A novel application of capnography during controlled human exposure to air pollution

Background

A detailed contrast bolus propagation model is essential for optimizing bolus-chasing Computed Tomography Angiography (CTA). Bolus characteristics were studied using bolus-timing datasets from Magnetic Resonance Angiography (MRA) for adaptive controller design and validation.

Methods

MRA bolus-timing datasets of the aorta in thirty patients were analyzed by a program developed with MATLAB. Bolus characteristics, such as peak position, dispersion and bolus velocity, were studied. The bolus profile was fit to a convolution function, which would serve as a mathematical model of bolus propagation in future controller design.

Results

The maximum speed of the bolus in the aorta ranged from 5–13 cm/s and the dwell time ranged from 7–13 seconds. Bolus characteristics were well described by the proposed propagation model, which included the exact functional relationships between the parameters and aortic location.

Conclusion

The convolution function describes bolus dynamics reasonably well and could be used to implement the adaptive controller design.     

Adaptive bolus-chasing computed tomography angiography in the cases of symmetric and asymmetric arterial flows in peripheral arteries

Synchronization of the contrast bolus peak and CT imaging aperture is a crucial issue for computed tomography angiography (CTA). It affects the CTA image quality and the amount of contrast dose. A whole-body CTA procedure means to scan from the abdominal aorta to pedal arteries. In this context, the synchronization is much more difficult with the asymmetric arterial flow in lower extremities than in the case of symmetric arterial flow. In this paper, we propose an adaptive optimal controller to chase the contrast bolus peak while it propagates in the aorta and lower extremities with symmetric flow. In the case of asymmetric flow after the contrast bolus splitting into two lower limbs, we propose a dynamic programming approach to cover the lower limbs optimally. Simulation and experimental results show that the proposed methods outperform the current constant-speed method substantially.     

Monitoring Radiofrequency Ablation Using Real-Time Ultrasound Nakagami Imaging Combined with Frequency and Temporal Compounding Techniques

Gas bubbles induced during the radiofrequency ablation (RFA) of tissues can affect the detection of ablation zones (necrosis zone or thermal lesion) during ultrasound elastography. To resolve this problem, our previous study proposed ultrasound Nakagami imaging for detecting thermal-induced bubble formation to evaluate ablation zones. To prepare for future applications, this study (i) created a novel algorithmic scheme based on the frequency and temporal compounding of Nakagami imaging for enhanced ablation zone visualization, (ii) integrated the proposed algorithm into a clinical scanner to develop a real-time Nakagami imaging system for monitoring RFA, and (iii) investigated the applicability of Nakagami imaging to various types of tissues. The performance of the real-time Nakagami imaging system in visualizing RFA-induced ablation zones was validated by measuring porcine liver (n = 18) and muscle tissues (n = 6). The experimental results showed that the proposed algorithm can operate on a standard clinical ultrasound scanner to monitor RFA in real time. The Nakagami imaging system effectively monitors RFA-induced ablation zones in liver tissues. However, because tissue properties differ, the system cannot visualize ablation zones in muscle fibers. In the future, real-time Nakagami imaging should be focused on the RFA of the liver and is suggested as an alternative monitoring tool when advanced elastography is unavailable or substantial bubbles exist in the ablation zone.     

Gating in small-animal cardio-thoracic CT

Gating is necessary in cardio-thoracic small-animal imaging because of the physiological motions that are present during scanning. In small-animal computed tomography (CT), gating is mainly performed on a projection base because full scans take much longer than the motion cycle. This paper presents and discusses various gating concepts of small-animal CT, and provides examples of concrete implementation. Since a wide variety of small-animal CT scanner systems exist, scanner systems are discussed with respect to the most suitable gating methods. Furthermore, an overview is given of cardio-thoracic imaging and gating applications. The necessary contrast media are discussed as well as gating limitations. Gating in small-animal imaging requires the acquisition of a gating signal during scanning. This can be done extrinsically (additional hardware, e.g. electrocardiogram) or intrinsically from the projection data itself. The gating signal is used retrospectively during CT reconstruction, or prospectively to trigger parts of the scan. Gating can be performed with respect to the phase or the amplitude of the gating signal, providing different advantages and challenges. Gating methods should be optimized with respect to the diagnostic question, scanner system, animal model, type of narcosis and actual setup. The software-based intrinsic gating approaches increasingly employed give the researcher independence from difficult and expensive hardware changes.     

