Effect of diagnostic cone-beam computed tomography protocols on image quality,patient dose,and lesion detection

ObjectiveTo evaluate the effect of cone-beam computed tomography (CBCT) image acquisition protocols on image quality, lesion detection, delineation, and patient dose.Methods100-patients and a CTDI phantom combined with an electron density phantom were examined using four different CBCT-image acquisition protocols during image-guided transarterial chemoembolization (TACE). Protocol-1 (time: 6 s, tube rotation: 360°), protocol-2 (5 s, 300°), protocol-3 (4 s, 240°) and protocol-4 (3 s, 180°) were used. The protocols were first investigated using a phantom. The protocols that were found to be clinically appropriate in terms of image quality and radiation dose were then assessed on patients. A higher radiation dose and/or a poor image quality were inappropriate for the patient imaging. Patient dose (patient-entrance dose and dose-area product), image quality (Hounsfield Unit, noise, signal-to-noise ratio and contrast-to-noise ratio), and lesion delineation (tumor-liver contrast) were assessed and compared using appropriate statistical tests. Lesion detectability, sensitivity, and predictive values were estimated for CBCT-image data using pre-treatment patient magnetic resonance imaging.ResultsThe estimated patient dose showed no statistical significance (p > 0.05) between protocols-2 and -3; the assessed image quality between these protocols manifested insignificant difference (p > 0.05). Two other phantom protocols were not considered for patient imaging due to significantly higher dose (protocols-1) and poor image quality (protocol-4). Lesion delineation and detection were insignificant (p > 0.05) between protocols-2 and -3. Lesion sensitivities generated were 81–89% (protocol-2) and 81–85% (protocol-3) for different lesion types.ConclusionData acquisition using protocols-2 and -3 provided good image quality, lesion detection and delineation with acceptable patient dose during CBCT-imaging mainly due to similar frame numbers acquired.     

影像引导对乳腺癌调强放射治疗精度的影响

目的：分析在乳腺癌图像引导放射治疗（IGRT）过程中,图像引导对于放射治疗的精确度的影响;同时观察图像引导放射治疗的毒性反应及放射治疗近期的治疗效果。方法：搜集2012年1月-2013年2月间,于哈尔滨医科大学附属第三医院放疗科收治的乳腺癌患者25例。使用医科达SynergyTM锥形束CT（CBCT）进行治疗前扫描,通过图像引导放射治疗技术对25例患者进行误差纠正,调整后行调强放疗。患者在进行放疗前,用锥形柬CT对射野的偏差进行校正,其偏差利用锥形束CT图像与计划螺旋CT图像进行手动匹配,在X、Y、Z三个方向上进行调整。根据误差调整治疗床位置后治疗。对急性放射性反应采用RTOG5级评价标准进行评价：急性放射性皮肤反应、急性放射性肺损伤及急性放射性心脏损伤。结果：25例乳腺癌患者治疗前经锥形束CT扫描采集的图像与计划参考图像比较在X、Y、Z方向上平均误差分别为0．429±1．683mm、0．431±1．728mm、0．583±2．041mm：摆位误差纠正后,误差值分别为：0．068±0．429、0．019±0．438、0．158±0．697,调整后摆位误差控制在1mm之内进行治疗。放疗后2周急性皮肤反应为0级23例、1级2例;4周为0级21例、1级4例。无急性放射性肺损伤及心脏损伤的病例出现。结论：目前调强放疗是乳腺癌临床放射治疗的重要手段,图像引导放射治疗的应用能够使放疗精度显著提高。     

A Monte Carlo software bench for simulation of spectral k-edge CT imaging: Initial results

PurposeSpectral Computed Tomography (SCT) systems equipped with photon counting detectors (PCD) are clinically desired, since such systems provide not only additional diagnostic information but also radiation dose reductions by a factor of two or more. The current unavailability of clinical PCDs makes a simulation of such systems necessary.MethodsIn this paper, we present a Monte Carlo-based simulation of a SCT equipped with a PCD. The aim of this development is to facilitate research on potential clinical applications. Our MC simulator takes into account scattering interactions within the scanned object and has the ability to simulate scans with and without scatter and a wide variety of imaging parameters. To demonstrate the usefulness of such a MC simulator for development of SCT applications, a phantom with contrast targets covering a wide range of clinically significant iodine concentrations is simulated. With those simulations the impact of scatter and exposure on image quality and material decomposition results is investigated.ResultsOur results illustrate that scatter radiation plays a significant role in visual as well as quantitative results. Scatter radiation can reduce the accuracy of contrast agent concentration by up to 15%.ConclusionsWe present a reliable and robust software bench for simulation of SCTs equipped with PCDs.     

