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Tomography, Volume 9, Issue 2 (April 2023) – 36 articles

Cover Story (view full-size image): Orbital floor fractures represent a common fracture type of the midface. The purpose of this study was to evaluate the accuracy of diagnostic measurements of isolated orbital floor fractures based on two-dimensional (2D) and three-dimensional (3D) measurement techniques. A cohort of 177 patients with an orbital floor fracture was retrospectively and multi-centrically investigated using 2D and 3D measurements. Calculated fracture areas using the 2D measurement technique revealed an average area of 287.59 mm2, while the 3D measurement showed fracture areas with a significantly larger average value of 374.16 mm2 (p < 0.001). Thus, the 3D measurements were 1.53 times larger compared to the 2D approach. Therefore, 3D-based measurement of orbital floor defects provides a more accurate estimation of fracture areas than the 2D-based technique. View this paper
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11 pages, 2771 KiB  
Article
The Cerebellum’s Orchestra: Understanding the Functional Connectivity of Its Lobes and Deep Nuclei in Coordination and Integration of Brain Networks
by Adnan A. S. Alahmadi
Tomography 2023, 9(2), 883-893; https://doi.org/10.3390/tomography9020072 - 21 Apr 2023
Cited by 1 | Viewed by 1809
Abstract
The cerebellum, a crucial brain region, significantly contributes to various brain functions. Although it occupies a small portion of the brain, it houses nearly half of the neurons in the nervous system. Previously thought to be solely involved in motor activities, the cerebellum [...] Read more.
The cerebellum, a crucial brain region, significantly contributes to various brain functions. Although it occupies a small portion of the brain, it houses nearly half of the neurons in the nervous system. Previously thought to be solely involved in motor activities, the cerebellum has since been found to play a role in cognitive, sensory, and associative functions. To further elucidate the intricate neurophysiological characteristics of the cerebellum, we investigated the functional connectivity of cerebellar lobules and deep nuclei with 8 major functional brain networks in 198 healthy subjects. Our findings revealed both similarities and differences in the functional connectivity of key cerebellar lobules and nuclei. Despite robust functional connectivity among these lobules, our results demonstrated that they exhibit heterogeneous functional integration with different functional networks. For instance, lobules 4, 5, 6, and 8 were linked to sensorimotor networks, while lobules 1, 2, and 7 were associated with higher-order, non-motor, and complex functional networks. Notably, our study uncovered a lack of functional connectivity in lobule 3, strong connections between lobules 4 and 5 with the default mode networks, and connections between lobules 6 and 8 with the salience, dorsal attention, and visual networks. Additionally, we found that cerebellar nuclei, particularly the dentate cerebellar nuclei, were connected to sensorimotor, salience, language, and default-mode networks. This study provides valuable insights into the diverse functional roles of the cerebellum in cognitive processing. Full article
(This article belongs to the Section Neuroimaging)
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12 pages, 2482 KiB  
Article
Application of Magnetic Resonance Strain Analysis Using Feature Tracking in a Myocardial Infarction Model
by Ryutaro Onishi, Junpei Ueda, Seiko Ide, Masahiro Koseki, Yasushi Sakata and Shigeyoshi Saito
Tomography 2023, 9(2), 871-882; https://doi.org/10.3390/tomography9020071 - 18 Apr 2023
Cited by 2 | Viewed by 1383
Abstract
This study validates the usefulness of myocardial strain analysis with cardiac cine magnetic resonance imaging (MRI) by evaluating the changes in the cardiac function and myocardial strain values longitudinally in a myocardial disease model. Six eight-week-old male Wistar rats were used as a [...] Read more.
This study validates the usefulness of myocardial strain analysis with cardiac cine magnetic resonance imaging (MRI) by evaluating the changes in the cardiac function and myocardial strain values longitudinally in a myocardial disease model. Six eight-week-old male Wistar rats were used as a model of myocardial infarction (MI). Cine images were taken in the short axis, two-chamber view longitudinal axis, and four-chamber view longitudinal axis directions in rats 3 and 9 days after MI and in control rats, with preclinical 7-T MRI. The control images and the images on days 3 and 9 were evaluated by measuring the ventricular ejection fraction (EF) and the strain values in the circumferential (CS), radial (RS), and longitudinal directions (LS). The CS decreased significantly 3 days after MI, but there was no difference between the images on days 3 and 9. The two-chamber view LS was −9.7 ± 2.1% at 3 days and −13.9 ± 1.4% at 9 days after MI. The four-chamber view LS was −9.9 ± 1.5% at 3 days and −11.9 ± 1.3% at 9 days after MI. Both the two- and four-chamber LS values were significantly decreased 3 days after MI. Myocardial strain analysis is, therefore, useful for assessing the pathophysiology of MI. Full article
(This article belongs to the Topic Cardiac Imaging: State of the Art)
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12 pages, 1490 KiB  
Article
Using Brain Tumor MRI Structured Reporting to Quantify the Impact of Imaging on Brain Tumor Boards
by Syed A. Abidi, Michael J. Hoch, Ranliang Hu, Gelareh Sadigh, Alfredo Voloschin, Jeffrey J. Olson, Hui-Kuo G. Shu, Stewart G. Neill and Brent D. Weinberg
Tomography 2023, 9(2), 859-870; https://doi.org/10.3390/tomography9020070 - 18 Apr 2023
Cited by 1 | Viewed by 2320
Abstract
Multidisciplinary tumor boards (TB) are an essential part of brain tumor care, but quantifying the impact of imaging on patient management is challenging due to treatment complexity and a lack of quantitative outcome measures. This work uses a structured reporting system for classifying [...] Read more.
Multidisciplinary tumor boards (TB) are an essential part of brain tumor care, but quantifying the impact of imaging on patient management is challenging due to treatment complexity and a lack of quantitative outcome measures. This work uses a structured reporting system for classifying brain tumor MRIs, the brain tumor reporting and data system (BT-RADS), in a TB setting to prospectively assess the impact of imaging review on patient management. Published criteria were used to prospectively assign three separate BT-RADS scores (an initial radiology report, secondary TB presenter review, and TB consensus) to brain MRIs reviewed at an adult brain TB. Clinical recommendations at TB were noted and management changes within 90 days after TB were determined by chart review. In total, 212 MRIs in 130 patients (median age = 57 years) were reviewed. Agreement was 82.2% between report and presenter, 79.0% between report and consensus, and 90.1% between presenter and consensus. Rates of management change increased with increasing BT-RADS scores (0—3.1%, 1a—0%, 1b—66.7%, 2—8.3%, 3a—38.5%, 3b—55.9, 3c—92.0%, and 4—95.6%). Of 184 (86.8%) cases with clinical follow-up within 90 days after the tumor board, 155 (84.2%) of the recommendations were implemented. Structured scoring of MRIs provides a quantitative way to assess rates of agreement interpretation alongside how often management changes are recommended and implemented in a TB setting. Full article
(This article belongs to the Special Issue Current Trends in Diagnostic and Therapeutic Imaging of Brain Tumors)
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2 pages, 187 KiB  
Editorial
Editor’s Review of Key Research Papers Published in Tomography during the Last Year
by Emilio Quaia
Tomography 2023, 9(2), 857-858; https://doi.org/10.3390/tomography9020069 - 13 Apr 2023
Viewed by 996
Abstract
Tomography is an open access journal dedicated to all aspects of imaging science from basic research to clinical applications and imaging trials [...] Full article
17 pages, 3945 KiB  
Article
Strain and Strain Rate Tensor Mapping of Medial Gastrocnemius at Submaximal Isometric Contraction and Three Ankle Angles
by Ryan Hernandez, Usha Sinha, Vadim Malis, Brandon Cunnane, Edward Smitaman and Shantanu Sinha
Tomography 2023, 9(2), 840-856; https://doi.org/10.3390/tomography9020068 - 11 Apr 2023
Cited by 2 | Viewed by 1429
Abstract
Introduction: The aim of this study is to analyze the muscle kinematics of the medial gastrocnemius (MG) during submaximal isometric contractions and to explore the relationship between deformation and force generated at plantarflexed (PF), neutral (N) and dorsiflexed (DF) ankle angles. Method: Strain [...] Read more.
