Biomedical subjects

Justin L Ducote

Publications and source records attributed to Justin L Ducote.

6 recordsLinked to original sources

PubMed2006

Dual-energy cardiac imaging: an image quality and dose comparison for a flat-panel detector and x-ray image intensifier.

This study presents a comparison of dual-energy imaging with an x-ray image intensifier and flat-panel detector for cardiac imaging. It also investigates if the wide dynamic range of the flat-panel detector can improve dual-energy image quality while reducing patient dose. Experimental contrast-to-noise (CNR) measurements were carried out in addition to simulation studies. Patient entrance exposure and system tube loading were also recorded. The studied contrast objects were calcium and iodine. System performance was quantified with a figure-of-merit (FOM) defined as the image CNR(2) over patient entrance exposure. The range of thickness studied was from 10 to 30 cm of Lucite (PMMA). Detector dose was initially set to 140 nGy (16 microR)/frame. The high-energy 120 kVp beam was filtered by an additional 0.8 mm silver filter. Keeping the same filament current, the kVp for the low-energy beam was adjusted as a function of thickness until 140 nGy was achieved. System performance was found to be similar for both systems, with the x-ray image intensifier performing better at lower thicknesses and the flat-panel detector performing better at higher thicknesses. This requirement of fixed detector entrance exposure was then relaxed and the kVp for the low-energy beam was allowed to vary while the mAs of the x-ray tube remained fixed to study changes in dual-energy image quality, patient dose and FOM with the flat-panel detector. It was found that as the kVp for the low-energy beam was reduced, system performance would rise until reaching a maximum while simultaneously lowering patient exposure. Suggested recommendations for optimal dual-energy imaging implementation are also provided.

Bone and Bones↗

PubMed2006

Positron autoradiography for intravascular imaging: feasibility evaluation.

Approximately 70% of acute coronary artery disease is caused by unstable (vulnerable) plaques with an inflammation of the overlying cap and high lipid content. A rupturing of the inflamed cap of the plaque results in propagation of the thrombus into the lumen, blockage of the artery and acute ischaemic syndrome or sudden death. Morphological imaging such as angiography or intravascular ultrasound cannot determine inflammation status of the plaque. A radiotracer such as 18F-FDG is accumulated in vulnerable plaques due to higher metabolic activity of the inflamed cap and could be used to detect a vulnerable plaque. However, positron emission tomography (PET) cannot detect the FDG-labelled plaques because of respiratory and heart motions, small size and low activity of the plaques. Plaques can be detected using a miniature particle (positron) detector inserted into the artery. In this work, a new detector concept is investigated for intravascular imaging of the plaques. The detector consists of a storage phosphor tip bound to the end of an intravascular catheter. It can be inserted into an artery, absorb the 18F-FDG positrons from the plaques, withdrawn from the artery and read out. Length and diameter of the storage phosphor tip can be matched to the length and the diameter of the artery. Monte Carlo simulations and experimental evaluations of coronary plaque imaging with the proposed detector were performed. It was shown that the sensitivity of the storage phosphor detector to the positrons of 18F-FDG is sufficient to detect coronary plaques with 1 mm and 2 mm sizes and 590 Bq and 1180 Bq activities in the arteries with 2 mm and 3 mm diameters, respectively. An experimental study was performed using plastic tubes with 2 mm diameter filled with an FDG solution, which simulates blood. FDG spots simulating plaques were placed over the surface of the tube. A phosphor tip was inserted into the tube and imaged the plaques. Exposure time was 1 min in all simulations and experiments. Experiments showed that detecting the coronary plaques using the proposed technique is possible. The proposed technique has the potential for fast and accurate detection of vulnerable coronary and other intravascular plaques.

Autoradiography↗

PubMed2006

Automated technique for angiographic determination of coronary blood flow and lumen volume.

