Brown-Roberts-Wells stereotactic frame modifications to accomplish magnetic resonance imaging guidance in three planes

The Brown-Roberts-Wells (BRW) computer tomography (CT) stereotactic guidance system has been modified to accommodate magnetic resonance imaging (MRI). A smaller head ring, which fits in standard MRI head coils, is constructed of a non-ferromagnetic aluminum ring that is split to prevent eddy currents and anodized to prevent MRI image distortion and resolution degradation. A new localizing device has been designed in a box configuration, which allows BRW stereotactic coordinates to be calculated from coronal and sagittal MRI images, in addition to axial images. The system was tested utilizing a phantom and T1- and T2-weighted images. Using 5-mm MRI scan slices, targets were localized accurately to a 5-mm cube in three combined planes. Optimized calibration of both low field strength (0.3 T) and high field strength (1.5 T) MRI systems is necessary to obtain thin slice (5 mm) images with acceptable image resolution. To date, 10 patients have had MRI stereotactic localization of brain lesions that were better defined by MRI than CT.     

Experience in the application of Java Technologies in telemedicine

Java language has been demonstrated to be an effective tool in supporting medical image viewing in Russia. This evaluation was completed by obtaining a maximum of 20 images, depending on the client's computer workstation from one patient using a commercially available computer tomography (CT) scanner. The images were compared against standard CT images that were viewed at the site of capture. There was no appreciable difference. The client side is a lightweight component that provides an intuitive interface for end users. Each image is loaded in its own thread and the user can begin work after the first image has been loaded. This feature is especially useful on slow connection speed, 9.6 Kbps for example. The server side, which is implemented by the Java Servlet Engine works more effective than common gateway interface (CGI) programs do. Advantages of the Java Technology place this program on the next level of application development. This paper presents a unique application of Java in telemedicine.     

The role of computed tomographic and digital radiographic techniques in stereotactic procedures for electrode implantation and mapping, and lesion localization

This paper describes a computer-based system for analyzing stereotactic CT scans and angiograms. Simple Plexiglas frames containing metallic marker pellets and rods are affixed to the sides of the frame during CT scanning and angiography. The images of these markers are recognized by the computer program and used to compute the frame coordinate system. Coordinates of a lesion on CT and angiogram images may be readily computed and coordinate sets specified by the operator may be displayed on the imager, along with positions of implanted electrodes and a numerical indication of recorded activity for each site.     

A method for measuring joint kinematics designed for accurate registration of kinematic data to models constructed from CT data

A method for measuring three-dimensional kinematics that incorporates the direct cross-registration of experimental kinematics with anatomic geometry from Computed Tomography (CT) data has been developed. Plexiglas registration blocks were attached to the bones of interest and the specimen was CT scanned. Computer models of the bone surface were developed from the CT image data. Determination of discrete kinematics was accomplished by digitizing three pre-selected contiguous surfaces of each registration block using a three-dimensional point digitization system. Cross-registration of bone surface models from the CT data was accomplished by identifying the registration block surfaces within the CT images. Kinematics measured during a biomechanical experiment were applied to the computer models of the bone surface. The overall accuracy of the method was shown to be at or below the accuracy of the digitization system used. For this experimental application, the accuracy was better than +/-0.1mm for position and 0.1 degrees for orientation for linkage digitization and better than +/-0.2mm and +/-0.2 degrees for CT digitization. Surface models of the radius and ulna were constructed from CT data, as an example application. Kinematics of the bones were measured for simulated forearm rotation. Screw-displacement axis analysis showed 0.1mm (proximal) translation of the radius (with respect to the ulna) from supination to neutral (85.2 degrees rotation) and 1.4mm (proximal) translation from neutral to pronation (65.3 degrees rotation). The motion of the radius with respect to the ulna was displayed using the surface models. This methodology is a useful tool for the measurement and application of rigid-body kinematics to computer models.     

基于知识的颅内出血（ICH）三维医学图像分割方法

本文描述一种基于知识的三维医学图像自动分割方法,用于进行人体颅内出血(Intracranial Hemorrhage,ICH)的分割和分析。首先,数字化CT胶片,并自动对数字化后的胶片按照有无异常分类。然后,阀值结合模糊C均值聚类算法将图像分类成多个具有统一亮度的区域。最后,在先验知识以及预定义的规则的基础上,借助基于知识的专家系统将各个区域标记为背景、钙化点、血肿、颅骨、脑干。     

Development and validation of a generic 3D model of the distal femur

The development and validation of a virtual generic 3D model of the distal femur using computer graphical methods is presented. The synthesis of the generic model requires the following steps: acquisition of bony 3D morphology using standard computed tomography (CT) imaging; alignment of 3D models reconstructed from CT images with a common coordinate system; computer graphical sectioning of the models; extraction of bone contours from the image sections; combining and averaging of extracted contours; and 3D reconstruction of the averaged contours. The generic models reconstructed from the averaged contours of six cadaver femora were validated by comparing their surface geometry on a point to point basis with that of the CT reconstructed reference models. The mean errors ranged from 0.99 to 2.5 mm and were in agreement with the qualitative assessment of the models.     