Introduction: The aim of this study is to analyze the muscle kinematics of the medial gastrocnemius (MG) during submaximal isometric contractions and to explore the relationship between deformation and force generated at plantarflexed (PF), neutral (N) and dorsiflexed (DF) ankle angles. Method: Strain and Strain Rate (SR) tensors were calculated from velocity-encoded magnetic resonance phase-contrast images in six young men acquired during 25% and 50% Maximum Voluntary Contraction (MVC). Strain and SR indices as well as force normalized values were statistically analyzed using two-way repeated measures ANOVA for differences with force level and ankle angle. An exploratory analysis of differences between absolute values of longitudinal compressive strain (Eλ1) and radial expansion strains (Eλ2) and maximum shear strain (Emax) based on paired t-test was also performed for each ankle angle. Results: Compressive strains/SRs were significantly lower at 25%MVC. Normalized strains/SR were significantly different between %MVC and ankle angles with lowest values for DF. Absolute values of Eλ2 and Emax were significantly higher than Eλ1 for DF suggesting higher deformation asymmetry and higher shear strain, respectively. Conclusions: In addition to the known optimum muscle fiber length, the study identified two potential new causes of increased force generation at dorsiflexion ankle angle, higher fiber cross-section deformation asymmetry and higher shear strains. Full article
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11 pages, 938 KiB  
Article
Quantitative Analysis of the Clinical Reasons Influencing the Frequency of Pediatric Head CT Examinations: A Single-Center Observation Study
by Takayasu Yoshitake, Osamu Miyazaki, Masayuki Kitamura, Koji Ono and Michiaki Kai
Tomography 2023, 9(2), 829-839; https://doi.org/10.3390/tomography9020067 - 11 Apr 2023
Viewed by 1370
Abstract
Epidemiological studies on radiation exposure from pediatric CT scans have attracted attention in terms of radiological protection. These studies have not taken into account the reasons why CT examinations were performed. It is presumed that there are clinical reasons that justify more frequent [...] Read more.
Epidemiological studies on radiation exposure from pediatric CT scans have attracted attention in terms of radiological protection. These studies have not taken into account the reasons why CT examinations were performed. It is presumed that there are clinical reasons that justify more frequent CT examinations in children. The purpose of this study was to characterize the clinical reasons why relatively high numbers of head CT examinations (NHCT) are frequently performed and to conduct a statistical analysis to determine the factors governing the NHCT. Patient information, the date of examination, and medical conditions for examination data stored on the radiology information system were used to investigate the reasons for undergoing CT examinations. The target facility was National Children’s Hospital; data were obtained from March 2002 to April 2017, and the age of the study population was less than 16 years old. Quantitative analysis of the factors associated with frequent examinations was conducted by Poisson regression analysis. Among all patients who had a CT scan, 76.6% had head CT examinations, and 43.4% of children were under 1 year old at the time of the initial examination. There were marked differences in the number of examinations depending on the disease. The average NHCT was higher for children younger than 5 days of age. Among children less than 1 year of age with surgery, there was a marked difference between hydrocephalus, with a mean = 15.5 (95% CI 14.3,16.8), and trauma, with a mean = 8.3 (95% CI 7.2,9.4). In conclusion, this study revealed that NHCT was significantly higher in children who had undergone surgery than in those who had not been to the hospital. The clinical reasons behind patients with higher NHCT should be considered in investigating a causal relationship between CT exposure and brain tumors. Full article
(This article belongs to the Special Issue Radiation Dose Management in Computed Tomography)
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19 pages, 2601 KiB  
Concept Paper
Toward Practical Integration of Omic and Imaging Data in Co-Clinical Trials
by Emel Alkim, Heidi Dowst, Julie DiCarlo, Lacey E. Dobrolecki, Anadulce Hernández-Herrera, David A. Hormuth II, Yuxing Liao, Apollo McOwiti, Robia Pautler, Mothaffar Rimawi, Ashley Roark, Ramakrishnan Rajaram Srinivasan, Jack Virostko, Bing Zhang, Fei Zheng, Daniel L. Rubin, Thomas E. Yankeelov and Michael T. Lewis
Tomography 2023, 9(2), 810-828; https://doi.org/10.3390/tomography9020066 - 10 Apr 2023
Cited by 1 | Viewed by 1921
Abstract
Co-clinical trials are the concurrent or sequential evaluation of therapeutics in both patients clinically and patient-derived xenografts (PDX) pre-clinically, in a manner designed to match the pharmacokinetics and pharmacodynamics of the agent(s) used. The primary goal is to determine the degree to which [...] Read more.
Co-clinical trials are the concurrent or sequential evaluation of therapeutics in both patients clinically and patient-derived xenografts (PDX) pre-clinically, in a manner designed to match the pharmacokinetics and pharmacodynamics of the agent(s) used. The primary goal is to determine the degree to which PDX cohort responses recapitulate patient cohort responses at the phenotypic and molecular levels, such that pre-clinical and clinical trials can inform one another. A major issue is how to manage, integrate, and analyze the abundance of data generated across both spatial and temporal scales, as well as across species. To address this issue, we are developing MIRACCL (molecular and imaging response analysis of co-clinical trials), a web-based analytical tool. For prototyping, we simulated data for a co-clinical trial in “triple-negative” breast cancer (TNBC) by pairing pre- (T0) and on-treatment (T1) magnetic resonance imaging (MRI) from the I-SPY2 trial, as well as PDX-based T0 and T1 MRI. Baseline (T0) and on-treatment (T1) RNA expression data were also simulated for TNBC and PDX. Image features derived from both datasets were cross-referenced to omic data to evaluate MIRACCL functionality for correlating and displaying MRI-based changes in tumor size, vascularity, and cellularity with changes in mRNA expression as a function of treatment. Full article
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12 pages, 2829 KiB  
Article
Making CT Dose Monitoring Meaningful: Augmenting Dose with Imaging Quality
by Njood Alsaihati, Francesco Ria, Justin Solomon, Aiping Ding, Donald Frush and Ehsan Samei
Tomography 2023, 9(2), 798-809; https://doi.org/10.3390/tomography9020065 - 7 Apr 2023
Cited by 2 | Viewed by 1855
Abstract
Due to the concerns about radiation dose associated with medical imaging, radiation dose monitoring systems (RDMSs) are now utilized by many radiology providers to collect, process, analyze, and manage radiation dose-related information. Currently, most commercially available RDMSs focus only on radiation dose information [...] Read more.
