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R Clack

Publications and source records attributed to R Clack.

16 recordsLinked to original sources

The dual-ellipse cross vertex path for exact reconstruction of long objects in cone-beam tomography.

We investigate the way data are used in the algorithm proposed by Kudo and Saito for the exact reconstruction of long objects from axially truncated cone-beam projections. Specifically, we show that the algorithm wastes a large part of the data. To overcome the problem, we propose to use a vertex path consisting of two crossing ellipses, for which we devised a new reconstruction algorithm, called the cross algorithm, which does not waste data and is still suitable to exactly handle axial truncation. Results of reconstruction are presented on simulated data and real data from an experimental scanner.

Algorithms↗

What happens subsequently in AML when cytogenetic abnormalities persist at bone marrow harvest? Results of the 10th UK MRC AML trial. Medical Research Council Leukaemia Working Parties.

Cytogenetic analysis performed at diagnosis is widely recognised to provide one of the most valuable prognostic indicators in AML. Yet any role for this technique in residual disease assessment, particularly in the context of subsequent transplantation procedures has been incompletely explored. The present study considers the outcome of 190 patients drawn from the UK MRC AML 10 trial in whom cytogenetics were assessed whilst in morphological CR at the time of bone marrow harvest. Cytogenetics at this stage were abnormal in 19 patients (10%). In 11/19 patients, the abnormalities detected reflected the acquisition of new clonal (3/11) or nonclonal changes (8/11) that were not identified at diagnosis; comparison of this group to patients with normal cytogenetics at harvest provided no evidence that such acquired changes are of prognostic significance. In 8/19 patients, abnormalities detected were indicative of persistence of the disease-related clone in harvested marrow. Two of these patients died of sepsis during consolidation therapy. Two received ABMT in first morphological CR: one patient with AML associated with a favourable karyotype (+8,inv(16)) remains in CR, 5.5 years post-transplant, whereas the other with cytogenetic abnormalities considered to confer a poor prognosis (inv(3q),-7), relapsed within 5 months of ABMT. All four of the remaining patients with cytogenetic evidence of persistent disease who were not transplanted in first CR, relapsed within 6.5 months of harvest. Therefore, among 101 of 190 patients with AML characterised by abnormal karyotype at diagnosis, persistence of the disease-related clone in eight patients (8%), revealed by conventional cytogenetic assessment at bone marrow harvest whilst in morphological remission, was found to predict a poor prognosis. Nevertheless, transplantation procedures using marrow which is obviously contaminated with the original leukaemic clone may occasionally still be associated with long-term survival.

Adolescent↗

Toward accurate attenuation correction in SPECT without transmission measurements.

The current trend in attenuation correction for single photon emission computed tomography (SPECT) is to measure and reconstruct the attenuation coefficient map using a transmission scan, performed either sequentially or simultaneously with the emission scan. This approach requires dedicated hardware and increases the cost (and in some cases the scanning time) required to produce a clinical SPECT image. Furthermore, if short focal-length fan-beam collimators are used for transmission imaging, the projection data may be truncated, leading to errors in the attenuation coefficient map. Our goal is to obtain information about the attenuation distribution from only the measured emission data by exploiting the fact that only certain attenuation distributions are consistent with a given emission dataset. Ultimately this consistency information will either be used directly to compensate for attenuation or combined with the incomplete information from fan-beam transmission measurements to produce a more accurate attenuation coefficient map. In this manuscript the consistency conditions (which relate the measured SPECT data to the sinogram of the attenuation distribution) are used to find the uniform elliptical attenuation object which is most consistent with the measured emission data. This object is then used for attenuation correction during the reconstruction of the emission data. The method is tested using both simulated and experimentally acquired data from uniformly and nonuniformly attenuating objects. The results show that, for uniform elliptical attenuators, the consistency conditions of the SPECT data can be used to produce an accurate estimate of the attenuation map without performing any transmission measurements. The results also show that, in certain circumstances, the consistency conditions can prove useful for attenuation compensation with nonuniform attenuators.

