The neotectonic evolution of the eastern Mediterranean is intimately tied to interactions between the underthrusting/subducting slab along the southern margin of Anatolia and the overriding plate. The lateral variations in the subduction zone can be viewed as a temporal analogue of the transition between continuous subduction and subduction termination by continent-continent collision. By investigating the lateral variations along this subduction zone in the overriding plate, we can gain insight into the processes that precede continent collision. This dissertation summarizes the results of three studies that focus on different parts of the subduction margin: 1) In the west, where the development of a slab tear represents the transition between continuous and enigmatic subduction, 2) In the east, where continent-continent collision between the Arabian and Eurasian Plate is leading to the development of the third largest orogenic plateau on earth after complete slab detachment, and 3) In central Anatolia, where the subducting slab is thought to be in the processes of breaking up, which is affecting the flow of mantle material leading to volcanism and uplift along the margin. In the first study, we interpret that variations in the composition of material in the downgoing plate (i.e. a change from the subduction of oceanic material to continental material) may have led to the development of a slab tear in the eastern Aegean. This underthrusting, buoyant continental fragment is controlling overriding plate deformation, separating the highly extensional strains of western Anatolia from the much lower extensional strains of central Anatolia. Based on intermediate depth seismicity, it appears that the oceanic portion of the slab is still attached to this underthrusting continental fragment. In the second study, we interpret that the introduction of continental lithosphere into the north-dipping subduction zone at the Arabian-Eurasian margin led to the rollback and eventual detachment of the downgoing oceanic lithosphere attached to the Arabian Plate. After detachment, high rates of exhumation in the overriding plate are recorded due to the removal of the oceanic lithosphere and accompanying rebound of the Arabian continental lithosphere. In the third study, we image a transitional stage between the complete slab breakoff of the second study and the continuous subduction slab of the first study. We interpret that trench-perpendicular volcanism and ~2 km of uplift of flat-lying carbonate rocks along the southern margin of Turkey can be attributed to the rollback and ongoing segmentation of the downgoing slab as attenuated continental material is introduced into the subduction zone. Combining these three studies allows us to understand the terminal processes of a long-lived subduction zone as continental material is introduced.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

AIM: Extraction of a tooth can lead to alveolar ridge resorption which can be minimized by socket preservation. The aim of this study is to analyze vertical and horizontal alveolar ridge dimensions clinically and by CBCT immediately following extraction and 3-4 months following socket preservation. METHODS: The preserved group (P) consisted of 20 patients with1-2 non-molar teeth requiring extraction with socket preservation, while the control group (C) consisted of 5 patients requiring extraction alone. An acrylic stent was fabricated presurgically in order to measure vertical and horizontal ridge dimensions clinically and radiographically immediately following extraction and 3-4 months following socket preservation. RESULTS: Overall, P sites gained ridge height and lost minimal ridge width over 3-4 months, while C sites lost both ridge height and width. Preserved sites in which the teeth were extracted due to caries had the most significant gain in the radiographic vertical occlusal dimension (RVO). Overall, high correlations were found between the clinical and radiographic measurements at the initial surgery and at the 3-4 month follow up. CONCLUSIONS: The preserved group had minimal ridge resorption and more socket bony fill when compared to the non-preserved group 3-4 months following tooth extraction, especially when the tooth was extracted due to caries. Additionally, the CBCT can be a useful diagnostic tool to evaluate socket preservation healing, as it compares well to clinical assessments of socket healing.

Accurate and automatic segmentation techniques that do not require any explicit prior model have been of high interest in the medical community. We propose a fully-automatic method for segmenting the femur from 3D Computed Tomography scans, based on the graph-cut segmentation framework and the bone boundary enhancement filter analyzing second-order local structures. The presented algorithm is evaluated in large-scale experiments, conducted on 197 CT volumes, and compared to other three automatic bone segmentation methods. Out of the four tested approaches, the proposed algorithm achieved most accurate results and segmented the femur correctly in 81% of the cases.