Due to the concerns about radiation dose associated with medical imaging, radiation dose monitoring systems (RDMSs) are now utilized by many radiology providers to collect, process, analyze, and manage radiation dose-related information. Currently, most commercially available RDMSs focus only on radiation dose information and do not track any metrics related to image quality. However, to enable comprehensive patient-based imaging optimization, it is equally important to monitor image quality as well. This article describes how RDMS design can be extended beyond radiation dose to simultaneously monitor image quality. A newly designed interface was evaluated by different groups of radiology professionals (radiologists, technologists, and physicists) on a Likert scale. The results show that the new design is effective in assessing both image quality and safety in clinical practices, with an overall average score of 7.8 out of 10.0 and scores ranging from 5.5 to 10.0. Radiologists rated the interface highest at 8.4 out of 10.0, followed by technologists at 7.6 out of 10.0, and medical physicists at 7.5 out of 10.0. This work demonstrates how the assessment of the radiation dose can be performed in conjunction with the image quality using customizable user interfaces based on the clinical needs associated with different radiology professions. Full article
(This article belongs to the Special Issue Radiation Protection Opportunities in Medical Imaging)
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8 pages, 1461 KiB  
Article
Changes in Choroidal Circulation Hemodynamics Measured Using Laser Speckle Flowgraphy after a Cold Pressor Test in Young Healthy Participants
by Sakurako Imabayashi, Yuki Hashimoto, Yumi Ishimaru, Rino Umemoto, Miho Chiyozono, Toshitaka Yamanokuchi and Takeshi Yoshitomi
Tomography 2023, 9(2), 790-797; https://doi.org/10.3390/tomography9020064 - 6 Apr 2023
Cited by 4 | Viewed by 1400
Abstract
Using laser speckle flowgraphy (LSFG), we investigated the time course of changes in choroidal circulation hemodynamics after a cold pressor test in healthy eyes. This prospective study included the right eye of 19 young healthy participants. The macular mean blur rate (MBR) was [...] Read more.
Using laser speckle flowgraphy (LSFG), we investigated the time course of changes in choroidal circulation hemodynamics after a cold pressor test in healthy eyes. This prospective study included the right eye of 19 young healthy participants. The macular mean blur rate (MBR) was measured with LSFG. The MBR, intraocular pressure (IOP), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), mean blood pressure (MBP), and ocular perfusion pressure (OPP) were evaluated at baseline; immediately after the test and 10, 20, and 30 min later. Immediately after the test (0 min), SBP, DBP, MBP, and OPP were significantly elevated compared with those at baseline. The macular MBR significantly increased by +10.3 ± 7.1% immediately after the test. However, there was no change after 10, 20, and 30 min in the above parameter. A significant positive correlation of the macular MBR with the SBP, MBP, and OPP was observed. In young healthy individuals, increased sympathetic activity induced by a cold pressor test increases choroidal hemodynamics in the macula along with an increase in systemic circulatory dynamics, which normalizes after 10 min. Therefore, LSFG may provide a novel approach for assessing sympathetic activity and intrinsic vascular responsiveness in the eye. Full article
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14 pages, 280 KiB  
Article
Do We Need Another CT Scanner?—The Pilot Study of the Adoption of an Evolutionary Algorithm to Investment Decision Making in Healthcare
by Katarzyna Kolasa, Grzegorz Kozinski, Maria Wisniewska, Aleksandra Pohadajlo, Agata Nosowicz and Piotr Kulas
Tomography 2023, 9(2), 776-789; https://doi.org/10.3390/tomography9020063 - 5 Apr 2023
Viewed by 1428
Abstract
Objectives: The purpose of this study was to assess the feasibility of the adoption of a machine learning (ML) algorithm in support of the investment decisions regarding high cost medical devices based on available clinical and epidemiological evidence. Methods: Following a [...] Read more.
Objectives: The purpose of this study was to assess the feasibility of the adoption of a machine learning (ML) algorithm in support of the investment decisions regarding high cost medical devices based on available clinical and epidemiological evidence. Methods: Following a literature search, the set of epidemiological and clinical need predictors was established. Both the data from The Central Statistical Office and The National Health Fund were used. An evolutionary algorithm (EA) model was developed to obtain the prediction of the need for CT scanners across local counties in Poland (hypothetical scenario). The comparison between the historical allocation and the scenario developed by the EA model based on epidemiological and clinical need predictors was established. Only counties with available CT scanners were included in the study. Results: In total, over 4 million CT scan procedures performed across 130 counties in Poland between 2015 and 2019 were used to develop the EA model. There were 39 cases of agreement between historical data and hypothetical scenarios. In 58 cases, the EA model indicated the need for a lower number of CT scanners than the historical data. A greater number of CT procedures required compared with historical use was predicted for 22 counties. The remaining 11 cases were inconclusive. Conclusions: Machine learning techniques might be successfully applied to support the optimal allocation of limited healthcare resources. Firstly, they enable automatization of health policy making utilising historical, epidemiological, and clinical data. Secondly, they introduce flexibility and transparency thanks to the adoption of ML to investment decisions in the healthcare sector as well. Full article
(This article belongs to the Section Artificial Intelligence in Medical Imaging)
8 pages, 1302 KiB  
Article
The Efficacy of CT Temporal Subtraction Images for Fibrodysplasia Ossificans Progressiva
by Mami Iima, Ryo Sakamoto, Takahide Kakigi, Akira Yamamoto, Bungo Otsuki, Yuji Nakamoto, Junya Toguchida and Shuichi Matsuda
Tomography 2023, 9(2), 768-775; https://doi.org/10.3390/tomography9020062 - 3 Apr 2023
Cited by 2 | Viewed by 1482
Abstract
Purpose: To evaluate the usefulness of CT temporal subtraction (TS) images for detecting emerging or growing ectopic bone lesions in fibrodysplasia ossificans progressiva (FOP). Materials and Methods: Four patients with FOP were retrospectively included in this study. TS images were produced by subtracting [...] Read more.
Purpose: To evaluate the usefulness of CT temporal subtraction (TS) images for detecting emerging or growing ectopic bone lesions in fibrodysplasia ossificans progressiva (FOP). Materials and Methods: Four patients with FOP were retrospectively included in this study. TS images were produced by subtracting previously registered CT images from the current images. Two residents and two board-certified radiologists independently interpreted a pair of current and previous CT images for each subject with or without TS images. Changes in the visibility of the lesion, the usefulness of TS images for lesions with TS images, and the interpreter’s confidence level in their interpretation of each scan were assessed on a semiquantitative 5-point scale (0–4). The Wilcoxon signed-rank test was used to compare the evaluated scores between datasets with and without TS images. Results: The number of growing lesions tended to be larger than that of the emerging lesions in all cases. A higher sensitivity was found in residents and radiologists using TS compared to those not using TS. For all residents and radiologists, the dataset with TS tended to have more false-positive scans than the dataset without TS. All the interpreters recognized TS as useful, and confidence levels when using TS tended to be lower or the same as when not using TS for two residents and one radiologist. Conclusions: TS improved the sensitivity of all interpreters in detecting emerging or growing ectopic bone lesions in patients with FOP. TS could be applied further, including the areas of systematic bone disease. Full article
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9 pages, 590 KiB  
Communication
CT Scan-Guided Fine Needle Aspiration Cytology for Lung Cancer Diagnosis through the COVID-19 Pandemic: What We Have Learned
by Giulia Maria Stella, Vittorio Chino, Paola Putignano, Francesco Bertuccio, Francesco Agustoni, Laura Saracino, Stefano Tomaselli, Jessica Saddi, Davide Piloni and Chandra Bortolotto
Tomography 2023, 9(2), 759-767; https://doi.org/10.3390/tomography9020061 - 31 Mar 2023
Cited by 1 | Viewed by 1482
Abstract
Background and rationale. Novel coronavirus-related disease (COVID-19) has profoundly influenced hospital organization and structures worldwide. In Italy, the Lombardy Region, with almost 17% of the Italian population, rapidly became the most severely affected area since the pandemic beginning. The first and the following [...] Read more.
