abstract: Coronary computed tomography angiography (CTA) has a high negative predictive value for ruling out coronary artery disease with non-invasive evaluation of the coronary arteries. My work has attempted to provide metrics that could increase the positive predictive value of coronary CTA through the use of dual energy CTA imaging. After developing an algorithm for obtaining calcium scores from a CTA exam, a dual energy CTA exam was performed on patients at dose levels equivalent to levels for single energy CTA with a calcium scoring exam. Calcium Agatston scores obtained from the dual energy CTA exam were within ±11% of scores obtained with conventional calcium scoring exams. In the presence of highly attenuating coronary calcium plaques, the virtual non-calcium images obtained with dual energy CTA were able to successfully measure percent coronary stenosis within 5% of known stenosis values, which is not possible with single energy CTA images due to the presence of the calcium blooming artifact. After fabricating an anthropomorphic beating heart phantom with coronary plaques, characterization of soft plaque vulnerability to rupture or erosion was demonstrated with measurements of the distance from soft plaque to aortic ostium, percent stenosis, and percent lipid volume in soft plaque. A classification model was developed, with training data from the beating heart phantom and plaques, which utilized support vector machines to classify coronary soft plaque pixels as lipid or fibrous. Lipid versus fibrous classification with single energy CTA images exhibited a 17% error while dual energy CTA images in the classification model developed here only exhibited a 4% error. Combining the calcium blooming correction and the percent lipid volume methods developed in this work will provide physicians with metrics for increasing the positive predictive value of coronary CTA as well as expanding the use of coronary CTA to patients with highly attenuating calcium plaques. / Dissertation/Thesis / Ph.D. Bioengineering 2013

No description available.

Development of state-of-the-art medical imaging modalities such as Magnetic Resonance Imaging, Computed Tomography, Galactography, MR Diffusion Tensor Imaging, and Tomosynthesis plays an important role for visualization and assessment of anatomical structures. Included among these structures are structures of branching topology such as the bronchial tree in chest computed tomography images, the blood vessels in retinal images and the breast ductal network in x-ray galactograms and the tubular bone patterns in dental radiography. Analysis of such images could help reveal abnormalities, assist in estimating a risk of diseases such as breast cancer and COPD, and aid in the development of realistic anatomy phantoms. This thesis aims at the development of a set of automated methods for the analysis of anatomical structures of tree and network topology. More specifically, the two main objectives include (i) the development of analysis framework to explore the association between topology and texture patterns of anatomical branching structures and (ii) the development of the image processing methods for enhanced visualization of regions of interest in anatomical branching structures such as branching nodes. / Computer and Information Science