Algorithms↗

Filtered backprojection reconstruction of combined parallel beam and cone beam SPECT data.

The reconstruction problem for a combined parallel beam (PB) and cone beam (CB) imaging geometry has been addressed. The general algorithm (CB-FBP) of Defrise and Clack has been applied to this geometry and shown to provide accurate images as expected. A second algorithm specifically tailored to the PB-CB geometry was developed. It uses the general principles of the CB-FBP method to combine a shift-variant filtering of the PB data with a standard reconstruction of the CB data using the algorithm of Feldkamp, Davis and Kress (FDK). This 'mixed' algorithm has the advantage of fewer interpolation steps, thereby reducing reconstruction time and providing more accurate reconstructions. The algorithms were applied to noiseless data from a computer-generated 3D Shepp phantom. Both the CB-FBP algorithm and the mixed algorithm successfully combine the CB and the PB data to correct the well known artefacts observed when reconstructing CB data acquired with a circular orbit. The mixed algorithm is about twice as fast as CB-FBP and results in better image quality, due to decreased discretization errors. However, the two algorithms yield comparable image quality when applied to a disc phantom measured with a two-headed SPECT system.

Algorithms↗

Application of convergent-beam collimation and simultaneous transmission emission tomography to cardiac single-photon emission computed tomography.

Single-photon emission computed tomography (SPECT) is the most commonly performed imaging technique for perfusion studies of the heart and brain. However, these organs are much smaller than the crystal surface of gamma cameras. SPECT sensitivity and resolution can be improved by using fan- and cone-beam collimators to magnify the image of these organs over a larger portion of the crystal face. Special orbits and reconstruction algorithms must be used with convergent-beam acquisitions to prevent image distortion. Differential attenuation of source activity in the chest is one of the most vexing problems in cardiac SPECT, especially with Thallium-201. Multi-headed cameras equipped with convergent-beam collimators allow a transmission image to be obtained at the same time as emission images. Applying a transmission map of the chest attenuation values to the emission images produces a truer picture of source distribution in the heart. This article reviews the technical problems associated with convergent-beam geometry and simultaneous transmission emission tomography SPECT imaging of the heart.

Algorithms↗

Implementation of Tuy's cone-beam inversion formula.

Tuy's cone-beam inversion formula was modified to develop a cone-beam reconstruction algorithm. The algorithm was implemented for a cone-beam vertex orbit consisting of a circle and two orthogonal lines. This orbit geometry satisfies the cone-beam data sufficiency condition and is easy to implement on commercial single photon emission computed tomography (PECT) systems. The algorithm, which consists of two derivative steps, one rebinning step, and one three-dimensional backprojection step, was verified by computer simulations and by reconstructing physical phantom data collected on a clinical SPECT system. The proposed algorithm gives equivalent results and is as efficient as other analytical cone-beam reconstruction algorithms.

Algorithms↗

Use of epicardial electrocardiograms for detecting cardiac allograft rejection.

Since the advent of cyclosporin A surface electrocardiograms have been unreliable for diagnosing cardiac allograft rejection. Although several noninvasive methods have been proposed, none have been sufficiently accurate to be considered for clinical use. We have studied the use of the QRS complex amplitude, the unipolar peak-to-peak amplitude, recorded from intramyocardial electrodes for detecting rejection. Ten adult mongrel dogs underwent placement of intramyocardial electrodes on each ventricle. After stabilization of signals the hearts were transplanted heterotopically into unmatched recipients receiving cyclosporin A, azathioprine and methylprednisolone. Endomyocardial biopsies were performed after stabilization of unipolar peak-to-peak amplitude, twice weekly thereafter, and when unipolar peak-to-peak amplitude fell significantly. This detected 13 of 14 episodes of rejection. There was one false-positive and one false-negative result. The false-negative study became positive the following day. Thus, analysis of unipolar peak-to-peak amplitude detected all episodes of rejection in a clinically relevant time frame and was able to detect mild forms of rejection and multiple episodes of rejection in the same heart even in the presence of therapeutic levels of cyclosporin A.