Background and rationale. Novel coronavirus-related disease (COVID-19) has profoundly influenced hospital organization and structures worldwide. In Italy, the Lombardy Region, with almost 17% of the Italian population, rapidly became the most severely affected area since the pandemic beginning. The first and the following COVID-19 surges significantly affected lung cancer diagnosis and subsequent management. Much data have been already published regarding the therapeutic repercussions whereas very few reports have focused on the consequences of the pandemic on diagnostic procedures. Methods. We, here, would like to analyze data of novel lung cancer diagnosis performed in our Institution in Norther Italy where we faced the earliest and largest outbreaks of COVID-19 in Italy. Results. We discuss, in detail, the strategies developed to perform biopsies and the safe pathways created in emergency settings to protect lung cancer patients in subsequent therapeutic phases. Quite unexpectedly, no significant differences emerged between cases enrolled during the pandemic and those before, and the two populations were homogeneous considering the composition and diagnostic and complication rates. Conclusions. By pointing out the role of multidisciplinarity in emergency contexts, these data will be of help in the future for designing tailored strategies to manage lung cancer in a real-life setting. Full article
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9 pages, 895 KiB  
Perspective
An Online Repository for Pre-Clinical Imaging Protocols (PIPs)
by Seth T. Gammon, Allison S. Cohen, Adrienne L. Lehnert, Daniel C. Sullivan, Dariya Malyarenko, Henry Charles Manning, David A. Hormuth, Heike E. Daldrup-Link, Hongyu An, James D. Quirk, Kooresh Shoghi, Mark David Pagel, Paul E. Kinahan, Robert S. Miyaoka, A. McGarry Houghton, Michael T. Lewis, Peder Larson, Renuka Sriram, Stephanie J. Blocker, Stephen Pickup, Alexandra Badea, Cristian T. Badea, Thomas E. Yankeelov and Thomas L. Chenevertadd Show full author list remove Hide full author list
Tomography 2023, 9(2), 750-758; https://doi.org/10.3390/tomography9020060 - 27 Mar 2023
Cited by 2 | Viewed by 2135
Abstract
Providing method descriptions that are more detailed than currently available in typical peer reviewed journals has been identified as an actionable area for improvement. In the biochemical and cell biology space, this need has been met through the creation of new journals focused [...] Read more.
Providing method descriptions that are more detailed than currently available in typical peer reviewed journals has been identified as an actionable area for improvement. In the biochemical and cell biology space, this need has been met through the creation of new journals focused on detailed protocols and materials sourcing. However, this format is not well suited for capturing instrument validation, detailed imaging protocols, and extensive statistical analysis. Furthermore, the need for additional information must be counterbalanced by the additional time burden placed upon researchers who may be already overtasked. To address these competing issues, this white paper describes protocol templates for positron emission tomography (PET), X-ray computed tomography (CT), and magnetic resonance imaging (MRI) that can be leveraged by the broad community of quantitative imaging experts to write and self-publish protocols in protocols.io. Similar to the Structured Transparent Accessible Reproducible (STAR) or Journal of Visualized Experiments (JoVE) articles, authors are encouraged to publish peer reviewed papers and then to submit more detailed experimental protocols using this template to the online resource. Such protocols should be easy to use, readily accessible, readily searchable, considered open access, enable community feedback, editable, and citable by the author. Full article
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14 pages, 30303 KiB  
Article
Metabolite-Specific Echo Planar Imaging for Preclinical Studies with Hyperpolarized 13C-Pyruvate MRI
by Sule I. Sahin, Xiao Ji, Shubhangi Agarwal, Avantika Sinha, Ivina Mali, Jeremy W. Gordon, Mark Mattingly, Sukumar Subramaniam, John Kurhanewicz, Peder E. Z. Larson and Renuka Sriram
Tomography 2023, 9(2), 736-749; https://doi.org/10.3390/tomography9020059 - 27 Mar 2023
Cited by 4 | Viewed by 2149
Abstract
Metabolite-specific echo-planar imaging (EPI) sequences with spectral–spatial (spsp) excitation are commonly used in clinical hyperpolarized [1-13C]pyruvate studies because of their speed, efficiency, and flexibility. In contrast, preclinical systems typically rely on slower spectroscopic methods, such as chemical shift imaging (CSI). In [...] Read more.
Metabolite-specific echo-planar imaging (EPI) sequences with spectral–spatial (spsp) excitation are commonly used in clinical hyperpolarized [1-13C]pyruvate studies because of their speed, efficiency, and flexibility. In contrast, preclinical systems typically rely on slower spectroscopic methods, such as chemical shift imaging (CSI). In this study, a 2D spspEPI sequence was developed for use on a preclinical 3T Bruker system and tested on in vivo mice experiments with patient-derived xenograft renal cell carcinoma (RCC) or prostate cancer tissues implanted in the kidney or liver. Compared to spspEPI sequences, CSI were found to have a broader point spread function via simulations and exhibited signal bleeding between vasculature and tumors in vivo. Parameters for the spspEPI sequence were optimized using simulations and verified with in vivo data. The expected lactate SNR and pharmacokinetic modeling accuracy increased with lower pyruvate flip angles (less than 15°), intermediate lactate flip angles (25° to 40°), and temporal resolution of 3 s. Overall SNR was also higher with coarser spatial resolution (4 mm isotropic vs. 2 mm isotropic). Pharmacokinetic modelling used to fit kPL maps showed results consistent with the previous literature and across different sequences and tumor xenografts. This work describes and justifies the pulse design and parameter choices for preclinical spspEPI hyperpolarized 13C-pyruvate studies and shows superior image quality to CSI. Full article
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15 pages, 5480 KiB  
Article
Textural Features of Mouse Glioma Models Measured by Dynamic Contrast-Enhanced MR Images with 3D Isotropic Resolution
by Karl Kiser, Jin Zhang and Sungheon Gene Kim
Tomography 2023, 9(2), 721-735; https://doi.org/10.3390/tomography9020058 - 24 Mar 2023
Viewed by 1710
Abstract
This paper investigates the effect of anisotropic resolution on the image textural features of pharmacokinetic (PK) parameters of a murine glioma model using dynamic contrast-enhanced (DCE) MR images acquired with an isotropic resolution at 7T with pre-contrast T1 mapping. The PK parameter maps [...] Read more.
This paper investigates the effect of anisotropic resolution on the image textural features of pharmacokinetic (PK) parameters of a murine glioma model using dynamic contrast-enhanced (DCE) MR images acquired with an isotropic resolution at 7T with pre-contrast T1 mapping. The PK parameter maps of whole tumors at isotropic resolution were generated using the two-compartment exchange model combined with the three-site-two-exchange model. The textural features of these isotropic images were compared with those of simulated, thick-slice, anisotropic images to assess the influence of anisotropic voxel resolution on the textural features of tumors. The isotropic images and parameter maps captured distributions of high pixel intensity that were absent in the corresponding anisotropic images with thick slices. A significant difference was observed in 33% of the histogram and textural features extracted from anisotropic images and parameter maps, compared to those extracted from corresponding isotropic images. Anisotropic images in different orthogonal orientations demonstrated 42.1% of the histogram and textural features to be significantly different from those of isotropic images. This study demonstrates that the anisotropy of voxel resolution needs to be carefully considered when comparing the textual features of tumor PK parameters and contrast-enhanced images. Full article
(This article belongs to the Special Issue Quantitative Imaging in Oncology)
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4 pages, 199 KiB  
Editorial
Optimizing Communication of Radiation Exposure in Medical Imaging, the Radiologist Challenge
by Chiara Pozzessere
Tomography 2023, 9(2), 717-720; https://doi.org/10.3390/tomography9020057 - 23 Mar 2023
Cited by 1 | Viewed by 1499
Abstract
Since I started my residency program in Radiology, I have been committed to promoting radiation protection, paying particular attention to the justification and optimization of the examinations [...] Full article
(This article belongs to the Special Issue Radiation Protection Opportunities in Medical Imaging)
11 pages, 2533 KiB  
Article
Repeated Lung Ultrasound versus Chest X-ray—Which One Predicts Better Clinical Outcome in COVID-19?
by Jakob Spogis, Stefano Fusco, Florian Hagen, Sascha Kaufmann, Nisar Malek and Tatjana Hoffmann
Tomography 2023, 9(2), 706-716; https://doi.org/10.3390/tomography9020056 - 21 Mar 2023
Cited by 3 | Viewed by 1779
Abstract
The purpose of this study was to evaluate whether changes in repeated lung ultrasound (LUS) or chest X-ray (CXR) of coronavirus disease 2019 (COVID-19) patients can predict the development of severe disease and the need for treatment in the intensive care unit (ICU). [...] Read more.