Thesis (MMed)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Hybrid imaging using single photon emission computed tomography/low dose (x-ray) computed tomography (SPECT/LDCT) is of benefit in preoperative scintigraphy of primary hyperparathyroidism. The role of SPECT/LDCT in preoperative assessment of renal hyperparathyroidism has not yet been examined. The aim of the study was to determine whether SPECT/LDCT conferred any benefit over SPECT alone in terms of detection and/or localization of hyperfunctioning parathyroid tissue in this patient group. Methods: A retrospective study of patients with renal hyperparathyroidism and positive planar and SPECT scintigraphy was undertaken. All patients underwent planar scintigraphy using 99mTc-pertechnetate immediately followed by 99mTc-sestamibi as well as SPECT/LDCT 60 min after sestamibi injection and a delayed static image to assess for differential washout at 2-3 hours. Planar subtraction images were generated. For each patient, two nuclear physicians reported on planar+ SPECT images followed by planar + SPECT/LDCT images (assisted by a radiologist). Confidence for the presence of hyperfunctioning parathyroid tissue as well as confidence of location was scored on a Likert-type scale. Interpretation of planar + SPECT was compared with interpretation of planar + SPECT/LDCT. The impact of LDCT on equivocal lesions and number of ectopic lesions detected was also assessed. Results: Twenty patients (M:13; F:7) imaged between February 2008 and June 2011 were included [mean age: 40 years (24 – 55)]. Mean creatinine was 687 μmol/l (169-1213), mean corrected calcium: 2.55 mmol/l (1.95-3.33) and median PTH 167 pmol/l (2.4 - >201). Thirty-five lesions were detected on planar and SPECT and this was unchanged after assessment of the LDCT data. Confidence for the presence of parathyroid pathology changed in 5 patients (5 lesions) with the addition of LDCT. LDCT changed the mean confidence of parathyroid pathology from 3.17 to 3.29 (p=0.16). Addition of LDCT reduced the number of equivocal lesions from 18 (14 patients) to 14 (10 patients) (p=0.13). The addition of LDCT changed localization in 4 lesions (3 patients). Confidence in localization of pathology changed in 9 lesions (7 patients) and the mean localization confidence score was improved from 4.2 to 4.46 (p=0.002) with LDCT. The number of lesions classified as ectopic increased from 5 (on planar+SPECT) to 8 (with addition of LDCT) (p=0.25). Conclusion: In renal hyperparathyroidism SPECT/LDCT altered localization of lesions detected on planar and SPECT alone and improved reader confidence of localization accuracy. SPECT/LDCT conferred no additional benefit over SPECT in terms of detection, confidence of parathyroid pathology or ability to distinguish equivocal from non-equivocal parathyroid lesions. The addition of LDCT did not detect significantly more ectopic lesions. Whereas the minor improvement in reader confidence of localization (with addition of LDCT) was of questionable clinical significance, we speculate that the changed and presumably improved localization of lesions on SPECT/LDCT had potential clinical impact in a significant proportion of patients. On this basis we recommend the use of hybrid SPECT/LDCT in imaging of renal hyperparathyroidism when surgery is considered. / AFRIKAANSE OPSOMMING: Agtergrond: Hibriedbeelding met enkelfoton emissie rekenaartomografie / lae dosis rekenaartomografie (EFERT/LDRT) is voordelig in pre-operatiewe beelding van primêre hiperparatiroïedisme. Die rol van EFERT/RT in pre-operatiewe evaluering van renale hiperparatiroïedisme is nog nie ondersoek nie. Die doel van hierdie studie was om in hierdie pasiëntgroep te bepaal of EFERT/RT 'n voordeel bo EFERT alleen verleen. Metode: 'n Retrospektiewe studie van pasiënte met renale hiperparatiroïedisme en positiewe planare en EFERT flikkergrafie is onderneem. Na die toediening van 99mTc-pertegnetaat is planare beelding op alle pasiënte gedoen, onmiddellik gevolg deur 99mTc-sestamibi sowel as EFERT/RT beelding 60 min na sestamibi inspuiting en 'n laat statiese beeld vir differensiële uitwas op 2-3 uur. Planare subtraksiebeelde is verkry. Twee kerngeneeskundiges het die planare + EFERT beelde van elke pasiënt gerapporteer, waarna die planare + EFERT/RT beelde met die hulp van 'n radioloog gerapporteer is. Sekerheid oor die teenwoordigheid van hiperfunksionerende paratiroïedweefsel sowel as die sekerheid oor die lokalisering daarvan, is op 'n Likert-tipe skaal verkry. Interpretasie van planare + EFERT is vergelyk met die interpretasie van planare + EFERT/RT. Die impak van LDRT op twyfelagtige letsels en die aantal ektopiese letsels waargeneem, is ook bepaal. Resultate: Twintig pasiënte (M:13; F:7) met beelding tussen Februarie 2008 en Junie 2011 is ingesluit [gemiddelde ouderdom: 40 jaar (24-55)] . Die gemiddelde kreatinien was 687 μmol/l (169-1213), gemiddelde gekorrigeerde kalsium 2.55 mmol/l (1.95-3.33) en mediaan PTH 167 pmol/l (2.4->201). Vyf en dertig letsels is op planare en EFERT beelde waargeneem en was onveranderd na assessering van die LDRT-data. Sekerheid oor die teenwoordigheid van paratiroïedpatologie het verander in 5 pasiënte (5 letsels) met die toevoeging van LDRT. LDRT het die gemiddelde sekerheid van paratiroïedpatologie van 3.17 tot 3.29 verander (p = 0.16). Toevoeging van LDRT het die aantal twyfelagtige letsels van 18 (14 pasiënte) tot 14 (10 pasiënte) verminder (p = 0.13). Die byvoeging van LDRT het die lokalisering in 4 letsels (3 pasiënte) verander. Sekerheid oor die lokalisering van patologie is in 9 letsels (7 pasiënte) verander en die gemiddelde lokalisering betroubaarheidswaarde is verbeter van 4.2 tot 4.46 (p = 0.002) met LDRT. Met die byvoeging van LDRT het die aantal letsels geklassifiseer as ektopies van 5 tot 8 (p = 0.25) toegeneem. Gevolgtrekking: In renale hiperparatiroïedisme het EFERT/RT die lokalisering van letsels wat op planare + EFERT beelding alleen waargeneem is, verander en die leser se vertroue om akkuraat te lokaliseer verbeter. EFERT/LDRT het geen bykomende voordeel bo EFERT in terme van die opsporing, sekerheid van paratiroïedpatologie of onderskeidingsvermoë tussen twyfelagtige teenoor nie-twyfelagtige paratiroïedletsels verleen nie. Met die byvoeging van LDRT is nie beduidend meer ektopiese letsels gevind nie. Terwyl die geringe verbetering in die sekerheid van lokalisering (met die byvoeging van LDRT) van twyfelagtige kliniese betekenis was, spekuleer ons dat die verandering en vermoedelik verbeterde lokalisering van letsels op EFERT/LDRT ʼn potensiële kliniese impak het in 'n beduidende aantal pasiënte. Die gebruik van EFERT/LDRT in die beelding van renale hiperparatiroïedisme wanneer chirurgie oorweeg word, word dus vir bogenoemde rede aanbeveel.

