The removal of scattered radiation is recognised as one of the major goals to be achieved in SPECT. In this work three scatter removal techniques were investigated. These were dual window scatter subtraction, deconvolution using a Wiener filter and energy weighted acquisition (EWA) using a weighted acquisition module (WAM). In addition to this, the effects of simple background subtraction on SPECT images was also investigated. The techniques were investigated in both a semi-quantitative manner, in terms of the effects of each technique on the cold lesion contrast and image mottle, and qualitatively, in terms of the ability of observers to perform a detection task. This was done using Relative Operating Characteristic (ROC) experiments. Each technique is investigated individually to discover the parameters needed to optimise performance. The results showed that the optimum parameters for each scatter reduction technique was dependent on the measure of image quality used for optimisation and showed that all of the techniques investigated produced better results than those produced using the standard 20&'37 photopeak acquisition approach, however, in general no significant difference could be found between the techniques. The image noise produced by each technique was also evaluated by calculating the noise power spectra (NPS) produced by each technique. The calculated NPS showed the spatial content of the noise produced by each technique was different for each scatter reduction technique. The results in this work showed that empirically defined measures of image quality are poor predictors of observer performance.

No description available.

Die moderne multimodale Computertomografie (CT) beinhaltet das Schichtröntgen des Gehirns (native CT), die Darstellung der hirnversorgenden Arterien (CT-Angiografie) und die Messung der Hirndurchblutung (CT-Perfusion). Mit Hilfe dieser Untersuchungstechnik kann bei Patienten mit akutem Schlaganfall rasch die Ursache der plötzlich eingesetzten Symptome beleuchtet werden: Liegt eine Gefäßobstruktion oder eine Blutung in das Gehirn vor? Wie ausgedehnt ist die Durchblutungsstörung und wie viel Hirngewebe ist bereits beschädigt bzw. vom Untergang bedroht? Anhand dieser Informationen kann sofort eine spezifische Therapie eingeleitet werden, die es ermöglicht, die Patienten vor dauerhafter schwerer Behinderung zu bewahren bzw. die Prognose schon früh abzuschätzen. / Computed tomography (CT), including CT perfusion imaging and CT angiography, has the capacity to assess stroke pathology on a functional and morphological level and can thus provide important information about patients with acute stroke. It excludes brain haemorrhage, assesses the extent of perfusion deficit, the extent of ischemic damage, and the site and type of arterial obstruction. Ischemic brain tissue below the blood flow level of structural integrity takes up water immediately and causes a decrease in x-ray attenuation. Computed tomography thus has the specific advantage of being able to identify the brain tissue which is irreversibly injured. If CT can exclude major ischemic damage in acute stroke patients, reperfusion strategies may rescue brain function and prevent disability.

No description available.

Cachexia occurs commonly and is a significant cause of morbidity and up to 20% mortality in patients with cancer. Loss of muscle mass occurs as part of the cachexia wasting process and low muscle mass is a key element of the most recent consensus cachexia definition. Measuring muscle mass and changes in skeletal muscle is important to phenotype cachectic individuals and to monitor response to anti-cachectic treatments. This thesis investigates minimally invasive or burdensome methods of measuring muscle mass and muscle protein kinetics for use in a clinical or research setting. Quantification of muscle area on routine diagnostic cross-sectional imaging offers a novel and relatively non-invasive method of assessing both regional (and by extrapolation) whole body muscle mass. The need for such a direct measurement of muscle mass was demonstrated by showing that simple anthropometric formulae are unable to predict muscularity accurately (within 25%) when compared with estimates derived from patients diagnostic CT scans. It may be that qualitative changes in muscle may be more sensitive indices of the wasting process rather than qualitative change. Myosteatosis (infiltration of muscle by fat) is known to occur in both cachexia and age related sarcopenia and can be quantified using the Hounsfield spectrum observed on routine diagnostic CT scans. However, not all patients undergo routine CT scanning and there is a need for a biomarker derived from urine or blood. Consequently, cross sectional imaging was used to phenotype patients in a proteomic analysis of urine with the aim of identifying protein or peptide biomarkers associated with myosteatosis in cancer cachexia. A biomarker model for myosteatosis was developed with good sensitivity (97%) but poor specificity (71%). Many of the potential protein / peptide markers identified had poor associations with known mechanisms of muscle wasting and further study of the identified peptides in an extended cohort would help determine the validity of the present findings. However, two proteins with potential roles in muscle repair or neuromuscular function (Agarin and Cathepsin C) were identified and these may warrant targeted investigation with evaluation against sequential measures of muscle mass to determine their value in defining muscle loss over time. As different regional measures of muscularity are available, trunk (L3 CT) and limb muscle (quadriceps MRI) cross sectional measurements were compared with functional assessments to determine the optimal site for measurement. Neither measure proved superior to the other but appeared to reflect different aspects of function. Quadriceps muscle area correlated with quadriceps strength and power whilst truncal muscle area correlated more with complex movements such as the timed-up-and-go test. Changes in regional muscle area in patients with upper gastrointestinal cancer were assessed by upper and lower limb MRI before and after surgery and by L3 CT cross sectional area before and after neo-adjuvant chemotherapy. No change in limb muscularity was seen at 220 days post operatively compared with pre-op measurements. During neo-adjuvant chemotherapy a significant loss of truncal muscle occurred in the absence of significant weight loss suggesting that sequential cross sectional imaging is capable of detecting changes in body composition that may not be apparent clinically. Whilst sequential scans may document changes in muscularity, they do not describe the underlying levels of muscle synthesis or degradation that may regulate muscle volume. The final section of this thesis describes the development of a novel tracer method to measure skeletal muscle synthesis and its application in a study of patients with cancer and healthy volunteers. This novel method was able to measure skeletal muscle fractional synthetic rate (FSR) over a longer time-period than previous methods (weeks rather than hours) and reduced the burden on the patient by the use of a single oral tracer dose and single muscle biopsy. Comparison of synthesis rates in quadriceps and rectus abdominis showed higher rates in quadriceps, 0.067% per hour vs 0.058% per hour respectively. Despite a net loss of muscle as measured by serial CT scans, skeletal muscle FSR appeared to be marginally increased in weight losing patients with cancer compared with weight stable patients and healthy controls. When FSR was combined with measures of muscle mass it was demonstrated that only small differences between synthesis and degradation are required to see the levels of muscle wasting seen in patients with cancer. In summary, routine cross sectional imaging provides a useful and unique measure of muscularity that is associated with function in patients with cancer Sequential scans can provide additional information about changes in body composition even in the absence of weight loss. There are significant regional variations in both muscle wasting and skeletal muscle fractional synthetic rate. The combination of sequential estimates of muscle mass from diagnostic CT scans along with estimates of FSR allow assessment of the contribution of altered synthesis and degradation to muscle loss. In patients with upper GI cancer it would appear that increased degradation may be more important that altered synthesis. The relative change in either process to account for absolute loss of muscle mass is small. Such findings have implications for the targeted therapy of muscle wasting in cancer patients.