Development and validation of a generic 3D model of the distal femur

The development and validation of a virtual generic 3D model of the distal femur using computer graphical methods is presented. The synthesis of the generic model requires the following steps: acquisition of bony 3D morphology using standard computed tomography (CT) imaging; alignment of 3D models reconstructed from CT images with a common coordinate system; computer graphical sectioning of the models; extraction of bone contours from the image sections; combining and averaging of extracted contours; and 3D reconstruction of the averaged contours.

The generic models reconstructed from the averaged contours of six cadaver femora were validated by comparing their surface geometry on a point to point basis with that of the CT reconstructed reference models. The mean errors ranged from 0.99 to 2.5 mm and were in agreement with the qualitative assessment of the models.     

First application of X-ray refraction-based computed tomography to a biomedical object

We have developed X-ray refraction-based computed tomography (CT) that is able to visualize soft tissue in between hard tissue. The experimental system consists of Si(220) diffraction double-crystals and is called the DEI (diffraction-enhanced imaging) method, in which the object is located between the crystals and a CCD camera to acquire data as 360 X-ray images. The X-ray energy used was 17.5 keV. The algorithm used to reconstruct CT images was developed by A. Maksimenko and colleagues. We successfully visualized articular cartilage and the distribution of bone marrow, which are inner structures. Our method has much higher contrast compared to the conventional absorption-based CT system.     

Validation study of skull three-dimensional computerized tomography measurements

Recent advances in imaging have led to high-resolution computerized tomography (CT) scanning with exquisitely detailed slice images of the skull and three-dimensional (3-D) surface reconstructions using computer software. It is possible to use CT scans to acquire morphologic information about the skull in a convenient digital form and to derive 3-D measurements from surface reconstruction images. Unfortunately, no effort has been made to date to test the validity of these measurements on laboratory specimens, and no compelling evidence is available from phantom studies to indicate the nature and magnitude of the errors inherent in the measurement technique. We have performed a pilot study to quantify the morphology of the skull based on surface features that can be found in CT scans and 3-D reconstructions. Comparative measurements were obtained from five skulls (two normal and three with dysmorphology) with calipers and a 3-D electromagnetic digitizer. These measurements were statistically compared with those based on original CT scan slices and reformatted 3-D images. It is concluded that 3D-CT measurement techniques are superior to those in which measurements are obtained directly from the original CT slices; 3-D CT methods, however, must be significantly improved before measurements based on these techniques can be used in studies that require a high degree of precision. The results are used to indicate the most fruitful areas of future study.     

PETSTEP: Generation of synthetic PET lesions for fast evaluation of segmentation methods

PurposeThis work describes PETSTEP (PET Simulator of Tracers via Emission Projection): a faster and more accessible alternative to Monte Carlo (MC) simulation generating realistic PET images, for studies assessing image features and segmentation techniques.MethodsPETSTEP was implemented within Matlab as open source software. It allows generating three-dimensional PET images from PET/CT data or synthetic CT and PET maps, with user-drawn lesions and user-set acquisition and reconstruction parameters. PETSTEP was used to reproduce images of the NEMA body phantom acquired on a GE Discovery 690 PET/CT scanner, and simulated with MC for the GE Discovery LS scanner, and to generate realistic Head and Neck scans. Finally the sensitivity (S) and Positive Predictive Value (PPV) of three automatic segmentation methods were compared when applied to the scanner-acquired and PETSTEP-simulated NEMA images.ResultsPETSTEP produced 3D phantom and clinical images within 4 and 6 min respectively on a single core 2.7 GHz computer. PETSTEP images of the NEMA phantom had mean intensities within 2% of the scanner-acquired image for both background and largest insert, and 16% larger background Full Width at Half Maximum. Similar results were obtained when comparing PETSTEP images to MC simulated data. The S and PPV obtained with simulated phantom images were statistically significantly lower than for the original images, but led to the same conclusions with respect to the evaluated segmentation methods.ConclusionsPETSTEP allows fast simulation of synthetic images reproducing scanner-acquired PET data and shows great promise for the evaluation of PET segmentation methods.     