Guide du bon usage de la TDM en médecine nucléaire. IntroductionCT good practices for hybrid nuclear medicine (SPECT/CT and PET/CT): Introduction

Nuclear medicine hybrid imaging is a technological evolution of gamma camera scintigraphy or positron emission tomography imaging methods that are now often coupled with an anatomical imaging device, essentially a CT scanner. Following a large demand from the nuclear physicians themselves, but also from the French Nuclear Safety Authority, this guide is intended for the entire nuclear medicine community to integrate both the aspects of radiation protection related to coupled CT and those related to the quality of the CT images according to the clinical context.     

A Low Cost Metal-Free Vascular Access Mini-Port for Artifact Free Imaging and Repeated Injections in Mice

Purpose

Small injection ports for mice are increasingly used for drug testing or when administering contrast agents. Commercially available mini-ports are expensive single-use items that cause imaging-artifacts. We developed and tested an artifact-free, low-cost, vascular access mini-port (VAMP) for mice.

Procedures

Leakage testing of the VAMP was conducted with high speed bolus injections of different contrast agents. VAMP-induced artifacts were assessed using a micro-CT and a small animal MRI (9.4T) scanner ex vivo. Repeated contrast administration was performed in vivo.

Results

With the VAMP there was no evidence of leakage with repeated punctures, high speed bolus contrast injections, and drawing of blood samples. In contrast to the tested commercially available ports, the VAMP did not cause artifacts with MRI or CT imaging.

Conclusions

The VAMP is an alternative to commercially available mini-ports and has useful applications in animal research involving imaging procedures and contrast agent testing.     

Neural adaptive control for vibration suppression in composite fin-tip of aircraft

In this paper, we present a neural adaptive control scheme for active vibration suppression of a composite aircraft fin tip. The mathematical model of a composite aircraft fin tip is derived using the finite element approach. The finite element model is updated experimentally to reflect the natural frequencies and mode shapes very accurately. Piezo-electric actuators and sensors are placed at optimal locations such that the vibration suppression is a maximum. Model-reference direct adaptive neural network control scheme is proposed to force the vibration level within the minimum acceptable limit. In this scheme, Gaussian neural network with linear filters is used to approximate the inverse dynamics of the system and the parameters of the neural controller are estimated using Lyapunov based update law. In order to reduce the computational burden, which is critical for real-time applications, the number of hidden neurons is also estimated in the proposed scheme. The global asymptotic stability of the overall system is ensured using the principles of Lyapunov approach. Simulation studies are carried-out using sinusoidal force functions of varying frequency. Experimental results show that the proposed neural adaptive control scheme is capable of providing significant vibration suppression in the multiple bending modes of interest. The performance of the proposed scheme is better than the H(infinity) control scheme.     

A decentralized control scheme for an effective coordination of phasic and tonic control in a snake-like robot

Autonomous decentralized control has attracted considerable attention because it enables us to understand the adaptive and versatile locomotion of animals and facilitates the construction of truly intelligent artificial agents. Thus far, we have developed a snake-like robot (HAUBOT I) that is driven by a decentralized control scheme based on a discrepancy function, which incorporates phasic control. In this paper, we investigate a decentralized control scheme in which phasic and tonic control are well coordinated, as an extension of our previous study. To verify the validity of the proposed control scheme, we apply it to a snake-like robot (HAUBOT II) that can adjust both the phase relationship between its body segments and the stiffness at each joint. The results indicate that the proposed control scheme enables the robot to exhibit remarkable real-time adaptability over various frictional and inclined terrains. These findings can potentially enable us to gain a deeper insight into the autonomous decentralized control mechanism underlying the adaptive and resilient locomotion of animals.     

How Much Is the Dose Varying between Follow-Up CT-Examinations Performed on the Same Scanner with the Same Imaging Protocol?

PurposeTo investigate the dose variation between follow-up CT examinations, when a patient is examined several times on the same scanner with the identical scan protocol which comprised automated exposure control.ResultsThe median percentage difference in DLP between follow-up examinations was 9.6% for CH-CT, 10.3% for LI-CT, and 10.1% for AB-CT; the median percentage difference in CTDI_vol 8.3% for CH-CT, 7.4% for LI-CT and 7.7% for AB-CT (p<0.0001 for all values). The maximum difference in DLP between follow-up examinations was 67.5% for CH-CT, 50.8% for LI-CT and 74.3% for AB-CT; the maximum difference in CTDI_vol 62.9% for CH-CT, 47.2% for LI-CT, and 49% for AB-CT.ConclusionA significant variance in the radiation dose occurs between follow-up CT examinations when the same CT scanner and the identical imaging protocol are used in combination with automated exposure control.     

