisted image guidance

    Science.gov (United States)

    Basafa, Ehsan; Foroughi, Pezhman; Hossbach, Martin; Bhanushali, Jasmine; Stolka, Philipp

    2017-03-01

    With optical cameras, many interventional navigation tasks previously relying on EM, optical, or mechanical guidance can be performed robustly, quickly, and conveniently. We developed a family of novel guidance systems based on wide-spectrum cameras and vision algorithms for real-time tracking of interventional instruments and multi-modality markers. These navigation systems support the localization of anatomical targets, support placement of imaging probe and instruments, and provide fusion imaging. The unique architecture - low-cost, miniature, in-hand stereo vision cameras fitted directly to imaging probes - allows for an intuitive workflow that fits a wide variety of specialties such as anesthesiology, interventional radiology, interventional oncology, emergency medicine, urology, and others, many of which see increasing pressure to utilize medical imaging and especially ultrasound, but have yet to develop the requisite skills for reliable success. We developed a modular system, consisting of hardware (the Optical Head containing the mini cameras) and software (components for visual instrument tracking with or without specialized visual features, fully automated marker segmentation from a variety of 3D imaging modalities, visual observation of meshes of widely separated markers, instant automatic registration, and target tracking and guidance on real-time multi-modality fusion views). From these components, we implemented a family of distinct clinical and pre-clinical systems (for combinations of ultrasound, CT, CBCT, and MRI), most of which have international regulatory clearance for clinical use. We present technical and clinical results on phantoms, ex- and in-vivo animals, and patients.

  16. Volumetric image-guidance: Does routine usage prompt adaptive re-planning? An institutional review

    International Nuclear Information System (INIS)

    Tanyi, James A.; Fuss, Martin H.

    2008-01-01

    Purpose. To investigate how the use of volumetric image-guidance using an on-board cone-beam computed tomography (CBCT) system impacts on the frequency of adaptive re-planning. Material and methods. Treatment courses of 146 patients who have undergone a course of external beam radiation therapy (EBRT) using volumetric CBCT image-guidance were analyzed. Target locations included the brain, head and neck, chest, abdomen, as well as prostate and non-prostate pelvis. The majority of patients (57.5%) were treated with hypo-fractionated treatment regimens (three to 15 fraction courses). The frequency of image-guidance ranged from daily (87.7%) to weekly or twice weekly. The underlying medical necessity for adaptive re-planning as well as frequency and consequences of plan adaptation to dose-volume parameters was assessed. Results. Radiation plans of 34 patients (23.3%) were adapted at least once (up to six time) during their course of EBRT as a result of image-guidance CBCT review. Most common causes for adaptive planning were: tumor change (mostly shrinkage: 10 patients; four patients more than one re-plan), change in abdominal girth (systematic change in hollow organ filling; n=7, two patients more than one re-plan), weight loss (n=5), and systematic target setup deviation from simulation (n=5). Adaptive re-plan was required mostly for conventionally fractionated courses; only 5 patient plans undergoing hypo-fractionated treatment were adjusted. In over 91% of adapted plans, the dose-volume parameters did deviate from the prescribed plan parameters by more than 5% for at least 10% of the target volume, or organs-at-risk in close proximity to the target volume. Discussion. Routine use of volumetric image-guidance has in our practice increased the demand for adaptive re-planning. Volumetric CBCT image-guidance provides sufficient imaging information to reliably predict the need for dose adjustment. In the vast majority of cases evaluated, the initial and adapted dose

  17. TH-CD-207A-08: Simulated Real-Time Image Guidance for Lung SBRT Patients Using Scatter Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Redler, G; Cifter, G; Templeton, A; Lee, C; Bernard, D; Liao, Y; Zhen, H; Turian, J; Chu, J [Rush University Medical Center, Chicago, IL (United States)

    2016-06-15

    Purpose: To develop a comprehensive Monte Carlo-based model for the acquisition of scatter images of patient anatomy in real-time, during lung SBRT treatment. Methods: During SBRT treatment, images of patient anatomy can be acquired from scattered radiation. To rigorously examine the utility of scatter images for image guidance, a model is developed using MCNP code to simulate scatter images of phantoms and lung cancer patients. The model is validated by comparing experimental and simulated images of phantoms of different complexity. The differentiation between tissue types is investigated by imaging objects of known compositions (water, lung, and bone equivalent). A lung tumor phantom, simulating materials and geometry encountered during lung SBRT treatments, is used to investigate image noise properties for various quantities of delivered radiation (monitor units(MU)). Patient scatter images are simulated using the validated simulation model. 4DCT patient data is converted to an MCNP input geometry accounting for different tissue composition and densities. Lung tumor phantom images acquired with decreasing imaging time (decreasing MU) are used to model the expected noise amplitude in patient scatter images, producing realistic simulated patient scatter images with varying temporal resolution. Results: Image intensity in simulated and experimental scatter images of tissue equivalent objects (water, lung, bone) match within the uncertainty (∼3%). Lung tumor phantom images agree as well. Specifically, tumor-to-lung contrast matches within the uncertainty. The addition of random noise approximating quantum noise in experimental images to simulated patient images shows that scatter images of lung tumors can provide images in as fast as 0.5 seconds with CNR∼2.7. Conclusions: A scatter imaging simulation model is developed and validated using experimental phantom scatter images. Following validation, lung cancer patient scatter images are simulated. These simulated

  18. TH-CD-207A-08: Simulated Real-Time Image Guidance for Lung SBRT Patients Using Scatter Imaging

    International Nuclear Information System (INIS)

    Redler, G; Cifter, G; Templeton, A; Lee, C; Bernard, D; Liao, Y; Zhen, H; Turian, J; Chu, J

    2016-01-01

    Purpose: To develop a comprehensive Monte Carlo-based model for the acquisition of scatter images of patient anatomy in real-time, during lung SBRT treatment. Methods: During SBRT treatment, images of patient anatomy can be acquired from scattered radiation. To rigorously examine the utility of scatter images for image guidance, a model is developed using MCNP code to simulate scatter images of phantoms and lung cancer patients. The model is validated by comparing experimental and simulated images of phantoms of different complexity. The differentiation between tissue types is investigated by imaging objects of known compositions (water, lung, and bone equivalent). A lung tumor phantom, simulating materials and geometry encountered during lung SBRT treatments, is used to investigate image noise properties for various quantities of delivered radiation (monitor units(MU)). Patient scatter images are simulated using the validated simulation model. 4DCT patient data is converted to an MCNP input geometry accounting for different tissue composition and densities. Lung tumor phantom images acquired with decreasing imaging time (decreasing MU) are used to model the expected noise amplitude in patient scatter images, producing realistic simulated patient scatter images with varying temporal resolution. Results: Image intensity in simulated and experimental scatter images of tissue equivalent objects (water, lung, bone) match within the uncertainty (∼3%). Lung tumor phantom images agree as well. Specifically, tumor-to-lung contrast matches within the uncertainty. The addition of random noise approximating quantum noise in experimental images to simulated patient images shows that scatter images of lung tumors can provide images in as fast as 0.5 seconds with CNR∼2.7. Conclusions: A scatter imaging simulation model is developed and validated using experimental phantom scatter images. Following validation, lung cancer patient scatter images are simulated. These simulated

  19. Evaluation of alignment error due to a speed artifact in stereotactic ultrasound image guidance

    International Nuclear Information System (INIS)

    Salter, Bill J; Wang, Brian; Szegedi, Martin W; Rassiah-Szegedi, Prema; Shrieve, Dennis C; Cheng, Roger; Fuss, Martin

    2008-01-01

    Ultrasound (US) image guidance systems used in radiotherapy are typically calibrated for soft tissue applications, thus introducing errors in depth-from-transducer representation when used in media with a different speed of sound propagation (e.g. fat). This error is commonly referred to as the speed artifact. In this study we utilized a standard US phantom to demonstrate the existence of the speed artifact when using a commercial US image guidance system to image through layers of simulated body fat, and we compared the results with calculated/predicted values. A general purpose US phantom (speed of sound (SOS) = 1540 m s -1 ) was imaged on a multi-slice CT scanner at a 0.625 mm slice thickness and 0.5 mm x 0.5 mm axial pixel size. Target-simulating wires inside the phantom were contoured and later transferred to the US guidance system. Layers of various thickness (1-8 cm) of commercially manufactured fat-simulating material (SOS = 1435 m s -1 ) were placed on top of the phantom to study the depth-related alignment error. In order to demonstrate that the speed artifact is not caused by adding additional layers on top of the phantom, we repeated these measurements in an identical setup using commercially manufactured tissue-simulating material (SOS = 1540 m s -1 ) for the top layers. For the fat-simulating material used in this study, we observed the magnitude of the depth-related alignment errors resulting from the speed artifact to be 0.7 mm cm -1 of fat imaged through. The measured alignment errors caused by the speed artifact agreed with the calculated values within one standard deviation for all of the different thicknesses of fat-simulating material studied here. We demonstrated the depth-related alignment error due to the speed artifact when using US image guidance for radiation treatment alignment and note that the presence of fat causes the target to be aliased to a depth greater than it actually is. For typical US guidance systems in use today, this will

  20. Evaluation of alignment error due to a speed artifact in stereotactic ultrasound image guidance.

    Science.gov (United States)

    Salter, Bill J; Wang, Brian; Szegedi, Martin W; Rassiah-Szegedi, Prema; Shrieve, Dennis C; Cheng, Roger; Fuss, Martin

    2008-12-07

    Ultrasound (US) image guidance systems used in radiotherapy are typically calibrated for soft tissue applications, thus introducing errors in depth-from-transducer representation when used in media with a different speed of sound propagation (e.g. fat). This error is commonly referred to as the speed artifact. In this study we utilized a standard US phantom to demonstrate the existence of the speed artifact when using a commercial US image guidance system to image through layers of simulated body fat, and we compared the results with calculated/predicted values. A general purpose US phantom (speed of sound (SOS) = 1540 m s(-1)) was imaged on a multi-slice CT scanner at a 0.625 mm slice thickness and 0.5 mm x 0.5 mm axial pixel size. Target-simulating wires inside the phantom were contoured and later transferred to the US guidance system. Layers of various thickness (1-8 cm) of commercially manufactured fat-simulating material (SOS = 1435 m s(-1)) were placed on top of the phantom to study the depth-related alignment error. In order to demonstrate that the speed artifact is not caused by adding additional layers on top of the phantom, we repeated these measurements in an identical setup using commercially manufactured tissue-simulating material (SOS = 1540 m s(-1)) for the top layers. For the fat-simulating material used in this study, we observed the magnitude of the depth-related alignment errors resulting from the speed artifact to be 0.7 mm cm(-1) of fat imaged through. The measured alignment errors caused by the speed artifact agreed with the calculated values within one standard deviation for all of the different thicknesses of fat-simulating material studied here. We demonstrated the depth-related alignment error due to the speed artifact when using US image guidance for radiation treatment alignment and note that the presence of fat causes the target to be aliased to a depth greater than it actually is. For typical US guidance systems in use today, this will

  1. 3D/3D registration of coronary CTA and biplane XA reconstructions for improved image guidance

    Energy Technology Data Exchange (ETDEWEB)

    Dibildox, Gerardo, E-mail: g.dibildox@erasmusmc.nl; Baka, Nora; Walsum, Theo van [Biomedical Imaging Group Rotterdam, Departments of Radiology and Medical Informatics, Erasmus Medical Center, 3015 GE Rotterdam (Netherlands); Punt, Mark; Aben, Jean-Paul [Pie Medical Imaging, 6227 AJ Maastricht (Netherlands); Schultz, Carl [Department of Cardiology, Erasmus Medical Center, 3015 GE Rotterdam (Netherlands); Niessen, Wiro [Quantitative Imaging Group, Faculty of Applied Sciences, Delft University of Technology, 2628 CJ Delft, The Netherlands and Biomedical Imaging Group Rotterdam, Departments of Radiology and Medical Informatics, Erasmus Medical Center, 3015 GE Rotterdam (Netherlands)

    2014-09-15

    Purpose: The authors aim to improve image guidance during percutaneous coronary interventions of chronic total occlusions (CTO) by providing information obtained from computed tomography angiography (CTA) to the cardiac interventionist. To this end, the authors investigate a method to register a 3D CTA model to biplane reconstructions. Methods: The authors developed a method for registering preoperative coronary CTA with intraoperative biplane x-ray angiography (XA) images via 3D models of the coronary arteries. The models are extracted from the CTA and biplane XA images, and are temporally aligned based on CTA reconstruction phase and XA ECG signals. Rigid spatial alignment is achieved with a robust probabilistic point set registration approach using Gaussian mixture models (GMMs). This approach is extended by including orientation in the Gaussian mixtures and by weighting bifurcation points. The method is evaluated on retrospectively acquired coronary CTA datasets of 23 CTO patients for which biplane XA images are available. Results: The Gaussian mixture model approach achieved a median registration accuracy of 1.7 mm. The extended GMM approach including orientation was not significantly different (P > 0.1) but did improve robustness with regards to the initialization of the 3D models. Conclusions: The authors demonstrated that the GMM approach can effectively be applied to register CTA to biplane XA images for the purpose of improving image guidance in percutaneous coronary interventions.

  2. What is the value of Image guidance in external beam radiotherapy?

    International Nuclear Information System (INIS)

    Kron, Tomas

    2010-01-01

    Full text: Image guided radiation therapy (lGRT) has become available in many radiotherapy centres in Australia. It is intuitive that frequent imaging of the patient with a modality that identifies the target directly at the time of treatment delivery should benefit patients. However, TGRT is also associated with increased cost for equipment, associated training, quality assurance and imaging time. The Trans Tasman Radiation Oncology Group (TROG) has been contracted by the Australian Commonwealth Department of Health and Ageing (DoHA) to investigate a framework that could be applied to establish a cost/utility assessment of IGRT. The present work aims to develop a study that can test this for daily image guidance of prostate cancer patients. Approach Thirty intermediate risk prostate cancer patients treated at ten or more radiotherapy centres in Australia will be invited to participate. Their treatment as per local practice will not be modified; however two additional treatment plans will be created with margins that would reflect a typical margin appropriate for a treatment delivery with and without daily image guidance. Patients will be stratified for volumetric versus planar orthogonal imaging and for IMRT or conformal approaches. The outcome will be a comparison of dose volume histograms for critical structures based on equal target coverage in all plans.

  3. Condylar guidance: correlation between protrusive interocclusal record and panoramic radiographic image: a pilot study.

    Science.gov (United States)

    Tannamala, Pavan Kumar; Pulagam, Mahesh; Pottem, Srinivas R; Swapna, B

    2012-04-01

    The purpose of this study was to compare the sagittal condylar angles set in the Hanau articulator by use of a method of obtaining an intraoral protrusive record to those angles found using a panoramic radiographic image. Ten patients, free of signs and symptoms of temporomandibular disorder and with intact dentition were selected. The dental stone casts of the subjects were mounted on a Hanau articulator with a springbow and poly(vinyl siloxane) interocclusal records. For all patients, the protrusive records were obtained when the mandible moved forward by approximately 6 mm. All procedures for recording, mounting, and setting were done in the same session. The condylar guidance angles obtained were tabulated. A panoramic radiographic image of each patient was made with the Frankfurt horizontal plane parallel to the floor of the mouth. Tracings of the radiographic images were made. The horizontal reference line was marked by joining the orbitale and porion. The most superior and most inferior points of the curvatures were identified. These two lines were connected by a straight line representing the mean curvature line. Angles made by the intersection of the mean curvature line and the horizontal reference line were measured. The results were subjected to statistical analysis with a significance level of p record method. The mean condylar guidance angle between the right and left side by both the methods was not statistically significant. The comparison of mean condylar guidance angles between the right side of the protrusive record method and the right side of the panoramic radiographic method and the left side of the protrusive record method and the left side of the panoramic radiographic method (p= 0.071 and p= 0.057, respectively) were not statistically significant. Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used in programming semi-adjustable articulators. © 2012

  4. First use of a truly-hybrid x-ray/MR imaging system for guidance of brain biopsy

    International Nuclear Information System (INIS)

    Fahrig, R.; Daniel, B.L.; Butts, K.; Pelc, N.J.; Heit, G.; Wen, Z.

    2003-01-01

    The use of a new hybrid imaging system for guidance of a brain biopsy is described. The system combines the strengths of MRI (soft-tissue contrast, arbitrary plane selection) with those of x-ray fluoroscopy (high-resolution real-time projection images, clear portrayal of bony structures) and allows switching between the imaging modalities without moving the patient. The biopsy was carried out using x-ray guidance for direction of the needle through the foramen ovale and MR guidance to target the soft-tissue lesion. Appropriate samples were acquired. The system could be particularly effective for guidance of those cases where motion, swelling, resection and other intra-operative anatomical changes cannot be accounted for using traditional stereotactic-based imaging approaches. (author)

  5. Respiration-correlated image guidance is the most important radiotherapy motion management strategy for most lung cancer patients

    DEFF Research Database (Denmark)

    Korreman, Stine; Persson, Gitte; Nygaard, Ditte Eklund

    2012-01-01

    The purpose of this study was to quantify the effects of four-dimensional computed tomography (4DCT), 4D image guidance (4D-IG), and beam gating on calculated treatment field margins in a lung cancer patient population....

  6. MO-AB-BRA-02: A Novel Scatter Imaging Modality for Real-Time Image Guidance During Lung SBRT

    International Nuclear Information System (INIS)

    Redler, G; Bernard, D; Templeton, A; Chu, J; Nair, C Kumaran; Turian, J

    2015-01-01

    approach, employing multiple simulation techniques and experiments, is taken to demonstrate the feasibility of a novel scatter imaging modality for the necessary real-time image guidance

  7. MO-AB-BRA-02: A Novel Scatter Imaging Modality for Real-Time Image Guidance During Lung SBRT

    Energy Technology Data Exchange (ETDEWEB)

    Redler, G; Bernard, D; Templeton, A; Chu, J [Rush University Medical Center, Chicago, IL (United States); Nair, C Kumaran [University of Chicago, Chicago, IL (United States); Turian, J [Rush University Medical Center, Chicago, IL (United States); Rush Radiosurgery LLC, Chicago, IL (United States)

    2015-06-15

    approach, employing multiple simulation techniques and experiments, is taken to demonstrate the feasibility of a novel scatter imaging modality for the necessary real-time image guidance.

  8. Evaluation of image-guidance protocols in the treatment of head and neck cancers

    International Nuclear Information System (INIS)

    Zeidan, Omar A.; Langen, Katja M.; Meeks, Sanford L.; Manon, Rafael R.; Wagner, Thomas H.; Willoughby, Twyla R.; Jenkins, D. Wayne; Kupelian, Patrick A.

    2007-01-01

    Purpose: The aim of this study was to assess the residual setup error of different image-guidance (IG) protocols in the alignment of patients with head and neck cancer. The protocols differ in the percentage of treatment fractions that are associated with image guidance. Using data from patients who were treated with daily IG, the residual setup errors for several different protocols are retrospectively calculated. Methods and Materials: Alignment data from 24 patients (802 fractions) treated with daily IG on a helical tomotherapy unit were analyzed. The difference between the daily setup correction and the setup correction that would have been made according to a specific protocol was used to calculate the residual setup errors for each protocol. Results: The different protocols are generally effective in reducing systematic setup errors. Random setup errors are generally not reduced for fractions that are not image guided. As a consequence, if every other treatment is image guided, still about 11% of all treatments (IG and not IG) are subject to three-dimensional setup errors of at least 5 mm. This frequency increases to about 29% if setup errors >3 mm are scored. For various protocols that require 15% to 31% of the treatments to be image guided, from 50% to 60% and from 26% to 31% of all fractions are subject to setup errors >3 mm and >5 mm, respectively. Conclusion: Residual setup errors reduce with increasing frequency of IG during the course of external-beam radiotherapy for head-and-neck cancer patients. The inability to reduce random setup errors for fractions that are not image guided results in notable residual setup errors

  9. The establishment of enteral nutrition with minimally-invasive interventional procedure under endoscopic or imaging guidance

    International Nuclear Information System (INIS)

    Li Feng; Cheng Yingsheng

    2010-01-01

    For patients unable to get the necessary nutrition orally, a variety of techniques,including surgical way, to make gastrostomy with tube placement have been employed. For recent years, gastrostomy and tube placement with the help of endoscopic guidance or percutaneous interventional management has been developed, which is superior to surgical procedure in minimizing injuries, decreasing cost and reducing complications. In certain clinical situations, both endoscopic method and interventional method can be employed. This paper aims to make a comprehensive review of the indications, techniques and skills, advantages and disadvantages of both the endoscopy-guided and the imaging-guided percutaneous gastrojejunostomy for the establishment of enteral nutrition. (authors)

  10. Accuracy of daily image guidance for hypofractionated liver radiotherapy with active breathing control

    International Nuclear Information System (INIS)

    Dawson, Laura A.; Eccles, Cynthia; Bissonnette, Jean-Pierre; Brock, Kristy K.

    2005-01-01

    Purpose: A six-fraction, high-precision radiotherapy protocol for unresectable liver cancer has been developed in which active breathing control (ABC) is used to immobilize the liver and daily megavoltage (MV) imaging and repositioning is used to decrease geometric uncertainties. We report the accuracy of setup in the first 20 patients consecutively treated using this approach. Methods and materials: After setup using conventional skin marks and lasers, orthogonal MV images were acquired with the liver immobilized using ABC. The images were aligned to reference digitally reconstructed radiographs using the diaphragm for craniocaudal (CC) alignment and the vertebral bodies for anterior-posterior (AP) and mediolateral (ML) alignment. Adjustments were made for positioning errors >3 mm. Verification imaging was repeated after repositioning to assess for residual positioning error. Offline image matching was conducted to determine the setup accuracy using this approach compared with the initial setup error before repositioning. Real-time beam's-eye-view MV movies containing an air-diaphragm interface were also evaluated. Results: A total of 405 images were evaluated from 20 patients. Repositioning occurred in 109 of 120 fractions because of offsets >3 mm. Three to eight beam angles, with up to four segments per field, were used for each isocenter. Breath holds of up to 27 s were used for imaging and treatment. The average time from the initial verification image to the last treatment beam was 21 min. Image guidance and repositioning reduced the population random setup errors (σ) from 6.5 mm (CC), 4.2 mm (ML), and 4.7 mm (AP) to 2.5 mm (CC), 2.8 mm (ML), and 2.9 mm (AP). The average individual random setup errors (σ) were reduced from 4.5 mm (CC), 3.2 mm (AP), and 2.5 mm (ML) to 2.2 mm (CC), 2.0 mm (AP), and 2.0 mm (ML). The standard deviation of the distribution of systematic deviations (Σ) was also reduced from 5.1 mm (CC), 3.4 mm (ML), and 3.1 mm (AP) to 1.4 mm (CC

  11. WE-D-BRB-03: Current State of Volumetric Image Guidance for Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hua, C. [St. Jude Children’s Research Hospital (United States)

    2016-06-15

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

  12. WE-D-BRB-03: Current State of Volumetric Image Guidance for Proton Therapy

    International Nuclear Information System (INIS)

    Hua, C.

    2016-01-01

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

  13. Image guidance quality assurance of a G4 CyberKnife robotic stereotactic radiosurgery system

    International Nuclear Information System (INIS)

    Pantelis, E; Antypas, C; Petrokokkinos, L

    2009-01-01

    The image guidance of a CyberKnife robotic radiosurgery system was quality controlled, including the overall performance of the target locating subsystem and the performance of the x-ray generators and flat panel digital cameras subcomponents. Accuracy and precision of the kV and exposure time settings of the x-ray generators, linearity of the x-ray output, spatial resolution and geometrical distortion of the acquired x-ray images were measured. Total accuracy and precision of the target locating subsystem in defining the position of an anthropomorphic head and neck phantom placed on treatment couch was also measured. Accuracy and precision of the kV as well as exposure time settings and linearity of the x-ray output were found within the acceptance limits suggested in diagnostic radiology. The acquired x-ray images were found to depict the shapes of the imaging objects without any geometrical distortion, being able to resolve differences in the features of imaging objects with critical frequency of 1.3 lp/mm and 1.5 lp/mm for camera A and B, respectively. Total target locating system accuracy was found within 0.2 mm and 0.2 deg. in translations and rotations, respectively. Corresponding precision was found lower than 0.5%. These findings render the target locating subsystem of the CyberKnife capable of accurately registering the patient to treatment position and monitoring patient's movement during treatment delivery.

  14. Ultrasound and PET-CT image fusion for prostate brachytherapy image guidance

    International Nuclear Information System (INIS)

    Hasford, F.

    2015-01-01

    Fusion of medical images between different cross-sectional modalities is widely used, mostly where functional images are fused with anatomical data. Ultrasound has for some time now been the standard imaging technique used for treatment planning of prostate cancer cases. While this approach is laudable and has yielded some positive results, latest developments have been the integration of images from ultrasound and other modalities such as PET-CT to compliment missing properties of ultrasound images. This study has sought to enhance diagnosis and treatment of prostate cancers by developing MATLAB algorithms to fuse ultrasound and PET-CT images. The fused ultrasound-PET-CT image has shown to contain improved quality of information than the individual input images. The fused image has the property of reduced uncertainty, increased reliability, robust system performance, and compact representation of information. The objective of co-registering the ultrasound and PET-CT images was achieved by conducting performance evaluation of the ultrasound and PET-CT imaging systems, developing image contrast enhancement algorithm, developing MATLAB image fusion algorithm, and assessing accuracy of the fusion algorithm. Performance evaluation of the ultrasound brachytherapy system produced satisfactory results in accordance with set tolerances as recommended by AAPM TG 128. Using an ultrasound brachytherapy quality assurance phantom, average axial distance measurement of 10.11 ± 0.11 mm was estimated. Average lateral distance measurements of 10.08 ± 0.07 mm, 20.01 ± 0.06 mm, 29.89 ± 0.03 mm and 39.84 ± 0.37 mm were estimated for the inter-target distances corresponding to 10 mm, 20 mm, 30 mm and 40 mm respectively. Volume accuracy assessment produced measurements of 3.97 cm 3 , 8.86 cm 3 and 20.11 cm 3 for known standard volumes of 4 cm 3 , 9 cm 3 and 20 cm 3 respectively. Depth of penetration assessment of the ultrasound system produced an estimate of 5.37 ± 0.02 cm

  15. A multimodal imaging framework for enhanced robot-assisted partial nephrectomy guidance

    Science.gov (United States)

    Halter, Ryan J.; Wu, Xiaotian; Hartov, Alex; Seigne, John; Khan, Shadab

    2015-03-01

    Robot-assisted laparoscopic partial nephrectomies (RALPN) are performed to treat patients with locally confined renal carcinoma. There are well-documented benefits to performing partial (opposed to radical) kidney resections and to using robot-assisted laparoscopic (opposed to open) approaches. However, there are challenges in identifying tumor margins and critical benign structures including blood vessels and collecting systems during current RALPN procedures. The primary objective of this effort is to couple multiple image and data streams together to augment visual information currently provided to surgeons performing RALPN and ultimately ensure complete tumor resection and minimal damage to functional structures (i.e. renal vasculature and collecting systems). To meet this challenge we have developed a framework and performed initial feasibility experiments to couple pre-operative high-resolution anatomic images with intraoperative MRI, ultrasound (US) and optical-based surface mapping and kidney tracking. With these registered images and data streams, we aim to overlay the high-resolution contrast-enhanced anatomic (CT or MR) images onto the surgeon's view screen for enhanced guidance. To date we have integrated the following components of our framework: 1) a method for tracking an intraoperative US probe to extract the kidney surface and a set of embedded kidney markers, 2) a method for co-registering intraoperative US scans with pre-operative MR scans, and 3) a method for deforming pre-op scans to match intraoperative scans. These components have been evaluated through phantom studies to demonstrate protocol feasibility.

  16. Planning, guidance, and quality assurance of pelvic screw placement using deformable image registration

    Science.gov (United States)

    Goerres, J.; Uneri, A.; Jacobson, M.; Ramsay, B.; De Silva, T.; Ketcha, M.; Han, R.; Manbachi, A.; Vogt, S.; Kleinszig, G.; Wolinsky, J.-P.; Osgood, G.; Siewerdsen, J. H.

    2017-12-01

    Percutaneous pelvic screw placement is challenging due to narrow bone corridors surrounded by vulnerable structures and difficult visual interpretation of complex anatomical shapes in 2D x-ray projection images. To address these challenges, a system for planning, guidance, and quality assurance (QA) is presented, providing functionality analogous to surgical navigation, but based on robust 3D-2D image registration techniques using fluoroscopy images already acquired in routine workflow. Two novel aspects of the system are investigated: automatic planning of pelvic screw trajectories and the ability to account for deformation of surgical devices (K-wire deflection). Atlas-based registration is used to calculate a patient-specific plan of screw trajectories in preoperative CT. 3D-2D registration aligns the patient to CT within the projective geometry of intraoperative fluoroscopy. Deformable known-component registration (dKC-Reg) localizes the surgical device, and the combination of plan and device location is used to provide guidance and QA. A leave-one-out analysis evaluated the accuracy of automatic planning, and a cadaver experiment compared the accuracy of dKC-Reg to rigid approaches (e.g. optical tracking). Surgical plans conformed within the bone cortex by 3-4 mm for the narrowest corridor (superior pubic ramus) and  >5 mm for the widest corridor (tear drop). The dKC-Reg algorithm localized the K-wire tip within 1.1 mm and 1.4° and was consistently more accurate than rigid-body tracking (errors up to 9 mm). The system was shown to automatically compute reliable screw trajectories and accurately localize deformed surgical devices (K-wires). Such capability could improve guidance and QA in orthopaedic surgery, where workflow is impeded by manual planning, conventional tool trackers add complexity and cost, rigid tool assumptions are often inaccurate, and qualitative interpretation of complex anatomy from 2D projections is prone to trial

  17. Potential of image-guidance, gating and real-time tracking to improve accuracy in pulmonary stereotactic body radiotherapy

    International Nuclear Information System (INIS)

    Guckenberger, Matthias; Krieger, Thomas; Richter, Anne; Baier, Kurt; Wilbert, Juergen; Sweeney, Reinhart A.; Flentje, Michael

    2009-01-01

    Purpose: To evaluate the potential of image-guidance, gating and real-time tumor tracking to improve accuracy in pulmonary stereotactic body radiotherapy (SBRT). Materials and methods: Safety margins for compensation of inter- and intra-fractional uncertainties of the target position were calculated based on SBRT treatments of 43 patients with pre- and post-treatment cone-beam CT imaging. Safety margins for compensation of breathing motion were evaluated for 17 pulmonary tumors using respiratory correlated CT, model-based segmentation of 4D-CT images and voxel-based dose accumulation; the target in the mid-ventilation position was the reference. Results: Because of large inter-fractional base-line shifts of the tumor, stereotactic patient positioning and image-guidance based on the bony anatomy required safety margins of 12 mm and 9 mm, respectively. Four-dimensional image-guidance targeting the tumor itself and intra-fractional tumor tracking reduced margins to <5 mm and <3 mm, respectively. Additional safety margins are required to compensate for breathing motion. A quadratic relationship between tumor motion and margins for motion compensation was observed: safety margins of 2.4 mm and 6 mm were calculated for compensation of 10 mm and 20 mm motion amplitudes in cranio-caudal direction, respectively. Conclusion: Four-dimensional image-guidance with pre-treatment verification of the target position and online correction of errors reduced safety margins most effectively in pulmonary SBRT.

  18. Rapidly-steered single-element ultrasound for real-time volumetric imaging and guidance

    Science.gov (United States)

    Stauber, Mark; Western, Craig; Solek, Roman; Salisbury, Kenneth; Hristov, Dmitre; Schlosser, Jeffrey

    2016-03-01

    Volumetric ultrasound (US) imaging has the potential to provide real-time anatomical imaging with high soft-tissue contrast in a variety of diagnostic and therapeutic guidance applications. However, existing volumetric US machines utilize "wobbling" linear phased array or matrix phased array transducers which are costly to manufacture and necessitate bulky external processing units. To drastically reduce cost, improve portability, and reduce footprint, we propose a rapidly-steered single-element volumetric US imaging system. In this paper we explore the feasibility of this system with a proof-of-concept single-element volumetric US imaging device. The device uses a multi-directional raster-scan technique to generate a series of two-dimensional (2D) slices that were reconstructed into three-dimensional (3D) volumes. At 15 cm depth, 90° lateral field of view (FOV), and 20° elevation FOV, the device produced 20-slice volumes at a rate of 0.8 Hz. Imaging performance was evaluated using an US phantom. Spatial resolution was 2.0 mm, 4.7 mm, and 5.0 mm in the axial, lateral, and elevational directions at 7.5 cm. Relative motion of phantom targets were automatically tracked within US volumes with a mean error of -0.3+/-0.3 mm, -0.3+/-0.3 mm, and -0.1+/-0.5 mm in the axial, lateral, and elevational directions, respectively. The device exhibited a mean spatial distortion error of 0.3+/-0.9 mm, 0.4+/-0.7 mm, and -0.3+/-1.9 in the axial, lateral, and elevational directions. With a production cost near $1000, the performance characteristics of the proposed system make it an ideal candidate for diagnostic and image-guided therapy applications where form factor and low cost are paramount.

  19. An image guidance system for positioning robotic cochlear implant insertion tools

    Science.gov (United States)

    Bruns, Trevor L.; Webster, Robert J.

    2017-03-01

    Cochlear implants must be inserted carefully to avoid damaging the delicate anatomical structures of the inner ear. This has motivated several approaches to improve the safety and efficacy of electrode array insertion by automating the process with specialized robotic or manual insertion tools. When such tools are used, they must be positioned at the entry point to the cochlea and aligned with the desired entry vector. This paper presents an image guidance system capable of accurately positioning a cochlear implant insertion tool. An optical tracking system localizes the insertion tool in physical space while a graphical user interface incorporates this with patient- specific anatomical data to provide error information to the surgeon in real-time. Guided by this interface, novice users successfully aligned the tool with an mean accuracy of 0.31 mm.

  20. Impact of Image Guidance on Outcomes After External Beam Radiotherapy for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Kupelian, Patrick A.; Willoughby, Twyla R.; Reddy, Chandana A.; Klein, Eric A.; Mahadevan, Arul

    2008-01-01

    Purpose: To verify whether rectal distention at the time of planning impacts outcomes in patients with localized prostate cancer treated with daily image guidance. Methods and Materials: Between 1998 and 2002, a total of 488 prostate cancer patients were treated with intensity-modulated radiotherapy. The radiation dose was 70 Gy delivered at 2.5 Gy per fraction in all cases. All cases were treated with a 4-mm margin posteriorly. In all cases the total rectal volume documented on the CT scan was used for treatment planning. No special bowel preparation instructions were given, either for the simulation or the daily treatments. Before each daily treatment, alignment of the prostate was performed with the B-mode acquisition and targeting (BAT) transabdominal ultrasound system. The median follow-up for all 488 patients was 60 months (range, 24-96 months). Results: For all patients the biochemical relapse-free survival (bRFS) rate at 5 years was 86%. The 5-year bRFS rate for the rectal distention 3 , 50 to 3 , and ≥100 cm 3 groups was 90%, 83%, and 85%, respectively (p = 0.18). To adjust for other potential variables affecting bRFS rates, a multivariate time-to-failure analysis using the Cox proportional hazards model was performed. Rectal distention was not an independent predictor of biochemical failure on multivariate analysis (p = 0.80). Rectal distention was not a predictor of rectal or urinary toxicity. Conclusion: The use of daily image guidance eliminates errors such as rectal distention at the initial planning stage that can affect outcomes after radiotherapy for localized prostate cancer

  1. Ultrasound-based Liver Elastography: Recent Advances

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Young; Choi, Byung Ihn [Seoul National University Hospital, Seoul (Korea, Republic of)

    2011-12-15

    The invasiveness and sampling errors of liver biopsies have prompted the development of diverse non-invasive methods for evaluating liver stiffness. Recently, shear wave-based ultrasound elastography, such as transient elastography (TE), acoustic radiation force impulse (ARFI) imaging and supersonic shear imaging (SSI), as well as quasi-static elastography, such as real-time tissue elastography, have been introduced as noninvasive techniques for evaluating liver stiffness. This editorial reviews each elastographic technique in terms of the principle and clinical applications for the liver diseases

  2. Mobile C-arm cone-beam CT for guidance of spine surgery: Image quality, radiation dose, and integration with interventional guidance

    Energy Technology Data Exchange (ETDEWEB)

    Schafer, S.; Nithiananthan, S.; Mirota, D. J.; Uneri, A.; Stayman, J. W.; Zbijewski, W.; Schmidgunst, C.; Kleinszig, G.; Khanna, A. J.; Siewerdsen, J. H. [Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21202 (United States); Department of Computer Science, Johns Hopkins University, Baltimore, Maryland 21218 (United States); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21202 (United States); Siemens Healthcare XP Division, Erlangen (Germany); Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland 21239 (United States); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21202 and Department of Computer Science, Johns Hopkins University, Baltimore, Maryland 21218 (United States)

    2011-08-15

    Purpose: A flat-panel detector based mobile isocentric C-arm for cone-beam CT (CBCT) has been developed to allow intraoperative 3D imaging with sub-millimeter spatial resolution and soft-tissue visibility. Image quality and radiation dose were evaluated in spinal surgery, commonly relying on lower-performance image intensifier based mobile C-arms. Scan protocols were developed for task-specific imaging at minimum dose, in-room exposure was evaluated, and integration of the imaging system with a surgical guidance system was demonstrated in preclinical studies of minimally invasive spine surgery. Methods: Radiation dose was assessed as a function of kilovolt (peak) (80-120 kVp) and milliampere second using thoracic and lumbar spine dosimetry phantoms. In-room radiation exposure was measured throughout the operating room for various CBCT scan protocols. Image quality was assessed using tissue-equivalent inserts in chest and abdomen phantoms to evaluate bone and soft-tissue contrast-to-noise ratio as a function of dose, and task-specific protocols (i.e., visualization of bone or soft-tissues) were defined. Results were applied in preclinical studies using a cadaveric torso simulating minimally invasive, transpedicular surgery. Results: Task-specific CBCT protocols identified include: thoracic bone visualization (100 kVp; 60 mAs; 1.8 mGy); lumbar bone visualization (100 kVp; 130 mAs; 3.2 mGy); thoracic soft-tissue visualization (100 kVp; 230 mAs; 4.3 mGy); and lumbar soft-tissue visualization (120 kVp; 460 mAs; 10.6 mGy) - each at (0.3 x 0.3 x 0.9 mm{sup 3}) voxel size. Alternative lower-dose, lower-resolution soft-tissue visualization protocols were identified (100 kVp; 230 mAs; 5.1 mGy) for the lumbar region at (0.3 x 0.3 x 1.5 mm{sup 3}) voxel size. Half-scan orbit of the C-arm (x-ray tube traversing under the table) was dosimetrically advantageous (prepatient attenuation) with a nonuniform dose distribution ({approx}2 x higher at the entrance side than at isocenter

  3. Continuous monitoring of prostate position using stereoscopic and monoscopic kV image guidance

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, M. Tynan R.; Parsons, Dave D.; Robar, James L. [Department of Medical Physics, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada and Nova Scotia Cancer Centre, QEII Health Science Centre, Halifax, Nova Scotia B3H 2Y9 (Canada)

    2016-05-15

    Purpose: To demonstrate continuous kV x-ray monitoring of prostate motion using both stereoscopic and monoscopic localizations, assess the spatial accuracy of these techniques, and evaluate the dose delivered from the added image guidance. Methods: The authors implemented both stereoscopic and monoscopic fiducial localizations using a room-mounted dual oblique x-ray system. Recently developed monoscopic 3D position estimation techniques potentially overcome the issue of treatment head interference with stereoscopic imaging at certain gantry angles. To demonstrate continuous position monitoring, a gold fiducial marker was placed in an anthropomorphic phantom and placed on the Linac couch. The couch was used as a programmable translation stage. The couch was programmed with a series of patient prostate motion trajectories exemplifying five distinct categories: stable prostate, slow drift, persistent excursion, transient excursion, and high frequency excursions. The phantom and fiducial were imaged using 140 kVp, 0.63 mAs per image at 1 Hz for a 60 s monitoring period. Both stereoscopic and monoscopic 3D localization accuracies were assessed by comparison to the ground-truth obtained from the Linac log file. Imaging dose was also assessed, using optically stimulated luminescence dosimeter inserts in the phantom. Results: Stereoscopic localization accuracy varied between 0.13 ± 0.05 and 0.33 ± 0.30 mm, depending on the motion trajectory. Monoscopic localization accuracy varied from 0.2 ± 0.1 to 1.1 ± 0.7 mm. The largest localization errors were typically observed in the left–right direction. There were significant differences in accuracy between the two monoscopic views, but which view was better varied from trajectory to trajectory. The imaging dose was measured to be between 2 and 15 μGy/mAs, depending on location in the phantom. Conclusions: The authors have demonstrated the first use of monoscopic localization for a room-mounted dual x-ray system. Three

  4. MO-B-BRC-02: Ultrasound Based Prostate HDR

    International Nuclear Information System (INIS)

    Chang, Z.

    2016-01-01

    Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR is U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions

  5. MO-B-BRC-02: Ultrasound Based Prostate HDR

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Z. [Duke University Medical Center (United States)

    2016-06-15

    Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR is U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.

  6. Accuracy of cranial coplanar beam therapy using an oblique, stereoscopic x-ray image guidance system

    International Nuclear Information System (INIS)

    Vinci, Justin P.; Hogstrom, Kenneth R.; Neck, Daniel W.

    2008-01-01

    A system for measuring two-dimensional (2D) dose distributions in orthogonal anatomical planes in the cranium was developed and used to evaluate the accuracy of coplanar conformal therapy using ExacTrac image guidance. Dose distributions were measured in the axial, sagittal, and coronal planes using a CIRS (Computerized Imaging Reference Systems, Inc.) anthropomorphic head phantom with a custom internal film cassette. Sections of radiographic Kodak EDR2 film were cut, processed, and digitized using custom templates. Spatial and dosimetric accuracy and precision of the film system were assessed. BrainScan planned a coplanar-beam treatment to conformally irradiate a 2-cm-diameterx2-cm-long cylindrical planning target volume. Prior to delivery, phantom misalignments were imposed in combinations of ±8 mm offsets in each of the principal directions. ExacTrac x-ray correction was applied until the phantom was within an acceptance criteria of 1 mm/1 deg. (first two measurement sets) or 0.4 mm/0.4 deg. (last two measurement sets). Measured dose distributions from film were registered to the treatment plan dose calculations and compared. Alignment errors, displacement between midpoints of planned and measured 70% isodose contours (Δc), and positional errors of the 80% isodose line were evaluated using 49 2D film measurements (98 profiles). Comparison of common, but independent measurements of Δc showed that systematic errors in the measurement technique were 0.2 mm or less along all three anatomical axes and that random error averaged (σ±σ σ ) 0.29±0.06 mm for the acceptance criteria of 1 mm/1 deg. and 0.15±0.02 mm for the acceptance criteria of 0.4 mm/0.4 deg. . The latter was consistent with independent estimates that showed the precision of the measurement system was 0.3 mm (2σ). Values of Δc were as great as 0.9, 0.3, and 1.0 mm along the P-A, R-L, and I-S axes, respectively. Variations in Δc along the P-A axis were correlated to misalignments between laser

  7. Image guidance doses delivered during radiotherapy: Quantification, management, and reduction: Report of the AAPM Therapy Physics Committee Task Group 180.

    Science.gov (United States)

    Ding, George X; Alaei, Parham; Curran, Bruce; Flynn, Ryan; Gossman, Michael; Mackie, T Rock; Miften, Moyed; Morin, Richard; Xu, X George; Zhu, Timothy C

    2018-05-01

    With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients. We briefly review the dose to radiotherapy (RT) patients resulting from different image guidance procedures and list typical organ doses resulting from MV and kV image acquisition procedures. We provide recommendations for managing the imaging dose, including different methods for its calculation, and techniques for reducing it. The recommended threshold beyond which imaging dose should be considered in the treatment planning process is 5% of the therapeutic target dose. Although the imaging dose resulting from current kV acquisition procedures is generally below this threshold, the ALARA principle should always be applied in practice. Medical physicists should make radiation oncologists aware of the imaging doses delivered to patients under their care. Balancing ALARA with the requirement for effective target localization requires that imaging dose be managed based on the consideration of weighing risks and benefits to the patient. © 2018 American Association of Physicists in Medicine.

  8. Cone-Beam Computed Tomographic Image Guidance for Lung Cancer Radiation Therapy

    International Nuclear Information System (INIS)

    Bissonnette, Jean-Pierre; Purdie, Thomas G.; Higgins, Jane A.; Li, Winnie; Bezjak, Andrea

    2009-01-01

    Purpose: To determine the geometric accuracy of lung cancer radiotherapy using daily volumetric, cone-beam CT (CBCT) image guidance and online couch position adjustment. Methods and Materials: Initial setup accuracy using localization CBCT was analyzed in three lung cancer patient cohorts. The first (n = 19) involved patients with early-stage non-small-cell lung cancer (NSCLC) treated using stereotactic body radiotherapy (SBRT). The second (n = 48) and third groups (n = 20) involved patients with locally advanced NSCLC adjusted with manual and remote-controlled couch adjustment, respectively. For each group, the couch position was adjusted when positional discrepancies exceeded ±3 mm in any direction, with the remote-controlled couch correcting all three directions simultaneously. Adjustment accuracy was verified with a second CBCT. Population-based setup margins were derived from systematic (Σ) and random (σ) positional errors for each group. Results: Localization imaging demonstrates that 3D positioning errors exceeding 5 mm occur in 54.5% of all delivered fractions. CBCT reduces these errors; post-correction Σ and σ ranged from 1.2 to 1.9 mm for Group 1, with 82% of all fractions within ±3 mm. For Group 2, Σ and σ ranged between 0.8 and 1.8 mm, with 76% of all treatment fractions within ±3 mm. For Group 3, the remote-controlled couch raised this to 84%, and Σ and σ were reduced to 0.4 to 1.7 mm. For each group, the postcorrection setup margins were 4 to 6 mm, 3 to 4 mm, and 2 to 3 mm, respectively. Conclusions: Using IGRT, high geometric accuracy is achievable for NSCLC patients, potentially leading to reduced PTV margins, improved outcomes and empowering adaptive radiation therapy for lung cancer

  9. Volumetric Image Guidance Using Carina vs Spine as Registration Landmarks for Conventionally Fractionated Lung Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lavoie, Caroline; Higgins, Jane; Bissonnette, Jean-Pierre [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, M5G 2M9 (Canada); Le, Lisa W. [Department of Biostatistics, Princess Margaret Hospital, Toronto, Ontario, M5G 2M9 (Canada); Sun, Alexander; Brade, Anthony; Hope, Andrew; Cho, John [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, M5G 2M9 (Canada); Bezjak, Andrea, E-mail: andrea.bezjak@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, M5G 2M9 (Canada)

    2012-12-01

    Purpose: To compare the relative accuracy of 2 image guided radiation therapy methods using carina vs spine as landmarks and then to identify which landmark is superior relative to tumor coverage. Methods and Materials: For 98 lung patients, 2596 daily image-guidance cone-beam computed tomography scans were analyzed. Tattoos were used for initial patient alignment; then, spine and carina registrations were performed independently. A separate analysis assessed the adequacy of gross tumor volume, internal target volume, and planning target volume coverage on cone-beam computed tomography using the initial, middle, and final fractions of radiation therapy. Coverage was recorded for primary tumor (T), nodes (N), and combined target (T+N). Three scenarios were compared: tattoos alignment, spine registration, and carina registration. Results: Spine and carina registrations identified setup errors {>=}5 mm in 35% and 46% of fractions, respectively. The mean vector difference between spine and carina matching had a magnitude of 3.3 mm. Spine and carina improved combined target coverage, compared with tattoos, in 50% and 34% (spine) to 54% and 46% (carina) of the first and final fractions, respectively. Carina matching showed greater combined target coverage in 17% and 23% of fractions for the first and final fractions, respectively; with spine matching, this was only observed in 4% (first) and 6% (final) of fractions. Carina matching provided superior nodes coverage at the end of radiation compared with spine matching (P=.0006), without compromising primary tumor coverage. Conclusion: Frequent patient setup errors occur in locally advanced lung cancer patients. Spine and carina registrations improved combined target coverage throughout the treatment course, but carina matching provided superior combined target coverage.

  10. Volumetric Image Guidance Using Carina vs Spine as Registration Landmarks for Conventionally Fractionated Lung Radiotherapy

    International Nuclear Information System (INIS)

    Lavoie, Caroline; Higgins, Jane; Bissonnette, Jean-Pierre; Le, Lisa W.; Sun, Alexander; Brade, Anthony; Hope, Andrew; Cho, John; Bezjak, Andrea

    2012-01-01

    Purpose: To compare the relative accuracy of 2 image guided radiation therapy methods using carina vs spine as landmarks and then to identify which landmark is superior relative to tumor coverage. Methods and Materials: For 98 lung patients, 2596 daily image-guidance cone-beam computed tomography scans were analyzed. Tattoos were used for initial patient alignment; then, spine and carina registrations were performed independently. A separate analysis assessed the adequacy of gross tumor volume, internal target volume, and planning target volume coverage on cone-beam computed tomography using the initial, middle, and final fractions of radiation therapy. Coverage was recorded for primary tumor (T), nodes (N), and combined target (T+N). Three scenarios were compared: tattoos alignment, spine registration, and carina registration. Results: Spine and carina registrations identified setup errors ≥5 mm in 35% and 46% of fractions, respectively. The mean vector difference between spine and carina matching had a magnitude of 3.3 mm. Spine and carina improved combined target coverage, compared with tattoos, in 50% and 34% (spine) to 54% and 46% (carina) of the first and final fractions, respectively. Carina matching showed greater combined target coverage in 17% and 23% of fractions for the first and final fractions, respectively; with spine matching, this was only observed in 4% (first) and 6% (final) of fractions. Carina matching provided superior nodes coverage at the end of radiation compared with spine matching (P=.0006), without compromising primary tumor coverage. Conclusion: Frequent patient setup errors occur in locally advanced lung cancer patients. Spine and carina registrations improved combined target coverage throughout the treatment course, but carina matching provided superior combined target coverage.

  11. On-line cone beam CT image guidance for vocal cord tumor targeting

    International Nuclear Information System (INIS)

    Osman, Sarah O.S.; Boer, Hans C.J. de; Astreinidou, Eleftheria; Gangsaas, Anne; Heijmen, Ben J.M.; Levendag, Peter C.

    2009-01-01

    Background and purpose: We are developing a technique for highly focused vocal cord irradiation in early glottic carcinoma to optimally treat a target volume confined to a single cord. This technique, in contrast with the conventional methods, aims at sparing the healthy vocal cord. As such a technique requires sub-mm daily targeting accuracy to be effective, we investigate the accuracy achievable with on-line kV-cone beam CT (CBCT) corrections. Materials and methods: CBCT scans were obtained in 10 early glottic cancer patients in each treatment fraction. The grey value registration available in X-ray volume imaging (XVI) software (Elekta, Synergy) was applied to a volume of interest encompassing the thyroid cartilage. After application of the thus derived corrections, residue displacements with respect to the planning CT scan were measured at clearly identifiable relevant landmarks. The intra- and inter-observer variations were also measured. Results: While before correction the systematic displacements of the vocal cords were as large as 2.4 ± 3.3 mm (cranial-caudal population mean ± SD Σ), daily CBCT registration and correction reduced these values to less than 0.2 ± 0.5 mm in all directions. Random positioning errors (SD σ) were reduced to less than 1 mm. Correcting only for translations and not for rotations did not appreciably affect this accuracy. The residue random displacements partly stem from intra-observer variations (SD = 0.2-0.6 mm). Conclusion: The use of CBCT for daily image guidance in combination with standard mask fixation reduced systematic and random set-up errors of the vocal cords to <1 mm prior to the delivery of each fraction dose. Thus, this facilitates the high targeting precision required for a single vocal cord irradiation.

  12. Added Value of Contrast-Enhanced Ultrasound on Biopsies of Focal Hepatic Lesions Invisible on Fusion Imaging Guidance.

    Science.gov (United States)

    Kang, Tae Wook; Lee, Min Woo; Song, Kyoung Doo; Kim, Mimi; Kim, Seung Soo; Kim, Seong Hyun; Ha, Sang Yun

    2017-01-01

    To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions. Biopsies were performed using CEUS for guidance if lesions were invisible on fusion imaging. We retrospectively evaluated the number of target lesions initially invisible on fusion imaging that became visible after applying CEUS, using a 4-point scale. Technical success rates of biopsies were evaluated based on histopathological results. In addition, the occurrence of changes in clinical decision making was assessed. Among 711 patients, 16 patients (2.3%) were included in the study. The median size of target lesions was 1.1 cm (range, 0.5-1.9 cm) in pre-procedural imaging. After CEUS, 15 of 16 (93.8%) focal hepatic lesions were visualized. The conspicuity score was significantly increased after adding CEUS, as compared to that on fusion imaging (p making for 11 of 16 patients (68.8%). The addition of CEUS could improve the conspicuity of focal hepatic lesions invisible on fusion imaging. This dual guidance using CEUS and fusion imaging may affect patient management via changes in clinical decision-making.

  13. SU-E-P-41: Imaging Coordination of Cone Beam CT, On-Board Image Conjunction with Optical Image Guidance for SBRT Treatment with Respiratory Motion Management

    International Nuclear Information System (INIS)

    Liu, Y; Campbell, J

    2015-01-01

    Purpose: To spare normal tissue for SBRT lung/liver patients, especially for patients with significant tumor motion, image guided respiratory motion management has been widely implemented in clinical practice. The purpose of this study was to evaluate imaging coordination of cone beam CT, on-board X-ray image conjunction with optical image guidance for SBRT treatment with motion management. Methods: Currently in our clinic a Varian Novlis Tx was utilized for treating SBRT patients implementing CBCT. A BrainLAB X-ray ExacTrac imaging system in conjunction with optical guidance was primarily used for SRS patients. CBCT and X-ray imaging system were independently calibrated with 1.0 mm tolerance. For SBRT lung/liver patients, the magnitude of tumor motion was measured based-on 4DCT and the measurement was analyzed to determine if patients would be beneficial with respiratory motion management. For patients eligible for motion management, an additional CT with breath holding would be scanned and used as primary planning CT and as reference images for Cone beam CT. During the SBRT treatment, a CBCT with pause and continuing technology would be performed with patients holding breath, which may require 3–4 partially scanned CBCT to combine as a whole CBCT depending on how long patients capable of holding breath. After patients being setup by CBCT images, the ExactTrac X-ray imaging system was implemented with patients’ on-board X-ray images compared to breath holding CT-based DRR. Results: For breath holding patients SBRT treatment, after initially localizing patients with CBCT, we then position patients with ExacTrac X-ray and optical imaging system. The observed deviations of real-time optical guided position average at 3.0, 2.5 and 1.5 mm in longitudinal, vertical and lateral respectively based on 35 treatments. Conclusion: The respiratory motion management clinical practice improved our physician confidence level to give tighter tumor margin for sparing normal

  14. Improved image quality of cone beam CT scans for radiotherapy image guidance using fiber-interspaced antiscatter grid.

    Science.gov (United States)

    Stankovic, Uros; van Herk, Marcel; Ploeger, Lennert S; Sonke, Jan-Jakob

    2014-06-01

    Medical linear accelerator mounted cone beam CT (CBCT) scanner provides useful soft tissue contrast for purposes of image guidance in radiotherapy. The presence of extensive scattered radiation has a negative effect on soft tissue visibility and uniformity of CBCT scans. Antiscatter grids (ASG) are used in the field of diagnostic radiography to mitigate the scatter. They usually do increase the contrast of the scan, but simultaneously increase the noise. Therefore, and considering other scatter mitigation mechanisms present in a CBCT scanner, the applicability of ASGs with aluminum interspacing for a wide range of imaging conditions has been inconclusive in previous studies. In recent years, grids using fiber interspacers have appeared, providing grids with higher scatter rejection while maintaining reasonable transmission of primary radiation. The purpose of this study was to evaluate the impact of one such grid on CBCT image quality. The grid used (Philips Medical Systems) had ratio of 21:1, frequency 36 lp/cm, and nominal selectivity of 11.9. It was mounted on the kV flat panel detector of an Elekta Synergy linear accelerator and tested in a phantom and a clinical study. Due to the flex of the linac and presence of gridline artifacts an angle dependent gain correction algorithm was devised to mitigate resulting artifacts. Scan reconstruction was performed using XVI4.5 augmented with inhouse developed image lag correction and Hounsfield unit calibration. To determine the necessary parameters for Hounsfield unit calibration and software scatter correction parameters, the Catphan 600 (The Phantom Laboratory) phantom was used. Image quality parameters were evaluated using CIRS CBCT Image Quality and Electron Density Phantom (CIRS) in two different geometries: one modeling head and neck and other pelvic region. Phantoms were acquired with and without the grid and reconstructed with and without software correction which was adapted for the different acquisition

  15. Improved image quality of cone beam CT scans for radiotherapy image guidance using fiber-interspaced antiscatter grid

    International Nuclear Information System (INIS)

    Stankovic, Uros; Herk, Marcel van; Ploeger, Lennert S.; Sonke, Jan-Jakob

    2014-01-01

    Purpose: Medical linear accelerator mounted cone beam CT (CBCT) scanner provides useful soft tissue contrast for purposes of image guidance in radiotherapy. The presence of extensive scattered radiation has a negative effect on soft tissue visibility and uniformity of CBCT scans. Antiscatter grids (ASG) are used in the field of diagnostic radiography to mitigate the scatter. They usually do increase the contrast of the scan, but simultaneously increase the noise. Therefore, and considering other scatter mitigation mechanisms present in a CBCT scanner, the applicability of ASGs with aluminum interspacing for a wide range of imaging conditions has been inconclusive in previous studies. In recent years, grids using fiber interspacers have appeared, providing grids with higher scatter rejection while maintaining reasonable transmission of primary radiation. The purpose of this study was to evaluate the impact of one such grid on CBCT image quality. Methods: The grid used (Philips Medical Systems) had ratio of 21:1, frequency 36 lp/cm, and nominal selectivity of 11.9. It was mounted on the kV flat panel detector of an Elekta Synergy linear accelerator and tested in a phantom and a clinical study. Due to the flex of the linac and presence of gridline artifacts an angle dependent gain correction algorithm was devised to mitigate resulting artifacts. Scan reconstruction was performed using XVI4.5 augmented with inhouse developed image lag correction and Hounsfield unit calibration. To determine the necessary parameters for Hounsfield unit calibration and software scatter correction parameters, the Catphan 600 (The Phantom Laboratory) phantom was used. Image quality parameters were evaluated using CIRS CBCT Image Quality and Electron Density Phantom (CIRS) in two different geometries: one modeling head and neck and other pelvic region. Phantoms were acquired with and without the grid and reconstructed with and without software correction which was adapted for the different

  16. Stereotactic Ablative Radiation Therapy for Subcentimeter Lung Tumors: Clinical, Dosimetric, and Image Guidance Considerations

    International Nuclear Information System (INIS)

    Louie, Alexander V.; Senan, Suresh; Dahele, Max; Slotman, Ben J.; Verbakel, Wilko F.A.R.

    2014-01-01

    tumors with image guidance, and excellent local control

  17. Accuracy of image guidance using free-breathing cone-beam computed tomography for stereotactic lung radiotherapy.

    Science.gov (United States)

    Kamomae, Takeshi; Monzen, Hajime; Nakayama, Shinichi; Mizote, Rika; Oonishi, Yuuichi; Kaneshige, Soichiro; Sakamoto, Takashi

    2015-01-01

    Movement of the target object during cone-beam computed tomography (CBCT) leads to motion blurring artifacts. The accuracy of manual image matching in image-guided radiotherapy depends on the image quality. We aimed to assess the accuracy of target position localization using free-breathing CBCT during stereotactic lung radiotherapy. The Vero4DRT linear accelerator device was used for the examinations. Reference point discrepancies between the MV X-ray beam and the CBCT system were calculated using a phantom device with a centrally mounted steel ball. The precision of manual image matching between the CBCT and the averaged intensity (AI) images restructured from four-dimensional CT (4DCT) was estimated with a respiratory motion phantom, as determined in evaluations by five independent operators. Reference point discrepancies between the MV X-ray beam and the CBCT image-guidance systems, categorized as left-right (LR), anterior-posterior (AP), and superior-inferior (SI), were 0.33 ± 0.09, 0.16 ± 0.07, and 0.05 ± 0.04 mm, respectively. The LR, AP, and SI values for residual errors from manual image matching were -0.03 ± 0.22, 0.07 ± 0.25, and -0.79 ± 0.68 mm, respectively. The accuracy of target position localization using the Vero4DRT system in our center was 1.07 ± 1.23 mm (2 SD). This study experimentally demonstrated the sufficient level of geometric accuracy using the free-breathing CBCT and the image-guidance system mounted on the Vero4DRT. However, the inter-observer variation and systematic localization error of image matching substantially affected the overall geometric accuracy. Therefore, when using the free-breathing CBCT images, careful consideration of image matching is especially important.