The construction of computer tomographic phantoms and their application in radiology and radiation protection

Summary In order to assess human organ doses for risk estimates under natural and man made radiation exposure conditions, human phantoms have to be used. As an improvement to the mathematical anthropomorphic phantoms, a new family of phantoms is proposed, constructed from computer tomographic (CT) data. A technique is developed which allows any physical phantom to be converted into computer files to be used for several applications. The new human phantoms present advantages towards the location and shape of the organs, in particular the hard bone and bone marrow. The CT phantoms were used to construct three dimensional images of high resolution; some examples are given and their potential is discussed. The use of CT phantoms is also demonstrated to assess accurately the proportion of bone marrow in the skeleton. Finally, the use of CT phantoms for Monte Carlo (MC) calculations of doses resulting from various photon exposures in radiology and radiation protection is discussed.Dedicated to Prof. W. Jacobi on the occasion of his 60th birthday     

Use of the Brown-Roberts-Wells stereotactic frame for functional neurosurgery

The Brown-Roberts-Wells (BRW) stereotactic unit has proven itself to be a highly accurate instrument for biopsying or locating pathologic intracranial lesions based on CT scan information. We utilized the BRW frame to select 18 target sites in 12 patients undergoing functional stereotactic procedures. Two patients had bilateral cingulumotomies, 5 had thalamotomies for movement disorders, and 5 underwent electrode implantations for the treatment of chronic pain. Stereotactic frame settings were determined using a positive contrast ventriculogram, orthogonal radiographs, and a computer program provided with the BRW system. In addition, attempts were made to select targets based on CT scan landmarks alone, and these were compared to those derived using ventriculography. We found the BRW frame to be a satisfactory device for performing functional neurosurgical procedures based on ventriculographic landmarks. Coordinates derived from CT scans were similar to those obtained with ventriculography, but were not accurate enough to permit the use of CT scanning as the sole means of target identification. Although future improvements in imaging techniques and computer software are likely to occur, our experience supports ventriculography as the current method of choice for the precise localization of functional targets with the BRW stereotactic system.     

Real-time three-dimensional graphic reconstructions using Brown-Roberts-Wells frame coordinates in a microcomputer environment

A desktop microcomputer environment that utilizes Brown-Roberts-Wells (BRW) frame coordinates for creation of three-dimensional depiction of operator-defined intracranial structures has been developed. The system allows direct reading of Siemens CT scan images from a floppy disc, structural edge definition, and reconstruction of defined images. The system is used in the operating room to view scans, perform standard BRW stereotactic functions, and create three-dimensional graphics for such tasks as defining tumor margins, conceptualizing positional relationships of intracranial structures, and radiation planning.     

Computer-assisted paleoanthropology

Paleoanthropologists are confronted by a steadily growing number of fossil specimens exhibiting diversity in both apparent morphology and state of preservation. Studying this material to answer phylogenetic and functional questions requires extensive qualitative assessment accompanied by quantitative evaluation of large volumes of data. Over the past decade, major new developments in both respects have been made possible through the advent of medical imaging technologies, most notably computer tomography (CT), and through concomitant progress in computer graphics technology. In paleoanthropology, these techniques offer noninvasive tools for visualization of inaccessible regions of the skeleton, computer-assisted reconstruction of fragmentary fossil specimens, and morphometric or biomechanical analysis of data derived from CT images. A series of CT based studies has already yielded new insights into character differences between fossil hominid species. © 1998 Wiley-Liss, Inc.     

Use of 3D geometry modeling of osteochondrosis-like iatrogenic lesions as a template for press-and-fit scaffold seeded with mesenchymal stem cells

Computed tomography (CT) is an effective diagnostic modality for three-dimensional imaging of bone structures, including the geometry of their defects. The aim of the study was to create and optimize 3D geometrical and real plastic models of the distal femoral component of the knee with joint surface defects. Input data included CT images of stifle joints in twenty miniature pigs with iatrogenic osteochondrosis-like lesions in medial femoral condyle of the left knee. The animals were examined eight and sixteen weeks after surgery. Philips MX 8000 MX and View workstation were used for scanning parallel plane cross section slices and Cartesian discrete volume creation. On the average, 100 slices were performed in each stifle joint. Slice matrices size was 512 x 512 with slice thickness of 1 mm. Pixel (voxel) size in the slice plane was 0.5 mm (with average accuracy of +/-0.5 mm and typical volume size 512 x 512 x 100 voxels). Three-dimensional processing of CT data and 3D geometrical modelling, using interactive computer graphic system MediTools formerly developed here, consisted of tissue segmentation (raster based method combination and 5 % of manual correction), vectorization by the marching-cubes method, smoothing and decimation. Stifle- joint CT images of three individuals of different body size (small, medium and large) were selected to make the real plastic models of their distal femurs from plaster composite using rapid prototyping technology of Zcorporation. Accuracy of the modeling was +/- 0.5 mm. The real plastic models of distal femurs can be used as a template for developing custom made press and fit scaffold implants seeded with mesenchymal stem cells that might be subsequently implanted into iatrogenic joint surface defects for articular cartilage-repair enhancement.     

