No description available.

No description available.

Yes / This study aimed to determine whether a reduction in radiation dose was found for percutaneous coronary interventional (PCI) patients using a cardiac interventional x-ray system with state-of-the-art image enhancement and x-ray optimization, compared to the current generation x-ray system, and to determine the corresponding impact on clinical image quality. Patient procedure dose area product (DAP) and fluoroscopy duration of 131 PCI patient cases from each x-ray system were compared using a Wilcoxon test on median values. Significant reductions in patient dose (p ≪ 0.001) were found for the new system with no significant change in fluoroscopy duration (p ¼ 0.2); procedure DAP reduced by 64%, fluoroscopy DAP by 51%, and “cine” acquisition DAP by 76%. The image quality of 15 patient angiograms from each x-ray system (30 total) was scored by 75 clinical professionals on a continuous scale for the ability to determine the presence and severity of stenotic lesions; image quality scores were analyzed using a two-sample t -test. Image quality was reduced by 9% (p ≪ 0.01) for the new x-ray system. This demonstrates a substantial reduction in patient dose, from acquisition more than fluoroscopy imaging, with slightly reduced image quality, for the new x-ray system compared to the current generation system. / This research was funded by Philips Healthcare (the Netherlands)

Yes / Cardiologists use x-ray image sequences of the moving heart acquired in real-time to diagnose and treat cardiac patients. The amount of radiation used is proportional to image quality; however, exposure to radiation is damaging to patients and personnel. The amount by which radiation dose can be reduced without compromising patient care was determined. For five patient image sequences, increments of computer-generated quantum noise (white + colored) were added to the images, frame by frame using pixel-to-pixel addition, to simulate corresponding increments of dose reduction. The noise adding software was calibrated for settings used in cardiac procedures, and validated using standard objective and subjective image quality measurements. The degraded images were viewed next to corresponding original (not degraded) images in a two-alternativeforced- choice staircase psychophysics experiment. Seven cardiologists and five radiographers selected their preferred image based on visualization of the coronary arteries. The point of subjective equality, i.e., level of degradation where the observer could not perceive a difference between the original and degraded images, was calculated; for all patients the median was 33% 15% dose reduction. This demonstrates that a 33% 15% increase in image noise is feasible without being perceived, indicating potential for 33% 15% dose reduction without compromising patient care. / Funded in part by Philips Healthcare, the Netherlands. Part of this work has been performed in the project PANORAMA, co-funded by grants from Belgium, Italy, France, the Netherlands, and the United Kingdom, and the ENIAC Joint Undertaking.

The author discusses the difficulties that arise with the determination of the concentration of the iodinated contrast agents in the blood stream via the traditional gray-scale computer tomography and searches for the new imaging modalities that would provide for better sensitivity. The topic of the energy-discriminative color CT is discussed as a potential solution and its suitability is evaluated by performing the experiments on the contrast materials phantom and the phantom containing the iohexol solutions of varying concentrations on the original CT system assembled by the author. A method of the effective atomic number mapping is discussed as a viable alternative to the traditional attenuation-based tomography. The dependency of the effective atomic number of the compound on the energy of the x-ray beam is a phenomenon well recorded in the literature, yet no formal study exists to correctly predict the effective atomic number for a given compound. An extensive physical model is developed based on the previously presented models and adaptations unique to the task in order to determine the effective atomic numbers for exact energies experimentally. The method is tested on different materials. The resultant effective atomic numbers for the water, oil, and iohexol-water solutions of varying concentrations are presented in the study. The effects of the k-edge on both the linear attenuation curve and the effective atomic number curve are discussed. The possible future venues of the research are presented in the final part of the thesis. / Master of Science