  18. Image Guidance Based on Prostate Position for Prostate Cancer Proton Therapy

    International Nuclear Information System (INIS)

    Vargas, Carlos; Wagner, Marcus; Indelicato, Daniel; Fryer, Amber; Horne, David; Chellini, Angela; McKenzie, Craig; Lawlor, Paula; Mahajan, Chaitali; Li Zuofeng; Lin Liyong; Keole, Sameer

    2008-01-01

    Purpose: To determine the target coverage for proton therapy with and without image guidance and daily prebeam reorientation. Methods and Materials: A total of 207 prostate positions were analyzed for 9 prostate cancer patients treated using our low-risk prostate proton therapy protocol (University of Florida Proton Therapy Institute 001). The planning target volume was defined as the prostate plus a 5-mm axial and 8-mm superoinferior extension. The prostate was repositioned using 5- and 10-mm shifts (anteriorly, inferiorly, posteriorly, and superiorly) and for Points A-D using a combination of 10-mm multidimensional movements (anteriorly or inferiorly; posteriorly or superiorly; and left or right). The beams were then realigned using the new prostate position. The prescription dose was 78 Gray equivalent (GE) to 95% of the planning target volume. Results: For small movements in the anterior, inferior, and posterior directions within the planning target volume (≤5 mm), treatment realignment demonstrated small, but significant, improvements in the clinical target volume (CTV) coverage to the prescribed dose (78 GE). The anterior and posterior shifts also significantly increased the minimal CTV dose (Δ +1.59 GE). For prostate 10-mm movements in the inferior, posterior, and superior directions, the beam realignment produced larger and significant improvements for both the CTV V 78 (Δ +6.4%) and the CTV minimal dose (Δ +8.22 GE). For the compounded 10-mm multidimensional shifts, realignment significantly improved the CTV V 78 (Δ +11.8%) and CTV minimal dose (Δ +23.6 GE). After realignment, the CTV minimal dose was >76.6 GE (>98%) for all points (A-D). Conclusion: Proton beam realignment after target shift will enhance CTV coverage for different prostate positions

  19. Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance.

    Science.gov (United States)

    Sveistrup, Joen; af Rosenschöld, Per Munck; Deasy, Joseph O; Oh, Jung Hun; Pommer, Tobias; Petersen, Peter Meidahl; Engelholm, Svend Aage

    2014-02-04

    Image-guided radiotherapy (IGRT) facilitates the delivery of a very precise radiation dose. In this study we compare the toxicity and biochemical progression-free survival between patients treated with daily image-guided intensity-modulated radiotherapy (IG-IMRT) and 3D conformal radiotherapy (3DCRT) without daily image guidance for high risk prostate cancer (PCa). A total of 503 high risk PCa patients treated with radiotherapy (RT) and endocrine treatment between 2000 and 2010 were retrospectively reviewed. 115 patients were treated with 3DCRT, and 388 patients were treated with IG-IMRT. 3DCRT patients were treated to 76 Gy and without daily image guidance and with 1-2 cm PTV margins. IG-IMRT patients were treated to 78 Gy based on daily image guidance of fiducial markers, and the PTV margins were 5-7 mm. Furthermore, the dose-volume constraints to both the rectum and bladder were changed with the introduction of IG-IMRT. The 2-year actuarial likelihood of developing grade > = 2 GI toxicity following RT was 57.3% in 3DCRT patients and 5.8% in IG-IMRT patients (p analysis, 3DCRT was associated with a significantly increased risk of developing grade > = 2 GI toxicity compared to IG-IMRT (p analysis there was no difference in biochemical progression-free survival between 3DCRT and IG-IMRT. The difference in toxicity can be attributed to the combination of the IMRT technique with reduced dose to organs-at-risk, daily image guidance and margin reduction.

  20. Integration and evaluation of a needle-positioning robot with volumetric microcomputed tomography image guidance for small animal stereotactic interventions

    International Nuclear Information System (INIS)

    Waspe, Adam C.; McErlain, David D.; Pitelka, Vasek; Holdsworth, David W.; Lacefield, James C.; Fenster, Aaron

    2010-01-01

    Purpose: Preclinical research protocols often require insertion of needles to specific targets within small animal brains. To target biologically relevant locations in rodent brains more effectively, a robotic device has been developed that is capable of positioning a needle along oblique trajectories through a single burr hole in the skull under volumetric microcomputed tomography (micro-CT) guidance. Methods: An x-ray compatible stereotactic frame secures the head throughout the procedure using a bite bar, nose clamp, and ear bars. CT-to-robot registration enables structures identified in the image to be mapped to physical coordinates in the brain. Registration is accomplished by injecting a barium sulfate contrast agent as the robot withdraws the needle from predefined points in a phantom. Registration accuracy is affected by the robot-positioning error and is assessed by measuring the surface registration error for the fiducial and target needle tracks (FRE and TRE). This system was demonstrated in situ by injecting 200 μm tungsten beads into rat brains along oblique trajectories through a single burr hole on the top of the skull under micro-CT image guidance. Postintervention micro-CT images of each skull were registered with preintervention high-field magnetic resonance images of the brain to infer the anatomical locations of the beads. Results: Registration using four fiducial needle tracks and one target track produced a FRE and a TRE of 96 and 210 μm, respectively. Evaluation with tissue-mimicking gelatin phantoms showed that locations could be targeted with a mean error of 154±113 μm. Conclusions: The integration of a robotic needle-positioning device with volumetric micro-CT image guidance should increase the accuracy and reduce the invasiveness of stereotactic needle interventions in small animals.

  1. Integration and evaluation of a needle-positioning robot with volumetric microcomputed tomography image guidance for small animal stereotactic interventions

    Energy Technology Data Exchange (ETDEWEB)

    Waspe, Adam C.; McErlain, David D.; Pitelka, Vasek; Holdsworth, David W.; Lacefield, James C.; Fenster, Aaron [Biomedical Engineering Graduate Program and Imaging Research Laboratories, Robarts Research Institute, University of Western Ontario, London, Ontario N6A 5K8 (Canada); Department of Medical Biophysics and Imaging Research Laboratories, Robarts Research Institute, University of Western Ontario, London, Ontario N6A 5K8 (Canada); Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario N6A 5C1 (Canada); Biomedical Engineering Graduate Program, Department of Medical Biophysics, Department of Medical Imaging, Department of Surgery, and Imaging Research Laboratories, Robarts Research Institute, University of Western Ontario, London, Ontario N6A 5K8 (Canada); Biomedical Engineering Graduate Program, Department of Electrical and Computer Engineering, Department of Medical Biophysics, and Imaging Research Laboratories, Robarts Research Institute, University of Western Ontario, London, Ontario N6A 5K8 (Canada); Biomedical Engineering Graduate Program, Department of Medical Biophysics, Department of Medical Imaging, and Imaging Research Laboratories, Robarts Research Institute, University of Western Ontario, London, Ontario N6A 5K8 (Canada)

    2010-04-15

    Purpose: Preclinical research protocols often require insertion of needles to specific targets within small animal brains. To target biologically relevant locations in rodent brains more effectively, a robotic device has been developed that is capable of positioning a needle along oblique trajectories through a single burr hole in the skull under volumetric microcomputed tomography (micro-CT) guidance. Methods: An x-ray compatible stereotactic frame secures the head throughout the procedure using a bite bar, nose clamp, and ear bars. CT-to-robot registration enables structures identified in the image to be mapped to physical coordinates in the brain. Registration is accomplished by injecting a barium sulfate contrast agent as the robot withdraws the needle from predefined points in a phantom. Registration accuracy is affected by the robot-positioning error and is assessed by measuring the surface registration error for the fiducial and target needle tracks (FRE and TRE). This system was demonstrated in situ by injecting 200 {mu}m tungsten beads into rat brains along oblique trajectories through a single burr hole on the top of the skull under micro-CT image guidance. Postintervention micro-CT images of each skull were registered with preintervention high-field magnetic resonance images of the brain to infer the anatomical locations of the beads. Results: Registration using four fiducial needle tracks and one target track produced a FRE and a TRE of 96 and 210 {mu}m, respectively. Evaluation with tissue-mimicking gelatin phantoms showed that locations could be targeted with a mean error of 154{+-}113 {mu}m. Conclusions: The integration of a robotic needle-positioning device with volumetric micro-CT image guidance should increase the accuracy and reduce the invasiveness of stereotactic needle interventions in small animals.

  2. Ultrasound-based teaching of cardiac anatomy and physiology to undergraduate medical students.

    Science.gov (United States)

    Hammoudi, Nadjib; Arangalage, Dimitri; Boubrit, Lila; Renaud, Marie Christine; Isnard, Richard; Collet, Jean-Philippe; Cohen, Ariel; Duguet, Alexandre

    2013-10-01

    Ultrasonography is a non-invasive imaging modality that offers the opportunity to teach living cardiac anatomy and physiology. The objectives of this study were to assess the feasibility of integrating an ultrasound-based course into the conventional undergraduate medical teaching programme and to analyse student and teacher feedback. An ultrasound-based teaching course was implemented and proposed to all second-year medical students (n=348) at the end of the academic year, after all the conventional modules at our faculty. After a brief theoretical and practical demonstration, students were allowed to take the probe and use the ultrasound machine. Students and teachers were asked to complete a survey and were given the opportunity to provide open feedback. Two months were required to implement the entire module; 330 (95%) students (divided into 39 groups) and 37 teachers participated in the course. Student feedback was very positive: 98% of students agreed that the course was useful; 85% and 74% considered that their understanding of cardiac anatomy and physiology, respectively, was improved. The majority of the teachers (97%) felt that the students were interested, 81% agreed that the course was appropriate for second-year medical students and 84% were willing to participate to future sessions. Cardiac anatomy and physiology teaching using ultrasound is feasible for undergraduate medical students and enhances their motivation to improve their knowledge. Student and teacher feedback on the course was very positive. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  3. Added value of contrast-enhanced ultrasound on biopsies of focal hepatic lesions invisible on fusion imaging guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Tae Wook; Lee, Min Woo; Song, Kyoung Doo; Kim, Mimi; Kim, Seung Soo; Kim, Seong Hyun; Ha, Sang Yun [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-01-15

    To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions. Biopsies were performed using CEUS for guidance if lesions were invisible on fusion imaging. We retrospectively evaluated the number of target lesions initially invisible on fusion imaging that became visible after applying CEUS, using a 4-point scale. Technical success rates of biopsies were evaluated based on histopathological results. In addition, the occurrence of changes in clinical decision making was assessed. Among 711 patients, 16 patients (2.3%) were included in the study. The median size of target lesions was 1.1 cm (range, 0.5–1.9 cm) in pre-procedural imaging. After CEUS, 15 of 16 (93.8%) focal hepatic lesions were visualized. The conspicuity score was significantly increased after adding CEUS, as compared to that on fusion imaging (p < 0.001). The technical success rate of biopsy was 87.6% (14/16). After biopsy, there were changes in clinical decision making for 11 of 16 patients (68.8%). The addition of CEUS could improve the conspicuity of focal hepatic lesions invisible on fusion imaging. This dual guidance using CEUS and fusion imaging may affect patient management via changes in clinical decision-making.

  4. Added value of contrast-enhanced ultrasound on biopsies of focal hepatic lesions invisible on fusion imaging guidance

    International Nuclear Information System (INIS)

    Kang, Tae Wook; Lee, Min Woo; Song, Kyoung Doo; Kim, Mimi; Kim, Seung Soo; Kim, Seong Hyun; Ha, Sang Yun

    2017-01-01

    To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions. Biopsies were performed using CEUS for guidance if lesions were invisible on fusion imaging. We retrospectively evaluated the number of target lesions initially invisible on fusion imaging that became visible after applying CEUS, using a 4-point scale. Technical success rates of biopsies were evaluated based on histopathological results. In addition, the occurrence of changes in clinical decision making was assessed. Among 711 patients, 16 patients (2.3%) were included in the study. The median size of target lesions was 1.1 cm (range, 0.5–1.9 cm) in pre-procedural imaging. After CEUS, 15 of 16 (93.8%) focal hepatic lesions were visualized. The conspicuity score was significantly increased after adding CEUS, as compared to that on fusion imaging (p < 0.001). The technical success rate of biopsy was 87.6% (14/16). After biopsy, there were changes in clinical decision making for 11 of 16 patients (68.8%). The addition of CEUS could improve the conspicuity of focal hepatic lesions invisible on fusion imaging. This dual guidance using CEUS and fusion imaging may affect patient management via changes in clinical decision-making

  5. Ultrasound-based testing of tendon mechanical properties

    DEFF Research Database (Denmark)

    Seynnes, O R; Bojsen-Møller, J.; Albracht, K

    2015-01-01

    In the past 20 years, the use of ultrasound-based methods has become a standard approach to measure tendon mechanical properties in vivo. Yet the multitude of methodological approaches adopted by various research groups probably contribute to the large variability of reported values. The technique......, or signal synchronization; and 2) in physiological considerations related to the viscoelastic behavior or length measurements of tendons. Hence, the purpose of the present review is to assess and discuss the physiological and technical aspects connected to in vivo testing of tendon mechanical properties...

  6. SU-G-BRA-03: PCA Based Imaging Angle Optimization for 2D Cine MRI Based Radiotherapy Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Chen, T; Yue, N; Jabbour, S; Zhang, M [Rutgers University, New Brunswick, NJ (United States)

    2016-06-15

    Purpose: To develop an imaging angle optimization methodology for orthogonal 2D cine MRI based radiotherapy guidance using Principal Component Analysis (PCA) of target motion retrieved from 4DCT. Methods: We retrospectively analyzed 4DCT of 6 patients with lung tumor. A radiation oncologist manually contoured the target volume at the maximal inhalation phase of the respiratory cycle. An object constrained deformable image registration (DIR) method has been developed to track the target motion along the respiration at ten phases. The motion of the center of the target mass has been analyzed using the PCA to find out the principal motion components that were uncorrelated with each other. Two orthogonal image planes for cineMRI have been determined using this method to minimize the through plane motion during MRI based radiotherapy guidance. Results: 3D target respiratory motion for all 6 patients has been efficiently retrieved from 4DCT. In this process, the object constrained DIR demonstrated satisfactory accuracy and efficiency to enable the automatic motion tracking for clinical application. The average motion amplitude in the AP, lateral, and longitudinal directions were 3.6mm (min: 1.6mm, max: 5.6mm), 1.7mm (min: 0.6mm, max: 2.7mm), and 5.6mm (min: 1.8mm, max: 16.1mm), respectively. Based on PCA, the optimal orthogonal imaging planes were determined for cineMRI. The average angular difference between the PCA determined imaging planes and the traditional AP and lateral imaging planes were 47 and 31 degrees, respectively. After optimization, the average amplitude of through plane motion reduced from 3.6mm in AP images to 2.5mm (min:1.3mm, max:3.9mm); and from 1.7mm in lateral images to 0.6mm (min: 0.2mm, max:1.5mm), while the principal in plane motion amplitude increased from 5.6mm to 6.5mm (min: 2.8mm, max: 17mm). Conclusion: DIR and PCA can be used to optimize the orthogonal image planes of cineMRI to minimize the through plane motion during radiotherapy

  7. SU-G-BRA-03: PCA Based Imaging Angle Optimization for 2D Cine MRI Based Radiotherapy Guidance

    International Nuclear Information System (INIS)

    Chen, T; Yue, N; Jabbour, S; Zhang, M

    2016-01-01

    Purpose: To develop an imaging angle optimization methodology for orthogonal 2D cine MRI based radiotherapy guidance using Principal Component Analysis (PCA) of target motion retrieved from 4DCT. Methods: We retrospectively analyzed 4DCT of 6 patients with lung tumor. A radiation oncologist manually contoured the target volume at the maximal inhalation phase of the respiratory cycle. An object constrained deformable image registration (DIR) method has been developed to track the target motion along the respiration at ten phases. The motion of the center of the target mass has been analyzed using the PCA to find out the principal motion components that were uncorrelated with each other. Two orthogonal image planes for cineMRI have been determined using this method to minimize the through plane motion during MRI based radiotherapy guidance. Results: 3D target respiratory motion for all 6 patients has been efficiently retrieved from 4DCT. In this process, the object constrained DIR demonstrated satisfactory accuracy and efficiency to enable the automatic motion tracking for clinical application. The average motion amplitude in the AP, lateral, and longitudinal directions were 3.6mm (min: 1.6mm, max: 5.6mm), 1.7mm (min: 0.6mm, max: 2.7mm), and 5.6mm (min: 1.8mm, max: 16.1mm), respectively. Based on PCA, the optimal orthogonal imaging planes were determined for cineMRI. The average angular difference between the PCA determined imaging planes and the traditional AP and lateral imaging planes were 47 and 31 degrees, respectively. After optimization, the average amplitude of through plane motion reduced from 3.6mm in AP images to 2.5mm (min:1.3mm, max:3.9mm); and from 1.7mm in lateral images to 0.6mm (min: 0.2mm, max:1.5mm), while the principal in plane motion amplitude increased from 5.6mm to 6.5mm (min: 2.8mm, max: 17mm). Conclusion: DIR and PCA can be used to optimize the orthogonal image planes of cineMRI to minimize the through plane motion during radiotherapy

  8. Cone beam computed tomography and its image guidance technology during percutaneous nucleoplasty procedures at L5/S1 lumbar level

    Energy Technology Data Exchange (ETDEWEB)

    Ierardi, Anna Maria; Piacentino, Filippo; Giorlando, Francesca [University of Insubria, Unit of Interventional Radiology, Department of Radiology, Varese (Italy); Magenta Biasina, Alberto; Carrafiello, Gianpaolo [University of Milan, San Paolo Hospital, Department of Diagnostic and Interventional Radiology, Milan (Italy); Bacuzzi, Alessandro [University of Insubria, Anaesthesia and Palliative Care, Varese (Italy); Novario, Raffaele [University of Insubria, Medical Physics Department, Varese (Italy)

    2016-12-15

    To demonstrate the feasibility of percutaneous nucleoplasty procedures at L5/S1 level using cone beam CT (CBCT) and its associated image guidance technology for the treatment of lumbar disc herniation (LDH). We retrospectively reviewed 25 cases (20 men, 5 women) of LDH at L5/S1 levels. CBCT as guidance imaging was chosen after a first unsuccessful fluoroscopy attempt that was related to complex anatomy (n = 15), rapid pathological changes due to degenerative diseases (n = 7) or both (n = 3). Technical success, defined as correct needle positioning in the target LDH, and safety were evaluated; overall procedure time and radiation dose were registered. A visual analog scale (VAS) was used to evaluate pain and discomfort pre-intervention after 1 week and 1, 3, and 6 months after the procedure. Technical success was 100 %; using CBCT as guidance imaging the needle was correctly positioned at the first attempt in 20 out of 25 patients. Neither major nor minor complications were registered during or after the procedure. The average procedure time was 11 min and 56 s (range, 9-15 min), whereas mean procedural radiation dose was 46.25 Gy.cm{sup 2} (range 38.10-52.84 Gy.cm{sup 2}), and mean fluoroscopy time was 5 min 34 s (range 3 min 40 s to 6 min 55 s). The VAS pain score decreased significantly from 7.6 preoperatively to 3.9 at 1 week, 2.8 at 1 month, 2.1 at 3 months, and 1.6 at 6 months postoperatively. CBCT-guided percutaneous nucleoplasty is a highly effective technique for LDH with acceptable procedure time and radiation dose. (orig.)

  9. Prototype volumetric ultrasound tomography image guidance system for prone stereotactic partial breast irradiation: proof-of-concept

    Science.gov (United States)

    Chiu, Tsuicheng D.; Parsons, David; Zhang, Yue; Hrycushko, Brian; Zhao, Bo; Chopra, Rajiv; Kim, Nathan; Spangler, Ann; Rahimi, Asal; Timmerman, Robert; Jiang, Steve B.; Lu, Weiguo; Gu, Xuejun

    2018-03-01

    Accurate dose delivery in stereotactic partial breast irradiation (S-PBI) is challenging because of the target position uncertainty caused by breast deformation, the target volume changes caused by lumpectomy cavity shrinkage, and the target delineation uncertainty on simulation computed tomography (CT) images caused by poor soft tissue contrast. We have developed a volumetric ultrasound tomography (UST) image guidance system for prone position S-PBI. The system is composed of a novel 3D printed rotation water tank, a patient-specific resin breast immobilization cup, and a 1D array ultrasound transducer. Coronal 2D US images were acquired in 5° increments over a 360° range, and planes were acquired every 2 mm in elevation. A super-compounding technique was used to reconstruct the image volume. The image quality of UST was evaluated with a BB-1 breast phantom and BioZorb surgical marker, and the results revealed that UST offered better soft tissue contrast than CT and similar image quality to MR. In the evaluated plane, the size and location of five embedded objects were measured and compared to MR, which is considered as the ground truth. Objects’ diameters and the distances between objects in UST differ by approximately 1 to 2 mm from those in MR, which showed that UST offers the image quality required for S-PBI. In future work we will develop a robotic system that will be ultimately implemented in the clinic.

  10. Respiration-Correlated Image Guidance Is the Most Important Radiotherapy Motion Management Strategy for Most Lung Cancer Patients

    International Nuclear Information System (INIS)

    Korreman, Stine; Persson, Gitte; Nygaard, Ditte; Brink, Carsten; Juhler-Nøttrup, Trine

    2012-01-01

    Purpose: The purpose of this study was to quantify the effects of four-dimensional computed tomography (4DCT), 4D image guidance (4D-IG), and beam gating on calculated treatment field margins in a lung cancer patient population. Materials and Methods: Images were acquired from 46 lung cancer patients participating in four separate protocols at three institutions in Europe and the United States. Seven patients were imaged using fluoroscopy, and 39 patients were imaged using 4DCT. The magnitude of respiratory tumor motion was measured. The required treatment field margins were calculated using a statistical recipe (van Herk M, et al. Int J Radiat Oncol Biol Phys 2000;474:1121–1135), with magnitudes of all uncertainties, except respiratory peak-to-peak displacement, the same for all patients, taken from literature. Required margins for respiratory motion management were calculated using the residual respiratory tumor motion for each patient for various motion management strategies. Margin reductions for respiration management were calculated using 4DCT, 4D-IG, and gated beam delivery. Results: The median tumor motion magnitude was 4.4 mm for the 46 patients (range 0–29.3 mm). This value corresponded to required treatment field margins of 13.7 to 36.3 mm (median 14.4 mm). The use of 4DCT, 4D-IG, and beam gating required margins that were reduced by 0 to 13.9 mm (median 0.5 mm), 3 to 5.2 mm (median 5.1 mm), and 0 to 7 mm (median 0.2 mm), respectively, to a total of 8.5 to 12.4 mm (median 8.6 mm). Conclusion: A respiratory management strategy for lung cancer radiotherapy including planning on 4DCT scans and daily image guidance provides a potential reduction of 37% to 47% in treatment field margins. The 4D image guidance strategy was the most effective strategy for >85% of the patients.

  11. Tailoring four-dimensional cone-beam CT acquisition settings for fiducial marker-based image guidance in radiation therapy.

    Science.gov (United States)

    Jin, Peng; van Wieringen, Niek; Hulshof, Maarten C C M; Bel, Arjan; Alderliesten, Tanja

    2018-04-01

    Use of four-dimensional cone-beam CT (4D-CBCT) and fiducial markers for image guidance during radiation therapy (RT) of mobile tumors is challenging due to the trade-off among image quality, imaging dose, and scanning time. This study aimed to investigate different 4D-CBCT acquisition settings for good visibility of fiducial markers in 4D-CBCT. Using these 4D-CBCTs, the feasibility of marker-based 4D registration for RT setup verification and manual respiration-induced motion quantification was investigated. For this, we applied a dynamic phantom with three different breathing motion amplitudes and included two patients with implanted markers. Irrespective of the motion amplitude, for a medium field of view (FOV), marker visibility was improved by reducing the imaging dose per projection and increasing the number of projection images; however, the scanning time was 4 to 8 min. For a small FOV, the total imaging dose and the scanning time were reduced (62.5% of the dose using a medium FOV, 2.5 min) without losing marker visibility. However, the body contour could be missing for a small FOV, which is not preferred in RT. The marker-based 4D setup verification was feasible for both the phantom and patient data. Moreover, manual marker motion quantification can achieve a high accuracy with a mean error of [Formula: see text].

  12. Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance

    International Nuclear Information System (INIS)

    Sveistrup, Joen; Rosenschöld, Per Munck af; Deasy, Joseph O; Oh, Jung Hun; Pommer, Tobias; Petersen, Peter Meidahl; Engelholm, Svend Aage

    2014-01-01

    Image-guided radiotherapy (IGRT) facilitates the delivery of a very precise radiation dose. In this study we compare the toxicity and biochemical progression-free survival between patients treated with daily image-guided intensity-modulated radiotherapy (IG-IMRT) and 3D conformal radiotherapy (3DCRT) without daily image guidance for high risk prostate cancer (PCa). A total of 503 high risk PCa patients treated with radiotherapy (RT) and endocrine treatment between 2000 and 2010 were retrospectively reviewed. 115 patients were treated with 3DCRT, and 388 patients were treated with IG-IMRT. 3DCRT patients were treated to 76 Gy and without daily image guidance and with 1–2 cm PTV margins. IG-IMRT patients were treated to 78 Gy based on daily image guidance of fiducial markers, and the PTV margins were 5–7 mm. Furthermore, the dose-volume constraints to both the rectum and bladder were changed with the introduction of IG-IMRT. The 2-year actuarial likelihood of developing grade > = 2 GI toxicity following RT was 57.3% in 3DCRT patients and 5.8% in IG-IMRT patients (p < 0.001). For GU toxicity the numbers were 41.8% and 29.7%, respectively (p = 0.011). On multivariate analysis, 3DCRT was associated with a significantly increased risk of developing grade > = 2 GI toxicity compared to IG-IMRT (p < 0.001, HR = 11.59 [CI: 6.67-20.14]). 3DCRT was also associated with an increased risk of developing GU toxicity compared to IG-IMRT. The 3-year actuarial biochemical progression-free survival probability was 86.0% for 3DCRT and 90.3% for IG-IMRT (p = 0.386). On multivariate analysis there was no difference in biochemical progression-free survival between 3DCRT and IG-IMRT. The difference in toxicity can be attributed to the combination of the IMRT technique with reduced dose to organs-at-risk, daily image guidance and margin reduction

  13. SU-C-207B-07: Deep Convolutional Neural Network Image Matching for Ultrasound Guidance in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, N; Najafi, M; Hancock, S; Hristov, D [Stanford University Cancer Center, Palo Alto, CA (United States)

    2016-06-15

    Purpose: Robust matching of ultrasound images is a challenging problem as images of the same anatomy often present non-trivial differences. This poses an obstacle for ultrasound guidance in radiotherapy. Thus our objective is to overcome this obstacle by designing and evaluating an image blocks matching framework based on a two channel deep convolutional neural network. Methods: We extend to 3D an algorithmic structure previously introduced for 2D image feature learning [1]. To obtain the similarity between two 3D image blocks A and B, the 3D image blocks are divided into 2D patches Ai and Bi. The similarity is then calculated as the average similarity score of Ai and Bi. The neural network was then trained with public non-medical image pairs, and subsequently evaluated on ultrasound image blocks for the following scenarios: (S1) same image blocks with/without shifts (A and A-shift-x); (S2) non-related random block pairs; (S3) ground truth registration matched pairs of different ultrasound images with/without shifts (A-i and A-reg-i-shift-x). Results: For S1 the similarity scores of A and A-shift-x were 32.63, 18.38, 12.95, 9.23, 2.15 and 0.43 for x=ranging from 0 mm to 10 mm in 2 mm increments. For S2 the average similarity score for non-related block pairs was −1.15. For S3 the average similarity score of ground truth registration matched blocks A-i and A-reg-i-shift-0 (1≤i≤5) was 12.37. After translating A-reg-i-shift-0 by 0 mm, 2 mm, 4 mm, 6 mm, 8 mm, and 10 mm, the average similarity scores of A-i and A-reg-i-shift-x were 11.04, 8.42, 4.56, 2.27, and 0.29 respectively. Conclusion: The proposed method correctly assigns highest similarity to corresponding 3D ultrasound image blocks despite differences in image content and thus can form the basis for ultrasound image registration and tracking.[1] Zagoruyko, Komodakis, “Learning to compare image patches via convolutional neural networks', IEEE CVPR 2015,pp.4353–4361.

  14. SU-C-207B-07: Deep Convolutional Neural Network Image Matching for Ultrasound Guidance in Radiotherapy

    International Nuclear Information System (INIS)

    Zhu, N; Najafi, M; Hancock, S; Hristov, D

    2016-01-01

    Purpose: Robust matching of ultrasound images is a challenging problem as images of the same anatomy often present non-trivial differences. This poses an obstacle for ultrasound guidance in radiotherapy. Thus our objective is to overcome this obstacle by designing and evaluating an image blocks matching framework based on a two channel deep convolutional neural network. Methods: We extend to 3D an algorithmic structure previously introduced for 2D image feature learning [1]. To obtain the similarity between two 3D image blocks A and B, the 3D image blocks are divided into 2D patches Ai and Bi. The similarity is then calculated as the average similarity score of Ai and Bi. The neural network was then trained with public non-medical image pairs, and subsequently evaluated on ultrasound image blocks for the following scenarios: (S1) same image blocks with/without shifts (A and A-shift-x); (S2) non-related random block pairs; (S3) ground truth registration matched pairs of different ultrasound images with/without shifts (A-i and A-reg-i-shift-x). Results: For S1 the similarity scores of A and A-shift-x were 32.63, 18.38, 12.95, 9.23, 2.15 and 0.43 for x=ranging from 0 mm to 10 mm in 2 mm increments. For S2 the average similarity score for non-related block pairs was −1.15. For S3 the average similarity score of ground truth registration matched blocks A-i and A-reg-i-shift-0 (1≤i≤5) was 12.37. After translating A-reg-i-shift-0 by 0 mm, 2 mm, 4 mm, 6 mm, 8 mm, and 10 mm, the average similarity scores of A-i and A-reg-i-shift-x were 11.04, 8.42, 4.56, 2.27, and 0.29 respectively. Conclusion: The proposed method correctly assigns highest similarity to corresponding 3D ultrasound image blocks despite differences in image content and thus can form the basis for ultrasound image registration and tracking.[1] Zagoruyko, Komodakis, “Learning to compare image patches via convolutional neural networks', IEEE CVPR 2015,pp.4353–4361.

  15. Volume of interest CBCT and tube current modulation for image guidance using dynamic kV collimation

    Energy Technology Data Exchange (ETDEWEB)

    Parsons, David, E-mail: david.parsons@dal.ca, E-mail: james.robar@nshealth.ca [Department of Physics and Atmospheric Science, Dalhousie University, 5820 University Avenue, Halifax, Nova Scotia B3H 1V7 (Canada); Robar, James L., E-mail: david.parsons@dal.ca, E-mail: james.robar@nshealth.ca [Department of Radiation Oncology and Department of Physics and Atmospheric Science, Dalhousie University, 5820 University Avenue, Halifax, Nova Scotia B3H 1V7 (Canada)

    2016-04-15

    Purpose: The focus of this work is the development of a novel blade collimation system enabling volume of interest (VOI) CBCT with tube current modulation using the kV image guidance source on a linear accelerator. Advantages of the system are assessed, particularly with regard to reduction and localization of dose and improvement of image quality. Methods: A four blade dynamic kV collimator was developed to track a VOI during a CBCT acquisition. The current prototype is capable of tracking an arbitrary volume defined by the treatment planner for subsequent CBCT guidance. During gantry rotation, the collimator tracks the VOI with adjustment of position and dimension. CBCT image quality was investigated as a function of collimator dimension, while maintaining the same dose to the VOI, for a 22.2 cm diameter cylindrical water phantom with a 9 mm diameter bone insert centered on isocenter. Dose distributions were modeled using a dynamic BEAMnrc library and DOSXYZnrc. The resulting VOI dose distributions were compared to full-field CBCT distributions to quantify dose reduction and localization to the target volume. A novel method of optimizing x-ray tube current during CBCT acquisition was developed and assessed with regard to contrast-to-noise ratio (CNR) and imaging dose. Results: Measurements show that the VOI CBCT method using the dynamic blade system yields an increase in contrast-to-noise ratio by a factor of approximately 2.2. Depending upon the anatomical site, dose was reduced to 15%–80% of the full-field CBCT value along the central axis plane and down to less than 1% out of plane. The use of tube current modulation allowed for specification of a desired SNR within projection data. For approximately the same dose to the VOI, CNR was further increased by a factor of 1.2 for modulated VOI CBCT, giving a combined improvement of 2.6 compared to full-field CBCT. Conclusions: The present dynamic blade system provides significant improvements in CNR for the same

  16. MO-DE-202-00: Image-Guided Interventions: Advances in Intraoperative Imaging, Guidance, and An Emerging Role for Medical Physics in Surgery

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  17. Tips and Tricks of Percutaneous Gastrostomy Under Image Guidance in Patients with Limited Access

    Energy Technology Data Exchange (ETDEWEB)

    Marcy, Pierre-Yves; Figl, Andrea; Thariat, Juliette [Sophia Antipolis University, Nice cedex (France); Lacout, Alexis [Centre Me' dico-Chirurgical, Aurillac (France)

    2011-10-15

    We read with great interest the article by Chan et al. (1) in the March issue of Korean Journal of Radiology on their experience of modified radiology-guided percutaneous gastrostomy (MRPG). The authors proposed a technique to access the stomach in patients with upper digestive tract obstruction (UDTO). Following marking a patient's left liver inferior margin and room air-colonography, the authors punctured the gastric area using a 21G fine needle under X-ray guidance and withdrew their syringe gradually while injecting contrast medium. We noted that the gastrostomy may be performed using a 0.0035-inch hydrophilic guide wire and a 6.5-Fr angled catheter in almost 100% of patients contraindicated for endoscopy gastrostomy, including those with tortuous or tight cervical stenosis (2). In patients with a collapsed stomach, orally administered effervescent sodium bicarbonate powder can produce sufficient gas in the stomach to allow for a percutaneous needle puncture. In UDTO patients, diatrizoate meglumine can be directly injected into the gastric lumen under ultrasound (US) guidance, as reported by Pugash et al. (3) in 1995. Since the stomach appears collapsed with apposed multi-layer walls and virtual lumen on US, the needle tip is hardly seen. In such circumstances, after having transfixed the stomach with a 21G Chiba needle, further gradual needle withdrawing is performed under fluoroscopic guidance while injecting small amounts of diatrizoate meglumine until a ruga pattern is seen. Moreover, a cancer patient's subcutaneous fat is often absent and the anterior gastric wall is close to the abdominal wall. High frequency US monitoring does improve needle visualization in such a circumstance. Conversely, in obese patients, back- and forth motions of the needle stylet under Doppler color US guidance clearly improves needle visualization. We noted that by using this technique we successfully performed percutaneous fluoroscopy gastrostomy (PFG) in two partially

  18. Tips and Tricks of Percutaneous Gastrostomy Under Image Guidance in Patients with Limited Access

    International Nuclear Information System (INIS)

    Marcy, Pierre-Yves; Figl, Andrea; Thariat, Juliette; Lacout, Alexis

    2011-01-01

    We read with great interest the article by Chan et al. (1) in the March issue of Korean Journal of Radiology on their experience of modified radiology-guided percutaneous gastrostomy (MRPG). The authors proposed a technique to access the stomach in patients with upper digestive tract obstruction (UDTO). Following marking a patient's left liver inferior margin and room air-colonography, the authors punctured the gastric area using a 21G fine needle under X-ray guidance and withdrew their syringe gradually while injecting contrast medium. We noted that the gastrostomy may be performed using a 0.0035-inch hydrophilic guide wire and a 6.5-Fr angled catheter in almost 100% of patients contraindicated for endoscopy gastrostomy, including those with tortuous or tight cervical stenosis (2). In patients with a collapsed stomach, orally administered effervescent sodium bicarbonate powder can produce sufficient gas in the stomach to allow for a percutaneous needle puncture. In UDTO patients, diatrizoate meglumine can be directly injected into the gastric lumen under ultrasound (US) guidance, as reported by Pugash et al. (3) in 1995. Since the stomach appears collapsed with apposed multi-layer walls and virtual lumen on US, the needle tip is hardly seen. In such circumstances, after having transfixed the stomach with a 21G Chiba needle, further gradual needle withdrawing is performed under fluoroscopic guidance while injecting small amounts of diatrizoate meglumine until a ruga pattern is seen. Moreover, a cancer patient's subcutaneous fat is often absent and the anterior gastric wall is close to the abdominal wall. High frequency US monitoring does improve needle visualization in such a circumstance. Conversely, in obese patients, back- and forth motions of the needle stylet under Doppler color US guidance clearly improves needle visualization. We noted that by using this technique we successfully performed percutaneous fluoroscopy gastrostomy (PFG) in two partially

  19. Investigation of variability in image acquisition and contouring during 3D ultrasound guidance for partial breast irradiation

    International Nuclear Information System (INIS)

    Landry, Anthony; Olivotto, Ivo; Beckham, Wayne; Berrang, Tanya; Gagne, Isabelle; Popescu, Carmen; Mitchell, Tracy; Vey, Hazel; Sand, Letricia; Soh, Siew Yan; Wark, Jill

    2014-01-01

    Three-dimensional ultrasound (3DUS) at simulation compared to 3DUS at treatment is an image guidance option for partial breast irradiation (PBI). This study assessed if user dependence in acquiring and contouring 3DUS (operator variability) contributed to variation in seroma shifts calculated for breast IGRT. Eligible patients met breast criteria for current randomized PBI studies. 5 Operators participated in this study. For each patient, 3 operators were involved in scan acquisitions and 5 were involved in contouring. At CT simulation (CT1), a 3DUS (US1) was performed by a single radiation therapist (RT). 7 to 14 days after CT1 a second CT (CT2) and 3 sequential 3DUS scans (US2a,b,c) were acquired by each of 3 RTs. Seroma shifts, between US1 and US2 scans were calculated by comparing geometric centers of the seromas (centroids). Operator contouring variability was determined by comparing 5 RT’s contours for a single image set. Scanning variability was assessed by comparing shifts between multiple scans acquired at the same time point (US1-US2a,b,c). Shifts in seromas contoured on CT (CT1-CT2) were compared to US data. From an initial 28 patients, 15 had CT visible seromas, met PBI dosimetric constraints, had complete US data, and were analyzed. Operator variability contributed more to the overall variability in seroma localization than the variability associated with multiple scan acquisitions (95% confidence mean uncertainty of 6.2 mm vs. 1.1 mm). The mean standard deviation in seroma shift was user dependent and ranged from 1.7 to 2.9 mm. Mean seroma shifts from simulation to treatment were comparable to CT. Variability in shifts due to different users acquiring and contouring 3DUS for PBI guidance were comparable to CT shifts. Substantial inter-observer effect needs to be considered during clinical implementation of 3DUS IGRT

  20. Digital Tomosynthesis for Respiratory Gated Liver Treatment: Clinical Feasibility for Daily Image Guidance

    International Nuclear Information System (INIS)

    Wu, Q. Jackie; Meyer, Jeffrey; Fuller, Jessica; Godfrey, Devon; Wang Zhiheng; Zhang Junan; Yin Fangfang

    2011-01-01

    Purpose: Breath-hold (BH) treatment minimizes internal target volumes (ITV) when treating sites prone to motion. Digital tomosynthesis (DTS) imaging has advantages over cone-beam CT (CBCT) for BH imaging: BH-DTS scan can be completed during a single breath-hold, whereas BH-CBCT is usually acquired by parsing the gantry rotation into multiple BH segments. This study evaluates the localization accuracy of DTS for BH treatment of liver tumors. Methods: Both planning CT and on-board DTS/CBCT images were acquired under BH, using the planning CT BH window as reference. Onboard imaging data sets included two independent DTS orientations (coronal and sagittal), and CBCT images. Soft tissue target positioning was measured by each imaging modality and translated into couch shifts. Performance of the two DTS orientations was evaluated by comparing target positioning with the CBCT benchmark, determined by two observers. Results: Image data sets were collected from thirty-eight treatment fractions (14 patients). Mean differences between the two DTS methods and the CBCT method were <1 mm in all directions (except the lateral direction with sagittal-DTS: 1.2 mm); the standard deviation was in the range of 2.1-3.5 mm for all techniques. The Pearson correlation showed good interobserver agreement for the coronal-DTS (0.72-0.78). The interobserver agreement for the sagittal-DTS was good for the in-plane directions (0.70-0.82), but poor in the out-of-plane direction (lateral, 0.26). Conclusions: BH-DTS may be a simpler alternative to BH-CBCT for onboard soft tissue localization of the liver, although the precision of DTS localization appears to be somewhat lower because of the presence of subtle out-of-plane blur.

  1. Evaluation of Online/Offline Image Guidance/Adaptation Approaches for Prostate Cancer Radiation Therapy

    International Nuclear Information System (INIS)

    Qin, An; Sun, Ying; Liang, Jian; Yan, Di

    2015-01-01

    Purpose: To evaluate online/offline image-guided/adaptive treatment techniques for prostate cancer radiation therapy with daily cone-beam CT (CBCT) imaging. Methods and Materials: Three treatment techniques were evaluated retrospectively using daily pre- and posttreatment CBCT images on 22 prostate cancer patients. Prostate, seminal vesicles (SV), rectal wall, and bladder were delineated on all CBCT images. For each patient, a pretreatment intensity modulated radiation therapy plan with clinical target volume (CTV) = prostate + SV and planning target volume (PTV) = CTV + 3 mm was created. The 3 treatment techniques were as follows: (1) Daily Correction: The pretreatment intensity modulated radiation therapy plan was delivered after online CBCT imaging, and position correction; (2) Online Planning: Daily online inverse plans with 3-mm CTV-to-PTV margin were created using online CBCT images, and delivered; and (3) Hybrid Adaption: Daily Correction plus an offline adaptive inverse planning performed after the first week of treatment. The adaptive plan was delivered for all remaining 15 fractions. Treatment dose for each technique was constructed using the daily posttreatment CBCT images via deformable image registration. Evaluation was performed using treatment dose distribution in target and critical organs. Results: Treatment equivalent uniform dose (EUD) for the CTV was within [85.6%, 100.8%] of the pretreatment planned target EUD for Daily Correction; [98.7%, 103.0%] for Online Planning; and [99.2%, 103.4%] for Hybrid Adaptation. Eighteen percent of the 22 patients in Daily Correction had a target dose deficiency >5%. For rectal wall, the mean ± SD of the normalized EUD was 102.6% ± 2.7% for Daily Correction, 99.9% ± 2.5% for Online Planning, and 100.6% ± 2.1% for Hybrid Adaptation. The mean ± SD of the normalized bladder EUD was 108.7% ± 8.2% for Daily Correction, 92.7% ± 8.6% for Online Planning, and 89.4% ± 10.8% for Hybrid

  2. The first clinical treatment with kilovoltage intrafraction monitoring (KIM): A real-time image guidance method

    DEFF Research Database (Denmark)

    Keall, Paul J.; Aun Ng, Jin; O'Brien, Ricky

    2015-01-01

    on September 16, 2014. Methods: KIM uses current and prior 2D x-ray images to estimate the 3D target position during cancer radiotherapy treatment delivery. KIM software was written to process kilovoltage (kV) images streamed from a standard C-arm linear accelerator with a gantry-mounted kV x-ray imaging...... system. A 120° pretreatment kV imaging arc was acquired to build the patient-specific 2D to 3D motion correlation. The kV imager was activated during the megavoltage (MV) treatment, a dual arc VMAT prostate treatment, to estimate the 3D prostate position in real-time. All necessary ethics, legal......, and regulatory requirements were met for this clinical study. The quality assurance processes were completed and peer reviewed. Results: During treatment, a prostate position offset of nearly 3 mm in the posterior direction was observed with KIM. This position offset did not trigger a gating event. After...

  3. Intraoperative Image Guidance in Neurosurgery: Development, Current Indications, and Future Trends

    International Nuclear Information System (INIS)

    Schulz, Ch.; Mauer, U.M.; Waldeck, S.

    2012-01-01

    Introduction. As minimally invasive surgery becomes the standard of care in neurosurgery, it is imperative that surgeons become skilled in the use of image-guided techniques. The development of image-guided neurosurgery represents a substantial improvement in the microsurgical treatment of tumors, vascular malformations, and other intracranial lesions. Objective. There have been numerous advances in neurosurgery which have aided the neurosurgeon to achieve accurate removal of pathological tissue with minimal disruption of surrounding healthy neuronal matter including the development of microsurgical, endoscopic, and endovascular techniques. Neuro navigation systems and intraoperative imaging should improve success in cranial neurosurgery. Additional functional imaging modalities such as PET, SPECT, DTI (for fiber tracking), and fMRI can now be used in order to reduce neurological deficits resulting from surgery; however the positive long-term effect remains questionable for many indications. Method. Pub Med database search using the search term “image guided neurosurgery.” More than 1400 articles were published during the last 25 years. The abstracts were scanned for prospective comparative trials. Results and Conclusion. 14 comparative trials are published. To date significant data amount show advantages in intraoperative accuracy influencing the perioperative morbidity and long-term outcome only for cerebral glioma surgery.

  4. Technical guidance for the development of a solid state image sensor for human low vision image warping

    Science.gov (United States)

    Vanderspiegel, Jan

    1994-01-01

    This report surveys different technologies and approaches to realize sensors for image warping. The goal is to study the feasibility, technical aspects, and limitations of making an electronic camera with special geometries which implements certain transformations for image warping. This work was inspired by the research done by Dr. Juday at NASA Johnson Space Center on image warping. The study has looked into different solid-state technologies to fabricate image sensors. It is found that among the available technologies, CMOS is preferred over CCD technology. CMOS provides more flexibility to design different functions into the sensor, is more widely available, and is a lower cost solution. By using an architecture with row and column decoders one has the added flexibility of addressing the pixels at random, or read out only part of the image.

  5. Improved Debulking of Peritoneal Tumor Implants by Near-Infrared Fluorescent Nanobody Image Guidance in an Experimental Mouse Model.

    Science.gov (United States)

    Debie, Pieterjan; Vanhoeij, Marian; Poortmans, Natalie; Puttemans, Janik; Gillis, Kris; Devoogdt, Nick; Lahoutte, Tony; Hernot, Sophie

    2017-10-31

    Debulking followed by combination chemotherapy is currently regarded as the most effective treatment for advanced ovarian cancer. Prognosis depends drastically on the degree of debulking. Accordingly, near-infrared (NIR) fluorescence imaging has been proposed to revolutionize cancer surgery by acting as a sensitive, specific, and real-time tool enabling visualization of cancer lesions. We have previously developed a NIR-labeled nanobody that allows fast, specific, and high-contrast imaging of HER2-positive tumors. In this study, we applied this tracer during fluorescence-guided surgery in a mouse model and investigated the effect on surgical efficiency. 0.5 × 10 6 SKOV3.IP1-Luc+ cells were inoculated intraperitoneally in athymic mice and were allowed to grow for 30 days. Two nanomoles of IRDye800CW-anti-HER2 nanobody was injected intravenously. After 1h30, mice were killed, randomized in two groups, and subjected to surgery. In the first animal group (n = 7), lesions were removed by a conventional surgical protocol, followed by excision of remaining fluorescent tissue using a NIR camera. The second group of mice (n = 6) underwent directly fluorescence-guided surgery. Bioluminescence imaging was performed before and after surgery. Resected tissue was categorized as visualized during conventional surgery or not, fluorescent or not, and bioluminescent positive or negative. Fluorescence imaging allowed clear visualization of tumor nodules within the abdomen, up to submillimeter-sized lesions. Fluorescence guidance resulted in significantly reduced residual tumor as compared to conventional surgery. Moreover, sensitivity increased from 59.3 to 99.0 %, and the percentage of false positive lesions detected decreased from 19.6 to 7.1 %. This study demonstrates the advantage of intraoperative fluorescence imaging using nanobody-based tracers on the efficiency of debulking surgery.

  6. Development of a real time imaging-based guidance system of magnetic nanoparticles for targeted drug delivery

    International Nuclear Information System (INIS)

    Zhang, Xingming; Le, Tuan-Anh; Yoon, Jungwon

    2017-01-01

    Targeted drug delivery using magnetic nanoparticles is an efficient technique as molecules can be directed toward specific tissues inside a human body. For the first time, we implemented a real-time imaging-based guidance system of nanoparticles using untethered electro-magnetic devices for simultaneous guiding and tracking. In this paper a low-amplitude-excitation-field magnetic particle imaging (MPI) is introduced. Based on this imaging technology, a hybrid system comprised of an electromagnetic actuator and MPI was used to navigate nanoparticles in a non-invasive way. The real-time low-amplitude-excitation-field MPI and electromagnetic actuator of this navigation system are achieved by applying a time-division multiplexing scheme to the coil topology. A one dimensional nanoparticle navigation system was built to demonstrate the feasibility of the proposed approach and it could achieve a 2 Hz navigation update rate with the field gradient of 3.5 T/m during the imaging mode and 8.75 T/m during the actuation mode. Particles with both 90 nm and 5 nm diameters could be successfully manipulated and monitored in a tube through the proposed system, which can significantly enhance targeting efficiency and allow precise analysis in a real drug delivery. - Highlights: • A real-time system comprised of an electromagnetic actuator and a low-amplitude-excitation-field MPI can navigate magnetic nanoparticles. • The imaging scheme is feasible to enlarge field of view size. • The proposed navigation system can be cost efficient, compact, and optimized for targeting of the nanoparticles.

  7. Development of a real time imaging-based guidance system of magnetic nanoparticles for targeted drug delivery

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xingming [School of Naval Architecture and Ocean Engineering, Harbin Institute of Technology at Weihai, Weihai, Shandong (China); School of Mechanical and Aerospace Engineering & ReCAPT, Gyeongsang National University, Jinju 660-701 (Korea, Republic of); Le, Tuan-Anh [School of Mechanical and Aerospace Engineering & ReCAPT, Gyeongsang National University, Jinju 660-701 (Korea, Republic of); Yoon, Jungwon, E-mail: jwyoon@gnu.ac.kr [School of Mechanical and Aerospace Engineering & ReCAPT, Gyeongsang National University, Jinju 660-701 (Korea, Republic of)

    2017-04-01

    Targeted drug delivery using magnetic nanoparticles is an efficient technique as molecules can be directed toward specific tissues inside a human body. For the first time, we implemented a real-time imaging-based guidance system of nanoparticles using untethered electro-magnetic devices for simultaneous guiding and tracking. In this paper a low-amplitude-excitation-field magnetic particle imaging (MPI) is introduced. Based on this imaging technology, a hybrid system comprised of an electromagnetic actuator and MPI was used to navigate nanoparticles in a non-invasive way. The real-time low-amplitude-excitation-field MPI and electromagnetic actuator of this navigation system are achieved by applying a time-division multiplexing scheme to the coil topology. A one dimensional nanoparticle navigation system was built to demonstrate the feasibility of the proposed approach and it could achieve a 2 Hz navigation update rate with the field gradient of 3.5 T/m during the imaging mode and 8.75 T/m during the actuation mode. Particles with both 90 nm and 5 nm diameters could be successfully manipulated and monitored in a tube through the proposed system, which can significantly enhance targeting efficiency and allow precise analysis in a real drug delivery. - Highlights: • A real-time system comprised of an electromagnetic actuator and a low-amplitude-excitation-field MPI can navigate magnetic nanoparticles. • The imaging scheme is feasible to enlarge field of view size. • The proposed navigation system can be cost efficient, compact, and optimized for targeting of the nanoparticles.

  8. Integration of image guidance and rapid prototyping technology in craniofacial surgery.

    Science.gov (United States)

    Bullock, P; Dunaway, D; McGurk, L; Richards, R

    2013-08-01

    This technical note demonstrates the benefits of preoperative planning, involving the use of rapid prototype models and rehearsal of the surgical procedure, using image-guided navigational surgery. Optimum reconstruction of large defects can be achieved with this technique. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Wide-field spectrally resolved quantitative fluorescence imaging system: toward neurosurgical guidance in glioma resection

    Science.gov (United States)

    Xie, Yijing; Thom, Maria; Ebner, Michael; Wykes, Victoria; Desjardins, Adrien; Miserocchi, Anna; Ourselin, Sebastien; McEvoy, Andrew W.; Vercauteren, Tom

    2017-11-01

    In high-grade glioma surgery, tumor resection is often guided by intraoperative fluorescence imaging. 5-aminolevulinic acid-induced protoporphyrin IX (PpIX) provides fluorescent contrast between normal brain tissue and glioma tissue, thus achieving improved tumor delineation and prolonged patient survival compared with conventional white-light-guided resection. However, commercially available fluorescence imaging systems rely solely on visual assessment of fluorescence patterns by the surgeon, which makes the resection more subjective than necessary. We developed a wide-field spectrally resolved fluorescence imaging system utilizing a Generation II scientific CMOS camera and an improved computational model for the precise reconstruction of the PpIX concentration map. In our model, the tissue's optical properties and illumination geometry, which distort the fluorescent emission spectra, are considered. We demonstrate that the CMOS-based system can detect low PpIX concentration at short camera exposure times, while providing high-pixel resolution wide-field images. We show that total variation regularization improves the contrast-to-noise ratio of the reconstructed quantitative concentration map by approximately twofold. Quantitative comparison between the estimated PpIX concentration and tumor histopathology was also investigated to further evaluate the system.

  10. Improving CT quality with optimized image parameters for radiation treatment planning and delivery guidance

    Directory of Open Access Journals (Sweden)

    Guang-Pei Chen

    2017-10-01

    Conclusion: CT image quality can be improved with the IQE protocols created in this study, to provide better soft tissue contrast, which would be beneficial for use in radiation therapy, e.g., for planning data acquisition or for IGRT for hypo-fractionated treatments.

  11. The role of Cobalt-60 in modern radiation therapy: Dose delivery and image guidance

    Directory of Open Access Journals (Sweden)

    Schreiner L

    2009-01-01

    Full Text Available The advances in modern radiation therapy with techniques such as intensity-modulated radiation therapy and image-guid-ed radiation therapy (IMRT and IGRT have been limited almost exclusively to linear accel-erators. Investigations of modern Cobalt-60 (Co-60 radiation delivery in the context of IMRT and IGRT have been very sparse, and have been limited mainly to computer-modeling and treatment-planning exercises. In this paper, we report on the results of experiments using a tomotherapy benchtop apparatus attached to a conventional Co-60 unit. We show that conformal dose delivery is possible and also that Co-60 can be used as the radiation source in megavoltage computed tomography imaging. These results complement our modeling studies of Co-60 tomotherapy and provide a strong motivation for continuing development of modern Cobalt-60 treatment devices.

  12. Image Processing in Optical Guidance for Autonomous Landing of Lunar Probe

    OpenAIRE

    Meng, Ding; Yun-feng, Cao; Qing-xian, Wu; Zhen, Zhang

    2008-01-01

    Because of the communication delay between earth and moon, the GNC technology of lunar probe is becoming more important than ever. Current navigation technology is not able to provide precise motion estimation for probe landing control system Computer vision offers a new approach to solve this problem. In this paper, author introduces an image process algorithm of computer vision navigation for autonomous landing of lunar probe. The purpose of the algorithm is to detect and track feature poin...

  13. Proton therapy for prostate cancer treatment employing online image guidance and an action level threshold.

    Science.gov (United States)

    Vargas, Carlos; Falchook, Aaron; Indelicato, Daniel; Yeung, Anamaria; Henderson, Randall; Olivier, Kenneth; Keole, Sameer; Williams, Christopher; Li, Zuofeng; Palta, Jatinder

    2009-04-01

    The ability to determine the accuracy of the final prostate position within a determined action level threshold for image-guided proton therapy is unclear. Three thousand one hundred ten images for 20 consecutive patients treated in 1 of our 3 proton prostate protocols from February to May of 2007 were analyzed. Daily kV images and patient repositioning were performed employing an action-level threshold (ALT) of > or = 2.5 mm for each beam. Isocentric orthogonal x-rays were obtained, and prostate position was defined via 3 gold markers for each patient in the 3 axes. To achieve and confirm our action level threshold, an average of 2 x-rays sets (median 2; range, 0-4) was taken daily for each patient. Based on our ALT, we made no corrections in 8.7% (range, 0%-54%), 1 correction in 82% (41%-98%), and 2 to 3 corrections in 9% (0-27%). No patient needed 4 or more corrections. All patients were treated with a confirmed error of < 2.5 mm for every beam delivered. After all corrections, the mean and standard deviations were: anterior-posterior (z): 0.003 +/- 0.094 cm; superior-inferior (y): 0.028 +/- 0.073 cm; and right-left (x) -0.013 +/- 0.08 cm. It is feasible to limit all final prostate positions to less than 2.5 mm employing an action level image-guided radiation therapy (IGRT) process. The residual errors after corrections were very small.

  14. The benefit of image guidance for the contralateral interhemispheric approach to the lateral ventricle.

    Science.gov (United States)

    Fronda, Chiara; Miller, Dorothea; Kappus, Christoph; Bertalanffy, Helmut; Sure, Ulrich

    2008-06-01

    Recently, neurosurgeons have increasingly faced small intracerebral lesions in asymptomatic or minimally symptomatic patients. Here, we evaluated a series of four patients with nearly asymptomatic intraventricular tumors close to the corpus callosum that had been treated with the aid of an image-guided transcallosal approach. Four consecutive patients suffering from left intra- and paraventricular tumors were operated on via a contralateral interhemispheric transcallosal approach with the aid of neuronavigation. Our image-guided system directed: (1) the skin incision, (2) the interhemispheric dissection, and (3) the incision of the corpus callosum. Using the image-guided contralateral interhemispheric transcallosal approach to the left ventricle all lesions have been completely resected without the risk of damage to the dominant hemisphere. The callosal incision was kept as limited as possible (1.2-2.1cm) depending on the size of the tumor. No postoperative neurological or neuropsychological deficit was observed in our series. Neuronavigation facilitates a safe and targeted contralateral interhemispheric transcallosal approach to the dominant hemisphere's lateral ventricle. Our technique minimizes the risk of damage to the dominant hemisphere and requires only a limited opening of the corpus callosum, which might decrease the risk of neuropsychological morbidity.

  15. TU-EF-210-00: Therapeutic Strategies and Image Guidance

    International Nuclear Information System (INIS)

    2015-01-01

    The use of therapeutic ultrasound to provide targeted therapy is an active research area that has a broad application scope. The invited talks in this session will address currently implemented strategies and protocols for both hyperthermia and ablation applications using therapeutic ultrasound. The role of both ultrasound and MRI in the monitoring and assessment of these therapies will be explored in both pre-clinical and clinical applications. Katherine Ferrara: High Intensity Focused Ultrasound, Drug Delivery, and Immunotherapy Rajiv Chopra: Translating Localized Doxorubicin Delivery to Pediatric Oncology using MRI-guided HIFU Elisa Konofagou: Real-time Ablation Monitoring and Lesion Quantification using Harmonic Motion Imaging Keyvan Farahani: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy Learning Objectives: Understand the role of ultrasound in localized drug delivery and the effects of immunotherapy when used in conjunction with ultrasound therapy. Understand potential targeted drug delivery clinical applications including pediatric oncology. Understand the technical requirements for performing targeted drug delivery. Understand how radiation-force approaches can be used to both monitor and assess high intensity focused ultrasound ablation therapy. Understand the role of AAPM task groups in ultrasound imaging and therapies. Chopra: Funding from Cancer Prevention and Research Initiative of Texas (CPRIT), Award R1308 Evelyn and M.R. Hudson Foundation; Research Support from Research Contract with Philips Healthcare; COI are Co-founder of FUS Instruments Inc Ferrara: Supported by NIH, UCDavis and California (CIRM and BHCE) Farahani: In-kind research support from Philips Healthcare

  16. TU-EF-210-00: Therapeutic Strategies and Image Guidance

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    The use of therapeutic ultrasound to provide targeted therapy is an active research area that has a broad application scope. The invited talks in this session will address currently implemented strategies and protocols for both hyperthermia and ablation applications using therapeutic ultrasound. The role of both ultrasound and MRI in the monitoring and assessment of these therapies will be explored in both pre-clinical and clinical applications. Katherine Ferrara: High Intensity Focused Ultrasound, Drug Delivery, and Immunotherapy Rajiv Chopra: Translating Localized Doxorubicin Delivery to Pediatric Oncology using MRI-guided HIFU Elisa Konofagou: Real-time Ablation Monitoring and Lesion Quantification using Harmonic Motion Imaging Keyvan Farahani: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy Learning Objectives: Understand the role of ultrasound in localized drug delivery and the effects of immunotherapy when used in conjunction with ultrasound therapy. Understand potential targeted drug delivery clinical applications including pediatric oncology. Understand the technical requirements for performing targeted drug delivery. Understand how radiation-force approaches can be used to both monitor and assess high intensity focused ultrasound ablation therapy. Understand the role of AAPM task groups in ultrasound imaging and therapies. Chopra: Funding from Cancer Prevention and Research Initiative of Texas (CPRIT), Award R1308 Evelyn and M.R. Hudson Foundation; Research Support from Research Contract with Philips Healthcare; COI are Co-founder of FUS Instruments Inc Ferrara: Supported by NIH, UCDavis and California (CIRM and BHCE) Farahani: In-kind research support from Philips Healthcare.

  17. Robust methods for automatic image-to-world registration in cone-beam CT interventional guidance

    International Nuclear Information System (INIS)

    Dang, H.; Otake, Y.; Schafer, S.; Stayman, J. W.; Kleinszig, G.; Siewerdsen, J. H.