Impact of miscentering on patient dose and image noise in x-ray CT imaging: Phantom and clinical studies

The operation of the bowtie filter in x-ray CT is correct if the object being scanned is properly centered in the scanner’s field-of-view. Otherwise, the dose delivered to the patient and image noise will deviate from optimal setting. We investigate the effect of miscentering on image noise and surface dose on three commercial CT scanners. Six cylindrical phantoms with different size and material were scanned on each scanner. The phantoms were positioned at 0, 2, 4 and 6 cm below the isocenter of the scanner’s field-of-view. Regression models of surface dose and noise were produced as a function of miscentering magnitude and phantom’s size. 480 patients were assessed using the calculated regression models to estimate the influence of patient miscentering on image noise and patient surface dose in seven imaging centers. For the 64-slice CT scanner, the maximum increase of surface dose using the CTDI-32 phantom was 13.5%, 33.3% and 51.1% for miscenterings of 2, 4 and 6 cm, respectively. The analysis of patients’ scout scans showed miscentering of 2.2 cm in average below the isocenter. An average increase of 23% and 7% was observed for patient dose and image noise, respectively. The maximum variation in patient miscentering derived from the comparison of imaging centers using the same scanner was 1.6 cm. Patient miscentering may substantially increase surface dose and image noise. Therefore, technologists are strongly encouraged to pay greater attention to patient centering.     

Brain imaging tools in neurosciences

In this chapter brain imaging tools in neurosciences are presented. These include a brief overview on single-photon emission tomography (SPET) and a detailed focus on positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). In addition, a critical discussion on the advantages and disadvantages of the three diagnostic systems is added.Furthermore, this article describes the image analysis tools from visual analysis over region-of-interest technique up to statistical parametric mapping, co-registration methods, and network analysis. It also compares the newly developed combined PET/CT scanner approach with established image fusion software approaches.There is rapid change: Better scanner qualities, new software packages and scanner concepts are on the road paved for an amply bright future in neurosciences.     

TEP/TDM dans le diagnostic et la stadification des lymphomes

Histological subtypes of lymphomas are important because FDG uptake is much greater in aggressive than in indolent lymphomas and this, results in lower sensitivity of PET for the staging of indolent lymphomas. Staging is especially useful when treatment is changed according to staging. Staging with imaging methods has traditionally been performed using a CT scanner and has been based on the detection of nodal enlargement, an increased number of small nodes and in the presence of extranodal masses. However, CT is limited by its poor sensitivity in the detection of extranodal sites of involvement, in the identification of tumour involvement of normal size lymph nodes and in the differentiation between malignant and inflammatory enlarged lymph nodes. The uptake of FDG detected with PET images reflects metabolic activity rather than the size of the tissue masses, localizing tumoral activity in enlarged and in normal size lymph nodes. In the literature review that compares PET with CT, PET usually indicates more lesions than CT would and PET improves sensitivity without losing specificity. However, the majority of studies report that PET, improves the staging in a relatively limited number of patients (10-20%) and may change treatment in less than 10% of patients. Diagnostic accuracy of PET may improve with the use of hybrid PET/CT systems that combine metabolic and morphological imaging, in the same scanner and without moving the patient. This is a promising technique that will overcome the limitations of both modalities and may enhance diagnostic accuracy in lymphoma patients. This hybrid equipment allows the use of PET/CT with contrast-enhanced full dose CT (a diagnostic CT) instead of carrying out PET and CT on different days.     

Image quality for radiotherapy CT simulators with different scanner bore size

PurposeWe compare image quality parameters derived from phantom images taken on three commercially available radiotherapy CT simulators. To make an unbiased evaluation, we assured images were obtained with the same surface dose measured using XR-QA2 model GafChromic™ film placed at the imaging phantom surface for all three CT-simulators.MethodsRadiotherapy CT simulators GE LS 16, Philips Brilliance Big Bore, and Toshiba Aquilion LB were compared in terms of spatial resolution, low contrast detectability, image uniformity, and contrast to noise ratio using CATPHAN-504 phantom, scanned with Head and Pelvis protocols. Dose was measured at phantom surface, with CT scans repeated until doses on all scanners were within 2%.ResultsIn terms of spatial resolution, the GE simulator appears slightly better, while Philips CT images are superior in terms of SNR for both scanning protocols. The CNR results show that Philips CT images appear to be better, except for high Z material, while Toshiba appears to fit in between the two simulators.ConclusionsWhile the image quality parameters for three RT CT simulators show comparable results, the scanner bore size is of vital importance in various radiotherapy applications. Since the image quality is a function of a large number of confounding parameters, any loss in image quality due to scanner bore size could be compensated by the appropriate choice of scanning parameters, including the exposure and by balancing between the additional imaging dose to the patient and high image quality required in highly conformal RT techniques.     