Ferritic chromium steels are important structural materials for future nuclear fission and fusion reactors due to their advantages over traditional austenitic steels, including low swelling rates, better thermal fatigue resistance, and lower thermal expansion coefficients. Radiation-induced segregation or depletion (RIS/RID) of solute atoms at grain boundaries is considered to be a potentially significant phenomenon for structural materials because of its potentially detrimental role in affecting microstructure and furthermore mechanical properties. However, the behaviour of Cr at grain boundaries in ferritic steels is not well understood. Both segregation and depletion of Cr at grain boundary under irradiation have been previously observed and no clear dependency on irradiation condition or alloy type has been presented. Furthermore, ferritic alloys are known to undergo hardening and embrittlement after thermal aging in the temperature range of 300-550DC and this phenomenon is related with a and a' phase separation occurring in the solid solution. However the low temperature a-a' miscibility gap in the currently used phase diagram is extrapolated from high temperature results and conflicts with many experimental observations. To understand the Cr behaviour at gram boundaries in ferritic steels under irradiation, a systematic approach combining SEM/EBSD, FIB specimen preparation and APT analysis has been developed and successfully applied to a Fe- 15.2at%Cr to investigate the effect of pre-irradiation chemistry, grain boundary misorientation, impurities, irradiation damage, irradiation depth, and other possible factors to get a better understanding of RIS/RID phenomena. Both low sigma boundaries and randomly selected high angle boundaries have been investigated in detail. Systematic differences between the behaviour of different classes of boundaries had been observed, and the operating mechanisms are also discussed in this thesis. The maximum separation method has been applied on APT data to study the C- enriched clusters and Cr-enriched clusters, which were not directly visible on the atom maps. The composition of the Cr-enriched clusters was consistent with a' phase and the irradiation was found to accelerate the nucleation rather than the growth of these clusters. Such results provided important information in re- determining the a-a' phase boundary.

Ovarian cancer is the deadliest gynecologic cancer for women. Diagnosis at the local stage leads to 91% 5-year survival rates, but only 15% of cases are detected early. Existing screening methods have proven ineffective in large clinical trials. Screening is complicated by the heterogeneity of the disease with multiple types of ovarian cancer originating both on the ovary and in the fallopian tube. Early stage cancer is too subtle for non-invasive imaging techniques such as ultrasound or magnetic resonance imaging. This study evaluates the feasibility and design of dual modality, multispectral fluorescence imaging (MFI) and optical coherence tomography (OCT) endoscopes for improved ovarian cancer screening. The study is broken up into three sections. In the first study MFI is validated in an ex vivo imaging study of human ovarian and fallopian tube tissue samples. Tissue autofluorescence excited by ultraviolet and blue wavelengths is shown to be a promising discriminator between normal and cancerous tissue. The second study combines OCT and MFI into a sub millimeter diameter endoscope designed to screen for ovarian cancer by screening inside the fallopian tube and at the ovary. The small size is required for screening the full length of the fallopian tube. MFI is implemented as a wide-field navigational imaging technique with high sensitivity complemented by high resolution structural depth imaging of OCT over a limited field of view. The final study presents a novel lens design for a scanning fiber endoscope with forward-viewing navigation and side-viewing OCT. A piezo tube is used to scan an optical fiber providing both the navigation channel’s illumination and OCT imaging. The design spatially separates the forward-viewing illumination from the OCT. As the piezo fiber circularly scans at its maximum deviation the OCT beam focus is rotationally scanned out the side of the endoscope tip by a rotationally symmetric double reflection in the cover plate.