    2012-01-01

    Purpose: Real-time surgical navigation relies on accurate image-to-world registration to align the coordinate systems of the image and patient. Conventional manual registration can present a workflow bottleneck and is prone to manual error and intraoperator variability. This work reports alternative means of automatic image-to-world registration, each method involving an automatic registration marker (ARM) used in conjunction with C-arm cone-beam CT (CBCT). The first involves a Known-Model registration method in which the ARM is a predefined tool, and the second is a Free-Form method in which the ARM is freely configurable. Methods: Studies were performed using a prototype C-arm for CBCT and a surgical tracking system. A simple ARM was designed with markers comprising a tungsten sphere within infrared reflectors to permit detection of markers in both x-ray projections and by an infrared tracker. The Known-Model method exercised a predefined specification of the ARM in combination with 3D-2D registration to estimate the transformation that yields the optimal match between forward projection of the ARM and the measured projection images. The Free-Form method localizes markers individually in projection data by a robust Hough transform approach extended from previous work, backprojected to 3D image coordinates based on C-arm geometric calibration. Image-domain point sets were transformed to world coordinates by rigid-body point-based registration. The robustness and registration accuracy of each method was tested in comparison to manual registration across a range of body sites (head, thorax, and abdomen) of interest in CBCT-guided surgery, including cases with interventional tools in the radiographic scene. Results: The automatic methods exhibited similar target registration error (TRE) and were comparable or superior to manual registration for placement of the ARM within ∼200 mm of C-arm isocenter. Marker localization in projection data was robust across all

  18. Manifold Embedding and Semantic Segmentation for Intraoperative Guidance With Hyperspectral Brain Imaging.

    Science.gov (United States)

    Ravi, Daniele; Fabelo, Himar; Callic, Gustavo Marrero; Yang, Guang-Zhong

    2017-09-01

    Recent advances in hyperspectral imaging have made it a promising solution for intra-operative tissue characterization, with the advantages of being non-contact, non-ionizing, and non-invasive. Working with hyperspectral images in vivo, however, is not straightforward as the high dimensionality of the data makes real-time processing challenging. In this paper, a novel dimensionality reduction scheme and a new processing pipeline are introduced to obtain a detailed tumor classification map for intra-operative margin definition during brain surgery. However, existing approaches to dimensionality reduction based on manifold embedding can be time consuming and may not guarantee a consistent result, thus hindering final tissue classification. The proposed framework aims to overcome these problems through a process divided into two steps: dimensionality reduction based on an extension of the T-distributed stochastic neighbor approach is first performed and then a semantic segmentation technique is applied to the embedded results by using a Semantic Texton Forest for tissue classification. Detailed in vivo validation of the proposed method has been performed to demonstrate the potential clinical value of the system.

  19. Multiparametric fat-water separation method for fast chemical-shift imaging guidance of thermal therapies.

    Science.gov (United States)

    Lin, Jonathan S; Hwang, Ken-Pin; Jackson, Edward F; Hazle, John D; Stafford, R Jason; Taylor, Brian A

    2013-10-01

    A k-means-based classification algorithm is investigated to assess suitability for rapidly separating and classifying fat/water spectral peaks from a fast chemical shift imaging technique for magnetic resonance temperature imaging. Algorithm testing is performed in simulated mathematical phantoms and agar gel phantoms containing mixed fat/water regions. Proton resonance frequencies (PRFs), apparent spin-spin relaxation (T2*) times, and T1-weighted (T1-W) amplitude values were calculated for each voxel using a single-peak autoregressive moving average (ARMA) signal model. These parameters were then used as criteria for k-means sorting, with the results used to determine PRF ranges of each chemical species cluster for further classification. To detect the presence of secondary chemical species, spectral parameters were recalculated when needed using a two-peak ARMA signal model during the subsequent classification steps. Mathematical phantom simulations involved the modulation of signal-to-noise ratios (SNR), maximum PRF shift (MPS) values, analysis window sizes, and frequency expansion factor sizes in order to characterize the algorithm performance across a variety of conditions. In agar, images were collected on a 1.5T clinical MR scanner using acquisition parameters close to simulation, and algorithm performance was assessed by comparing classification results to manually segmented maps of the fat/water regions. Performance was characterized quantitatively using the Dice Similarity Coefficient (DSC), sensitivity, and specificity. The simulated mathematical phantom experiments demonstrated good fat/water separation depending on conditions, specifically high SNR, moderate MPS value, small analysis window size, and low but nonzero frequency expansion factor size. Physical phantom results demonstrated good identification for both water (0.997 ± 0.001, 0.999 ± 0.001, and 0.986 ± 0.001 for DSC, sensitivity, and specificity, respectively) and fat (0.763 ± 0.006, 0

  20. A hybrid strategy of offline adaptive planning and online image guidance for prostate cancer radiotherapy

    International Nuclear Information System (INIS)

    Lei Yu; Wu Qiuwen

    2010-01-01

    Offline adaptive radiotherapy (ART) has been used to effectively correct and compensate for prostate motion and reduce the required margin. The efficacy depends on the characteristics of the patient setup error and interfraction motion through the whole treatment; specifically, systematic errors are corrected and random errors are compensated for through the margins. In online image-guided radiation therapy (IGRT) of prostate cancer, the translational setup error and inter-fractional prostate motion are corrected through pre-treatment imaging and couch correction at each fraction. However, the rotation and deformation of the target are not corrected and only accounted for with margins in treatment planning. The purpose of this study was to investigate whether the offline ART strategy is necessary for an online IGRT protocol and to evaluate the benefit of the hybrid strategy. First, to investigate the rationale of the hybrid strategy, 592 cone-beam-computed tomography (CBCT) images taken before and after each fraction for an online IGRT protocol from 16 patients were analyzed. Specifically, the characteristics of prostate rotation were analyzed. It was found that there exist systematic inter-fractional prostate rotations, and they are patient specific. These rotations, if not corrected, are persistent through the treatment fraction, and rotations detected in early fractions are representative of those in later fractions. These findings suggest that the offline adaptive replanning strategy is beneficial to the online IGRT protocol with further margin reductions. Second, to quantitatively evaluate the benefit of the hybrid strategy, 412 repeated helical CT scans from 25 patients during the course of treatment were included in the replanning study. Both low-risk patients (LRP, clinical target volume, CTV = prostate) and intermediate-risk patients (IRP, CTV = prostate + seminal vesicles) were included in the simulation. The contours of prostate and seminal vesicles were

  1. Alignment Focus of Daily Image Guidance for Concurrent Treatment of Prostate and Pelvic Lymph Nodes

    International Nuclear Information System (INIS)

    Ferjani, Samah; Huang, Guangshun; Shang, Qingyang; Stephans, Kevin L.; Zhong, Yahua; Qi, Peng; Tendulkar, Rahul D.; Xia, Ping

    2013-01-01

    Purpose: To determine the dosimetric impact of daily imaging alignment focus on the prostate soft tissue versus the pelvic bones for the concurrent treatment of the prostate and pelvic lymph nodes (PLN) and to assess whether multileaf collimator (MLC) tracking or adaptive planning (ART) is necessary with the current clinical planning margins of 8 mm/6 mm posterior to the prostate and 5 mm to the PLN. Methods and Materials: A total of 124 kilovoltage cone-beam computed tomography (kV-CBCT) images from 6 patients were studied. For each KV-CBCT, 4 plans were retrospectively created using an isocenter shifting method with 2 different alignment focuses (prostate, PLN), an MLC shifting method, and the ART method. The selected dosimetric endpoints were compared among these plans. Results: For the isoshift contour, isoshift bone, MLC shift, and ART plans, D99 of the prostate was ≥97% of the prescription dose in 97.6%, 73.4%, 98.4%, and 96.8% of 124 fractions, respectively. Accordingly, D99 of the PLN was ≥97% of the prescription dose in 98.4%, 98.4%, 98.4%, and 100% of 124 fractions, respectively. For the rectum, D5 exceeded 105% of the planned D5 (and D5 of ART plans) in 11% (4%), 10% (2%), and 13% (5%) of 124 fractions, respectively. For the bladder, D5 exceeded 105% of the planned D5 (and D5 of ART) plans in 0% (2%), 0% (2%), and 0% (1%) of 124 fractions, respectively. Conclusion: For concurrent treatment of the prostate and PLN, with a planning margin to the prostate of 8 mm/6 mm posterior and a planning margin of 5 mm to the PLN, aligning to the prostate soft tissue can achieve adequate dose coverage to the both target volumes; aligning to the pelvic bone would result in underdosing to the prostate in one-third of fractions. With these planning margins, MLC tracking and ART methods have no dosimetric advantages

  2. Alignment focus of daily image guidance for concurrent treatment of prostate and pelvic lymph nodes.

    Science.gov (United States)

    Ferjani, Samah; Huang, Guangshun; Shang, Qingyang; Stephans, Kevin L; Zhong, Yahua; Qi, Peng; Tendulkar, Rahul D; Xia, Ping

    2013-10-01

    To determine the dosimetric impact of daily imaging alignment focus on the prostate soft tissue versus the pelvic bones for the concurrent treatment of the prostate and pelvic lymph nodes (PLN) and to assess whether multileaf collimator (MLC) tracking or adaptive planning (ART) is necessary with the current clinical planning margins of 8 mm/6 mm posterior to the prostate and 5 mm to the PLN. A total of 124 kilovoltage cone-beam computed tomography (kV-CBCT) images from 6 patients were studied. For each KV-CBCT, 4 plans were retrospectively created using an isocenter shifting method with 2 different alignment focuses (prostate, PLN), an MLC shifting method, and the ART method. The selected dosimetric endpoints were compared among these plans. For the isoshift contour, isoshift bone, MLC shift, and ART plans, D99 of the prostate was ≥97% of the prescription dose in 97.6%, 73.4%, 98.4%, and 96.8% of 124 fractions, respectively. Accordingly, D99 of the PLN was ≥97% of the prescription dose in 98.4%, 98.4%, 98.4%, and 100% of 124 fractions, respectively. For the rectum, D5 exceeded 105% of the planned D5 (and D5 of ART plans) in 11% (4%), 10% (2%), and 13% (5%) of 124 fractions, respectively. For the bladder, D5 exceeded 105% of the planned D5 (and D5 of ART) plans in 0% (2%), 0% (2%), and 0% (1%) of 124 fractions, respectively. For concurrent treatment of the prostate and PLN, with a planning margin to the prostate of 8 mm/6 mm posterior and a planning margin of 5 mm to the PLN, aligning to the prostate soft tissue can achieve adequate dose coverage to the both target volumes; aligning to the pelvic bone would result in underdosing to the prostate in one-third of fractions. With these planning margins, MLC tracking and ART methods have no dosimetric advantages. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Intraprostatic fiducials for image guidance: Workflow implications in a single linac department

    International Nuclear Information System (INIS)

    Middleton, Mark; See, Andrew; Rolfo, Aldo; Medwell, Steve; Joon, Michael Lim; Joon, Daryl Lim; Martin, Jarad; Khoo, Vincent

    2008-01-01

    Purpose: To assess the accuracy and implications on workflow of an online correction electronic portal imaging (EPI) protocol utilising bony anatomy in the online environment and an assessment of three implanted gold seed fiducial markers in the offline environment. This paper summarises an initial trial to establish the range of systematic and random errors present in patient set-up for both bony anatomy and fiducial markers, and to calculate optimal clinical target volume (CTV) to planning target volume (PTV) margins. The impact of the introduction of such a technique was also assessed in terms of impact on workflow and resource management in a single machine unit (SMU). Methods and materials: Pre treatment electronic portal images (EPIs) were acquired and bony anatomy was matched with CT derived digitally reconstructed radiographs (DRRs). Intervention in field placement was made if field placement fell outside the range of 4 mm on any of the orthogonal axes. In the offline environment the position of the implanted gold seed fiducials was aligned with that of the DRRs. An analysis of set-up error, total error and internal organ motion was then undertaken, with full statistical analysis of systematic and random errors. Results: Eleven patients completed treatment as specified, with 1006 EPIs available for analysis. Treatment times were in the order of 10.4 min. Set-up errors were in the order of 2.7 mm right-left, 2.4 mm sup-inf and 1.6 mm ant-pst. These were reduced to 1.2 mm, 0.7 mm and 0.9 mm respectively utilising an online correction protocol. However there was minimal impact on total error and internal organ motion. Using the data obtained in both the online and offline environments optimal CTV-PTV margins were calculated for correcting to bone, correcting to gold seed fiducials and also the possibility of EPI malfunction. Conclusions: Daily targeting of the prostate is both technically feasible and can be carried out in an efficient and accurate manner. An

  4. Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions

    International Nuclear Information System (INIS)

    Moraes, Fabio Ynoe de; Neves-Junior, Wellington Furtado Pimenta; Hanna, Samir Abdallah; Carvalho, Heloisa de Andrade; Laufer, Ilya

    2016-01-01

    Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurgery is an increasingly utilized treatment method that improves local control and pain relief after delivering ablative doses of radiation. Here, we present a review highlighting the use of spinal radiosurgery for the treatment of metastatic tumors of the spine. The data used in the review were collected from both published studies and ongoing trials. We found that spinal radiosurgery is safe and provides excellent tumor control (up to 94% local control) and pain relief (up to 96%), independent of histology. Extensive data regarding clinical outcomes are available; however, this information has primarily been generated from retrospective and non randomized prospective series. Currently, two randomized trials are enrolling patients to study clinical applications of fractionation schedules spinal Radiosurgery. Additionally, a phase I clinical trial is being conducted to assess the safety of concurrent stereotactic body radiotherapy and ipilimumab for spinal metastases. Clinical trials to refine clinical indications and dose fractionation are ongoing. The concomitant use of targeted agents may produce better outcomes in the future. (author)

  5. Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions

    Energy Technology Data Exchange (ETDEWEB)

    Moraes, Fabio Ynoe de; Neves-Junior, Wellington Furtado Pimenta; Hanna, Samir Abdallah; Carvalho, Heloisa de Andrade [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Departamento de Radioterapia; Taunk, Neil Kanth; Yamada, Yoshiya [Memorial Sloan Kettering Cancer Center, Department of Radiation Oncology, New York, NY (United States); Laufer, Ilya, E-mail: fymoraes@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Neurosurgery, New York, NY (United States)

    2016-02-15

    Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurgery is an increasingly utilized treatment method that improves local control and pain relief after delivering ablative doses of radiation. Here, we present a review highlighting the use of spinal radiosurgery for the treatment of metastatic tumors of the spine. The data used in the review were collected from both published studies and ongoing trials. We found that spinal radiosurgery is safe and provides excellent tumor control (up to 94% local control) and pain relief (up to 96%), independent of histology. Extensive data regarding clinical outcomes are available; however, this information has primarily been generated from retrospective and non randomized prospective series. Currently, two randomized trials are enrolling patients to study clinical applications of fractionation schedules spinal Radiosurgery. Additionally, a phase I clinical trial is being conducted to assess the safety of concurrent stereotactic body radiotherapy and ipilimumab for spinal metastases. Clinical trials to refine clinical indications and dose fractionation are ongoing. The concomitant use of targeted agents may produce better outcomes in the future. (author)

  6. WE-E-BRF-01: The ESTRO-AAPM Joint Symposium On Imaging for Proton Treatment Planning and Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Parodi, K [Ludwig-Maximilians-University Munich, Garching, Bavaria (Germany); Dauvergne, D [Institut de Physique Nucleaire de Lyon, Lyon (France); Kruse, J [Mayo Clinic, Rochester, MN (United States)

    2014-06-15

    beam scale for active proton beam delivery in homogenous targets. The development of gamma cameras, that has been studied by several groups worldwide over the last years, now reaches - for some of them - the stage of being applicable in clinical conditions, with real size prototypes and count rate capability matching the therapeutic beam intensities. We will review the different concepts of gamma cameras, the advantages and limitations of this method, and the main challenges that should still be overcome before the widespread of prompt gamma quality assurance for proton and hadrontherapy. Jon Kruse (Mayo Clinic, Rochester, MN, USA) Treatment simulation images for proton therapy are used to determine proton stopping power and range in the patient. This talk will discuss the careful control of CT numbers and conversion of CT number to stopping power required in proton therapy. Imaging for treatment guidance of proton therapy also presents unique challenges which will be addressed. Among them are the enhanced relationship between internal anatomy changes and dosimetry, the need for imaging to support adaptive planning protocols, and high operational efficiency. Learning Objectives: To learn about the possibilities of using activation products to determine the range of particle beams in a patient treatment setting To be informed on an alternative methodology using prompt gamma detectors To understand the impact of the accuracy of the knowledge of the patient information with respect to the delivered treatment.

  7. The dilemma of parotid gland and pharyngeal constrictor muscles preservation—Is daily online image guidance required? A dosimetric analysis

    Energy Technology Data Exchange (ETDEWEB)

    Duffy, Olivia; Forde, Elizabeth; Leech, Michelle, E-mail: leechm@tcd.ie

    2017-04-01

    With margin reduction common in head and neck radiotherapy, it is critical that the dosimetric effects of setup deviations are quantified. With past studies focusing on the quantification of positional and volumetric changes of organs at risk (OARs), this study aimed to measure the dose delivered to these the parotid gland (PG) and pharyngeal constrictor muscles (PCMs) using cone beam computed tomography (CBCT). Furthermore, this investigation sought to establish a potential time trend of change in dose delivered to target volumes secondary to ascertaining the need for daily image guidance (IG) to reduce the dose burden to these important OARs. Intensity modulated radiotherapy (IMRT) plans for 5 locally advanced head and neck patients' plans were created and mapped to weekly CBCTs. Each plan was recalculated without heterogeneity correction allowing for dosimetric comparison. Dosimetric endpoints recorded to assess the effect of positional variation were as per ICRU 83 and included D{sub 95} and D{sub 98} for the target volumes, mean dose (MD) and V{sub 30} {sub Gy} for the PGs, and V{sub 50} {sub Gy} and MD for the PCMs. Results were deemed statistically significant if p < 0.05. No significant time trends were established for these OARs. A significant decrease in V{sub 50} {sub Gy} was observed for all PCMs (p < 0.001) on all CBCTs relative to the original plan. Regarding target volumes, a highly significant decrease in MD (MD = 20 Gy, CI: −20.310 to −19.820) in D{sub 98} of the high-dose planning target volume (PTV [70 Gy]; PTVD{sub 98%} = 70 Gy) for case 3 was found (p ≤ 0.001). A nonpredictable, yet significant dosimetric effect was found. A clinically acceptable balance must be achieved between OAR dosimetry and target coverage as can be achieved by frequent IG.

  8. Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a 60Co Magnetic Resonance Image Guidance Radiation Therapy System

    International Nuclear Information System (INIS)

    Wooten, H. Omar; Green, Olga; Yang, Min; DeWees, Todd; Kashani, Rojano; Olsen, Jeff; Michalski, Jeff; Yang, Deshan; Tanderup, Kari; Hu, Yanle; Li, H. Harold; Mutic, Sasa

    2015-01-01

    Purpose: This work describes a commercial treatment planning system, its technical features, and its capabilities for creating 60 Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. Methods and Materials: The ViewRay treatment planning system (Oakwood Village, OH) was used to create 60 Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The 60 Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. Results: All 60 Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for 60 Co was within <1% and 3% of linac plans for 100% and 95% prescription reference isodoses, respectively, and heterogeneity was on average 4% greater. Comparisons of OAR mean dose showed generally better sparing with linac plans in the low-dose range <20 Gy, but comparable sparing for organs with mean doses >20 Gy. The mean doses for all 60 Co plan OARs were within clinical tolerances. Conclusions: A commercial 60 Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system

  9. Active ultrasound pattern injection system (AUSPIS for interventional tool guidance.

    Directory of Open Access Journals (Sweden)

    Xiaoyu Guo

    Full Text Available Accurate tool tracking is a crucial task that directly affects the safety and effectiveness of many interventional medical procedures. Compared to CT and MRI, ultrasound-based tool tracking has many advantages, including low cost, safety, mobility and ease of use. However, surgical tools are poorly visualized in conventional ultrasound images, thus preventing effective tool tracking and guidance. Existing tracking methods have not yet provided a solution that effectively solves the tool visualization and mid-plane localization accuracy problem and fully meets the clinical requirements. In this paper, we present an active ultrasound tracking and guiding system for interventional tools. The main principle of this system is to establish a bi-directional ultrasound communication between the interventional tool and US imaging machine within the tissue. This method enables the interventional tool to generate an active ultrasound field over the original imaging ultrasound signals. By controlling the timing and amplitude of the active ultrasound field, a virtual pattern can be directly injected into the US machine B mode display. In this work, we introduce the time and frequency modulation, mid-plane detection, and arbitrary pattern injection methods. The implementation of these methods further improves the target visualization and guiding accuracy, and expands the system application beyond simple tool tracking. We performed ex vitro and in vivo experiments, showing significant improvements of tool visualization and accurate localization using different US imaging platforms. An ultrasound image mid-plane detection accuracy of ±0.3 mm and a detectable tissue depth over 8.5 cm was achieved in the experiment. The system performance is tested under different configurations and system parameters. We also report the first experiment of arbitrary pattern injection to the B mode image and its application in accurate tool tracking.

  10. Laparoscopic Heller Myotomy for Non-Dilated Esophageal Achalasia in Children with Intraoperative Stepped Dilation Under Image Guidance: Attempting Complete Myotomy.

    Science.gov (United States)

    Miyano, Go; Miyake, Hiromu; Koyama, Mariko; Morita, Keiichi; Kaneshiro, Masakatsu; Nouso, Hiroshi; Yamoto, Masaya; Fukumoto, Koji; Urushihara, Naoto

    2016-05-01

    This study presents a modified surgical approach to laparoscopic myotomy for achalasia using stepped dilation with a Rigiflex balloon and contrast medium under image guidance. A 10-year-old boy with persistent dysphagia and vomiting had ingested only liquids for 3 months, losing >10 kg in body weight. Barium swallow and esophageal manometry diagnosed esophageal achalasia with mild esophageal dilatation. After failed pneumatic dilatation, laparoscopic Heller myotomy with Dor fundoplication was performed. Prior to surgery, a Rigiflex balloon dilator was placed within the esophagus near the diaphragmatic hiatus. A four-port technique was used, and mobilization of the esophagus was limited to the anterior aspect. A 5-cm Heller myotomy was performed, extending another 2 cm onto the anterior gastric wall. During myotomy, the Rigiflex balloon was serially dilated from 30 to 50 mL, and filled with contrast medium under fluoroscopic image guidance in order to maintain appropriate tension on the esophagus to facilitate myotomy, and to confirm adequate myotomy with sufficient release of lower esophageal sphincter by resecting residual circular muscle fibers. Residual circular muscle fibers can be simultaneously visualized under both fluoroscopic image guidance and direct observation through the laparoscope, and they were cut precisely until the residual notch fully disappeared. Dor fundoplication was completed. The operative time was 180 minutes, and oral intake was started after esophagography on postoperative day 1. As of the 12-month follow-up, the patient has not shown any symptoms, and his postoperative course appeared satisfactory.

  11. SU-E-T-406: Online Image-Guidance for Prostate SBRT: Dosimetric Benefits and Margin Analysis.

    Science.gov (United States)

    Li, T; Yuan, L; Lee, W; Yin, F; Wu, Q J

    2012-06-01

    To evaluate the dosimetric benefits of online image guidance during prostate stereotactic body radiotherapy (SBRT) and the potential on margin reduction. 28 prostate SBRT patients were retrospectively studied, each treated with 37Gy in 5 fractions. RTOG recently opened a similar protocol (0938). During treatments, per-beam couch corrections were made based on the actual target motion provided by dynamic tracking with either Calypso or per-beam OBI imaging. Dosimetric benefits of online correction were evaluated by comparing delivered dose distributions with and without such correction. The dose distribution without correction was generated in the same treatment planning system by accumulating doses without online correction from the each beam and each fraction. Quantitative analyses include the dosimetric difference between delivered doses with and without correction; the correction magnitude and frequency; and the potential on margin reduction based on the margin recipe by Van Herk et al. (1) Delivery without online correction results in small reduction on target mean dose (0.03±0.05Gy), maximal dose (0.01±0.06Gy), and conformity index (<0.06). (2) Delivery without online correction has small impact on OAR dose: 26 out of 28 patients have <1%/1.5cc differences in V18.5Gy/V24Gy/V28Gy/V33Gy/V37Gy for both the bladder and the rectum. Maximal differences are 4cc of the bladder and 1.6cc of the rectum in mid-dose regions (V18.5Gy). (3) For femoral heads, <1cc/1Gy differences are observed in V20Gy/Dmean/D1cc.(4) Average number of couch corrections per fraction is 0.49. The magnitudes are: (-0.2±2)mm vertically, (-0.1±2.1)mm longitudinally, and (-0.2±1.4)mm laterally. (5) Margin determined by actual target motion in this patient population is 2.5mm isotropic. For both target coverage and OAR sparing, overall small benefit is seen from per-beam couch correction under dynamic tracking. The target motion between beams is small and random, and indicates a population

  12. Survey of image quality and patient dose in simple radiographic examinations: establishing guidance levels and comparison with international standards

    International Nuclear Information System (INIS)

    Manatrakul, N.; Bunsoong, T.; Krisanachinda, A.; Suwanpradit, P.; Rungruengthanakit, P.; Kanchart, S.; Chaiwong, Rajikorn; Tsapakig, V.A.

    2008-01-01

    Purpose: To investigate image quality and patient dose for commonly radiographic examinations in Thailand, to establish national reference or guidance levels (GL) and compare with international standards, as part of an International Atomic Energy Agency (IAEA) project on Radiation Protection of Patients and Medical Exposure Control (RAS/9/034 and RAS/9/047). Materials and Methods: Film reject rate analysis, image quality and patient dose assessment before and after Quality Control (QC) implementation were investigated in 8 X-ray machines in 4 hospitals. Air kerma (in mGy) at 1 meter focus-detector-distance for different kVp settings for each X-ray machines were measured using an ionization chamber under standardized condition. The entrance skin air kerma (ESAK) for Chest PA, Lumbar spine AP, Lumbar spine LAT, Pelvis AP, Abdomen AP, Skull AP and Skull LAT were calculated for at least 10 adult patients of average body mass (60 to 80 kg) for each projection. The obtained values were compared with international standards. Results: The highest film rejection rate reduction recorded after corrective actions from 9.15% to 6.8%. Mean ESAK values were less than international standards both before and after QC implementation in all projections but Chest PA projection. Maximum ESAK in Chest PA projection before corrective action was 0.55 mGy which was higher than the IAEA GL of 0.2 mGy. However, it was reduced to 0.25 mGy after QC tests on X- ray machine and using high kilovoltage (kV) technique. Conclusion: Proposed national GL of Thailand were obtained by estimating the 3rd quartile of the whole sample: Chest PA: 0.1 mGy, Lumbar Spine AP: 2.1 mGy, Lumbar Spine LAT: 6.3 mGy, Pelvis AP: 1.8 mGy, Abdomen: 1.5 mGy, Skull PA: 1.3 mGy and Skull LAT: 0.9 mGy. (author)

  13. Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma.

    Science.gov (United States)

    Stengel, Dirk; Rademacher, Grit; Ekkernkamp, Axel; Güthoff, Claas; Mutze, Sven

    2015-09-14

    Ultrasonography (performed by means of a four-quadrant, focused assessment of sonography for trauma (FAST)) is regarded as a key instrument for the initial assessment of patients with suspected blunt abdominal and thoraco-abdominal trauma in the emergency department setting. FAST has a high specificity but low sensitivity in detecting and excluding visceral injuries. Proponents of FAST argue that ultrasound-based clinical pathways enhance the speed of primary trauma assessment, reduce the number of unnecessary multi-detector computed tomography (MDCT) scans, and enable quicker triage to surgical and non-surgical care. Given the proven accuracy, increasing availability of, and indication for, MDCT among patients with blunt abdominal and multiple injuries, we aimed to compile the best available evidence of the use of FAST-based assessment compared with other primary trauma assessment protocols. To assess the effects of diagnostic algorithms using ultrasonography including in FAST examinations in the emergency department in relation to the early, late, and overall mortality of patients with suspected blunt abdominal trauma. The most recent search was run on 30th June 2015. We searched the Cochrane Injuries Group Specialised Register, The Cochrane Library, MEDLINE (OvidSP), EMBASE (OvidSP), ISI Web of Science (SCI-EXPANDED, SSCI, CPCI-S, and CPSI-SSH), clinical trials registers, and screened reference lists. Trial authors were contacted for further information and individual patient data. We included randomised controlled trials (RCTs). Participants were patients with blunt torso, abdominal, or multiple trauma undergoing diagnostic investigations for abdominal organ injury. The intervention was diagnostic algorithms comprising emergency ultrasonography (US). The control was diagnostic algorithms without US examinations (for example, primary computed tomography (CT) or diagnostic peritoneal lavage (DPL)). Outcomes were mortality, use of CT or invasive procedures (DPL

  14. WE-DE-BRA-03: Construction of An Ultrasound Guidance Platform for Image-Guided Radiotherapy with the Intent to Treat Transitional Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Sick, J; Rancilio, N; Fulkerson, C; LaPetina, P; Poulson, J; Knapp, D; Stantz, K [Purdue University, West Lafayette, IN (United States)

    2016-06-15

    Purpose: Ultrasound (US) is a noninvasive, nonradiographic imaging technique with high spatial and temporal resolution that can be used for localizing soft-tissue structures and tumors in real-time during radiotherapy (inter- and intra-fraction). A detailed methodology integrating 3D-US within RT is presented. This method is easier to adopt into current treatment protocol than current US based systems and reduces user variability for image acquisition, thus eliminating transducer induced changes that limit CT planning system. Methods: We designed an in-house integrated US manipulator and platform to relate CT, 3D-US and linear accelerator coordinate systems. To validate the platform, an agar-based phantom with measured densities and speed-of-sound consistent with tissues surrounding the bladder, was rotated (0–45°) resulting in translations (up to 55mm) relative to the CT and US coordinate systems. After acquiring and integrating CT and US images into the treatment planning system, US-to-US and US-to-CT images were co-registered to re-align the phantom relative to the linear accelerator. Errors in the transformation matrix components were calculate to determine precision of this method under different patient positions. Results: Statistical errors from US-US registrations for different patient orientations ranged from 0.06–1.66mm for x, y, and z translational components, and 0.00–1.05° for rotational components. Statistical errors from US-CT registrations were 0.23–1.18mm for the x, y and z translational components, and 0.08–2.52° for the rotational components. Conclusion: Based on our result, this is consistent with currently used techniques for positioning prostate patients if couch re-positioning is less than a 5 degree rotation. We are now testing this on a dog patient to obtain both inter and intra-fractional positional errors. Additional design considerations include the future use of ultrasound-based functionality (photoacoustics, radioacoustics

  15. Dual in vivo Photoacoustic and Fluorescence Imaging of HER2 Expression in Breast Tumors for Diagnosis, Margin Assessment, and Surgical Guidance

    Directory of Open Access Journals (Sweden)

    Azusa Maeda

    2015-01-01

    Full Text Available Biomarker-specific imaging probes offer ways to improve molecular diagnosis, intraoperative margin assessment, and tumor resection. Fluorescence and photoacoustic imaging probes are of particular interest for clinical applications because the combination enables deeper tissue penetration for tumor detection while maintaining imaging sensitivity compared to a single optical imaging modality. Here we describe the development of a human epidermal growth factor receptor 2 (HER2-targeting imaging probe to visualize differential levels of HER2 expression in a breast cancer model. Specifically, we labeled trastuzumab with Black Hole Quencher 3 (BHQ3 and fluorescein for photoacoustic and fluorescence imaging of HER2 overexpression, respectively. The dual-labeled trastuzumab was tested for its ability to detect HER2 overexpression in vitro and in vivo. We demonstrated an over twofold increase in the signal intensity for HER2-overexpressing tumors in vivo, compared to low–HER2-expressing tumors, using photoacoustic imaging. Furthermore, we demonstrated the feasibility of detecting tumors and positive surgical margins by fluorescence imaging. These results suggest that multimodal HER2-specific imaging of breast cancer using the BHQ3-fluorescein trastuzumab enables molecular-level detection and surgical margin assessment of breast tumors in vivo. This technique may have future clinical impact for primary lesion detection, as well as intraoperative molecular-level surgical guidance in breast cancer.

  16. Accuracy and inter-observer variability of 3D versus 4D cone-beam CT based image-guidance in SBRT for lung tumors

    International Nuclear Information System (INIS)

    Sweeney, Reinhart A; Seubert, Benedikt; Stark, Silke; Homann, Vanessa; Müller, Gerd; Flentje, Michael; Guckenberger, Matthias

    2012-01-01

    To analyze the accuracy and inter-observer variability of image-guidance (IG) using 3D or 4D cone-beam CT (CBCT) technology in stereotactic body radiotherapy (SBRT) for lung tumors. Twenty-one consecutive patients treated with image-guided SBRT for primary and secondary lung tumors were basis for this study. A respiration correlated 4D-CT and planning contours served as reference for all IG techniques. Three IG techniques were performed independently by three radiation oncologists (ROs) and three radiotherapy technicians (RTTs). Image-guidance using respiration correlated 4D-CBCT (IG-4D) with automatic registration of the planning 4D-CT and the verification 4D-CBCT was considered gold-standard. Results were compared with two IG techniques using 3D-CBCT: 1) manual registration of the planning internal target volume (ITV) contour and the motion blurred tumor in the 3D-CBCT (IG-ITV); 2) automatic registration of the planning reference CT image and the verification 3D-CBCT (IG-3D). Image quality of 3D-CBCT and 4D-CBCT images was scored on a scale of 1–3, with 1 being best and 3 being worst quality for visual verification of the IGRT results. Image quality was scored significantly worse for 3D-CBCT compared to 4D-CBCT: the worst score of 3 was given in 19 % and 7.1 % observations, respectively. Significant differences in target localization were observed between 4D-CBCT and 3D-CBCT based IG: compared to the reference of IG-4D, tumor positions differed by 1.9 mm ± 0.9 mm (3D vector) on average using IG-ITV and by 3.6 mm ± 3.2 mm using IG-3D; results of IG-ITV were significantly closer to the reference IG-4D compared to IG-3D. Differences between the 4D-CBCT and 3D-CBCT techniques increased significantly with larger motion amplitude of the tumor; analogously, differences increased with worse 3D-CBCT image quality scores. Inter-observer variability was largest in SI direction and was significantly larger in IG using 3D-CBCT compared to 4D-CBCT: 0.6 mm versus 1.5 mm

  17. SU-D-BRF-05: A Novel System to Provide Real-Time Image-Guidance for Intrauterine Tandem Insertion and Placement

    Energy Technology Data Exchange (ETDEWEB)

    Price, M; Fontenot, J [pF Biomedical Solutions LLC, Baton Rouge, LA (United States)

    2014-06-01

    Purpose: To develop a system that provides real-time image-guidance for intrauterine tandem insertion and placement for brachytherapy. Methods: The conceptualized system consists of an intrauterine tandem with a transparent, lensed tip, a flexible miniature fiber optic scope, light source and interface for CCD coupling. The tandem tip was designed to act as a lens providing a wide field-of-view (FOV) with minimal image distortion and focus length appropriate for the application. The system is designed so that once inserted, the image-guidance component of the system can be removed and brachytherapy can be administered without interfering with source transport or disturbing tandem placement. Proof-of-principle studies were conducted to assess the conceptualized system's (1) lens functionality (clarity, focus and FOV) (2) and ability to visualize the cervical os of a female placed in the lithotomy position. Results: A prototype of this device was constructed using a commercial tandem modified to incorporate a transparent tip that internally coupled with a 1.9mm diameter fiber optic cable. The 900mm-long cable terminated at an interface that provided illumination as well as facilitated visualization of patient anatomy on a computer. The system provided a 23mm FOV with a focal length of 1cm and provided clear visualization of the cervix, cervical fornix and cervical os. The optical components of the system are easily removed without perturbing the position of a tandem placed in a common fixation clamp. Conclusion: Clinicians frequently encounter difficulty inserting an intrauterine tandem through the cervical os, circumventing fibrotic tissue or masses within the uterus, and positioning the tandem without perforating the uterus. To mitigate these challenges, we have designed and conducted proof-of- principle studies to discern the utility of a prototype device that provides real-time image-guidance for intrauterine tandem placement using fiber optic components.

  18. Target volume geometric change and/or deviation from the cranium during fractionated stereotactic radiotherapy for brain metastases: potential pitfalls in image guidance based on bony anatomy alignment.

    Science.gov (United States)

    Ohtakara, Kazuhiro; Hoshi, Hiroaki

    2014-12-01

    This study sought to evaluate the potential geometrical change and/or displacement of the target relative to the cranium during fractionated stereotactic radiotherapy (FSRT) for treating newly developed brain metastases. For 16 patients with 21 lesions treated with image-guided frameless FSRT in 5 or 10 fractions using a 6-degree-of-freedom image guidance system-integrated platform, the unenhanced computed tomography or T2-weighted magnetic resonance images acquired until the completion of FSRT were fused to the planning image datasets for comparison. Significant change was defined as ≥3-mm change in the tumour diameter or displacement of the tumour centroid. FSRT was started 1 day after planning image acquisition. Tumour shrinkage, deviation and both were observed in 2, 1 and 1 of the 21 lesions, respectively, over a period of 7-13 days. Tumour shrinkage or deviation resulted in an increase or decrease in the marginal dose to the tumour, respectively, and a substantial increase in the irradiated volume for the surrounding tissue irrespective of the pattern of alteration. No obvious differences in the clinical and treatment characteristics were noted among the populations with or without significant changes in tumour volume or position. Target deformity and/or deviation can unexpectedly occur even during relatively short-course FSRT, inevitably leading to a gradual discrepancy between the planned and actually delivered doses to the tumour and surrounding tissue. To appropriately weigh the treatment outcome against the planned dose distribution, target deformity and/or deviation should also be considered in addition to the immobilisation accuracy, as image guidance with bony anatomy alignment does not necessarily guarantee accurate target localisation until completion of FSRT. © 2014 The Royal Australian and New Zealand College of Radiologists.

  19. Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy

    DEFF Research Database (Denmark)

    Boesen, Lars; Noergaard, Nis; Chabanova, Elizaveta

    2015-01-01

    OBJECTIVES: The purpose of this study was to investigate the detection rate of prostate cancer (PCa) by multiparametric magnetic resonance imaging-targeted biopsies (mp-MRI-bx) in patients with prior negative transrectal ultrasound biopsy (TRUS-bx) sessions without previous experience of this......-RADS) and Likert classification. All underwent repeated TRUS-bx (10 cores) and mp-MRI-bx under visual TRUS guidance of any mp-MRI-suspicious lesion not targeted by systematic TRUS-bx. RESULTS: PCa was found in 39 out of 83 patients (47%) and mp-MRI identified at least one lesion with some degree of suspicion...

  20. SU-E-J-24: Image-Guidance Using Cone-Beam CT for Stereotactic Body Radiotherapy (SBRT) of Lung Cancer Patients: Bony Alignment or Soft Tissue Alignment?

    Science.gov (United States)

    Wang, L; Turaka, A; Meyer, J; Spoka, D; Jin, L; Fan, J; Ma, C

    2012-06-01

    To assess the reliability of soft tissue alignment by comparing pre- and post-treatment cone-beam CT (CBCT) for image guidance in stereotactic body radiotherapy (SBRT) of lung cancers. Our lung SBRT procedures require all patients undergo 4D CT scan in order to obtain patient-specific target motion information through reconstructed 4D data using the maximum-intensity projection (MIP) algorithm. The internal target volume (ITV) was outlined directly from the MIP images and a 3-5 mm margin expansion was then applied to the ITV to create the PTV. Conformal treatment planning was performed on the helical images, to which the MIP images were fused. Prior to each treatment, CBCT was used for image guidance by comparing with the simulation CT and for patient relocalization based on the bony anatomy. Any displacement of the patient bony structure would be considered as setup errors and would be corrected by couch shifts. Theoretically, as the PTV definition included target internal motion, no further shifts other than setup corrections should be made. However, it is our practice to have treating physicians further check target localization within the PTV. Whenever the shifts based on the soft-tissue alignment (that is, target alignment) exceeded a certain value (e.g. 5 mm), a post-treatment CBCT was carried out to ensure that the tissue alignment is reliable by comparing between pre- and post-treatment CBCT. Pre- and post-CBCT has been performed for 7 patients so far who had shifts beyond 5 mm despite bony alignment. For all patients, post CBCT confirmed that the visualized target position was kept in the same position as before treatment after adjusting for soft-tissue alignment. For the patient population studied, it is shown that soft-tissue alignment is necessary and reliable in the lung SBRT for individual cases. © 2012 American Association of Physicists in Medicine.

  1. SU-E-J-45: The Correlation Between CBCT Flat Panel Misalignment and 3D Image Guidance Accuracy

    International Nuclear Information System (INIS)

    Kenton, O; Valdes, G; Yin, L; Teo, B; Brousmiche, S; Wikler, D

    2015-01-01

    Purpose To simulate the impact of CBCT flat panel misalignment on the image quality, the calculated correction vectors in 3D image guided proton therapy and to determine if these calibration errors can be caught in our QA process. Methods The X-ray source and detector geometrical calibration (flexmap) file of the CBCT system in the AdaPTinsight software (IBA proton therapy) was edited to induce known changes in the rotational and translational calibrations of the imaging panel. Translations of up to ±10 mm in the x, y and z directions (see supplemental) and rotational errors of up to ±3° were induced. The calibration files were then used to reconstruct the CBCT image of a pancreatic patient and CatPhan phantom. Correction vectors were calculated for the patient using the software’s auto match system and compared to baseline values. The CatPhan CBCT images were used for quantitative evaluation of image quality for each type of induced error. Results Translations of 1 to 3 mm in the x and y calibration resulted in corresponding correction vector errors of equal magnitude. Similar 10mm shifts were seen in the y-direction; however, in the x-direction, the image quality was too degraded for a match. These translational errors can be identified through differences in isocenter from orthogonal kV images taken during routine QA. Errors in the z-direction had no effect on the correction vector and image quality.Rotations of the imaging panel calibration resulted in corresponding correction vector rotations of the patient images. These rotations also resulted in degraded image quality which can be identified through quantitative image quality metrics. Conclusion Misalignment of CBCT geometry can lead to incorrect translational and rotational patient correction vectors. These errors can be identified through QA of the imaging isocenter as compared to orthogonal images combined with monitoring of CBCT image quality

  2. Accuracy and inter-observer variability of 3D versus 4D cone-beam CT based image-guidance in SBRT for lung tumors

    Directory of Open Access Journals (Sweden)

    Sweeney Reinhart A

    2012-06-01

    Full Text Available Abstract Background To analyze the accuracy and inter-observer variability of image-guidance (IG using 3D or 4D cone-beam CT (CBCT technology in stereotactic body radiotherapy (SBRT for lung tumors. Materials and methods Twenty-one consecutive patients treated with image-guided SBRT for primary and secondary lung tumors were basis for this study. A respiration correlated 4D-CT and planning contours served as reference for all IG techniques. Three IG techniques were performed independently by three radiation oncologists (ROs and three radiotherapy technicians (RTTs. Image-guidance using respiration correlated 4D-CBCT (IG-4D with automatic registration of the planning 4D-CT and the verification 4D-CBCT was considered gold-standard. Results were compared with two IG techniques using 3D-CBCT: 1 manual registration of the planning internal target volume (ITV contour and the motion blurred tumor in the 3D-CBCT (IG-ITV; 2 automatic registration of the planning reference CT image and the verification 3D-CBCT (IG-3D. Image quality of 3D-CBCT and 4D-CBCT images was scored on a scale of 1–3, with 1 being best and 3 being worst quality for visual verification of the IGRT results. Results Image quality was scored significantly worse for 3D-CBCT compared to 4D-CBCT: the worst score of 3 was given in 19 % and 7.1 % observations, respectively. Significant differences in target localization were observed between 4D-CBCT and 3D-CBCT based IG: compared to the reference of IG-4D, tumor positions differed by 1.9 mm ± 0.9 mm (3D vector on average using IG-ITV and by 3.6 mm ± 3.2 mm using IG-3D; results of IG-ITV were significantly closer to the reference IG-4D compared to IG-3D. Differences between the 4D-CBCT and 3D-CBCT techniques increased significantly with larger motion amplitude of the tumor; analogously, differences increased with worse 3D-CBCT image quality scores. Inter-observer variability was largest in SI direction and was

  3. Next Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue Specimens for Enhanced Clinical Guidance

    Science.gov (United States)

    2016-07-01

    AWARD NUMBER: W81XWH- 14-1-0192 TITLE: Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer...DATES COVERED 4. TITLE AND SUBTITLE Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue

  4. Dual-energy compared to single-energy CT in pediatric imaging: a phantom study for DECT clinical guidance

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Xiaowei; Servaes, Sabah; Darge, Kassa [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); University of Pennsylvania, The Perelman School of Medicine, Philadelphia, PA (United States); McCullough, William P. [University of Virginia Health System, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Mecca, Patricia [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2016-11-15

    Dual-energy CT technology is available on scanners from several vendors and offers significant advantages over classic single-energy CT technology in multiple clinical applications. Many studies have detailed dual-energy CT applications in adults and several have evaluated the relative radiation dose performance of dual-energy CT in adult imaging. However, little has been published on dual-energy CT imaging in the pediatric population, and the relative dose performance of dual-energy CT imaging in the pediatric population is not well described. When evaluating dual-energy CT technology for implementation into a routine clinical pediatric imaging practice, the radiation dose implications must be considered, and when comparing relative CT dose performance, image quality must also be evaluated. Therefore the purpose of this study is to develop dual-energy CT scan protocols based on our optimized single-energy scan protocols and compare the dose. We scanned the head, chest and abdomen regions of pediatric-size anthropomorphic phantoms with contrast inserts, using our optimized single-energy clinical imaging protocols on a Siemens Flash {sup registered} CT scanner. We then scanned the phantoms in dual-energy mode using matching image-quality reference settings. The effective CT dose index volume (CTDI{sub vol}) of the scans was used as a surrogate for relative dose in comparing the single- and dual-energy scans. Additionally, we evaluated image quality using visual assessment and contrast-to-noise ratio. Dual-energy CT scans of the head and abdomen were dose-neutral for all three phantoms. Dual-energy CT scans of the chest showed a relative dose increase over the single-energy scan for 1- and 5-year-old child-based age-equivalent phantoms, ranging 11-20%. Quantitative analysis of image quality showed no statistically significant difference in image quality between the single-energy and dual-energy scans. There was no clinically significant difference in image quality by

  5. Dual-energy compared to single-energy CT in pediatric imaging: a phantom study for DECT clinical guidance

    International Nuclear Information System (INIS)

    Zhu, Xiaowei; Servaes, Sabah; Darge, Kassa; McCullough, William P.; Mecca, Patricia

    2016-01-01

    Dual-energy CT technology is available on scanners from several vendors and offers significant advantages over classic single-energy CT technology in multiple clinical applications. Many studies have detailed dual-energy CT applications in adults and several have evaluated the relative radiation dose performance of dual-energy CT in adult imaging. However, little has been published on dual-energy CT imaging in the pediatric population, and the relative dose performance of dual-energy CT imaging in the pediatric population is not well described. When evaluating dual-energy CT technology for implementation into a routine clinical pediatric imaging practice, the radiation dose implications must be considered, and when comparing relative CT dose performance, image quality must also be evaluated. Therefore the purpose of this study is to develop dual-energy CT scan protocols based on our optimized single-energy scan protocols and compare the dose. We scanned the head, chest and abdomen regions of pediatric-size anthropomorphic phantoms with contrast inserts, using our optimized single-energy clinical imaging protocols on a Siemens Flash "r"e"g"i"s"t"e"r"e"d CT scanner. We then scanned the phantoms in dual-energy mode using matching image-quality reference settings. The effective CT dose index volume (CTDI_v_o_l) of the scans was used as a surrogate for relative dose in comparing the single- and dual-energy scans. Additionally, we evaluated image quality using visual assessment and contrast-to-noise ratio. Dual-energy CT scans of the head and abdomen were dose-neutral for all three phantoms. Dual-energy CT scans of the chest showed a relative dose increase over the single-energy scan for 1- and 5-year-old child-based age-equivalent phantoms, ranging 11-20%. Quantitative analysis of image quality showed no statistically significant difference in image quality between the single-energy and dual-energy scans. There was no clinically significant difference in image quality

  6. MO-DE-210-06: Development of a Supercompounded 3D Volumetric Ultrasound Image Guidance System for Prone Accelerated Partial Breast Irradiation (APBI)

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, T; Hrycushko, B; Zhao, B; Jiang, S; Gu, X [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: For early-stage breast cancer, accelerated partial breast irradiation (APBI) is a cost-effective breast-conserving treatment. Irradiation in a prone position can mitigate respiratory induced breast movement and achieve maximal sparing of heart and lung tissues. However, accurate dose delivery is challenging due to breast deformation and lumpectomy cavity shrinkage. We propose a 3D volumetric ultrasound (US) image guidance system for accurate prone APBI Methods: The designed system, set beneath the prone breast board, consists of a water container, an US scanner, and a two-layer breast immobilization cup. The outer layer of the breast cup forms the inner wall of water container while the inner layer is attached to patient breast directly to immobilization. The US transducer scans is attached to the outer-layer of breast cup at the dent of water container. Rotational US scans in a transverse plane are achieved by simultaneously rotating water container and transducer, and multiple transverse scanning forms a 3D scan. A supercompounding-technique-based volumetric US reconstruction algorithm is developed for 3D image reconstruction. The performance of the designed system is evaluated with two custom-made gelatin phantoms containing several cylindrical inserts filled in with water (11% reflection coefficient between materials). One phantom is designed for positioning evaluation while the other is for scaling assessment. Results: In the positioning evaluation phantom, the central distances between the inserts are 15, 20, 30 and 40 mm. The distances on reconstructed images differ by −0.19, −0.65, −0.11 and −1.67 mm, respectively. In the scaling evaluation phantom, inserts are 12.7, 19.05, 25.40 and 31.75 mm in diameter. Measured inserts’ sizes on images differed by 0.23, 0.19, −0.1 and 0.22 mm, respectively. Conclusion: The phantom evaluation results show that the developed 3D volumetric US system can accurately localize target position and determine

  7. Remotely supported prehospital ultrasound: A feasibility study of real-time image transmission and expert guidance to aid diagnosis in remote and rural communities.

    Science.gov (United States)

    Eadie, Leila; Mulhern, John; Regan, Luke; Mort, Alasdair; Shannon, Helen; Macaden, Ashish; Wilson, Philip

    2017-01-01

    Introduction Our aim is to expedite prehospital assessment of remote and rural patients using remotely-supported ultrasound and satellite/cellular communications. In this paradigm, paramedics are remotely-supported ultrasound operators, guided by hospital-based specialists, to record images before receiving diagnostic advice. Technology can support users in areas with little access to medical imaging and suboptimal communications coverage by connecting to multiple cellular networks and/or satellites to stream live ultrasound and audio-video. Methods An ambulance-based demonstrator system captured standard trauma and novel transcranial ultrasound scans from 10 healthy volunteers at 16 locations across the Scottish Highlands. Volunteers underwent brief scanning training before receiving expert guidance via the communications link. Ultrasound images were streamed with an audio/video feed to reviewers for interpretation. Two sessions were transmitted via satellite and 21 used cellular networks. Reviewers rated image and communication quality, and their utility for diagnosis. Transmission latency and bandwidth were recorded, and effects of scanner and reviewer experience were assessed. Results Appropriate views were provided in 94% of the simulated trauma scans. The mean upload rate was 835/150 kbps and mean latency was 114/2072 ms for cellular and satellite networks, respectively. Scanning experience had a significant impact on time to achieve a diagnostic image, and review of offline scans required significantly less time than live-streamed scans. Discussion This prehospital ultrasound system could facilitate early diagnosis and streamlining of treatment pathways for remote emergency patients, being particularly applicable in rural areas worldwide with poor communications infrastructure and extensive transport times.

  8. [Features of maxillary and mandibular nerves imaging during stem regional blockades. From paresthesia to 3D-CT guidance].

    Science.gov (United States)

    Zaytsev, A Yu; Nazaryan, D N; Kim, S Yu; Dubrovin, K V; Svetlov, V A; Khovrin, V V

    2014-01-01

    There are difficulties in procedure of regional block of 2 and 3 brunches of the trigeminal nerve despite availability of many different methods of nerves imaging. The difficulties are connected with complex anatomy structure. Neurostimulation not always effective and as a rule, is accompanied with wrong interpretation of movement response on stimulation. The changing of the tactics on paraesthesia search improves the situation. The use of new methods of nerves imaging (3D-CT) also allows decreasing the frequency of fails during procedure of regional block of the brunches of the trigeminal nerve.

  9. Deep inspiration breath-hold radiotherapy for lung cancer: impact on image quality and registration uncertainty in cone beam CT image guidance

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Persson, Gitte F; Bangsgaard, Jens Peter

    2016-01-01

    OBJECTIVE: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image-guided DIBH radiotherapy (RT) for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT)-guided free...... for the craniocaudal direction in FB, where it was >3 mm. On the 31st fraction, the intraobserver uncertainty increased compared with the second fraction. This increase was more pronounced in FB. Image quality scores improved in DIBH compared with FB for all parameters in all patients. Simulated tumour baseline shifts...... ≤2 mm did not affect the CBCT image quality considerably. CONCLUSION: DIBH CBCT improved image quality and reduced registration uncertainty in the craniocaudal direction in image-guided RT of locally advanced lung cancer. Baseline shifts ≤2 mm in DIBH during CBCT acquisition did not affect image...

  10. Image Guidance to Aid Pedicle Screw Fixation of a Lumbar Fracture-Dislocation Injury in a Toddler.

    Science.gov (United States)

    Houten, John K; Nahkla, Jonathan; Ghandi, Shashank

    2017-09-01

    Pedicle screw fixation of the lumbar spine in children age <2 years is particularly challenging, as successful cannulation of the small pedicle dimensions requires a high level of precision and there are no implants specifically designed for the infant spine. Image-guided navigation is commonly used in adult spinal surgery and may be particularly helpful for the placement of spinal screws in areas where the bony anatomy is small and/or anatomically complex, as in the upper cervical area. A 19-month-old female presented with a fracture-dislocation injury of L1-2. Intraoperative imaging using the O-arm multidimensional imaging system was networked to a workstation, and neuronavigation was used to place pedicle instrumentation with 3.5-mm-diameter polyaxial screws designed for posterior cervical fixation. At a 48-month follow-up, the patient was neurologically intact, demonstrated normal physical development, and was engaging in normal physical activity for her age. Radiographs obtained approximately 4 years postsurgery showed no evidence of loss for fixation. Image-guided placement of pedicle screws may be a useful aid in achieving accurate and safe fixation in the small dimensions of the infant spine. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Evaluation of contrast reproduction method based on the anatomical guidance of the cerebral images reconstruction in positron emission tomography

    International Nuclear Information System (INIS)

    Bataille, F.

    2007-04-01

    Positron emission tomography is a medical imaging modality providing in-vivo volumetric images of functional processes of the human body, which is used for the diagnosis and the following of neuro degenerative diseases. PET efficiency is however limited by its poor spatial resolution, which generates a decrease of the image local contrast and leads to an under-estimation of small cerebral structures involved in the degenerative mechanism of those diseases. This so-called partial volume effect degradation is usually corrected in a post-reconstruction processing framework through the use of anatomical information, whose spatial resolution allows a better discrimination between functional tissues. However, this kind of method has the major drawback of being very sensitive to the residual mismatches on the anatomical information processing. We developed in this thesis an alternative methodology to compensate for the degradation, by incorporating in the reconstruction process both a model of the system impulse response and an anatomically-based image prior constraint. This methodology was validated by comparison with a post-reconstruction correction strategy, using data from an anthropomorphic phantom acquisition and then we evaluated its robustness to the residual mismatches through a realistic Monte Carlo simulation corresponding to a cerebral exam. The proposed algorithm was finally applied to clinical data reconstruction. (author)

  12. Image guidance during head-and-neck cancer radiation therapy: analysis of alignment trends with in-room cone-beam computed tomography scans.

    Science.gov (United States)

    Zumsteg, Zachary; DeMarco, John; Lee, Steve P; Steinberg, Michael L; Lin, Chun Shu; McBride, William; Lin, Kevin; Wang, Pin-Chieh; Kupelian, Patrick; Lee, Percy

    2012-06-01

    On-board cone-beam computed tomography (CBCT) is currently available for alignment of patients with head-and-neck cancer before radiotherapy. However, daily CBCT is time intensive and increases the overall radiation dose. We assessed the feasibility of using the average couch shifts from the first several CBCTs to estimate and correct for the presumed systematic setup error. 56 patients with head-and-neck cancer who received daily CBCT before intensity-modulated radiation therapy had recorded shift values in the medial-lateral, superior-inferior, and anterior-posterior dimensions. The average displacements in each direction were calculated for each patient based on the first five or 10 CBCT shifts and were presumed to represent the systematic setup error. The residual error after this correction was determined by subtracting the calculated shifts from the shifts obtained using daily CBCT. The magnitude of the average daily residual three-dimensional (3D) error was 4.8 ± 1.4 mm, 3.9 ± 1.3 mm, and 3.7 ± 1.1 mm for uncorrected, five CBCT corrected, and 10 CBCT corrected protocols, respectively. With no image guidance, 40.8% of fractions would have been >5 mm off target. Using the first five CBCT shifts to correct subsequent fractions, this percentage decreased to 19.0% of all fractions delivered and decreased the percentage of patients with average daily 3D errors >5 mm from 35.7% to 14.3% vs. no image guidance. Using an average of the first 10 CBCT shifts did not significantly improve this outcome. Using the first five CBCT shift measurements as an estimation of the systematic setup error improves daily setup accuracy for a subset of patients with head-and-neck cancer receiving intensity-modulated radiation therapy and primarily benefited those with large 3D correction vectors (>5 mm). Daily CBCT is still necessary until methods are developed that more accurately determine which patients may benefit from alternative imaging strategies. Copyright © 2012 Elsevier

  13. Spine Stereotactic Body Radiotherapy Utilizing Cone-Beam CT Image-Guidance With a Robotic Couch: Intrafraction Motion Analysis Accounting for all Six Degrees of Freedom

    Energy Technology Data Exchange (ETDEWEB)

    Hyde, Derek [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario (Canada); British Columbia Cancer Agency, The Sindi Hawkins Cancer Centre for the Southern Interior, Kelowna (Canada); Lochray, Fiona; Korol, Renee; Davidson, Melanie; Wong, C. Shun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario (Canada); Ma, Lijun [Department of Radiation Oncology, University of California San Francisco, San Francisco, CA (United States); Sahgal, Arjun, E-mail: Arjun.sahgal@rmp.uhn.on.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario (Canada); Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto (Canada)

    2012-03-01

    Purpose: To evaluate the residual setup error and intrafraction motion following kilovoltage cone-beam CT (CBCT) image guidance, for immobilized spine stereotactic body radiotherapy (SBRT) patients, with positioning corrected for in all six degrees of freedom. Methods and Materials: Analysis is based on 42 consecutive patients (48 thoracic and/or lumbar metastases) treated with a total of 106 fractions and 307 image registrations. Following initial setup, a CBCT was acquired for patient alignment and a pretreatment CBCT taken to verify shifts and determine the residual setup error, followed by a midtreatment and posttreatment CBCT image. For 13 single-fraction SBRT patients, two midtreatment CBCT images were obtained. Initially, a 1.5-mm and 1 Degree-Sign tolerance was used to reposition the patient following couch shifts which was subsequently reduced to 1 mm and 1 Degree-Sign degree after the first 10 patients. Results: Small positioning errors after the initial CBCT setup were observed, with 90% occurring within 1 mm and 97% within 1 Degree-Sign . In analyzing the impact of the time interval for verification imaging (10 {+-} 3 min) and subsequent image acquisitions (17 {+-} 4 min), the residual setup error was not significantly different (p > 0.05). A significant difference (p = 0.04) in the average three-dimensional intrafraction positional deviations favoring a more strict tolerance in translation (1 mm vs. 1.5 mm) was observed. The absolute intrafraction motion averaged over all patients and all directions along x, y, and z axis ({+-} SD) were 0.7 {+-} 0.5 mm and 0.5 {+-} 0.4 mm for the 1.5 mm and 1 mm tolerance, respectively. Based on a 1-mm and 1 Degree-Sign correction threshold, the target was localized to within 1.2 mm and 0.9 Degree-Sign with 95% confidence. Conclusion: Near-rigid body immobilization, intrafraction CBCT imaging approximately every 15-20 min, and strict repositioning thresholds in six degrees of freedom yields minimal intrafraction motion

  14. Deep inspiration breath-hold radiotherapy for lung cancer: impact on image quality and registration uncertainty in cone beam CT image guidance

    DEFF Research Database (Denmark)

    Josipovic, Mirjana; Persson, Gitte F; Bangsgaard, Jens Peter

    2016-01-01

    OBJECTIVE: We investigated the impact of deep inspiration breath-hold (DIBH) and tumour baseline shifts on image quality and registration uncertainty in image-guided DIBH radiotherapy (RT) for locally advanced lung cancer. METHODS: Patients treated with daily cone beam CT (CBCT)-guided free...