Monte Carlo-based assessment of the trade-off between spatial resolution,field-of-view and scattered radiation in the variable resolution X-ray CT scanner

ObjectiveThe purpose of this work is to evaluate the impact of optimization of magnification on performance parameters of the variable resolution X-ray (VRX) CT scanner.MethodsA realistic model based on an actual VRX CT scanner was implemented in the GATE Monte Carlo simulation platform. To evaluate the influence of system magnification, spatial resolution, field-of-view (FOV) and scatter-to-primary ratio of the scanner were estimated for both fixed and optimum object magnification at each detector rotation angle. Comparison and inference between these performance parameters were performed angle by angle to determine appropriate object position at each opening half angle.ResultsOptimization of magnification resulted in a trade-off between spatial resolution and FOV of the scanner at opening half angles of 90°–12°, where the spatial resolution increased up to 50% and the scatter-to-primary ratio decreased from 4.8% to 3.8% at a detector angle of about 90° for the same FOV and X-ray energy spectrum. The disadvantage of magnification optimization at these angles is the significant reduction of the FOV (up to 50%). Moreover, magnification optimization was definitely beneficial for opening half angles below 12° improving the spatial resolution from 7.5 cy/mm to 20 cy/mm. Meanwhile, the FOV increased by more than 50% at these angles.ConclusionIt can be concluded that optimization of magnification is essential for opening half angles below 12°. For opening half angles between 90° and 12°, the VRX CT scanner magnification should be set according to the desired spatial resolution and FOV.     

医用PACS系统及其主要技术问题

医用图像归档与通信系统(简称PACS)是近年来医学图像处理的一个研究热点。本文介绍了这一系统的基本功能、系统构成及其几个主要技术问题。     

All-Atom Monte Carlo Approach to Protein-Peptide Binding

We develop a procedure for exploring the free energy landscape of protein-peptide binding at atomic detail and apply it to PDZ domain-peptide interactions. The procedure involves soft constraints on receptor proteins providing limited chain flexibility, including backbone motions. Peptide chains are left fully flexible and kept in spatial proximity of the protein through periodic boundary conditions. By extensive Monte Carlo simulations, full representative conformational ensembles at temperatures where bound and unbound states coexist are obtained. To make this approach computationally feasible, we develop an effective all-atom energy function centering on hydrophobicity, hydrogen bonding, and electrostatic interactions. Our initial focus is a set of 11 PDZ domain-peptide pairs with experimentally determined complex structures. Minimum-energy conformations are found to be highly similar to the respective native structures in eight of the cases (all-atom peptide RMSDs < 6 Å). Having achieved that, we turn to a more complete characterization of the bound peptide state through a clustering scheme applied on the full ensembles of peptide structures. We find a significant diversity among bound peptide conformations for several PDZ domains, in particular involving the N terminal side of the peptide chains. Our computational model is then tested further on a set of nine PDZ domain-peptide pairs where the peptides are not originally present in the experimentally determined structures. We find a similar success rate in terms of the nativeness of minimum-energy conformations. Finally, we investigate the ability of our approach to capture variations in binding affinities for different peptide sequences. This is done in particular for a set of related sequences binding to the third PDZ domain of PSD-95 with encouraging results.     

赛加羚羊头骨的三维重建研究及其精确度评价

为建立赛加羚羊（Saiga tatarica）头骨三维可视化模型,进一步研究赛加羚羊头骨的解剖特征,建立赛加羚羊头骨的“数字化标本”,以提高其疾病诊治的准确率和物种保护的有效性。本研究以国家林业局甘肃濒危动物保护中心的赛加羚羊为研究对象,经锥形束CT扫描获得影像数据,运用MIMICS 20.0软件对赛加羚羊头骨扫描数据进行处理和三维重建,以建立赛加羚羊的“数字化头骨”用于形态研究。运用MIMICS 20.0软件对数字化头骨的26项形态学指标（n = 8）进行三维测量,且与头骨标本游标卡尺的测量值（n = 8）进行配对样本t检验分析,经与真实测量值比较后评价数字化模型及其三维测量的准确性。结果显示,26项形态测量指标均与真实头骨无显著性差异（P > 0.05）,例如颅全长游标卡尺测量值为（227.147 ± 10.646）mm,三维测量值为（227.130 ± 10.638）mm,P = 0.635,表明三维重建后的数字化头骨和真实的头骨标本高度相似,且“数字标本”能够实现任意角度的旋转、剖切和测量。本研究可为赛加羚羊头部疾病如骨折等的治疗及骨骼系统的三维可视化研究提供基础依据和技术支撑,同时可为CT扫描和医学图像三维可视化技术在野生动物的临床应用和相关研究提供理论基础。