Bakgrund: Uteblivna patientbesök är ett problem som påverkar sjukhusen ekonomi men även patienternas hälsa. No shows är ett uttryck som används för de patienter som utan att meddela ej kommer till bokade besök och denna patientgrupp riskerar i högre grad att insjukna akut samt förvärra sitt sjukdomstillstånd genom att utebli. No shows ger även en stor ekonomisk belastning på sjukvården. Patienter som avbokar eller väljer att ej närvara vid besök, där bland screeningpatienter, löper en högre risk att insjukna akut än de som deltar vid screening. Syfte: Syftet med denna studie var att undersöka faktorer till att patienter uteblir från besök vid röntgenavdelningen. Metod: Denna studie genomfördes som en allmän litteraturöversikt. Artikelsökningen gjordes i databaserna PubMed samt Cinhal och resulterade i 15 artiklar som svarade mot syftet. Resultat: Orsaker till uteblivna besök sammanställdes i sex huvudgrenar; rädsla, praktiska faktorer, ålder, administration, familj och socioekonomisk status. Slutsats: Liknande resultat återfinns i studier vid andra avdelningar och resultatet kunde således generaliseras. Mer forskning behövs om varför dessa huvudgrenar påverkar att patienterna ej kommer på sina besök. Det är av vikt för röntgensjuksköterskan att veta om orsaker till uteblivna besök för att kunna jobba mot en förändring som kan förbättra både sjukhusens ekonomi men även patienthälsan. / Background: Missed appointments is a problem that effects the hospital economics and the patients’ health, No- show patients is a term for patients thats without informing don't come to their booked appointment.This patient’s group has a higher risk of falling ill urgently or aggravate the already existing disease. A patient cost too the health care system is bigger when they miss booked appointments. Patient’s who decline or select not to participate in screening also increases their risk of falling ill. the Screening patients that’s participate decreases risk of sickness or finding it early. Purpose: The purpose of this study was to examine factors to no show patient’s in radiology. Method: A literature review was conducted. Articles searches using databases PubMed and Cinhal resulted in 15 articles that’s matched the purpose of the study. Result: Six different factors/reasons was found, fear, practical factors, aged, administrations, family and social status. Conclusions: Similar results was found in study’s in other departments of the hospital and there for a generalization was possible. More research needs to be done in to how the seven main branches actually effects missed appointments and no show patient’s. It is of importance to the radiology nurse to know the reasons so they can work towards a positive change in both hospital economics and patient’s health.

COVID-19 is a highly contagious and virulent disease caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). COVID-19 disease induces lung changes observed in lung computerized tomography (CT) and the percentage of those diseased areas on the CT correlates with the severity of the disease. Therefore, segmentation of CT images to delineate the diseased or lesioned areas is a logical first step to quantify disease severity, which will help physicians predict disease prognosis and guide early treatments to deliver more positive patient outcomes. It is crucial to develop an automated analysis of CT images to save their time and efforts. This dissertation proposes CoviNet, a deep three-dimensional convolutional neural network (3D-CNN) to diagnose COVID-19 in CT images. It also proposes CoviNet Enhanced, a hybrid approach with 3D-CNN and support vector machines. It also proposes CoviSegNet and CoviSegNet Enhanced, which are enhanced U-Net models to segment ground-glass opacities and consolidations observed in computerized tomography (CT) images of COVID-19 patients. We trained and tested the proposed approaches using several public datasets of CT images. The experimental results show the proposed methods are highly effective for COVID-19 detection and segmentation and exhibit better accuracy, precision, sensitivity, specificity, F-1 score, Matthew's correlation coefficient (MCC), dice score, and Jaccard index in comparison with recently published studies.