  15. A novel technique combining laparoscopic and endovascular approaches using image fusion guidance for anterior embolization of type II endoleak

    Directory of Open Access Journals (Sweden)

    M. Mujeeb Zubair, MD

    2017-03-01

    Full Text Available Type II endoleak (T2E leading to aneurysm sac enlargement is one of the challenging complications associated with endovascular aneurysm repair. Recent guidelines recommend embolization of T2E associated with aneurysmal sac enlargement. Various percutaneous and endovascular techniques have been reported for embolization of T2E. We report a novel technique for T2E embolization combining laparoscopic and endovascular approaches using preoperative image fusion. We believe our technique provides a more direct access to the lumbar feeding vessels that is typically challenging with transarterial or translumbar embolization techniques.

  16. SU-F-J-18: Feasibility of Open Mask Immobilization with Optical Imaging Guidance (OIG) for H&N Radiotherapy

    International Nuclear Information System (INIS)

    Zhao, B; Maquilan, G; Anders, M; Jiang, S; Schwartz, D

    2016-01-01

    Purpose: Full face and neck thermoplastic masks provide standard-of-care immobilization for patients receiving H&N IMRT. However, these masks are uncomfortable and increase skin dose. The purpose of this pilot study was to investigate the feasibility and setup accuracy of open face and neck mask immobilization with OIG. Methods: Ten patients were consented and enrolled to this IRB-approved protocol. Patients were immobilized with open masks securing only forehead and chin. Standard IMRT to 60–70 Gy in 30 fractions were delivered in all cases. Patient simulation information, including isocenter location and CT skin contours, were imported to a commercial OIG system. On the first day of treatment, patients were initially set up to surface markings and then OIG referenced to face and neck skin regions of interest (ROI) localized on simulation CT images, followed by in-room CBCT. CBCTs were acquired at least weekly while planar OBI was acquired on the days without CBCT. Following 6D robotic couch correction with kV imaging, a new optical real-time surface image was acquired to track intrafraction motion and to serve as a reference surface for setup at the next treatment fraction. Therapists manually recorded total treatment time as well as couch shifts based on kV imaging. Intrafractional ROI motion tracking was automatically recorded. Results: Setup accuracy of OIG was compared with CBCT results. The setup error based on OIG was represented as a 6D shift (vertical/longitudinal/lateral/rotation/pitch/roll). Mean error values were −0.70±3.04mm, −0.69±2.77mm, 0.33±2.67 mm, −0.14±0.94 o, −0.15±1.10o and 0.12±0.82o, respectively for the cohort. Average treatment time was 24.1±9.2 minutes, comparable to standard immobilization. The amplitude of intrafractional ROI motion was 0.69±0.36 mm, driven primarily by respiratory neck motion. Conclusion: OGI can potentially provide accurate setup and treatment tracking for open face and neck immobilization. Study

  17. SU-F-J-18: Feasibility of Open Mask Immobilization with Optical Imaging Guidance (OIG) for H&N Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, B; Maquilan, G; Anders, M; Jiang, S; Schwartz, D [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: Full face and neck thermoplastic masks provide standard-of-care immobilization for patients receiving H&N IMRT. However, these masks are uncomfortable and increase skin dose. The purpose of this pilot study was to investigate the feasibility and setup accuracy of open face and neck mask immobilization with OIG. Methods: Ten patients were consented and enrolled to this IRB-approved protocol. Patients were immobilized with open masks securing only forehead and chin. Standard IMRT to 60–70 Gy in 30 fractions were delivered in all cases. Patient simulation information, including isocenter location and CT skin contours, were imported to a commercial OIG system. On the first day of treatment, patients were initially set up to surface markings and then OIG referenced to face and neck skin regions of interest (ROI) localized on simulation CT images, followed by in-room CBCT. CBCTs were acquired at least weekly while planar OBI was acquired on the days without CBCT. Following 6D robotic couch correction with kV imaging, a new optical real-time surface image was acquired to track intrafraction motion and to serve as a reference surface for setup at the next treatment fraction. Therapists manually recorded total treatment time as well as couch shifts based on kV imaging. Intrafractional ROI motion tracking was automatically recorded. Results: Setup accuracy of OIG was compared with CBCT results. The setup error based on OIG was represented as a 6D shift (vertical/longitudinal/lateral/rotation/pitch/roll). Mean error values were −0.70±3.04mm, −0.69±2.77mm, 0.33±2.67 mm, −0.14±0.94 o, −0.15±1.10o and 0.12±0.82o, respectively for the cohort. Average treatment time was 24.1±9.2 minutes, comparable to standard immobilization. The amplitude of intrafractional ROI motion was 0.69±0.36 mm, driven primarily by respiratory neck motion. Conclusion: OGI can potentially provide accurate setup and treatment tracking for open face and neck immobilization. Study

  18. Visual guidance of forward flight in hummingbirds reveals control based on image features instead of pattern velocity.

    Science.gov (United States)

    Dakin, Roslyn; Fellows, Tyee K; Altshuler, Douglas L

    2016-08-02

    Information about self-motion and obstacles in the environment is encoded by optic flow, the movement of images on the eye. Decades of research have revealed that flying insects control speed, altitude, and trajectory by a simple strategy of maintaining or balancing the translational velocity of images on the eyes, known as pattern velocity. It has been proposed that birds may use a similar algorithm but this hypothesis has not been tested directly. We examined the influence of pattern velocity on avian flight by manipulating the motion of patterns on the walls of a tunnel traversed by Anna's hummingbirds. Contrary to prediction, we found that lateral course control is not based on regulating nasal-to-temporal pattern velocity. Instead, birds closely monitored feature height in the vertical axis, and steered away from taller features even in the absence of nasal-to-temporal pattern velocity cues. For vertical course control, we observed that birds adjusted their flight altitude in response to upward motion of the horizontal plane, which simulates vertical descent. Collectively, our results suggest that birds avoid collisions using visual cues in the vertical axis. Specifically, we propose that birds monitor the vertical extent of features in the lateral visual field to assess distances to the side, and vertical pattern velocity to avoid collisions with the ground. These distinct strategies may derive from greater need to avoid collisions in birds, compared with small insects.

  19. SU-E-J-34: Setup Accuracy in Spine SBRT Using CBCT 6D Image Guidance in Comparison with 6D ExacTrac

    Energy Technology Data Exchange (ETDEWEB)

    Han, Z; Yip, S; Lewis, J; Mannarino, E; Friesen, S; Wagar, M; Hacker, F [Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA (United States)

    2015-06-15

    Purpose Volumetric information of the spine captured on CBCT can potentially improve the accuracy in spine SBRT setup that has been commonly performed through 2D radiographs. This work evaluates the setup accuracy in spine SBRT using 6D CBCT image guidance that recently became available on Varian systems. Methods ExacTrac radiographs have been commonly used for Spine SBRT setup. The setup process involves first positioning patients with lasers followed by localization imaging, registration, and repositioning. Verification images are then taken providing the residual errors (ExacTracRE) before beam on. CBCT verification is also acquired in our institute. The availability of both ExacTrac and CBCT verifications allows a comparison study. 41 verification CBCT of 16 patients were retrospectively registered with the planning CT enabling 6D corrections, giving CBCT residual errors (CBCTRE) which were compared with ExacTracRE. Results The RMS discrepancies between CBCTRE and ExacTracRE are 1.70mm, 1.66mm, 1.56mm in vertical, longitudinal and lateral directions and 0.27°, 0.49°, 0.35° in yaw, roll and pitch respectively. The corresponding mean discrepancies (and standard deviation) are 0.62mm (1.60mm), 0.00mm (1.68mm), −0.80mm (1.36mm) and 0.05° (0.58°), 0.11° (0.48°), −0.16° (0.32°). Of the 41 CBCT, 17 had high-Z surgical implants. No significant difference in ExacTrac-to-CBCT discrepancy was observed between patients with and without the implants. Conclusion Multiple factors can contribute to the discrepancies between CBCT and ExacTrac: 1) the imaging iso-centers of the two systems, while calibrated to coincide, can be different; 2) the ROI used for registration can be different especially if ribs were included in ExacTrac images; 3) small patient motion can occur between the two verification image acquisitions; 4) the algorithms can be different between CBCT (volumetric) and ExacTrac (radiographic) registrations.

  20. Prospective Trial of High-Dose Reirradiation Using Daily Image Guidance With Intensity-Modulated Radiotherapy for Recurrent and Second Primary Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Chen, Allen M.; Farwell, D. Gregory; Luu, Quang; Cheng, Suzan; Donald, Paul J.; Purdy, James A.

    2011-01-01

    Purpose: To report a single-institutional experience using intensity-modulated radiotherapy with daily image-guided radiotherapy for the reirradiation of recurrent and second cancers of the head and neck. Methods and Materials: Twenty-one consecutive patients were prospectively treated with intensity-modulated radiotherapy from February 2006 to March 2009 to a median dose of 66 Gy (range, 60-70 Gy). None of these patients received concurrent chemotherapy. Daily helical megavoltage CT scans were obtained before each fraction as part of an image-guided radiotherapy registration protocol for patient alignment. Results: The 1- and 2-year estimates of in-field control were 72% and 65%, respectively. A total of 651 daily megavoltage CT scans were obtained. The mean systematic shift to account for interfraction motion was 1.38 ± 1.25 mm, 1.79 ± 1.45 mm, and 1.98 ± 1.75 mm for the medial-lateral, superior-inferior, and anterior-posterior directions, respectively. Pretreatment shifts of >3 mm occurred in 19% of setups in the medial-lateral, 27% in the superior-inferior, and 33% in the anterior-posterior directions, respectively. There were no treatment-related fatalities or hospitalizations. Complications included skin desquamation, odynophagia, otitis externa, keratitis, naso-lacrimal duct stenosis, and brachial plexopathy. Conclusions: Intensity-modulated radiotherapy with daily image guidance results in effective disease control with relatively low morbidity and should be considered for selected patients with recurrent and second primary cancers of the head and neck.

  1. Effect of Body Mass Index on Magnitude of Setup Errors in Patients Treated With Adjuvant Radiotherapy for Endometrial Cancer With Daily Image Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Lilie L., E-mail: lin@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States); Hertan, Lauren; Rengan, Ramesh; Teo, Boon-Keng Kevin [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States)

    2012-06-01

    Purpose: To determine the impact of body mass index (BMI) on daily setup variations and frequency of imaging necessary for patients with endometrial cancer treated with adjuvant intensity-modulated radiotherapy (IMRT) with daily image guidance. Methods and Materials: The daily shifts from a total of 782 orthogonal kilovoltage images from 30 patients who received pelvic IMRT between July 2008 and August 2010 were analyzed. The BMI, mean daily shifts, and random and systematic errors in each translational and rotational direction were calculated for each patient. Margin recipes were generated based on BMI. Linear regression and spearman rank correlation analysis were performed. To simulate a less-than-daily IGRT protocol, the average shift of the first five fractions was applied to subsequent setups without IGRT for assessing the impact on setup error and margin requirements. Results: Median BMI was 32.9 (range, 23-62). Of the 30 patients, 16.7% (n = 5) were normal weight (BMI <25); 23.3% (n = 7) were overweight (BMI {>=}25 to <30); 26.7% (n = 8) were mildly obese (BMI {>=}30 to <35); and 33.3% (n = 10) were moderately to severely obese (BMI {>=} 35). On linear regression, mean absolute vertical, longitudinal, and lateral shifts positively correlated with BMI (p = 0.0127, p = 0.0037, and p < 0.0001, respectively). Systematic errors in the longitudinal and vertical direction were found to be positively correlated with BMI category (p < 0.0001 for both). IGRT for the first five fractions, followed by correction of the mean error for all subsequent fractions, led to a substantial reduction in setup error and resultant margin requirement overall compared with no IGRT. Conclusions: Daily shifts, systematic errors, and margin requirements were greatest in obese patients. For women who are normal or overweight, a planning target margin margin of 7 to 10 mm may be sufficient without IGRT, but for patients who are moderately or severely obese, this is insufficient.

  2. On-line image guidance for frameless stereotactic radiotherapy of lung malignancies by cone beam CT: Comparison between target localization and alignment on bony anatomy

    International Nuclear Information System (INIS)

    Masi, Laura; Casamassima, Franco; Menichelli, Claudia; Pasciuti, Katia; Doro, Raffaela; Polli, Caterina; D'imporzano, Elena; Bonucci, Ivano

    2008-01-01

    Introduction. Free-breathing stereotactic radiotherapy for lung malignancies requires reliable prediction of respiratory motion and accurate target localization. A protocol was adopted for reproducibility and reduction of respiratory motion and for target localization by CBCT image guidance. Tumor respiratory displacements and tumor positioning errors relative to bony anatomy alignment are analyzed. Materials and method. Image guided SRT was performed for 99 lung malignancies. Two groups of patients were considered: group A did not perform any breathing control; group B controlled visually their respiratory cycle and volumes on an Active Breathing Coordinator (ABC) monitor during the acquisition of simulation CT and CBCT, and treatment delivery. GTV on end inhale and exhale CT data sets were fused in an ITV and the extent of tumor motion evaluated between these 2 phases. A pre-treatment CBCT was acquired and aligned to the reference CT using bony anatomy; for tumor positioning the ITV contour on the reference CT was matched to the visible tumor on CBCT. Interobserver variability of tumor positioning was evaluated. ITV and CBCT tumor dimensions were compared. Results. 3D tumor breathing displacement (mean±SD) was significantly higher for group A (14.7±9.9 mm) than for group B (4.7±3.1 mm). The detected differences between tumor and bony structure alignment below 3 mm were 68% for group B and 45% for group A, reaching statistical significance. Interobserver variability was 1.7±1.1 mm (mean±SD). Dimensions of tumor image on CBCT were consistent with ITV dimensions for group B (max difference 14%). Conclusions. The adopted protocol seems effective in reducing respiratory internal movements and margin. Tumor positioning errors relative to bony anatomy are also reduced. However bony anatomy as a surrogate of the target may still lead to some relevant positioning errors. Target visualization on CBCT is essential for an accurate localization in lung SRT

  3. Effect of Body Mass Index on Magnitude of Setup Errors in Patients Treated With Adjuvant Radiotherapy for Endometrial Cancer With Daily Image Guidance

    International Nuclear Information System (INIS)

    Lin, Lilie L.; Hertan, Lauren; Rengan, Ramesh; Teo, Boon-Keng Kevin

    2012-01-01

    Purpose: To determine the impact of body mass index (BMI) on daily setup variations and frequency of imaging necessary for patients with endometrial cancer treated with adjuvant intensity-modulated radiotherapy (IMRT) with daily image guidance. Methods and Materials: The daily shifts from a total of 782 orthogonal kilovoltage images from 30 patients who received pelvic IMRT between July 2008 and August 2010 were analyzed. The BMI, mean daily shifts, and random and systematic errors in each translational and rotational direction were calculated for each patient. Margin recipes were generated based on BMI. Linear regression and spearman rank correlation analysis were performed. To simulate a less-than-daily IGRT protocol, the average shift of the first five fractions was applied to subsequent setups without IGRT for assessing the impact on setup error and margin requirements. Results: Median BMI was 32.9 (range, 23–62). Of the 30 patients, 16.7% (n = 5) were normal weight (BMI <25); 23.3% (n = 7) were overweight (BMI ≥25 to <30); 26.7% (n = 8) were mildly obese (BMI ≥30 to <35); and 33.3% (n = 10) were moderately to severely obese (BMI ≥ 35). On linear regression, mean absolute vertical, longitudinal, and lateral shifts positively correlated with BMI (p = 0.0127, p = 0.0037, and p < 0.0001, respectively). Systematic errors in the longitudinal and vertical direction were found to be positively correlated with BMI category (p < 0.0001 for both). IGRT for the first five fractions, followed by correction of the mean error for all subsequent fractions, led to a substantial reduction in setup error and resultant margin requirement overall compared with no IGRT. Conclusions: Daily shifts, systematic errors, and margin requirements were greatest in obese patients. For women who are normal or overweight, a planning target margin margin of 7 to 10 mm may be sufficient without IGRT, but for patients who are moderately or severely obese, this is insufficient.

  4. High precision bladder cancer irradiation by integrating a library planning procedure of 6 prospectively generated SIB IMRT plans with image guidance using lipiodol markers

    International Nuclear Information System (INIS)

    Meijer, Gert Johan; Toorn, Peter-Paul van der; Bal, Matthieu; Schuring, Danny; Weterings, Jan; Wildt, Michel de

    2012-01-01

    Purpose: To increase local control and decrease side effects for urinary bladder cancer patients by integrating a library planning procedure with image guidance using lipiodol markers. Methods and materials: Twenty patients with T2-T4N0M0 grade 2–3 invasive bladder carcinoma were treated according to an online adaptive protocol. Initially, the gross tumour volume (GTV) was demarcated during cystoscopy by injecting several drops of lipiodol in the submucosa around the tumour. Subsequently two CT scans were acquired with a full bladder and a voided bladder. On both scans, the boost volume (GTV) and the low-risk bladder volume were delineated. Using an interpolation tool, six concomitant boost IMRT plans with increasing bladder volumes were generated. For each fraction the procedure at the treatment unit was as follows: Firstly, a ConeBeam-CT was acquired and based on the amount of bladder filling the best fitting bladder contours and corresponding GTV and IMRT plans were selected. Secondly, the lipiodol markers were registered using the corresponding GTV contours and it was verified that the corresponding 95%-isodose surface covered the entire bladder. Finally, an online setup correction was applied based on this registration and the corresponding treatment plan was irradiated. Results: The lipiodol markers were very useful in outlining the GTV at the planning CT and for daily setup correction. While the patients strived for a full bladder filling at time of the treatment, this was seldom accomplished. Due to our protocol an appropriate plan with adequate coverage of the PTV and without excessive dose to healthy tissue was delivered every day. The treatment was very well tolerated by all patients. At the end of the treatment no grade 3 urinary or gastro-intestinal toxicity was observed. After a median follow-up of 28 months two local relapses occurred. Conclusion: Using the library planning approach combined with online image guidance using lipiodol markers, we

  5. High precision bladder cancer irradiation by integrating a library planning procedure of 6 prospectively generated SIB IMRT plans with image guidance using lipiodol markers.

    Science.gov (United States)

    Meijer, Gert Johan; van der Toorn, Peter-Paul; Bal, Matthieu; Schuring, Danny; Weterings, Jan; de Wildt, Michel

    2012-11-01

    To increase local control and decrease side effects for urinary bladder cancer patients by integrating a library planning procedure with image guidance using lipiodol markers. Twenty patients with T2-T4N0M0 grade 2-3 invasive bladder carcinoma were treated according to an online adaptive protocol. Initially, the gross tumour volume (GTV) was demarcated during cystoscopy by injecting several drops of lipiodol in the submucosa around the tumour. Subsequently two CT scans were acquired with a full bladder and a voided bladder. On both scans, the boost volume (GTV) and the low-risk bladder volume were delineated. Using an interpolation tool, six concomitant boost IMRT plans with increasing bladder volumes were generated. For each fraction the procedure at the treatment unit was as follows: Firstly, a ConeBeam-CT was acquired and based on the amount of bladder filling the best fitting bladder contours and corresponding GTV and IMRT plans were selected. Secondly, the lipiodol markers were registered using the corresponding GTV contours and it was verified that the corresponding 95%-isodose surface covered the entire bladder. Finally, an online setup correction was applied based on this registration and the corresponding treatment plan was irradiated. The lipiodol markers were very useful in outlining the GTV at the planning CT and for daily setup correction. While the patients strived for a full bladder filling at time of the treatment, this was seldom accomplished. Due to our protocol an appropriate plan with adequate coverage of the PTV and without excessive dose to healthy tissue was delivered every day. The treatment was very well tolerated by all patients. At the end of the treatment no grade 3 urinary or gastro-intestinal toxicity was observed. After a median follow-up of 28 months two local relapses occurred. Using the library planning approach combined with online image guidance using lipiodol markers, we were able to deliver a highly conformal dose distribution

  6. Projector-based augmented reality for intuitive intraoperative guidance in image-guided 3D interstitial brachytherapy.

    Science.gov (United States)

    Krempien, Robert; Hoppe, Harald; Kahrs, Lüder; Daeuber, Sascha; Schorr, Oliver; Eggers, Georg; Bischof, Marc; Munter, Marc W; Debus, Juergen; Harms, Wolfgang

    2008-03-01

    The aim of this study is to implement augmented reality in real-time image-guided interstitial brachytherapy to allow an intuitive real-time intraoperative orientation. The developed system consists of a common video projector, two high-resolution charge coupled device cameras, and an off-the-shelf notebook. The projector was used as a scanning device by projecting coded-light patterns to register the patient and superimpose the operating field with planning data and additional information in arbitrary colors. Subsequent movements of the nonfixed patient were detected by means of stereoscopically tracking passive markers attached to the patient. In a first clinical study, we evaluated the whole process chain from image acquisition to data projection and determined overall accuracy with 10 patients undergoing implantation. The described method enabled the surgeon to visualize planning data on top of any preoperatively segmented and triangulated surface (skin) with direct line of sight during the operation. Furthermore, the tracking system allowed dynamic adjustment of the data to the patient's current position and therefore eliminated the need for rigid fixation. Because of soft-part displacement, we obtained an average deviation of 1.1 mm by moving the patient, whereas changing the projector's position resulted in an average deviation of 0.9 mm. Mean deviation of all needles of an implant was 1.4 mm (range, 0.3-2.7 mm). The developed low-cost augmented-reality system proved to be accurate and feasible in interstitial brachytherapy. The system meets clinical demands and enables intuitive real-time intraoperative orientation and monitoring of needle implantation.

  7. Projector-Based Augmented Reality for Intuitive Intraoperative Guidance in Image-Guided 3D Interstitial Brachytherapy

    International Nuclear Information System (INIS)

    Krempien, Robert; Hoppe, Harald; Kahrs, Lueder; Daeuber, Sascha; Schorr, Oliver; Eggers, Georg; Bischof, Marc; Munter, Marc W.; Debus, Juergen; Harms, Wolfgang

    2008-01-01

    Purpose: The aim of this study is to implement augmented reality in real-time image-guided interstitial brachytherapy to allow an intuitive real-time intraoperative orientation. Methods and Materials: The developed system consists of a common video projector, two high-resolution charge coupled device cameras, and an off-the-shelf notebook. The projector was used as a scanning device by projecting coded-light patterns to register the patient and superimpose the operating field with planning data and additional information in arbitrary colors. Subsequent movements of the nonfixed patient were detected by means of stereoscopically tracking passive markers attached to the patient. Results: In a first clinical study, we evaluated the whole process chain from image acquisition to data projection and determined overall accuracy with 10 patients undergoing implantation. The described method enabled the surgeon to visualize planning data on top of any preoperatively segmented and triangulated surface (skin) with direct line of sight during the operation. Furthermore, the tracking system allowed dynamic adjustment of the data to the patient's current position and therefore eliminated the need for rigid fixation. Because of soft-part displacement, we obtained an average deviation of 1.1 mm by moving the patient, whereas changing the projector's position resulted in an average deviation of 0.9 mm. Mean deviation of all needles of an implant was 1.4 mm (range, 0.3-2.7 mm). Conclusions: The developed low-cost augmented-reality system proved to be accurate and feasible in interstitial brachytherapy. The system meets clinical demands and enables intuitive real-time intraoperative orientation and monitoring of needle implantation

  8. Robotic-Assisted Fluorescence Sentinel Lymph Node Mapping Using Multi-Modal Image-Guidance in an Animal Model

    Science.gov (United States)

    Liss, Michael A.; Stroup, Sean P.; Cand, Zhengtao Qin; Hoh, Carl; Hall, David J.; Vera, David R.; Kane, Christopher J.

    2015-01-01

    Objectives To investigate PET/CT pre-operative imaging and intraoperative detection of a fluorescent-labeled receptor-targeted radiopharmaceutical in a prostate cancer animal model. Methods Three male Beagle dogs underwent an intra-prostatic injection of fluorescent-tagged tilmanocept radio-labeled with both gallium-68 and technetium-99m. One hour after injection a pelvic PET/CT scan was performed for pre-operative sentinel lymph node (SLN) mapping. Definition of SLN was a standardized uptake value (SUV) that exceeded 5% of the lymph node with the highest SUV. Thirty-six hours later we performed robotic-assisted SLN dissection using a fluorescence-capable camera system. Fluorescent lymph nodes were clipped, the abdomen was opened, and the pelvic and retroperitoneal nodes were excised. All excised nodal packets were assayed by in vitro nuclear counting and reported as percent-of-injected dose. Results Pre-operative PET/CT imaging identified a median of three sentinel lymph nodes per animal. All sentinel lymph nodes (100%) identified by the PET/CT were fluorescent during robotic-assisted lymph node dissection. Of all fluorescent nodes visualized by the camera system, 83% (10/12) satisfied the 5%-rule defined by the PET/CT scan. The two lymph nodes that did not qualify accumulated less than 0.002% of the injected dose. Conclusions Fluorescent-labeled tilmanocept has optimal logistical properties to obtain pre-operative PET/CT and subsequent real-time intraoperative confirmation during robotic-assisted sentinel lymph node dissection. PMID:25139676

  9. Interfractional changes in tumour volume and position during entire radiotherapy courses for lung cancer with respiratory gating and image guidance

    Energy Technology Data Exchange (ETDEWEB)

    Juhler-Noettrup, Trine; Korreman, Stine S.; Pedersen, Anders N.; Persson, Gitte F.; Aarup, Lasse R.; Nystroem, Haakan; Olsen, Mikael; Tarnavski, Nikolai; Specht, Lena (Dept. of Radiation Oncology, The Finsen Centre, Copenhagen (Denmark))

    2008-08-15

    Introduction. With the purpose of implementing gated radiotherapy for lung cancer patients, this study investigated the interfraction variations in tumour size and internal displacement over entire treatment courses. To explore the potential of image guided radiotherapy (IGRT) the variations were measured using a set-up strategy based on imaging of bony landmarks and compared to a strategy using in room lasers, skin tattoos and cupper landmarks. Materials and methods. During their six week treatment course of 60Gy in 2Gy fractions, ten patients underwent 3 respiratory gated CT scans. The tumours were contoured on each CT scan to evaluate the variations in volumes and position. The lung tumours and the mediastinal tumours were contoured separately. The positional variations were measured as 3D mobility vectors and correlated to matching of the scans using the two different strategies. Results. The tumour size was significantly reduced from the first to the last CT scan. For the lung tumours the reduction was 19%, p=0.03, and for the mediastinal tumours the reduction was 34%, p=0.0007. The mean 3D mobility vector and the SD for the lung tumours was 0.51cm (+-0.21) for matching using bony landmarks and 0.85cm (+-0.54) for matching using skin tattoos. For the mediastinal tumours the corresponding vectors and SD's were 0.55cm (+-0.19) and 0.72cm (+-0.43). The differences between the vectors were significant for the lung tumours p=0.004. The interfractional overlap of lung tumours was 80-87% when matched using bony landmarks and 70-76% when matched using skin tattoos. The overlap of the mediastinal tumours were 60-65% and 41-47%, respectively. Conclusions. Despite the use of gating the tumours varied considerably, regarding both position and volume. The variations in position were dependent on the set-up strategy. Set-up using IGRT was superior to set-up using skin tattoos.

  10. Interfractional changes in tumour volume and position during entire radiotherapy courses for lung cancer with respiratory gating and image guidance

    International Nuclear Information System (INIS)

    Juhler-Noettrup, Trine; Korreman, Stine S.; Pedersen, Anders N.; Persson, Gi tte F.; Aarup, Lasse R.; Nystroem, Haakan; Olsen, Mikael; Tarnavski, Nikolai; Sp echt, Lena

    2008-01-01

    Introduction. With the purpose of implementing gated radiotherapy for lung cancer patients, this study investigated the interfraction variations in tumour size and internal displacement over entire treatment courses. To explore the potential of image guided radiotherapy (IGRT) the variations were measured using a set-up strategy based on imaging of bony landmarks and compared to a strategy using in room lasers, skin tattoos and cupper landmarks. Materials and methods. During their six week treatment course of 60Gy in 2Gy fractions, ten patients underwent 3 respiratory gated CT scans. The tumours were contoured on each CT scan to evaluate the variations in volumes and position. The lung tumours and the mediastinal tumours were contoured separately. The positional variations were measured as 3D mobility vectors and correlated to matching of the scans using the two different strategies. Results. The tumour size was significantly reduced from the first to the last CT scan. For the lung tumours the reduction was 19%, p=0.03, and for the mediastinal tumours the reduction was 34%, p=0.0007. The mean 3D mobility vector and the SD for the lung tumours was 0.51cm (±0.21) for matching using bony landmarks and 0.85cm (±0.54) for matching using skin tattoos. For the mediastinal tumours the corresponding vectors and SD's were 0.55cm (±0.19) and 0.72cm (±0.43). The differences between the vectors were significant for the lung tumours p=0.004. The interfractional overlap of lung tumours was 80-87% when matched using bony landmarks and 70-76% when matched using skin tattoos. The overlap of the mediastinal tumours were 60-65% and 41-47%, respectively. Conclusions. Despite the use of gating the tumours varied considerably, regarding both position and volume. The variations in position were dependent on the set-up strategy. Set-up using IGRT was superior to set-up using skin tattoos

  11. Current External Beam Radiation Therapy Quality Assurance Guidance: Does It Meet the Challenges of Emerging Image-Guided Technologies?

    International Nuclear Information System (INIS)

    Palta, Jatinder R.; Liu, Chihray; Li, Jonathan G.

    2008-01-01

    The traditional prescriptive quality assurance (QA) programs that attempt to ensure the safety and reliability of traditional external beam radiation therapy are limited in their applicability to such advanced radiation therapy techniques as three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, inverse treatment planning, stereotactic radiosurgery/radiotherapy, and image-guided radiation therapy. The conventional QA paradigm, illustrated by the American Association of Physicists in Medicine Radiation Therapy Committee Task Group 40 (TG-40) report, consists of developing a consensus menu of tests and device performance specifications from a generic process model that is assumed to apply to all clinical applications of the device. The complexity, variation in practice patterns, and level of automation of high-technology radiotherapy renders this 'one-size-fits-all' prescriptive QA paradigm ineffective or cost prohibitive if the high-probability error pathways of all possible clinical applications of the device are to be covered. The current approaches to developing comprehensive prescriptive QA protocols can be prohibitively time consuming and cost ineffective and may sometimes fail to adequately safeguard patients. It therefore is important to evaluate more formal error mitigation and process analysis methods of industrial engineering to more optimally focus available QA resources on process components that have a significant likelihood of compromising patient safety or treatment outcomes

  12. Health Service use of ionising radiations: Guidance

    International Nuclear Information System (INIS)

    1995-01-01

    This booklet gives outline guidance on the use of ionising radiations in the Health Service in the United Kingdom. Extensive reference is made to documents where more detailed information may be found. The guidance covers general advice on the medical use of ionising radiations, statutory requirements, and guidance on selected Health Service issues such as patient identification procedures, information management systems, deviations from prescribed radiation dose, imaging and radiotherapy. (57 references) (U.K.)

  13. WE-EF-207-01: FEATURED PRESENTATION and BEST IN PHYSICS (IMAGING): Task-Driven Imaging for Cone-Beam CT in Interventional Guidance

    International Nuclear Information System (INIS)

    Gang, G; Stayman, J; Ouadah, S; Siewerdsen, J; Ehtiati, T

    2015-01-01

    Purpose: This work introduces a task-driven imaging framework that utilizes a patient-specific anatomical model, mathematical definition of the imaging task, and a model of the imaging system to prospectively design acquisition and reconstruction techniques that maximize task-based imaging performance. Utility of the framework is demonstrated in the joint optimization of tube current modulation and view-dependent reconstruction kernel in filtered-backprojection reconstruction and non-circular orbit design in model-based reconstruction. Methods: The system model is based on a cascaded systems analysis of cone-beam CT capable of predicting the spatially varying noise and resolution characteristics as a function of the anatomical model and a wide range of imaging parameters. Detectability index for a non-prewhitening observer model is used as the objective function in a task-driven optimization. The combination of tube current and reconstruction kernel modulation profiles were identified through an alternating optimization algorithm where tube current was updated analytically followed by a gradient-based optimization of reconstruction kernel. The non-circular orbit is first parameterized as a linear combination of bases functions and the coefficients were then optimized using an evolutionary algorithm. The task-driven strategy was compared with conventional acquisitions without modulation, using automatic exposure control, and in a circular orbit. Results: The task-driven strategy outperformed conventional techniques in all tasks investigated, improving the detectability of a spherical lesion detection task by an average of 50% in the interior of a pelvis phantom. The non-circular orbit design successfully mitigated photon starvation effects arising from a dense embolization coil in a head phantom, improving the conspicuity of an intracranial hemorrhage proximal to the coil. Conclusion: The task-driven imaging framework leverages a knowledge of the imaging task within

  14. WE-EF-207-01: FEATURED PRESENTATION and BEST IN PHYSICS (IMAGING): Task-Driven Imaging for Cone-Beam CT in Interventional Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Gang, G; Stayman, J; Ouadah, S; Siewerdsen, J [Johns Hopkins University, Baltimore, MD (United States); Ehtiati, T [Siemens Healthcare AX Division, Erlangen, DE (Germany)

    2015-06-15

    Purpose: This work introduces a task-driven imaging framework that utilizes a patient-specific anatomical model, mathematical definition of the imaging task, and a model of the imaging system to prospectively design acquisition and reconstruction techniques that maximize task-based imaging performance. Utility of the framework is demonstrated in the joint optimization of tube current modulation and view-dependent reconstruction kernel in filtered-backprojection reconstruction and non-circular orbit design in model-based reconstruction. Methods: The system model is based on a cascaded systems analysis of cone-beam CT capable of predicting the spatially varying noise and resolution characteristics as a function of the anatomical model and a wide range of imaging parameters. Detectability index for a non-prewhitening observer model is used as the objective function in a task-driven optimization. The combination of tube current and reconstruction kernel modulation profiles were identified through an alternating optimization algorithm where tube current was updated analytically followed by a gradient-based optimization of reconstruction kernel. The non-circular orbit is first parameterized as a linear combination of bases functions and the coefficients were then optimized using an evolutionary algorithm. The task-driven strategy was compared with conventional acquisitions without modulation, using automatic exposure control, and in a circular orbit. Results: The task-driven strategy outperformed conventional techniques in all tasks investigated, improving the detectability of a spherical lesion detection task by an average of 50% in the interior of a pelvis phantom. The non-circular orbit design successfully mitigated photon starvation effects arising from a dense embolization coil in a head phantom, improving the conspicuity of an intracranial hemorrhage proximal to the coil. Conclusion: The task-driven imaging framework leverages a knowledge of the imaging task within

  15. Manipulation of tumor oxygenation and radiosensitivity through modification of cell respiration. A critical review of approaches and imaging biomarkers for therapeutic guidance.

    Science.gov (United States)

    Gallez, Bernard; Neveu, Marie-Aline; Danhier, Pierre; Jordan, Bénédicte F

    2017-08-01

    Tumor hypoxia has long been considered as a detrimental factor for the response to irradiation. In order to improve the sensitivity of tumors cells to radiation therapy, tumor hypoxia may theoretically be alleviated by increasing the oxygen delivery or by decreasing the oxygen consumption by tumor cells. Mathematical modelling suggested that decreasing the oxygen consumption should be more efficient than increasing oxygen delivery in order to alleviate tumor hypoxia. In this paper, we review several promising strategies targeting the mitochondrial respiration for which alleviation of tumor hypoxia and increase in sensitivity to irradiation have been demonstrated. Because the translation of these approaches into the clinical arena requires the use of pharmacodynamics biomarkers able to identify shift in oxygen consumption and tumor oxygenation, we also discuss the relative merits of imaging biomarkers (Positron Emission Tomography and Magnetic Resonance) that may be used for therapeutic guidance. This article is part of a Special Issue entitled Mitochondria in Cancer, edited by Giuseppe Gasparre, Rodrigue Rossignol and Pierre Sonveaux. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a ⁶⁰Co Magnetic Resonance Image Guidance Radiation Therapy System.

    Science.gov (United States)

    Wooten, H Omar; Green, Olga; Yang, Min; DeWees, Todd; Kashani, Rojano; Olsen, Jeff; Michalski, Jeff; Yang, Deshan; Tanderup, Kari; Hu, Yanle; Li, H Harold; Mutic, Sasa

    2015-07-15

    This work describes a commercial treatment planning system, its technical features, and its capabilities for creating (60)Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. The ViewRay treatment planning system (Oakwood Village, OH) was used to create (60)Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The (60)Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. All (60)Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for (60)Co was within 20 Gy. The mean doses for all (60)Co plan OARs were within clinical tolerances. A commercial (60)Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Dosimetric and geometric evaluation of a hybrid strategy of offline adaptive planning and online image guidance for prostate cancer radiotherapy

    International Nuclear Information System (INIS)

    Liu Han; Wu Qiuwen

    2011-01-01

    For prostate cancer patients, online image-guided (IG) radiotherapy has been widely used in clinic to correct the translational inter-fractional motion at each treatment fraction. For uncertainties that cannot be corrected online, such as rotation and deformation of the target volume, margins are still required to be added to the clinical target volume (CTV) for the treatment planning. Offline adaptive radiotherapy has been implemented to optimize the treatment for each individual patient based on the measurements at early stages of treatment process. It has been shown that offline adaptive radiotherapy can effectively reduce the required margin. Recently a hybrid strategy of offline adaptive replanning and online IG was proposed and the geometric evaluation was performed. It was found that the planning margins can further be reduced by 1-2 mm compared to online IG only strategy. The purpose of this study was to investigate the dosimetric benefits of such a hybrid strategy on the target and organs at risk. A total of 420 repeated helical computed tomography scans from 28 patients were included in the study. Both low-risk patients (LRP, CTV = prostate) and intermediate-risk patients (IRP, CTV = prostate + seminal vesicles, SV) were included in the simulation. Two registration methods, based on center-of-mass shift of prostate only and prostate plus SV, were performed for IRP. The intensity-modulated radiotherapy was used in the simulation. Criteria on both cumulative and fractional doses were evaluated. Furthermore, the geometric evaluation was extended to investigate the optimal number of fractions necessary to construct the internal target volume (ITV) for the hybrid strategy. The dosimetric margin improvement was smaller than its geometric counterpart and was in the range of 0-1 mm. The optimal number of fractions necessary for the ITV construction is 2 for LRPs and 3-4 for IRPs in a hypofractionation protocol. A new cumulative index of target volume was proposed

  18. Development of patient-controlled respiratory gating system based on visual guidance for magnetic-resonance image-guided radiation therapy.

    Science.gov (United States)

    Kim, Jung-In; Lee, Hanyoung; Wu, Hong-Gyun; Chie, Eui Kyu; Kang, Hyun-Cheol; Park, Jong Min

    2017-09-01

    The aim of this study is to develop a visual guidance patient-controlled (VG-PC) respiratory gating system for respiratory-gated magnetic-resonance image-guided radiation therapy (MR-IGRT) and to evaluate the performance of the developed system. The near-real-time cine planar MR image of a patient acquired during treatment was transmitted to a beam projector in the treatment room through an optical fiber cable. The beam projector projected the cine MR images inside the bore of the ViewRay system in order to be visible to a patient during treatment. With this visual information, patients voluntarily controlled their respiration to put the target volume into the gating boundary (gating window). The effect of the presence of the beam projector in the treatment room on the image quality of the MRI was investigated by evaluating the signal-to-noise ratio (SNR), uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity with the VG-PC gating system. To evaluate the performance of the developed system, we applied the VG-PC gating system to a total of seven patients; six patients received stereotactic ablative radiotherapy (SABR) and one patient received conventional fractionated radiation therapy. The projected cine MR images were visible even when the room light was on. No image data loss or additional time delay during delivery of image data were observed. Every indicator representing MRI quality, including SNR, uniformity, low-contrast detectability, high-contrast spatial resolution, and spatial integrity exhibited values higher than the tolerance levels of the manufacturer with the VG-PC gating system; therefore, the presence of the VG-PC gating system in the treatment room did not degrade the MR image quality. The average beam-off times due to respiratory gating with and without the VG-PC gating system were 830.3 ± 278.2 s and 1264.2 ± 302.1 s respectively (P = 0.005). Consequently, the total treatment times excluding

  19. Nigerian Journal of Guidance and Counselling

    African Journals Online (AJOL)

    The Nigerian Journal of Guidance and Counselling. ... Journal Homepage Image ... by the Department of Counsellor Education, University of Ilorin, Ilorin, Nigeria. ... Awareness and use of Meseron therapy among clinical psychologists in ...

  20. Custom-designed Laser-based Heating Apparatus for Triggered Release of Cisplatin from Thermosensitive Liposomes with Magnetic Resonance Image Guidance.

    Science.gov (United States)

    Dou, Yannan N; Weersink, Robert A; Foltz, Warren D; Zheng, Jinzi; Chaudary, Naz; Jaffray, David A; Allen, Christine

    2015-12-13

    Liposomes have been employed as drug delivery systems to target solid tumors through exploitation of the enhanced permeability and retention (EPR) effect resulting in significant reductions in systemic toxicity. Nonetheless, insufficient release of encapsulated drug from liposomes has limited their clinical efficacy. Temperature-sensitive liposomes have been engineered to provide site-specific release of drug in order to overcome the problem of limited tumor drug bioavailability. Our lab has designed and developed a heat-activated thermosensitive liposome formulation of cisplatin (CDDP), known as HTLC, to provide triggered release of CDDP at solid tumors. Heat-activated delivery in vivo was achieved in murine models using a custom-built laser-based heating apparatus that provides a conformal heating pattern at the tumor site as confirmed by MR thermometry (MRT). A fiber optic temperature monitoring device was used to measure the temperature in real-time during the entire heating period with online adjustment of heat delivery by alternating the laser power. Drug delivery was optimized under magnetic resonance (MR) image guidance by co-encapsulation of an MR contrast agent (i.e., gadoteridol) along with CDDP into the thermosensitive liposomes as a means to validate the heating protocol and to assess tumor accumulation. The heating protocol consisted of a preheating period of 5 min prior to administration of HTLC and 20 min heating post-injection. This heating protocol resulted in effective release of the encapsulated agents with the highest MR signal change observed in the heated tumor in comparison to the unheated tumor and muscle. This study demonstrated the successful application of the laser-based heating apparatus for preclinical thermosensitive liposome development and the importance of MR-guided validation of the heating protocol for optimization of drug delivery.

  1. The potential role of respiratory motion management and image guidance in the reduction of severe toxicities following stereotactic ablative radiation therapy for patients with centrally located early stage non-small cell lung cancer or lung metastases

    Directory of Open Access Journals (Sweden)

    Alexander eChi

    2014-06-01

    Full Text Available Image guidance allows delivery of very high doses of radiation over a few fractions, known as stereotactic ablative radiotherapy (SABR. This treatment is associated with excellent outcome for early stage non-small cell lung cancer and metastases to the lungs. In the delivery of SABR, central location constantly poses a challenge due to the difficulty of adequately sparing critical thoracic structures that are immediately adjacent to the tumor if an ablative dose of radiation is to be delivered to the tumor target. As of current, various respiratory motion management and image guidance strategies can be used to ensure accurate tumor target localization prior and/ or during daily treatment, which allows for maximal and safe reduction of set up margins. The incorporation of both may lead to the most optimal normal tissue sparing and the most accurate SABR delivery. Here, the clinical outcome, treatment related toxicities, and the pertinent respiratory motion management/image guidance strategies reported in the current literature on SABR for central lung tumors are reviewed.

  2. Graphic Turbulence Guidance

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Forecast turbulence hazards identified by the Graphical Turbulence Guidance algorithm. The Graphical Turbulence Guidance product depicts mid-level and upper-level...

  3. Graphical Turbulence Guidance - Composite

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Forecast turbulence hazards identified by the Graphical Turbulence Guidance algorithm. The Graphical Turbulence Guidance product depicts mid-level and upper-level...

  4. Career guidance in communities

    DEFF Research Database (Denmark)

    Thomsen, Rie

    for the development of a critically reflexive career guidance practice. The considerations are organised around seven elements. 1. Creating opportunity, structure and access 2. Entering a community and increasing visibility 3. Providing guidance in communities 4. Exploring potentials in guidance situations 5...... in career guidance practices as well as in the lives of the people in the communities. This paper falls into two parts: The first part considers the collective as the starting point for the development of meaningful career guidance activities. Based on previous research on career guidance in communities......The aim of this paper is to inspire practitioners and professionals to leave their offices to bring career guidance into communities that might not identify with career guidance in the first instance. By making the effort to engage with communities, practitioners may bring about a critical change...

  5. Ultrasound based monitoring of the injection moulding process - Methods, applications and limitations

    International Nuclear Information System (INIS)

    Praher, B.; Straka, K.; Usanovic, J.; Steinbichler, G.

    2014-01-01

    We developed novel non-invasive ultrasound based systems for the measurement of temperature distributions in the screw-ante chamber, the detection of unmelted granules and for the monitoring of the plasticizing process along the screw channel. The temperature of the polymer melt stored in the screw ante-chamber after the plasticization should be homogeneous. However, in reality the polymer melt in the screw ante-chamber is not homogeneous. Due to the fact the sound velocity in a polymer melt is temperature depending, we developed a tomography system using the measured transit times of ultrasonic pulses along different sound paths for calculating the temperature distribution in radial direction of a polymer melt in the screw ante-chamber of an injection moulding machine. For the detection of unmelted granules in the polymer melt we implemented an ultrasound transmission measurement. By analyzing the attenuation of the received pulses it is possible to detect unwanted inclusions. For the monitoring of the plasticizing process in the channels of the screw an ultrasonic pulse is transmitted into the barrel. By analyzing the reflected pulses it is possible to estimate solid bed and melt regions in the screw channel. The proposed systems were tested for accuracy and validity by simulations and test measurements

  6. Ultrasound-based measurement of liquid-layer thickness: A novel time-domain approach

    Science.gov (United States)

    Praher, Bernhard; Steinbichler, Georg

    2017-01-01

    Measuring the thickness of a thin liquid layer between two solid materials is important when the adequate separation of metallic parts by a lubricant film (e.g., in bearings or mechanical seals) is to be assessed. The challenge in using ultrasound-based systems for such measurements is that the signal from the liquid layer is a superposition of multiple reflections. We have developed an algorithm for reconstructing this superimposed signal in the time domain. By comparing simulated and measured signals, the time-of-flight of the ultrasonic pulse in a layer can be estimated. With the longitudinal sound velocity known, the layer thickness can then be calculated. In laboratory measurements, we validate successfully (maximum relative error 4.9%) our algorithm for layer thicknesses ranging from 30 μm to 200 μm. Furthermore, we tested our method in the high-temperature environment of polymer processing by measuring the clearance between screw and barrel in the plasticisation unit of an injection moulding machine. The results of such measurements can indicate (i) the wear status of the tribo-mechanical screw-barrel system and (ii) unsuitable process conditions.

  7. Ultrasound based monitoring of the injection moulding process - Methods, applications and limitations

    Energy Technology Data Exchange (ETDEWEB)

    Praher, B., E-mail: bernhard.praher@jku.at, E-mail: klaus.straka@jku.at, E-mail: jesenka.usanovic@jku.at, E-mail: georg.steinbichler@jku.at; Straka, K., E-mail: bernhard.praher@jku.at, E-mail: klaus.straka@jku.at, E-mail: jesenka.usanovic@jku.at, E-mail: georg.steinbichler@jku.at; Usanovic, J., E-mail: bernhard.praher@jku.at, E-mail: klaus.straka@jku.at, E-mail: jesenka.usanovic@jku.at, E-mail: georg.steinbichler@jku.at; Steinbichler, G., E-mail: bernhard.praher@jku.at, E-mail: klaus.straka@jku.at, E-mail: jesenka.usanovic@jku.at, E-mail: georg.steinbichler@jku.at [Institute of Polymer Injection Moulding and Process Automation, Johannes Kepler University Linz (Austria)

    2014-05-15

    We developed novel non-invasive ultrasound based systems for the measurement of temperature distributions in the screw-ante chamber, the detection of unmelted granules and for the monitoring of the plasticizing process along the screw channel. The temperature of the polymer melt stored in the screw ante-chamber after the plasticization should be homogeneous. However, in reality the polymer melt in the screw ante-chamber is not homogeneous. Due to the fact the sound velocity in a polymer melt is temperature depending, we developed a tomography system using the measured transit times of ultrasonic pulses along different sound paths for calculating the temperature distribution in radial direction of a polymer melt in the screw ante-chamber of an injection moulding machine. For the detection of unmelted granules in the polymer melt we implemented an ultrasound transmission measurement. By analyzing the attenuation of the received pulses it is possible to detect unwanted inclusions. For the monitoring of the plasticizing process in the channels of the screw an ultrasonic pulse is transmitted into the barrel. By analyzing the reflected pulses it is possible to estimate solid bed and melt regions in the screw channel. The proposed systems were tested for accuracy and validity by simulations and test measurements.

  8. Visual guidance of mobile platforms

    Science.gov (United States)

    Blissett, Rodney J.

    1993-12-01

    Two systems are described and results presented demonstrating aspects of real-time visual guidance of autonomous mobile platforms. The first approach incorporates prior knowledge in the form of rigid geometrical models linking visual references within the environment. The second approach is based on a continuous synthesis of information extracted from image tokens to generate a coarse-grained world model, from which potential obstacles are inferred. The use of these techniques in workplace applications is discussed.

  9. Ultrasound Guidance for Botulinum Neurotoxin Chemodenervation Procedures

    Directory of Open Access Journals (Sweden)

    Katharine E. Alter

    2017-12-01

    Full Text Available Injections of botulinum neurotoxins (BoNTs are prescribed by clinicians for a variety of disorders that cause over-activity of muscles; glands; pain and other structures. Accurately targeting the structure for injection is one of the principle goals when performing BoNTs procedures. Traditionally; injections have been guided by anatomic landmarks; palpation; range of motion; electromyography or electrical stimulation. Ultrasound (US based imaging based guidance overcomes some of the limitations of traditional techniques. US and/or US combined with traditional guidance techniques is utilized and or recommended by many expert clinicians; authors and in practice guidelines by professional academies. This article reviews the advantages and disadvantages of available guidance techniques including US as well as technical aspects of US guidance and a focused literature review related to US guidance for chemodenervation procedures including BoNTs injection.

  10. NGST fine guidance sensor

    Science.gov (United States)

    Rowlands, Neil; Hutchings, John; Murowinski, Richard G.; Alexander, Russ

    2003-03-01

    Instrumentation for the Next Generation Space Telescope (NGST) is currently in the Phase A definition stage. We have developed a concept for the NGST Fine Guidance Sensor or FGS. The FGS is a detector array based imager which resides in the NGST focal plane. We report here on tradeoff studies aimed at defining an overall configuration of the FGS which will meet the performance and interface requirements. A key performance requirement is a noise equivalent angle of 3 milli-arcseconds to be achieved with 95% probability for any pointing of the observatory in the celestial sphere. A key interface requirement is compatibility with the architecture of the Integrated Science Instrument Module (ISIM). The concept developed consists of two independent and redundant FGS modules, each with a 4' x 2' field of view covered by two 2048 x 2048 infrared detector arrays, providing 60 milli-arcsecond sampling. Performance modeling supporting the choice of this architecture and the trade space considered is presented. Each module has a set of readout electronics which perform star detection, pixel-by-pixel correction, and in fine guiding mode, centroid calculation. These readout electronics communicate with the ISIM Command &Data Handling Units where the FGS control software is based. Rationale for this choice of architecture is also presented.

  11. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology.

    Science.gov (United States)

    Räber, Lorenz; Mintz, Gary S; Koskinas, Konstantinos C; Johnson, Thomas W; Holm, Niels R; Onuma, Yoshinubo; Radu, Maria D; Joner, Michael; Yu, Bo; Jia, Haibo; Menevau, Nicolas; de la Torre Hernandez, Jose M; Escaned, Javier; Hill, Jonathan; Prati, Francesco; Colombo, Antonio; di Mario, Carlo; Regar, Evelyn; Capodanno, Davide; Wijns, William; Byrne, Robert A; Guagliumi, Giulio

    2018-05-22

    This Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior to PCI for optimizing stent sizing (stent length and diameter) and planning the procedural strategy is discussed. Regarding post-implantation imaging, the consensus group recommends key parameters that characterize an optimal PCI result and provides cut-offs to guide corrective measures and optimize the stenting result. Moreover, routine performance of intracoronary imaging in patients with stent failure (restenosis or stent thrombosis) is recommended. Finally, strengths and limitations of IVUS and OCT for guiding PCI and assessing stent failures and areas that warrant further research are critically discussed.

  12. Advantages of computed tomographic guidance

    International Nuclear Information System (INIS)

    Casola, G.; Vansonnenberg, E.

    1987-01-01

    Both ultrasound and CT are successfully used to guide interventional procedures throughout the body. There are advantages and disadvantages to each modality and choosing one over the other will vary from case to case. Major factors influencing choice are discussed in this paper. As a general rule CT guidance is usually required for lesions in the thorax, the adrenals, the pancreas, lymph nodes, and for percutaneous abscess drainage. The authors feel that a complimentary use of ultrasound and CT is essential to optimize success and cost-effectiveness; therefore, the interventional radiologist should be familiar with both imaging modalities

  13. Fine Guidance Sensing for Coronagraphic Observatories

    Science.gov (United States)

    Brugarolas, Paul; Alexander, James W.; Trauger, John T.; Moody, Dwight C.

    2011-01-01

    Three options have been developed for Fine Guidance Sensing (FGS) for coronagraphic observatories using a Fine Guidance Camera within a coronagraphic instrument. Coronagraphic observatories require very fine precision pointing in order to image faint objects at very small distances from a target star. The Fine Guidance Camera measures the direction to the target star. The first option, referred to as Spot, was to collect all of the light reflected from a coronagraph occulter onto a focal plane, producing an Airy-type point spread function (PSF). This would allow almost all of the starlight from the central star to be used for centroiding. The second approach, referred to as Punctured Disk, collects the light that bypasses a central obscuration, producing a PSF with a punctured central disk. The final approach, referred to as Lyot, collects light after passing through the occulter at the Lyot stop. The study includes generation of representative images for each option by the science team, followed by an engineering evaluation of a centroiding or a photometric algorithm for each option. After the alignment of the coronagraph to the fine guidance system, a "nulling" point on the FGS focal point is determined by calibration. This alignment is implemented by a fine alignment mechanism that is part of the fine guidance camera selection mirror. If the star images meet the modeling assumptions, and the star "centroid" can be driven to that nulling point, the contrast for the coronagraph will be maximized.

  14. Optimal Aerocapture Guidance

    Data.gov (United States)

    National Aeronautics and Space Administration — The main goal of my research is to develop, implement, verify, and validate an optimal numerical predictor-corrector aerocapture guidance algorithm that is...

  15. Coral Reef Guidance

    Science.gov (United States)

    Guidance prepared by EPA and Army Corps of Engineers concerning coral reef protection under the Clean Water Act, Marine Protection, Research, and Sanctuaries Act, Rivers and Harbors Act, and Federal Project Authorities.

  16. Laser Guidance Analysis Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This facility, which provides for real time, closed loop evaluation of semi-active laser guidance hardware, has and continues to be instrumental in the development...

  17. WE-EF-BRD-03: I Want It Now!: Advances in MRI Acquisition, Reconstruction and the Use of Priors to Enable Fast Anatomic and Physiologic Imaging to Inform Guidance and Adaptation Decisions

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Y. [Mayo Clinic Arizona (United States)

    2015-06-15

    MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

  18. Evaluations of the setup discrepancy between BrainLAB 6D ExacTrac and cone-beam computed tomography used with the imaging guidance system Novalis-Tx for intracranial stereotactic radiosurgery.

    Science.gov (United States)

    Oh, Se An; Park, Jae Won; Yea, Ji Woon; Kim, Sung Kyu

    2017-01-01

    The objective of this study was to evaluate the setup discrepancy between BrainLAB 6 degree-of-freedom (6D) ExacTrac and cone-beam computed tomography (CBCT) used with the imaging guidance system Novalis Tx for intracranial stereotactic radiosurgery. We included 107 consecutive patients for whom white stereotactic head frame masks (R408; Clarity Medical Products, Newark, OH) were used to fix the head during intracranial stereotactic radiosurgery, between August 2012 and July 2016. The patients were immobilized in the same state for both the verification image using 6D ExacTrac and online 3D CBCT. In addition, after radiation treatment, registration between the computed tomography simulation images and the CBCT images was performed with offline 6D fusion in an offline review. The root-mean-square of the difference in the translational dimensions between the ExacTrac system and CBCT was <1.01 mm for online matching and <1.10 mm for offline matching. Furthermore, the root-mean-square of the difference in the rotational dimensions between the ExacTrac system and the CBCT were <0.82° for online matching and <0.95° for offline matching. It was concluded that while the discrepancies in residual setup errors between the ExacTrac 6D X-ray and the CBCT were minor, they should not be ignored.

  19. Direct measurement of the signal intensity of diffusion-weighted magnetic resonance imaging for preoperative grading and treatment guidance for brain gliomas

    Directory of Open Access Journals (Sweden)

    Chih-Chun Wu

    2012-11-01

    Conclusion: The proposed method – direct measuring of tumor signal intensity of DWI on PACS monitors – is feasible for grading gliomas in clinical neuro-oncology imaging services and has a high level of reliability and reproducibility.

  20. Doppler ultrasound for diagnosis of soft tissue sarcoma: efficacy of ultrasound-based screening score

    Directory of Open Access Journals (Sweden)

    Nagano Satoshi

    2015-06-01

    Full Text Available Background. The utility of ultrasound imaging in the screening of soft-part tumours (SPTs has been reported. We classified SPTs according to their blood flow pattern on Doppler ultrasound and re-evaluated the efficacy of this imaging modality as a screening method. Additionally, we combined Doppler ultrasound with several values to improve the diagnostic efficacy and to establish a new diagnostic tool.

  1. SU-E-J-39: Comparison of PTV Margins Determined by In-Room Stereoscopic Image Guidance and by On-Board Cone Beam Computed Tomography Technique for Brain Radiotherapy Patients

    International Nuclear Information System (INIS)

    Ganesh, T; Paul, S; Munshi, A; Sarkar, B; Krishnankutty, S; Sathya, J; George, S; Jassal, K; Roy, S; Mohanti, B

    2014-01-01

    Purpose: Stereoscopic in room kV image guidance is a faster tool in daily monitoring of patient positioning. Our centre, for the first time in the world, has integrated such a solution from BrainLAB (ExacTrac) with Elekta's volumetric cone beam computed tomography (XVI). Using van Herk's formula, we compared the planning target volume (PTV) margins calculated by both these systems for patients treated with brain radiotherapy. Methods: For a total of 24 patients who received partial or whole brain radiotherapy, verification images were acquired for 524 treatment sessions by XVI and for 334 sessions by ExacTrac out of the total 547 sessions. Systematic and random errors were calculated in cranio-caudal, lateral and antero-posterior directions for both techniques. PTV margins were then determined using van Herk formula. Results: In the cranio-caudal direction, systematic error, random error and the calculated PTV margin were found to be 0.13 cm, 0.12 cm and 0.41 cm with XVI and 0.14 cm, 0.13 cm and 0.44 cm with ExacTrac. The corresponding values in lateral direction were 0.13 cm 0.1 cm and 0.4 cm with XVI and 0.13 cm, 0.12 cm and 0.42 cm with ExacTrac imaging. The same parameters for antero-posterior were for 0.1 cm, 0.11 cm and 0.34 cm with XVI and 0.13 cm, 0.16 cm and 0.43 cm with ExacTrac imaging. The margins estimated with the two imaging modalities were comparable within ± 1 mm limit. Conclusion: Verification of setup errors in the major axes by two independent imaging systems showed the results are comparable and within ± 1 mm. This implies that planar imaging based ExacTrac can yield equal accuracy in setup error determination as the time consuming volumetric imaging which is considered as the gold standard. Accordingly PTV margins estimated by this faster imaging technique can be confidently used in clinical setup

  2. Virtual Ultrasound Guidance for Inexperienced Operators

    Science.gov (United States)

    Caine, Timothy; Martin, David

    2012-01-01

    Medical ultrasound or echocardiographic studies are highly operator-dependent and generally require lengthy training and internship to perfect. To obtain quality echocardiographic images in remote environments, such as on-orbit, remote guidance of studies has been employed. This technique involves minimal training for the user, coupled with remote guidance from an expert. When real-time communication or expert guidance is not available, a more autonomous system of guiding an inexperienced operator through an ultrasound study is needed. One example would be missions beyond low Earth orbit in which the time delay inherent with communication will make remote guidance impractical. The Virtual Ultrasound Guidance system is a combination of hardware and software. The hardware portion includes, but is not limited to, video glasses that allow hands-free, full-screen viewing. The glasses also allow the operator a substantial field of view below the glasses to view and operate the ultrasound system. The software is a comprehensive video program designed to guide an inexperienced operator through a detailed ultrasound or echocardiographic study without extensive training or guidance from the ground. The program contains a detailed description using video and audio to demonstrate equipment controls, ergonomics of scanning, study protocol, and scanning guidance, including recovery from sub-optimal images. The components used in the initial validation of the system include an Apple iPod Classic third-generation as the video source, and Myvue video glasses. Initially, the program prompts the operator to power-up the ultrasound and position the patient. The operator would put on the video glasses and attach them to the video source. After turning on both devices and the ultrasound system, the audio-video guidance would then instruct on patient positioning and scanning techniques. A detailed scanning protocol follows with descriptions and reference video of each view along with

  3. Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue Specimens for Enhanced Clinical Guidance

    Science.gov (United States)

    2015-07-01

    in soft tissue sarcoma . J Surg Oncol 2005;92:267–271. 3. Stack EC, Wang C, Roman KA, et al. Multiplexed immuno- histochemistry, imaging, and...Contributions: M.A., S.B., and R.F. conducted experiments and wrote the manuscript. M.H. designed and fabricated reagents. C.H. assisted in data acquisition and

  4. Dosimetric Effect of Intrafraction Motion and Residual Setup Error for Hypofractionated Prostate Intensity-Modulated Radiotherapy With Online Cone Beam Computed Tomography Image Guidance

    International Nuclear Information System (INIS)

    Adamson, Justus; Wu Qiuwen; Yan Di

    2011-01-01

    Purpose: To quantify the dosimetric effect and margins required to account for prostate intrafractional translation and residual setup error in a cone beam computed tomography (CBCT)-guided hypofractionated radiotherapy protocol. Methods and Materials: Prostate position after online correction was measured during dose delivery using simultaneous kV fluoroscopy and posttreatment CBCT in 572 fractions to 30 patients. We reconstructed the dose distribution to the clinical tumor volume (CTV) using a convolution of the static dose with a probability density function (PDF) based on the kV fluoroscopy, and we calculated the minimum dose received by 99% of the CTV (D 99 ). We compared reconstructed doses when the convolution was performed per beam, per patient, and when the PDF was created using posttreatment CBCT. We determined the minimum axis-specific margins to limit CTV D 99 reduction to 1%. Results: For 3-mm margins, D 99 reduction was ≤5% for 29/30 patients. Using post-CBCT rather than localizations at treatment delivery exaggerated dosimetric effects by ∼47%, while there was no such bias between the dose convolved with a beam-specific and patient-specific PDF. After eight fractions, final cumulative D 99 could be predicted with a root mean square error of <1%. For 90% of patients, the required margins were ≤2, 4, and 3 mm, with 70%, 40%, and 33% of patients requiring no right-left (RL), anteroposterior (AP), and superoinferior margins, respectively. Conclusions: For protocols with CBCT guidance, RL, AP, and SI margins of 2, 4, and 3 mm are sufficient to account for translational errors; however, the large variation in patient-specific margins suggests that adaptive management may be beneficial.

