Modern image-guided surgery aids minimally-invasive, high-precision procedures that increase efficacy of treatment. This thesis investigates two research aims to improve precision and integration of intraoperative cone-beam CT (CBCT) imaging in guidance of head and neck (H&N) surgery. First, marker configurations were examined to identify arrangements that minimize target registration error (TRE). Best arrangements minimized the distance between the configuration centroid and surgical target while maximizing marker separation. Configurations of few markers could minimized TRE with more markers providing improved uniformity. Second, an algorithm for automatic registration of image and world reference frames was pursued to streamline integration of CBCT with real-time tracking and provide automatic updates per scan. Markers visible to the tracking and imaging systems are automatically co-localized and registered with equivalent accuracy and superior reproducibility compared to conventional registration. Such work helps the implementation of CBCT in H&N surgery to maximize surgical precision and exploit intraoperative image guidance.

Cobalt 60 (Co-60) radiation therapy is a simple and reliable method of treating cancer by irradiating treatment volumes within the patient with high energy gamma rays. Medical linear accelerators (linacs) began to replace Co-60 units during the 1960’s in more developed countries, but Co 60 has remained the main source of radiotherapy treatment in less developed countries around the world. As a result, technological advancements made in more developed countries to deliver more precise radiation treatment that improves patient outcome have not been clinically applied to Co-60 machines. The medical physics group at the Cancer Centre of Southeastern Ontario has shown that these same technological advancements can be applied to Co-60 machines which would increase the accessibility of these modern improvements in radiotherapy treatment. However, for these modern treatments to improve patient outcome they require more precise localization of the patient prior to therapy. In more developed countries, this is currently provided by comparing computed tomography (CT) used for treatment planning with images acquired on the linac immediately before treatment. In the past decade, cone-beam CT (CBCT) has been developed to provide 3D CT images of the patient immediately prior to treatment on a linac. This imaging modality would also be ideal for patient localization when conducting modern Co-60 treatments since it would only require the addition of an imaging panel to produce CBCT images using the Co-60 source. A prototype Co-60 CBCT imaging system was implemented and characterized. Image noise, contrast, spatial resolution, and artifacts were studied. Algorithms to reduce the image artifacts were implemented and found to improve perceived image quality. The imaging system was found to have a ~1.8 mm high-contrast spatial resolution and the ability to detect 3 cm low-contrast soft-tissue structures in water. Anthropomorphic phantoms were also imaged and the observed anatomy in Co-60 CBCT images was comparable to kilovoltage CT. These results are comparable to clinically relevant linac-based CBCT using high energy X rays of similar energies to Co-60 gamma rays. This suggests that Co-60 CBCT should be able to provide the necessary images to localize patients for modern Co-60 radiation treatments. / Thesis (Master, Physics, Engineering Physics and Astronomy) -- Queen's University, 2010-11-30 13:40:07.61

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This study assessed the accuracy and reliability of tooth length measurements through axial, coronal and sagittal serial slices of CBCT volumes; conventional panoramic radiographs; and CBCT panoramic reconstructions to that of a digital caliper gold standard. Samples consisted of maxillary premolars collected from patients requiring extractions for routine orthodontic treatment. Extracted teeth were measured directly with digital calipers and images were digitally measured in Dolphin 3D software. Analysis of CBCT serial slices resulted in highly accurate and reliable tooth length measurements for all slice orientations compared to the gold standard. Conventional panoramic radiographs were relatively inaccurate, overestimating tooth lengths by 29%, while CBCT panoramic reconstructions underestimated lengths by 4%. CBCT serial slice volume analysis provides clinicians with greater measurement confidence, while panoramic radiographs, produced either by conventional means or reconstructed from 3-D volumes should be considered less accurate and reliable for the detection of mild root resorption. / Medical Sciences - Orthodontics

The purpose of this research was to compare skeletal and dental changes assessed by digital volumetric images produced during and after rapid maxillary expansion (RME) between a bone-borne anchored expansion appliance and a conventional tooth-borne RME. Initial steps included the development of a methodology to analyze CBCT images. Reliability of traditional two dimensional (2D) cephalometric landmarks identified in CBCT images was explored, and new landmarks identifiable on the CBCT images were also evaluated. This methodology was later tested through a clinical trial with 62 patients where skeletal and dental changes found after maxillary expansion using either a bone-borne or tooth-borne maxillary expander and compared to a non-treated control group. The conclusions that were obtained from this thesis were that the NewTom 9” and 12” three dimensional (3D) images present a 1-to-1 ratio with real coordinates, linear and angular distances obtained by a coordinate measurement machine (CMM). Landmark intra- and inter-reliability (ICC) was high for all CBCT landmarks and for most of the 2D lateral cephalometric landmarks. Foramen Spinosum, foramen Ovale, foramen Rotundum and the Hypoglossal canal all provided excellent intra-observer reliability and accuracy. Midpoint between both foramen Spinosums (ELSA) presented a high intra-reliability and is an adequate landmark to be used as a reference point in 3D cephalometric analysis. ELSA, both AEM and DFM points presented a high intra-reliability when located on 3D images. Minor variations in location of these landmarks produced unacceptable uncertainty in coordinate system alignment. The potential error associated with location of distant landmarks is unacceptable for analysis of growth and treatment changes. Thus, an alternative is the use of vectors. Selection of landmarks for use in 3D image analysis should follow certain characteristics and modifications in their definitions should be applied. When measuring 3D maxillary complex structural changes during maxillary expansion treatments using CBCT, both tooth-anchored and bone-anchored expanders presented similar results. The greatest changes occurred in the transverse dimension while changes in the vertical and antero-posterior dimension were negligible. Dental expansion was also greater than skeletal expansion. Bone-anchored maxillary expanders can be considered as an alternative choice for tooth-anchored maxillary expanders. / Medical Sciences in Orthodontics

