Fluorescence-enhanced optical imaging using near-infrared (NIR) light developed for in-vivo molecular targeting and reporting of cancer provides promising opportunities for diagnostic imaging. However, prior to the administration of unproven contrast agents, the benefits of fluorescence-enhanced optical imaging must be assessed in feasibility phantom studies. A novel intensified charge-coupled device (ICCD) imaging system has been developed to perform 3-D fluorescence tomographic imaging in the frequency-domain using near-infrared contrast agents. This study is unique since it (i) employs a large tissue-mimicking phantom (~1087 cc), which is shaped and sized to resemble a female breast and part of the extended chest wall region, and (ii) enables rapid data acquisition in the frequency-domain by using a gain-modulated ICCD camera. Diagnostic 3-D fluorescence-enhanced optical tomography is demonstrated using 0.5-1 cc single and multiple targets contrasted from their surrounding by ??M concentrations of Indocyanine green (ICG) in the breast-shaped phantom (10 cm diameter), under varying conditions of target-to-background absorption contrast ratios (1:0 and 100:1) and target depths (up to 3 cm deep). Boundary surface fluorescence measurements of referenced amplitude and phase shift were used along with the coupled diffusion equation of light propagation in order to perform 3-D image reconstructions using the approximate extended Kalman filter (AEKF) algorithm, and hence differentiate the target from the background based on fluorescent optical contrast. Detection of single and multiple targets is demonstrated under various conditions of target depths (up to 2 cm deep), absorption optical contrast ratio (1:0 and 100:1), target volumes (0.5-1 cc), and multiple targets (up to three 0.5 cc targets). The feasibility of 3-D image reconstructions from simultaneous multiple point excitation sources are presented. Preliminary lifetime imaging studies with 1:2 and 2:1 optical contrast in fluorescence lifetime of the contrast agents is also demonstrated. The specificity of the optical imager is further assessed from homogeneous phantom studies containing no fluorescently contrasted targets. While nuclear imaging currently provides clinical diagnostic opportunities using radioactive tracers, molecular targeting of tumors using non-ionizing NIR contrast agents tomographically imaged using the frequency-domain ICCD imaging system could possibly become a new method of diagnostic imaging.

Computed tomography is one of the most evolving fields of modern radiology. The current CT applications permit among other things angiography, 3D image reconstructions, material decomposition and tissue characterization. CT is an important tool in the assessment of specific patient populations prior to an invasive or surgical procedure. The aim of this dissertation was to demonstrate the decisive role of CT with 3D-image reconstructions in haemodialysis patients scheduled to undergo fistulography, in patients undergoing surgical breast reconstructions with a perforator flap and in patients with complicated renal calculi scheduled to undergo percutaneous nephrolithotomy. CT Angiography with 3D image reconstructions was performed in 31 patients with failing arteriovenous fistulas and grafts, illustrating the vascular anatomy in a comprehensive manner in 93.5% of the evaluated segments and demonstrating a sensitivity of 95% compared to fistulography. In 59 mastectomy patients scheduled to undergo reconstructive breast surgery with a deep inferior epigastric perforator flap, the preoperative planning with CT Angiography with 3D image reconstructions of the anterior abdominal wall providing details of its vascular supply, reduced surgery time significantly (p< 0.001) and resulted in fewer complications. Dual Energy CT Urography with advanced image reconstructions in 31 patients with complicated renal calculi scheduled to undergo PNL, resulted in a new method of material characterisation (depicting renal calculi within excreted contrast) and in the possibility of reducing radiation dose by 28% by omitting the nonenhanced scanning phase. Detailed analysis of the changes renal calculi undergo when virtually reconstructed was performed and a comparison of renal calculi number, volume, height and attenuation between virtual nonenhanced and true nonenhanced images was undertaken. All parameters were significantly underestimated in the virtual nonenhanced images. CT with 3D-reconstructions is more than just “flashy images”. It is crucial in preoperative planning, optimizes various procedures and can reduce radiation dose.