Today tumour diseases are the second most cause of death in Western countries. But only 45 percent of the patients can be cured by the established treatment methods. The further improvement of the these forms of therapy and the development of new therapeutical approaches is urgent. A substantial proportion of the patients could benefit from particle therapy with heavy ions. Beams of accelerated heavy ions (e.g. carbon, nitrogen or oxygen) with an energy between 70 and 500 AMeV are characterised by physical and biological properties superior to the radiation used in conventional radiotherapy (photons, electrons, neutrons). They form a sharp dose maximum (Bragg peak) shortly before coming to rest and are scarcely scattered while penetrating tissue. Because of the increased relative biological efficiency of these ions in the Bragg peak region they are suitable for precision therapy of deeply seated, compact, radioresistant tumours near to organs at risk. For a safe application of heavy ions close to radiosensitive structures (brain stem, optical nerves, eyes) an in situ monitoring of the therapy is desirable. This can be accomplished by positron emission tomography (PET), since fragmentation reactions between the stable ions of the therapy beam and the atomic nuclei of the tissue generate a dynamic spatial distribution of positron emitters (ß+-emitters) that can be observed by a positron camera. At the Gesellschaft für Schwerionenforschung in Darmstadt a medical treatment site for heavy ion therapy has been established in co-operation with the Radiologische Universitätsklinik Heidelberg, the Deutsches Krebsforschungszentrum Heidelberg and the Forschungszentrum Rossendorf. The fast variation of the beam energy in conjunction with the vertical and horizontal beam deflection by dipole magnets (raster scanning) allows the three-dimensional, strictly tumour shape conformed irradiations. The dual head positron camera BASTEI has been installed at the treatment place in order to measure the decay of the ß+-emitters during the irradiation and a few minutes after. Two ways to verify the treatment plan by PET are possible. # In critical situations when the beam has to pass very heterogeneous structures and radiosensitive organs are situated in the direction of the beam behind the Bragg peak, a monoenergetic low dose beam pulse can be applied to the patient. The range of the particles can be derived from the simultaneous PET scan, so that the correct range calculation of the treatment plan is ensured before the therapeutical irradiations are started. # During each fraction of the heavy ion therapy the ß+-activity distributions are measured routinely. Based on the time course of every individual therapy fraction the expected ß+-emitter distribution is computed. By comparing the simulated with the measured data the precision of the dose deposition of this single therapy fraction is assessed. If a considerable disagreement between these two distributions is revealed by this comparison the treatment plan has to be modified before proceeding with the following therapy fraction. The PET data are recorded in list mode, together with a protocol of important accelerator parameters of the irradiation. Because of the half-lives of the most abundant ß+-emitters 11C and 15O it is on principle impossible to obtain the precise position of the 12C therapy beam by PET during the irradiation. …

Today tumour diseases are the second most cause of death in Western countries. But only 45 percent of the patients can be cured by the established treatment methods. The further improvement of the these forms of therapy and the development of new therapeutical approaches is urgent. A substantial proportion of the patients could benefit from particle therapy with heavy ions. Beams of accelerated heavy ions (e.g. carbon, nitrogen or oxygen) with an energy between 70 and 500 AMeV are characterised by physical and biological properties superior to the radiation used in conventional radiotherapy (photons, electrons, neutrons). They form a sharp dose maximum (Bragg peak) shortly before coming to rest and are scarcely scattered while penetrating tissue. Because of the increased relative biological efficiency of these ions in the Bragg peak region they are suitable for precision therapy of deeply seated, compact, radioresistant tumours near to organs at risk. For a safe application of heavy ions close to radiosensitive structures (brain stem, optical nerves, eyes) an in situ monitoring of the therapy is desirable. This can be accomplished by positron emission tomography (PET), since fragmentation reactions between the stable ions of the therapy beam and the atomic nuclei of the tissue generate a dynamic spatial distribution of positron emitters (ß+-emitters) that can be observed by a positron camera. At the Gesellschaft für Schwerionenforschung in Darmstadt a medical treatment site for heavy ion therapy has been