Intraoperative computer tomography control within the scope of maxillofacial traumatology using a mobile scanner]

Advances in intra-operative imaging and the development of new minimally invasive techniques are having an ever greater impact on modern surgery. Mobile CT scanners in the operating room is a new technique that permits image-guided surgery, and helps minimize postoperative complications. We report on our initial experience with intraoperative CT scanning during surgery on patients suffering lateral midface trauma. A mobile CT unit, the Tomoscan M (Philips, Utrecht, Netherlands) set up in the operating room, was evaluated in 6 patients with zygomatic bone fractures. The patients were placed on the CT scanner table, which is detachable from the gantry. The unit is powered by batteries charged from an ordinary ring mains supply via a conventional plug. The CT images obtained were of good quality in all cases. No technical problems were observed during surgery. Using repeat CT scans, the procedure also permits accurate intraoperative monitoring of the anatomical repositioning of the bone fragments, and accurate implantation. No intraoperative or early postoperative complications were observed. This new technical aid ensures highly accurate reduction of the bone fragments, and minimizes the need for reoperation. High-quality intraoperative imaging with surgical navigation increase surgical outcome, and expand the spectrum of minimally invasive surgery.     

Profile control scheme in a Bakers' yeast fed-batch culture

This article develops and discusses a practical and useful computer control scheme so that the biomass concentration or the specific growth rate will as accurately as possible follow a desired profile specified in advance. Many computer simulations certified the validity of the proposed control scheme. The control scheme proposed, called "programmed-controller/feedback-compensator (PF) system," consists of a programmed controller that will follow the desired profile unless there is noise or disturbance and a feedback compensator that will compensate the noise and correct error in the model parameters. As the feedback compensator, the model reference adaptive control (MRAC) algorithm was also proposed. The PF system with MRAC, named PF-MRAC, could be used sufficiently for the profile control of the specific growth rate. For the profile control of the cell concentration, "predictive control algorithm" should be added to the PF system, and the consequent control scheme was named as the PFP system. Many numerical examples showed that the PFP system with MRAC, named PFP-MRAC, proposed here worked sufficiently well.     

Thresholding technique for accurate analysis of density and geometry in QCT, pQCT and microCT images

Computed tomography (CT) is widely used in the assessment of bone parameters in live patients and animals as well as bone samples. Quantitative analysis requires the segmentation of the bone from the surrounding tissue, and most segmentation methods rely on some type of thresholding technique. The aim of this communication is to highlight the influence of threshold selection on various bone parameters and recommend appropriate thresholds. Two types of information are of interest in bone analysis from images: geometric parameters and density parameters. We know from imaging theory that blurring is an inherent byproduct of all imaging methods. Depending on the threshold used for segmentation, the object boundary moves in space due to the sloping edge. It is, thus, critical to select the threshold that creates an object boundary that reflects the actual object size. Similarly, due to blurring, the imaged density shows erroneous values at the object boundaries. Such values must not be included for an accurate representation of the object density. Using a pQCT scanner and a bone phantom with known density and geometry, we show that the thresholds for geometry and density are different. The threshold for accurate geometric segmentation was 49% of the difference of the density between the adjacent tissues. The threshold for accurate density assessment was 95% of the maximum density value of the bone. These specific thresholds are valid only for the scanner tested; however, the principle for selecting the thresholds is valid across scanner platforms and scale of imaging.     

Adaptive feedback control models of the vestibulocerebellum and spinocerebellum

We extend the cerebellar learning model proposed by Kawato and Gomi (1992) to the case where a specific region of the cerebellum executes adaptive feed-back control as well as feedforward control. The model is still based on the feedback-error-learning scheme. The proposed adaptive feedback control model is developed in detail as a specific neural circuit model for three different regions of the cerebellum and the learning of the corresponding representative movements: (i) the flocculus and adaptive modification of the vestibulo-ocular reflex and optokinetic eye-movement responses, (ii) the vermis and adaptive posture control, and (iii) the intermediate zones of the hemisphere and adaptive control of locomotion. As a representative example, simultaneous adaptation of the vestibulo-ocular reflex and the optokinetic eye-movement response was successfully simulated while the Purkinje cells receive copies of motor commands through recurrent neural connections as well as vestibular and retinal-slip parallel-fiber inputs.     

Using Adaptive Methods to Select Variables in Case‐Control Studies

A variables selection method for case‐control studies is proposed that uses an adaptive weighting scheme along with a permutation method to determine if a variable is useful in differentiating the cases from the controls. This adaptive method is used to select exposure variables for the analysis of data from a bladder cancer case‐control study. An extensive simulation study shows that the adaptive method is nearly as effective at finding those variables that are related to case‐control status when normally distributed variables are used. The simulation also shows that the proposed variable selection procedure is much more effective than the stepwise discriminant analysis method when the variables are not normally distributed. (© 2004 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)