Liver vessel segmentation based on extreme learning machine

Liver-vessel segmentation plays an important role in vessel structure analysis for liver surgical planning. This paper presents a liver-vessel segmentation method based on extreme learning machine (ELM). Firstly, an anisotropic filter is used to remove noise while preserving vessel boundaries from the original computer tomography (CT) images. Then, based on the knowledge of prior shapes and geometrical structures, three classical vessel filters including Sato, Frangi and offset medialness filters together with the strain energy filter are used to extract vessel structure features. Finally, the ELM is applied to segment liver vessels from background voxels. Experimental results show that the proposed method can effectively segment liver vessels from abdominal CT images, and achieves good accuracy, sensitivity and specificity.     

The "third" dimension in craniofacial surgery

A new method for reconstruction of a three-dimensional surface from a sequence of high-resolution axial CT scans has been developed. This algorithm is realized as a set of computer programs that can operate on commercially available CT scanners or evaluation consoles. The program is both efficient and easy to implement. No operator intervention is required. The images produced simulate photographs of the skull. Frontal, lateral, oblique, bird's eye, worm's eye, and rear views are generated. As with photographs and conventional radiographs, each of these projections uniquely displays specific anatomic details. This method of osseous surface reconstruction is now routinely applied to all patients evaluated for major craniofacial reconstruction at our institution. The images are useful in defining aberrant anatomy, planning surgical procedures, and evaluating the results of such operations. This method replaces an inexact concept in the surgeon's imagination with a three-dimensional image of the craniofacial skeleton.     

录象机在生物组织连续切片的计算机三维重建系统中的应用

录象机(Video Tape Recorder)作为输入、输出设备,应用于“生物组织连续切片的计算机三维重建系统”中,其效果是令人满意的.由于研制的“同步再生”单元(Sync RecoveryUnit)有效地消除了静放噪声,从而使Cromemco微型计算机的图象输入接口SDD(Super DazzlerDigitizer)能够稳定地逐帧采集录象机输出的静止图象.录制并编辑计算机三维重建后的生物组织显微结构的空间旋转视图,使其在录象机的监视器上显示得更生动、逼真,更有体视感;还可脱离主机在任何场合演示重建结果.本文还就录象机在生物医学序列图象分析中的应用前景进行了讨论.     

Imaging technics in bronchology

Bronchoscopic imaging and diagnostics are tightly connected with radiological and pathological techniques. While computer tomography (virtual bronchoscopy) makes possible to mimic a realistic endobronchial situation, autofluorescent bronchoscopy holds significant potential to discover precancerous lesions not identifiable by standard bronchoscopy. Endoscopic ultrasound and fluoroscopy can be applied in order to obtain images and tissue samples from the extrabronchial areas. Electromagnetic navigation during flexible bronchoscopy, a novel technology that facilitates approaching peripheral lung lesions, involves creating an electromagnetic field around the thorax and localizing an endoscopic tool using a microsensor overlaid upon previously acquired CT images. In conclusion, parallel use of invasive and non-invasive imaging has the potential for considerable improvements in the diagnostic possibilities of routine bronchoscopic procedures.     

La caméra à semi-conducteur D-Spect : aspects techniques et applications cliniques

Clinical practice in nuclear medicine has largely changed in the last decade, particularly with the arrival of PET/CT and SPECT/CT. New semiconductor cameras could represent the next evolution in our nuclear medicine practice. Due to the resolution and sensitivity improvement, this technology authorizes fast speed acquisitions, high contrast and resolution images performed with low activity injection. The dedicated cardiology D-Spect camera (Spectrum Dynamics, Israel) is based on semiconductor technology and provides an original system for collimation and images reconstruction. We describe here our clinical experience in using the D-Spect with a preliminary study comparing D-DPECT and conventional gamma camera.