The purpose of this study was to evaluate whether changes in repeated lung ultrasound (LUS) or chest X-ray (CXR) of coronavirus disease 2019 (COVID-19) patients can predict the development of severe disease and the need for treatment in the intensive care unit (ICU). In this prospective monocentric study, COVID-19 patients received standardized LUS and CXR at day 1, 3 and 5. Scores for changes in LUS (LUS score) and CXR (RALE and M-RALE) were calculated and compared. Intra-class correlation was calculated for two readers of CXR and ROC analysis to evaluate the best discriminator for the need for ICU treatment. A total of 30 patients were analyzed, 26 patients with follow-up LUS and CXR. Increase in M-RALE between baseline and follow-up 1 was significantly higher in patients with need for ICU treatment in the further hospital stay (p = 0.008). Both RALE and M-RALE significantly correlated with LUS score (r = 0.5, p < 0.0001). ROC curves with need for ICU treatment as separator were not significantly different for changes in M-RALE (AUC: 0.87) and LUS score (AUC: 0.79), both being good discriminators. ICC was moderate for RALE (0.56) and substantial for M-RALE (0.74). The present study demonstrates that both follow-up LUS and CXR are powerful tools to track the evolution of COVID-19, and can be used equally as predictors for the need for ICU treatment. Full article
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13 pages, 1966 KiB  
Article
Characterization of Effects of Compressed Sensing on High Spectral and Spatial Resolution (HiSS) MRI with Comparison to SENSE
by Milica Medved, Marco Vicari and Gregory S. Karczmar
Tomography 2023, 9(2), 693-705; https://doi.org/10.3390/tomography9020055 - 19 Mar 2023
Viewed by 1274
Abstract
High Spectral and Spatial resolution (HiSS) MRI shows high diagnostic performance in the breast. Acceleration methods based on k-space undersampling could allow stronger T2*-based image contrast and/or higher spectral resolution, potentially increasing diagnostic performance. An agar/oil phantom was prepared with water-fat boundaries perpendicular [...] Read more.
High Spectral and Spatial resolution (HiSS) MRI shows high diagnostic performance in the breast. Acceleration methods based on k-space undersampling could allow stronger T2*-based image contrast and/or higher spectral resolution, potentially increasing diagnostic performance. An agar/oil phantom was prepared with water-fat boundaries perpendicular to the readout and phase encoding directions in a breast coil. HiSS MRI was acquired at 3T, at sensitivity encoding (SENSE) acceleration factors R of up to 10, and the R = 1 dataset was used to simulate corresponding compressed sensing (CS) accelerations. Image quality was evaluated by quantifying noise and artifact levels. Effective spatial resolution was determined via modulation transfer function analysis. Dispersion vs. absorption (DISPA) analysis and full width at half maximum (FWHM) quantified spectral lineshape changes. Noise levels remained constant with R for CS but amplified with SENSE. SENSE preserved the spatial resolution of HiSS MRI, while CS reduced it in the phase encoding direction. SENSE showed no effect on FWHM or DISPA markers, while CS increased FWHM. Thus, CS might perform better in noise-limited or geometrically constrained applications, but in geometric configurations specific to breast MRI, spectral analysis might be compromised, decreasing the diagnostic performance of HiSS MRI. Full article
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12 pages, 3836 KiB  
Article
Different Ultrasound Shear Wave Elastography Techniques as Novel Imaging-Based Approaches for Quantitative Evaluation of Hepatic Steatosis—Preliminary Findings
by Natascha Platz Batista da Silva, Gregor Scharf, Lukas Lürken, Niklas Verloh, Stephan Schleder, Christian Stroszczynski, Ernst Michael Jung and Michael Haimerl
Tomography 2023, 9(2), 681-692; https://doi.org/10.3390/tomography9020054 - 16 Mar 2023
Cited by 3 | Viewed by 1593
Abstract
Background: Modern ultrasound (US) shear-wave dispersion (SWD) and attenuation imaging (ATI) can be used to quantify changes in the viscosity and signal attenuation of the liver parenchyma, which are altered in hepatic steatosis. We aimed to evaluate modern shear-wave elastography (SWE), SWD and [...] Read more.
Background: Modern ultrasound (US) shear-wave dispersion (SWD) and attenuation imaging (ATI) can be used to quantify changes in the viscosity and signal attenuation of the liver parenchyma, which are altered in hepatic steatosis. We aimed to evaluate modern shear-wave elastography (SWE), SWD and ATI for the assessment of hepatic steatosis. Methods: We retrospectively analyzed the US data of 15 patients who underwent liver USs and MRIs for the evaluation of parenchymal disease/liver lesions. The USs were performed using a multifrequency convex probe (1–8 MHz). The quantitative US measurements for the SWE (m/s/kPa), the SWD (kPa-m/s/kHz) and the ATI (dB/cm/MHz) were acquired after the mean value of five regions of interest (ROIs) was calculated. The liver MRI (3T) quantification of hepatic steatosis was performed by acquiring proton density fat fraction (PDFF) mapping sequences and placing five ROIs in artifact-free areas of the PDFF scan, measuring the fat-signal fraction. We correlated the SWE, SWD and ATI measurements to the PDFF results. Results: Three patients showed mild steatosis, one showed moderate steatosis and eleven showed no steatosis in the PDFF sequences. The calculated SWE cut-off (2.5 m/s, 20.4 kPa) value identified 3/4 of patients correctly (AUC = 0.73, p > 0.05). The SWD cut-off of 18.5 m/s/kHz, which had a significant correlation (r = 0.55, p = 0.034) with the PDFF results (AUC = 0.73), identified four patients correctly (p < 0.001). The ideal ATI (AUC = 0.53 (p < 0.05)) cut-off was 0.59 dB/cm/MHz, which showed a significantly good correlation with the PDFF results (p = 0.024). Conclusion: Hepatic steatosis can be accurately detected using all the US-elastography techniques applied in this study, although the SWD and the SWE showed to be more sensitive than the PDFF. Full article
(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)
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24 pages, 3249 KiB  
Review
Animal Models and Their Role in Imaging-Assisted Co-Clinical Trials
by Donna M. Peehl, Cristian T. Badea, Thomas L. Chenevert, Heike E. Daldrup-Link, Li Ding, Lacey E. Dobrolecki, A. McGarry Houghton, Paul E. Kinahan, John Kurhanewicz, Michael T. Lewis, Shunqiang Li, Gary D. Luker, Cynthia X. Ma, H. Charles Manning, Yvonne M. Mowery, Peter J. O'Dwyer, Robia G. Pautler, Mark A. Rosen, Raheleh Roudi, Brian D. Ross, Kooresh I. Shoghi, Renuka Sriram, Moshe Talpaz, Richard L. Wahl and Rong Zhouadd Show full author list remove Hide full author list
Tomography 2023, 9(2), 657-680; https://doi.org/10.3390/tomography9020053 - 16 Mar 2023
Cited by 3 | Viewed by 3762
Abstract
The availability of high-fidelity animal models for oncology research has grown enormously in recent years, enabling preclinical studies relevant to prevention, diagnosis, and treatment of cancer to be undertaken. This has led to increased opportunities to conduct co-clinical trials, which are studies on [...] Read more.