The authors present an unusual case of a highly mobile gallbladder which simulated a pancreatic mass on computed tomograms. Radiographic features of this interesting variant are illustrated.

ECG-gated multidetector computed tomography (MDCT) is an imaging modality widely utilized for the evaluation of cardiac pathology by physicians. However, there has been little research of cardiac MDCT imaging in veterinary patients. Presently, ECG-gating is an upgrade for MDCT, which few veterinary institutions currently possess. The purpose of this study was to compare image quality between a 16 non ECG-gated and 64 ECG-gated MDCT for clinically important cardiac anatomy in dogs. In a crossover trial, six dogs were scanned using 16 non ECG-gated and 64 ECG-gated MDCT. A standardized anesthetic protocol, designed to induce bradycardia (mean HR 45 bpm ± 12.6) was used. Five post-contrast sequential scans through the heart were performed for each patient when utilizing the 16 non ECG-gated MDCT, in attempt to obtain a motion free series of images of the heart. For each scan, assessment of cardiac morphology was performed by evaluating a group of 21 cardiac structures, using a 3-point scale. Each of the images were scored as 0 (motion present, scan non-diagnostic), 1 (motion present, scan diagnostic), and 2 (no motion, therefore diagnostic scan of high quality). Quality scores (QS) from all scans within a dog (30 scans total) were assigned for each cardiac structure. QS from the six ECG-gated MDCT scans were of high diagnostic quality, generating diagnostic images for all of the 21 cardiac structures evaluated for each of the 6 scans. Individual non ECG-gated scans were of variable quality, primarily generating QS of 1 or 2. A complete set of diagnostic images for all 21 structures was not achieved from an individual scan. Minimum number of non ECG-gated scans to identify a single structure was calculated, and ranged from 1-2 scans for all structures. Cumulative number of sequential non ECG-gated scans needed to achieve images of all cardiac structures was calculated and determined to be 5. A 16 non ECG-gated MDCT scanner can produce cardiac images that are similar in quality, to those of 64 ECG-gated MDCT. Cardiac motion negatively impacts image quality in studies acquired without ECG-gating. However, this can be overcome by performing multiple sequential scans through the heart. / Master of Science

X-ray Computed Tomography (CT) is a process that produces three-dimensional x-ray images, allowing for better diagnosis and analysis of complex internal medical conditions. New advances in the optical techniques used in this process promise to produce better results while reducing patient risk. One of these developments calls for precise optical gratings that can be expensive and difficult to manufacture. This paper presents a simple process developed specifically for the production of these gratings using cost effective techniques. The process uses well understood semiconductor fabrication steps including oxidation, deep reactive ion etching and electroplating. While not entirely successful, the process presented within provides a proof of concept for development of the gratings and discusses improvements that could be made to allow for success. / Master of Science

Dissertation

An adaptive pre-clinical x-ray computed tomography system, named "FaCT" was designed, built, and tested at the University of Arizona's Center for Gamma-Ray Imaging (CGRI). The FaCT system possesses the unique ability to change its magnification and dynamically mask the x-ray beam profile. Using these two abilities, the FaCT system can adapt its configuration to the object being imaged, and the task being performed, while achieving a reduction in the radiation dose applied for imaging.Development of the system included the design of all mechanical components, motion systems, and safety systems. It also included system integration of all electronics, motors, and communication channels. Control software was developed for the system and several high-performance reconstruction algorithms were implemented on graphics processing units for reconstructing tomographic data sets acquired by the system. A new geometrical calibration method was developed for calibrating the system that makes use of the full image data gathered by the system and does not rely on markers.An adaptive imaging procedure consisting of a preliminary scout scan, human guidance, and a diagnostic quality scan was developed for imaging small volumes of interest in the interior of an object at substantially reduced dose. The adaptive imaging procedure makes use of FaCT's adjustable magnification, beam-masking capability, and high-performance reconstruction software to achieve high-quality reconstruction of a volume of interest with less dose than would be required by a traditional x-ray computed tomography system without adaptive capabilities.To address ongoing research into mathematical rules for adapting an imaging system, such as FaCT, to better perform a given estimation task, a method of quantifying a system's ability to estimate a parameter of interest in the presence of nuisance parameters based on the Fisher Information was proposed. The method requires a statistical model of object variability. Possible strategies for increasing the performance of an estimation task, given an adaptive system, were suggested.