RATIONALE AND OBJECTIVES: Visual interpretation of angiographic images has been shown to be inadequate for assessing the severity of intermediate coronary stenoses. An approach for evaluating both the anatomic and functional impact of a stenosis is needed. An automated technique for determining both coronary blood flow and lumen volume based on a first-pass analysis (FPA) of coronary angiograms and a template matching algorithm was evaluated. MATERIALS AND METHODS: Coronary angiograms of a swine animal model were obtained during power injections of contrast material into the left coronary ostium. Background anatomy was subtracted with an automated phase matching program. A template matching algorithm and first-pass analysis were then used to quantify coronary blood flow and lumen volume. Coronary blood flow and lumen volume measurements were validated with a transit-time ultrasound flow probe and a polymer cast of the coronary arteries, respectively. RESULTS: In 14 independent comparisons, the mean coronary blood flow measured with FPA showed strong correlation with the mean flow measured with the ultrasound flow probe (Q(FPA) = 0.88Q(probe) - 1.99; r = 0.977; standard error of estimate = 3.23 mL/minute). The lumen volumes determined with FPA and cast measurements demonstrated excellent correlation and can be related to each other by V(FPA) = 0.95V(C) - 0.01 (r = 0.997; standard error of estimate = 0.01 mL). CONCLUSIONS: The proposed automated method for accurate determination of coronary blood flow and lumen volume can supplement visual evaluation of coronary anatomy with quantitative physiologic data. This automated technique potentially offers a clinically feasible method of quantifying coronary blood flow and lumen volume in conjunction with routine cardiac catheterization.

Algorithms↗

PubMed2006

Optimization of a flat-panel based real time dual-energy system for cardiac imaging.

A simulation study was conducted to evaluate the effects of high-energy beam filtration, dual-gain operation and noise reduction on dual-energy images using a digital flat-panel detector. High-energy beam filtration increases image contrast through greater beam separation and tends to reduce total radiation exposure and dose per image pair. It is also possible to reduce dual-energy image noise by acquiring low and high-energy images at two different detector gains. In addition, dual-energy noise reduction algorithms can further reduce image noise. The cumulative effect of these techniques applied in series was investigated in this study. The contrast from a small thickness of calcium was simulated over a step phantom of tissue equivalent material with a CsI phosphor as the image detector. The dual-energy contrast-to-noise ratio was calculated using values of energy absorption and energy variance. A figure-of-merit (FOM) was calculated from dual-energy contrast-to-noise ratio (CNR) and patient effective dose estimated from values of entrance exposure. Filter atomic numbers in the range of 1-100 were considered with thicknesses ranging from 0-2500 mg/cm2. The simulation examined combinations of the above techniques which maximized the FOM. The application of a filter increased image contrast by as much as 45%. Near maximal increases were seen for filter atomic numbers in the range of 40-60 and 85-100 with masses above 750 mg/cm2. Increasing filter thickness beyond 1000 mg/cm2 increased tube loading without further significant contrast enhancement. No additional FOM improvements were seen with dual gain before or after the application of any noise reduction algorithm. Narrow beam experiments were carried out to verify predictions. The measured FOM increased by more than a factor of 3.5 for a silver filter thickness of 800 microm, equal energy weighting and application of a noise clipping algorithm. The main limitation of dynamic high-energy filtration is increased tube loading. The results of this study can be used to help develop an optimal dual-energy imaging system.

Algorithms↗

PubMed2006

Feasibility of real time dual-energy imaging based on a flat panel detector for coronary artery calcium quantification.