No description available.

A new method of registering multiple range datasets collected in a GPS-denied, tunnel-like environment is presented. The method is designed to function with minimal user inputs and be effective over a wide range of changes in observation angle. The method is initially developed to operate on data in a general 2.5D coordinate system. Then, the general registration method is specifically tailored to a 2.5D spherical coordinate system. To apply the method, the range data is first filtered with a series of discrete Gaussian-based filters to construct a second-order Taylor series approximation to the surface about each sampled point. Finally, principal curvatures are calculated and compared across neighboring datasets to determine homologies and the best fit transfer matrix. The new method relaxes the minimum change in perspective requirement between neighboring datasets typical of other algorithms. Results from the application of the method on both synthetic and real-world data are shown. The real-world data comes from a series of high explosive tests performed in a tunnel environment. The tunnels were oriented horizontally in rock and constructed with boring equipment. The tunnel surfaces were surveyed with a Faro Focus3D terrestrial panorama scanning light detection and ranging (lidar) system both before and after a high explosive device was detonated inside the tunnel with the intent of documenting damage to the tunnel surface.

This work focuses on two complementary aspects of magnetic source imaging using Magnetoencephalography: 1. Imaging of neural current sources from MEG surface recordings. 2. Dynamic characterization of neural current patterns at the surface of the cortex. MEG Source Imaging Accurate estimation of the local spatial extent of neural current activity is very important for the quantitative analysis of neural current sources, as estimated from Magnetoencephalography (MEG) surface recordings. In association with the excellent time resolution offered by MEG, this would represent a major advancement in non invasive, time-resolved functional brain imaging. We address this issue through a new method called Multipole Cortical Remapping (MCR) to accurately specify the spatial extent of neural current sources. In MCR, the zero-order Tikhonov regularized image of the current distribution on the cortex is rst estimated from MEG surface data for which we sought for a realistic model of neural generators. Then the resulting functional image is thresholded using a simple histogram-based principle. This thresholded image is then decomposed into groups of activation patterns following an automatic labeling algorithm based on the geometrical properties of the cortical surface. The equivalent multipolar decomposition of each current patch is then obtained. By default, the multipolar moments are not readily related to the actual anatomical support of the actual neural currents detected using MEG. Hence we introduce an image remapping techniques of the multipolar parameters back onto the original cortical manifold in a Bayesian framework that includes physiological and anatomical priors. MEG Source Dynamic Characterization For dynamic characterization of neural current patterns at the surface of the cortex, we used modied Helmholtz Hodge Decomposition (HHD) which is applied on motion eld of neural current sources. This motion eld is also known as optical ow. Optical ow is the apparent motion due to variations in the pattern of brightness and, under specic conditions, may mimic the velocity eld of an object. Normally, the optical ow is obtained in a two-dimensional domain, which may prevent access to some essential features of the object's motion with respect to the topology or geometry of the domain onto which it is evolving. A new variational method to represent optical ow on non at surfaces using Riemannian formulation was recently introduced by our group to overcome this issue. We broaden this framework and introduce a new formalism to detect features in the resulting optical ow model using a modied and extend framework to the HHD on 2-Riemannian manifolds, which we use to characterize neural current sources. HHD is a technique used to decompose a two-dimensional (resp. threedimensional) continuous vector eld into the sum of 3 distinct components: 1. a non-rotational element, deriving from the gradient of a scalar potential U; 2. a non-diverging component, deriving from the rotational of a scalar potential A (resp. vectorial potential); 3. a harmonic vectorial part, i.e., whose Laplacian vanishes The HHD approach enables the decomposition and tracking of time-resolved neural current ows as obtained from MEG source imaging as sources and sinks, e.g., by detecting relative maxima of the non-rotational scalar potential. It also extends the analysis of brain activity in terms of tracking travelling objects onto the cortical manifold by detecting vectors of largest amplitudes in zero Laplacian harmonic vector elds. We also apply HHD in structural and functional brain imaging applications. The results are very encouraging. We believe that HHD has an enormous potential and it can decipher many riddles in neuroscience. The methods discussed in HHD portion of the thesis are implemented in Matlab as plug-in to the Brainstorm (MEG/EEG data processing software) and can be downloaded from: http://neuroimage.usc.edu/brainstorm

