Biomedical subjects

K P McGee

Publications and source records attributed to K P McGee.

16 recordsLinked to original sources

PubMed2006

MR guided focused ultrasound: technical acceptance measures for a clinical system.

Magnetic resonance (MR) guided focused ultrasound (MRgFUS) is a hybrid technique which offers efficient and safe focused ultrasound (FUS) treatments of uterine fibroids under MR guidance and monitoring. As a therapy device, MRgFUS requires systematic testing over a wide range of operational parameters prior to use in the clinical environment. We present technical acceptance tests and data for the first clinical MRgFUS system, ExAblate 2000 (InSightec Inc., Haifa, Israel), that has been FDA approved for treating uterine fibroids. These tests characterize MRgFUS by employing MR temperature measurements in tissue mimicking phantoms. The coronal scan plane is empirically demonstrated to be most reliable for measuring temperature elevations resulting from high intensity ultrasound (US) pulses ('sonications') and shows high sensitivity to changes in sonication parameters. Temperatures measured in the coronal plane were used as a measure of US energy deposited within the focal spot for a range of sonication parameters used in clinical treatments: spot type, spot length, output power, sonication duration, US frequency, and depth of sonication. In addition, MR images acquired during sonications were used to measure effective diameters and lengths of available sonication spot types and lengths. At a constant 60 W output power, the effective spot type diameters were measured to vary between 4.7 +/- 0.3 mm and 6.6 +/- 0.4 mm; treatment temperatures were found to decrease with increasing spot diameter. Prescribing different spot lengths was found to have no effect on the measured length or on measured temperatures. Tests of MRgFUS positioning accuracy determined errors in the direction parallel to the propagation of the US beam to be significantly greater than those in the perpendicular direction; most sonication spots were erroneously positioned towards the FUS transducer. The tests reported here have been demonstrated to be sufficiently sensitive to detect water leakage inside the FUS transducer. The data presented could be used for comparison by those conducting acceptance tests on other clinical MRgFUS systems.

Equipment Design↗

PubMed2006

Magnetic resonance elastography of the lung: technical feasibility.

Magnetic resonance elastography (MRE) is a phase-contrast technique that can spatially map shear stiffness within tissue-like materials. To date, however, MRE of the lung has been too technically challenging-primarily because of signal-to-noise ratio (SNR) limitations and phase instability. We describe an approach in which shear wave propagation is not encoded into the phase of the MR signal of a material, but rather from the signal arising from a polarized noble gas encapsulated within. To determine the feasibility of the approach, three experiments were performed. First, to establish whether shear wave propagation within lung parenchyma can be visualized with phase-contrast MR techniques, MRE was performed on excised porcine lungs inflated with room air. Second, a phantom consisting of open-cell foam filled with thermally polarized (3)He gas was imaged with MRE to determine whether shear wave propagation can be encoded by the gas. Third, preliminary evidence of the feasibility of MRE in vivo was obtained by using a longitudinal driver on the chest of a normal volunteer to generate shear waves in the lung. The results suggest that MRE in combination with hyperpolarized noble gases is potentially useful for noninvasively assessing the regional elastic properties of lung parenchyma, and merits further investigation.

Algorithms↗

PubMed2001

Clinical use of electronic portal imaging: report of AAPM Radiation Therapy Committee Task Group 58.

AAPM Task Group 58 was created to provide materials to help the medical physicist and colleagues succeed in the clinical implementation of electronic portal imaging devices (EPIDs) in radiation oncology. This complex technology has matured over the past decade and is capable of being integrated into routine practice. However, the difficulties encountered during the specification, installation, and implementation process can be overwhelming. TG58 was charged with providing sufficient information to allow the users to overcome these difficulties and put EPIDs into routine clinical practice. In answering the charge, this report provides; comprehensive information about the physics and technology of currently available EPID systems; a detailed discussion of the steps required for successful clinical implementation, based on accumulated experience; a review of software tools available and clinical use protocols to enhance EPID utilization; and specific quality assurance requirements for initial and continuing clinical use of the systems. Specific recommendations are summarized to assist the reader with successful implementation and continuing use of an EPID.