Animals↗

Accurate attenuation correction for a 3D PET system.

An accurate attenuation correction has been developed for a small-volume three-dimensional positron emission tomography (PET) system. Transmission data were measured as twenty-four 2D slices which were reconstructed and combined to form a 3D attenuation image. Emission data were reconstructed using a backproject-then-filter technique, and each event was corrected for attenuation at backprojection time by a reprojection through the attenuation image. This correction restores the spatial invariance of the point response function, thus allowing a valid deconvolution and producing an undistorted emission image. Scattering corrections were not applied to either the transmission or the emission data but simulation studies indicated that scattering made only a small contribution to the attenuation measurement. Results are presented for two phantoms, in which transmission scans of 57,500 and 18,700 events/slice were used to correct emission images of 5.2 and 2.8 million events. Although the attenuation images had poor statistical accuracy and a resolution of 13 mm, the method resulted in accurate attenuation-corrected images with no degradation in image resolution (which was 3 mm for the first emission image), and with little effect on image noise.

Image Processing, Computer-Assisted↗

Three-dimensional image reconstruction from complete projections.

Three-dimensional medical image reconstruction for both transmission and emission tomography has traditionally decomposed the problem into a set of two-dimensional reconstructions on parallel transverse sections. There is, however, increasing interest in reconstructing projection data directly in three dimensions. For emission tomography in particular, such a reconstruction procedure would clearly make more efficient use of the available photon flux. In the past few years, a number of authors have studied the problems associated with full three-dimensional reconstruction, especially in the case of positron tomography where three-dimensional reconstruction is likely to offer the greatest benefits. While most approaches follow that of filtered backprojection, the relationship between the various filters that have been proposed is far from evident. This paper clarifies this relationship by analysing and generalising the different classes of published filters and establishes the properties and characteristics of a general solution to the three-dimensional reconstruction problem. Some guidelines are suggested for the choice of an appropriate filter in a given situation.

Algorithms↗

Physical and mechanical effects of cardioplegic injection on flow distribution and myocardial damage in hearts with normal coronary arteries.

The physical and mechanical effects of injecting crystalloid cardioplegic solution under various pressures and flows was studied (in canine hearts) to establish a safe method for administering it in the presence of normal coronary arteries. A constant pressure system (300 mm Hg = 15 psi) was maintained in the solution reservoir, and flows and pressures were varied with the use of cannulas of different inner diameters: 0.8, 1.35, 1.6, 2.3, 2.58, and 2.80 mm. Cardioplegia distribution was measured by 15 microns radioactive microspheres. Peak flow rate, total flow, and mean flow rate per infusion were measured by an inline electromagnetic flowmeter probe. Direct aortic root pressure, time to standstill, and myocardial temperatures were recorded by continuous monitoring. Cardiac isoenzymes were measured in the coronary sinus, peripheral blood, and directly in the myocardial tissue. Histologic changes in the left ventricle were examined by light microscopy. The results showed that the higher the flow and pressure, the shorter the prearrest period, the better the flow distribution, and the faster the myocardial temperature drop. Mean aortic root pressures higher than 110 mm Hg and peak flow rates greater than 1500 ml/min caused a higher incidence of mechanical-physical trauma to the vascular endothelium and the endocardium, but cellular protection was good. Low pressure (less than 30 mm Hg) and peak flows (less than 125 ml/min) showed a higher incidence of cellular (myocardial) ischemia, focal necrosis, and uneven flow distribution. An aortic root pressure of 61 +/- 5 mm Hg, a mean peak flow rate of 622 +/- 52 ml/min, and a total flow of 600 ml for the first injection seem to offer the best cellular protection with minimal physical injury to the endothelium and endocardium for a mean canine heart weight of 236 gm.

Animals↗

Growth of fresh-frozen pulmonary allograft conduit in growing lambs.