The degree of mineral liberation is important for the efficiency of subsequent physical separation processes such as froth flotation. Mineral liberation studies involve determining the volumetric abundance or volumetric grade distribution of a specific mineralogical phase in a particular mineral. Currently, methodologies for assessing mineral liberation are laborious regarding sample preparation, analysis time (from weeks to months), and the need for stereological correction. These constraints can be eliminated by using X-ray CT which gives the cross-sections directly from three-dimensional data in shorter time (from ten minutes to hours) with minimal sample preparation. X-ray computed tomography (CT) is a non-destructive technique which allows three-dimensional visualisation of inner structures of an object based on the variations in density and atomic composition. Initially, it was developed as a medical tool for imaging soft tissue and bone. During the last decade, the number of X-ray CT applications in engineering and geology has steadily increased, with the improvements in performance and imaging capabilities. The aim of the present work is to apply X-ray CT technique for finely divided ore samples and to study the relationship between mineral liberation and CT results. Four different ore types were used in this study: Northparkes ore (Australia), Ernest Henry ore (Australia), Keetac ore (USA) and Cannington ore (Australia). Different settings of the desktop X-ray CT technique were applied for each particular ore sample for several ore liberation (particle size distribution) properties. Two dimensional CT images were reconstructed from the three-dimensional X-ray CT data. It was found that the settings for CT technique were a function of the ore type. Particularly in the case of Cannington (high density ore) the best setting conditions split from the rest of the ores tested. The appearance of different artifacts occurring during the analysis were studied and kept to the minimum. A functionality between mineral liberation and CT results was found. The variables affecting the most the results were the Voltage and Minimum Intensity Percentage. Contrary to the expected trends, variables having a negligible effect on the results were found to be exposure time / equivalent Al filter thickness.

The degree of mineral liberation is important for the efficiency of subsequent physical separation processes such as froth flotation. Mineral liberation studies involve determining the volumetric abundance or volumetric grade distribution of a specific mineralogical phase in a particular mineral. Currently, methodologies for assessing mineral liberation are laborious regarding sample preparation, analysis time (from weeks to months), and the need for stereological correction. These constraints can be eliminated by using X-ray CT which gives the cross-sections directly from three-dimensional data in shorter time (from ten minutes to hours) with minimal sample preparation. X-ray computed tomography (CT) is a non-destructive technique which allows three-dimensional visualisation of inner structures of an object based on the variations in density and atomic composition. Initially, it was developed as a medical tool for imaging soft tissue and bone. During the last decade, the number of X-ray CT applications in engineering and geology has steadily increased, with the improvements in performance and imaging capabilities. The aim of the present work is to apply X-ray CT technique for finely divided ore samples and to study the relationship between mineral liberation and CT results. Four different ore types were used in this study: Northparkes ore (Australia), Ernest Henry ore (Australia), Keetac ore (USA) and Cannington ore (Australia). Different settings of the desktop X-ray CT technique were applied for each particular ore sample for several ore liberation (particle size distribution) properties. Two dimensional CT images were reconstructed from the three-dimensional X-ray CT data. It was found that the settings for CT technique were a function of the ore type. Particularly in the case of Cannington (high density ore) the best setting conditions split from the rest of the ores tested. The appearance of different artifacts occurring during the analysis were studied and kept to the minimum. A functionality between mineral liberation and CT results was found. The variables affecting the most the results were the Voltage and Minimum Intensity Percentage. Contrary to the expected trends, variables having a negligible effect on the results were found to be exposure time / equivalent Al filter thickness.

The degree of mineral liberation is important for the efficiency of subsequent physical separation processes such as froth flotation. Mineral liberation studies involve determining the volumetric abundance or volumetric grade distribution of a specific mineralogical phase in a particular mineral. Currently, methodologies for assessing mineral liberation are laborious regarding sample preparation, analysis time (from weeks to months), and the need for stereological correction. These constraints can be eliminated by using X-ray CT which gives the cross-sections directly from three-dimensional data in shorter time (from ten minutes to hours) with minimal sample preparation. X-ray computed tomography (CT) is a non-destructive technique which allows three-dimensional visualisation of inner structures of an object based on the variations in density and atomic composition. Initially, it was developed as a medical tool for imaging soft tissue and bone. During the last decade, the number of X-ray CT applications in engineering and geology has steadily increased, with the improvements in performance and imaging capabilities. The aim of the present work is to apply X-ray CT technique for finely divided ore samples and to study the relationship between mineral liberation and CT results. Four different ore types were used in this study: Northparkes ore (Australia), Ernest Henry ore (Australia), Keetac ore (USA) and Cannington ore (Australia). Different settings of the desktop X-ray CT technique were applied for each particular ore sample for several ore liberation (particle size distribution) properties. Two dimensional CT images were reconstructed from the three-dimensional X-ray CT data. It was found that the settings for CT technique were a function of the ore type. Particularly in the case of Cannington (high density ore) the best setting conditions split from the rest of the ores tested. The appearance of different artifacts occurring during the analysis were studied and kept to the minimum. A functionality between mineral liberation and CT results was found. The variables affecting the most the results were the Voltage and Minimum Intensity Percentage. Contrary to the expected trends, variables having a negligible effect on the results were found to be exposure time / equivalent Al filter thickness.