X-ray phase-contrast imaging has seen rapid development in recent decades due to its superior performance in imaging low-absorption objects, compared to traditional attenuation x-ray imaging. Having higher demand on coherence, x-ray phase-contrast imaging is performed mostly at synchrotrons. With the development of different imaging techniques, and the development of laboratory sources and x-ray optics, x-ray phase-contrast imaging can now be implemented on laboratory systems, which is promising and practical for broader range of applications. The subject of this thesis is the implementation, development and comparison of different laboratory phase-contrast methods using a liquid-metal-jet source. The three x-ray phase-contrast imaging methods included in this thesis are the propagation-, grating-, and speckle-based techniques. The grating-based method has been implemented on a laboratory system with a liquid-metal-jet source, which yields several times higher brightness than a standard solid-anode microfocus source. This allows shorter exposure time or a higher signal-to-noise ratio. The performance of the grating-based method has been experimentally and numerically compared with the propagation-based method, and the dose required to observe an object as a function of the object’s diameter has been investigated with simulations. The result indicates a lower dose requirement for the propagation-based method in this system but a potential advantage for the grating-based method to detect relatively large samples using a monochromatic beam. The speckle-based method, both the speckle-tracking and speckle-scanning techniques, has been implemented on a laboratory system for the first time, showing its adaptability to radiation of low temporal coherence. Tomography has been performed and shows the potential applications of this method on quantitative analysis on both absorption and phase information of materials. As a basis for further optimization and comparisons to other methods, the noise properties of the differential phase contrast of the speckle-based method have been studied and an analytical expression for the noise variance introduced, showing a similarity to the grating-based method. / Faskontrastavbildning med röntgenstrålning är en teknik som har utvecklats kraftigt de senaste årtiondena, eftersom den fungerar bättre än traditionella, absorptionsbaserade röntgenundersökningar för objekt med låg absorption. Den har dock höga krav på koherens, vilket gjort att den huvudsakligen används vid stora synkrotron-anläggningar. Tack vare utveckligen av nya avbildningstekniker, laboratoriekällor och röntgenoptik kan numera faskontrast användas även med laboratoriesystem, vilket är lovande då tekniken kan användas vid ett större antal olika tillämpningsområden Denna avhandling syftar till att tillämpa, utveckla och jämföra olika faskontrastmetoder i laboratoriemiljö, med en metallstråleröntgenkälla. De tre faskontrastmetoderna som behandlas i denna avhandling är propogation, gitter och speckelbaserad faskontrast. Den gitterbaserade metoden har implementerats i ett laboratoriesystem med en metallstrålekälla som ger flera gånger högre radians än en vanlig, fast mikrofokuskälla. Den högre radians en möjliggör kortare exponeringstider eller högre signal-brusförhållande. Den gitterbaserade tekniken har jämförts experimentellt och numeriskt med den propageringsbaserade metoden. Den strålningsdos som krävs för observera ett objekt, som funktion av dess diameter, har jämförts för de båda teknikerna, den här gången via simuleringar. Resultaten visar på en lägre strålningsdos för den propagationsbaserade tekniken i detta fall, men även att det finns en potentiell fördel för den gitterbaserade tekniken för något större objekt med monokromatisk röntgenstrålning. Speckelbaserade tekniker, nämare bestämt den som bygger på att spåra speckel och den som bygger på att scanna diffusorn, har för första gången implementerats i laboratoriemiljö. Därmed har visats att de fungerar även för strålning med låg tidskoherens. Tekniken har även använts för tomografi och visar möjliga tillämpningar inom kvantitativ analys av material. För att förenkla framtida optimeringar och jämförelser av tekniken med andra metoder, har brusegenskaperna för den speckelbaserade metoden studerats och visat sig likna den gitterbaserade metoden. / <p>QC 20160921</p>