Biophysical Phenomena↗

PubMed2001

Autocorrection of three-dimensional time-of-flight MR angiography of the Circle of Willis.

OBJECTIVE: The purpose of this study was to investigate the efficacy of a retrospective adaptive motion correction technique known as autocorrection for reducing motion-induced artifacts in high-resolution three-dimensional time-of-flight MR angiography of the circle of Willis. MATERIALS AND METHODS: Ten consecutive volunteers were imaged with an unenhanced gradient-recalled echo three-dimensional time-of-flight MR angiography sequence of the circle of Willis. Each volunteer was asked to rotate approximately 2 degrees after completion of one third and one half of the acquisition in the axial, sagittal, and oblique planes (45 degrees to the axial and sagittal planes). A single static data set was also acquired for each volunteer. Unprocessed and autocorrected maximum-intensity-projection images were reviewed as blinded image pairs by six radiologists and were compared on a five-point image quality scale. RESULTS: Mean improvement in image quality after autocorrection was 1.4 (p < 0.0001), 1.1 (p < 0.0001), and 0.2 (p = 0.003) observer points (maximum value, 2.0), respectively, for examinations corrupted by motion in the axial, oblique, and sagittal planes. All three axes had statistically significant improvement in image quality compared with the uncorrected images. Changes in image quality after the application of the autocorrection algorithm to static angiogram data were not statistically significant (mean change in score = -0.13 points; p = 0.29). CONCLUSION: Autocorrection can reduce artifacts in motion-corrupted MR angiography of the circle of Willis without distorting motion-free examinations.

Artifacts↗

PubMed2000

Image metric-based correction (autocorrection) of motion effects: analysis of image metrics.

Magnetic resonance (MR) imaging of the shoulder necessitates high spatial and contrast resolution resulting in long acquisition times, predisposing these images to degradation due to motion. Autocorrection is a new motion correction algorithm that attempts to deduce motion during imaging by calculating a metric that reflects image quality and searching for motion values that optimize this metric. The purpose of this work is to report on the evaluation of 24 metrics for use in autocorrection of MR images of the rotator cuff. Raw data from 164 clinical coronal rotator cuff exams acquired with interleaved navigator echoes were used. Four observers then scored the original and corrected images based on the presence of any motion-induced artifacts. Changes in metric values before and after navigator-based adaptive motion correction were correlated with changes in observer score using a least-squares linear regression model. Based on this analysis, the metric that exhibited the strongest relationship with observer ratings of MR shoulder images was the entropy of the one-dimensional gradient along the phase-encoding direction. We speculate (and show preliminary evidence) that this metric will be useful not only for autocorrection of shoulder MR images but also for autocorrection of other MR exams.

Algorithms↗

PubMed2000

Rapid autocorrection using prescan navigator echoes.

Autocorrection is an adaptive motion correction algorithm that does not require an in vivo measurement of the motion record. A novel method for ensuring convergence of this algorithm when motion is severe is presented. A limited number of navigator echoes are acquired before the imaging sequence to obtain a "snapshot" of the object. Phase differences between the navigator and image k-space data are used as an estimate of motion-induced phase shifts in the image, followed by autocorrection. In phantom data a six-fold reduction in computation time compared to autocorrection alone was realized. These results indicate that this navigator/autocorrection combination may be useful for reducing motion artifacts and computation time for MR exams when motion along the image phase encoding axis is severe.

Algorithms↗

PubMed2000

Simultaneous image acquisition utilizing hybrid body and phased array receiver coils.

In clinical MR imaging the design and selection of receiver coil is an important step in ensuring the highest image quality. Often this choice is based on selecting a receiver coil characterized by high spatial uniformity such as the body and head volume receiver coils or a surface coil (or array of coils) that provide high signal-to-noise ratio (SNR). In the past, it has been difficult to accomplish both high SNR and spatial uniformity as both coil types achieve one of these characteristics at the expense of the other. The purpose of this study was to achieve both high SNR and spatial uniformity through the simultaneous acquisition of the MR signal using the body and a surface coil array. Results indicate that this hybrid system can provide uniformity and SNR values comparable to those achieved by the body and surface coil arrays, respectively.