  5. Dosimetric effect of intrafraction motion and residual setup error for hypofractionated prostate intensity-modulated radiotherapy with online cone beam computed tomography image guidance.

    LENUS (Irish Health Repository)

    Adamson, Justus

    2012-02-01

    PURPOSE: To quantify the dosimetric effect and margins required to account for prostate intrafractional translation and residual setup error in a cone beam computed tomography (CBCT)-guided hypofractionated radiotherapy protocol. METHODS AND MATERIALS: Prostate position after online correction was measured during dose delivery using simultaneous kV fluoroscopy and posttreatment CBCT in 572 fractions to 30 patients. We reconstructed the dose distribution to the clinical tumor volume (CTV) using a convolution of the static dose with a probability density function (PDF) based on the kV fluoroscopy, and we calculated the minimum dose received by 99% of the CTV (D(99)). We compared reconstructed doses when the convolution was performed per beam, per patient, and when the PDF was created using posttreatment CBCT. We determined the minimum axis-specific margins to limit CTV D(99) reduction to 1%. RESULTS: For 3-mm margins, D(99) reduction was <\\/=5% for 29\\/30 patients. Using post-CBCT rather than localizations at treatment delivery exaggerated dosimetric effects by ~47%, while there was no such bias between the dose convolved with a beam-specific and patient-specific PDF. After eight fractions, final cumulative D(99) could be predicted with a root mean square error of <1%. For 90% of patients, the required margins were <\\/=2, 4, and 3 mm, with 70%, 40%, and 33% of patients requiring no right-left (RL), anteroposterior (AP), and superoinferior margins, respectively. CONCLUSIONS: For protocols with CBCT guidance, RL, AP, and SI margins of 2, 4, and 3 mm are sufficient to account for translational errors; however, the large variation in patient-specific margins suggests that adaptive management may be beneficial.

  6. Thermoacoustic Imaging and Therapy Guidance based on Ultra-short Pulsed Microwave Pumped Thermoelastic Effect Induced with Superparamagnetic Iron Oxide Nanoparticles.

    Science.gov (United States)

    Wen, Liewei; Yang, Sihua; Zhong, Junping; Zhou, Quan; Xing, Da

    2017-01-01

    Multifunctional nanoparticle-mediated imaging and therapeutic techniques are promising modalities for accurate localization and targeted treatment of cancer in clinical settings. Thermoacoustic (TA) imaging is highly sensitive to detect the distribution of water, ions or specific nanoprobes and provides excellent resolution, good contrast and superior tissue penetrability. TA therapy is a potential non-invasive approach for the treatment of deep-seated tumors. In this study, human serum albumin (HSA)-functionalized superparamagnetic iron oxide nanoparticle (HSA-SPIO) is used as a multifunctional nanoprobe with clinical application potential for MRI, TA imaging and treatment of tumor. In addition to be a MRI contrast agent for tumor localization, HSA-SPIO can absorb pulsed microwave energy and transform it into shockwave via the thermoelastic effect. Thereby, the reconstructed TA image by detecting TA signal is expected to be a sensitive and accurate representation of the HSA-SPIO accumulation in tumor. More importantly, owing to the selective retention of HSA-SPIO in tumor tissues and strong TA shockwave at the cellular level, HSA-SPIO induced TA effect under microwave-pulse radiation can be used to highly-efficiently kill cancer cells and inhibit tumor growth. Furthermore, ultra-short pulsed microwave with high excitation efficiency and deep penetrability in biological tissues makes TA therapy a highly-efficient anti-tumor modality on the versatile platform. Overall, HSA-SPIO mediated MRI and TA imaging would offer more comprehensive diagnostic information and enable dynamic visualization of nanoagents in the tumorous tissue thereby tumor-targeted therapy.

  7. A comparison of CT- and ultrasound-based imaging to localize the prostate for external beam radiotherapy

    International Nuclear Information System (INIS)

    McNair, Helen A.; Mangar, Stephen A.; Coffey, Jerome; Shoulders, Beverley; Hansen, Vibeke N.; Norman, Andrew; Staffurth, John; Sohaib, S. Aslam; Warrington, Alan P.; Dearnaley, David P.

    2006-01-01

    Purpose: This study assesses the accuracy of NOMOS B-mode acquisition and targeting system (BAT) compared with computed tomography (CT) in localizing the prostate. Methods and Materials: Twenty-six patients were CT scanned, and the prostate was localized by 3 observers using the BAT system. The BAT couch shift measurements were compared with the CT localization. Six of the patients had gold markers present in the prostate, and the prostate movement determined by BAT was compared with the movement determined by the gold markers. Results: Using the BAT system, the 3 observers determined the prostate position to be a mean of 1-5 mm over all directions with respect to the CT. The proportion of readings with a difference >3 mm between the observers was in the range of 25% to 44%. The prostate movement based on gold markers was an average of 3-5 mm different from that measured by BAT. The literature assessing the accuracy and reproducibility on BAT is summarized and compared with our findings. Conclusions: We have found that there are systematic differences between the BAT-defined prostate position compared with that estimated on CT using gold grain marker seeds

  8. Dose Matters: FDA's Guidance on Children's X-rays

    Science.gov (United States)

    ... Consumer Updates Dose Matters: FDA's Guidance on Children's X-rays Share Tweet Linkedin Pin it More sharing options ... exposure during medical procedures. The level of ionizing radiation from X-ray imaging is generally very low, but can ...

  9. Threshold guidance update

    International Nuclear Information System (INIS)

    Wickham, L.E.

    1986-01-01

    The Department of Energy (DOE) is developing the concept of threshold quantities for use in determining which waste materials must be handled as radioactive waste and which may be disposed of as nonradioactive waste at its sites. Waste above this concentration level would be managed as radioactive or mixed waste (if hazardous chemicals are present); waste below this level would be handled as sanitary waste. Last years' activities (1984) included the development of a threshold guidance dose, the development of threshold concentrations corresponding to the guidance dose, the development of supporting documentation, review by a technical peer review committee, and review by the DOE community. As a result of the comments, areas have been identified for more extensive analysis, including an alternative basis for selection of the guidance dose and the development of quality assurance guidelines. Development of quality assurance guidelines will provide a reasonable basis for determining that a given waste stream qualifies as a threshold waste stream and can then be the basis for a more extensive cost-benefit analysis. The threshold guidance and supporting documentation will be revised, based on the comments received. The revised documents will be provided to DOE by early November. DOE-HQ has indicated that the revised documents will be available for review by DOE field offices and their contractors

  10. Regulatory guidance document

    International Nuclear Information System (INIS)

    1994-05-01

    The Office of Civilian Radioactive Waste Management (OCRWM) Program Management System Manual requires preparation of the OCRWM Regulatory Guidance Document (RGD) that addresses licensing, environmental compliance, and safety and health compliance. The document provides: regulatory compliance policy; guidance to OCRWM organizational elements to ensure a consistent approach when complying with regulatory requirements; strategies to achieve policy objectives; organizational responsibilities for regulatory compliance; guidance with regard to Program compliance oversight; and guidance on the contents of a project-level Regulatory Compliance Plan. The scope of the RGD includes site suitability evaluation, licensing, environmental compliance, and safety and health compliance, in accordance with the direction provided by Section 4.6.3 of the PMS Manual. Site suitability evaluation and regulatory compliance during site characterization are significant activities, particularly with regard to the YW MSA. OCRWM's evaluation of whether the Yucca Mountain site is suitable for repository development must precede its submittal of a license application to the Nuclear Regulatory Commission (NRC). Accordingly, site suitability evaluation is discussed in Chapter 4, and the general statements of policy regarding site suitability evaluation are discussed in Section 2.1. Although much of the data and analyses may initially be similar, the licensing process is discussed separately in Chapter 5. Environmental compliance is discussed in Chapter 6. Safety and Health compliance is discussed in Chapter 7

  11. PIV Logon Configuration Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Glen Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-04

    This document details the configurations and enhancements implemented to support the usage of federal Personal Identity Verification (PIV) Card for logon on unclassified networks. The guidance is a reference implementation of the configurations and enhancements deployed at the Los Alamos National Laboratory (LANL) by Network and Infrastructure Engineering – Core Services (NIE-CS).

  12. MO-FG-BRC-02: Low-Z Switching Linear Accelerator Targets: New Options for Image Guidance and Dose Enhancement in Radiotherapy

    International Nuclear Information System (INIS)

    Robar, J.

    2016-01-01

    Experimental research in medical physics has expanded the limits of our knowledge and provided novel imaging and therapy technologies for patients around the world. However, experimental efforts are challenging due to constraints in funding, space, time and other forms of institutional support. In this joint ESTRO-AAPM symposium, four exciting experimental projects from four different countries are highlighted. Each project is focused on a different aspect of radiation therapy. From the USA, we will hear about a new linear accelerator concept for more compact and efficient therapy devices. From Canada, we will learn about novel linear accelerator target design and the implications for imaging and therapy. From France, we will discover a mature translational effort to incorporate theranostic nanoparticles in MR-guided radiation therapy. From Germany, we will find out about a novel in-treatment imaging modality for particle therapy. These examples of high impact, experimental medical physics research are representative of the diversity of such efforts that are on-going around the globe. J. Robar, Research is supported through collaboration with Varian Medical Systems and Brainlab AGD. Westerly, This work is supported by the Department of Radiation Oncology at the University of Colorado School of Medicine. COI: NONEK. Parodi, Part of the presented work is supported by the DFG (German Research Foundation) Cluster of Excellence MAP (Munich-Centre for Advanced Photonics) and has been carried out in collaboration with IBA.

  13. MO-FG-BRC-02: Low-Z Switching Linear Accelerator Targets: New Options for Image Guidance and Dose Enhancement in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Robar, J. [Capital District Health Authority (Canada)

    2016-06-15

    Experimental research in medical physics has expanded the limits of our knowledge and provided novel imaging and therapy technologies for patients around the world. However, experimental efforts are challenging due to constraints in funding, space, time and other forms of institutional support. In this joint ESTRO-AAPM symposium, four exciting experimental projects from four different countries are highlighted. Each project is focused on a different aspect of radiation therapy. From the USA, we will hear about a new linear accelerator concept for more compact and efficient therapy devices. From Canada, we will learn about novel linear accelerator target design and the implications for imaging and therapy. From France, we will discover a mature translational effort to incorporate theranostic nanoparticles in MR-guided radiation therapy. From Germany, we will find out about a novel in-treatment imaging modality for particle therapy. These examples of high impact, experimental medical physics research are representative of the diversity of such efforts that are on-going around the globe. J. Robar, Research is supported through collaboration with Varian Medical Systems and Brainlab AGD. Westerly, This work is supported by the Department of Radiation Oncology at the University of Colorado School of Medicine. COI: NONEK. Parodi, Part of the presented work is supported by the DFG (German Research Foundation) Cluster of Excellence MAP (Munich-Centre for Advanced Photonics) and has been carried out in collaboration with IBA.

  14. Towards 4D intervention guidance using compressed sensing

    Energy Technology Data Exchange (ETDEWEB)

    Kuntz, Jan; Bartling, Soenke [Deutsches Krebsforschungszentrum DKFZ, Heidelberg (Germany); Brehm, Marcus; Kachelriess, Marc [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. of Medical Physics (IMP)

    2011-07-01

    Interventional radiology is nowadays usually guided with projection radiography using mono- or biplane systems. Due to the projective nature of this guidance imaging certain intraprocedural situations remain unclear. Although helpful, the use of 3D CT is limited due to radiation dose. Using advanced reconstruction techniques incorporating prior knowledge, one could overcome these limitations without exceeding dose limitations. Intervention guidance is especially appealing to those algorithms, because certain constrains apply to useful images in intervention guidance that vary relevantly from other CT applications. These are: key relevance of high contrast structures, sparse temporal updates and little relevance of absolute CT values. In this paper the principal usability of reconstruction algorithms for intervention guidance is tested. Compressed sensing algorithms PICCS and ASD-POCS are compared to the McKinnon-Bates and Feldkamp-Davis-Kress algorithm. Animal experiments as well as simulations are performed. An outlook towards 4D intervention guidance is provided. (orig.)

  15. Development and application of pulmonary structure-function registration methods: towards pulmonary image-guidance tools for improved airway targeted therapies and outcomes

    Science.gov (United States)

    Guo, Fumin; Pike, Damien; Svenningsen, Sarah; Coxson, Harvey O.; Drozd, John J.; Yuan, Jing; Fenster, Aaron; Parraga, Grace

    2014-03-01

    Objectives: We aimed to develop a way to rapidly generate multi-modality (MRI-CT) pulmonary imaging structurefunction maps using novel non-rigid image registration methods. This objective is part of our overarching goal to provide an image processing pipeline to generate pulmonary structure-function maps and guide airway-targeted therapies. Methods: Anatomical 1H and functional 3He MRI were acquired in 5 healthy asymptomatic ex-smokers and 7 ex-smokers with chronic obstructive pulmonary disease (COPD) at inspiration breath-hold. Thoracic CT was performed within ten minutes of MRI using the same breath-hold volume. Landmark-based affine registration methods previously validated for imaging of COPD, was based on corresponding fiducial markers located in both CT and 1H MRI coronal slices and compared with shape-based CT-MRI non-rigid registration. Shape-based CT-MRI registration was developed by first identifying the shapes of the lung cavities manually, and then registering the two shapes using affine and thin-plate spline algorithms. We compared registration accuracy using the fiducial localization error (FLE) and target registration error (TRE). Results: For landmark-based registration, the TRE was 8.4±5.3 mm for whole lung and 7.8±4.6 mm for the R and L lungs registered independently (p=0.4). For shape-based registration, the TRE was 8.0±4.6 mm for whole lung as compared to 6.9±4.4 mm for the R and L lung registered independently and this difference was significant (p=0.01). The difference for shape-based (6.9±4.4 mm) and landmark-based R and L lung registration (7.8±4.6 mm) was also significant (p=.04) Conclusion: Shape-based registration TRE was significantly improved compared to landmark-based registration when considering L and R lungs independently.

  16. Ultrasound-based tumor movement compensation during navigated laparoscopic liver interventions.

    Science.gov (United States)

    Shahin, Osama; Beširević, Armin; Kleemann, Markus; Schlaefer, Alexander

    2014-05-01

    Image-guided navigation aims to provide better orientation and accuracy in laparoscopic interventions. However, the ability of the navigation system to reflect anatomical changes and maintain high accuracy during the procedure is crucial. This is particularly challenging in soft organs such as the liver, where surgical manipulation causes significant tumor movements. We propose a fast approach to obtain an accurate estimation of the tumor position throughout the procedure. Initially, a three-dimensional (3D) ultrasound image is reconstructed and the tumor is segmented. During surgery, the position of the tumor is updated based on newly acquired tracked ultrasound images. The initial segmentation of the tumor is used to automatically detect the tumor and update its position in the navigation system. Two experiments were conducted. First, a controlled phantom motion using a robot was performed to validate the tracking accuracy. Second, a needle navigation scenario based on pseudotumors injected into ex vivo porcine liver was studied. In the robot-based evaluation, the approach estimated the target location with an accuracy of 0.4 ± 0.3 mm. The mean navigation error in the needle experiment was 1.2 ± 0.6 mm, and the algorithm compensated for tumor shifts up to 38 mm in an average time of 1 s. We demonstrated a navigation approach based on tracked laparoscopic ultrasound (LUS), and focused on the neighborhood of the tumor. Our experimental results indicate that this approach can be used to quickly and accurately compensate for tumor movements caused by surgical manipulation during laparoscopic interventions. The proposed approach has the advantage of being based on the routinely used LUS; however, it upgrades its functionality to estimate the tumor position in 3D. Hence, the approach is repeatable throughout surgery, and enables high navigation accuracy to be maintained.

  17. {sup 124}I-L19-SIP for immuno-PET imaging of tumour vasculature and guidance of {sup 131}I-L19-SIP radioimmunotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tijink, Bernard M.; Perk, Lars R.; Budde, Marianne; Stigter-van Walsum, Marijke; Leemans, C.R. [VU University Medical Center, Department of Otolaryngology/Head and Neck Surgery, Amsterdam (Netherlands); Visser, Gerard W.M.; Kloet, Reina W. [VU University Medical Center, Nuclear Medicine and PET Research, Amsterdam (Netherlands); Dinkelborg, Ludger M. [Bayer Schering Pharma AG, Global Drug Discovery, Berlin (Germany); Neri, Dario [Swiss Federal Institute of Technology, Institute of Pharmaceutical Sciences, Zurich (Switzerland); Dongen, Guus A.M.S. van [VU University Medical Center, Department of Otolaryngology/Head and Neck Surgery, Amsterdam (Netherlands); VU University Medical Center, Nuclear Medicine and PET Research, Amsterdam (Netherlands)

    2009-08-15

    The human monoclonal antibody (MAb) fragment L19-SIP is directed against extra domain B (ED-B) of fibronectin, a marker of tumour angiogenesis. A clinical radioimmunotherapy (RIT) trial with {sup 131}I-L19-SIP was recently started. In the present study, after GMP production of {sup 124}I and efficient production of {sup 124}I-L19-SIP, we aimed to demonstrate the suitability of {sup 124}I-L19-SIP immuno-PET for imaging of angiogenesis at early-stage tumour development and as a scouting procedure prior to clinical {sup 131}I-L19-SIP RIT. {sup 124}I was produced in a GMP compliant way via {sup 124}Te(p,n){sup 124}I reaction and using a TERIMO trademark module for radioiodine separation. L19-SIP was radioiodinated by using a modified version of the IODO-GEN method. The biodistribution of coinjected {sup 124}I- and {sup 131}I-L19-SIP was compared in FaDu xenograft-bearing nude mice, while {sup 124}I PET images were obtained from mice with tumours of <50 to {proportional_to}700 mm{sup 3}. {sup 124}I was produced highly pure with an average yield of 15.4 {+-} 0.5 MBq/{mu}Ah, while separation yield was {proportional_to}90% efficient with <0.5% loss of TeO{sub 2}. Overall labelling efficiency, radiochemical purity and immunoreactive fraction were for {sup 124}I-L19-SIP: {proportional_to}80, 99.9 and >90%, respectively. Tumour uptake was 7.3{+-}2.1, 10.8{+-}1.5, 7.8{+-}1.4, 5.3{+-}0.6 and 3.1{+-}0.4%ID/g at 3, 6, 24, 48 and 72 h p.i., resulting in increased tumour to blood ratios ranging from 6.0 at 24 h to 45.9 at 72 h p.i. Fully concordant labelling and biodistribution results were obtained with {sup 124}I- and {sup 131}I-L19-SIP. Immuno-PET with {sup 124}I-L19-SIP using a high-resolution research tomograph PET scanner revealed clear delineation of the tumours as small as 50 mm{sup 3} and no adverse uptake in other organs. {sup 124}I-MAb conjugates for clinical immuno-PET can be efficiently produced. Immuno-PET with {sup 124}I-L19-SIP appeared qualified for sensitive

  18. Environmental guidance regulatory bulletin

    International Nuclear Information System (INIS)

    1997-01-01

    This document describes the background on expanding public participation in the Resource Conservation and Recovery Act and DOE's response. The bulletin also describes the changes made by the final rule to existing regulations, guidance provided by EPA in the preamble and in the revised RCRA Public Participation Manual, the relationship between public participation and environmental justice, and DOE's recent public participation and environmental justice initiatives

  19. Preliminary In-vivo Results For Spatially Coded Synthetic Transmit Aperture Ultrasound Based On Frequency Division

    DEFF Research Database (Denmark)

    Gran, Fredrik; Hansen, Kristoffer Lindskov; Jensen, Jørgen Arendt

    2006-01-01

    This paper investigates the possibility of using spatial coding based on frequency division for in-vivo synthetic transmit aperture (STA) ultrasound imaging. When using spatial encoding for STA, it is possible to use several transmitters simultaneously and separate the signals at the receiver....... This increases the maximum transmit power compared to conventional STA, where only one transmitter can be active. The signal-to-noise-ratio can therefore he increased and better penetration can be obtained. For frequency division, the coding is achieved by designing a number of transmit waveforms with disjoint...... spectral support, spanning the passband of the ultrasound transducer. The signals can therefore he separated at the receiver using matched filtering. The method is tested using a commercial linear array transducer with a center frequency of 9 MHz and 68% fractional bandwidth. In this paper, the transmit...

  20. Implementing an ultrasound-based protocol for diagnosingappendicitis while maintaining diagnostic accuracy

    International Nuclear Information System (INIS)

    Van Atta, Angela J.; Baskin, Henry J.; Maves, Connie K.; Dansie, David M.; Rollins, Michael D.; Bolte, Robert G.; Mundorff, Michael B.; Andrews, Seth P.

    2015-01-01

    The use of ultrasound to diagnose appendicitis in children is well-documented but not universally employed outside of pediatric academic centers, especially in the United States. Various obstacles make it difficult for institutions and radiologists to abandon a successful and accurate CT-based imaging protocol in favor of a US-based protocol. To describe how we overcame barriers to implementing a US-based appendicitis protocol among a large group of nonacademic private-practice pediatric radiologists while maintaining diagnostic accuracy and decreasing medical costs. A multidisciplinary team of physicians (pediatric surgery, pediatric emergency medicine and pediatric radiology) approved an imaging protocol using US as the primary modality to evaluate suspected appendicitis with CT for equivocal cases. The protocol addressed potential bias against US and accommodated for institutional limitations of radiologist and sonographer experience and availability. Radiologists coded US reports according to the probability of appendicitis. Radiology reports were compared with clinical outcomes to assess diagnostic accuracy. During the study period, physicians from each group were apprised of the interim US protocol accuracy results. Problematic cases were discussed openly. A total of 512 children were enrolled and underwent US for evaluation of appendicitis over a 30-month period. Diagnostic accuracy was comparable to published results for combined US/CT protocols. Comparing the first 12 months to the last 12 months of the study period, the proportion of children achieving an unequivocal US result increased from 30% (51/169) to 53% (149/282) and the proportion of children undergoing surgery based solely on US findings increased from 55% (23/42) to 84% (92/109). Overall, 63% (325/512) of patients in the protocol did not require a CT. Total patient costs were reduced by $30,182 annually. We overcame several barriers to implementing a US protocol. During the study period our

  1. Implementing an ultrasound-based protocol for diagnosingappendicitis while maintaining diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Van Atta, Angela J. [University of Utah School of Medicine, Salt Lake City, UT (United States); Baskin, Henry J.; Maves, Connie K.; Dansie, David M. [Primary Children' s Hospital, Department of Radiology, Salt Lake City, UT (United States); Rollins, Michael D. [University of Utah School of Medicine, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT (United States); Bolte, Robert G. [University of Utah School of Medicine, Department of Pediatrics, Division of Pediatric Emergency Medicine, Salt Lake City, UT (United States); Mundorff, Michael B.; Andrews, Seth P. [Primary Children' s Hospital, Systems Improvement, Salt Lake City, UT (United States)

    2015-05-01

    The use of ultrasound to diagnose appendicitis in children is well-documented but not universally employed outside of pediatric academic centers, especially in the United States. Various obstacles make it difficult for institutions and radiologists to abandon a successful and accurate CT-based imaging protocol in favor of a US-based protocol. To describe how we overcame barriers to implementing a US-based appendicitis protocol among a large group of nonacademic private-practice pediatric radiologists while maintaining diagnostic accuracy and decreasing medical costs. A multidisciplinary team of physicians (pediatric surgery, pediatric emergency medicine and pediatric radiology) approved an imaging protocol using US as the primary modality to evaluate suspected appendicitis with CT for equivocal cases. The protocol addressed potential bias against US and accommodated for institutional limitations of radiologist and sonographer experience and availability. Radiologists coded US reports according to the probability of appendicitis. Radiology reports were compared with clinical outcomes to assess diagnostic accuracy. During the study period, physicians from each group were apprised of the interim US protocol accuracy results. Problematic cases were discussed openly. A total of 512 children were enrolled and underwent US for evaluation of appendicitis over a 30-month period. Diagnostic accuracy was comparable to published results for combined US/CT protocols. Comparing the first 12 months to the last 12 months of the study period, the proportion of children achieving an unequivocal US result increased from 30% (51/169) to 53% (149/282) and the proportion of children undergoing surgery based solely on US findings increased from 55% (23/42) to 84% (92/109). Overall, 63% (325/512) of patients in the protocol did not require a CT. Total patient costs were reduced by $30,182 annually. We overcame several barriers to implementing a US protocol. During the study period our

  2. Investigating the performance and cost-effectiveness of the simple ultrasound-based rules compared to the risk of malignancy index in the diagnosis of ovarian cancer (SUBSONiC-study): protocol of a prospective multicenter cohort study in the Netherlands

    International Nuclear Information System (INIS)

    Meys, Evelyne MJ; Rutten, Iris JG; Kruitwagen, Roy FPM; Slangen, Brigitte F; Bergmans, Martin GM; Mertens, Helen JMM; Nolting, Ernst; Boskamp, Dieuwke; Beets-Tan, Regina GH; Gorp, Toon van

    2015-01-01

    Estimating the risk of malignancy is essential in the management of adnexal masses. An accurate differential diagnosis between benign and malignant masses will reduce morbidity and costs due to unnecessary operations, and will improve referral to a gynecologic oncologist for specialized cancer care, which improves outcome and overall survival. The Risk of Malignancy Index is currently the most commonly used method in clinical practice, but has a relatively low diagnostic accuracy (sensitivity 75–80 % and specificity 85–90 %). Recent reports show that other methods, such as simple ultrasound-based rules, subjective assessment and (Diffusion Weighted) Magnetic Resonance Imaging might be superior to the RMI in the pre-operative differentiation of adnexal masses. A prospective multicenter cohort study will be performed in the south of The Netherlands. A total of 270 women diagnosed with at least one pelvic mass that is suspected to be of ovarian origin who will undergo surgery, will be enrolled. We will apply the Risk of Malignancy Index with a cut-off value of 200 and a two-step triage test consisting of simple ultrasound-based rules supplemented -if necessary- with either subjective assessment by an expert sonographer or Magnetic Resonance Imaging with diffusion weighted sequences, to characterize the adnexal masses. The histological diagnosis will be the reference standard. Diagnostic performances will be expressed as sensitivity, specificity, positive and negative predictive values and likelihood ratios. We hypothesize that this two-step triage test, including the simple ultrasound-based rules, will have better diagnostic accuracy than the Risk of Malignancy Index and therefore will improve the management of women with adnexal masses. Furthermore, we expect this two-step test to be more cost-effective. If the hypothesis is confirmed, the results of this study could have major effects on current guidelines and implementation of the triage test in daily clinical

  3. Treatment-Related Morbidity in Prostate Cancer: A Comparison of 3-Dimensional Conformal Radiation Therapy With and Without Image Guidance Using Implanted Fiducial Markers

    International Nuclear Information System (INIS)

    Singh, Jasmeet; Greer, Peter B.; White, Martin A.; Parker, Joel; Patterson, Jackie; Tang, Colin I.; Capp, Anne; Wratten, Christopher; Denham, James W.

    2013-01-01

    Purpose: To estimate the prevalence of rectal and urinary dysfunctional symptoms using image guided radiation therapy (IGRT) with fiducials and magnetic resonance planning for prostate cancer. Methods and Materials: During the implementation stages of IGRT between September 2008 and March 2010, 367 consecutive patients were treated with prostatic irradiation using 3-dimensional conformal radiation therapy with and without IGRT (non-IGRT). In November 2010, these men were asked to report their bowel and bladder symptoms using a postal questionnaire. The proportions of patients with moderate to severe symptoms in these groups were compared using logistic regression models adjusted for tumor and treatment characteristic variables. Results: Of the 282 respondents, the 154 selected for IGRT had higher stage tumors, received higher prescribed doses, and had larger volumes of rectum receiving high dosage than did the 128 selected for non-IGRT. The follow-up duration was 8 to 26 months. Compared with the non-IGRT group, improvement was noted in all dysfunctional rectal symptoms using IGRT. In multivariable analyses, IGRT improved rectal pain (odds ratio [OR] 0.07 [0.009-0.7], P=.02), urgency (OR 0.27 [0.11-0.63], P=<.01), diarrhea (OR 0.009 [0.02-0.35], P<.01), and change in bowel habits (OR 0.18 [0.06-0.52], P<.010). No correlation was observed between rectal symptom levels and dose-volume histogram data. Urinary dysfunctional symptoms were similar in both treatment groups. Conclusions: In comparison with men selected for non-IGRT, a significant reduction of bowel dysfunctional symptoms was confirmed in men selected for IGRT, even though they had larger volumes of rectum treated to higher doses

  4. 3D Rapid Prototyping for Otolaryngology—Head and Neck Surgery: Applications in Image-Guidance, Surgical Simulation and Patient-Specific Modeling

    Science.gov (United States)

    Chan, Harley H. L.; Siewerdsen, Jeffrey H.; Vescan, Allan; Daly, Michael J.; Prisman, Eitan; Irish, Jonathan C.

    2015-01-01

    The aim of this study was to demonstrate the role of advanced fabrication technology across a broad spectrum of head and neck surgical procedures, including applications in endoscopic sinus surgery, skull base surgery, and maxillofacial reconstruction. The initial case studies demonstrated three applications of rapid prototyping technology are in head and neck surgery: i) a mono-material paranasal sinus phantom for endoscopy training ii) a multi-material skull base simulator and iii) 3D patient-specific mandible templates. Digital processing of these phantoms is based on real patient or cadaveric 3D images such as CT or MRI data. Three endoscopic sinus surgeons examined the realism of the endoscopist training phantom. One experienced endoscopic skull base surgeon conducted advanced sinus procedures on the high-fidelity multi-material skull base simulator. Ten patients participated in a prospective clinical study examining patient-specific modeling for mandibular reconstructive surgery. Qualitative feedback to assess the realism of the endoscopy training phantom and high-fidelity multi-material phantom was acquired. Conformance comparisons using assessments from the blinded reconstructive surgeons measured the geometric performance between intra-operative and pre-operative reconstruction mandible plates. Both the endoscopy training phantom and the high-fidelity multi-material phantom received positive feedback on the realistic structure of the phantom models. Results suggested further improvement on the soft tissue structure of the phantom models is necessary. In the patient-specific mandible template study, the pre-operative plates were judged by two blinded surgeons as providing optimal conformance in 7 out of 10 cases. No statistical differences were found in plate fabrication time and conformance, with pre-operative plating providing the advantage of reducing time spent in the operation room. The applicability of common model design and fabrication techniques

  5. 3D Rapid Prototyping for Otolaryngology-Head and Neck Surgery: Applications in Image-Guidance, Surgical Simulation and Patient-Specific Modeling.

    Science.gov (United States)

    Chan, Harley H L; Siewerdsen, Jeffrey H; Vescan, Allan; Daly, Michael J; Prisman, Eitan; Irish, Jonathan C

    2015-01-01

    The aim of this study was to demonstrate the role of advanced fabrication technology across a broad spectrum of head and neck surgical procedures, including applications in endoscopic sinus surgery, skull base surgery, and maxillofacial reconstruction. The initial case studies demonstrated three applications of rapid prototyping technology are in head and neck surgery: i) a mono-material paranasal sinus phantom for endoscopy training ii) a multi-material skull base simulator and iii) 3D patient-specific mandible templates. Digital processing of these phantoms is based on real patient or cadaveric 3D images such as CT or MRI data. Three endoscopic sinus surgeons examined the realism of the endoscopist training phantom. One experienced endoscopic skull base surgeon conducted advanced sinus procedures on the high-fidelity multi-material skull base simulator. Ten patients participated in a prospective clinical study examining patient-specific modeling for mandibular reconstructive surgery. Qualitative feedback to assess the realism of the endoscopy training phantom and high-fidelity multi-material phantom was acquired. Conformance comparisons using assessments from the blinded reconstructive surgeons measured the geometric performance between intra-operative and pre-operative reconstruction mandible plates. Both the endoscopy training phantom and the high-fidelity multi-material phantom received positive feedback on the realistic structure of the phantom models. Results suggested further improvement on the soft tissue structure of the phantom models is necessary. In the patient-specific mandible template study, the pre-operative plates were judged by two blinded surgeons as providing optimal conformance in 7 out of 10 cases. No statistical differences were found in plate fabrication time and conformance, with pre-operative plating providing the advantage of reducing time spent in the operation room. The applicability of common model design and fabrication techniques

  6. Surgical resection of low-grade gliomas in eloquent areas with the guidance of the preoperative functional magnetic resonance imaging and craniometric points

    Directory of Open Access Journals (Sweden)

    Ahmed Abdullah

    2016-01-01

    Full Text Available Objectives: Surgical resection of low-grade gliomas (LGGs in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation; however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. Materials and Methods: The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas. Preoperative functional magnetic resonance imaging (fMRI, pre- and post-operative MRI with volumetric analysis of the tumor size was conducted, and intraoperative determination of the craniometric points related to the tumor (navigation guided in 10 cases were studied to evaluate the effectiveness of the aforementioned tools in safe excision of the aforementioned tumors. Results: Total-near total excision in 14 (66.67% subtotal in 6 (28.57%, and biopsy in 1 case (4.57%. In long-term follow–up, only one case experienced persistent dysphasia. Conclusion: In spite of its simplicity, the identification of the safe anatomical landmarks guided by the preoperative fMRI is a useful technique that serves in safe excision of LGGs in eloquent areas. Such technique can replace intraoperative evoked potentials or the awake craniotomy in most of the cases. However, navigation-guided excision might be crucial in deeply seated and large tumors to allow safe and radical excision.

  7. 3D Rapid Prototyping for Otolaryngology-Head and Neck Surgery: Applications in Image-Guidance, Surgical Simulation and Patient-Specific Modeling.

    Directory of Open Access Journals (Sweden)

    Harley H L Chan

    Full Text Available The aim of this study was to demonstrate the role of advanced fabrication technology across a broad spectrum of head and neck surgical procedures, including applications in endoscopic sinus surgery, skull base surgery, and maxillofacial reconstruction. The initial case studies demonstrated three applications of rapid prototyping technology are in head and neck surgery: i a mono-material paranasal sinus phantom for endoscopy training ii a multi-material skull base simulator and iii 3D patient-specific mandible templates. Digital processing of these phantoms is based on real patient or cadaveric 3D images such as CT or MRI data. Three endoscopic sinus surgeons examined the realism of the endoscopist training phantom. One experienced endoscopic skull base surgeon conducted advanced sinus procedures on the high-fidelity multi-material skull base simulator. Ten patients participated in a prospective clinical study examining patient-specific modeling for mandibular reconstructive surgery. Qualitative feedback to assess the realism of the endoscopy training phantom and high-fidelity multi-material phantom was acquired. Conformance comparisons using assessments from the blinded reconstructive surgeons measured the geometric performance between intra-operative and pre-operative reconstruction mandible plates. Both the endoscopy training phantom and the high-fidelity multi-material phantom received positive feedback on the realistic structure of the phantom models. Results suggested further improvement on the soft tissue structure of the phantom models is necessary. In the patient-specific mandible template study, the pre-operative plates were judged by two blinded surgeons as providing optimal conformance in 7 out of 10 cases. No statistical differences were found in plate fabrication time and conformance, with pre-operative plating providing the advantage of reducing time spent in the operation room. The applicability of common model design and

  8. Evidence of Limited Motion of the Prostate by Carefully Emptying the Rectum as Assessed by Daily MVCT Image Guidance with Helical Tomotherapy

    International Nuclear Information System (INIS)

    Fiorino, Claudio Ph.D.; Di Muzio, Nadia; Broggi, Sara; Cozzarini, Cesare; Maggiulli, Eleonora M.Sc.; Alongi, Filippo; Valdagni, Riccardo; Fazio, Ferruccio; Calandrino, Riccardo

    2008-01-01

    Purpose: To assess setup and organ motion error by means of analysis of daily megavoltage computed tomography (MVCT) of patients treated with hypofractionated helical tomotherapy (71.4-74.2 Gy in 28 fractions). Methods and Materials: Data from 21 patients were analyzed. Patients were instructed to empty the rectum carefully before planning CT and every morning before therapy by means of a self-applied rectal enema. The position of the prostate was assessed by means of automatic bone matching (BM) with the planning kilovoltage CT (BM, setup error) followed by a direct visualization (DV) match on the prostate. Deviations between planning and therapy positions referred to BM and BM + DV were registered for the three main axes. In case of a full rectum at MVCT with evident shift of the prostate, treatment was postponed until after additional rectal emptying procedures; in this case, additional MVCT was performed before delivering the treatment. Data for 522 fractions were available; the impact of post-MVCT procedure was investigated for 17 of 21 patients (410 fractions). Results: Prostate motion relative to bony anatomy was limited. Concerning posterior-anterior shifts, only 4.9% and 2.7% of fractions showed deviation of 3 mm or greater of the prostate relative to BM without and with consideration of post-MVCT procedures, respectively. Interobserver variability for BM + DV match was within 0.8 mm (1 SD). Conclusions: Daily MVCT-based correction is feasible. The BM + DV matching was found to be consistent between operators. Rectal emptying using a daily enema is an efficient tool to minimize prostate motion, even for centers that have not yet implemented image-guided radiotherapy

  9. An ultrasound-based liquid pressure measurement method in small diameter pipelines considering the installation and temperature.

    Science.gov (United States)

    Li, Xue; Song, Zhengxiang

    2015-04-09

    Liquid pressure is a key parameter for detecting and judging faults in hydraulic mechanisms, but traditional measurement methods have many deficiencies. An effective non-intrusive method using an ultrasound-based technique to measure liquid pressure in small diameter (less than 15 mm) pipelines is presented in this paper. The proposed method is based on the principle that the transmission speed of an ultrasonic wave in a Kneser liquid correlates with liquid pressure. Liquid pressure was calculated using the variation of ultrasonic propagation time in a liquid under different pressures: 0 Pa and X Pa. In this research the time difference was obtained by an electrical processing approach and was accurately measured to the nanosecond level through a high-resolution time measurement module. Because installation differences and liquid temperatures could influence the measurement accuracy, a special type of circuit called automatic gain control (AGC) circuit and a new back propagation network (BPN) model accounting for liquid temperature were employed to improve the measurement results. The corresponding pressure values were finally obtained by utilizing the relationship between time difference, transient temperature and liquid pressure. An experimental pressure measurement platform was built and the experimental results confirm that the proposed method has good measurement accuracy.

  10. PSD Increment Consumption Guidance

    Science.gov (United States)

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  11. Accuracy of Ultrasound-Based (BAT) Prostate-Repositioning: A Three-Dimensional On-Line Fiducial-Based Assessment With Cone-Beam Computed Tomography

    International Nuclear Information System (INIS)

    Boda-Heggemann, Judit; Koehler, Frederick Marc; Kuepper, Beate; Wolff, Dirk; Wertz, Hansjoerg; Mai, Sabine; Hesser, Juergen; Lohr, Frank; Wenz, Frederik

    2008-01-01

    Purpose: To assess the accuracy of ultrasound-based repositioning (BAT) before prostate radiation with fiducial-based three-dimensional matching with cone-beam computed tomography (CBCT). Patients and Methods: Fifty-four positionings in 8 patients with 125 I seeds/intraprostatic calcifications as fiducials were evaluated. Patients were initially positioned according to skin marks and after this according to bony structures based on CBCT. Prostate position correction was then performed with BAT. Residual error after repositioning based on skin marks, bony anatomy, and BAT was estimated by a second CBCT based on user-independent automatic fiducial registration. Results: Overall mean value (MV ± SD) residual error after BAT based on fiducial registration by CBCT was 0.7 ± 1.7 mm in x (group systematic error [M] = 0.5 mm; SD of systematic error [Σ] = 0.8 mm; SD of random error [σ] = 1.4 mm), 0.9 ± 3.3 mm in y (M = 0.5 mm, Σ = 2.2 mm, σ = 2.8 mm), and -1.7 ± 3.4 mm in z (M = -1.7 mm, Σ = 2.3 mm, σ = 3.0 mm) directions, whereas residual error relative to positioning based on skin marks was 2.1 ± 4.6 mm in x (M = 2.6 mm, Σ = 3.3 mm, σ = 3.9 mm), -4.8 ± 8.5 mm in y (M = -4.4 mm, Σ = 3.7 mm, σ = 6.7 mm), and -5.2 ± 3.6 mm in z (M = -4.8 mm, Σ = 1.7 mm, σ = 3.5mm) directions and relative to positioning based on bony anatomy was 0 ± 1.8 mm in x (M = 0.2 mm, Σ = 0.9 mm, σ = 1.1 mm), -3.5 ± 6.8 mm in y (M = -3.0 mm, Σ = 1.8 mm, σ = 3.7 mm), and -1.9 ± 5.2 mm in z (M = -2.0 mm, Σ = 1.3 mm, σ = 4.0 mm) directions. Conclusions: BAT improved the daily repositioning accuracy over skin marks or even bony anatomy. The results obtained with BAT are within the precision of extracranial stereotactic procedures and represent values that can be achieved with several users with different education levels. If sonographic visibility is insufficient, CBCT or kV/MV portal imaging with implanted fiducials are recommended

  12. Preoperative magnetic resonance and intraoperative ultrasound fusion imaging for real-time neuronavigation in brain tumor surgery.

    Science.gov (United States)

    Prada, F; Del Bene, M; Mattei, L; Lodigiani, L; DeBeni, S; Kolev, V; Vetrano, I; Solbiati, L; Sakas, G; DiMeco, F

    2015-04-01

    Brain shift and tissue deformation during surgery for intracranial lesions are the main actual limitations of neuro-navigation (NN), which currently relies mainly on preoperative imaging. Ultrasound (US), being a real-time imaging modality, is becoming progressively more widespread during neurosurgical procedures, but most neurosurgeons, trained on axial computed tomography (CT) and magnetic resonance imaging (MRI) slices, lack specific US training and have difficulties recognizing anatomic structures with the same confidence as in preoperative imaging. Therefore real-time intraoperative fusion imaging (FI) between preoperative imaging and intraoperative ultrasound (ioUS) for virtual navigation (VN) is highly desirable. We describe our procedure for real-time navigation during surgery for different cerebral lesions. We performed fusion imaging with virtual navigation for patients undergoing surgery for brain lesion removal using an ultrasound-based real-time neuro-navigation system that fuses intraoperative cerebral ultrasound with preoperative MRI and simultaneously displays an MRI slice coplanar to an ioUS image. 58 patients underwent surgery at our institution for intracranial lesion removal with image guidance using a US system equipped with fusion imaging for neuro-navigation. In all cases the initial (external) registration error obtained by the corresponding anatomical landmark procedure was below 2 mm and the craniotomy was correctly placed. The transdural window gave satisfactory US image quality and the lesion was always detectable and measurable on both axes. Brain shift/deformation correction has been successfully employed in 42 cases to restore the co-registration during surgery. The accuracy of ioUS/MRI fusion/overlapping was confirmed intraoperatively under direct visualization of anatomic landmarks and the error was surgery and is less expensive and time-consuming than other intraoperative imaging techniques, offering high precision and

  13. Non-cable vehicle guidance

    Energy Technology Data Exchange (ETDEWEB)

    Daugela, G.C.; Willott, A.M.; Chopiuk, R.G.; Thornton, S.E.

    1988-06-01

    The purpose is to determine the most promising driverless mine vehicle guidance systems that are not dependent on buried cables, and to plan their development. The project is presented in two phases: a preliminary study and literature review to determine whether suitable technologies exist to justify further work; and an in-depth assessment and selection of technologies for vehicle guidance. A large number of guidance elements are involved in a completely automated vehicle. The technologies that hold the best potential for development of guidance systems for mine vehicles are ultrasonics, radar, lasers, dead reckoning, and guidance algorithms. The best approach to adaptation of these technologies is on a step by step basis. Guidance modules that are complete in themselves and are designed to be integrated with other modules can provide short term benefits. Two modules are selected for development: the dragline operations monitor and automated machine control for optimized mining (AMCOM). 99 refs., 20 figs., 40 tabs.

  14. The European Society of Therapeutic Radiology and Oncology-European Institute of Radiotherapy (ESTRO-EIR) report on 3D CT-based in-room image guidance systems: a practical and technical review and guide.

    Science.gov (United States)

    Korreman, Stine; Rasch, Coen; McNair, Helen; Verellen, Dirk; Oelfke, Uwe; Maingon, Philippe; Mijnheer, Ben; Khoo, Vincent

    2010-02-01

    The past decade has provided many technological advances in radiotherapy. The European Institute of Radiotherapy (EIR) was established by the European Society of Therapeutic Radiology and Oncology (ESTRO) to provide current consensus statement with evidence-based and pragmatic guidelines on topics of practical relevance for radiation oncology. This report focuses primarily on 3D CT-based in-room image guidance (3DCT-IGRT) systems. It will provide an overview and current standing of 3DCT-IGRT systems addressing the rationale, objectives, principles, applications, and process pathways, both clinical and technical for treatment delivery and quality assurance. These are reviewed for four categories of solutions; kV CT and kV CBCT (cone-beam CT) as well as MV CT and MV CBCT. It will also provide a framework and checklist to consider the capability and functionality of these systems as well as the resources needed for implementation. Two different but typical clinical cases (tonsillar and prostate cancer) using 3DCT-IGRT are illustrated with workflow processes via feedback questionnaires from several large clinical centres currently utilizing these systems. The feedback from these clinical centres demonstrates a wide variability based on local practices. This report whilst comprehensive is not exhaustive as this area of development remains a very active field for research and development. However, it should serve as a practical guide and framework for all professional groups within the field, focussed on clinicians, physicists and radiation therapy technologists interested in IGRT. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Computed tomography guidance for skeletal biopsy

    International Nuclear Information System (INIS)

    Frager, D.H.; Goldman, M.J.; Elkin, C.M.; Cynamon, J.; Leeds, N.E.; Seimon, L.P.; Habermann, E.T.; Schreiber, K.; Freeman, L.M.

    1987-01-01

    Computed tomographic (CT) guided biopsy and abscess drainage of multiple organ systems have been well described. Reports of spinal and skeletal applications have been less common. This study describes the use of CT guidance in the biopsy of various skeletal lesions in 46 patients. Forty-one patients had skinny needle aspirations (18 or 22 gauge) and 23 patients had trephine core biopsies. Sites of the lesions included: thoracic spine - 15 patients, lumbosacral spine - 17 patients, bony pelvis - 6 patients, rib - 2 patients, and long bones - 6 patients. Fast scanners capable of rapid image reconstruction have overcome many constraints. With CT guidance, the physician who performs the procedure receives virtually no ionizing radiation. The exact location of the needle tip is accurately visualized in relation to the lesion being biopsied and to the vital organs. (orig.)

  16. International guidance activities

    International Nuclear Information System (INIS)

    Richardson, Allan C.B.

    1989-01-01

    International principles for setting Protective Action Guides (PAGs) are contained in two key documents that contain identical statements. One is Publication Number 40 of the ICRP, which was issued in 1985. The title is 'Protection of the Public in the Event of Major Radiation Accidents, Principles for Planning'. The other is the IAEA's Safety Series Publication Number 72, also issued in 1985, written by many of the same authors and titled, 'Principles for Establishing Intervention Levels'. The principles that were set forth in these documents were identical, were incomplete, and they are, unfortunately, the only principles that are now in effect, while proposed revisions go through one draft after another. There are several such draft revisions that are of significance. The most important is that of the ICRP. The basic guidance that applies to most planned exposure to radiation is ICRP Publication 26. That document has been under revision by the Commission for a number of years, and the new version will, for the first time, include recommendations for emergency response. They are now getting close to closure, and I think it should be a very much improved and useful document. But it isn't finished yet. Such guidance doesn't get developed in a vacuum, and there have been a couple of parallel efforts which have provided significant input to the ICRP, which is essentially a behind-closed-doors effort. These other efforts are more open. One of these is being carried out within the IAEA, which has convened annual meetings of national experts for a number of years in Vienna, to generate a replacement for Safety Series No. 72, mentioned earlier. There is a meeting scheduled this December to complete this effort; and, hopefully, we will reach closure at that meeting on at least the basic principles. The Nuclear Energy Agency (NEA) has also been at work. It has convened a group of experts from member nations that have been developing recommendations. There is an overlap

  17. RH Packaging Program Guidance

    International Nuclear Information System (INIS)

    2006-01-01

    The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: 'each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, Operating Procedures, of the application.' It further states: 'each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application.' Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M and O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with 10 Code of Federal Regulations (CFR) 1.8, 'Deliberate Misconduct.' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. CBFO will evaluate the issue and notify the NRC if required. In accordance with 10 CFR Part 71, 'Packaging and Transportation of Radioactive Material,' certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, 'Reporting of Defects and Noncompliance,' regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a conspicuous location where the activities subject to these

  18. RH Packaging Program Guidance

    International Nuclear Information System (INIS)

    2008-01-01

    The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package (also known as the 'RH-TRU 72-B cask') and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: 'each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, Operating Procedures, of the application.' It further states: 'each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application.' Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M and O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with Title 10 Code of Federal Regulations (CFR) 71.8, 'Deliberate Misconduct.' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. The CBFO will evaluate the issue and notify the NRC if required.In accordance with 10 CFR Part 71, 'Packaging and Transportation of Radioactive Material,' certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, 'Reporting of Defects and Noncompliance,' regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a conspicuous

  19. Plowshare radiation protection guidance

    International Nuclear Information System (INIS)

    Parker, H.M.

    1969-01-01

    The recommendations of the ICRP and the NCRP were developed primarily for occupational radiation exposures. They were later modified and applied to non-occupational exposures of populations. These, with appropriate interpretations, can be used to provide Plowshare radiation protection guidance. Exposures from Plowshare operations will tend to be acute, arising from radionuclides of relatively short half-life, but will have some chronic aspects due to small amounts of long-lived radionuclides generated. In addition, the neutron activation process of Plowshare technology will produce radionuclides not commonly encountered in routine nuclear energy programs. How these radionuclides contribute to personnel exposure is known for only a few situations that may not be representative of Plowshare exposure. Further complications arise from differences in radionuclide deposition and physiological sensitivity among individuals of different ages and states of health in the exposed population. All parameters necessary to evaluate such exposures are not available, even for good quantitative approximations, resulting in the need for interpretive experience. (author)

  20. Plowshare radiation protection guidance

    Energy Technology Data Exchange (ETDEWEB)

    Parker, H M [Environmental and Life Sciences Division, Battelle Memorial Institute, Pacific Northwest Laboratory, Richland, WA (United States)

    1969-07-01

    The recommendations of the ICRP and the NCRP were developed primarily for occupational radiation exposures. They were later modified and applied to non-occupational exposures of populations. These, with appropriate interpretations, can be used to provide Plowshare radiation protection guidance. Exposures from Plowshare operations will tend to be acute, arising from radionuclides of relatively short half-life, but will have some chronic aspects due to small amounts of long-lived radionuclides generated. In addition, the neutron activation process of Plowshare technology will produce radionuclides not commonly encountered in routine nuclear energy programs. How these radionuclides contribute to personnel exposure is known for only a few situations that may not be representative of Plowshare exposure. Further complications arise from differences in radionuclide deposition and physiological sensitivity among individuals of different ages and states of health in the exposed population. All parameters necessary to evaluate such exposures are not available, even for good quantitative approximations, resulting in the need for interpretive experience. (author)

  1. Three-Year Analysis of Value and Utilization After Development of an Ultrasound-Based Orthopedic Injection Clinic.

    Science.gov (United States)

    Dukes, Chase; Melton, Thomas; Turner, Eric; Jackson, Andrew; Grassbaugh, Jason; Slevin, John; Arrington, Edward D; Eichinger, Josef K

    2017-09-01

    Sonography is an effective method of diagnosing and treating musculoskeletal conditions, and the use of ultrasound has been shown to improve the accuracy, safety, and efficacy of both therapeutic and diagnostic injections. In 2012, we established an injection clinic at our institution to address our growing need for diagnostic and therapeutic injections. We performed an analysis of value and utilization following the development of an orthopedic injection clinic. This included an evaluation of the cost of materials, equipment, and training required to develop and run the clinic, and an analysis of the services rendered and relative value units (RVUs) generated over 3 fiscal years (FYs). The cost to develop the clinic was $42,498.30. The cost to run the clinic thereafter was $16.90 to $21.60 per injection. By the end of FY 2012, 60% of providers performed at least 1 injection under ultrasound guidance. Every successive year thereafter, 100% of providers were using ultrasound guidance. In FY 2012, we performed 738 injections, 5.4% used ultrasound guidance and generated a total of 1,786.36 RVUs. In FY 2013, we performed 1,814 injections, 17.6% used ultrasound guidance, and generated a total of 7,224.5 RVUs. In FY 2014, we performed 2,821 injections, 25.2% used ultrasound guidance, and generated 13,786.82 RVUs. RVUs generated solely from ultrasound guided injections were 463.2 (2012), 3,694 (2013), 8,221.8 (2014). Injection accuracy was at least 98%. Average time until injection was 0 days. The cost to start an injection clinic is modest, with the potential for large annual growth and early return on investment, and can generate significant revenue by recapturing RVUs that would otherwise be lost to outside referrals. Furthermore, it helps to increase clinic throughput, maximize services rendered during a single patient visit improving the overall quality of their encounter, expands the clinical practice of our midlevel providers, offloads clinical time for surgical

  2. Combined photothermal therapy and magneto-motive ultrasound imaging using multifunctional nanoparticles

    Science.gov (United States)

    Mehrmohammadi, Mohammad; Ma, Li L.; Chen, Yun-Sheng; Qu, Min; Joshi, Pratixa; Chen, Raeanna M.; Johnston, Keith P.; Emelianov, Stanislav

    2010-02-01

    Photothermal therapy is a laser-based non-invasive technique for cancer treatment. Photothermal therapy can be enhanced by employing metal nanoparticles that absorb the radiant energy from the laser leading to localized thermal damages. Targeting of nanoparticles leads to more efficient uptake and localization of photoabsorbers thus increasing the effectiveness of the treatment. Moreover, efficient targeting can reduce the required dosage of photoabsorbers; thereby reducing the side effects associated with general systematic administration of nanoparticles. Magnetic nanoparticles, due to their small size and response to an external magnetic field gradient have been proposed for targeted drug delivery. In this study, we investigate the applicability of multifunctional nanoparticles (e.g., magneto-plasmonic nanoparticles) and magneto-motive ultrasound imaging for image-guided photothermal therapy. Magneto-motive ultrasound imaging is an ultrasound based imaging technique capable of detecting magnetic nanoparticles indirectly by utilizing a high strength magnetic field to induce motion within the magnetically labeled tissue. The ultrasound imaging is used to detect the internal tissue motion. Due to presence of the magnetic component, the proposed multifunctional nanoparticles along with magneto-motive ultrasound imaging can be used to detect the presence of the photo absorbers. Clearly the higher concentration of magnetic carriers leads to a monotonic increase in magneto-motive ultrasound signal. Thus, magnetomotive ultrasound can determine the presence of the hybrid agents and provide information about their location and concentration. Furthermore, the magneto-motive ultrasound signal can indicate the change in tissue elasticity - a parameter that is expected to change significantly during the photothermal therapy. Therefore, a comprehensive guidance and assessment of the photothermal therapy may be feasible through magneto-motive ultrasound imaging and

  3. General RMP Guidance - Appendix D: OSHA Guidance on PSM

    Science.gov (United States)

    OSHA's Process Safety Management (PSM) Guidance on providing complete and accurate written information concerning process chemicals, process technology, and process equipment; including process hazard analysis and material safety data sheets.

  4. CAREER GUIDANCE EXPERIENCE ABROAD

    Directory of Open Access Journals (Sweden)

    Sergey N. Tolstoguzov

    2015-01-01

    Full Text Available The aim of this paper is to describe the experience of careeroriented activities carried out with students of schools in developed and developing countries. Career Guidance in Russia, despite the vast experience of its implementation, is experiencing serious difficulties. In this regard, it is important to take into account the international experience career-oriented activities, such as in the developed countries of North America and the European Union as well as in several Asian countries with rapidly growing economies and a large demographic potential, taking into account the best variants for the Russian education system. Methods. The experience of career-oriented work undertaken with pupils of the USA, Canada, Israel, France, UK, Germany, Denmark, Sweden, Japan, Singapore, China and India is shown on the basis of the comparative analysis of different publications and information sources. The author has made an attempt to generalize the principles of psycho-pedagogical and administrative assistance in professional self-determination of senior pupils abroad. Scientific novelty. The approaches to career-oriented activities in countries with different levels of economic development are compared for the first time. Some principles are revealed. Firstly, the higher the income level per capita in the country, the greater attention is given to vocational guidance. The politics in the developed countries is based on interests of the individual: children’s acquaintance with the world of professions begins already at younger school and the moment of definitive selfdetermination is postponed till the end of their senior stage of education; the possibility of direction change of professional preparation in case of detection of discrepancy of qualities of the pupil to originally selected profile is provided. Career-oriented activity in developing countries, on the contrary, is rigidly coordinated to requirements of economy and a labour market

  5. RH Packaging Program Guidance

    International Nuclear Information System (INIS)

    Washington TRU Solutions, LLC

    2003-01-01

    The purpose of this program guidance document is to provide technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the SARP and/or C of C shall govern. The C of C states: ''...each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, ''Operating Procedures,'' of the application.'' It further states: ''...each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, ''Acceptance Tests and Maintenance Program of the Application.'' Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M and O) contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC approved, users need to be familiar with 10 CFR (section) 71.11, ''Deliberate Misconduct.'' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the Carlsbad Field Office (CBFO) shall be notified immediately. CBFO will evaluate the issue and notify the NRC if required. This document details the instructions to be followed to operate, maintain, and test the RH-TRU 72-B packaging. This Program Guidance standardizes instructions for all users. Users shall follow these instructions. Following these instructions assures that operations are safe and meet the requirements of the SARP. This document is available on the Internet at: ttp://www.ws/library/t2omi/t2omi.htm. Users are responsible for ensuring they are using the current revision and change notices. Sites may prepare their own document using the word

  6. The continuum of behavior guidance.

    Science.gov (United States)

    Nelson, Travis

    2013-01-01

    Behavior guidance is a continuum of techniques, basic and advanced, fundamental to the provision of quality dental care for pediatric patients. This practice must be individualized, pairing the correct method of behavior guidance with each child. To select the appropriate technique, the clinician must have a thorough understanding of each aspect of the continuum and anticipate parental expectations, child temperament, and the technical procedures necessary to complete care. By effectively using techniques within the continuum of behavior guidance, a healing relationship with the family is maintained while addressing dental disease and empowering the child to receive dental treatment throughout their lifetime. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Regulatory guidance for license renewal

    International Nuclear Information System (INIS)

    Thoma, John A.

    1991-01-01

    The proposed 10 CFR Part 54 rule proceduralizes the process for license renewal by identifying both the administrative and technical requirements for a renewal application. To amplify and support this regulation, written guidance has been provided in the form of a draft Regulatory Guide (DG 1009) and a draft Standard Review Plan for License Renewal (NUREG 1299). This guidance is scheduled to be finalized in 1992. Similar guidance will be provided for the proposed revisions to 10 CFR Part 51 concerning the environmental aspects of license renewal. (author)

  8. Validity of eyeball estimation for range of motion during the cervical flexion rotation test compared to an ultrasound-based movement analysis system.