<p>One of the challenges facing clinical practice today is intra-operative margin detection in breast conserving surgeries (BCS) or lumpectomy procedures. When a surgeon removes a breast tumor from a patient during a BCS procedure, the surgically excised tissue specimen is examined to see whether it contains a margin of healthy tissue around the tumor. A healthy margin of tissue around the tumor would indicate that the tumor in its entirety has been removed. On the other hand, if cancerous tissue is at the surface of the specimen, that would indicate that the tumor may have been transected during the procedure, leaving some residual cancerous tissue inside the patient. The most effective intra-operative real-time margin detection techniques currently used in clinical practice are frozen section analysis (FSA) and touch-prep cytology. These methods have been shown to possess inconsistent accuracy, which result in 20% to 30% of BCS patients being called back for a repeat BCS procedure to remove the residual tumor tissue. In addition these techniques have been shown to be time-consuming--requiring the operating room team to have to wait at least 20 minutes for the results. Therefore, there is a need for accurate and faster technology for intra-operative margin detection. </p><p>In this dissertation, we describe an x-ray coherent scatter imaging technique for intra-operative margin detection with greater accuracy and speed than currently available techniques. The method is based on cross-sectional imaging of the differential coherent scatter cross section in the sample. We first develop and validate a Monte Carlo simulation of coherent scattering. Then we use that simulation to design and test coherent scatter computed tomography (CSCT) and coded aperture coherent scatter spectral imaging (CACSSI) for cancerous voxel detection and for intra-operative margin detection using (virtual) clinical trials. Finally, we experimentally implement a CACSSI system and determine its accuracy in cancer detection using tissue histology. </p><p>We find that CSCT and CACSSI are able to accurately detect cancerous voxels inside of breast tissue specimens and accurately perform intra-operative margin detection. Specifically, for the task of individual cancerous voxel detection, we show that CSCT and CACSSI have AUC values of 0.97 and 0.94, respectively. Whereas for the task of intra-operative margin detection, the results of our virtual clinical trials show that CSCT and CACSSI have AUC values of 0.975 and 0.741, respectively. The gap in spatial resolution between CSCT and CACSSI affects the results of intra-operative margin detection much more than it does the task of individual cancerous voxel detection. Finally, we also show that CSCT would require on the order of 30 minutes to create a 3D image of a breast cancer specimen, whereas CACSSI would require on the order of 3 minutes. </p><p>These results of this work show that coherent scatter imaging has the potential to provide more accurate intra-operative margin detection than currently used clinical techniques. In addition, the speed (and therefore low scan duration: 3 min) of CACSSI, along with its ability to automatically classify cancerous tissue for margin detection means that coherent scatter imaging would be much more cost-effective than the clinical techniques that require up to 20 minutes and a trained pathologist. With the cancerous voxel detection accuracy of a 0.94 AUC and scan time of on the order of 3 minutes demonstrated for coherent scatter imaging in this work, coherent scatter imaging has the potential to reduce healthcare costs for BCS procedures and rates of repeat BCS surgeries. The accuracy for CACSSI can be considerably improved to match CSCT accuracy by improving its spatial resolution through a number of techniques: incorporating into the CACSSI reconstruction algorithm the ability to differentiate noise from high frequency signal so that we can image with higher frequency coded aperture masks; implementing a 2D coded aperture mask with a 2D detector; or acquiring additional angles of projection data.</p> / Dissertation

No description available.

The term“Digital X-ray Imaging" refers to a variety of technologies that electronically capture x-ray images. Once captured the images may be electronically processed, stored, displayed and communicated. Digital imaging has the potential to overcome weaknesses inherent in traditional screen-film imaging, with high detection efficiency, high dynamic range and the capability for contrast enhancement. Image processing also makes possible innovative techniques such as computer-aided diagnosis, tomosynthesis, dual-energy imaging, and digital subtraction imaging. Several different approaches to digital imaging are being studied, and in some cases, have been developed and are being marketed. Common to all these approaches are a number of technological and medical issues to be resolved. One of the technological issues is the optimal pixel size for any particular image sensor technology. In general, the spatial resolution of the digital image is limited by the pixel size. Unfortunately while reducing pixel size improves spatial resolution this comes at the expense of signal to noise ratio (SNR). In a scintillator-charge-coupled device (CCD) system, the signal can be increased by improving the efficiency of the scintillator or by reducing noise. This study used a very low noise CCD to determine if image quality, as indicated by the modulation transfer function (MTF), the noise power spectrum (NPS) and the detective quantum efficiency (DQE), could be maintained while reducing pixel size. Two scintillators, one a commonly used radiographic screen the other a thallium doped cesium iodide scintillator, were used and the results compared. The results of this study show that image quality can be maintained as pixel size is reduced and that high DQE can be attained and maintained over a wide range of spatial frequencies with a well designed scintillator.