<p>X-ray computed tomography (CT) is a non-invasive medical imaging technique that generates cross-sectional images by acquiring attenuation-based projection measurements at multiple angles. Since its first introduction in the 1970s, substantial technical improvements have led to the expanding use of CT in clinical examinations. CT has become an indispensable imaging modality for the diagnosis of a wide array of diseases in both pediatric and adult populations [1, 2]. Currently, approximately 272 million CT examinations are performed annually worldwide, with nearly 85 million of these in the United States alone [3]. Although this trend has decelerated in recent years, CT usage is still expected to increase mainly due to advanced technologies such as multi-energy [4], photon counting [5], and cone-beam CT [6].</p><p>Despite the significant clinical benefits, concerns have been raised regarding the population-based radiation dose associated with CT examinations [7]. From 1980 to 2006, the effective dose from medical diagnostic procedures rose six-fold, with CT contributing to almost half of the total dose from medical exposure [8]. For each patient, the risk associated with a single CT examination is likely to be minimal. However, the relatively large population-based radiation level has led to enormous efforts among the community to manage and optimize the CT dose.</p><p>As promoted by the international campaigns Image Gently and Image Wisely, exposure to CT radiation should be appropriate and safe [9, 10]. It is thus a responsibility to optimize the amount of radiation dose for CT examinations. The key for dose optimization is to determine the minimum amount of radiation dose that achieves the targeted image quality [11]. Based on such principle, dose optimization would significantly benefit from effective metrics to characterize radiation dose and image quality for a CT exam. Moreover, if accurate predictions of the radiation dose and image quality were possible before the initiation of the exam, it would be feasible to personalize it by adjusting the scanning parameters to achieve a desired level of image quality. The purpose of this thesis is to design and validate models to quantify patient-specific radiation dose prospectively and task-based image quality. The dual aim of the study is to implement the theoretical models into clinical practice by developing an organ-based dose monitoring system and an image-based noise addition software for protocol optimization. </p><p>More specifically, Chapter 3 aims to develop an organ dose-prediction method for CT examinations of the body under constant tube current condition. The study effectively modeled the anatomical diversity and complexity using a large number of patient models with representative age, size, and gender distribution. The dependence of organ dose coefficients on patient size and scanner models was further evaluated. Distinct from prior work, these studies use the largest number of patient models to date with representative age, weight percentile, and body mass index (BMI) range.</p><p>With effective quantification of organ dose under constant tube current condition, Chapter 4 aims to extend the organ dose prediction system to tube current modulated (TCM) CT examinations. The prediction, applied to chest and abdominopelvic exams, was achieved by combining a convolution-based estimation technique that quantifies the radiation field, a TCM scheme that emulates modulation profiles from major CT vendors, and a library of computational phantoms with representative sizes, ages, and genders. The prospective quantification model is validated by comparing the predicted organ dose with the dose estimated based on Monte Carlo simulations with TCM function explicitly modeled. </p><p>Chapter 5 aims to implement the organ dose-estimation framework in clinical practice to develop an organ dose-monitoring program based on a commercial software (Dose Watch, GE Healthcare, Waukesha, WI). In the first phase of the study we focused on body CT examinations, and so the patient’s major body landmark information was extracted from the patient scout image in order to match clinical patients against a computational phantom in the library. The organ dose coefficients were estimated based on CT protocol and patient size as reported in Chapter 3. The exam CTDIvol, DLP, and TCM profiles were extracted and used to quantify the radiation field using the convolution technique proposed in Chapter 4. </p><p>With effective methods to predict and monitor organ dose, Chapters 6 aims to develop and validate improved measurement techniques for image quality assessment. Chapter 6 outlines the method that was developed to assess and predict quantum noise in clinical body CT images. Compared with previous phantom-based studies, this study accurately assessed the quantum noise in clinical images and further validated the correspondence between phantom-based measurements and the expected clinical image quality as a function of patient size and scanner attributes. </p><p>Chapter 7 aims to develop a practical strategy to generate hybrid CT images and assess the impact of dose reduction on diagnostic confidence for the diagnosis of acute pancreatitis. The general strategy is (1) to simulate synthetic CT images at multiple reduced-dose levels from clinical datasets using an image-based noise addition technique; (2) to develop quantitative and observer-based methods to validate the realism of simulated low-dose images; (3) to perform multi-reader observer studies on the low-dose image series to assess the impact of dose reduction on the diagnostic confidence for multiple diagnostic tasks; and (4) to determine the dose operating point for clinical CT examinations based on the minimum diagnostic performance to achieve protocol optimization. </p><p>Chapter 8 concludes the thesis with a summary of accomplished work and a discussion about future research.</p> / Dissertation