    Science.gov (United States)

    Schäfer, Axel; Lüdtke, Kerstin; Breuel, Franziska; Gerloff, Nikolas; Knust, Maren; Kollitsch, Christian; Laukart, Alex; Matej, Laura; Müller, Antje; Schöttker-Königer, Thomas; Hall, Toby

    2018-08-01

    Headache is a common and costly health problem. Although pathogenesis of headache is heterogeneous, one reported contributing factor is dysfunction of the upper cervical spine. The flexion rotation test (FRT) is a commonly used diagnostic test to detect upper cervical movement impairment. The aim of this cross-sectional study was to investigate concurrent validity of detecting high cervical ROM impairment during the FRT by comparing measurements established by an ultrasound-based system (gold standard) with eyeball estimation. Secondary aim was to investigate intra-rater reliability of FRT ROM eyeball estimation. The examiner (6 years experience) was blinded to the data from the ultrasound-based device and to the symptoms of the patients. FRT test result (positive or negative) was based on visual estimation of range of rotation less than 34° to either side. Concurrently, range of rotation was evaluated using the ultrasound-based device. A total of 43 subjects with headache (79% female), mean age of 35.05 years (SD 13.26) were included. According to the International Headache Society Classification 23 subjects had migraine, 4 tension type headache, and 16 multiple headache forms. Sensitivity and specificity were 0.96 and 0.89 for combined rotation, indicating good concurrent reliability. The area under the ROC curve was 0.95 (95% CI 0.91-0.98) for rotation to both sides. Intra-rater reliability for eyeball estimation was excellent with Fleiss Kappa 0.79 for right rotation and left rotation. The results of this study indicate that the FRT is a valid and reliable test to detect impairment of upper cervical ROM in patients with headache.

  9. Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS).

    Science.gov (United States)

    Eichhorn, Klaus Wolfgang; Westphal, Ralf; Rilk, Markus; Last, Carsten; Bootz, Friedrich; Wahl, Friedrich; Jakob, Mark; Send, Thorsten

    2017-10-01

    Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.

  10. SPLC Sustainable Purchasing Guidance Profile

    Science.gov (United States)

    To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

  11. CDM Convective Forecast Planning guidance

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The CDM Convective Forecast Planning (CCFP) guidance product provides a foreast of en-route aviation convective hazards. The forecasts are updated every 2 hours and...

  12. Guidance at the educational marketplace

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    in educational policies and institutions. As educational systems have expanded and, further, have been restructured with the expansion of choice opportunities since the 1980s, guidance has become prioritized as a form of counseling or coaching, which can support students. Thus, guidance has become an important...... `agent´ on the educational "market´, assisting (potential) students into and around the `marketplace´. Consequently, guidance is also an important `agent´ for educational institutions that increasingly use marketing strategies to promote themselves on the market to attract and hold on to their “customers......” in order for the institutions to increase their ´market value´, `sales” and “turnover”. Thus, the expansion of guidance is nurtured by the expansion of the logic of marketization and consumerism. Drawing on Foucauldian perspectives in educational research, which highlight the expansion of powerful...

  13. [Anterior guidance in complete dentures].

    Science.gov (United States)

    Dubreuil, J; Trevelo, A

    1990-01-01

    Although the anterior guidance in complete dentures is not really a guide, the arrangement of the anterior maxillary and mandibular prosthetic teeth, defines a propulsive line called the virtual anterior guidance, a part from the cinematic criterias. The influence of this guide on cuspal movement is superior, in all mandibular points, to the influence of the condylar pathway. If this line is not respected, the practitioner may have to do excessive grindings during occlusal adjustments.

  14. A parallelizable real-time motion tracking algorithm with applications to ultrasonic strain imaging

    International Nuclear Information System (INIS)

    Jiang, J; Hall, T J

    2007-01-01

    Ultrasound-based mechanical strain imaging systems utilize signals from conventional diagnostic ultrasound systems to image tissue elasticity contrast that provides new diagnostically valuable information. Previous works (Hall et al 2003 Ultrasound Med. Biol. 29 427, Zhu and Hall 2002 Ultrason. Imaging 24 161) demonstrated that uniaxial deformation with minimal elevation motion is preferred for breast strain imaging and real-time strain image feedback to operators is important to accomplish this goal. The work reported here enhances the real-time speckle tracking algorithm with two significant modifications. One fundamental change is that the proposed algorithm is a column-based algorithm (a column is defined by a line of data parallel to the ultrasound beam direction, i.e. an A-line), as opposed to a row-based algorithm (a row is defined by a line of data perpendicular to the ultrasound beam direction). Then, displacement estimates from its adjacent columns provide good guidance for motion tracking in a significantly reduced search region to reduce computational cost. Consequently, the process of displacement estimation can be naturally split into at least two separated tasks, computed in parallel, propagating outward from the center of the region of interest (ROI). The proposed algorithm has been implemented and optimized in a Windows (registered) system as a stand-alone ANSI C++ program. Results of preliminary tests, using numerical and tissue-mimicking phantoms, and in vivo tissue data, suggest that high contrast strain images can be consistently obtained with frame rates (10 frames s -1 ) that exceed our previous methods

  15. Evaluating the Agreement of Risk Categorization for Fetal Down Syndrome Screening between Ultrasound-Based Gestational Age and Menstrual-Based Gestational Age by Maternal Serum Markers.

    Science.gov (United States)

    Chaksuwat, Pakorn; Sirichotiyakul, Supatra; Luewan, Suchaya; Tongsong, Theera

    2018-01-01

    To evaluate the agreement of risk categorization for Down syndrome screening between ultrasound scan-based gestational age (GA) and last menstrual period-based gestational age in both first and second trimesters by maternal serum markers. Data comprising 4,055 and 4,016 cases of first and second trimester screening were used. The maternal serum markers were analyzed using the ultrasound-based GA and menstrual age. The subjects whose menstrual age and ultrasound-based GA fell in different trimesters were excluded because the risk could not be calculated due to the different serum markers used in each trimester. The agreement of risk categorization for fetal Down syndrome was evaluated. The agreement of Down syndrome screening in the first and the second trimesters were 92.7% and 89%, respectively. The study found a good agreement of risk categorization by Kappa index, which was 0.615 for the overall screening. The menstrual age had a slight decrease in the detection rate and a lower false-positive rate. Menstrual age is acceptable in cases of accurate last menstrual period. However, in places where ultrasonography is not readily available, gestational age estimation by menstrual age along with clinical examination that corresponds to the gestational age can be reliable.

  16. Performance of hand-held whole-breast ultrasound based on BI-RADS in women with mammographically negative dense breast

    International Nuclear Information System (INIS)

    Youk, Ji Hyun; Kim, Eun-Kyung; Kim, Min Jung; Kwak, Jin Young; Son, Eun Ju

    2011-01-01

    To assess the performance of breast ultrasound based on BI-RADS final assessment categories in women with mammographically negative dense breast. Of 3,820 cases with mammographically negative dense breast and subsequent hand-held bilateral whole-breast ultrasound, a total of 1,507 cases in 1,046 women who had biopsy or at least 2-year follow-up ultrasound constituted the basis of this retrospective study. Cancer rate of each sonographic BI-RADS category was determined and medical audit was performed separately in screening-general, screening-treated, and diagnostic group. A total of 43 cases (2.9%) were confirmed as malignancy. Cancer rate among BI-RADS categories was significantly different (p < 0.0001). Among three groups, the cancer rate was significantly different (p < 0.0001) and the highest in diagnostic group (15.8%, 22 of 139). Abnormal interpretation rate, PPV of biopsy performed, cancer detection rate, and rate of early stage cancer, and the size of invasive cancer were significantly different among three groups and the highest in diagnostic group. Regarding cancer characteristics, the proportion of advanced cancer was the highest in diagnostic group. Breast ultrasound based on BI-RADS as an adjunctive to negative mammography can be useful for predicting malignancy in women with dense breast. (orig.)

  17. Transsphenoidal pituitary resection with intraoperative MR guidance: preliminary results

    Science.gov (United States)

    Pergolizzi, Richard S., Jr.; Schwartz, Richard B.; Hsu, Liangge; Wong, Terence Z.; Black, Peter M.; Martin, Claudia; Jolesz, Ferenc A.

    1999-05-01

    The use of intraoperative MR image guidance has the potential to improve the precision, extent and safety of transsphenoidal pituitary resections. At Brigham and Women's Hospital, an open-bore configuration 0.5T MR system (SIGNA SP, GE Medical Systems, Milwaukee, WI) has been used to provide image guidance for nine transsphenoidal pituitary adenoma resections. The intraoperative MR system allowed the radiologist to direct the surgeon toward the sella turcica successfully while avoiding the cavernous sinus, optic chiasm and other sensitive structures. Imaging performed during the surgery monitored the extent of resection and allowed for removal of tumor beyond the surgeon's view in five cases. Dynamic MR imaging was used to distinguish residual tumor from normal gland and postoperative changes permitting more precise tumor localization. A heme-sensitive long TE gradient echo sequence was used to evaluate for the presence of hemorrhagic debris. All patients tolerated the procedure well without significant complications.

  18. Quality in career guidance: The Danish case

    DEFF Research Database (Denmark)

    Plant, Peter

    2011-01-01

    Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach......Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach...

  19. Electronic portal imaging devices

    International Nuclear Information System (INIS)

    Lief, Eugene

    2008-01-01

    The topics discussed include, among others, the following: Role of portal imaging; Port films vs. EPID; Image guidance: Elekta volume view; Delivery verification; Automation tasks of portal imaging; Types of portal imaging (Fluorescent screen, mirror, and CCD camera-based imaging; Liquid ion chamber imaging; Amorpho-silicon portal imagers; Fluoroscopic portal imaging; Kodak CR reader; and Other types of portal imaging devices); QA of EPID; and Portal dosimetry (P.A.)

  20. 77 FR 39498 - Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection...

    Science.gov (United States)

    2012-07-03

    ...] Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection Devices Applied... Clinical Performance Assessment: Considerations for Computer-Assisted Detection Devices Applied to... guidance, entitled ``Computer-Assisted Detection Devices Applied to Radiology Images and Radiology Device...

  1. Exclusive image guided IMRT vs. radical prostatectomy followed by postoperative IMRT for localized prostate cancer: a matched-pair analysis based on risk-groups

    International Nuclear Information System (INIS)

    Azelie, Caroline; Créhange, Gilles; Gauthier, Mélanie; Mirjolet, Céline; Cormier, Luc; Martin, Etienne; Peignaux-Casasnovas, Karine; Truc, Gilles; Chamois, Jérôme; Maingon, Philippe

    2012-01-01

    To investigate whether patients treated for a localized prostate cancer (PCa) require a radical prostatectomy followed by postoperative radiotherapy or exclusive radiotherapy, in the modern era of image guided IMRT. 178 patients with PCa were referred for daily exclusive image guided IMRT (IG-IMRT) using an on-line 3D ultra-sound based system and 69 patients were referred for postoperative IMRT without image guidance after radical prostatectomy (RP + IMRT). Patients were matched in a 1:1 ratio according to their baseline risk group before any treatment. Late toxicity was scored using the CTV v3.0 scale. Biochemical failure was defined as a postoperative PSA ≤ 0.1 ng/mL followed by 1 consecutive rising PSA for the postoperative group of patients and by the Phoenix definition (nadir + 2 ng/mL) for the group of patients treated with exclusive radiotherapy. A total of 98 patients were matched (49:49). From the start of any treatment, the median follow-up was 56.6 months (CI 95% = [49.6-61.2], range [18.2-115.1]). No patient had late gastrointestinal grade ≥ 2 toxicity in the IG-IMRT group vs. 4% in the RP + IMRT group. Forty two percent of the patients in both groups had late grade ≥ 2 genitourinary toxicity. The 5-year FFF rates in the IG-IMRT group and in the RP + IMRT groups were 93.1% [80.0-97.8] and 76.5% [58.3-87.5], respectively (p = 0.031). Patients with a localized PCa treated with IG-IMRT had better oncological outcome than patients treated with RP + IMRT. Further improvements in postoperative IMRT using image guidance and dose escalation are urgently needed

  2. Information architecture. Volume 3: Guidance

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    The purpose of this document, as presented in Volume 1, The Foundations, is to assist the Department of Energy (DOE) in developing and promulgating information architecture guidance. This guidance is aimed at increasing the development of information architecture as a Departmentwide management best practice. This document describes departmental information architecture principles and minimum design characteristics for systems and infrastructures within the DOE Information Architecture Conceptual Model, and establishes a Departmentwide standards-based architecture program. The publication of this document fulfills the commitment to address guiding principles, promote standard architectural practices, and provide technical guidance. This document guides the transition from the baseline or defacto Departmental architecture through approved information management program plans and budgets to the future vision architecture. This document also represents another major step toward establishing a well-organized, logical foundation for the DOE information architecture.

  3. DOE Waste Treatability Group Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kirkpatrick, T.D.

    1995-01-01

    This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level.

  4. Agent Based Individual Traffic Guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen

    of the project were not previously considered. We define a special inseparable cost function and develop a solution complex capable of using this cost function. In relation to calibration and estimation of statistical models used for dynamic route guidance we worked with generating random number sequences...

  5. Consensus standard requirements and guidance

    International Nuclear Information System (INIS)

    Putman, V.L.

    1995-01-01

    This report presents information from the ANS Criticality Alarm System Workshop relating to the consensus standard requirements and guidance. Topics presented include: definition; nomenclature; requirements and recommendations; purpose of criticality alarms; design criteria; signal characteristics; reliability, dependability and durability; tests; and emergency preparedness and planning

  6. DOE Waste Treatability Group Guidance

    International Nuclear Information System (INIS)

    Kirkpatrick, T.D.

    1995-01-01

    This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level

  7. Implementation and utility of a daily ultrasound-based localization system with intensity-modulated radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Morr, Jody; DiPetrillo, Thomas; Tsai, J.-S.; Engler, Mark; Wazer, David E. MD.

    2002-01-01

    Purpose: To evaluate the clinical feasibility of daily computer-assisted transabdominal ultrasonography for target position verification in the setting of intensity-modulated radiotherapy (IMRT) for prostate cancer. Methods and Materials: Twenty-three patients with clinically localized prostate cancer were treated using a sequential tomotherapy IMRT technique (Peacock) and daily computer-assisted transabdominal ultrasonography (BAT) for target localization. Patients were instructed to maintain a full bladder and were placed in the supine position using triangulation tattoos and a leg immobilizer to minimize pelvic rotation. The BAT ultrasound system is docked to the treatment collimator and electronically imports the CT simulation target contours and isocenter. The system is able to use the machine isocenter as a reference point to overlay the corresponding CT contours onto the ultrasound images captured in the transverse and sagittal planes. A touch screen menu is used to maneuver the CT contours in three dimensions such that they match the ultrasound images. The system then displays the three-dimensional couch shifts required to produce field alignment. Data were prospectively collected to measure the frequency by which useful ultrasound images were obtained, the amount of time required for localization/setup, and the direction/magnitude of the positional adjustments. Results: Of the 23 patients, the BAT ultrasound system produced images of sufficient quality to perform the overlay of the CT contours in 19 patients such that positional verification could be reliably performed. Poor image quality was associated with patient inability to maintain a full bladder, large body habitus, or other anatomic constraints. Of the 19 assessable patients, a total of 185 treatment alignments were performed (mean 8.8/patient). For all cases, the average time required for the daily ultrasound imaging and positional adjustments was 11.9 min. After the initial 5 cases, the user

  8. High definition ultrasound imaging for battlefield medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Kwok, K.S.; Morimoto, A.K.; Kozlowski, D.M.; Krumm, J.C.; Dickey, F.M. [Sandia National Labs., Albuquerque, NM (United States); Rogers, B; Walsh, N. [Texas Univ. Health Science Center, San Antonio, TX (United States)

    1996-06-23

    A team has developed an improved resolution ultrasound system for low cost diagnostics. This paper describes the development of an ultrasound based imaging system capable of generating 3D images showing surface and subsurface tissue and bone structures. We include results of a comparative study between images obtained from X-Ray Computed Tomography (CT) and ultrasound. We found that the quality of ultrasound images compares favorably with those from CT. Volumetric and surface data extracted from these images were within 7% of the range between ultrasound and CT scans. We also include images of porcine abdominal scans from two different sets of animal trials.

  9. attitude of secondary school students towards guidance

    African Journals Online (AJOL)

    Elizabeth Egbochuku

    gender and school location significantly influenced students' attitude towards guidance ... students respond and perceive guidance and counselling services will, to ... counsellors will be appointed in post-primary institutions and tertiary levels.

  10. Guidance of attention by information held in working memory.

    Science.gov (United States)

    Calleja, Marissa Ortiz; Rich, Anina N

    2013-05-01

    Information held in working memory (WM) can guide attention during visual search. The authors of recent studies have interpreted the effect of holding verbal labels in WM as guidance of visual attention by semantic information. In a series of experiments, we tested how attention is influenced by visual features versus category-level information about complex objects held in WM. Participants either memorized an object's image or its category. While holding this information in memory, they searched for a target in a four-object search display. On exact-match trials, the memorized item reappeared as a distractor in the search display. On category-match trials, another exemplar of the memorized item appeared as a distractor. On neutral trials, none of the distractors were related to the memorized object. We found attentional guidance in visual search on both exact-match and category-match trials in Experiment 1, in which the exemplars were visually similar. When we controlled for visual similarity among the exemplars by using four possible exemplars (Exp. 2) or by using two exemplars rated as being visually dissimilar (Exp. 3), we found attentional guidance only on exact-match trials when participants memorized the object's image. The same pattern of results held when the target was invariant (Exps. 2-3) and when the target was defined semantically and varied in visual features (Exp. 4). The findings of these experiments suggest that attentional guidance by WM requires active visual information.

  11. Image-guided radiotherapy and motion management in lung cancer

    DEFF Research Database (Denmark)

    Korreman, Stine

    2015-01-01

    In this review, image guidance and motion management in radiotherapy for lung cancer is discussed. Motion characteristics of lung tumours and image guidance techniques to obtain motion information are elaborated. Possibilities for management of image guidance and motion in the various steps...

  12. Review of soil contamination guidance

    International Nuclear Information System (INIS)

    Mueller, M.A.; Kennedy, W.E. Jr.; Soldat, J.K.

    1981-08-01

    A review of existing and proposed radioactive soil contamination standards and guidance was conducted for United Nuclear Corporation (UNC), Office of Surplus Facilities Management. Information was obtained from both government agencies and other sources during a literature survey. The more applicable standards were reviewed, evaluated, and summarized. Information pertaining to soil contamination for both facility operation and facility decommissioning was obtained from a variety of sources. These sources included: the Code of Federal Regulations, regulatory guides, the Federal Register, topical reports written by various government agencies, topical reports written by national laboratories, and publications from the American National Standards Institute (ANSI). It was difficult to directly compare the standards and guidance obtained from these sources since each was intended for a specific situation and different units or bases were used. However, most of the information reviewed was consistent with the philosophy of maintaining exposures at levels as low as reasonably achievable

  13. Guidance on future art commissioning.

    Science.gov (United States)

    2009-05-01

    Delegates at Building Better Healthcare's recent "National Patient Environment and the Arts Conference 2009" in London heard how national public arts think tank ixia has appointed Bristol-based arts and wellbeing development agency Willis Newson to write "concise and convincing guidance" on commissioning art for new healthcare facilities. A key message, during a joint presentation, was that integrating artwork into hospitals and other healthcare premises requires the earliest possible consideration to reap the maximum rewards.

  14. Current materiality guidance for auditors

    OpenAIRE

    McKee, Thomas E.; Eilifsen, Aasmund

    2000-01-01

    Auditors have to make materiality judgments on every audit. This is a difficult process, as both quantitative and qualitative factors have to be evaluated. Additionally, there is no formal guidance for how to implement the materiality concepts discussed in the auditing standards. Although they are sometimes difficult to make, good materiality judgments are crucial for the conduct of a successful audit as poor judgments can result in an audit that is ineffective and/or inefficient. This report...

  15. 2011 Army Strategic Planning Guidance

    Science.gov (United States)

    2011-03-25

    TESI ) of 22,000 Soldiers, the Army’s total force by the end of the mid-term period is programmed to be 520K (AC). We will achieve a more...dwell ratios, extending TESI authority to adequately man deploying units and sustain the All-Volunteer Force, right-sizing the generating force, and... TESI Temporary End-Strength Increase WMD Weapons of Mass Destruction 2011 ARMY STRATEGIC PLANNING GUIDANCE Page 19 2011

  16. Vocational guidance in social volunteering

    Directory of Open Access Journals (Sweden)

    Nikolay S. Pryazhnikov

    2017-03-01

    Full Text Available The paper discusses the possibilities and limitations of vocational guidance in the social volunteering system. The essence of volunteer work is closely related with assistance to desperate people in searching for the meaning of living, often coinciding with labour activity that are deemed in terms of “the main matter of life” and “the leading activity”. For adolescents, it is the choice of career, and for adults, it is the work proper (i.e. an essential condition for personal self-realization. The problem of “forced volunteering” for experts in vocational guidance also means that they often have to work voluntarily and unselfishly outside the official guidelines. To clarify the terms «volunteer» and «a person in desperate need of help» the study used the method of analyzing the documents, e.g. the Regulations on Social Volunteering, the generalization of psychological sources, the initial survey of university students as active supporters of the volunteer movement, On the essence of volunteering and the place of career guidance in selfless social work. Vocational guidance is not excluded from the general system of volunteerism, but has an insufficiently defined status and low popularity among participants in social volunteering. Also, the problem of «forced volunteering» of experts in career counseling, which often requires voluntary and unselfish performance of quality work outside the framework of official instructions, is also indicated. Simultaneously, positive aspects of such disinterested career initiatives are noted, in particular, less control by the official inspectors (or customers and, accordingly, greater freedom of creativity than when someone else does the work.

  17. Individual plant examination: Submittal guidance

    International Nuclear Information System (INIS)

    1989-08-01

    Based on a Policy Statement on Severe Accidents Regarding Future Designs and Existing Plants, the performance of a plant examination is requested from the licensee of each nuclear power plant. The plant examination looks for vulnerabilities to severe accidents and cost-effective safety improvements that reduce or eliminate the important vulnerabilities. This document delineates guidance for reporting the results of that plant examination. 38 refs., 2 tabs

  18. Quality Assurance in University Guidance Services

    Science.gov (United States)

    Simon, Alexandra

    2014-01-01

    In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…

  19. Providing Career Guidance for Young Women.

    Science.gov (United States)

    Colby, Pamela G.

    This module is directed at personnel working or planning to work in the areas of guidance, counseling, placement and follow-through in junior and senior high school settings, grades 7-12. The module topic is career guidance for young women of junior and senior high school age, aand the focus will be on providing nonbiased career guidance which…

  20. Radionuclide Data Quality Evaluation Guidance

    International Nuclear Information System (INIS)

    Tucker, B.J.; Winters, M.S.; Evans, D.

    2009-01-01

    A considerable amount of radioanalytical data is generated during various phases of the characterization and remediation of radiologically-contaminated sites and properties. It is critical that data generated from the analysis of collected samples be to a level of quality usable by the project and acceptable to stakeholders. In July 2004, the final version of a multi-agency guidance manual entitled Multi-Agency Radiological Analytical Protocols Manual (MARLAP) was issued by the Environmental Protection Agency, Department of Energy, Department of Homeland Security, Nuclear Regulatory Commission, Department of Defense, National Institute of Standards and Technology, U. S. Geological Survey, Food and Drug Administration, and the States of Kentucky and California. The authors' purpose is to introduce readers to some key elements of MARLAP as it relates to radioanalytical lab quality control, and to demonstrate how these guidance elements can be effectively incorporated into mature radioanalytical lab operations and data validation regimes. Based upon the logic and statistical methodologies presented in MARLAP, the authors have revised existing project-specific Radioanalytical Data Evaluation Guidance (RadDEG) used at the FUSRAP Maywood Site in Maywood, NJ. The RadDEG allows users to qualify data in a meaningful way by tying the usability of the data to its activity and uncertainty relative to project action levels and QC results. This exercise may be useful to other projects looking to implement a MARLAP-based approach into their project/site-specific data evaluation methodologies. (authors)

  1. 78 FR 4848 - Social Media: Consumer Compliance Risk Management Guidance

    Science.gov (United States)

    2013-01-23

    ...: Consumer Compliance Risk Management Guidance AGENCY: Federal Financial Institutions Examination Council... Media: Consumer Compliance Risk Management Guidance'' (guidance). Upon completion of the guidance, and... management practices adequately address the consumer compliance and legal risks, as well as related risks...

  2. SU-E-J-244: Validation of a 6D-Robotic-Couch and Image Guidance Radiation Therapy (IGRT) System for Localization in World's First Single-Room Proton Therapy System

    Energy Technology Data Exchange (ETDEWEB)

    Rankine, L; Klein, E [Washington University, Saint Louis, MO (United States); Grantham, K [University of Missouri, Columbia, MO (United States); Goddu, S [Washington University, St. Louis, MO (United States); Cessac, R [Mevion Medical Systems, Littleton, MA (United States); Baker, K [Barne-Jewish Hospital, St. Louis, MO (United States); Santanam, L [Washington University School of Medicine, St.louis, MO (United States)

    2014-06-01

    Purpose: The Mevion S250 proton therapy unit is equipped with a 6D-robotic couch and IGRT system (Verity). The patient alignment process allows corrections in six degrees of freedom: translation (x,y,z), pitch, roll, and yaw (θ,ϑ,ψ). Geometric accuracy of couch corrections and imaging vs. radiation isocenter coincidence were quantified before clinical implementation. Methods: A commercial phantom with sixteen 2mm tungsten BBs was rigidly couch-mounted and imaged with CT. Seventeen rigid translations/rotations of known magnitude were digitally applied to the original CT image using commercial software, validated with Varian OBI system. For each altered image, phantom was mounted on robotic couch in original position, then Verity 2D:2D match (PA-LLAT) was performed using DRRs from altered images. Corrections were recorded and applied, phantom was imaged a second time and residual corrections recorded. Physical measurements verified that applied couch corrections coincided with both physical couch shifts/rotations and known CT image translations/rotations. Additionally, image vs. radiation isocenter coicidence was quantified over couch treatment angles (±90° from setup position) using radiochromic film and an image-guided couch star-shot. Posterior-anterior and left-lateral kV radiographs were taken before each beam was delivered to verify imaging/radiation isocentricity. Results: Verity suggested couch corrections and known CT shifts/rotations agreed within ±1mm (average: Δ lat=0.5mm; Δ vert=0.4mm; Δ long=0.3mm) and ± 0.4° (average: Δ pitch=0.24° Δ roll=0.01°; Δ yaw=0.10°). Physical couch measurements and Verity applied corrections agreed within ± 1mm (average: Δlat=0.5mm; Δvert=0.4mm; Δlong=0.2mm) and ±0.2° (average: Δpitch=0.03°; Δ roll=0.04°; Δ yaw=0.04°). The directionality of all translations and rotations were qualitatively verified. The image vs. radiation isocenter coincidence was <1mm and radiation-isocenter precision was <1mm

  3. Design and implementation of a GPS guidance system for agricultural tractors using augmented reality technology.

    Science.gov (United States)

    Santana-Fernández, Javier; Gómez-Gil, Jaime; del-Pozo-San-Cirilo, Laura

    2010-01-01

    Current commercial tractor guidance systems present to the driver information to perform agricultural tasks in the best way. This information generally includes a treated zones map referenced to the tractor's position. Unlike actual guidance systems where the tractor driver must mentally associate treated zone maps and the plot layout, this paper presents a guidance system that using Augmented Reality (AR) technology, allows the tractor driver to see the real plot though eye monitor glasses with the treated zones in a different color. The paper includes a description of the system hardware and software, a real test done with image captures seen by the tractor driver, and a discussion predicting that the historical evolution of guidance systems could involve the use of AR technology in the agricultural guidance and monitoring systems.

  4. Design and Implementation of a GPS Guidance System for Agricultural Tractors Using Augmented Reality Technology

    Directory of Open Access Journals (Sweden)

    Laura del-Pozo-San-Cirilo

    2010-11-01

    Full Text Available Current commercial tractor guidance systems present to the driver information to perform agricultural tasks in the best way. This information generally includes a treated zones map referenced to the tractor’s position. Unlike actual guidance systems where the tractor driver must mentally associate treated zone maps and the plot layout, this paper presents a guidance system that using Augmented Reality (AR technology, allows the tractor driver to see the real plot though eye monitor glasses with the treated zones in a different color. The paper includes a description of the system hardware and software, a real test done with image captures seen by the tractor driver, and a discussion predicting that the historical evolution of guidance systems could involve the use of AR technology in the agricultural guidance and monitoring systems.

  5. Guidance on accidents involving radioactivity

    International Nuclear Information System (INIS)

    1989-01-01

    This annex contains advice to Health Authorities on their response to accidents involving radioactivity. The guidance is in six parts:-(1) planning the response required to nuclear accidents overseas, (2) planning the response required to UK nuclear accidents a) emergency plans for nuclear installations b) nuclear powered satellites, (3) the handling of casualties contaminated with radioactive substances, (4) background information for dealing with queries from the public in the event of an accident, (5) the national arrangements for incident involving radioactivity (NAIR), (6) administrative arrangements. (author)

  6. Agent Based Individual Traffic guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen Bundgaard

    2004-01-01

    When working with traffic planning or guidance it is common practice to view the vehicles as a combined mass. >From this models are employed to specify the vehicle supply and demand for each region. As the models are complex and the calculations are equally demanding the regions and the detail...... of the road network is aggregated. As a result the calculations reveal only what the mass of vehicles are doing and not what a single vehicle is doing. This is the crucial difference to ABIT (Agent Based Individual Trafficguidance). ABIT is based on the fact that information on the destination of each vehicle...

  7. SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

    International Nuclear Information System (INIS)

    Pollock, S; Keall, P; Keall, R

    2015-01-01

    Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

  8. SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, S; Keall, P [University of Sydney, Sydney (Australia); Keall, R [Hammond Care Palliative and Supportive Care Service, Sydney, NSW (Australia)

    2015-06-15

    Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

  9. Advanced approach for intraoperative MRI guidance and potential benefit for neurosurgical applications.

    Science.gov (United States)

    Busse, Harald; Schmitgen, Arno; Trantakis, Christos; Schober, Ralf; Kahn, Thomas; Moche, Michael

    2006-07-01

    To present an advanced approach for intraoperative image guidance in an open 0.5 T MRI and to evaluate its effectiveness for neurosurgical interventions by comparison with a dynamic scan-guided localization technique. The built-in scan guidance mode relied on successive interactive MRI scans. The additional advanced mode provided real-time navigation based on reformatted high-quality, intraoperatively acquired MR reference data, allowed multimodal image fusion, and used the successive scans of the built-in mode for quick verification of the position only. Analysis involved tumor resections and biopsies in either scan guidance (N = 36) or advanced mode (N = 59) by the same three neurosurgeons. Technical, surgical, and workflow aspects were compared. The image quality and hand-eye coordination of the advanced approach were improved. While the average extent of resection, neurologic outcome after functional MRI (fMRI) integration, and diagnostic yield appeared to be slightly better under advanced guidance, particularly for the main surgeon, statistical analysis revealed no significant differences. Resection times were comparable, while biopsies took around 30 minutes longer. The presented approach is safe and provides more detailed images and higher navigation speed at the expense of actuality. The surgical outcome achieved with advanced guidance is (at least) as good as that obtained with dynamic scan guidance. (c) 2006 Wiley-Liss, Inc.

  10. Ultrasound-based scores as predictors for nodular hyperplasia in patients with secondary hyperparathyroidism: a prospective validation study.

    Science.gov (United States)

    Gwiasda, Jill; Kaltenborn, Alexander; Müller, Jörg A; Serttas, Michaela; Scheumann, Georg W F; Schrem, Harald; Jäger, Mark D

    2017-03-01

    Former studies evaluated echostructural and vascular patterns in ultrasound of the parathyroid gland to identify nodular hyperplasia in patients with secondary hyperparathyroidism due to chronic kidney disease. This prospective study aims to externally validate suggested ultrasound classifications. Parathyroid glands of 27 patients with secondary hyperparathyroidism undergoing parathyroidectomy were prospectively analyzed. Ultrasound including Doppler imaging was performed 1 day prior to surgery. Ultrasound data were available for 70 parathyroid glands. Echostructural and vascular scores according to previous studies were applied calculating the area under the receiver operating characteristic curve (AUROC). Overall correctness, sensitivity, and specificity of the investigated scores were assessed with the Youden index method. The Doppler score introduced by Vulpio and colleagues based on characteristic blood flow patterns in parathyroid glands showed an AUROC of 0.749 for the prediction of nodular hyperplasia with an overall correctness of 72.8%. Other ultrasound classifications based on blood flow patterns, as well as echostructure of the parathyroid gland displayed AUROCs of secondary hyperparathyroidism was externally validated for the first time. Other ultrasound scores fail as prognostic models in this study population. Doppler sonography of the parathyroid gland has prognostic capability to identify nodular hyperplasia as surrogate marker for patients with secondary hyperparathyroidism indicating the need for ablative or surgical treatment when failing conservative therapy.

  11. Techniques for Interventional MRI Guidance in Closed-Bore Systems.

    Science.gov (United States)

    Busse, Harald; Kahn, Thomas; Moche, Michael

    2018-02-01

    Efficient image guidance is the basis for minimally invasive interventions. In comparison with X-ray, computed tomography (CT), or ultrasound imaging, magnetic resonance imaging (MRI) provides the best soft tissue contrast without ionizing radiation and is therefore predestined for procedural control. But MRI is also characterized by spatial constraints, electromagnetic interactions, long imaging times, and resulting workflow issues. Although many technical requirements have been met over the years-most notably magnetic resonance (MR) compatibility of tools, interventional pulse sequences, and powerful processing hardware and software-there is still a large variety of stand-alone devices and systems for specific procedures only.Stereotactic guidance with the table outside the magnet is common and relies on proper registration of the guiding grids or manipulators to the MR images. Instrument tracking, often by optical sensing, can be added to provide the physicians with proper eye-hand coordination during their navigated approach. Only in very short wide-bore systems, needles can be advanced at the extended arm under near real-time imaging. In standard magnets, control and workflow may be improved by remote operation using robotic or manual driving elements.This work highlights a number of devices and techniques for different interventional settings with a focus on percutaneous, interstitial procedures in different organ regions. The goal is to identify technical and procedural elements that might be relevant for interventional guidance in a broader context, independent of the clinical application given here. Key challenges remain the seamless integration into the interventional workflow, safe clinical translation, and proper cost effectiveness.

  12. New modalities of ultrasound-based intima-media thickness, arterial stiffness and non-coronary vascular calcifications detection to assess cardiovascular risk.

    Science.gov (United States)

    Flore, R; Ponziani, F R; Tinelli, G; Arena, V; Fonnesu, C; Nesci, A; Santoro, L; Tondi, P; Santoliquido, A

    2015-04-01

    Carotid intima-media thickness (c-IMT), arterial stiffness (AS) and vascular calcification (VC) are now considered important new markers of atherosclerosis and have been associated with increased prevalence of cardiovascular events. An accurate, reproducible and easy detection of these parameters could increase the prognostic value of the traditional cardiovascular risk factors in many subjects at low and intermediate risk. Today, c-IMT and AS can be measured by ultrasound, while cardiac computed tomography is the gold standard to quantify coronary VC, although concern about the reproducibility of the former and the safety of the latter have been raised. Nevertheless, a safe and reliable method to quantify non-coronary (i.e., peripheral) VC has not been detected yet. To review the most innovative and accurate ultrasound-based modalities of c-IMT and AS detection and to describe a novel UltraSound-Based Carotid, Aortic and Lower limbs Calcification Score (USB-CALCs, simply named CALC), allowing to quantify peripheral calcifications. Finally, to propose a system for cardiovascular risk reclassification derived from the global evaluation of "Quality Intima-Media Thickness", "Quality Arterial Stiffness", and "CALC score" in addition to the Framingham score.

  13. Challenging the in-vivo assessment of biomechanical properties of the uterine cervix: A critical analysis of ultrasound based quasi-static procedures.

    Science.gov (United States)

    Maurer, M M; Badir, S; Pensalfini, M; Bajka, M; Abitabile, P; Zimmermann, R; Mazza, E

    2015-06-25

    Measuring the stiffness of the uterine cervix might be useful in the prediction of preterm delivery, a still unsolved health issue of global dimensions. Recently, a number of clinical studies have addressed this topic, proposing quantitative methods for the assessment of the mechanical properties of the cervix. Quasi-static elastography, maximum compressibility using ultrasound and aspiration tests have been applied for this purpose. The results obtained with the different methods seem to provide contradictory information about the physiologic development of cervical stiffness during pregnancy. Simulations and experiments were performed in order to rationalize the findings obtained with ultrasound based, quasi-static procedures. The experimental and computational results clearly illustrate that standardization of quasi-static elastography leads to repeatable strain values, but for different loading forces. Since force cannot be controlled, this current approach does not allow the distinction between a globally soft and stiff cervix. It is further shown that introducing a reference elastomer into the elastography measurement might overcome the problem of force standardization, but a careful mechanical analysis is required to obtain reliable stiffness values for cervical tissue. In contrast, the maximum compressibility procedure leads to a repeatable, semi-quantitative assessment of cervical consistency, due to the nonlinear nature of the mechanical behavior of cervical tissue. The evolution of cervical stiffness in pregnancy obtained with this procedure is in line with data from aspiration tests. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Ecological Restoration: Guidance from Theory

    Directory of Open Access Journals (Sweden)

    Joy Zedler

    2005-09-01

    Full Text Available A review of the science and practice of ecosystem restoration led me to identify key ecological theories and concepts that are relevant to planning, implementing, and sustaining restoration efforts. From experience with actual restoration projects, I provide guidance for improving the restoration process. Despite an abundance of theory and guidance, restoration goals are not always achieved, and pathways toward targets are not highly predictable. This is understandable, since each restoration project has many constraints and unique challenges. To improve restoration progress, I advise that sites be designed as experiments to allow learning while doing. At least the larger projects can be restored in phases, each designed as experimental treatments to test alternative restoration approaches. Subsequent phases can then adopt one or more of the treatments that best achieved goals in earlier phases while applying new tests of other restoration measures. Both science and restoration can progress simultaneously. This phased, experimental approach (called “adaptive restoration” is an effective tool for improving restoration when monitoring, assessment, interpretation and research are integrated into the process.

  15. Laser guidance of mesoscale particles

    Science.gov (United States)

    Underdown, Frank Hartman, Jr.

    Mesoscale particles are guided and trapped in hollow optical fibers using radiation pressure forces. Laser light from a 0.4W, 780nm diode laser is guided in a low- loss fiber mode and used to generate the guidance forces. Laser scattering and absorption forces propels particles along the fiber and polarization gradient forces attract them to the fiber's axial center. Using two counter propagating laser beams, inside the fiber, particles can be trapped in three dimensions. Measuring the spring constant of the trap gives the gradient force. This dissertation describes Rayleigh and Mie scattering models for calculating guidance forces. Calculated forces as a function of particle size and composition (i.e. dielectric, semiconductor, and metals) will be presented. For example, under typical experimental conditions 100nm Au particles are guided by a 2 × 10-14 N propulsive force in a water filled fiber. In comparison, the measured force, obtained from the particle's velocity and Stokes' law, is 7.98 × 10-14 N.

  16. Efficacy and safety in performing of large bore percutaneous nephrostomy under ultrasound guidance

    International Nuclear Information System (INIS)

    Smilov, N.; Mlachkova, D.; Rizov, A.; Lozev, I.

    2009-01-01

    The aim of the study was to compare the success rate, complications and the outcomes from large-bore percutaneous nephrostomy under ultrasound guidance performed to 178 cases with another 54 when nephrostomy under x-ray control was performed. We have performed 178 large-bore percutaneous nephrostomy under ultrasound guidance and another 54 percutaneous nephrostomy under x-ray guidance to patients diagnosed with obstructive uropathy resulting from benign or malignant supravesical obstruction. We have performed successful nephrostomy in 93,8% of the cases under ultrasound guidance and 100% successful nephrostomy in the cases under x-ray control. In 2,8% of patients under ultrasound guidance the nephrostomy was performed using 4 additional punctures of the pyelocaliceal system and artificially caused hydronephrosis via infiltration of normal saline; and in the remaining 1,7% it was successful at the second attempt after 24 hours. It was not necessary to perform open surgery nephrostomy in any of the cases. The performance of percutaneous nephrostomy under ultrasound guidance has a success rate similar to the one done under x-ray guidance and with commensurable frequency and severity of complications, however without the patient and the operator being exposed to x-ray radiation. In general, the percutaneous nephrostomy under ultrasound guidance is performed without difficulties in the cases of third or fourth degree hydronephrosis. The lateral decubital patient position, the appropriate place for the puncture, the usage of Color Doppler imaging when the puncture is performed and the continuos ultrasound guidance during dilatation and placement of the nephrostomy tube should ensure the successful performance of the procedure in the case of first or second degree hydronephrosis. When hydronephrosis is absent, the nephrostomy should be performed under x-ray guidance. In emergency cases the application of ultrasound guidance allows the nephrostomy to be performed along the

  17. Comparison of Real-Time Intraoperative Ultrasound-Based Dosimetry With Postoperative Computed Tomography-Based Dosimetry for Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Nag, Subir; Shi Peipei; Liu Bingren; Gupta, Nilendu; Bahnson, Robert R.; Wang, Jian Z.

    2008-01-01

    Purpose: To evaluate whether real-time intraoperative ultrasound (US)-based dosimetry can replace conventional postoperative computed tomography (CT)-based dosimetry in prostate brachytherapy. Methods and Materials: Between December 2001 and November 2002, 82 patients underwent 103 Pd prostate brachytherapy. An interplant treatment planning system was used for real-time intraoperative transrectal US-guided treatment planning. The dose distribution was updated according to the estimated seed position to obtain the dose-volume histograms. Postoperative CT-based dosimetry was performed a few hours later using the Theraplan-Plus treatment planning system. The dosimetric parameters obtained from the two imaging modalities were compared. Results: The results of this study revealed correlations between the US- and CT-based dosimetry. However, large variations were found in the implant-quality parameters of the two modalities, including the doses covering 100%, 90%, and 80% of the prostate volume and prostate volumes covered by 100%, 150%, and 200% of the prescription dose. The mean relative difference was 38% and 16% for doses covering 100% and 90% of the prostate volume and 10% and 21% for prostate volumes covered by 100% and 150% of the prescription dose, respectively. The CT-based volume covered by 200% of the prescription dose was about 30% greater than the US-based one. Compared with CT-based dosimetry, US-based dosimetry significantly underestimated the dose to normal organs, especially for the rectum. The average US-based maximal dose and volume covered by 100% of the prescription dose for the rectum was 72 Gy and 0.01 cm 3 , respectively, much lower than the 159 Gy and 0.65 cm 3 obtained using CT-based dosimetry. Conclusion: Although dosimetry using intraoperative US-based planning provides preliminary real-time information, it does not accurately reflect the postoperative CT-based dosimetry. Until studies have determined whether US-based dosimetry or

  18. Multimodal system for the planning and guidance of bronchoscopy

    Science.gov (United States)

    Higgins, William E.; Cheirsilp, Ronnarit; Zang, Xiaonan; Byrnes, Patrick

    2015-03-01

    Many technical innovations in multimodal radiologic imaging and bronchoscopy have emerged recently in the effort against lung cancer. Modern X-ray computed-tomography (CT) scanners provide three-dimensional (3D) high-resolution chest images, positron emission tomography (PET) scanners give complementary molecular imaging data, and new integrated PET/CT scanners combine the strengths of both modalities. State-of-the-art bronchoscopes permit minimally invasive tissue sampling, with vivid endobronchial video enabling navigation deep into the airway-tree periphery, while complementary endobronchial ultrasound (EBUS) reveals local views of anatomical structures outside the airways. In addition, image-guided intervention (IGI) systems have proven their utility for CT-based planning and guidance of bronchoscopy. Unfortunately, no IGI system exists that integrates all sources effectively through the complete lung-cancer staging work flow. This paper presents a prototype of a computer-based multimodal IGI system that strives to fill this need. The system combines a wide range of automatic and semi-automatic image-processing tools for multimodal data fusion and procedure planning. It also provides a flexible graphical user interface for follow-on guidance of bronchoscopy/EBUS. Human-study results demonstrate the system's potential.

  19. Intraoperative magnetic tracker calibration using a magneto-optic hybrid tracker for 3-D ultrasound-based navigation in laparoscopic surgery.

    Science.gov (United States)

    Nakamoto, Masahiko; Nakada, Kazuhisa; Sato, Yoshinobu; Konishi, Kozo; Hashizume, Makoto; Tamura, Shinichi

    2008-02-01

    This paper describes a ultrasound (3-D US) system that aims to achieve augmented reality (AR) visualization during laparoscopic surgery, especially for the liver. To acquire 3-D US data of the liver, the tip of a laparoscopic ultrasound probe is tracked inside the abdominal cavity using a magnetic tracker. The accuracy of magnetic trackers, however, is greatly affected by magnetic field distortion that results from the close proximity of metal objects and electronic equipment, which is usually unavoidable in the operating room. In this paper, we describe a calibration method for intraoperative magnetic distortion that can be applied to laparoscopic 3-D US data acquisition; we evaluate the accuracy and feasibility of the method by in vitro and in vivo experiments. Although calibration data can be acquired freehand using a magneto-optic hybrid tracker, there are two problems associated with this method--error caused by the time delay between measurements of the optical and magnetic trackers, and instability of the calibration accuracy that results from the uniformity and density of calibration data. A temporal calibration procedure is developed to estimate the time delay, which is then integrated into the calibration, and a distortion model is formulated by zeroth-degree to fourth-degree polynomial fitting to the calibration data. In the in vivo experiment using a pig, the positional error caused by magnetic distortion was reduced from 44.1 to 2.9 mm. The standard deviation of corrected target positions was less than 1.0 mm. Freehand acquisition of calibration data was performed smoothly using a magneto-optic hybrid sampling tool through a trocar under guidance by realtime 3-D monitoring of the tool trajectory; data acquisition time was less than 2 min. The present study suggests that our proposed method could correct for magnetic field distortion inside the patient's abdomen during a laparoscopic procedure within a clinically permissible period of time, as well as

  20. ICRP guidance on radioactive waste disposal

    International Nuclear Information System (INIS)

    Cooper, J.R.

    2002-01-01

    The International Commission on Radiological Protection (ICRP) issued recommendations for a system of radiological protection in 1991 as the 1990 Recommendations. Guidance on the application of these recommendations in the general area of waste disposal was issued in 1997 as Publication 77 and guidance specific to disposal of solid long-lived radioactive waste was issued as Publication 81. This paper summarises ICRP guidance in radiological protection requirements for waste disposal concentrating on the ones of relevance to the geological disposal of solid radioactive waste. Suggestions are made for areas where further work is required to apply the ICRP guidance. (author)

  1. Widening opportunities for career guidance

    DEFF Research Database (Denmark)

    Poulsen, Bo Klindt; Skovhus, Randi Boelskifte; Thomsen, Rie

    2017-01-01

    This chapter discusses research circles as a way of organising collaboration between career guidance researchers and practitioners. Such collaboration, it is argued, helps resist neoliberal governance mechanisms and supports social justice perspectives among teachers involved in the provision...... of career education in Danish schools. Based on a research and development project on career education, case analysis is used to explore research circles as a means for collaboration between researchers and practitioners. This analysis shows that research circles provide teachers with a space to reflect...... both in and on action. Career education is the key focus of the case presented in this chapter and it is argued that, in order to increase social mobility through education, there is a need to widen opportunities through experience-based activities among pupils in Danish schools. The chapter contends...

  2. Widening opportunities for career guidance

    DEFF Research Database (Denmark)

    Poulsen, Bo Klindt; Skovhus, Randi Boelskifte; Thomsen, Rie

    2018-01-01

    This chapter discusses research circles as a way of organising collaboration between career guidance researchers and practitioners. Such collaboration, it is argued, helps resist neoliberal governance mechanisms and supports social justice perspectives among teachers involved in the provision...... of career education in Danish schools. Based on a research and development project on career education, case analysis is used to explore research circles as a means for collaboration between researchers and practitioners. This analysis shows that research circles provide teachers with a space to reflect...... both in and on action. Career education is the key focus of the case presented in this chapter and it is argued that, in order to increase social mobility through education, there is a need to widen opportunities through experience-based activities among pupils in Danish schools. The chapter contends...

  3. Breathing guidance in radiation oncology and radiology: A systematic review of patient and healthy volunteer studies

    International Nuclear Information System (INIS)

    Pollock, Sean; Keall, Paul; Keall, Robyn

    2015-01-01

    Purpose: The advent of image-guided radiation therapy has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion irregularities is the use of breathing guidance systems during imaging and treatment. These systems aim to facilitate regular respiratory motion which in turn improves image quality and radiation treatment accuracy. A review of such research has yet to be performed; it was therefore their aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: From August 1–14, 2014, the following online databases were searched: Medline, Embase, PubMed, and Web of Science. Results of these searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with preferred reporting items for systematic reviews and meta-analyses. Reference lists of included articles, and repeat authors of included articles, were hand-searched. Results: The systematic search yielded a total of 480 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. These 27 articles detailed the intervention of breathing guidance strategies in controlled studies assessing its impact on such outcomes as breathing regularity, image quality, target coverage, and treatment margins, recruiting either healthy adult volunteers or patients with thoracic or abdominal lesions. In 21/27 studies, significant (p < 0.05) improvements from the use of breathing guidance were observed. Conclusions: There is a trend toward the number of breathing guidance studies increasing with time, indicating a growing clinical interest. The results found here indicate that further clinical studies are warranted that quantify the

  4. Breathing guidance in radiation oncology and radiology: A systematic review of patient and healthy volunteer studies

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, Sean, E-mail: sean.pollock@sydney.edu.au; Keall, Paul [Radiation Physics Laboratory, University of Sydney, Sydney 2050 (Australia); Keall, Robyn [Central School of Medicine, University of Sydney, Sydney 2050, Australia and Hammond Care, Palliative Care and Supportive Care Service, Greenwich 2065 (Australia)

    2015-09-15

    Purpose: The advent of image-guided radiation therapy has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion irregularities is the use of breathing guidance systems during imaging and treatment. These systems aim to facilitate regular respiratory motion which in turn improves image quality and radiation treatment accuracy. A review of such research has yet to be performed; it was therefore their aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: From August 1–14, 2014, the following online databases were searched: Medline, Embase, PubMed, and Web of Science. Results of these searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with preferred reporting items for systematic reviews and meta-analyses. Reference lists of included articles, and repeat authors of included articles, were hand-searched. Results: The systematic search yielded a total of 480 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. These 27 articles detailed the intervention of breathing guidance strategies in controlled studies assessing its impact on such outcomes as breathing regularity, image quality, target coverage, and treatment margins, recruiting either healthy adult volunteers or patients with thoracic or abdominal lesions. In 21/27 studies, significant (p < 0.05) improvements from the use of breathing guidance were observed. Conclusions: There is a trend toward the number of breathing guidance studies increasing with time, indicating a growing clinical interest. The results found here indicate that further clinical studies are warranted that quantify the

  5. Guidance for evidence-informed policies about health systems: rationale for and challenges of guidance development.

    Directory of Open Access Journals (Sweden)

    Xavier Bosch-Capblanch

    Full Text Available In the first paper in a three-part series on health systems guidance, Xavier Bosch-Capblanch and colleagues examine how guidance is currently formulated in low- and middle-income countries, and the challenges to developing such guidance.

  6. 78 FR 48175 - Retrospective Review of Draft Guidance Documents Issued Before 2010; Withdrawal of Guidances

    Science.gov (United States)

    2013-08-07

    ... guidances (number 19 through 22), contact the Office of Pharmaceutical Science in CDER. 23. ``Qualifying for... to the pharmaceutical industry. In most cases, FDA has developed other guidances and resources to... guidances: 1. ``Manufacturing, Processing, or Holding Active Pharmaceutical Ingredients''--issued April 1998...

  7. Imaging

    International Nuclear Information System (INIS)

    Kellum, C.D.; Fisher, L.M.; Tegtmeyer, C.J.

    1987-01-01

    This paper examines the advantages of the use of excretory urography for diagnosis. According to the authors, excretory urography remains the basic radiologic examination of the urinary tract and is the foundation for the evaluation of suspected urologic disease. Despite development of the newer diagnostic modalities such as isotope scanning, ultrasonography, CT, and magnetic resonsance imaging (MRI), excretory urography has maintained a prominent role in ruorradiology. Some indications have been altered and will continue to change with the newer imaging modalities, but the initial evaluation of suspected urinary tract structural abnormalities; hematuria, pyuria, and calculus disease is best performed with excretory urography. The examination is relatively inexpensive and simple to perform, with few contraindictions. Excretory urography, when properly performed, can provide valuable information about the renal parenchyma, pelvicalyceal system, ureters, and urinary bladder

  8. Fusion Guidance in Endovascular Peripheral Artery Interventions: A Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Sailer, Anna M., E-mail: anni.sailer@mumc.nl; Haan, Michiel W. de, E-mail: m.de.haan@mumc.nl; Graaf, Rick de, E-mail: r.de.graaf@mumc.nl; Zwam, Willem H. van, E-mail: w.van.zwam@mumc.nl [Maastricht University Medical Center, Department of Radiology (Netherlands); Schurink, Geert Willem H., E-mail: gwh.schurink@mumc.nl [Maastricht University Medical Center, Department of Surgery (Netherlands); Nelemans, Patricia J., E-mail: patty.nelemans@maastrichtuniversity.nl [Maastricht University Medical Centre, Department of Epidemiology (Netherlands); Wildberger, Joachim E., E-mail: j.wildberger@mumc.nl; Das, Marco, E-mail: m.das@mumc.nl [Maastricht University Medical Center, Department of Radiology (Netherlands)

    2015-04-15

    PurposeThis study was designed to evaluate the feasibility of endovascular guidance by means of live fluoroscopy fusion with magnetic resonance angiography (MRA) and computed tomography angiography (CTA).MethodsFusion guidance was evaluated in 20 endovascular peripheral artery interventions in 17 patients. Fifteen patients had received preinterventional diagnostic MRA and two patients had undergone CTA. Time for fluoroscopy with MRA/CTA coregistration was recorded. Feasibility of fusion guidance was evaluated according to the following criteria: for every procedure the executing interventional radiologists recorded whether 3D road-mapping provided added value (yes vs. no) and whether PTA and/or stenting could be performed relying on the fusion road-map without need for diagnostic contrast-enhanced angiogram series (CEAS) (yes vs. no). Precision of the fusion road-map was evaluated by recording maximum differences between the position of the vasculature on the virtual CTA/MRA images and conventional angiography.ResultsAverage time needed for image coregistration was 5 ± 2 min. Three-dimensional road-map added value was experienced in 15 procedures in 12 patients. In half of the patients (8/17), intervention was performed relying on the fusion road-map only, without diagnostic CEAS. In two patients, MRA roadmap showed a false-positive lesion. Excluding three patients with inordinate movements, mean difference in position of vasculature on angiography and MRA/CTA road-map was 1.86 ± 0.95 mm, implying that approximately 95 % of differences were between 0 and 3.72 mm (2 ± 1.96 standard deviation).ConclusionsFluoroscopy with MRA/CTA fusion guidance for peripheral artery interventions is feasible. By reducing the number of CEAS, this technology may contribute to enhance procedural safety.

  9. Fusion Guidance in Endovascular Peripheral Artery Interventions: A Feasibility Study

    International Nuclear Information System (INIS)

    Sailer, Anna M.; Haan, Michiel W. de; Graaf, Rick de; Zwam, Willem H. van; Schurink, Geert Willem H.; Nelemans, Patricia J.; Wildberger, Joachim E.; Das, Marco

    2015-01-01

    PurposeThis study was designed to evaluate the feasibility of endovascular guidance by means of live fluoroscopy fusion with magnetic resonance angiography (MRA) and computed tomography angiography (CTA).MethodsFusion guidance was evaluated in 20 endovascular peripheral artery interventions in 17 patients. Fifteen patients had received preinterventional diagnostic MRA and two patients had undergone CTA. Time for fluoroscopy with MRA/CTA coregistration was recorded. Feasibility of fusion guidance was evaluated according to the following criteria: for every procedure the executing interventional radiologists recorded whether 3D road-mapping provided added value (yes vs. no) and whether PTA and/or stenting could be performed relying on the fusion road-map without need for diagnostic contrast-enhanced angiogram series (CEAS) (yes vs. no). Precision of the fusion road-map was evaluated by recording maximum differences between the position of the vasculature on the virtual CTA/MRA images and conventional angiography.ResultsAverage time needed for image coregistration was 5 ± 2 min. Three-dimensional road-map added value was experienced in 15 procedures in 12 patients. In half of the patients (8/17), intervention was performed relying on the fusion road-map only, without diagnostic CEAS. In two patients, MRA roadmap showed a false-positive lesion. Excluding three patients with inordinate movements, mean difference in position of vasculature on angiography and MRA/CTA road-map was 1.86 ± 0.95 mm, implying that approximately 95 % of differences were between 0 and 3.72 mm (2 ± 1.96 standard deviation).ConclusionsFluoroscopy with MRA/CTA fusion guidance for peripheral artery interventions is feasible. By reducing the number of CEAS, this technology may contribute to enhance procedural safety

  10. Fusion guidance in endovascular peripheral artery interventions: a feasibility study.

    Science.gov (United States)

    Sailer, Anna M; de Haan, Michiel W; de Graaf, Rick; van Zwam, Willem H; Schurink, Geert Willem H; Nelemans, Patricia J; Wildberger, Joachim E; Das, Marco

    2015-04-01

    This study was designed to evaluate the feasibility of endovascular guidance by means of live fluoroscopy fusion with magnetic resonance angiography (MRA) and computed tomography angiography (CTA). Fusion guidance was evaluated in 20 endovascular peripheral artery interventions in 17 patients. Fifteen patients had received preinterventional diagnostic MRA and two patients had undergone CTA. Time for fluoroscopy with MRA/CTA coregistration was recorded. Feasibility of fusion guidance was evaluated according to the following criteria: for every procedure the executing interventional radiologists recorded whether 3D road-mapping provided added value (yes vs. no) and whether PTA and/or stenting could be performed relying on the fusion road-map without need for diagnostic contrast-enhanced angiogram series (CEAS) (yes vs. no). Precision of the fusion road-map was evaluated by recording maximum differences between the position of the vasculature on the virtual CTA/MRA images and conventional angiography. Average time needed for image coregistration was 5 ± 2 min. Three-dimensional road-map added value was experienced in 15 procedures in 12 patients. In half of the patients (8/17), intervention was performed relying on the fusion road-map only, without diagnostic CEAS. In two patients, MRA roadmap showed a false-positive lesion. Excluding three patients with inordinate movements, mean difference in position of vasculature on angiography and MRA/CTA road-map was 1.86 ± 0.95 mm, implying that approximately 95 % of differences were between 0 and 3.72 mm (2 ± 1.96 standard deviation). Fluoroscopy with MRA/CTA fusion guidance for peripheral artery interventions is feasible. By reducing the number of CEAS, this technology may contribute to enhance procedural safety.

  11. Real-time tomosynthesis for radiation therapy guidance.

    Science.gov (United States)

    Hsieh, Scott S; Ng, Lydia W

    2017-11-01

    Fluoroscopy has been a tool of choice for monitoring treatments or interventions because of its extremely fast imaging times. However, the contrast obtained in fluoroscopy may be insufficient for certain clinical applications. In stereotactic ablative radiation therapy of the lung, fluoroscopy often lacks sufficient contrast for gating treatment. The purpose of this work is to describe and assess a real-time tomosynthesis design that can produce sufficient contrast for guidance of lung tumor treatment within a small field of view. Previous tomosynthesis designs in radiation oncology have temporal resolution on the order of seconds. The proposed system design uses parallel acquisition of multiple frames by simultaneously illuminating the field of view with multiple sources, enabling a temporal resolution of up to 30 frames per second. For a small field of view, a single flat-panel detector could be used if different sectors of the detector are assigned to specific sources. Simulated images were generated by forward projection of existing clinical datasets. The authors varied the number of tubes and the power of each tube in order to determine the impact on tumor visualization. Visualization of the tumor was much clearer in tomosynthesis than in fluoroscopy. Contrast generally improved with the number of sources used, and a minimum of four sources should be used. The high contrast of the lung allows very low system power, and in most cases, less than 1 mA was needed. More power is required in the lateral direction than the AP direction. The proposed system produces images adequate for real-time guidance of radiation therapy. The additional hardware requirements are modest, and the system is capable of imaging at high frame rates and low dose. Further development, including a prototype system and a dosimetry study, is needed to further evaluate the feasibility of this device for radiation therapy guidance. © 2017 American Association of Physicists in Medicine.

  12. 48 CFR 427.104 - General guidance.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false General guidance. 427.104... REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS General 427.104 General guidance. As used in FAR part 27, the agency head or agency head designee is the Senior Procurement Executive, except under FAR 27.306(a) and (b...