established in co-operation with the Radiologische Universitätsklinik Heidelberg, the Deutsches Krebsforschungszentrum Heidelberg and the Forschungszentrum Rossendorf. The fast variation of the beam energy in conjunction with the vertical and horizontal beam deflection by dipole magnets (raster scanning) allows the three-dimensional, strictly tumour shape conformed irradiations. The dual head positron camera BASTEI has been installed at the treatment place in order to measure the decay of the ß+-emitters during the irradiation and a few minutes after. Two ways to verify the treatment plan by PET are possible. # In critical situations when the beam has to pass very heterogeneous structures and radiosensitive organs are situated in the direction of the beam behind the Bragg peak, a monoenergetic low dose beam pulse can be applied to the patient. The range of the particles can be derived from the simultaneous PET scan, so that the correct range calculation of the treatment plan is ensured before the therapeutical irradiations are started. # During each fraction of the heavy ion therapy the ß+-activity distributions are measured routinely. Based on the time course of every individual therapy fraction the expected ß+-emitter distribution is computed. By comparing the simulated with the measured data the precision of the dose deposition of this single therapy fraction is assessed. If a considerable disagreement between these two distributions is revealed by this comparison the treatment plan has to be modified before proceeding with the following therapy fraction. The PET data are recorded in list mode, together with a protocol of important accelerator parameters of the irradiation. Because of the half-lives of the most abundant ß+-emitters 11C and 15O it is on principle impossible to obtain the precise position of the 12C therapy beam by PET during the irradiation. …

Magnetic resonance imaging is derogated by the presence of metal implants and image quality is impaired. Artifacts are categorized according to their sources, the differences in susceptibility between metal and tissue and the modulation of the magnetic radiofrequency (RF) transmit field. Generally, these artifacts are intensified at higher field strength. The purpose of this work is to analyze the efficiency of current methods used for metal artifact reduction at 3T and to investigate improvements. The impact of high-bandwidth RF pulses on susceptibility-induced artifacts is tested. In addition, the benefit of a two-channel transmit system with respect to shading close to total hip replacements and other elongated metal structures in parallel to the magnetic field is analyzed. Local transmit/receive coils feature a higher peak B1 amplitude than conventional body coils and thus enable high-bandwidth RF pulses. Susceptibility-induced through-plane distortion relates reciprocally to the RF bandwidth, which is evaluated in vitro for a total knee arthroplasty. Clinically relevant sequences (TSE and SEMAC) with conventional and high RF pulse bandwidths and different contrasts are tested on eight patients with different types of knee implants. Distortion is rated by two radiologists. An additional analysis assesses the capability of a local spine transmit coil. Furthermore, B1 effects close to elongated metal structures are described by an analytical model comprising a water cylinder and a metal rod, which is verified numerically and experimentally. The dependence of the optimal polarization of the transmit B1 field, creating minimum shading, on the position of the metal is analyzed. In addition, the optimal polarization is determined for two patients; its benefit compared to circular polarization is assessed. Phantom experiments confirm the relation of the RF bandwidth and the through-plane distortion, which can be reduced by up to 79% by exploitation of a commercial local transmit/receive knee coil at 3T. On average, artifacts are rated “hardly visible” for patients with joint arthroplasties, when high-bandwidth RF pulses and SEMAC are used, and for patients with titanium fixtures, when high-bandwidth RF pulses are used in combination with TSE. The benefits of the local spine transmit coil are less compared to the knee coil, but enable a bandwidth 3.9 times as high as the body coil. The modulation of B1 due to metal is approximated well by the model presented and the position of the metal has strong influence on this effect. The optimal polarization can mitigate shading substantially. In conclusion, through-plane distortion and related artifacts can be reduced significantly by the application of high-bandwidth RF pulses by local transmit coils at 3T. Parallel transmission offers an option to substantially reduce shading close to long metal structures aligned with the magnetic field. Effective techniques dedicated for metal implant imaging at 3T are introduced in this work. / Metallimplantate beeinträchtigen die