To investigate the fate of cryopreserved pulmonary conduit allografts, an experimental model was used in lambs. The lambs underwent resection of the pulmonary trunk and valve to the level of the bifurcation of the pulmonary arteries and then were replaced by cryopreserved (CryoLife, Incorporated, Laboratories) pulmonary conduit allografts obtained from lambs of similar size. Lambs were operated on at 4 weeks of age and followed up with cardiac catheterization and cineangiography every 3 months for a period of 18 months. Lambs were electively sacrificed in the following order: two at 1 month, two at 3 months, one at 6 months, two at 12 months, and five at 18 months. To assess the structure of the conduit tissue, sections for light microscopy were obtained from the proximal, midportion, and distal ends of the conduit. While the lambs grew from a weight of 11.7 kg at the time of implant to more than 70 kg at 18 months, the diameter of the pulmonary conduit distended from 16 mm at the time of implant to 17.7, 19.1, 24.9, 34.3, and 33.7 mm at 1, 3, 6, 12, and 18 months, respectively. The length of the conduit also extended from an original inner length of 25 mm and an original outer length of 32 mm to the following dimensions: inner lengths of 27.9, 32.7, 38.8, 43.6, and 45.3 mm, respectively, at 1, 3, 6, 12, and 18 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Measurement of radiation dose to the thyroid using positron emission tomography.

Measurements of the functioning volume of thyroid tissue have been made in 22 patients undergoing radioiodine therapy for thyrotoxicosis, using a prototype multiwire proportional counter positron camera. Tomographic images were produced of the distribution of 124I in the thyroid. Functioning volumes were found to be in the range 21-79 cm3 with volume errors of the order of +/- 4% to +/- 14%. Radioiodine uptake varied from 28% to 98%. Using a value of 6 days for the effective half-life of radioiodine in hyperactive thyroids, radiation doses from a standard therapy administration of 75 MBq of 131I varied from 11 to 48 Gy (compared with a recommended 50-70 Gy). In five cases PET imaging showed a non-uniform distribution of radioiodine in thyroids thought to have uniform uptake from conventional pinhole scintigraphy.

Humans↗

A general method for three-dimensional filter computation.

Application of the Fourier space deconvolution algorithm to three-dimensional (3D) reconstruction problems necessitates the computation of a frequency space filter; which requires taking the 3D Fourier transform of the system response function. In this paper, it is shown that for system response functions of the specific form d(theta, phi)/r2, with d(theta, phi) an angular function describing the imaging system, the filter computation can always be reduced to a single integration which, in many cases, may be performed analytically. Complete expressions are derived for the general 3D filter, and two examples are given to illustrate the use of such expressions.

Mathematics↗

Long-term evaluation of prosthetic mitral valves in sheep.

We have developed an in vivo model for chronic evaluation of prosthetic heart valves using juvenile domestic sheep. This report summarizes the results of a study conducted to assess a new bileaflet prosthetic valve. Nine juvenile sheep underwent mitral valve replacement using standard cardiopulmonary bypass techniques including mild hemodilution, systemic hypothermia, and cold fibrillatory arrest. The average time on cardiopulmonary bypass was 57 min. There were no surgical or anesthetic complications. Two (22%) early deaths occurred due to prosthetic annular size disproportion (1) and preexisting pneumonitis (1); postmortem examination of both implanted devices revealed normal function. The remaining seven animals (78%) remained clinically well and underwent left and right heart catheterization, angiography, and sacrifice after the 150th postoperative day. Left ventriculograms demonstrated normal valve function in all cases. The average mitral transvalvular gradient, as determined by simultaneous pulmonary capillary wedge and left ventricular and diastolic pressure, was 5.4 mm Hg. Thus we have developed a new in vivo model that provides a successful model for chronic evaluation of prosthetic valves using a sheep model. There are several features contributing to the success of our model. First, to decrease the possibility of bacteremia and seeding of the prosthesis, a single incision is used and intraoperative monitoring lines minimized. Second, we use a short cardiopulmonary bypass run (range 52-62 min), with no period of ischemia. Third, fresh sheep blood is transfused immediately following bypass to prevent anemia. Fourth, gastric decompression is used to prevent ruminal bloating, with the resulting vena caval compression that decreases blood return while on bypass.

Animals↗