The availability of high-fidelity animal models for oncology research has grown enormously in recent years, enabling preclinical studies relevant to prevention, diagnosis, and treatment of cancer to be undertaken. This has led to increased opportunities to conduct co-clinical trials, which are studies on patients that are carried out parallel to or sequentially with animal models of cancer that mirror the biology of the patients’ tumors. Patient-derived xenografts (PDX) and genetically engineered mouse models (GEMM) are considered to be the models that best represent human disease and have high translational value. Notably, one element of co-clinical trials that still needs significant optimization is quantitative imaging. The National Cancer Institute has organized a Co-Clinical Imaging Resource Program (CIRP) network to establish best practices for co-clinical imaging and to optimize translational quantitative imaging methodologies. This overview describes the ten co-clinical trials of investigators from eleven institutions who are currently supported by the CIRP initiative and are members of the Animal Models and Co-clinical Trials (AMCT) Working Group. Each team describes their corresponding clinical trial, type of cancer targeted, rationale for choice of animal models, therapy, and imaging modalities. The strengths and weaknesses of the co-clinical trial design and the challenges encountered are considered. The rich research resources generated by the members of the AMCT Working Group will benefit the broad research community and improve the quality and translational impact of imaging in co-clinical trials. Full article
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10 pages, 1886 KiB  
Article
Using Deep-Learning-Based Artificial Intelligence Technique to Automatically Evaluate the Collateral Status of Multiphase CTA in Acute Ischemic Stroke
by Chun-Chao Huang, Hsin-Fan Chiang, Cheng-Chih Hsieh, Chao-Liang Chou, Zong-Yi Jhou, Ting-Yi Hou and Jin-Siang Shaw
Tomography 2023, 9(2), 647-656; https://doi.org/10.3390/tomography9020052 - 16 Mar 2023
Cited by 4 | Viewed by 2007
Abstract
Background: Collateral status is an important predictor for the outcome of acute ischemic stroke with large vessel occlusion. Multiphase computed-tomography angiography (mCTA) is useful to evaluate the collateral status, but visual evaluation of this examination is time-consuming. This study aims to use an [...] Read more.
Background: Collateral status is an important predictor for the outcome of acute ischemic stroke with large vessel occlusion. Multiphase computed-tomography angiography (mCTA) is useful to evaluate the collateral status, but visual evaluation of this examination is time-consuming. This study aims to use an artificial intelligence (AI) technique to develop an automatic AI prediction model for the collateral status of mCTA. Methods: This retrospective study enrolled subjects with acute ischemic stroke receiving endovascular thrombectomy between January 2015 and June 2020 in a tertiary referral hospital. The demographic data and images of mCTA were collected. The collateral status of all mCTA was visually evaluated. Images at the basal ganglion and supraganglion levels of mCTA were selected to produce AI models using the convolutional neural network (CNN) technique to automatically predict the collateral status of mCTA. Results: A total of 82 subjects were enrolled. There were 57 cases randomly selected for the training group and 25 cases for the validation group. In the training group, there were 40 cases with a positive collateral result (good or intermediate) and 17 cases with a negative collateral result (poor). In the validation group, there were 21 cases with a positive collateral result and 4 cases with a negative collateral result. During training for the CNN prediction model, the accuracy of the training group could reach 0.999 ± 0.015, whereas the prediction model had a performance of 0.746 ± 0.008 accuracy on the validation group. The area under the ROC curve was 0.7. Conclusions: This study suggests that the application of the AI model derived from mCTA images to automatically evaluate the collateral status is feasible. Full article
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14 pages, 2363 KiB  
Article
Spectroscopic MRI-Guided Proton Therapy in Non-Enhancing Pediatric High-Grade Glioma
by Vicki Huang, Abinand Rejimon, Kartik Reddy, Anuradha G. Trivedi, Karthik K. Ramesh, Alexander S. Giuffrida, Robert Muiruri, Hyunsuk Shim and Bree R. Eaton
Tomography 2023, 9(2), 633-646; https://doi.org/10.3390/tomography9020051 - 9 Mar 2023
Viewed by 1787
Abstract
Radiation therapy (RT) is a critical part of definitive therapy for pediatric high-grade glioma (pHGG). RT is designed to treat residual tumor defined on conventional MRI (cMRI), though pHGG lesions may be ill-characterized on standard imaging. Spectroscopic MRI (sMRI) measures endogenous metabolite concentrations [...] Read more.
Radiation therapy (RT) is a critical part of definitive therapy for pediatric high-grade glioma (pHGG). RT is designed to treat residual tumor defined on conventional MRI (cMRI), though pHGG lesions may be ill-characterized on standard imaging. Spectroscopic MRI (sMRI) measures endogenous metabolite concentrations in the brain, and Choline (Cho)/N-acetylaspartate (NAA) ratio is a highly sensitive biomarker for metabolically active tumor. We provide a preliminary report of our study introducing a novel treatment approach of whole brain sMRI-guided proton therapy for pHGG. An observational cohort (c1 = 10 patients) receives standard of care RT; a therapeutic cohort (c2 = 15 patients) receives sMRI-guided proton RT. All patients undergo cMRI and sMRI, a high-resolution 3D whole-brain echo-planar spectroscopic imaging (EPSI) sequence (interpolated resolution of 12 µL) prior to RT and at several follow-up timepoints integrated into diagnostic scans. Treatment volumes are defined by cMRI for c1 and by cMRI and Cho/NAA ≥ 2x for c2. A longitudinal imaging database is used to quantify changes in lesion and metabolite volumes. Four subjects have been enrolled (c1 = 1/c2 = 3) with sMRI imaging follow-up of 4–18 months. Preliminary data suggest sMRI improves identification of pHGG infiltration based on abnormal metabolic activity, and using proton therapy to target sMRI-defined high-risk regions is safe and feasible. Full article
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12 pages, 1750 KiB  
Article
Comparing Radiation Dose of Cerebral Angiography Using Conventional and High kV Techniques: A Retrospective Study on Intracranial Aneurysm Patients and a Phantom Study
by Woranan Kirisattayakul, Panuwat Pattum, Waranon Munkong, Thawatchai Prabsattroo, Chonnatcha Khottapat, Tanyalak Chomkhunthod and Vithit Pungkun
Tomography 2023, 9(2), 621-632; https://doi.org/10.3390/tomography9020050 - 8 Mar 2023
Cited by 2 | Viewed by 1727
Abstract
Evaluation of patient radiation dose after the implementation of a high kV technique during a cerebral angiographic procedure is an important issue. This study aimed to determine and compare the patient radiation dose of intracranial aneurysm patients undergoing cerebral angiography using the conventional [...] Read more.