Funktionsweise der Magnetresonanztomographie und verschlechtern die Bildqualität. Die Artefakte werden entsprechend ihres Ursprungs kategorisiert, in einerseits Suszeptibilitätsunterschiede zwischen Metall und Gewebe und andererseits die Modulation des B1-Feldes. Im Allgemeinen verstärken sich diese Artefakte bei höheren Feldstärken. Das Ziel dieser Arbeit ist es, die Effizienz vorhandener Methoden zur Artefaktreduktion bei 3T zu bewerten und mögliche Verbesserungen herauszuarbeiten. Der Einfluss von breitbandigen Hochfrequenz-Pulsen (HF-Pulsen) auf Suszeptibilitätsartefakte wird untersucht. Zusätzlich wird der Einfluss eines Zwei-Kanal Sendesystems auf Abschattungen analysiert, die in der Nähe von Hüftimplantaten und anderen länglichen Implantaten auftreten, welche parallel zu B0 liegen. Im Gegensatz zu konventionellen Ganzkörper-Sendespulen erlauben lokale Sende-/Empfangsspulen eine höhere maximale B1-Amplitude, die breitbandigere HF-Pulse ermöglicht. Die reziproke Abhängigkeit der Suszeptibilitätsartefakte in Schichtrichtung zur HF-Bandbreite wird in vitro für eine Kniegelenkplastik evaluiert. An acht Patienten mit verschiedenen Knieimplantaten werden klinisch relevante Sequenzen (TSE und SEMAC) mit konventionellen und breitbandigen HF-Pulsen in verschiedenen Kontrasten getestet und die Verzerrungen werden von zwei Radiologen bewertet. Eine weitere Studie untersucht das Potenzial einer lokalen Sendespule für die Wirbelsäule. Darüberhinaus werden B1-Effekte nahe länglicher Metallstrukturen durch ein analytisches Modell beschrieben, das numerisch und experimentell überprüft wird. Des Weiteren wird die Abhängigkeit der optimalen Polarisation des B1-Feldes, die minimale Abschattung verursacht, von der Position des Metalls untersucht. Für zwei Patienten wird die optimale Polarisation bestimmt und deren Vorteil gegenüber der zirkularen Polarisation analysiert. Phantomversuche bestätigen die Abhängigkeit zwischen HF-Bandbreite und der Schichtverzerrung, die durch die Verwendung einer lokalen Kniespule mit Sende- und Empfangsfunktion bei 3T um 79% reduziert werden kann. Die Artefakte bei Patienten mit Vollimplantaten, bzw. Titanimplantaten, werden als "kaum sichtbar" bewertet, wenn SEMAC, bzw. TSE, mit breitbandigen HF-Pulsen kombiniert appliziert wird. Im Vergleich zur lokalen Kniespule fallen die Vorteile der lokalen Wirbelsäulen-Sendespule geringer aus; dennoch kann die 3,9-fache HF-Bandbreite der Ganzkörpersendespule erreicht werden. Die B1-Modulation aufgrund von Metall wird im dargestellten Modell gut wiedergegeben und die Position des Metalls im Objekt hat großen Einfluss auf den Effekt. Die Verwendung der optimalen Polarisation kann Abschattungen stark reduzieren. Zusammenfassend können Artefakte aufgrund von Schichtverzerrungen durch die Verwendung lokaler Sendespulen und breitbandiger HF-Pulse bei 3T stark abgeschwächt werden. Die individuelle Wahl der Polarisation des B1-Feldes bietet eine gute Möglichkeit, Abschattungen in der Nähe von länglichen Metallstrukturen zu reduzieren, soweit diese näherungsweise parallel zu B0 ausgerichtet sind. Somit werden in dieser Arbeit wirksame Methoden zur Metallbildgebung bei 3T eingeführt.

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Imaging photoplethysmography (iPPG) has attracted much attention over the last years. The vast majority of works focuses on methods to reliably extract the heart rate from videos. Only a few works addressed iPPGs ability to exploit spatio-temporal perfusion pattern to derive further diagnostic statements. This work directs at the spatio-temporal analysis of blood perfusion from videos. We present a novel algorithm that bases on the two-dimensional representation of the blood pulsation (perfusion map). The basic idea behind the proposed algorithm consists of a pairwise estimation of time delays between photoplethysmographic signals of spatially separated regions. The probabilistic approach yields a parameter denoted as perfusion speed. We compare the perfusion speed versus two parameters, which assess the strength of blood pulsation (perfusion strength and signal to noise ratio). Preliminary results using video data with different physiological stimuli (cold pressure test, cold face test) show that all measures are in fluenced by those stimuli (some of them with statistical certainty). The perfusion speed turned out to be more sensitive than the other measures in some cases. However, our results also show that the intraindividual stability and interindividual comparability of all used measures remain critical points. This work proves the general feasibility of employing the perfusion speed as novel iPPG quantity. Future studies will address open points like the handling of ballistocardiographic effects and will try to deepen the understanding of the predominant physiological mechanisms and their relation to the algorithmic performance.

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