The feasibility of a real-time dual-energy imaging technique with dynamic filtration using a flat panel detector for quantifying coronary arterial calcium was evaluated. In this technique, the x-ray beam was switched at 15 Hz between 60 kVp and 120 kVp with the 120 kVp beam having an additional 0.8 mm silver filter. The performance of the dynamic filtration technique was compared with a static filtration technique (4 mm Al+0.2 mm Cu for both beams). The ability to quantify calcium mass was evaluated using calcified arterial vessel phantoms with 20-230 mg of hydroxylapatite. The vessel phantoms were imaged over a Lucite phantom and then an anthropomorphic chest phantom. The total thickness of Lucite phantom ranges from 13.5-26.5 cm to simulate patient thickness of 16-32 cm. The calcium mass was measured using a densitometric technique. The effective dose to patient was estimated from the measured entrance exposure. The effects of patient thickness on contrast-to-noise ratio (CNR), effective dose, and the precision of calcium mass quantification (i.e., the frame to frame variability) were studied. The effects of misregistration artifacts were also measured by shifting the vessel phantoms manually between low- and high-energy images. The results show that, with the same detector signal level, the dynamic filtration technique produced 70% higher calcium contrast-to-noise ratio with only 4% increase in patient dose as compared to the static filtration technique. At the same time, x-ray tube loading increased by 30% with dynamic filtration. The minimum detectability of calcium with anatomical background was measured to be 34 mg of hydroxyapatite. The precision in calcium mass measurement, determined from 16 repeated dual-energy images, ranges from 13 mg to 41 mg when the patient thickness increased from 16 to 32 cm. The CNR was found to decrease with the patient thickness linearly at a rate of (-7%/cm). The anatomic background produced measurement root-mean-square (RMS) errors of 13 mg and 18 mg when the vessel phantoms were imaged over a uniform (over the rib) and nonuniform (across the edge of rib) bone background, respectively. Misregistration artifacts due to motions of up to 1.0 mm between the low- and high-energy images introduce RMS error of less than 4.3 mg, which is much smaller than the frame to frame variability and the measurement error due to anatomic background. The effective dose ranged from 1.1 to 6.6 microSv for each dual-energy image, depending on patient thickness. The study shows that real-time dual-energy imaging can potentially be used as a low dose technique for quantifying coronary arterial calcium.

Artifacts↗

PubMed2006

Real-time tumor tracking using implanted positron emission markers: concept and simulation study.

The delivery accuracy of radiation therapy for pulmonary and abdominal tumors suffers from tumor motion due to respiration. Respiratory gating should be applied to avoid the use of a large target volume margin that results in a substantial dose to the surrounding normal tissue. Precise respiratory gating requires the exact spatial position of the tumor to be determined in real time during treatment. Usually, fiducial markers are implanted inside or next to the tumor to provide both accurate patient setup and real-time tumor tracking. However, current tumor tracking systems require either substantial x-ray exposure to the patient or large fiducial markers that limit the value of their application for pulmonary tumors. We propose a real-time tumor tracking system using implanted positron emission markers (PeTrack). Each marker will be labeled with low activity positron emitting isotopes, such as 124I, 74As, or 84Rb. These isotopes have half-lives comparable to the duration of radiation therapy (from a few days to a few weeks). The size of the proposed PeTrack marker will be 0.5-0.8 mm, which is approximately one-half the size of markers currently employed in other techniques. By detecting annihilation gammas using position-sensitive detectors, multiple positron emission markers can be tracked in real time. A multimarker localization algorithm was developed using an Expectation-Maximization clustering technique. A Monte Carlo simulation model was developed for the PeTrack system. Patient dose, detector sensitivity, and scatter fraction were evaluated. Depending on the isotope, the lifetime dose from a 3.7 MBq PeTrack marker was determined to be 0.7-5.0 Gy at 10 mm from the marker. At the center of the field of view (FOV), the sensitivity of the PeTrack system was 240-320 counts/s per 1 MBq marker activity within a 30 cm thick patient. The sensitivity was reduced by 45% when the marker was near the edge of the FOV. The scatter fraction ranged from 12% (124I, 74As) to 16% (84Rb). In addition, four markers (labeled with 124I) inside a 30 cm diameter water phantom were simulated to evaluate the feasibility of the multimarker localization algorithm. Localization was considered successful if a marker was localized to within 2 mm from its true location. The success rate of marker localization was found to depend on the number of annihilation events used and the error in the initial estimate of the marker position. By detecting 250 positron annihilation events from 4 markers (average of 62 events per marker), the marker success rates for initial errors of +/-5, +/-10, and +/-15 mm were 99.9%, 99.6%, and 92.4%, respectively. Moreover, the average localization error was 0.55 (+/-0.27) mm, which was independent of initial error. The computing time for localizing four markers was less than 20 ms (Pentium 4, 2.8 GHz processor, 512 MB memory). In conclusion, preliminary results demonstrate that the PeTrack technique can potentially provide real-time tumor tracking with low doses associated with the marker's activity. Furthermore, the small size of PeTrack markers is expected to facilitate implantation and reduce patient risk.

Algorithms↗