Evaluation of patient radiation dose after the implementation of a high kV technique during a cerebral angiographic procedure is an important issue. This study aimed to determine and compare the patient radiation dose of intracranial aneurysm patients undergoing cerebral angiography using the conventional and high kV techniques in a retrospective study and a phantom study. A total of 122 cases (61 cases with conventional technique and 61 cases with high kV technique) of intracranial aneurysm patients, who underwent cerebral angiographic procedure and met the inclusion criteria, were recruited. The radiation dose and the angiographic exposure parameters were reviewed retrospectively. The radiation dose in the phantom study was conducted using nanoDotTM optically stimulating luminescence (OSLD), which were placed on the scalp of the head phantom, the back of the neck, and the phantom skin at the position of the eyes. The standard cerebral angiographic procedure using the conventional and high kV techniques was performed following the standard protocol. The results showed that the high kV technique significantly reduced patient radiation dose and phantom skin dose. This study confirms that the implementation of a high kV technique in routine cerebral angiography for aneurysm diagnosis provides an effective reduction in radiation dose. Further investigation of radiation dose in other interventional neuroradiology procedures, particularly embolization procedure, should be performed. Full article
(This article belongs to the Special Issue Radiation Protection Opportunities in Medical Imaging)
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18 pages, 5589 KiB  
Article
MRI of Implantation Sites Using Parallel Transmission of an Optimized Radiofrequency Excitation Vector
by Mostafa Berangi, Andre Kuehne, Helmar Waiczies and Thoralf Niendorf
Tomography 2023, 9(2), 603-620; https://doi.org/10.3390/tomography9020049 - 8 Mar 2023
Cited by 1 | Viewed by 1571
Abstract
Postoperative care of orthopedic implants is aided by imaging to assess the healing process and the implant status. MRI of implantation sites might be compromised by radiofrequency (RF) heating and RF transmission field (B1+) inhomogeneities induced by electrically conducting [...] Read more.
Postoperative care of orthopedic implants is aided by imaging to assess the healing process and the implant status. MRI of implantation sites might be compromised by radiofrequency (RF) heating and RF transmission field (B1+) inhomogeneities induced by electrically conducting implants. This study examines the applicability of safe and B1+-distortion-free MRI of implantation sites using optimized parallel RF field transmission (pTx) based on a multi-objective genetic algorithm (GA). Electromagnetic field simulations were performed for eight eight-channel RF array configurations (f = 297.2 MHz), and the most efficient array was manufactured for phantom experiments at 7.0 T. Circular polarization (CP) and orthogonal projection (OP) algorithms were applied for benchmarking the GA-based shimming. B1+ mapping and MR thermometry and imaging were performed using phantoms mimicking muscle containing conductive implants. The local SAR10g of the entire phantom in GA was 12% and 43.8% less than the CP and OP, respectively. Experimental temperature mapping using the CP yielded ΔT = 2.5–3.0 K, whereas the GA induced no extra heating. GA-based shimming eliminated B1+ artefacts at implantation sites and enabled uniform gradient-echo MRI. To conclude, parallel RF transmission with GA-based excitation vectors provides a technical foundation en route to safe and B1+-distortion-free MRI of implantation sites. Full article
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14 pages, 2564 KiB  
Article
Improved Repeatability of Mouse Tibia Volume Segmentation in Murine Myelofibrosis Model Using Deep Learning
by Aman Kushwaha, Rami F. Mourad, Kevin Heist, Humera Tariq, Heang-Ping Chan, Brian D. Ross, Thomas L. Chenevert, Dariya Malyarenko and Lubomir M. Hadjiiski
Tomography 2023, 9(2), 589-602; https://doi.org/10.3390/tomography9020048 - 7 Mar 2023
Cited by 2 | Viewed by 2050
Abstract
A murine model of myelofibrosis in tibia was used in a co-clinical trial to evaluate segmentation methods for application of image-based biomarkers to assess disease status. The dataset (32 mice with 157 3D MRI scans including 49 test–retest pairs scanned on consecutive days) [...] Read more.
A murine model of myelofibrosis in tibia was used in a co-clinical trial to evaluate segmentation methods for application of image-based biomarkers to assess disease status. The dataset (32 mice with 157 3D MRI scans including 49 test–retest pairs scanned on consecutive days) was split into approximately 70% training, 10% validation, and 20% test subsets. Two expert annotators (EA1 and EA2) performed manual segmentations of the mouse tibia (EA1: all data; EA2: test and validation). Attention U-net (A-U-net) model performance was assessed for accuracy with respect to EA1 reference using the average Jaccard index (AJI), volume intersection ratio (AVI), volume error (AVE), and Hausdorff distance (AHD) for four training scenarios: full training, two half-splits, and a single-mouse subsets. The repeatability of computer versus expert segmentations for tibia volume of test–retest pairs was assessed by within-subject coefficient of variance (%wCV). A-U-net models trained on full and half-split training sets achieved similar average accuracy (with respect to EA1 annotations) for test set: AJI = 83–84%, AVI = 89–90%, AVE = 2–3%, and AHD = 0.5 mm–0.7 mm, exceeding EA2 accuracy: AJ = 81%, AVI = 83%, AVE = 14%, and AHD = 0.3 mm. The A-U-net model repeatability wCV [95% CI]: 3 [2, 5]% was notably better than that of expert annotators EA1: 5 [4, 9]% and EA2: 8 [6, 13]%. The developed deep learning model effectively automates murine bone marrow segmentation with accuracy comparable to human annotators and substantially improved repeatability. Full article
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10 pages, 2326 KiB  
Article
Two-Dimensional Post-Traumatic Measurements of Orbital Floor Blowout Fractures Underestimate Defect Sizes Compared to Three-Dimensional Approaches
by Juergen Taxis, Lena Ungerboeck, Mika R. Gehrking, Constantin Motel, Matthias Wurm, Alexander W. Eckert, Gerrit Spanier, Felix Nieberle, Natascha Platz Batista da Silva, Nils Ludwig, Johannes K. Meier, Tobias Ettl, Torsten E. Reichert and Steffen Spoerl
Tomography 2023, 9(2), 579-588; https://doi.org/10.3390/tomography9020047 - 5 Mar 2023
Cited by 2 | Viewed by 2080
Abstract
Orbital floor fractures represent a common fracture type of the midface and are standardly diagnosed clinically as well as radiologically using linear measurement methods. The aim of this study was to evaluate the accuracy of diagnostic measurements of isolated orbital floor fractures based [...] Read more.
Orbital floor fractures represent a common fracture type of the midface and are standardly diagnosed clinically as well as radiologically using linear measurement methods. The aim of this study was to evaluate the accuracy of diagnostic measurements of isolated orbital floor fractures based on two-dimensional (2D) and three-dimensional (3D) measurement techniques. A cohort of 177 patients was retrospectively and multi-centrically evaluated after surgical treatment of an orbital floor fracture between 2010 and 2020. In addition to 2D and 3D measurements of the fracture area, further fracture-related parameters were investigated. Calculated fracture areas using the 2D measurement technique revealed an average area of 287.59 mm2, whereas the 3D measurement showed fracture areas with a significantly larger average value of 374.16 mm2 (p < 0.001). On average, the 3D measurements were 1.53-fold larger compared to the 2D measurements. This was observed in 145 patients, whereas only 32 patients showed smaller values in the 3D-based approach. However, the process duration of the 3D measurement took approximately twice as long as the 2D-based procedure. Nonetheless, 3D-based measurement of orbital floor defects provides a more accurate estimation of the fracture area than the 2D-based procedure and can be helpful in determining the indication and planning the surgical procedure. Full article
(This article belongs to the Special Issue New Trends in Diagnostic and Interventional Radiology)
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12 pages, 4969 KiB  
Article
Integrated Small Animal PET/CT/RT with Onboard PET/CT Image Guidance for Preclinical Radiation Oncology Research
by Xinyi Cheng, Dongxu Yang, Debabrata Saha, Xiankai Sun and Yiping Shao
Tomography 2023, 9(2), 567-578; https://doi.org/10.3390/tomography9020046 - 4 Mar 2023
Cited by 1 | Viewed by 2013
Abstract
We have integrated a compact and lightweight PET with an existing CT image-guided small animal irradiator to enable practical onboard PET/CT image-guided preclinical radiation therapy (RT) research. The PET with a stationary and full-ring detectors has ~1.1 mm uniform spatial resolution over its [...] Read more.