Humans↗

PubMed2000

Autocorrection in MR imaging: adaptive motion correction without navigator echoes.

A technique for automatic retrospective correction of motion artifacts on magnetic resonance (MR) images was developed that uses only the raw (complex) data from the MR imager and requires no knowledge of patient motion during the acquisition. The algorithm was tested on coronal images of the rotator cuff in a series of 144 patients, and the improvements in image quality were similar to those achieved with navigator echoes. The results demonstrate that autocorrection can significantly reduce motion artifacts in a technically demanding MR imaging application.

Algorithms↗

PubMed1997

The value of setup portal films as an estimate of a patient's position throughout fractionated tangential breast irradiation: an on-line study.

PURPOSE: To determine if portal setup films are an accurate representation of a patient's position throughout the course of fractionated tangential breast irradiation. METHODS AND MATERIALS: Thirteen patients undergoing external beam irradiation for T1-T2 infiltrating ductal carcinoma of the breast following excisional biopsy and axillary dissection were imaged using an on-line portal imaging device attached to a 6 MV linear accelerator. Medial and lateral tangential fields were imaged and a total of 139 fractions, 225 portal fields, and 4450 images were obtained. Interfractional and intrafractional variations for anatomical parameters including the central lung distance (CLD), central flash distance (CFD), and inferior central margin (ICM) were calculated from these images. A pooled estimate of the random error associated with a given treatment was determined by adding the interfractional and intrafractional standard deviations in quadrature. A 95% confidence level assigned a value of two standard deviations of the random error estimate. Central lung distance, CFD, and ICM distances were then measured for all portal setup films. Significant differences were defined as occurring when the simulation-setup difference was greater than the 95% confidence value. RESULTS: Differences between setup portal and simulation films were less than their 95% confidence values in 70 instances indicating that in 90% of the time these differences are a result of random differences in daily treatment positioning. CONCLUSIONS: In 90% of cases tested, initial portal setup films are an accurate representation of a patients daily treatment setup.

Breast Neoplasms↗

PubMed1997

The shoulder: adaptive motion correction of MR images.

PURPOSE: To evaluate an adaptive-motion-correction technique to reduce global motion in shoulder magnetic resonance (MR) images. MATERIALS AND METHODS: In the adaptive-motion-correction technique, interleaved navigator echoes are used to provide a measure of view-to-view displacement along the craniocaudal direction for each image echo in the acquisition. The information is then retrospectively applied to the k-space data to correct for global shoulder motion. This algorithm was evaluated in a series of 143 consecutive patient shoulder examinations by comparing the original image set for each patient with the same image set after retrospective correction by means of this algorithm. RESULTS: The average amplitude of craniocaudal motion was 1.4 mm. Image degradation due to motion was apparent in 100 (70%) of the 143 examinations. Application of the adaptive-motion-correction technique improved image quality in 73 (73%) of these 100 examinations or 51% of all 143 examinations. CONCLUSION: Adaptive motion correction improved image quality in approximately three-quarters of the examinations in which motion was present.

Humans↗

PubMed1996

Intra- and interfractional reproducibility of tangential breast fields: a prospective on-line portal imaging study.