Collagen scaffolds are porous structures which are used in bioreactors and in a wide range of tissue engineering applications. In these contexts, the scaffolds may be subjected to conditions in which fluid is forced through the structure and the scaffold is simultaneously compressed. It is clear that fluid transport within collagen scaffolds, and the inter-relationships between permeability, scaffold structure, fluid pressure and scaffold deformation are of key importance. However, these relationships remain poorly understood. In this thesis, a series of isotropic collagen structures were produced using a freeze-drying technique from aqueous slurry concentrations 0.5, 0.75 and 1 wt%, and fully characterised using X-ray micro-tomography and compression testing. It was found that collagen wt% influenced structural parameters such as pore size, porosity, relative density and mechanical properties. Percolation theory was used to investigate the pore interconnectivity of each scaffold. Structures with lower collagen fraction resulted in larger percolation diameters, but lower mechanical stiffness. Aligned collagen scaffolds were also produced by altering the freeze-drying protocol and using different types of mould materials and designs. It was found that a polycarbonate mould with stainless base resulted in vertically aligned structures with low angular variation. When compared with isotropic scaffolds from slurry of the same concentration, aligned scaffolds had a larger percolation diameter. Tortuosity was used as a mathematical tool to characterise the interconnected pathways within each porous structure. The effect of the size of the region of interest (ROI) chosen and the size of the virtual probe particle used in the analysis on the values of tortuosity calculated were determined and an optimised calculation methodology developed. Increasing the collagen fraction within isotropic scaffolds increased the tortuosity, and aligned structures had smaller tortuosity values than their isotropic counterparts. Permeability studies were conducted using two complementary experimental rigs designed to cover a range of pressure regimes and the results were compared with predictions from mathematical models and computational simulations. At low pressures, it was found that the lower collagen fraction structures, which had more open morphologies, had higher permeabilities. Alignment of the structure also enhanced permeability. The scaffolds all experienced deformation at high pressures resulting in a restriction of fluid flow. The lower collagen fraction scaffolds experienced a sharper decrease in permeability with increased pressure and aligned structures were more responsive to deformation than their isotropic counterparts. The inter-relationships between permeability, scaffold structure, fluid pressure and deformation of collagen scaffolds were explored. For isotropic samples, permeability followed a broad $(1- \epsilon)^2$ behaviour with strain as predicted by a tetrakaidecahedral structural model, with the constant of proportionality changing with collagen fraction. In contrast, the aligned structures did not follow this behaviour with the permeability dropping much more sharply in the early stages of compression. Open-cell polyurethane (PU) foams, sometimes used as dressings in wound healing applications, are often compared with collagen scaffolds in permeability models and were used in this thesis as a comparison structure. The foam had a higher permeability than the scaffolds due to its larger pore sizes and higher interconnectivity. In the light of the effects of compression on permeability, the changes in porous structure with compression were explored in isotropic and aligned 0.75 wt% scaffolds. Unlike the fluid flow experiments, these experiments were carried out in the dry state. Deformation in simple linear compression and in step-wise compression was studied, and the stress relaxation behaviour of the scaffolds characterised. A methodology was developed to characterise the structural changes accompanying compression using X-ray micro-tomography with an in situ compression stage. The methodology accounted for the need for samples to remain unchanged during the scan collection period for stable image reconstruction. The scaffolds were studied in uniaxial compression and biaxial compression and it was found that pore size and percolation diameter decreased with increasing compressive strain, while the tortuosity increased. The aligned structure was less affected than the isotropic at low compressions, in contrast to the results from the permeability study in which the aligned structure was more responsive to strain. This suggests that the degree of hydration may affect the structural changes observed. The insights gained in this study of the inter-relationships between microstructure, fluid dynamics and deformation in collagen scaffolds are of relevance to the informed design of porous structures for medical applications.