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Reducing 4D CT imaging artifacts at the source: first experimental results from the respiratory adaptive computed tomography (REACT) system.

减少4D CT成像伪影的来源: 来自呼吸自适应计算机断层扫描 (REACT) 系统的第一个实验结果。

  • 影响因子:3.29
  • DOI:10.1088/1361-6560/ab7abe
  • 作者列表:"Morton N","Sykes J","Barber J","Hofmann C","Keall P","O'Brien R
  • 发表时间:2020-04-08
Abstract

:Breathing variations during 4D CT imaging often manifest as geometric irregularities known as respiratory-induced image artifacts and ultimately effect radiotherapy treatment efficacy. To reduce such image artifacts we developed Respiratory Adaptive Computed Tomography (REACT) to trigger CT acquisition during periods of regular breathing. For the first time, we integrate REACT with clinical hardware and hypothesize that REACT will reduce respiratory-induced image artifacts ≥ 4 mm compared to conventional 4D CT. 4D image sets were acquired using REACT and conventional 4D CT on a Siemens Somatom scanner. Scans were taken for 13 respiratory traces (12 patients) that were reproduced on a lung-motion phantom. Motion was observed by the Varian RPM system and sent to the REACT software where breathing irregularity was evaluated in real-time and used to trigger the imaging beam. REACT and conventional 4D CT images were compared to a ground truth static-phantom image and compared for absolute geometric differences within the region-of-interest. Breathing irregularity during imaging was retrospectively assessed using the root-mean-square error of the RPM measured respiratory signal during beam on (RMSE_Beam_on) for each phase of the respiratory cycle. REACT significantly reduced the average frequency of respiratory-induced image artifacts ≥ 4 mm by 70% for the tumor (p = 0.003) and 76% for the lung (p = 0.0002) compared to conventional 4D CT. Volume reductions of 10% to 6% of the tumor and 2% to 1% of the lung compared to conventional 4D CT were seen. Breathing irregularity during imaging (RMSE_Beam_on) was significantly reduced by 27% (p = 0.013) using the REACT method. For the first time, REACT was successfully integrated with clinical hardware. Our findings support the hypothesis that REACT significantly reduced respiratory-induced image artifacts compared to conventional 4D CT. These experimental results provide compelling evidence for further REACT investigation, potentially providing clearer images for clinical use.

摘要

: 4dct成像期间的呼吸变化通常表现为称为呼吸诱导的图像伪影的几何不规则性,并最终影响放射治疗疗效。为了减少这样的图像伪影,我们开发了呼吸自适应计算机断层扫描 (REACT) 以在规律呼吸期间触发CT采集。我们首次将REACT与临床硬件整合,并假设REACT与传统4D CT相比将减少呼吸诱导的图像伪影 ≥ 4毫米。使用REACT和常规4dct在西门子Somatom扫描仪上获取4D图像集。对在肺运动体模上再现的13条呼吸迹线 (12例患者) 进行扫描。运动由varianrpm系统观察并发送到REACT软件,其中呼吸不规则性被实时评估并用于触发成像光束。将REACT和常规4dct图像与地面实况静态幻像图像进行比较,并比较感兴趣区域内的绝对几何差异。使用呼吸循环的每个阶段的光束开启 (RMSE_Beam_on) 期间RPM测量的呼吸信号的均方根误差,回顾性评估成像期间的呼吸不规则性。与常规4dct相比,REACT显著降低了肿瘤 (p = 4毫米) 和肺 (p = 70%) 的呼吸诱导图像伪影 ≥ 0.003的平均频率76% 和0.0002。与常规4dct相比,肿瘤体积减少10% 至6%,肺体积减少2% 至1%。使用REACT方法,成像过程中的呼吸不规则性 (RMSE_Beam_on) 显著降低了27% (p = 0.013)。首次将REACT与临床硬件成功集成。我们的研究结果支持以下假设: 与传统4D CT相比,REACT显著减少了呼吸诱导的图像伪影。这些实验结果为进一步的反应研究提供了令人信服的证据,可能为临床使用提供更清晰的图像。

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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.

翻译标题与摘要 下载文献
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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