  13. Driving change : sustainable development action plans Guidance

    OpenAIRE

    Sustainable Development Commission

    2008-01-01

    This guidance builds upon the Sustainable Development Commission’s previous guidance, Getting Started (August 2005), which set out the basic elements that the Sustainable Development Commission would expect to see in a good Sustainable Development Action Plan. Publisher PDF Original published August 2005.

  14. Guidance for performing preliminary assessments under CERCLA

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1991-09-01

    EPA headquarters and a national site assessment workgroup produced this guidance for Regional, State, and contractor staff who manage or perform preliminary assessments (PAs). EPA has focused this guidance on the types of sites and site conditions most commonly encountered. The PA approach described in this guidance is generally applicable to a wide variety of sites. However, because of the variability among sites, the amount of information available, and the level of investigative effort required, it is not possible to provide guidance that is equally applicable to all sites. PA investigators should recognize this and be aware that variation from this guidance may be necessary for some sites, particularly for PAs performed at Federal facilities, PAs conducted under EPA`s Environmental Priorities Initiative (EPI), and PAs at sites that have previously been extensively investigated by EPA or others. The purpose of this guidance is to provide instructions for conducting a PA and reporting results. This guidance discusses the information required to evaluate a site and how to obtain it, how to score a site, and reporting requirements. This document also provides guidelines and instruction on PA evaluation, scoring, and the use of standard PA scoresheets. The overall goal of this guidance is to assist PA investigators in conducting high-quality assessments that result in correct site screening or further action recommendations on a nationally consistent basis.

  15. Career Guidance and Public Mental Health

    Science.gov (United States)

    Robertson, Peter J.

    2013-01-01

    Career guidance may have the potential to promote public health by contributing positively to both the prevention of mental health conditions and to population level well-being. The policy implications of this possibility have received little attention. Career guidance agencies are well placed to reach key target groups. Producing persuasive…

  16. Standards for School Guidance Programs in Maryland.

    Science.gov (United States)

    Maryland State Dept. of Education, Baltimore. Div. of Compensatory, Urban, and Supplementary Programs.

    This brochure is a checklist to rate school compliance with the standards for school guidance programs in Maryland, which were developed by the Maryland State Department of Education. The first set of standards addresses the philosophy and goals of school guidance programs in Maryland and the extent to which program goals and objectives are…

  17. HANDBOOK: HAZARDOUS WASTE INCINERATION MEASUREMENT GUIDANCE

    Science.gov (United States)

    This publication, Volume III of the Hazardous Waste Incineration Guidance Series, contains general guidance to permit writers in reviewing hazardous waste incineration permit applications and trial burn plans. he handbook is a how-to document dealing with how incineration measure...

  18. 33 CFR 385.5 - Guidance memoranda.

    Science.gov (United States)

    2010-07-01

    ... ability of the Corps of Engineers, the South Florida Water Management District, and other non-Federal... § 385.5 Guidance memoranda. (a) General. (1) Technical guidance for internal management of Corps of...) General format and content of Project Implementation Reports (§ 385.26(a)); (ii) Instructions for...

  19. Guidance Counsellor Strategies for Handling Bullying

    Science.gov (United States)

    Power-Elliott, Michleen; Harris, Gregory E.

    2012-01-01

    The purpose of this exploratory-descriptive study was to examine how guidance counsellors in the province of Newfoundland and Labrador would handle a specific verbal-relational bullying incident. Also of interest was guidance counsellor involvement and training in bullying programmes and Positive Behaviour Supports. Data for this study was…

  20. Why Guidance Works Better than Punishment.

    Science.gov (United States)

    Gartrell, Dan

    1995-01-01

    Examines how guidance techniques address the full spectrum of intervention methods, from prevention to conflict resolution to long-term management strategies. Discusses how punishment affects both children and teachers. Suggests that to put guidance into practice teachers should: be realistic, tailor activities to each child, practice positive…

  1. Real-Time 3D Image Guidance Using a Standard LINAC: Measured Motion, Accuracy, and Precision of the First Prospective Clinical Trial of Kilovoltage Intrafraction Monitoring-Guided Gating for Prostate Cancer Radiation Therapy

    DEFF Research Database (Denmark)

    Keall, Paul J; Ng, Jin Aun; Juneja, Prabhjot

    2016-01-01

    for prostate cancer radiation therapy. In this paper we report on the measured motion accuracy and precision using real-time KIM-guided gating. METHODS AND MATERIALS: Imaging and motion information from the first 200 fractions from 6 patient prostate cancer radiation therapy volumetric modulated arc therapy...... treatments were analyzed. A 3-mm/5-second action threshold was used to trigger a gating event where the beam is paused and the couch position adjusted to realign the prostate to the treatment isocenter. To quantify the in vivo accuracy and precision, KIM was compared with simultaneously acquired k...

  2. Lumbar pedicle screw placement: Using only AP plane imaging

    Directory of Open Access Journals (Sweden)

    Anil Sethi

    2012-01-01

    Conclusion: Placement of pedicle screws under fluoroscopic guidance using AP plane imaging alone with tactile guidance is safe, fast, and reliable. However, a good understanding of the radiographic landmarks is a prerequisite.

  3. Optofluidic control of axonal guidance

    Science.gov (United States)

    Gu, Ling; Ordonez, Simon; Black, Bryan; Mohanty, Samarendra K.

    2013-03-01

    Significant efforts are being made for control on axonal guidance due to its importance in nerve regeneration and in the formation of functional neuronal circuitry in-vitro. These include several physical (topographic modification, optical force, and electric field), chemical (surface functionalization cues) and hybrid (electro-chemical, photochemical etc) methods. Here, we report comparison of the effect of linear flow versus microfluidic flow produced by an opticallydriven micromotor in guiding retinal ganglion axons. A circularly polarized laser tweezers was used to hold, position and spin birefringent calcite particle near growth cone, which in turn resulted in microfluidic flow. The flow rate and resulting shear-force on axons could be controlled by a varying the power of the laser tweezers beam. The calcite particles were placed separately in one chamber and single particle was transported through microfluidic channel to another chamber containing the retina explant. In presence of flow, the turning of axons was found to strongly correlate with the direction of flow. Turning angle as high as 90° was achieved. Optofluidic-manipulation can be applied to other types of mammalian neurons and also can be extended to stimulate mechano-sensing neurons.

  4. Optimal guidance law in quantum mechanics

    International Nuclear Information System (INIS)

    Yang, Ciann-Dong; Cheng, Lieh-Lieh

    2013-01-01

    Following de Broglie’s idea of a pilot wave, this paper treats quantum mechanics as a problem of stochastic optimal guidance law design. The guidance scenario considered in the quantum world is that an electron is the flight vehicle to be guided and its accompanying pilot wave is the guidance law to be designed so as to guide the electron to a random target driven by the Wiener process, while minimizing a cost-to-go function. After solving the stochastic optimal guidance problem by differential dynamic programming, we point out that the optimal pilot wave guiding the particle’s motion is just the wavefunction Ψ(t,x), a solution to the Schrödinger equation; meanwhile, the closed-loop guidance system forms a complex state–space dynamics for Ψ(t,x), from which quantum operators emerge naturally. Quantum trajectories under the action of the optimal guidance law are solved and their statistical distribution is shown to coincide with the prediction of the probability density function Ψ ∗ Ψ. -- Highlights: •Treating quantum mechanics as a pursuit-evasion game. •Reveal an interesting analogy between guided flight motion and guided quantum motion. •Solve optimal quantum guidance problem by dynamic programming. •Gives a formal proof of de Broglie–Bohm’s idea of a pilot wave. •The optimal pilot wave is shown to be a wavefunction solved from Schrödinger equation

  5. Optimal guidance law in quantum mechanics

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ciann-Dong, E-mail: cdyang@mail.ncku.edu.tw; Cheng, Lieh-Lieh, E-mail: leo8101@hotmail.com

    2013-11-15

    Following de Broglie’s idea of a pilot wave, this paper treats quantum mechanics as a problem of stochastic optimal guidance law design. The guidance scenario considered in the quantum world is that an electron is the flight vehicle to be guided and its accompanying pilot wave is the guidance law to be designed so as to guide the electron to a random target driven by the Wiener process, while minimizing a cost-to-go function. After solving the stochastic optimal guidance problem by differential dynamic programming, we point out that the optimal pilot wave guiding the particle’s motion is just the wavefunction Ψ(t,x), a solution to the Schrödinger equation; meanwhile, the closed-loop guidance system forms a complex state–space dynamics for Ψ(t,x), from which quantum operators emerge naturally. Quantum trajectories under the action of the optimal guidance law are solved and their statistical distribution is shown to coincide with the prediction of the probability density function Ψ{sup ∗}Ψ. -- Highlights: •Treating quantum mechanics as a pursuit-evasion game. •Reveal an interesting analogy between guided flight motion and guided quantum motion. •Solve optimal quantum guidance problem by dynamic programming. •Gives a formal proof of de Broglie–Bohm’s idea of a pilot wave. •The optimal pilot wave is shown to be a wavefunction solved from Schrödinger equation.

  6. International guidance, evolution and trends

    International Nuclear Information System (INIS)

    Ruiz Lopez, C.

    2010-01-01

    Carmen Ruiz Lopez, (CSN) addressed the evolution of some of the fundamental concepts related to the objective of protecting future generations, with the intention of encouraging the discussion, and to determine whether the recent international guidance implied any change in philosophy and approach regarding the practical interpretation and implementation of such fundamental concepts. C. Ruiz presented a general overview of the ICRP and IAEA guidance developments as well as the major changes or reorientations introduced by the latest ICRP Recommendations and IAEA Safety Standards that are relevant to long-term issues of geological disposal, namely, ICRP 103 (2009), ICRP 101 (2006), IAEA Safety Fundamentals SF-1(2006) and WS-R-4. As for the ICRP developments, ICRP 103 confirms the validity of ICRP 81(1998) as the main ICRP reference for long-lived waste disposal. C. Ruiz then noted the extension of the scope of ICPR 81 mentioning some of the principles and recommendations related to the objective of protecting future generations and the view of the Commission for demonstrating compliance. ICRP 103 and ICRP 101 reinforce the importance of transparency in the decision-making process and in the demonstration of confidence in situations of increasing uncertainties about time, giving more weight to the process itself and strengthening the need for an open dialogue between regulator and implementer. In both recommendations the Commission recognises the influence of societal values in the final decision on the level of radiological protection, as well as the influence of social concerns and political aspects in the decision-making process. The evolution of internationally agreed safety fundamental objectives and principles can be observed in the changes from the IAEA's Waste Safety Fundamentals of 1995 to the new Safety Fundamentals of 2006. C Ruiz presented a comparison of both documents focussing on the differences in dealing with fundamental concepts related to the

  7. Assessment of the effectiveness of guidance services in senior ...

    African Journals Online (AJOL)

    Guidance Service Assessment Questionnaire for Teacher/Students (GSAQTS) was used to measure the extent of guidance services and their perception of it. ... to counsellor, and a misconception of the counsellors role has made guidance ...

  8. Vacuum mammotomy under ultrasound guidance

    International Nuclear Information System (INIS)

    Luczynska, E.; Kocurek, A.; Pawlik, T.; Aniol, J.; Herman, K.; Skotnicki, P.

    2007-01-01

    Breast ultrasound is a non-invasive method of breast examination. You can use it also for fine needle biopsy, core needle biopsy, vacuum mammotomy and for placing the '' wire '' before open surgical biopsy. 106 patients (105 women and 1 man) aged 20-71 years (mean age 46.9) were treated in Cancer Institute in Cracow by vacuum mammotomy under ultrasound guidance. The lesions found in ultrasonography were divided into three groups: benign lesions (BI RADS II), ambiguous lesions (BI RADS 0, III and IVa), and suspicious lesions (BI RADS IV B, IV C and V). Then lesions were qualified to vacuum mammotomy. According to USG, fibroadenoma or '' fibroadenoma-like '' lesions were found in 75 women, in 6 women complicated cysts, in 6 women cyst with dense fluid (to differentiate with FA), and in 19 patients undefined lesions. Fibroadenoma was confirmed in histopathology in 74% patients among patients with fibroadenoma or '' fibroadenoma-like '' lesions in ultrasound (in others also benign lesions were found). Among lesions undefined after ultrasound examination (total 27 patients) cancer was confirmed in 6 % (DCIS and IDC). In 6 patients with complicated cysts in ultrasound examination, histopathology confirmed fibroadenoma in 4 women, an intraductal lesion in 1 woman and inflamatory process in 1 woman. Also in 6 women with a dense cyst or fibroadenoma seen in ultrasound, histopathology confirmed fibroadenoma in 3 women and fibrosclerosis in 3 women. Any breast lesions undefined or suspicious after ultrasound examination should be verified. The method of verification or kind of operation of the whole lesion (vacuum mammotomy or '' wire '') depends on many factors, for example: lesion localization; lesion size; BI RADS category. (author)

  9. Online thesis guidance management information system

    Science.gov (United States)

    Nasution, T. H.; Pratama, F.; Tanjung, K.; Siregar, I.; Amalia, A.

    2018-03-01

    The development of internet technology in education is still not maximized, especially in the process of thesis guidance between students and lecturers. Difficulties met the lecturers to help students during thesis guidance is the limited communication time and the compatibility of schedule between students and lecturer. To solve this problem, we designed an online thesis guidance management information system that helps students and lecturers to do thesis tutoring process anytime, anywhere. The system consists of a web-based admin app for usage management and an android-based app for students and lecturers.

  10. Significant Guidance Issued by the Federal Motor Carrier Safety Administration

    Data.gov (United States)

    Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

  11. Significant Guidance Issued by the Federal Transit Administration

    Data.gov (United States)

    Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

  12. Significant Guidance Issued by the Federal Aviation Administration

    Data.gov (United States)

    Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

  13. Significant Guidance Issued by the Federal Highway Administration

    Data.gov (United States)

    Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

  14. European Union Sustainable Purchasing Guidance Profile

    Science.gov (United States)

    To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

  15. Responsible Purchasing Network - Sustainable Purchasing Guidance Profile

    Science.gov (United States)

    To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

  16. Regulatory systems-based licensing guidance documentation

    International Nuclear Information System (INIS)

    Delligatti, M.S.

    1991-01-01

    The US Nuclear Regulatory Commission (NRC) has developed a series of licensing guidance documents based on the regulatory requirements in Part 60 of Title 10 of the Code of Federal Regulations (10 CFR Part 60). This regulatory systems-based approach to licensing guidance documentation relies on the definition of the high-level waste repository in 10 CFR Part 60. A document which is important for the frame-work it gives to other programmatic licensing guidance is the Draft Regulatory Guide open-quotes Format and Content for the License Application for the High-Level Waste Repositoryclose quotes (FCRG). The FCRG describes a format and content acceptable to NRC for a high-level waste repository license application pursuant to the requirements of 10 CFR Part 60. Other licensing guidance documents will be compatible with the FCRG

  17. Drill machine guidance using natural occurring radiation

    International Nuclear Information System (INIS)

    Dahl, H.D.; Schroeder, R.L.; Williams, B.J.

    1980-01-01

    A drilling machine guidance system is described which uses only the naturally occuring radiation within the seam or stratum of interest. The apparatus can be used for guiding horizontal drilling machines through coal seams and the like. (U.K.)

  18. Smartphone Video Guidance Sensor for Small Satellites

    Data.gov (United States)

    National Aeronautics and Space Administration — Smartphone Video Guidance Sensor(SVGS) for Small Satellites will provide a low-cost,integrated rendezvous & proximity operations sensor system to allow an...

  19. Moisture Control Guidance for Commercial and Public ...

    Science.gov (United States)

    This document provides guidance to designers, construction mangers, and building operation/maintenance managers to improve IEQ and reduce risks of encountering IEQ problems due to insufficient moisture control. EPA will be producing a document entitled

  20. RCRA Programmatic Information Policy and Guidance

    Data.gov (United States)

    U.S. Environmental Protection Agency — This asset includes program policy and guidance documents that are used by the EPA regions, states, tribes and private parties to implement the hazardous waste...

  1. Construction machine control guidance implementation strategy.

    Science.gov (United States)

    2010-07-01

    Machine Controlled Guidance (MCG) technology may be used in roadway and bridge construction to improve construction efficiencies, potentially resulting in reduced project costs and accelerated schedules. The technology utilizes a Global Positioning S...

  2. Precision Guidance with Impact Angle Requirements

    National Research Council Canada - National Science Library

    Ford, Jason

    2001-01-01

    This paper examines a weapon system precision guidance problem in which the objective is to guide a weapon onto a non-manoeuvring target so that a particular desired angle of impact is achieved using...

  3. Guidance for the national healthcare disparities report

    National Research Council Canada - National Science Library

    Swift, Elaine K

    2002-01-01

    The Agency for Healthcare Research Quality commissioned the Institute of Medicine establish a committee to provide guidance on the National Healthcare Disparities Report is of access to health care...

  4. UV DISINFECTION GUIDANCE MANUAL FOR THE ...

    Science.gov (United States)

    Provides technical information on selection, design and operation of UV systems; provides regulatory agencies with guidance and the necessary tools to assess UV systems at the design, start-up, and routine operation phase; provides manufacturers with the testing and performance standards for UV components and systems for treating drinking water. Provide guidance to water systems, regulators and manufacturers on UV disinfection of drinking water.

  5. A New Approach to Lane Guidance Systems

    OpenAIRE

    Eidehall, Andreas; Pohl, Jochen; Gustafsson, Fredrik

    2005-01-01

    This paper presents a new automotive safety function called Emergency Lane Assist (ELA). ELA combines conventional lane guidance systems with a threat assessment module that tries to activate and deactivate the lane guidance interventions according to the actual risk level of lane departure. The goal is to only prevent dangerous lane departure manoeuvres. Such a threat assessment algorithm is dependent on detailed information about the vehicle surroundings, i.e., positions and motion of other...

  6. The evaluation of radiologic methods for access guidance in percutaneous nephrolithotomy

    DEFF Research Database (Denmark)

    Breda, Alberto; Territo, Angelo; Scoffone, Cesare

    2018-01-01

    is controversial? A systematic review of the literature was performed comparing image guidance modalities for obtaining access in PNL. Evidence acquisition and synthesis: A PubMed, Scopus and Cochrane search for peer-reviewed studies was performed using the keywords "ultrasound" AND "fluoroscopy" AND "Percutaneous...

  7. Sacro-iliac joint arthrography in low back pain: feasibility of MRI guidance

    International Nuclear Information System (INIS)

    Ojala, Risto; Klemola, Rauli; Karppinen, Jaro; Sequeiros, Roberto Blanco; Tervonen, Osmo

    2001-01-01

    Objective: Evaluation of the feasibility of MR-guidance in sacro-iliac joint arthrography in patients whose low back pain is suspected to arise from the sacro-iliac joint (SIJ). Methods and patients: Twenty patients with low back pain underwent MR-guided sacro-iliac joint arthrography. Needles made from titanium (size 20 G, MDTech, USA) were used. For image guidance a 0.23T open-configuration C arm magnet (Proview, Marconi Medical Systems, USA) with special interventional hardware and software package (I-Path 200, Marconi Medical Systems) containing an MR compatible in-room console, large-screen (36'') display, optical navigator and accompanying software with dedicated sequences was used. No other image guidance modalities were used. Results: MR-guided SIJ arthrography was successfully performed in all twenty patients without complications. The optimal imaging sequence both for preoperative and intraoperative images was 3D-Gradient Echo sequence. The dispersal of the injected saline and anaesthetic could be determined inside the joint in all cases with heavily T2-weighted fast spin echo sequence. In the present study, 60% of the patients had significant reduction of pain after sacro-iliac joint arthrography and sacro-iliac joint was considered to be the source of patients low back pain in these patients. Conclusion: The present study shows that MR guidance with open configuration low field scanner is an accurate guiding method for sacro-iliac joint arthrography

  8. 78 FR 57395 - Guidance for Industry on Electronic Source Data in Clinical Investigations; Availability

    Science.gov (United States)

    2013-09-18

    ... providers and institutions, electronic laboratory reports, electronic medical images from devices, and... operating and maintenance costs, because sponsors and others already have and are experienced with using the computer-based equipment and software necessary to be consistent with the guidance. IV. Electronic Access...

  9. Constituent Aspects of Workplace Guidance in Secondary VET

    Science.gov (United States)

    Swager, Robert; Klarus, Ruud; van Merriënboer, Jeroen J. G.; Nieuwenhuis, Loek F. M.

    2015-01-01

    Purpose: This paper aims to present an integrated model of workplace guidance to enhance awareness of what constitutes good guidance, to improve workplace guidance practices in vocational education and training. Design/methodology/approach: To identify constituent aspects of workplace guidance, a systematic search of Web of Science was conducted,…

  10. The Development of a Lifelong Guidance System in Hungary

    Science.gov (United States)

    Watts, A. G.; Borbely-Pecze, Bors Tibor

    2011-01-01

    The development of a lifelong guidance system in Hungary Systematic work is currently being undertaken in Hungary to develop a lifelong guidance system, in line with principles outlined by leading international organisations. The origins of career guidance in Hungary, and the nature of the current career guidance system, are outlined. The main…

  11. Non-Participation in Guidance: An Opportunity for Development?

    Science.gov (United States)

    Thomsen, Rie

    2014-01-01

    This article discusses how new opportunities for guidance can emerge from an analysis of the interplay between the participation (or lack of participation) of the individuals in career guidance, and the career guidance practitioner's response. The article suggests critical psychology as a framework for career guidance research and presents…

  12. Constituent aspects of workplace guidance in secondary VET

    NARCIS (Netherlands)

    Swager, Robert; Klarus, Ruud; Van Merriënboer, Jeroen; Nieuwenhuis, Loek

    2018-01-01

    Purpose – This paper aims to present an integrated model of workplace guidance to enhance awareness of what constitutes good guidance, to improve workplace guidance practices in vocational education and training. Design/methodology/approach – To identify constituent aspects of workplace guidance,

  13. 76 FR 61098 - Guidance for 1-Hour SO2

    Science.gov (United States)

    2011-10-03

    ...Notice is hereby given that the EPA has posted its draft non- binding guidance titled, ``Guidance for 1-Hour SO2 NAAQS SIP Submissions'' on its Web site. The EPA invites public comments on this guidance document during the comment period specified below, and plans to issue an updated version of the guidance after reviewing timely submitted comments.

  14. Guidance and Counselling in the Universal Basic Education ...

    African Journals Online (AJOL)

    Quite a number of personnel has significant and diverse roles to play. The guidance counsellor whose role is to provide indispensable guidance services is the primary focus of this paper. The paper justifies the relevance of guidance services to the UBE scheme and also isolates a number of challenges facing the guidance ...

  15. Intraluminal laser atherectomy with ultrasound and electromagnetic guidance

    Science.gov (United States)

    Gregory, Kenton W.; Aretz, H. Thomas; Martinelli, Michael A.; LeDet, Earl G.; Hatch, G. F.; Gregg, Richard E.; Sedlacek, Tomas; Haase, Wayne C.

    1991-05-01

    The MagellanTM coronary laser atherectomy system is described. It uses high- resolution ultrasound imaging and electromagnetic sensing to provide real-time guidance and control of laser therapy in the coronary arteries. The system consists of a flexible catheter, an electromagnetic navigation antenna, a sensor signal processor and a computer for image processing and display. The small, flexible catheter combines an ultrasound transducer and laser delivery optics, aimed at the artery wall, and an electromagnetic receiving sensor. An extra-corporeal electromagnetic transmit antenna, in combination with catheter sensors, locates the position of the ultrasound and laser beams in the artery. Navigation and ultrasound data are processed electronically to produce real-time, transverse, and axial cross-section images of the artery wall at selected locations. By exploiting the ability of ultrasound to image beneath the surface of artery walls, it is possible to identify candidate treatment sites and perform safe radial laser debulking of atherosclerotic plaque with reduced danger of perforation. The utility of the system in plaque identification and ablation is demonstrated with imaging and experimental results.

  16. Raising the Profile of Career Guidance: Educational and Vocational Guidance Practitioner

    Science.gov (United States)

    Hiebert, Bryan

    2009-01-01

    In 2007 the International Association for Educational and Vocational Guidance (IAEVG) launched the Educational and Vocational Guidance Practitioner credential (EVGP) as one means of formally acknowledging the knowledge, skills, and personal attributes that practitioners need in order to provide quality career development services to clients. This…

  17. Safety of magnetic fusion facilities: Guidance

    International Nuclear Information System (INIS)

    1996-05-01

    This document provides guidance for the implementation of the requirements identified in DOE-STD-6002-96, Safety of Magnetic Fusion Facilities: Requirements. This guidance is intended for the managers, designers, operators, and other personnel with safety responsibilities for facilities designated as magnetic fusion facilities. While the requirements in DOE-STD-6002-96 are generally applicable to a wide range of fusion facilities, this Standard, DOE-STD-6003-96, is concerned mainly with the implementation of those requirements in large facilities such as the International Thermonuclear Experimental Reactor (ITER). Using a risk-based prioritization, the concepts presented here may also be applied to other magnetic fusion facilities. This Standard is oriented toward regulation in the Department of Energy (DOE) environment as opposed to regulation by other regulatory agencies. As the need for guidance involving other types of fusion facilities or other regulatory environments emerges, additional guidance volumes should be prepared. The concepts, processes, and recommendations set forth here are for guidance only. They will contribute to safety at magnetic fusion facilities

  18. Guidance levels, achievable doses and expectation levels

    International Nuclear Information System (INIS)

    Li, Lianbo; Meng, Bing

    2002-01-01

    The National Radiological Protection Board (NRPB), the International Atomic Energy Agency (IAEA) and the Commission of the European Communities (CEC) published their guidance levels and reference doses for typical X-ray examination and nuclear medicine in their documents in 1993, 1994 and 1996 respectively. From then on, the concept of guidance levels or reference doses have been applied to different examinations in the field of radiology and proved to be effective for reduction of patient doses. But the guidance levels or reference doses are likely to have some shortcomings and can do little to make further reduction of patient dose in the radiology departments where patient dose are already below them. For this reason, the National Radiological Protection Board (NRPB) proposed a concept named achievable doses which are based on the mean dose observed for a selected sample of radiology departments. This paper will review and discuss the concept of guidance levels and achievable doses, and propose a new concept referred to as Expectation Levels that will encourage the radiology departments where patient dose are already below the guidance levels to keep patient dose as low as reasonably achievable. Some examples of the expectation levels based on the data published by a few countries are also illustrated in this paper

  19. Comparison of CT and PET/CT for biopsy guidance in oncological patients

    International Nuclear Information System (INIS)

    Cerci, Juliano J.; Bogoni, Mateos; Cunha Pereira, Carlos; Cerci, Rodrigo J.; Krauzer, Cassiano; Vicente Vitola, Joao; Tabacchi, Elena; Fanti, Stefano; Delbeke, Dominique; Giacometti Sakamoto, Danielle

    2017-01-01

    To compare FDG PET/CT and CT for the guidance of percutaneous biopsies with histological confirmation of lesions. We prospectively evaluated 323 patients of whom 181 underwent FDG PET/CT-guided biopsy (total 188 biopsies) and 142 underwent CT-guided biopsy (total 146 biopsies). Biopsies were performed using the same PET/CT scanner with a fluoroscopic imaging system. Technical feasibility, clinical success and complication rates in the two groups were evaluated. Of the 188 biopsies with PET/CT guidance, 182 (96.8%) were successful with conclusive tissue samples obtained and of the 146 biopsies with CT guidance, 137 (93.8%) were successful. Therefore, 6 of 188 biopsies (3.1%) with PET/CT guidance and 9 of 146 (6.1%) with CT guidance were inconclusive (p = 0.19). Due to inconclusive histological results, 4 of the 188 lesions (2.1%) were rebiopsied with PET/CT guidance and 3 of 146 lesions (2.0%) were rebiopsied with CT guidance. Histology demonstrated that 142 of 188 lesions (75.5%) were malignant, and 40 (21.2%) were benign in the PET/CT-guided group, while 89 of 146 lesions (60.9%) were malignant and 48 (32.8%) were benign in the CT-guided group (p = 0.004 and 0.01, respectively). Patients with a histological diagnosis of benign lesion had no recurrence of disease with a minimum of 6 months follow-up. Of the 188 PET/CT-guided biopsies, 6 (3.1%) were repeat biopsies due to a previous nondiagnostic CT-guided biopsy performed in a different diagnostic centre. The interval between the two biopsies was less than a month in all cases. Histology revealed five malignant lesions and one benign lesion among these. The complication rate in the PET/CT-guided biopsy group was 12.7% (24 of 188), while in the CT-guided group, was 9.5% (14 of 146, p = 0.26). Therefore, there was no significant difference in complication rates between PET/CT and CT guidance. PET/CT-guided biopsy is already known to be a feasible and accurate method in the diagnostic work-up of suspected malignant

  20. Comparison of CT and PET/CT for biopsy guidance in oncological patients

    Energy Technology Data Exchange (ETDEWEB)

    Cerci, Juliano J.; Bogoni, Mateos; Cunha Pereira, Carlos; Cerci, Rodrigo J.; Krauzer, Cassiano; Vicente Vitola, Joao [Quanta - Diagnostico e Terapia, Curitiba, PR (Brazil); Tabacchi, Elena; Fanti, Stefano [University Hospital S. Orsola-Malpighi, Nuclear Medicine Department, Bologna (Italy); Delbeke, Dominique [Vanderbilt University, Nashville, TN (United States); Giacometti Sakamoto, Danielle [Byori - Laboratorio de Patologia, Curitiba (Brazil)

    2017-08-15

    To compare FDG PET/CT and CT for the guidance of percutaneous biopsies with histological confirmation of lesions. We prospectively evaluated 323 patients of whom 181 underwent FDG PET/CT-guided biopsy (total 188 biopsies) and 142 underwent CT-guided biopsy (total 146 biopsies). Biopsies were performed using the same PET/CT scanner with a fluoroscopic imaging system. Technical feasibility, clinical success and complication rates in the two groups were evaluated. Of the 188 biopsies with PET/CT guidance, 182 (96.8%) were successful with conclusive tissue samples obtained and of the 146 biopsies with CT guidance, 137 (93.8%) were successful. Therefore, 6 of 188 biopsies (3.1%) with PET/CT guidance and 9 of 146 (6.1%) with CT guidance were inconclusive (p = 0.19). Due to inconclusive histological results, 4 of the 188 lesions (2.1%) were rebiopsied with PET/CT guidance and 3 of 146 lesions (2.0%) were rebiopsied with CT guidance. Histology demonstrated that 142 of 188 lesions (75.5%) were malignant, and 40 (21.2%) were benign in the PET/CT-guided group, while 89 of 146 lesions (60.9%) were malignant and 48 (32.8%) were benign in the CT-guided group (p = 0.004 and 0.01, respectively). Patients with a histological diagnosis of benign lesion had no recurrence of disease with a minimum of 6 months follow-up. Of the 188 PET/CT-guided biopsies, 6 (3.1%) were repeat biopsies due to a previous nondiagnostic CT-guided biopsy performed in a different diagnostic centre. The interval between the two biopsies was less than a month in all cases. Histology revealed five malignant lesions and one benign lesion among these. The complication rate in the PET/CT-guided biopsy group was 12.7% (24 of 188), while in the CT-guided group, was 9.5% (14 of 146, p = 0.26). Therefore, there was no significant difference in complication rates between PET/CT and CT guidance. PET/CT-guided biopsy is already known to be a feasible and accurate method in the diagnostic work-up of suspected malignant

  1. 75 FR 69089 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2010-11-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0514] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document... Administration (FDA) is announcing the availability of the guidance entitled ``Class II Special Controls Guidance...

  2. 76 FR 29251 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls; Guidance...

    Science.gov (United States)

    2011-05-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2006-D-0094] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls; Guidance Document... of the guidance entitled ``Guidance for Industry and Food and Drug Administration Staff; Class II...

  3. Measuring Integrated Socioemotional Guidance at School: Factor Structure and Reliability of the Socioemotional Guidance Questionnaire (SEG-Q)

    Science.gov (United States)

    Jacobs, Karen; Struyf, Elke

    2013-01-01

    Socioemotional guidance of students has recently become an integral part of education, however no instrument exists to measure integrated socioemotional guidance. This study therefore examines the factor structure and reliability of the Socioemotional Guidance Questionnaire. Psychometric properties of the Socioemotional Guidance Questionnaire and…

  4. Automated low-thrust guidance for the orbital maneuvering vehicle

    Science.gov (United States)

    Rose, Richard E.; Schmeichel, Harry; Shortwell, Charles P.; Werner, Ronald A.

    1988-01-01

    This paper describes the highly autonomous OMV Guidance Navigation and Control system. Emphasis is placed on a key feature of the design, the low thrust guidance algorithm. The two guidance modes, orbit change guidance and rendezvous guidance, are discussed in detail. It is shown how OMV will automatically transfer from its initial orbit to an arbitrary target orbit and reach a specified rendezvous position relative to the target vehicle.

  5. 76 FR 66925 - Guidance for 1-Hour SO2

    Science.gov (United States)

    2011-10-28

    ...The EPA is announcing an extension of the public comment period for its draft non-binding guidance titled, ``Guidance for 1-Hour SO2 SIP Submissions.'' The draft of the guidance document is currently on the EPA's Web site. The EPA is extending the comment period for an additional 30-day period and invites public comments on this guidance during this period. The EPA plans to issue an updated version of the guidance after reviewing timely submitted comments.

  6. Amending the Characterization of Guidance in Visual Analytics

    OpenAIRE

    Ceneda, Davide; Gschwandtner, Theresia; May, Thorsten; Miksch, Silvia; Schulz, Hans-Jörg; Streit, Marc; Tominski, Christian

    2017-01-01

    At VAST 2016, a characterization of guidance has been presented. It includes a definition of guidance and a model of guidance based on van Wijk's model of visualization. This note amends the original characterization of guidance in two aspects. First, we provide a clarification of what guidance actually is (and is not). Second, we insert into the model a conceptually relevant link that was missing in the original version.

  7. Quality assurance and quality control in mammography: a review of available guidance worldwide.

    Science.gov (United States)

    Reis, Cláudia; Pascoal, Ana; Sakellaris, Taxiarchis; Koutalonis, Manthos

    2013-10-01

    Review available guidance for quality assurance (QA) in mammography and discuss its contribution to harmonise practices worldwide. Literature search was performed on different sources to identify guidance documents for QA in mammography available worldwide in international bodies, healthcare providers, professional/scientific associations. The guidance documents identified were reviewed and a selection was compared for type of guidance (clinical/technical), technology and proposed QA methodologies focusing on dose and image quality (IQ) performance assessment. Fourteen protocols (targeted at conventional and digital mammography) were reviewed. All included recommendations for testing acquisition, processing and display systems associated with mammographic equipment. All guidance reviewed highlighted the importance of dose assessment and testing the Automatic Exposure Control (AEC) system. Recommended tests for assessment of IQ showed variations in the proposed methodologies. Recommended testing focused on assessment of low-contrast detection, spatial resolution and noise. QC of image display is recommended following the American Association of Physicists in Medicine guidelines. The existing QA guidance for mammography is derived from key documents (American College of Radiology and European Union guidelines) and proposes similar tests despite the variations in detail and methodologies. Studies reported on QA data should provide detail on experimental technique to allow robust data comparison. Countries aiming to implement a mammography/QA program may select/prioritise the tests depending on available technology and resources. •An effective QA program should be practical to implement in a clinical setting. •QA should address the various stages of the imaging chain: acquisition, processing and display. •AEC system QC testing is simple to implement and provides information on equipment performance.

  8. HUMAN FACTORS GUIDANCE FOR CONTROL ROOM EVALUATION

    International Nuclear Information System (INIS)

    OHARA, J.; BROWN, W.; STUBLER, W.; HIGGINS, J.; WACHTEL, J.; PERSENSKY, J.J.

    2000-01-01

    The Human-System Interface Design Review Guideline (NUREG-0700, Revision 1) was developed by the US Nuclear Regulatory Commission (NRC) to provide human factors guidance as a basis for the review of advanced human-system interface technologies. The guidance consists of three components: design review procedures, human factors engineering guidelines, and a software application to provide design review support called the ''Design Review Guideline.'' Since it was published in June 1996, Rev. 1 to NUREG-0700 has been used successfully by NRC staff, contractors and nuclear industry organizations, as well as by interested organizations outside the nuclear industry. The NRC has committed to the periodic update and improvement of the guidance to ensure that it remains a state-of-the-art design evaluation tool in the face of emerging and rapidly changing technology. This paper addresses the current research to update of NUREG-0700 based on the substantial work that has taken place since the publication of Revision 1

  9. Image guidance in orthopaedics and traumatology: A historical perspective.

    Science.gov (United States)

    Székely, Gabor; Nolte, Lutz-P

    2016-10-01

    In this note we summarize the history of computer aided surgery in orthopaedics and traumatology from the end of the nineteenth century to currently observable future trends. We concentrate on the two major components of such systems, pre-operative planning and intra-operative execution. The evolution of the necessary technological components, the numerous platforms and components offered commercially as well as their clinical use are surveyed. Copyright © 2016. Published by Elsevier B.V.

  10. Overcoming consumer inertia to dietary guidance.

    Science.gov (United States)

    Webb, Densie; Byrd-Bredbenner, Carol

    2015-07-01

    Despite 35 y of dietary guidance, there has been no substantial shift in consumer compliance. Consumers report that they seek information on nutrition and healthy eating, but most are not paying attention to dietary recommendations. For guidance to be effective, it must be realistic. Even with increasingly detailed nutrition information and evidence that diet affects health outcomes, convenience and taste remain the strongest determinants of food choices. It is up to health educators to clear up confusion and give consumers control with nutrition messages that are realistic, positive, easy to understand, and actionable without an expectation that consumers will surrender foods they love. © 2015 American Society for Nutrition.

  11. Overcoming Consumer Inertia to Dietary Guidance12

    Science.gov (United States)

    Webb, Densie; Byrd-Bredbenner, Carol

    2015-01-01

    Despite 35 y of dietary guidance, there has been no substantial shift in consumer compliance. Consumers report that they seek information on nutrition and healthy eating, but most are not paying attention to dietary recommendations. For guidance to be effective, it must be realistic. Even with increasingly detailed nutrition information and evidence that diet affects health outcomes, convenience and taste remain the strongest determinants of food choices. It is up to health educators to clear up confusion and give consumers control with nutrition messages that are realistic, positive, easy to understand, and actionable without an expectation that consumers will surrender foods they love. PMID:26178023

  12. Regional information guidance system based on hypermedia concept

    Science.gov (United States)

    Matoba, Hiroshi; Hara, Yoshinori; Kasahara, Yutako

    1990-08-01

    A regional information guidance system has been developed on an image workstation. Two main features of this system are hypermedia data structure and friendly visual interface realized by the full-color frame memory system. As the hypermedia data structure manages regional information such as maps, pictures and explanations of points of interest, users can retrieve those information one by one, next to next according to their interest change. For example, users can retrieve explanation of a picture through the link between pictures and text explanations. Users can also traverse from one document to another by using keywords as cross reference indices. The second feature is to utilize a full-color, high resolution and wide space frame memory for visual interface design. This frame memory system enables real-time operation of image data and natural scene representation. The system also provides half tone representing function which enables fade-in/out presentations. This fade-in/out functions used in displaying and erasing menu and image data, makes visual interface soft for human eyes. The system we have developed is a typical example of multimedia applications. We expect the image workstation will play an important role as a platform for multimedia applications.

  13. Intraluminal ultrasound guidance of transverse laser coronary atherectomy

    Science.gov (United States)

    Aretz, H. Thomas; Martinelli, Michael A.; LeDet, Earl G.; Sedlacek, Tomas; Hatch, G. F.; Gregg, Richard E.

    1990-07-01

    A coronary laser atherectomy system combining laser delivery and ultrasonic imaging capability is described. The system is being developed by Intra-Sonix, Inc. to treat severe stenoses. The imaging system provides the clinician with the guidance needed to remove substantial plaque without perforation. The ultrasound transducers and laser optics are mounted in a small (less than 4 F), flexible catheter, that is deliverable over a standard guidewire (0.016 inch). The laser and ultrasound beams are directed at the artery wall to permit debulking of lesions and ultrasonic depth profiling of the tissue structure throughout the thickness of the artery. This allows the physician to determine the level of therapy to be applied and to monitor the plaque removal as the therapy progresses. The precise location of the ultrasound and laser beams in the artery is determined by a navigation system. Navigation data are processed electronically in conjunction with ultrasound data to produce real-time cross-sectional and longitudinal images of the artery wall at selected locations, which are updated as the catheter progresses through the vessel lumen. Results of in vitro tests on human atherosclerotic arteries and early in vivo experiments in a canine-human xenograft model showing image construction and radial laser delivery are discussed.

  14. REAL-TIME CAMERA GUIDANCE FOR 3D SCENE RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    F. Schindler

    2012-07-01

    Full Text Available We propose a framework for operator guidance during the image acquisition process for reliable multi-view stereo reconstruction. Goal is to achieve full coverage of the object and sufficient overlap. Multi-view stereo is a commonly used method to reconstruct both camera trajectory and 3D object shape. After determining an initial solution, a globally optimal reconstruction is usually obtained by executing a bundle adjustment involving all images. Acquiring suitable images, however, still requires an experienced operator to ensure accuracy and completeness of the final solution. We propose an interactive framework for guiding unexperienced users or possibly an autonomous robot. Using approximate camera orientations and object points we estimate point uncertainties within a sliding bundle adjustment and suggest appropriate camera movements. A visual feedback system communicates the decisions to the user in an intuitive way. We demonstrate the suitability of our system with a virtual image acquisition simulation as well as in real-world scenarios. We show that when following the camera movements suggested by our system, the proposed framework is able to generate good approximate values for the bundle adjustment, leading to accurate results compared to ground truth after few iterations. Possible applications are non-professional 3D acquisition systems on low-cost platforms like mobile phones, autonomously navigating robots as well as online flight planning of unmanned aerial vehicles.

  15. 28 CFR 91.53 - Other guidance.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Other guidance. 91.53 Section 91.53 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) GRANTS FOR CORRECTIONAL FACILITIES Environmental... Justice has also published NEPA procedures that incorporate the CEQ regulations at 28 CFR part 61...

  16. 21 CFR 601.29 - Guidance documents.

    Science.gov (United States)

    2010-04-01

    ... Manufacturers Assistance (HFM-40), Center for Biologics Evaluation and Research, Food and Drug Administration... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Guidance documents. 601.29 Section 601.29 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS...

  17. 21 CFR 312.145 - Guidance documents.

    Science.gov (United States)

    2010-04-01

    ... of Drug Information, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New... Evaluation and Research, Food and Drug Administration, 1401 Rockville Pike, Rockville, MD 20852-1448. [65 FR... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Guidance documents. 312.145 Section 312.145 Food...

  18. Chinese Human Rights Guidance on Minerals Sourcing

    DEFF Research Database (Denmark)

    Buhmann, Karin

    2017-01-01

    in the minerals sector and due diligence to ensure socially responsible sourcing of minerals with a particular focus on human rights, the guidelines refer to international human rights standards and are designed to be consistent with guidance issued by the OECD. The article discusses the Chinese guidelines...

  19. Guidance for performing site inspections under CERCLA

    Energy Technology Data Exchange (ETDEWEB)

    1992-09-01

    This guidance presents EPA`s site inspection (SI) strategy. The strategy discusses procedural guidelines to investigate potential Superfund (CERCLA) sites for evaluation pursuant to the Hazard Ranking System (HRS), revised in accordance with the Superfund Amendments and Reauthorization Act of 1986. The HRS is the primary means by which EPA evaluates sites for superfund`s National Priorities List (NPL).

  20. Bridge over troubled water: Guidance crosses | Amundson ...

    African Journals Online (AJOL)

    This article is based on a keynote presentation at an international conference where the focus was cross-over career guidance. Simon and Garfunkel's popular song, "Bridge ... and the future, and building connections. There also was the suggestion that other metaphors could be used as a way to broaden the exploration.

  1. Guidance on Port Biological Baseline Surveys (PBBS)

    Digital Repository Service at National Institute of Oceanography (India)

    Awad, A.; Haag, F.; Anil, A.C.; Abdulla, A.

    This publication has been prepared by GBP, IOI, CSIR-NIO and IUCN in order to serve as guidance to those who are planning to carry out a port biological baseline survey, in particular in the context of Ballast Water Management. It has been drafted...

  2. The Guidance Counselor and the Reading Curriculum.

    Science.gov (United States)

    Ediger, Marlow

    There are many ways guidance counselors can help teachers achieve more optimal reading instruction. Counselors first may have to ascertain the kinds of problems faced by a student in learning to read. Assessing a student's ability to use picture clues to decipher words may be necessary with primary grade students. Knowledge about phonics, using…

  3. Guidance of eruption for general practitioners.

    Science.gov (United States)

    Ngan, Peter W; Kao, Elizabeth C; Wei, Stephen H

    2003-04-01

    The principle of early treatment through well-planned extraction of primary teeth followed by removal of permanent teeth has stood the test of time. The objective of this article is to develop some simple guidelines for general dental practitioners to perform 'guidance of eruption' in malocclusion with severe crowding.

  4. ROUTE PLAN DESIGNER FOR TRACTOR GUIDANCE SYSTEMS

    DEFF Research Database (Denmark)

    Sveistrup, Daniel; Jørgensen, Rasmus Nyholm; Green, Ole

    2010-01-01

    Earlier works have shown field trial designs to be very labor extensive, even when combining autoguidancesystems with conventional machinery.Designing routes for semi-automated systems in a controlled manner is both resource demandingand complicated. Different types of auto-guidance systems vary ...

  5. Semantic guidance of eye movements in real-world scenes.

    Science.gov (United States)

    Hwang, Alex D; Wang, Hsueh-Cheng; Pomplun, Marc

    2011-05-25

    The perception of objects in our visual world is influenced by not only their low-level visual features such as shape and color, but also their high-level features such as meaning and semantic relations among them. While it has been shown that low-level features in real-world scenes guide eye movements during scene inspection and search, the influence of semantic similarity among scene objects on eye movements in such situations has not been investigated. Here we study guidance of eye movements by semantic similarity among objects during real-world scene inspection and search. By selecting scenes from the LabelMe object-annotated image database and applying latent semantic analysis (LSA) to the object labels, we generated semantic saliency maps of real-world scenes based on the semantic similarity of scene objects to the currently fixated object or the search target. An ROC analysis of these maps as predictors of subjects' gaze transitions between objects during scene inspection revealed a preference for transitions to objects that were semantically similar to the currently inspected one. Furthermore, during the course of a scene search, subjects' eye movements were progressively guided toward objects that were semantically similar to the search target. These findings demonstrate substantial semantic guidance of eye movements in real-world scenes and show its importance for understanding real-world attentional control. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Electromechanical wave imaging for arrhythmias

    International Nuclear Information System (INIS)

    Provost, Jean; Nguyen, Vu Thanh-Hieu; Legrand, Diégo; Okrasinski, Stan; Costet, Alexandre; Konofagou, Elisa E; Gambhir, Alok; Garan, Hasan

    2011-01-01

    Electromechanical wave imaging (EWI) is a novel ultrasound-based imaging modality for mapping of the electromechanical wave (EW), i.e. the transient deformations occurring in immediate response to the electrical activation. The correlation between the EW and the electrical activation has been established in prior studies. However, the methods used previously to map the EW required the reconstruction of images over multiple cardiac cycles, precluding the application of EWI for non-periodic arrhythmias such as fibrillation. In this study, new imaging sequences are developed and applied based on flash- and wide-beam emissions to image the entire heart at very high frame rates (2000 fps) during free breathing in a single heartbeat. The methods are first validated by imaging the heart of an open-chest canine while simultaneously mapping the electrical activation using a 64-electrode basket catheter. Feasibility is then assessed by imaging the atria and ventricles of closed-chest, conscious canines during sinus rhythm and during right-ventricular pacing following atrio-ventricular dissociation, i.e., during a non-periodic rhythm. The EW was validated against electrode measurements in the open-chest case, and followed the expected electrical propagation pattern in the closed-chest setting. These results indicate that EWI can be used for the characterization of non-periodic arrhythmias in conditions similar to the clinical setting, in a single heartbeat, and during free breathing. (fast track communication)

  7. RMP Guidance for Chemical Distributors - Appendix D: OSHA Guidance on PSM

    Science.gov (United States)

    Guidance on the Process Safety Management standard says information (including MSDS) about chemicals, including process intermediates, must enable accurate assessment of fire/explosion characteristics, reactivity hazards, and corrosing/erosion effects.

  8. A Formal Investigation of the Organization of Guidance Behavior: Implications for Humans and Autonomous Guidance

    Science.gov (United States)

    Kong, Zhaodan

    Guidance behavior generated either by artificial agents or humans has been actively studied in the fields of both robotics and cognitive science. The goals of these two fields are different. The former is the automatic generation of appropriate or even optimal behavior, while the latter is the understanding of the underlying mechanism. Their challenges, though, are closely related, the most important one being the lack of a unified, formal and grounded framework where the guidance behavior can be modeled and studied. This dissertation presents such a framework. In this framework, guidance behavior is analyzed as the closed-loop dynamics of the whole agent-environment system. The resulting dynamics give rise to interaction patterns. The central points of this dissertation are that: first of all, these patterns, which can be explained in terms of symmetries that are inherent to the guidance behavior, provide building blocks for the organization of behavior; second, the existence of these patterns and humans' organization of their guidance behavior based on these patterns are the reasons that humans can generate successful behavior in spite of all the complexities involved in the planning and control. This dissertation first gives an overview of the challenges existing in both scientific endeavors, such as human and animal spatial behavior study, and engineering endeavors, such as autonomous guidance system design. It then lays out the foundation for our formal framework, which states that guidance behavior should be interpreted as the collection of the closed-loop dynamics resulting from the agent's interaction with the environment. The following, illustrated by examples of three different UAVs, shows that the study of the closed-loop dynamics should not be done without the consideration of vehicle dynamics, as is the common practice in some of the studies in both autonomous guidance and human behavior analysis. The framework, the core concepts of which are

  9. Evaluation of contrast reproduction method based on the anatomical guidance of the cerebral images reconstruction in positron emission tomography; Evaluation d'une methode de restitution de contraste basee sur le guidage anatomique de la reconstruction des images cerebrales en tomographie par emission de positons

    Energy Technology Data Exchange (ETDEWEB)

    Bataille, F

    2007-04-15

    Positron emission tomography is a medical imaging modality providing in-vivo volumetric images of functional processes of the human body, which is used for the diagnosis and the following of neuro degenerative diseases. PET efficiency is however limited by its poor spatial resolution, which generates a decrease of the image local contrast and leads to an under-estimation of small cerebral structures involved in the degenerative mechanism of those diseases. This so-called partial volume effect degradation is usually corrected in a post-reconstruction processing framework through the use of anatomical information, whose spatial resolution allows a better discrimination between functional tissues. However, this kind of method has the major drawback of being very sensitive to the residual mismatches on the anatomical information processing. We developed in this thesis an alternative methodology to compensate for the degradation, by incorporating in the reconstruction process both a model of the system impulse response and an anatomically-based image prior constraint. This methodology was validated by comparison with a post-reconstruction correction strategy, using data from an anthropomorphic phantom acquisition and then we evaluated its robustness to the residual mismatches through a realistic Monte Carlo simulation corresponding to a cerebral exam. The proposed algorithm was finally applied to clinical data reconstruction. (author)

  10. Evaluation of contrast reproduction method based on the anatomical guidance of the cerebral images reconstruction in positron emission tomography; Evaluation d'une methode de restitution de contraste basee sur le guidage anatomique de la reconstruction des images cerebrales en tomographie par emission de positons

    Energy Technology Data Exchange (ETDEWEB)

    Bataille, F

    2007-04-15

    Positron emission tomography is a medical imaging modality providing in-vivo volumetric images of functional processes of the human body, which is used for the diagnosis and the following of neuro degenerative diseases. PET efficiency is however limited by its poor spatial resolution, which generates a decrease of the image local contrast and leads to an under-estimation of small cerebral structures involved in the degenerative mechanism of those diseases. This so-called partial volume effect degradation is usually corrected in a post-reconstruction processing framework through the use of anatomical information, whose spatial resolution allows a better discrimination between functional tissues. However, this kind of method has the major drawback of being very sensitive to the residual mismatches on the anatomical information processing. We developed in this thesis an alternative methodology to compensate for the degradation, by incorporating in the reconstruction process both a model of the system impulse response and an anatomically-based image prior constraint. This methodology was validated by comparison with a post-reconstruction correction strategy, using data from an anthropomorphic phantom acquisition and then we evaluated its robustness to the residual mismatches through a realistic Monte Carlo simulation corresponding to a cerebral exam. The proposed algorithm was finally applied to clinical data reconstruction. (author)

  11. Design Guidance for New Windows | Efficient Windows Collaborative

    Science.gov (United States)

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  12. Design Guidance for Replacement Windows | Efficient Windows Collaborative

    Science.gov (United States)

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  13. 78 FR 25454 - Issuance of Final Guidance Publication

    Science.gov (United States)

    2013-05-01

    ... NIOSH-161-A] Issuance of Final Guidance Publication AGENCY: National Institute for Occupational Safety... Human Services (HHS). ACTION: Notice of issuance of final guidance publication. SUMMARY: The National...), announces the availability of the following publication: ``NIOSH Current Intelligence Bulletin 65...

  14. 77 FR 74194 - Issuance of Final Guidance Publication

    Science.gov (United States)

    2012-12-13

    ... NIOSH-238] Issuance of Final Guidance Publication AGENCY: National Institute for Occupational Safety and... Services (HHS). ACTION: Notice of issuance of final guidance publication. SUMMARY: The National Institute...), announces the availability of the following publication: NIOSH Alert entitled ``Preventing Occupational...

  15. 78 FR 13097 - Electric Power Research Institute; Seismic Evaluation Guidance

    Science.gov (United States)

    2013-02-26

    ... NUCLEAR REGULATORY COMMISSION [NRC-2013-0038] Electric Power Research Institute; Seismic... Electric Power Research Institute (EPRI)-1025287, ``Seismic Evaluation Guidance: Screening, Prioritization... guidance and clarification of an acceptable approach to assist nuclear power reactor licensees when...

  16. Machine Visual Guidance For An Autonomous Undersea Submersible

    Science.gov (United States)

    Nguyen, Hoa G.; Kaomea, Peter K.; Heckman, Paul J.

    1988-12-01

    Optical imaging is the preferred sensory modality for underwater robotic activities requiring high resolution at close range, such as station keeping, docking, control of manipulator, and object retrieval. Machine vision will play a vital part in the design of next generation autonomous underwater submersibles. This paper describes an effort to demonstrate that real-time vision-based guidance and control of autonomous underwater submersibles is possible with compact, low-power, and vehicle-imbeddable hardware. The Naval Ocean Systems Center's EAVE-WEST (Experimental Autonomous Vehicle-West) submersible is being used as the testbed. The vision hardware consists of a PC-bus video frame grabber and an IBM-PC/AT compatible single-board computer, both residing in the artificial intelligence/vision electronics bottle of the submersible. The specific application chosen involves the tracking of underwater buoy cables. Image recognition is performed in two steps. Feature points are identified in the underwater video images using a technique which detects one-dimensional local brightness minima and maxima. Hough transformation is then used to detect the straight line among these feature points. A hierarchical coarse-to-fine processing method is employed which terminates when enough feature points have been identified to allow a reliable fit. The location of the cable identified is then reported to the vehicle controller computer for automatic steering control. The process currently operates successfully with a throughput of approximately 2 frames per second.

  17. A Dual-Field Sensing Scheme for a Guidance System for the Blind

    Directory of Open Access Journals (Sweden)

    Qing Lin

    2016-05-01

    Full Text Available An electronic guidance system is very helpful in improving blind people’s perceptions in a local environment. In our previous work “Lin, Q.; Han, Y. A Context-Aware-Based Audio Guidance System for Blind People Using a Multimodal Profile Model. Sensors 2014, 14, 18670–18700”, a context-aware guidance system using a combination of a laser scanner and a camera was proposed. By using a near-field graphical model, the proposed system could interpret a near-field scene in very high resolution. In this paper, our work is extended by adding a far-field graphical model. The integration of the near-field and the far-field models constitutes a dual-field sensing scheme. In the near-field range, reliable inference of the ground and object status is obtained by fusing range data and image data using the near-field graphical model. In the far-field range, which only the camera can cover, the far-field graphical model is proposed to interpret far-field image data based on appearance and spatial prototypes built using the near-field interpreted data. The dual-field sensing scheme provides a solution for the guidance systems to optimise their scene interpretation capability using simple sensor configurations. Experiments under various local conditions were conducted to show the efficiency of the proposed scheme in improving blind people’s perceptions in urban environments.

  18. Balloon pulmonary angioplasty: applicability of C-Arm CT for procedure guidance

    Energy Technology Data Exchange (ETDEWEB)

    Hinrichs, Jan B. [Department for Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover (Germany); Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover (Germany); Renne, Julius; Wacker, Frank K.; Meyer, Bernhard C. [Department for Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover (Germany); Hoeper, Marius M.; Olsson, Karen M. [Clinic for Pneumology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover (Germany)

    2016-11-15

    To investigate the feasibility of and compare two C-Arm CT (CACT) guidance methods during balloon pulmonary angioplasty (BPA). Forty-two BPAs [27 CTEPH patients (nine males, 70 ± 14y)] targeting 143 pulmonary arteries were included. Twenty-two BPAs were guided by contrast-enhanced CACT acquired immediately before BPA (G3D). In another 20 BPAs (G2D), two orthogonal fluoroscopy images of the chest where acquired to compute a registration of a previously acquired CACT. Volume rendering-based graphic representations (VRT guidance) were generated indicating the origin and course of the vessels. Based on VRT guidance, the intervention was planned. Procedure durations and radiation exposure data were compared between the two groups (Wilcoxon test). The overall intervention time was approximately 2 h in both groups (p = 0.31). BPA was successfully performed in G3D 91 % and G2D 94 %. No significant difference was found concerning the mean dose area product (DAP) related to fluoroscopy (p = 0.38), while DAP related to DSA was slightly higher in G3D (p = 0.048). Overall, DAP was significantly higher in G3D (p = 0.002). The use of CACT for procedure guidance in patients undergoing BPA is feasible and accurate. Image fusion of a pre-acquired CACT can be used to decrease radiation exposure due to multiple BPA sessions. (orig.)

  19. Strategies for Structural Youth Unemployment: a Capability Approach for Guidance

    OpenAIRE

    Massimiliano Costa; Daniele Morselli; John Polesel; Suzanne Rice

    2015-01-01

    The aim of this article is to present an innovative approach for guidance. The article starts by introducing the structural reason of unemployment in Italy. It presents the Australian model of guidance and the new reforms on guidance which are being introduced in Italy. It then describes a Change Laboratory intervention carried in a vocational setting in Australia in 2012, which is proposed as model of guidance based on the capability approach.The different stakeholders actively participate i...

  20. Taxonometric Guidance for Developing Quality Assurance

    International Nuclear Information System (INIS)

    Thomadsen, Bruce; Lin, She-Woei

    2008-01-01

    A taxonomy is an ordered classification system. In error reduction analysis, an examination of the human failures that lead to an event often uses a taxonomy to classify the failures according to some aspect of their characteristics. These classifications provide insights into the forces that kept the persons involved from achieving their intended actions. They also can provide guidance for changing the situation to prevent failure in the future. For example, the corrective action would be different if a therapist pressed the wrong button because several buttons looked alike or they forgot which button to press. Different types of failures lead to particular types of remediation. Taxonomies can provide guidance in selecting between possible corrective actions

  1. Guidance and justification in particularistic ethics.

    Science.gov (United States)

    Kihlbom, U

    2000-10-01

    This paper argues that, contrary to a common line of criticism followed by scholars such as Helga Kuhse, a particularistic version of virtue ethics properly elaborated, can provide sound moral guidance and a satisfactory account for moral justification of our opinions regarding, for instance, health care practice. In the first part of the paper, three criteria for comparing normative theories with respect to action-guiding power are outlined, and it is argued that the presented particularistic version of virtue ethics actually can provide more guidance than the universalistic theories followed by Kuhse and others. In the second part of the paper it is claimed that universalist normative theories have serious problems accounting for the role that moral principles are supposed to play in the justification, of moral opinions, whereas the present version of virtue ethics accommodates a plausible alternative idea of justification without invoking moral principles or eschewing objectivity.

  2. Meninges-derived cues control axon guidance.

    Science.gov (United States)

    Suter, Tracey A C S; DeLoughery, Zachary J; Jaworski, Alexander

    2017-10-01

    The axons of developing neurons travel long distances along stereotyped pathways under the direction of extracellular cues sensed by the axonal growth cone. Guidance cues are either secreted proteins that diffuse freely or bind the extracellular matrix, or membrane-anchored proteins. Different populations of axons express distinct sets of receptors for guidance cues, which results in differential responses to specific ligands. The full repertoire of axon guidance cues and receptors and the identity of the tissues producing these cues remain to be elucidated. The meninges are connective tissue layers enveloping the vertebrate brain and spinal cord that serve to protect the central nervous system (CNS). The meninges also instruct nervous system development by regulating the generation and migration of neural progenitors, but it has not been determined whether they help guide axons to their targets. Here, we investigate a possible role for the meninges in neuronal wiring. Using mouse neural tissue explants, we show that developing spinal cord meninges produce secreted attractive and repulsive cues that can guide multiple types of axons in vitro. We find that motor and sensory neurons, which project axons across the CNS-peripheral nervous system (PNS) boundary, are attracted by meninges. Conversely, axons of both ipsi- and contralaterally projecting dorsal spinal cord interneurons are repelled by meninges. The responses of these axonal populations to the meninges are consistent with their trajectories relative to meninges in vivo, suggesting that meningeal guidance factors contribute to nervous system wiring and control which axons are able to traverse the CNS-PNS boundary. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. A novel method for accurate needle-tip identification in trans-rectal ultrasound-based high-dose-rate prostate brachytherapy.