<p>The diagnosis and treatment of pulmonary diseases still rely on pulmonary function tests that offer archaic or insensitive biomarkers of lung structure and function. As a consequence, chronic obstructive pulmonary disease is the third leading cause of death in the US, and the hospitalization costs for asthma are on the order of $29 Billion. Pulmonary diseases have created a large and unsustainable economic burden, and hence there is still a dire need for biomarkers that can predict early changes in lung function. The work presented in this thesis looks to address this very issue, by taking advantage of the unique properties of hyperpolarized (HP) <super>129</super>Xe in conjunction with magnetic resonance imaging (MRI), to probe the fundamental function of the lung - gas-exchange. </p><p>While a bulk of the inhaled HP <super>129</super>Xe stays in the alveolar spaces, its moderate solubility in the pulmonary tissues causes a small fraction of this xenon in the alveolar spaces to diffuse into the pulmonary barrier tissue and plasma, and further into the red blood cells (RBC). Additionally, when in either of these compartments, xenon experiences a unique shift in its resonance frequency from the gas-phase (barrier - 198 ppm, RBC - 217 ppm). These unique resonances are collectively called the dissolved-phase of xenon. As the pathway taken by xenon to reach the RBCs is identical to that of oxygen, this dissolved-phase offers a non-invasive probe to study the oxygen transfer pathway, and imaging its distribution, to first order, would give us an image of gas-exchange in the lung.</p><p>Gas-exchange is controlled by ventilation, perfusion, and lastly diffusion of gases across the capillary membrane. This process of diffusion is dictated by Fick's first law of diffusion, and hence the volume of gas taken up by the capillary blood stream depends on the alveolar surface area, and the interstitial thickness. Interestingly, changes in these factors can be measured using the resonances of xenon. Changes in the alveolar surface area brought on by diseases like emphysema will increase the diffusion of xenon within the alveolus. Thus, by using diffusion-weighted imaging of the gas-phase of <super>129</super>Xe, which is the focus of chapter 3, one can extract the `apparent diffusion coefficient' (ADC) of xenon, that is sensitive to the changes in the alveolar surface area. The dissolved-phase on the other hand, while sensitive to the surface area, is also sensitive to subtle changes in the interstitial thickness. In fact, after the application of an RF pulse on the dissolved-phase, the recovery time for the xenon signal in the RBCs is significantly delayed by micron scale thickening of the interstitium. This delayed signal recovery can be used as a sensitive marker for diffusion impairment in the lung. </p><p>While direct imaging of the dissolved-phase was shown to be feasible, truly quantifying gas-exchange in the lung will require two additional technical advances - 1) As the gas-phase is the source magnetization for the dissolved-phase signal, it is imperative to acquire both the gas and dissolved-phase images in a single breath. The technical details of this achievement are discussed in chapters 4 and 5. 2) As the dissolved-phase consists of both the barrier and the RBC components, obtaining a fundamental image of gas-exchange in the lung will require creating independent images of <super>129</super>Xe in the barrier and <super>129</super>Xe in the RBCs. This goal first required creating a global metric of gas-transfer in the lung (chapter 6), which aided the implementation of the 1-point Dixon acquisition strategy to separate the components of the dissolved-phase. In conjunction with aim 1, it was finally possible to image all three resonances of <super>129</super>Xe in a single breath (chapter 7). These <super>129</super>Xe-RBC images were acquired in healthy volunteers and their efficacy was tested in subjects with idiopathic pulmonary fibrosis (IPF). These IPF subjects are known for their characteristic diffusion limitation, and in regions of fibrosis shown on their CT scans, the <super>129</super>Xe-RBC images showed gas-transfer defects. </p><p>Hyperpolarized <super>129</super>Xe MRI thus provides a non-invasive, ionizing radiation free method to probe ventilation, microstructural changes and most importantly, gas-exchange. These preliminary results indicate that xenon MRI has potential as a sensitive tool in therapeutic clinical trials to evaluate longitudinal changes in lung function.</p> / Dissertation