We have integrated a compact and lightweight PET with an existing CT image-guided small animal irradiator to enable practical onboard PET/CT image-guided preclinical radiation therapy (RT) research. The PET with a stationary and full-ring detectors has ~1.1 mm uniform spatial resolution over its imaging field-of-view of 8.0 cm diameter and 3.5 cm axial length and was mechanically installed inside the irradiator in a tandem configuration with CT and radiation unit. A common animal bed was used for acquiring sequential dual functional and anatomical images with independent PET and CT control and acquisition systems. The reconstructed dual images were co-registered based on standard multi-modality image calibration and registration processes. Phantom studies were conducted to evaluate the integrated system and dual imaging performance. The measured mean PET/CT image registration error was ~0.3 mm. With one-bed and three-bed acquisitions, initial tumor focused and whole-body [18F]FDG animal images were acquired to test the capability of onboard PET/CT image guidance for preclinical RT research. Overall, the results have shown that integrated PET/CT/RT can provide advantageous and practical onboard PET/CT image to significantly enhance the accuracy of tumor delineation and radiation targeting that should enhance the existing and enable new and potentially breakthrough preclinical RT research and applications. Full article
(This article belongs to the Special Issue Advances of PET-CT Imaging in Oncology)
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15 pages, 2034 KiB  
Article
Repeatability of Quantitative Magnetic Resonance Imaging Biomarkers in the Tibia Bone Marrow of a Murine Myelofibrosis Model
by Brian D. Ross, Dariya Malyarenko, Kevin Heist, Ghoncheh Amouzandeh, Youngsoon Jang, Christopher A. Bonham, Cyrus Amirfazli, Gary D. Luker and Thomas L. Chenevert
Tomography 2023, 9(2), 552-566; https://doi.org/10.3390/tomography9020045 - 28 Feb 2023
Cited by 2 | Viewed by 2054
Abstract
Quantitative MRI biomarkers are sought to replace painful and invasive sequential bone-marrow biopsies routinely used for myelofibrosis (MF) cancer monitoring and treatment assessment. Repeatability of MRI-based quantitative imaging biomarker (QIB) measurements was investigated for apparent diffusion coefficient (ADC), proton density fat fraction (PDFF), [...] Read more.
Quantitative MRI biomarkers are sought to replace painful and invasive sequential bone-marrow biopsies routinely used for myelofibrosis (MF) cancer monitoring and treatment assessment. Repeatability of MRI-based quantitative imaging biomarker (QIB) measurements was investigated for apparent diffusion coefficient (ADC), proton density fat fraction (PDFF), and magnetization transfer ratio (MTR) in a JAK2 V617F hematopoietic transplant model of MF. Repeatability coefficients (RCs) were determined for three defined tibia bone-marrow sections (2–9 mm; 10–12 mm; and 12.5–13.5 mm from the knee joint) across 15 diseased mice from 20–37 test-retest pairs. Scans were performed on consecutive days every two weeks for a period of 10 weeks starting 3–4 weeks after transplant. The mean RC with (95% confidence interval (CI)) for these sections, respectively, were for ADC: 0.037 (0.031, 0.050), 0.087 (0.069, 0.116), and 0.030 (0.022, 0.044) μm2/ms; for PDFF: 1.6 (1.3, 2.0), 15.5 (12.5, 20.2), and 25.5 (12.0, 33.0)%; and for MTR: 0.16 (0.14, 0.19), 0.11 (0.09, 0.15), and 0.09 (0.08, 0.15). Change-trend analysis of these QIBs identified a dynamic section within the mid-tibial bone marrow in which confident changes (exceeding RC) could be observed after a four-week interval between scans across all measured MRI-based QIBs. Our results demonstrate the capability to derive quantitative imaging metrics from mouse tibia bone marrow for monitoring significant longitudinal MF changes. Full article
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11 pages, 1417 KiB  
Systematic Review
Initial CT Imaging Predicts Mortality in Severe Traumatic Brain Injuries in Pediatric Population—A Systematic Review and Meta-Analysis
by Doris Goubran, Divjeet Batoo, Janice Linton and Jai Shankar
Tomography 2023, 9(2), 541-551; https://doi.org/10.3390/tomography9020044 - 27 Feb 2023
Cited by 1 | Viewed by 2391
Abstract
The purpose of this systematic review was to analyze evidence based on existing studies on the ability of initial CT imaging to predict mortality in severe traumatic brain injuries (TBIs) in pediatric patients. An experienced librarian searched for all existing studies based on [...] Read more.
The purpose of this systematic review was to analyze evidence based on existing studies on the ability of initial CT imaging to predict mortality in severe traumatic brain injuries (TBIs) in pediatric patients. An experienced librarian searched for all existing studies based on the inclusion and exclusion criteria. The studies were screened by two blinded reviewers. Of the 3277 studies included in the search, data on prevalence of imaging findings and mortality rate could only be extracted from 22 studies. A few of those studies had patient-specific data relating specific imaging findings to outcome, allowing the data analysis, calculation of the area under the curve (AUC) and receiver operating characteristic (ROC), and generation of a forest plot for each finding. The data were extracted to calculate the sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predicted value (NPV), AUC, and ROC for extradural hematoma (EDH), subdural hematoma (SDH), traumatic subarachnoid hemorrhage (tSAH), skull fractures, and edema. There were a total of 2219 patients, 747 females and 1461 males. Of the total, 564 patients died and 1651 survived; 293 patients had SDH, 76 had EDH, 347 had tSAH, 244 had skull fractures, and 416 had edema. The studies included had high bias and lower grade of evidence. Out of the different CT scan findings, brain edema had the highest SN, PPV, NPV, and AUC. EDH had the highest SP to predict in-hospital mortality. Full article
(This article belongs to the Special Issue Diagnostic and Interventional Radiology in Neuroendocrine Tumor)
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12 pages, 6251 KiB  
Article
Recognition of Facial Emotion Expressions in Patients with Depressive Disorders: A Functional MRI Study
by Sergey Ternovoy, Dmitry Ustyuzhanin, Merab Shariya, Alena Beliaevskaia, Ernesto Roldan-Valadez, Rodion Shishorin, Roman Akhapkin and Beatrice Volel
Tomography 2023, 9(2), 529-540; https://doi.org/10.3390/tomography9020043 - 27 Feb 2023
Cited by 3 | Viewed by 1755
Abstract
Background: The present study evaluated the cortical activation during emotional information recognition. Methods: The study group included 16 patients with depression, and 16 healthy subjects were enrolled as a control group. Patients received eight weeks of antidepressant therapy. Functional MRI evaluated the cortical [...] Read more.
Background: The present study evaluated the cortical activation during emotional information recognition. Methods: The study group included 16 patients with depression, and 16 healthy subjects were enrolled as a control group. Patients received eight weeks of antidepressant therapy. Functional MRI evaluated the cortical activation twice in the patient group and once in the control group. The fMRI task processed the emotional information with face demonstration from the PennCNP test battery. Results: During the processing of emotional information, patients showed activation in the middle and the inferior frontal gyri, the fusiform gyrus, and the occipital cortex. After treatment, patients showed a significant decrease in the frontal cortex activation for negative face demonstration and no frontal activation for positive emotion recognition. The left superior temporal gyrus activation zone appeared in patients after treatment and in the control group. Healthy subjects showed more intense frontal cortex activation when processing neutral emotions and less when showing happy and sad faces. Activation zones in the amygdala and the insula and deactivation zones in the posterior cingulate cortex were revealed in the controls. Conclusion: This study confirms the hypothesis that anomalies in the processing of emotional stimuli can be a sign of a depressive disorder. Full article
(This article belongs to the Special Issue Innovative Approaches in Neuronal Imaging and Mental Health)
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