A short report submitted to the Faculty of Medicine, University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Medicine in Nuclear Medicine / 19 patients were selected, from the patients screened, for investigation within 48 hours of the onset of an ischaemic cerebrovascular accident. Clinical neurulogical scoring, computerized tomography lCT) scans and single photon emission computed tomography (SPECT) scans were performed on day 1, day 10 and day 30. SPECT scan data was analysed by 5 semi-quantitative methods, and findings were compared with neuroloyical clinical scores on each respective day. It was found that day 1 SPECT scans are of value for early localization of the acute ischaemic infarction. A multiple regression model was developed using both the day 30 Defect Volume index and segmental analysis score which related to the day 30 clinical scores. The day 1 model was unsatisfactory and no such model was found relating day 10 SPECT semi-quantitative methods to day 10 clinical scoring. Changes in semi-quantitative scores from day 1 to day 30 did not correlate with clinical changes. Longer follow up may be required for there to be value in performing SPECT scans in stroke trials. A prognostic equation was derived by multiple regression analysis of day 1 SPECT scan scores and day 30 clinical scores. / Andrew Chakane 2019

M.Med. (Radiology), Faculty of Health Sciences, University of the Witwatersrand, 2011 / Lymphobronchial tuberculosis (LBTB) is tuberculous lymphadenopathy involving the airways, which is particularly common in children. AIM: To describe the CT findings of LBTB in children, the parenchymal complications and associated abnormalities. METHOD: CT scans of 98 children with LBTB were retrospectively reviewed. Lymphadenopathy, bronchial narrowing, parenchymal complications and associations were documented. RESULTS: Infants comprised 51% of patients. The commonest lymphadenopathy was subcarinal (97% of patients). Bronchial compressions (259 in total) were present in all patients, of which 23% were severe / complete stenoses and 28% affected bronchus intermedius. Parenchymal complications were present in 94% of patients, including consolidation (88%), breakdown (42%), air trapping (38%), expansile pneumonia (28%), collapse (17%) and bronchiectasis (9%), all predominantly right-sided (63%). Associations included oval focal bodies, miliary nodules, pleural disease and intracavitory bodies. CONCLUSIONS: The most important CT finding of children with LBTB is visible airway compression as a result of lymphadenopathy. CT of children with LBTB showed that airway compressions were more severe in infants and most commonly involved bronchus intermedius. Numerous parenchymal complications were documented, all showing rightsided predominance. Several associations were identified.

Fluorine-18 Fluorodeoxyglucose positron emission tomography-computed tomography (F-18 FDG PET-CT) is now established in the staging, restaging and therapy response monitoring of Hodgkin’s lymphoma (HL) and high grade Non-Hodgkin’s lymphoma (HG NHL), specifically for nodal disease and extra-nodal disease excluding the bone marrow. The role of FDG PET-CT for evaluating bone marrow involvement in HL and HG NHL has not been established yet. There are however several publications on this subject but no consensus has been reached. Bone marrow trephine biopsy (BMB) is the gold standard for bone marrow assessment in lymphoma. Although the occurrence of adverse effects is uncommon, BMB is an invasive procedure that may induce anxiety in patients. A retrospective review of FDG PET-CT bone marrow findings of HL patients referred for a staging scan from June 2008 to January 2014 was done, these findings were compared to the BMB findings also done as part of initial staging. The findings of 55 patients were reviewed analysed.