PURPOSE: A perception exists that weekly verification films accurately reflect the setup of the tangential breast portals. This prospective study was undertaken to assess patient movement during treatment and setup reproducibility of tangential breast fields using electronic on-line portal imaging. METHODS AND MATERIALS: Thirteen patients with carcinoma of the breast were treated on a linear accelerator equipped with an on-line portal imaging system. Patients were immobilized daily with an alpha cradle. The medial and lateral tangential fields were imaged and 139 fractions, 225 portal fields, and 4450 images were obtained. Images were then analyzed off line and 22,250 measurements were made from these images. Anatomical features recorded include the lung area (LA), central lung distance (CLD), central breast distance (CBD), central flash distance (CFD), and inferior central margin (ICM). Intrafractional variations were calculated for every portal field and fraction for each patient. Interfractional variations were determined by finding the variance of intrafractional means for each patient. A population standard deviation for each of the five parameters for intra- and interfractional variations were determined. The simulation to treatment setup errors were calculated for all five variables. RESULTS: Lung area variation was 1.50 and 4.19 cm(2) [1 standard deviation (SD)] for intra- and interfractional movement. Intrafractional variation for the other four variables ranged from 0.85 mm for ICM to 2.1 mm (1 SD) for CBD, while interfractional variations ranged from 3.2 to 6.25 mm for CBD and ICM, respectively. The simulation-to-treatment setup variation was greater than the interfractional variation for three of the five variables and was similar for the other two. CONCLUSIONS: On-line verification of intrafractional variation shows a moderate deviation from the treatment setup position for all five parameters studied, while interfractional variation showed even greater deviations for these five parameters. To cover the breast target in 95% of cases, margins of 7.70, 7.70, and 10.30 mm corresponding to the CLD, CFD, and ICM distances, respectively, are required.

Breast Neoplasms↗

PubMed1995

A heuristic approach to edge detection in on-line portal imaging.

PURPOSE: Portal field edge detection is an essential component of several postprocessing techniques used in on-line portal imaging, including field shape verification, selective contrast enhancement, and treatment setup error detection. Currently edge detection of successive fractions in a multifraction portal image series involves the repetitive application of the same algorithm. As the number of changes in the field is small compared to the total number of fractions, standard edge detection algorithms essentially recalculate the same field shape numerous times. A heuristic approach to portal edge detection has been developed that takes advantage of the relatively few changes in the portal field shape throughout a fractionation series. METHODS AND MATERIALS: The routine applies a standard edge detection routine to calculate an initial field edge and saves the edge information. Subsequent fractions are processed by applying an edge detection operator over a small region about each point of the previously defined contour, to determine any shifts in the field shape in the new image. Failure of this edge check indicates that a significant change in the field edge has occurred, and the original edge detection routine is applied to the image. Otherwise the modified edge contour is used to define the new edge. RESULTS: Two hundred and eighty-one portal images collected from an electronic portal imaging device were processed by the edge detection routine. The algorithm accurately calculated each portal field edge, as well as reducing processing time in subsequent fractions of an individual portal field by a factor of up to 14. CONCLUSIONS: The heuristic edge detection routine is an accurate and fast method for calculating portal field edges and determining field edge setup errors.

Breast Neoplasms↗

PubMed1995

Picture archiving and communications systems in radiation oncology (PACSRO): tools for a physician-based digital image review system.

Digital imaging is becoming more and more important in the diagnosis, staging, and treatment of patients in radiation oncology. In order to facilitate the most efficient interface of this technology to physicians and other users of this information, a medical image display system (MID) has been developed at the Fox Chase Cancer Center (FCCC). The system runs on 20 personal computers situated in physicians offices as well as a modified system located in the radiation oncology conference room. Access to CT, MRI, and EPID information is achieved through an Ethernet connection to the hospital picture archiving and communications system (PACS). Over a 1-year period a total of 503 patients and 3845 images have been stored on the system. Physician approval using the MID system (without conventional films) was performed on 106 patients. Of these, 22%, 16%, 11%, 10%, and 9% consisted of breast, prostate, pelvic, lung, and head and neck patients, respectively. Digital images sent from a variety of image sources to the MID system take up to 15 s to process and format while image access and display can take 2-5 s, dependent upon image size and speed of the host computer.

Adult↗

PubMed1995

Electron-beam characteristics at extended treatment distances.

