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Development of a robot-assisted ultrasound-guided radiation therapy (USgRT).

机器人辅助超声引导放射治疗 (USgRT) 的发展。

  • 影响因子:2.34
  • DOI:10.1007/s11548-019-02104-y
  • 作者列表:"Seitz PK","Baumann B","Johnen W","Lissek C","Seidel J","Bendl R
  • 发表时间:2020-03-01
Abstract

PURPOSE:Radiation treatment is improved by the use of image-guided workflows. This work pursues the approach of using ultrasound (US) as a real-time imaging modality. The primary focus of this study is to develop and test a breathing and motion control for a robotic-guided US transducer. All control functions of the robot and the US image processing were then integrated into one software platform enabling US-guided radiation therapy. METHODS:The robot (KUKA LBR iiwa 7 R800) and the US image processing workflows were integrated into the Medical Interaction Toolkit (MITK) (Nolden et al. in Int J Comput Assist Radiol Surg 8(4):607-620, 2013). The positions of the US probe were tracked with an optical tracking system. As a main function of robot positioning control, a highly sensitive breathing and motion compensation method was developed using KUKA's robotic application programming interface. The resulting autonomous robot motions were tested by the use of defined breathing patterns with two volunteers. Furthermore, a filter pipeline for 3D US image processing with MITK was developed. Thus, image registration of US images and previously acquired planning image data was enabled. RESULTS:The implemented breathing and motion compensation feature was successful with the addition of the remote rotating, translating capability of the US probe. Desired force applied to the US probe, and thus to the patient, is stable and enables a continuous US imaging. The developed filter pipeline for image processing facilitates registration and display of planning data and US image data in one graphical user interface. CONCLUSION:A stable and robust method for motion compensation for robot-assisted US imaging was developed and tested successfully. This is a first step toward the safe use of autonomous robot motions in interaction with patients. Furthermore, main software components were integrated into a single platform and used with the purpose of ultrasound-guided radiation therapy.

摘要

目的: 通过使用图像引导工作流来改进放射治疗。这项工作追求使用超声 (US) 作为实时成像模态的方法。本研究的主要焦点是开发和测试用于机器人引导的US换能器的呼吸和运动控制。然后将机器人和美国图像处理的所有控制功能集成到一个软件平台中,实现美国引导的放射治疗。 方法: 将机器人 (KUKA LBR iiwa 7 R800) 和美国图像处理工作流集成到医疗交互工具包 (MITK) 中 (Nolden等人在Int J Comput Assist radiosurg 8(4):607-620,2013)。用光学跟踪系统跟踪美国探测器的位置。作为机器人定位控制的主要功能,使用KUKA的机器人应用编程接口开发了一种高灵敏度的呼吸和运动补偿方法。通过使用两个志愿者的限定呼吸模式来测试所得到的自主机器人运动。此外,开发了一种用于MITK的3D US图像处理的滤波流水线。因此,实现了US图像和先前获取的计划图像数据的图像配准。 结果: 实施的呼吸和运动补偿功能是成功的,增加了美国探头的远程旋转、平移能力。施加到US探头并且因此施加到患者的期望的力是稳定的并且能够实现连续的US成像。开发的用于图像处理的滤波器流水线便于在一个图形用户界面中注册和显示计划数据和US图像数据。 结论: 开发了一种稳定、鲁棒的机器人辅助超声成像运动补偿方法,并成功进行了测试。这是在与患者交互中安全使用自主机器人运动的第一步。此外,主要软件组件被集成到单个平台中,并用于超声引导放射治疗的目的。

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发表时间:2020-01-01
来源期刊:European radiology
DOI:10.1007/s00330-019-06319-0
作者列表:["Delattre BMA","Boudabbous S","Hansen C","Neroladaki A","Hachulla AL","Vargas MI"]

METHODS:OBJECTIVES:The aim was to evaluate the image quality and sensitivity to artifacts of compressed sensing (CS) acceleration technique, applied to 3D or breath-hold sequences in different clinical applications from brain to knee. METHODS:CS with an acceleration from 30 to 60% and conventional MRI sequences were performed in 10 different applications in 107 patients, leading to 120 comparisons. Readers were blinded to the technique for quantitative (contrast-to-noise ratio or functional measurements for cardiac cine) and qualitative (image quality, artifacts, diagnostic findings, and preference) image analyses. RESULTS:No statistically significant difference in image quality or artifacts was found for each sequence except for the cardiac cine CS for one of both readers and for the wrist 3D proton density (PD)-weighted CS sequence which showed less motion artifacts due to the reduced acquisition time. The contrast-to-noise ratio was lower for the elbow CS sequence but not statistically different in all other applications. Diagnostic findings were similar between conventional and CS sequence for all the comparisons except for four cases where motion artifacts corrupted either the conventional or the CS sequence. CONCLUSIONS:The evaluated CS sequences are ready to be used in clinical daily practice except for the elbow application which requires a lower acceleration. The CS factor should be tuned for each organ and sequence to obtain good image quality. It leads to 30% to 60% acceleration in the applications evaluated in this study which has a significant impact on clinical workflow. KEY POINTS:• Clinical implementation of compressed sensing (CS) reduced scan times of at least 30% with only minor penalty in image quality and no change in diagnostic findings. • The CS acceleration factor has to be tuned separately for each organ and sequence to guarantee similar image quality than conventional acquisition. • At least 30% and up to 60% acceleration is feasible in specific sequences in clinical routine.

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影响因子:2.98
发表时间:2020-01-01
DOI:10.1136/neurintsurg-2019-014962
作者列表:["Guo W","Liu H","Tan Z","Zhang X","Gao J","Zhang L","Guo H","Bai H","Cui W","Liu X","Wu X","Luo J","Qu Y"]

METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.

影响因子:0.96
发表时间:2020-02-01
DOI:10.1002/jcu.22762
作者列表:["Meng L","Zhao D","Yang Z","Wang B"]

METHODS:OBJECTIVE:The primary purpose of this study was to evaluate the effectiveness of a three-dimensional (3D) software tool (smart planes) for displaying fetal brain planes, and the secondary purpose was to evaluate its accuracy in performing automatic measurements. MATERIAL AND METHODS:This prospective study included singleton fetuses with a gestational age (GA) greater than 18 weeks. Transabdominal two-dimensional ultrasound (2DUS) and 3D smart planes images were respectively used to obtain the basic planes of the fetal brain, with five parameters measured. The images, by either two-dimensional (2D) manual or 3D automatic operation, were reviewed by two experienced sonographers. The agreements between two measurements were analyzed. RESULTS:A total of 226 cases were included. The rates of successful detection by automatic display were as high as 80%. There was substantial agreement between the measurements of the biparietal diameter, head circumference and transcerebellar diameter, but poor agreement between the measurements of cisterna magna and lateral ventricle width. CONCLUSIONS:Smart Planes might be valuable for the rapid evaluation of fetal brain, because it simplifies the evaluation process. However, the technology requires improvement. In addition, this technology cannot replace the conventional manual US scans; it can only be used as an additional approach.

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