    Science.gov (United States)

    Zheng, Dandan; Todor, Dorin A

    2011-01-01

    In real-time trans-rectal ultrasound (TRUS)-based high-dose-rate prostate brachytherapy, the accurate identification of needle-tip position is critical for treatment planning and delivery. Currently, needle-tip identification on ultrasound images can be subject to large uncertainty and errors because of ultrasound image quality and imaging artifacts. To address this problem, we developed a method based on physical measurements with simple and practical implementation to improve the accuracy and robustness of needle-tip identification. Our method uses measurements of the residual needle length and an off-line pre-established coordinate transformation factor, to calculate the needle-tip position on the TRUS images. The transformation factor was established through a one-time systematic set of measurements of the probe and template holder positions, applicable to all patients. To compare the accuracy and robustness of the proposed method and the conventional method (ultrasound detection), based on the gold-standard X-ray fluoroscopy, extensive measurements were conducted in water and gel phantoms. In water phantom, our method showed an average tip-detection accuracy of 0.7 mm compared with 1.6 mm of the conventional method. In gel phantom (more realistic and tissue-like), our method maintained its level of accuracy while the uncertainty of the conventional method was 3.4mm on average with maximum values of over 10mm because of imaging artifacts. A novel method based on simple physical measurements was developed to accurately detect the needle-tip position for TRUS-based high-dose-rate prostate brachytherapy. The method demonstrated much improved accuracy and robustness over the conventional method. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  4. River City High School Guidance Services: A Conceptual Model.

    Science.gov (United States)

    American Coll. Testing Program, Iowa City, IA.

    This model describes how the guidance staff at a hypothetical high school communicated the effectiveness of the guidance program to students, parents, teachers, and administrators. A description of the high school is presented, and guidance services and personnel are described. A conceptual model responding to student needs is outlined along with…

  5. 76 FR 411 - Regulatory Guidance Concerning Electronic Signatures and Documents

    Science.gov (United States)

    2011-01-04

    ... guidance, including memoranda and letters, may no longer be relied upon to the extent they are inconsistent... Concerning Electronic Signatures and Documents AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of regulatory guidance. SUMMARY: FMCSA issues regulatory guidance concerning the...

  6. Adapting haptic guidance authority based on user grip

    NARCIS (Netherlands)

    Smisek, J.; Mugge, W.; Smeets, J.B.J.; Van Paassen, M.M.; Schiele, A

    2014-01-01

    Haptic guidance systems support the operator in task execution using additional forces on the input device. Scaling of the guidance forces determines the control authority of the support system. As task complexity may vary, one level of the guidance scaling may be insufficient, and adaptation of the

  7. Assessment of Adaptive Guidance for Responsive Launch Vehicles and Spacecraft

    Science.gov (United States)

    2009-04-29

    Figures 1 Earth centered inertial and launch plumbline coordinate systems . . . . . . . 7 2 Geodetic and geocentric latitude...Dramatically reduced reoccurring costs related to guidance. The same features of the closed-loop ascent guidance that provide operational flexibility...also result in greatly reduced need for human intervention. Thus the operational costs related to ascent guidance could be reduced to minimum

  8. 78 FR 49782 - Interim Staff Guidance on Changes During Construction

    Science.gov (United States)

    2013-08-15

    ... Construction AGENCY: Nuclear Regulatory Commission. ACTION: Draft interim staff guidance; request for comment... During Construction.'' This ISG provides guidance to the NRC staff on the Preliminary Amendment Request...-ISG-025 ``Interim Staff Guidance on Changes during Construction under 10 CFR Part 52'' is available...

  9. Draft Guidance for Protective Action Strategies Development

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Hyun; Jeong, Seung Young; Kim, Wanjoo [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2016-10-15

    National nuclear emergency preparedness and response (EPR) framework has been improved since the Fukushima accident in 2011. There are still many needs to be amended and improved in regulatory requirements and technical criteria to warrant efficacy of the EPR framework. As an important part of the framework, protective actions have to be implemented with optimized and justified manner during whole emergency phases. In this study, to enhance protective action strategies in response to severe accident or general emergency, existing procedures were reviewed. And generic guidance to develop protective action recommendations (PARs) was proposed considering revised EPZ and recent technical information on protective action strategies. The generic guidance for PARs based on facility status was introduced. Revision of EPZ and some recent information on protective action strategies, such as staged evacuation, specific approach for rapidly progressing accident were considered. It would be employed as a basis to develop site-specific strategies of PARs and regulatory guidance for emergency plan by nuclear licensee. It was focused on an early phase of nuclear emergency. Further efforts to develop site specific strategies of PARs and strategies which cover full range of nuclear emergency would be followed by several stake holders.

  10. NRC ARDC Guidance Support Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Holbrook, Mark R. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2017-07-01

    This report provides a summary that reflects the progress and status of proposed regulatory design criteria for advanced non-light water reactor (LWR) designs in accordance with the Level 3 milestone M3AT-17IN2001013 in work package AT-17IN200101. These criteria have been designated as advanced reactor design criteria (ARDC) and they provide guidance to future applicants for addressing the general design criteria (GDC) that are currently applied specifically to LWR designs. This report provides a summary of Phase 2 activities related to the various tasks associated with ARDC development and the subsequent development of ARDC regulatory guidance for sodium fast reactor (SFR) and modular high-temperature gas-cooled reactor (HTGR) designs. Status Report Organization: Section 2 discusses the origin of the GDC and their application to LWRs. Section 3 addresses the objective of this initiative and how it benefits the advanced non-LWR reactor vendors. Section 4 discusses the scope and structure of the initiative. Section 5 provides background on the U.S. Department of Energy (DOE) ARDC team’s original development of the proposed ARDC that were submitted to the NRC for consideration. Section 6 provides a summary of recent ARDC Phase 2 activities. Appendices A through E document the DOE ARDC team’s public comments on various sections of the NRC’s draft regulatory guide DG–1330, “Guidance for Developing Principal Design Criteria for Non-Light Water Reactors.”

  11. NRC ARDC Guidance Support Status Report

    International Nuclear Information System (INIS)

    Holbrook, Mark R.

    2017-01-01

    This report provides a summary that reflects the progress and status of proposed regulatory design criteria for advanced non-light water reactor (LWR) designs in accordance with the Level 3 milestone M3AT-17IN2001013 in work package AT-17IN200101. These criteria have been designated as advanced reactor design criteria (ARDC) and they provide guidance to future applicants for addressing the general design criteria (GDC) that are currently applied specifically to LWR designs. This report provides a summary of Phase 2 activities related to the various tasks associated with ARDC development and the subsequent development of ARDC regulatory guidance for sodium fast reactor (SFR) and modular high-temperature gas-cooled reactor (HTGR) designs. Status Report Organization: Section 2 discusses the origin of the GDC and their application to LWRs. Section 3 addresses the objective of this initiative and how it benefits the advanced non-LWR reactor vendors. Section 4 discusses the scope and structure of the initiative. Section 5 provides background on the U.S. Department of Energy (DOE) ARDC team’s original development of the proposed ARDC that were submitted to the NRC for consideration. Section 6 provides a summary of recent ARDC Phase 2 activities. Appendices A through E document the DOE ARDC team’s public comments on various sections of the NRC’s draft regulatory guide DG–1330, “Guidance for Developing Principal Design Criteria for Non-Light Water Reactors.”

  12. Observability-Based Guidance and Sensor Placement

    Science.gov (United States)

    Hinson, Brian T.

    Control system performance is highly dependent on the quality of sensor information available. In a growing number of applications, however, the control task must be accomplished with limited sensing capabilities. This thesis addresses these types of problems from a control-theoretic point-of-view, leveraging system nonlinearities to improve sensing performance. Using measures of observability as an information quality metric, guidance trajectories and sensor distributions are designed to improve the quality of sensor information. An observability-based sensor placement algorithm is developed to compute optimal sensor configurations for a general nonlinear system. The algorithm utilizes a simulation of the nonlinear system as the source of input data, and convex optimization provides a scalable solution method. The sensor placement algorithm is applied to a study of gyroscopic sensing in insect wings. The sensor placement algorithm reveals information-rich areas on flexible insect wings, and a comparison to biological data suggests that insect wings are capable of acting as gyroscopic sensors. An observability-based guidance framework is developed for robotic navigation with limited inertial sensing. Guidance trajectories and algorithms are developed for range-only and bearing-only navigation that improve navigation accuracy. Simulations and experiments with an underwater vehicle demonstrate that the observability measure allows tuning of the navigation uncertainty.

  13. Non-rigid CT/CBCT to CBCT registration for online external beam radiotherapy guidance

    Science.gov (United States)

    Zachiu, Cornel; de Senneville, Baudouin Denis; Tijssen, Rob H. N.; Kotte, Alexis N. T. J.; Houweling, Antonetta C.; Kerkmeijer, Linda G. W.; Lagendijk, Jan J. W.; Moonen, Chrit T. W.; Ries, Mario

    2018-01-01

    Image-guided external beam radiotherapy (EBRT) allows radiation dose deposition with a high degree of accuracy and precision. Guidance is usually achieved by estimating the displacements, via image registration, between cone beam computed tomography (CBCT) and computed tomography (CT) images acquired at different stages of the therapy. The resulting displacements are then used to reposition the patient such that the location of the tumor at the time of treatment matches its position during planning. Moreover, ongoing research aims to use CBCT-CT image registration for online plan adaptation. However, CBCT images are usually acquired using a small number of x-ray projections and/or low beam intensities. This often leads to the images being subject to low contrast, low signal-to-noise ratio and artifacts, which ends-up hampering the image registration process. Previous studies addressed this by integrating additional image processing steps into the registration procedure. However, these steps are usually designed for particular image acquisition schemes, therefore limiting their use on a case-by-case basis. In the current study we address CT to CBCT and CBCT to CBCT registration by the means of the recently proposed EVolution registration algorithm. Contrary to previous approaches, EVolution does not require the integration of additional image processing steps in the registration scheme. Moreover, the algorithm requires a low number of input parameters, is easily parallelizable and provides an elastic deformation on a point-by-point basis. Results have shown that relative to a pure CT-based registration, the intrinsic artifacts present in typical CBCT images only have a sub-millimeter impact on the accuracy and precision of the estimated deformation. In addition, the algorithm has low computational requirements, which are compatible with online image-based guidance of EBRT treatments.

  14. Guidance and control, 1993; Annual Rocky Mountain Guidance and Control Conference, 16th, Keystone, CO, Feb. 6-10, 1993

    Science.gov (United States)

    Culp, Robert D.; Bickley, George

    Papers from the sixteenth annual American Astronautical Society Rocky Mountain Guidance and Control Conference are presented. The topics covered include the following: advances in guidance, navigation, and control; control system videos; guidance, navigation and control embedded flight control systems; recent experiences; guidance and control storyboard displays; and applications of modern control, featuring the Hubble Space Telescope (HST) performance enhancement study. For individual titles, see A95-80390 through A95-80436.

  15. 78 FR 12761 - Guidance for Industry: Guidance on the Labeling of Certain Uses of Lecithin Derived From Soy...

    Science.gov (United States)

    2013-02-25

    ...] (formerly 2006D-0169) Guidance for Industry: Guidance on the Labeling of Certain Uses of Lecithin Derived... on the Labeling of Certain Uses of Lecithin Derived From Soy Under Section 403(w) of the Federal Food.... The guidance explained FDA's then current thinking on the labeling of certain uses of lecithin derived...

  16. 77 FR 34390 - Draft Guidance for Industry: Amendment to “Guidance for Industry: Revised Preventive Measures To...

    Science.gov (United States)

    2012-06-11

    ... recommendations for plasma-derived products, including albumin and products containing plasma-derived albumin, in..., submit either electronic or written comments on the draft guidance by September 10, 2012. ADDRESSES... electronic access to the draft guidance document. Submit electronic comments on the draft guidance to http...

  17. 78 FR 12759 - Draft Guidance for Industry on Attachment to Guidance on Antiviral Product Development-Conducting...

    Science.gov (United States)

    2013-02-25

    ...; formerly 2005D-0183] Draft Guidance for Industry on Attachment to Guidance on Antiviral Product Development... guidance to the Division of Drug Information, Center for Drug Evaluation and Research, Food and Drug... 20852. FOR FURTHER INFORMATION CONTACT: Lisa K. Naeger, Center for Drug Evaluation and Research, Food...

  18. European Lifelong Guidance Policy Network Representatives' Conceptions of the Role of Information and Communication Technologies Related to National Guidance Policies

    Science.gov (United States)

    Kettunen, Jaana; Vuorinen, Raimo; Ruusuvirta, Outi

    2016-01-01

    This article reports findings from a phenomenographic investigation into European Lifelong Guidance Policy Network representatives' conceptions of the role of information and communication technologies (ICT) related to national lifelong guidance policies. The role of ICT in relation to national lifelong guidance policies was conceived as (1)…

  19. 75 FR 54637 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

    Science.gov (United States)

    2010-09-08

    ... conferencing and electronic submissions, Mammography Matters, and other device-oriented information. The CDRH... approval) into class II (special controls). DATES: Submit written or electronic comments on this guidance... electronic access to the guidance. Submit electronic comments on the guidance to http://www.regulations.gov...

  20. Contextual cueing improves attentional guidance, even when guidance is supposedly optimal.

    Science.gov (United States)

    Harris, Anthony M; Remington, Roger W

    2017-05-01

    Visual search through previously encountered contexts typically produces reduced reaction times compared with search through novel contexts. This contextual cueing benefit is well established, but there is debate regarding its underlying mechanisms. Eye-tracking studies have consistently shown reduced number of fixations with repetition, supporting improvements in attentional guidance as the source of contextual cueing. However, contextual cueing benefits have been shown in conditions in which attentional guidance should already be optimal-namely, when attention is captured to the target location by an abrupt onset, or under pop-out conditions. These results have been used to argue for a response-related account of contextual cueing. Here, we combine eye tracking with response time to examine the mechanisms behind contextual cueing in spatially cued and pop-out conditions. Three experiments find consistent response time benefits with repetition, which appear to be driven almost entirely by a reduction in number of fixations, supporting improved attentional guidance as the mechanism behind contextual cueing. No differences were observed in the time between fixating the target and responding-our proxy for response related processes. Furthermore, the correlation between contextual cueing magnitude and the reduction in number of fixations on repeated contexts approaches 1. These results argue strongly that attentional guidance is facilitated by familiar search contexts, even when guidance is near-optimal. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Optimization of levitation and guidance forces in a superconducting Maglev system

    Science.gov (United States)

    Yildizer, Irfan; Cansiz, Ahmet; Ozturk, Kemal

    2016-09-01

    Optimization of the levitation for superconducting Maglev systems requires effective use of vertical and guidance forces during the operation. In this respect the levitation and guidance forces in terms of various permanent magnet array configurations are analyzed. The arrangements of permanent magnet arrays interacting with the superconductor are configured for the purpose of increasing the magnetic flux density. According to configurations, modeling the interaction forces between the permanent magnet and the superconductor are established in terms of the frozen image model. The model is complemented with the analytical calculations and provides a reasonable agreement with the experiments. The agreement of the analytical calculation associated with the frozen image model indicates a strong case to establish an optimization, in which provides preliminary analysis before constructing more complex Maglev system.

  2. On the design of fuzzified trajectory shaping guidance law.

    Science.gov (United States)

    Lin, Chun-Liang; Lin, Yu-Ping; Chen, Kai-Ming

    2009-04-01

    Midcourse guidance is commonly designed to save as much energy as possible so that the missile's final speed can be maximized while entering the homing stage. For this purpose, a competitive guidance design should be able to generate an admissible flight trajectory as to bring the interceptor to a superior altitude for a favorable target engagement. In this paper, a new adaptive trajectory shaping guidance scheme based on the adaptive fuzzy inference system, which is capable of generating a variety of trajectories for efficient target interception, is presented. The guidance law is developed with the aim of saving the interceptor's energy conservation while improving performance robustness. Applications of the presented approach have included a variety of mission oriented guidance, such as cruise missile guidance, anti-ballistic missile guidance, etc.

  3. Dissecting Attending Surgeons' Operating Room Guidance: Factors That Affect Guidance Decision Making.

    Science.gov (United States)

    Chen, Xiaodong Phoenix; Williams, Reed G; Smink, Douglas S

    2015-01-01

    The amount of guidance provided by the attending surgeon in the operating room (OR) is a key element in developing residents' autonomy. The purpose of this study is to explore factors that affect attending surgeons' decision making regarding OR guidance provided to the resident. We used video-stimulated recall interviews (VSRI) throughout this 2-phase study. In Phase 1, 3 attending surgeons were invited to review separately 30 to 45 minute video segments of their prerecorded surgical operations to explore factors that influenced their OR guidance decision making. In Phase 2, 3 attending surgeons were observed and documented in the OR (4 operations, 341min). Each operating surgeon reviewed their videotaped surgical performance within 5 days of the operation to reflect on factors that affected their decision making during the targeted guidance events. All VSRI were recorded. Thematic analysis and manual coding were used to synthesize and analyze data from VSRI transcripts, OR observation documents, and field notes. A total of 255 minutes of VSRI involving 6 surgeons and 7 surgical operations from 5 different procedures were conducted. A total of 13 guidance decision-making influence factors from 4 categories were identified (Cohen's κ = 0.674): Setting (case schedule and patient morbidity), content (procedure attributes and case progress), resident (current competency level, trustworthiness, self-confidence, and personal traits), and attending surgeon (level of experience, level of comfort, preferred surgical technique, OR training philosophy, and responsibility as surgeon). A total of 5 factors (case schedule, patient morbidity, procedure attributes, resident current competency level, and trustworthiness) influenced attending surgeons' pre-OR guidance plans. "OR training philosophy" and "responsibility as surgeon" were anchor factors that affected attending surgeons' OR guidance decision-making patterns. Surgeons' OR guidance decision making is a dynamic process

  4. Human Guidance Behavior Decomposition and Modeling

    Science.gov (United States)

    Feit, Andrew James

    Trained humans are capable of high performance, adaptable, and robust first-person dynamic motion guidance behavior. This behavior is exhibited in a wide variety of activities such as driving, piloting aircraft, skiing, biking, and many others. Human performance in such activities far exceeds the current capability of autonomous systems in terms of adaptability to new tasks, real-time motion planning, robustness, and trading safety for performance. The present work investigates the structure of human dynamic motion guidance that enables these performance qualities. This work uses a first-person experimental framework that presents a driving task to the subject, measuring control inputs, vehicle motion, and operator visual gaze movement. The resulting data is decomposed into subspace segment clusters that form primitive elements of action-perception interactive behavior. Subspace clusters are defined by both agent-environment system dynamic constraints and operator control strategies. A key contribution of this work is to define transitions between subspace cluster segments, or subgoals, as points where the set of active constraints, either system or operator defined, changes. This definition provides necessary conditions to determine transition points for a given task-environment scenario that allow a solution trajectory to be planned from known behavior elements. In addition, human gaze behavior during this task contains predictive behavior elements, indicating that the identified control modes are internally modeled. Based on these ideas, a generative, autonomous guidance framework is introduced that efficiently generates optimal dynamic motion behavior in new tasks. The new subgoal planning algorithm is shown to generate solutions to certain tasks more quickly than existing approaches currently used in robotics.

  5. Early school leaving and lifelong guidance

    DEFF Research Database (Denmark)

    Plant, Peter; Oomen, Annemarie

    Early school leaving (ESL) is costly for the individual, for society and for the economy. Not just in economic terms, but also in terms of low self esteem, and the risk of social exclusion. More, and, in particular, better education can lead to positive outcomes, in relation to employment, level...... of salaries, better health, less crime, higher social cohesion, lower public and social costs and higher productivity. This is why ESL is a policy focal point. In these terms, lifelong guidance has a key role to play in terms of both prevention, intervention, and of compensation strategies....

  6. Cannabinoid receptor CB2 modulates axon guidance

    DEFF Research Database (Denmark)

    Duff, Gabriel; Argaw, Anteneh; Cecyre, Bruno

    2013-01-01

    on axon guidance. These effects are specific to CB2R since no changes were observed in mice where the gene coding for this receptor was altered (cnr2 (-/-)). The CB2R induced morphological changes observed at the growth cone are PKA dependent and require the presence of the netrin-1 receptor, Deleted...... CB2R's implication in retinothalamic development. Overall, this study demonstrates that the contribution of endocannabinoids to brain development is not solely mediated by CB1R, but also involves CB2R....

  7. Avoiding plagiarism: guidance for nursing students.

    Science.gov (United States)

    Price, Bob

    The pressures of study, diversity of source materials, past assumptions relating to good writing practice, ambiguous writing guidance on best practice and students' insecurity about their reasoning ability, can lead to plagiarism. With the use of source checking software, there is an increased chance that plagiarised work will be identified and investigated, and penalties given. In extreme cases, plagiarised work may be reported to the Nursing and Midwifery Council and professional as well as academic penalties may apply. This article provides information on how students can avoid plagiarism when preparing their coursework for submission.

  8. Equal employment opportunity plan development guidance

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-09-01

    The purpose of this publication is to provide instructions for the development of EEO Plans for Fiscal Year 1979. It supplements the National EEO Plan for the Department of Energy issued in August 1978 (DOE/S-0002). The material included should be used immediately as guidance to develop, document, and implement subordinate echelon commitments to EEO. A schedule for the development and submission of EEO Plans is included. Most of the continuing requirements will be published at a later date as part of the directives system. Any comments or helpful suggestions concerned with the program outlined would be appreciated by the Office of Equal Opportunity.

  9. Configuration management: Phase II implementation guidance

    Energy Technology Data Exchange (ETDEWEB)

    1994-03-01

    Configuration management (CM) is essential to maintaining an acceptable level of risk to the public, workers, environment, or mission success. It is a set of activities and techniques used to maintain consistency among physical and functional configuration, applicable requirements, and key documents. This document provides guidance for continuing the implementation of CM in a phased and graded manner. It describes a cost-effective approach to documented consistency with requirements, with early emphasis on items most important to safety and environmental protection. It is intended to help responsible line managers and configuration management staff personnel in meeting the Energy Systems configuration management policy standard.

  10. Environmental restoration value engineering guidance document

    International Nuclear Information System (INIS)

    1995-07-01

    This document provides guidance on Value Engineering (VE). VE is an organized team effort led by a person trained in the methodology to analyze the functions of projects, systems, equipment, facilities, services, and processes for achieving the essential functions at the lowest life cycle cost while maintaining required performance, reliability, availability, quality, and safety. VE has proven to be a superior tool to improve up-front project planning, cut costs, and create a better value for each dollar spent. This document forms the basis for the Environmental Restoration VE Program, describes the VE process, and provides recommendations on when it can be most useful on ER projects

  11. Development and validation of a new guidance device for lateral approach stereotactic breast biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Ma, K.; Kornecki, A.; Bax, J.; Mundt, Y.; Fenster, A. [Imaging Research Laboratories, Robarts Research Institute, London, Ontario N6A 5K8 (Canada) and Biomedical Engineering Graduate Program, University of Western Ontario, London, Ontario N6A 5B9 (Canada); Department of Radiology, St. Joseph' s Health Care London, London, Ontario N6A 4V2 (Canada) and Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 5A5 (Canada); Imaging Research Laboratories, Robarts Research Institute, London, Ontario N6A 5K8 (Canada) and Biomedical Engineering Graduate Program, University of Western Ontario, London, Ontario N6A 5B9 (Canada); Department of Radiology, St. Joseph' s Health Care London, London, Ontario N6A 4V2 (Canada) and Department of Diagnostic Radiology and Nuclear Medicine, University of Western Ontario, London, Ontario N6A 5A5 (Canada); Imaging Research Laboratories, Robarts Research Institute, London, Ontario N6A 5K8 (Canada); Biomedical Engineering Graduate Program, University of Western Ontario, London, Ontario N6A 5B9 (Canada) and Department of Medical Imaging, University of Western Ontario, London, Ontario N6A 5A5 (Canada)

    2009-06-15

    Stereotactic breast biopsy (SBB) is the gold standard for minimally invasive breast cancer diagnosis. Current systems rely on one of two methods for needle insertion: A vertical approach (perpendicular to the breast compression plate) or a lateral approach (parallel to the compression plate). While the vertical approach is more frequently used, it is not feasible in patients with thin breasts (<3 cm thick after compression) or with superficial lesions. Further, existing SBB guidance hardware provides at most one degree of rotational freedom in the needle trajectory, and as such requires a separate skin incision for each biopsy target. The authors present a new design of lateral guidance device for SBB, which addresses the limitations of the vertical approach and provides improvements over the existing lateral guidance hardware. Specifically, the new device provides (1) an adjustable rigid needle support to minimize needle deflection within the breast and (2) an additional degree of rotational freedom in the needle trajectory, allowing the radiologist to sample multiple targets through a single skin incision. This device was compared to a commercial lateral guidance device in a series of phantom experiments. Needle placement error using each device was measured in agar phantoms for needle insertions at lateral depths of 2 and 5 cm. The biopsy success rate for each device was then estimated by performing biopsy procedures in commercial SBB phantoms. SBB performed with the new lateral guidance device provided reduced needle placement error relative to the commercial lateral guidance device (0.89{+-}0.22 vs 1.75{+-}0.35 mm for targets at 2 cm depth; 1.94{+-}0.20 vs 3.21{+-}0.31 mm for targets at 5 cm depth). The new lateral guidance device also provided improved biopsy accuracy in SBB procedures compared to the commercial lateral guidance device (100% vs 58% success rate). Finally, experiments were performed to demonstrate that the new device can accurately sample

  12. 77 FR 27461 - Draft Guidance for Industry and Food and Drug Administration Staff; Pediatric Information for X...

    Science.gov (United States)

    2012-05-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-0384] Draft Guidance for Industry and Food and Drug Administration Staff; Pediatric Information for X-Ray Imaging Device Premarket Notifications; Availability AGENCY: Food and Drug Administration, HHS. ACTION...

  13. 75 FR 5356 - Office of New Reactors; Final Interim Staff Guidance on Post-Combined License Commitments

    Science.gov (United States)

    2010-02-02

    ... the guidance provided to the NRC staff in Section 1.0, ``Introduction and Interfaces,'' of NUREG-0800, ``Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power Plants,'' concerning the... maintains ADAMS, which provides text and image files of NRC's public documents. These documents may be...

  14. 78 FR 67442 - Congestion Mitigation and Air Quality Improvement Program Interim Guidance

    Science.gov (United States)

    2013-11-12

    ...] Congestion Mitigation and Air Quality Improvement Program Interim Guidance AGENCY: Federal Highway... Comment. SUMMARY: The FHWA is issuing Interim Guidance on the Congestion Mitigation and Air Quality.../environment/air_quality/cmaq/policy_and_guidance/2008_guidance/ guidance/. DATES: This Interim Guidance is...

  15. Video-Guidance Design for the DART Rendezvous Mission

    Science.gov (United States)

    Ruth, Michael; Tracy, Chisholm

    2004-01-01

    NASA's Demonstration of Autonomous Rendezvous Technology (DART) mission will validate a number of different guidance technologies, including state-differenced GPS transfers and close-approach video guidance. The video guidance for DART will employ NASA/Marshall s Advanced Video Guidance Sensor (AVGS). This paper focuses on the terminal phase of the DART mission that includes close-approach maneuvers under AVGS guidance. The closed-loop video guidance design for DART is driven by a number of competing requirements, including a need for maximizing tracking bandwidths while coping with measurement noise and the need to minimize RCS firings. A range of different strategies for attitude control and docking guidance have been considered for the DART mission, and design decisions are driven by a goal of minimizing both the design complexity and the effects of video guidance lags. The DART design employs an indirect docking approach, in which the guidance position targets are defined using relative attitude information. Flight simulation results have proven the effectiveness of the video guidance design.

  16. An Innovate Robotic Endoscope Guidance System for Transnasal Sinus and Skull Base Surgery: Proof of Concept.

    Science.gov (United States)

    Friedrich, D T; Sommer, F; Scheithauer, M O; Greve, J; Hoffmann, T K; Schuler, P J

    2017-12-01

    Objective  Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods  The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head. Visualization was enabled using a commercially available endoscope with adjustable viewing angle (15-90 degrees). Results  Visualization and instrumentation of all paranasal sinuses, including the anterior and middle skull base, were feasible with the presented setup. Controlling the robotic endoscope guidance system was effectively precise, and the adjustable endoscope lens extended the view in the surgical field without the common change of fixed viewing angle endoscopes. Conclusion  The combination of a robotic endoscope guidance system and an advanced endoscope with adjustable viewing angle enables bimanual surgery in transnasal interventions of the paranasal sinuses and the anterior skull base in a human cadaver model. The adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time and resources, without reducing the quality of imaging.

  17. Cask system design guidance for robotic handling

    International Nuclear Information System (INIS)

    Griesmeyer, J.M.; Drotning, W.D.; Morimoto, A.K.; Bennett, P.C.

    1990-10-01

    Remote automated cask handling has the potential to reduce both the occupational exposure and the time required to process a nuclear waste transport cask at a handling facility. The ongoing Advanced Handling Technologies Project (AHTP) at Sandia National Laboratories is described. AHTP was initiated to explore the use of advanced robotic systems to perform cask handling operations at handling facilities for radioactive waste, and to provide guidance to cask designers regarding the impact of robotic handling on cask design. The proof-of-concept robotic systems developed in AHTP are intended to extrapolate from currently available commercial systems to the systems that will be available by the time that a repository would be open for operation. The project investigates those cask handling operations that would be performed at a nuclear waste repository facility during cask receiving and handling. The ongoing AHTP indicates that design guidance, rather than design specification, is appropriate, since the requirements for robotic handling do not place severe restrictions on cask design but rather focus on attention to detail and design for limited dexterity. The cask system design features that facilitate robotic handling operations are discussed, and results obtained from AHTP design and operation experience are summarized. The application of these design considerations is illustrated by discussion of the robot systems and their operation on cask feature mock-ups used in the AHTP project. 11 refs., 11 figs

  18. Guidance documents relating to landfills and contaminants

    Energy Technology Data Exchange (ETDEWEB)

    Schomaker, N.B.; Zunt, D.A.

    1990-01-01

    The Environmental Protection Agency is developing and updating a series of Technical Guidance Documents to provide best engineering control technology to meet the needs of the Resource Conservation and Recovery Act (RCRA) and the Comprehensive Environmental Response Compensation and Liability Act (CERCLA), respectively. These documents are the compilation of the research efforts to date relating to containment of pollutants from waste disposal to the land as relates to residuals management. The specific areas of research being conducted under the RCRA land disposal program relates to laboratory, pilot and field validation studies in cover systems, waste leaching and solidification, liner systems and disposal facility evaluation. The specific areas of research being conducted under the CERCLA uncontrolled waste sites (Superfund) program relate to in situ treatment, solidification/stabilization for treating hazardous waste, combustion technologies, best demonstrated available technology (BDAT), on-site treatment technologies, emerging biosystems, expert systems, personnel health protection equipment, and site and situation assessment. The Guidance Documents are intended to assist both the regulated community and the permitting authorities, as well as the Program Offices, and Regions, as well as the states and other interested parties, with the latest information relevant to waste management.

  19. Axon guidance molecules in vascular patterning.

    Science.gov (United States)

    Adams, Ralf H; Eichmann, Anne

    2010-05-01

    Endothelial cells (ECs) form extensive, highly branched and hierarchically organized tubular networks in vertebrates to ensure the proper distribution of molecular and cellular cargo in the vertebrate body. The growth of this vascular system during development, tissue repair or in disease conditions involves the sprouting, migration and proliferation of endothelial cells in a process termed angiogenesis. Surprisingly, specialized ECs, so-called tip cells, which lead and guide endothelial sprouts, share many feature with another guidance structure, the axonal growth cone. Tip cells are motile, invasive and extend numerous filopodial protrusions sensing growth factors, extracellular matrix and other attractive or repulsive cues in their tissue environment. Axonal growth cones and endothelial tip cells also respond to signals belonging to the same molecular families, such as Slits and Roundabouts, Netrins and UNC5 receptors, Semaphorins, Plexins and Neuropilins, and Eph receptors and ephrin ligands. Here we summarize fundamental principles of angiogenic growth, the selection and function of tip cells and the underlying regulation by guidance cues, the Notch pathway and vascular endothelial growth factor signaling.

  20. Guidance of retinal axons in mammals.

    Science.gov (United States)

    Herrera, Eloísa; Erskine, Lynda; Morenilla-Palao, Cruz

    2017-11-26

    In order to navigate through the surrounding environment many mammals, including humans, primarily rely on vision. The eye, composed of the choroid, sclera, retinal pigmented epithelium, cornea, lens, iris and retina, is the structure that receives the light and converts it into electrical impulses. The retina contains six major types of neurons involving in receiving and modifying visual information and passing it onto higher visual processing centres in the brain. Visual information is relayed to the brain via the axons of retinal ganglion cells (RGCs), a projection known as the optic pathway. The proper formation of this pathway during development is essential for normal vision in the adult individual. Along this pathway there are several points where visual axons face 'choices' in their direction of growth. Understanding how these choices are made has advanced significantly our knowledge of axon guidance mechanisms. Thus, the development of the visual pathway has served as an extremely useful model to reveal general principles of axon pathfinding throughout the nervous system. However, due to its particularities, some cellular and molecular mechanisms are specific for the visual circuit. Here we review both general and specific mechanisms involved in the guidance of mammalian RGC axons when they are traveling from the retina to the brain to establish precise and stereotyped connections that will sustain vision. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. The evaluation of radiologic methods for access guidance in percutaneous nephrolithotomy: a systematic review of the literature.

    Science.gov (United States)

    Breda, Alberto; Territo, Angelo; Scoffone, Cesare; Seitz, Christian; Knoll, Thomas; Herrmann, Thomas; Brehmer, Mariannhe; Osther, Palle J S; Liatsikos, Evangelos

    2017-11-12

    Percutaneous nephrolithotomy (PNL) is the treatment of choice for larger and complex renal calculi. First step in performing PNL is to obtain access to the renal cavity using either fluoroscopy or ultrasound (US) guidance or a combination of both. Which guiding method to choose is controversial? A systematic review of the literature was performed comparing image guidance modalities for obtaining access in PNL. Evidence acquisition and synthesis: A PubMed, Scopus and Cochrane search for peer-reviewed studies was performed using the keywords "ultrasound" AND "fluoroscopy" AND "Percutaneous nephrolithotomy". Eligible articles were reviewed according to PRISMA criteria. Two hundred and forty records were identified using the keywords. Of these twelve studies were considered relevant. US guidance seems to be associated with a slightly lower complication rate, which may be related to fewer puncture attempts needed for obtaining access and to better peri-renal organ visualization. On the other hand, US-guidance alone needs the adjunct of fluoroscopy in a significant number of cases for achieving access. Stone free rate (SFR) was comparable between groups. Using US for renal access unequivocally reduces radiation exposure. Current evidence indicates that both fluoroscopy and US guidance may be successfully used for obtaining percutaneous renal access. Combining the image-guiding modalities - US and fluoroscopy - seems to increase outcome in PNL both with regard to success in achieving access and reducing complications. Furthermore, including US in the access strategy of PNL reduces radiation exposure to surgeon and staff as well as patients.

  2. Endometrial imaging

    OpenAIRE

    Vassallo, Pierre

    2012-01-01

      "nAbnormal uterine bleeding, whether in peri menopausal or postmenopausal patients, is an important clinical concern and results in much medical intervention. When bleeding occurs in women over 40 years of age as well as any postmenopausal women, endometrial assessment is mandatory. In the past and present, many clinicians prefer to begin such assessment with blind endometrial sampling. However, when an ultrasound-based approach to such patients is present, a thin distinct end...

  3. Multimodality imaging of Candida tropicalis myositis

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, Daniel M. [Children' s Memorial Hospital, Department of Medical Imaging, 2300 Children' s Plaza, Box 9, Chicago, IL (United States); Morgan, Elaine R. [Children' s Memorial Hospital, Department of Hematology and Oncology, Chicago, IL (United States)

    2008-04-15

    Fungal myositis is a rare entity that has been described in immunocompromised patients. We present a boy with biopsy proven fungal myositis who was examined with multiple imaging modalities. MR imaging proved to be very effective for diagnostic purposes, while US imaging was able to provide guidance for biopsy. (orig.)

  4. Multimodality imaging of Candida tropicalis myositis

    International Nuclear Information System (INIS)

    Schwartz, Daniel M.; Morgan, Elaine R.

    2008-01-01

    Fungal myositis is a rare entity that has been described in immunocompromised patients. We present a boy with biopsy proven fungal myositis who was examined with multiple imaging modalities. MR imaging proved to be very effective for diagnostic purposes, while US imaging was able to provide guidance for biopsy. (orig.)

  5. Orion Powered Flight Guidance Burn Options for Near Term Exploration

    Science.gov (United States)

    Fill, Tom; Goodman, John; Robinson, Shane

    2018-01-01

    NASA's Orion exploration spacecraft will fly more demanding mission profiles than previous NASA human flight spacecraft. Missions currently under development are destined for cislunar space. The EM-1 mission will fly unmanned to a Distant Retrograde Orbit (DRO) around the Moon. EM-2 will fly astronauts on a mission to the lunar vicinity. To fly these missions, Orion requires powered flight guidance that is more sophisticated than the orbital guidance flown on Apollo and the Space Shuttle. Orion's powered flight guidance software contains five burn guidance options. These five options are integrated into an architecture based on a proven shuttle heritage design, with a simple closed-loop guidance strategy. The architecture provides modularity, simplicity, versatility, and adaptability to future, yet-to-be-defined, exploration mission profiles. This paper provides a summary of the executive guidance architecture and details the five burn options to support both the nominal and abort profiles for the EM-1 and EM-2 missions.

  6. Trajectory reshaping based guidance with impact time and angle constraints

    Directory of Open Access Journals (Sweden)

    Zhao Yao

    2016-08-01

    Full Text Available This study presents a novel impact time and angle constrained guidance law for homing missiles. The guidance law is first developed with the prior-assumption of a stationary target, which is followed by the practical extension to a maneuvering target scenario. To derive the closed-form guidance law, the trajectory reshaping technique is utilized and it results in defining a specific polynomial function with two unknown coefficients. These coefficients are determined to satisfy the impact time and angle constraints as well as the zero miss distance. Furthermore, the proposed guidance law has three additional guidance gains as design parameters which make it possible to adjust the guided trajectory according to the operational conditions and missile’s capability. Numerical simulations are presented to validate the effectiveness of the proposed guidance law.

  7. Standardized Duplex Ultrasound-Based Protocol for Early Diagnosis of Transplant Renal Artery Stenosis: Results of a Single-Institution Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Vincenzo Li Marzi

    2018-01-01

    Full Text Available Transplant renal artery stenosis (TRAS is the most frequent vascular complication after kidney transplantation (KT and has been associated with potentially reversible refractory hypertension, graft dysfunction, and reduced patient survival. The aim of the study is to describe the outcomes of a standardized Duplex Ultrasound- (DU- based screening protocol for early diagnosis of TRAS and for selection of patients potentially requiring endovascular intervention. We retrospectively reviewed our prospectively collected database of KT from January 1998 to select patients diagnosed with TRAS. The follow-up protocol was based on a risk-adapted, dynamic subdivision of eligible KT patients in different risk categories (RC with different protocol strategies (PS. Of 598 patients included in the study, 52 (9% patients had hemodynamically significant TRAS and underwent percutaneous angioplasty (PTA and stent placement. Technical and clinical success rates were 97% and 90%, respectively. 7 cases of restenosis were recorded at follow-up and treated with re-PTA plus stenting. Both DU imaging and clinical parameters improved after stent placement. Prospective high-quality studies are needed to test the efficacy and safety of our protocol in larger series. Accurate trial design and standardized reporting of patient outcomes will be key to address the current clinical needs.

  8. Image, Image, Image

    Science.gov (United States)

    Howell, Robert T.

    2004-01-01

    With all the talk today about accountability, budget cuts, and the closing of programs in public education, teachers cannot overlook the importance of image in the field of industrial technology. It is very easy for administrators to cut ITE (industrial technology education) programs to save school money--money they might shift to teaching the…

  9. Existing ingestion guidance: Problems and recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Mooney, Robert R; Ziegler, Gordon L; Peterson, Donald S [Environmental Radiation Section, Division of Radiation Protection, WA (United States)

    1989-09-01

    Washington State has been developing plans and procedures for responding to nuclear accidents since the early 1970s. A key part of this process has been formulating a method for calculating ingestion pathway concentration guides (CGs). Such a method must be both technically sound and easy to use. This process has been slow and frustrating. However, much technical headway has been made in recent years, and hopefully the experience of the State of Washington will provide useful insight to problems with the existing guidance. Several recommendations are offered on ways to deal with these problems. In January 1986, the state held an ingestion pathway exercise which required the determination of allowed concentrations of isotopes for various foods, based upon reactor source term and field data. Objectives of the exercise were not met because of the complexity of the necessary calculations. A major problem was that the allowed concentrations had to be computed for each isotope and each food group, given assumptions on the average diet. To solve problems identified during that exercise, Washington developed, by March 1986, partitioned CGs. These CGs apportioned doses from each food group for an assumed mix of radionuclides expected to result from a reactor accident. This effort was therefore in place just in time for actual use during the Chernobyl fallout episode in May 1986. This technique was refined and described in a later report and presented at the 1987 annual meeting of the Health Physics Society. Realizing the technical weaknesses which still existed and a need to simplify the numbers for decision makers, Washington State has been developing computer methods to quickly calculate, from an accident specific relative mix of isotopes, CGs which allow a single radionuclide concentration for all food groups. This latest approach allows constant CGs for different periods of time following the accident, instead of peak CGs, which are good only for a short time after the

  10. Existing ingestion guidance: Problems and recommendations

    International Nuclear Information System (INIS)

    Mooney, Robert R.; Ziegler, Gordon L.; Peterson, Donald S.

    1989-01-01

    Washington State has been developing plans and procedures for responding to nuclear accidents since the early 1970s. A key part of this process has been formulating a method for calculating ingestion pathway concentration guides (CGs). Such a method must be both technically sound and easy to use. This process has been slow and frustrating. However, much technical headway has been made in recent years, and hopefully the experience of the State of Washington will provide useful insight to problems with the existing guidance. Several recommendations are offered on ways to deal with these problems. In January 1986, the state held an ingestion pathway exercise which required the determination of allowed concentrations of isotopes for various foods, based upon reactor source term and field data. Objectives of the exercise were not met because of the complexity of the necessary calculations. A major problem was that the allowed concentrations had to be computed for each isotope and each food group, given assumptions on the average diet. To solve problems identified during that exercise, Washington developed, by March 1986, partitioned CGs. These CGs apportioned doses from each food group for an assumed mix of radionuclides expected to result from a reactor accident. This effort was therefore in place just in time for actual use during the Chernobyl fallout episode in May 1986. This technique was refined and described in a later report and presented at the 1987 annual meeting of the Health Physics Society. Realizing the technical weaknesses which still existed and a need to simplify the numbers for decision makers, Washington State has been developing computer methods to quickly calculate, from an accident specific relative mix of isotopes, CGs which allow a single radionuclide concentration for all food groups. This latest approach allows constant CGs for different periods of time following the accident, instead of peak CGs, which are good only for a short time after the

  11. Automatic guidance and control laws for helicopter obstacle avoidance

    Science.gov (United States)

    Cheng, Victor H. L.; Lam, T.

    1992-01-01

    The authors describe the implementation of a full-function guidance and control system for automatic obstacle avoidance in helicopter nap-of-the-earth (NOE) flight. The guidance function assumes that the helicopter is sufficiently responsive so that the flight path can be readily adjusted at NOE speeds. The controller, basically an autopilot for following the derived flight path, was implemented with parameter values to control a generic helicopter model used in the simulation. Evaluation of the guidance and control system with a 3-dimensional graphical helicopter simulation suggests that the guidance has the potential for providing good and meaningful flight trajectories.

  12. Integrating mechanisms of visual guidance in naturalistic language production.

    Science.gov (United States)

    Coco, Moreno I; Keller, Frank

    2015-05-01

    Situated language production requires the integration of visual attention and linguistic processing. Previous work has not conclusively disentangled the role of perceptual scene information and structural sentence information in guiding visual attention. In this paper, we present an eye-tracking study that demonstrates that three types of guidance, perceptual, conceptual, and structural, interact to control visual attention. In a cued language production experiment, we manipulate perceptual (scene clutter) and conceptual guidance (cue animacy) and measure structural guidance (syntactic complexity of the utterance). Analysis of the time course of language production, before and during speech, reveals that all three forms of guidance affect the complexity of visual responses, quantified in terms of the entropy of attentional landscapes and the turbulence of scan patterns, especially during speech. We find that perceptual and conceptual guidance mediate the distribution of attention in the scene, whereas structural guidance closely relates to scan pattern complexity. Furthermore, the eye-voice span of the cued object and its perceptual competitor are similar; its latency mediated by both perceptual and structural guidance. These results rule out a strict interpretation of structural guidance as the single dominant form of visual guidance in situated language production. Rather, the phase of the task and the associated demands of cross-modal cognitive processing determine the mechanisms that guide attention.

  13. Ultrasound Guidance as a Rescue Technique for Peripheral Intravenous Cannulation

    National Research Council Canada - National Science Library

    Pappas, Nancy L; Michaud, Terese E; Wolbers, Russell M; Steward, James C; Fevurly, Thomas A; Samolitis, Timothy J; Shoneboom, Bruce A; Watts, Dorraine D

    2006-01-01

    .... Ultrasound guidance has shown efficacy in expediting the cannulation of central veins, but there is limited information on its utility in facilitating cannulation in peripheral veins, particularly...

  14. Guidance for Facilities on Risk Management Programs (RMP)

    Science.gov (United States)

    Includes supplemental guidance specific to ammonia refrigeration, wastewater treatment, propane storage, warehouses, chemical distributors, offsite consequence analysis, retail agriculture, applicability of program levels, prevention, emergency response.

  15. Resection of deep-seated gliomas using neuroimaging for stereotactic placement of guidance catheters

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Kengo; Higashi, Hisato; Tomita, Susumu; Furuta, Tomohisa; Ohmoto, Takashi [Okayama Univ. (Japan). School of Medicine

    1995-03-01

    A simple computed tomography- (CT) or magnetic resonance (MR) imaging-guided stereotactic method for guided microsurgical resection of either deep-seated gliomas or tumors adjacent to an eloquent area is described. The technique employs the Brown-Roberts-Wells stereotactic system and twist drills, 2.7 mm in diameter, for the stereotactic placement of 2.4 mm diameter scaled guidance catheters through the calvaria. In a patient with a deep-seated small glioma, less than 2 cm diameter, one catheter was implanted into the center of the enhanced mass through the cerebral cortex. In the other 14 patients, three to six catheters were used which made the tumor border clearer. After implantation of the guidance catheters, the stereotactic frame was removed and a standard open craniotomy performed. Target localization is not affected by brain movement, which is inevitable during open surgery. The tumor involved the frontal lobe in eight patients, the parietal lobe in two, and the thalamus in five. In all cases the lesion was quickly localized and radical removal was acheived. Neurological complications occurred in only one patient who suffered transient hemiparesis after the resection of a lesion in the pyramidal tract. The results demonstrate that microsurgery combined with CT- or MR imaging-guided stereotactic placement of guidance catheters is a new option for surgery of deep-seated gliomas or tumors adjacent to an eloquent area. (author).

  16. Monitoring and guidance of HIFU beams with dual-mode ultrasound arrays.

    Science.gov (United States)

    Ballard, John R; Casper, Andrew J; Ebbini, Emad S

    2009-01-01

    We present experimental results illustrating the unique advantages of dual-mode array (DMUA) systems in monitoring and guidance of high intensity focused ultrasound (HIFU) lesion formation. DMUAs offer a unique paradigm in image-guided surgery; one in which images obtained using the same therapeutic transducer provide feedback for: 1) refocusing the array in the presence of strongly scattering objects, e.g. the ribs, 2) temperature change at the intended location of the HIFU focus, and 3) changes in the echogenicity of the tissue in response to therapeutic HIFU. These forms of feedback have been demonstrated in vitro in preparation for the design and implementation of a real-time system for imaging and therapy with DMUAs. The results clearly demonstrate that DMUA image feedback is spatially accurate and provide sufficient spatial and contrast resolution for identification of high contrast objects like the ribs and significant blood vessels in the path of the HIFU beam.

  17. Approach to DOE threshold guidance limits

    International Nuclear Information System (INIS)

    Shuman, R.D.; Wickham, L.E.

    1984-01-01

    The need for less restrictive criteria governing disposal of extremely low-level radioactive waste has long been recognized. The Low-Level Waste Management Program has been directed by the Department of Energy (DOE) to aid in the development of a threshold guidance limit for DOE low-level waste facilities. Project objectives are concernd with the definition of a threshold limit dose and pathway analysis of radionuclide transport within selected exposure scenarios at DOE sites. Results of the pathway analysis will be used to determine waste radionuclide concentration guidelines that meet the defined threshold limit dose. Methods of measurement and verification of concentration limits round out the project's goals. Work on defining a threshold limit dose is nearing completion. Pathway analysis of sanitary landfill operations at the Savannah River Plant and the Idaho National Engineering Laboratory is in progress using the DOSTOMAN computer code. Concentration limit calculations and determination of implementation procedures shall follow completion of the pathways work. 4 references

  18. Commercial radioactive waste minimization program development guidance

    International Nuclear Information System (INIS)

    Fischer, D.K.

    1991-01-01

    This document is one of two prepared by the EG ampersand G Idaho, Inc., Waste Management Technical Support Program Group, National Low-Level Waste Management Program Unit. One of several Department of Energy responsibilities stated in the Amendments Act of 1985 is to provide technical assistance to compact regions Host States, and nonmember States (to the extent provided in appropriations acts) in establishing waste minimization program plans. Technical assistance includes, among other things, the development of technical guidelines for volume reduction options. Pursuant to this defined responsibility, the Department of Energy (through EG ampersand G Idaho, Inc.) has prepared this report, which includes guidance on defining a program, State/compact commission participation, and waste minimization program plans

  19. Improvements in inservice testing regulatory guidance

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, P.L.

    1996-12-01

    Over the last few years, the NRC has issued guidance to licensees toward improving the quality of requests for relief or alternatives to the code requirements and bring some measure of consistency to the implementation of the code requirements. Based on the majority of the recent submittals, the overall quality has improved. If all of the steps in the internal process for responding to the requests are timely, the review of an updated program can be completed in six to nine months. When a single or only a few requests are submitted, the staff is generally able to complete an evaluation in less than three months. When schedules are related to outages or exigent circumstances, the NRC responds accordingly. The improvements in schedules can be attributed to publication of staff guideline documents, licensees` efforts in preparing more complete descriptions and justification and an increase in the number of NRC technical staff reviewers assigned to IST.

  20. Improvements in inservice testing regulatory guidance

    International Nuclear Information System (INIS)

    Campbell, P.L.

    1996-01-01

    Over the last few years, the NRC has issued guidance to licensees toward improving the quality of requests for relief or alternatives to the code requirements and bring some measure of consistency to the implementation of the code requirements. Based on the majority of the recent submittals, the overall quality has improved. If all of the steps in the internal process for responding to the requests are timely, the review of an updated program can be completed in six to nine months. When a single or only a few requests are submitted, the staff is generally able to complete an evaluation in less than three months. When schedules are related to outages or exigent circumstances, the NRC responds accordingly. The improvements in schedules can be attributed to publication of staff guideline documents, licensees' efforts in preparing more complete descriptions and justification and an increase in the number of NRC technical staff reviewers assigned to IST

  1. Technical guidance for siting criteria development

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, D.C.; Sprung, J.L.; Alpert, D.J.; Diegert, K.; Ostmeyer, R.M.; Ritchie, L.T.; Strip, D.R.; Johnson, J.D.; Hansen, K.; Robinson, J.

    1982-12-01

    Technical guidance to support the formulation and comparison of possible siting criteria for nuclear power plants has been developed in four areas: (1) consequences of hypothetical severe nuclear-power-plant accidents, (2) characteristics of population distributions about current reactor sites, (3) site availability within the continental United States, and (4) socioeconomic impacts of reactor siting. The impact on consequences of source-term magnitude, meteorology, population distribution, and emergency response have been analyzed. Population distributions about current sites were analyzed to identify statistical characteristics, time trends, and regional differences. A site-availability data bank was constructed for the continential United States. The data bank contains information about population densities, seismicity, topography, water availability, and land-use restrictions. Finally, the socioeconomic impacts of rural-industrialization projects, energy boomtowns, and nuclear power plants were examined to determine their nature, magnitude, and dependence on site demography and remoteness.

  2. GUIDANCE ON SELECTING AGE GROUPS FOR ...

    Science.gov (United States)

    This guidance document provides a set of early-lifestage age groups for Environmental Protection Agency scientists to consider when assessing children’s exposure to environmental contaminants and the resultant potential dose. These recommended age groups are based on current understanding of differences in behavior and physiology which may impact exposures in children. A consistent set of early-life age groups, supported by an underlying scientific rationale, is expected to improve Agency exposure and risk assessments for children by increasing the consistency and comparability of risk assessments across the Agency; by improving accuracy and transparency in assessments for those cases where current practice might too broadly combine behaviorally and physiologically disparate age groups; and by fostering a consistent approach to future exposure surveys and monitoring efforts to generate improved exposure factors for children. see description

  3. Technical guidance for siting criteria development

    International Nuclear Information System (INIS)

    Aldrich, D.C.; Sprung, J.L.; Alpert, D.J.

    1982-12-01

    Technical guidance to support the formulation and comparison of possible siting criteria for nuclear power plants has been developed in four areas: (1) consequences of hypothetical severe nuclear-power-plant accidents, (2) characteristics of population distributions about current reactor sites, (3) site availability within the continental United States, and (4) socioeconomic impacts of reactor siting. The impact on consequences of source-term magnitude, meteorology, population distribution, and emergency response have been analyzed. Population distributions about current sites were analyzed to identify statistical characteristics, time trends, and regional differences. A site-availability data bank was constructed for the continential United States. The data bank contains information about population densities, seismicity, topography, water availability, and land-use restrictions. Finally, the socioeconomic impacts of rural-industrialization projects, energy boomtowns, and nuclear power plants were examined to determine their nature, magnitude, and dependence on site demography and remoteness

  4. Chief Inspector's guidance to inspectors: combustion processes

    International Nuclear Information System (INIS)

    1992-01-01

    This Note is issued by the Chief Inspector of Her Majesty's Inspectorate of Pollution (HMIP) as one of a series providing guidance for processes prescribed for integrated pollution control in Regulations made under Section 2 of the United Kingdom Environmental Protection Act 1990. It covers the burning of solid fuel manufactured from or comprised of tyres, tyre rubber or similar rubber waste primarily for the purpose of producing energy, in an appliance with a net rated thermal input of 3 megawatts or more. The note includes: a list of prescribed substances most likely to be present in releases to the environment by the processes considered; release limits for release to air, water and land; an outline of techniques for pollution abatement; monitoring requirements. (Author)

  5. On-line MRI guidance for Radiotherapy

    NARCIS (Netherlands)

    Crijns, S.P.M.

    2013-01-01

    Image-guided radiotherapy has the potential to increase success of treatment by decreasing uncertainties concerning tumour position and shape. MRI is the modality of choice when it comes to imaging for tumour delineation and characterisation, set-up correction, treatment plan adaptation, response

  6. D ampersand D screening risk evaluation guidance

    International Nuclear Information System (INIS)

    Robers, S.K.; Golden, K.M.; Wollert, D.A.

    1995-09-01

    The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D ampersand D) facilities. Although this method has been developed for D ampersand D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and visitors inside contaminated D ampersand D facilities due to contaminant exposure. The Future Release Index (FRI) calculates the hypothetical risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risks to human health due to factors other than that of contaminants. Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form, and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, as determined on a project-by-project basis

  7. D & D screening risk evaluation guidance

    Energy Technology Data Exchange (ETDEWEB)

    Robers, S.K.; Golden, K.M.; Wollert, D.A.

    1995-09-01

    The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D&D) facilities. Although this method has been developed for D&D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and visitors inside contaminated D&D facilities due to contaminant exposure. The Future Release Index (FRI) calculates the hypothetical risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risks to human health due to factors other than that of contaminants. Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form, and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, as determined on a project-by-project basis.

  8. Pilot Study of a New Nonradioactive Surgical Guidance Technology for Locating Nonpalpable Breast Lesions.

    Science.gov (United States)

    Cox, Charles E; Garcia-Henriquez, Norbert; Glancy, M Jordan; Whitworth, Pat; Cox, John M; Themar-Geck, Melissa; Prati, Ronald; Jung, Michelle; Russell, Scott; Appleton, Kristie; King, Jeff; Shivers, Steven C

    2016-06-01

    The current technique for locating nonpalpable breast lesions is wire localization (WL). Radioactive seed localization and intraoperative ultrasound were developed to improve difficulties with WL. The SAVI SCOUT surgical guidance system was developed to improve these methods. The SCOUT system is a non-radioactive, FDA-cleared medical device that uses electromagnetic wave technology to provide real-time guidance during excisional breast procedures. Consenting patients underwent localization and excision using an implantable electromagnetic wave reflective device (reflector) and a detector handpiece with a console. Using image guidance, the reflector was placed up to 7 days before the surgical procedure. The primary end points of the study were successful reflector placement, localization, and retrieval. The secondary end points were percentage of clear margins, reexcision rates, days of placement before excision, and physician comparison with WL. This study analyzed 50 patients. The reflectors were placed under mammographic guidance (n = 18, 36 %) or ultrasound guidance (n = 32, 64 %). Of the 50 patients, 10 (20 %) underwent excisional biopsy and 40 (80 %) had a lumpectomy. The lesion and reflector were successfully removed in all 50 patients, and no adverse events occurred. Of the 41 patients who had in situ and/or invasive carcinoma identified, 38 (93 %) had clear margins and 3 (7 %) were recommended for reexcision. These data suggest that the SCOUT system is safe and effective for guiding the excision of nonpalpable breast lesions and a viable alternative to standard localization options. A larger prospective, multi-institution trial of SCOUT currently is underway to validate these findings.

  9. MRI-guidance in percutaneous core decompression of osteonecrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Kerimaa, Pekka; Vaeaenaenen, Matti; Ojala, Risto; Tervonen, Osmo; Blanco Sequeiros, Roberto [Oulu University Hospital, Department of Radiology (Finland); Hyvoenen, Pekka; Lehenkari, Petri [Oulu University Hospital, Department of Surgery (Finland)

    2016-04-15

    The purpose of this study was to evaluate the usefulness of MRI-guidance for core decompression of avascular necrosis of the femoral head. Twelve MRI-guided core decompressions were performed on patients with different stages of avascular necrosis of the femoral head. The patients were asked to evaluate their pain and their ability to function before and after the procedure and imaging findings were reviewed respectively. Technical success in reaching the target was 100 % without complications. Mean duration of the procedure itself was 54 min. All patients with ARCO stage 1 osteonecrosis experienced clinical benefit and pathological MRI findings were seen to diminish. Patients with more advanced disease gained less, if any, benefit and total hip arthroplasty was eventually performed on four patients. MRI-guidance seems technically feasible, accurate and safe for core decompression of avascular necrosis of the femoral head. Patients with early stage osteonecrosis may benefit from the procedure. (orig.)

  10. MRI-guidance in percutaneous core decompression of osteonecrosis of the femoral head

    International Nuclear Information System (INIS)

    Kerimaa, Pekka; Vaeaenaenen, Matti; Ojala, Risto; Tervonen, Osmo; Blanco Sequeiros, Roberto; Hyvoenen, Pekka; Lehenkari, Petri

    2016-01-01

    The purpose of this study was to evaluate the usefulness of MRI-guidance for core decompression of avascular necrosis of the femoral head. Twelve MRI-guided core decompressions were performed on patients with different stages of avascular necrosis of the femoral head. The patients were asked to evaluate their pain and their ability to function before and after the procedure and imaging findings were reviewed respectively. Technical success in reaching the target was 100 % without complications. Mean duration of the procedure itself was 54 min. All patients with ARCO stage 1 osteonecrosis experienced clinical benefit and pathological MRI findings were seen to diminish. Patients with more advanced disease gained less, if any, benefit and total hip arthroplasty was eventually performed on four patients. MRI-guidance seems technically feasible, accurate and safe for core decompression of avascular necrosis of the femoral head. Patients with early stage osteonecrosis may benefit from the procedure. (orig.)

  11. Vision based guidance and flight control in problems of aerial tracking

    Science.gov (United States)

    Stepanyan, Vahram

    unknown time-varying disturbance. In both cases, in order to meet the objective, an intelligent excitation signal is added to the reference commands. These guidance laws are modified to accommodate measurement noise, which is inherently available when using visual sensors and image processing algorithms associated with them. They are implemented on a full scale