A uniform dose to the target site is required with a knowledge of delivered dose, central axis depth dose, and beam flatness for successful electron treatment at an extended source to surface distance (SSD). The central axis depth dose is shown to be nearly independent of moderate changes in the treatment distance. The delivered dose at a point could be calculated with the concept of virtual source position and an inverse square correction. In an extended SSD treatment, underdosage of the lateral tissue may occur due to reduced beam flatness. To study the changes in beam characteristics, the depth dose and beam flatness were measured at different SSDs for clinically used field sizes [(3 x 3)-(15 x 15) cm2] and beam energies ranging from 6 to 20 MeV. Our results indicate that the changes in depth dose are minimal except in the buildup region for most energies. In general, the surface dose is decreased (< or = 10%) as the SSD is increased moderately. Beam flatness was measured in terms of target coverage factor (TCF) defined as the ratio of the width of a specified isodose line to the geometrical field width. It was observed that the loss in beam flatness is significant for smaller fields, higher isodose lines, and lower energies. Variations in SSD have a minimal effect on the relative changes in beam flatness for field sizes greater than 8 x 8 cm2. The lateral loss of beam uniformity could be estimated by various parameters, such as the full width at half maximum, the homogeneity index, the uniformity index, and the TCF; however, TCF is a simpler parameter to use clinically. The beam characteristics (depth dose and TCF) at extended treatment distances are presented for electron beams.

Electrons↗

PubMed1995

Evaluation of digitally reconstructed radiographs (DRRs) used for clinical radiotherapy: a phantom study.

Digitally reconstructed radiographs produced from a commercial CT simulator have been evaluated using an in-house test phantom. The phantom consists of a polystyrene cubic block of dimension 15 cm. It contains four test patterns to measure contrast detail, modulation transfer function, ray line divergence accuracy, and spatial distortion. A total of six CT data sets, which vary by CT slice thickness and separation between slices, as well as CT slice reconstruction area have been used to analyze digitally reconstructed radiographs produced by the system. Results show that contrast detail is independent of slice thickness and separation but dependent upon slice reconstruction area for small object diameters (< or = 1.5 mm). Half field (24-cm diameter) reconstruction images provide lower threshold contrasts than full field (48-cm diameter) scans. The modulation transfer function for each data set was calculated and the spatial frequency at which the modulation transfer function is 50% (f50) of the maximum indicates that high contrast resolution depends on slice thickness for both the full and half field reconstructions. For full field scans, f50 values were 0.19, 0.10, and 0.10 line pairs/mm for the 2 mm/2 mm (slice thickness/separation), 5 mm/3 mm, and 5 mm/5 mm data sets, respectively. Similarly, half field f50 values were 0.19, 0.10, and 0.10 line pairs/mm for these same three thickness/separation data sets, respectively. The error in the ray tracing component of the digitally reconstructed radiograph algorithm for source to skin distances between 60 and 200 cm was 1.0 mm while the spatial linearity error was < or = 2.5 mm. Errors in CT simulator collimator and table rotations were calculated by measuring the angle between a grid pattern inlayed onto two orthogonal faces of the phantom and a graphical grid superimposed onto the digitally reconstructed radiograph by the CT simulator software. Measured angular differences were < or = 1.0 degree. The largest error in shifting the CT simulator field isocenter was 2.2 mm and occurred on the 5-mm slice thickness and separation CT data sets.

Biophysical Phenomena↗

PubMed1995

Use of multiplanar reformatted radiographic and digitally reconstructed radiographic images for planning conformal radiation therapy.

A three-dimensional treatment planning system capable of gantry, collimator, and table rotations is required for a noncoplanar conformal therapy. Unfortunately, such a system is not widely available. A method in which multiplanar reformatted radiographic (MPR) and digitally reconstructed radiographic (DRR) images are used is presented for conformal treatment of brain tumors. A head phantom containing a target volume was scanned on a computed tomographic (CT) simulator. The coronal MPR images were digitized on a treatment planning system to create a conformal block of the planned treatment field. The DRR images were generated on the CT simulator with the setup parameters calculated from the treatment planning system. A second set of conformal blocks was generated based on DRR images of the fields. The accuracy of the MPR- and DRR-generated blocks was verified on the vertex field. The differences between the actual planning target volume and the field edges of the MPR and DRR blocks were within +/- 4 mm and +/- 2 mm, respectively. The authors conclude that the MPR and DRR images could be successfully used to generate conformal blocks and for treatment planning of noncoplanar beams in radiation therapy.

Brain Neoplasms↗