Biomedical subjects

Rebecca Fahrig

Publications and source records attributed to Rebecca Fahrig.

16 recordsLinked to original sources

PubMed2006

Transjugular intrahepatic portosystemic shunt creation in a polycystic liver facilitated by hybrid cross-sectional/angiographic imaging.

Polycystic liver disease (PCLD) has long been considered to represent a contraindication to transjugular intrahepatic portosystemic shunt (TIPS) creation, primarily because of the risk of hemorrhage. Three-dimensional (3D) navigation within the enlarged and potentially disorienting parenchyma can now be performed during the procedure with the development of C-arm cone-beam computed tomography, which relies on the same equipment already used for angiography. Such a hybrid 3D reconstruction-enabled angiography system was used for safe image guidance of a TIPS procedure in a patient with PCLD. This technology has the potential to expedite any image-guided procedure that requires 3D navigation.

Angiography↗

PubMed2006

Towards cardiac C-arm computed tomography.

Cardiac interventional procedures would benefit tremendously from sophisticated three-dimensional image guidance. Such procedures are typically performed with C-arm angiography systems, and tomographic imaging is currently available only by using preprocedural computed tomography (CT) or magnetic resonance imaging (MRI) scans. Recent developments in C-arm CT (Angiographic CT) allow three-dimensional (3-D) imaging of low contrast details with angiography imaging systems for noncardiac applications. We propose a new approach for cardiac imaging that takes advantage of this improved contrast resolution and is based on intravenous contrast injection. The method is an analogue to multisegment reconstruction in cardiac CT adapted to the much slower rotational speed of C-arm CT. Motion of the heart is considered in the reconstruction process by retrospective electrocardiogram (ECG)-gating, using only projections acquired at a similar heart phase. A series of N almost identical rotational acquisitions is performed at different heart phases to obtain a complete data set at a minimum temporal resolution of 1/N of the heart cycle time. First results in simulation, using an experimental phantom, and in preclinical in vivo studies showed that excellent image quality can be achieved.

Algorithms↗

PubMed2006

Scatter correction method for X-ray CT using primary modulation: theory and preliminary results.

An X-ray system with a large area detector has high scatter-to-primary ratios (SPRs), which result in severe artifacts in reconstructed computed tomography (CT) images. A scatter correction algorithm is introduced that provides effective scatter correction but does not require additional patient exposure. The key hypothesis of the algorithm is that the high-frequency components of the X-ray spatial distribution do not result in strong high-frequency signals in the scatter. A calibration sheet with a checkerboard pattern of semitransparent blockers (a "primary modulator") is inserted between the X-ray source and the object. The primary distribution is partially modulated by a high-frequency function, while the scatter distribution still has dominant low-frequency components, based on the hypothesis. Filtering and demodulation techniques suffice to extract the low-frequency components of the primary and hence obtain the scatter estimation. The hypothesis was validated using Monte Carlo (MC) simulation, and the algorithm was evaluated by both MC simulations and physical experiments. Reconstructions of a software humanoid phantom suggested system parameters in the physical implementation and showed that the proposed method reduced the relative mean square error of the reconstructed image in the central region of interest from 74.2% to below 1%. In preliminary physical experiments on the standard evaluation phantom, this error was reduced from 31.8% to 2.3%, and it was also demonstrated that the algorithm has no noticeable impact on the resolution of the reconstructed image in spite of the filter-based approach. Although the proposed scatter correction technique was implemented for X-ray CT, it can also be used in other X-ray imaging applications, as long as a primary modulator can be inserted between the X-ray source and the imaged object.

Algorithms↗

PubMed2006

Optimization of a tomosynthesis system for the detection of lung nodules.

Mathematical observers that track human performance can be used to reduce the number of human observer studies needed to optimize imaging systems. The performance of human observers for the detection of a 3.6 mm lung nodule in anatomical backgrounds was measured as a function of varying tomosynthetic angle and compared with mathematical observers. The human observer results showed a dramatic increase in the percent of correct responses, from 80% in the projection images to 96% in the projection images with a tomosynthetic angle of just 3 degrees. This result suggests the potential usefulness of the scanned beam digital x-ray system for this application. Given the small number of images (40) used per tomosynthetic angle and the highly nonstationary statistical nature of the backgrounds, the nonprewhitening eye observer achieved a higher performance than the channelized Hotelling observer using a Laguerre-Gauss basis. The channelized Hotelling observer with internal noise and the eye filter matched to the projection data were shown to track human performance as the tomosynthetic angle changed. The validation of these mathematical observers extends their applicability to the optimization of tomosynthesis systems.

Algorithms↗

PubMed2006

A prototype table-top inverse-geometry volumetric CT system.

A table-top volumetric CT system has been implemented that is able to image a 5-cm-thick volume in one circular scan with no cone-beam artifacts. The prototype inverse-geometry CT (IGCT) scanner consists of a large-area, scanned x-ray source and a detector array that is smaller in the transverse direction. The IGCT geometry provides sufficient volumetric sampling because the source and detector have the same axial, or slice direction, extent. This paper describes the implementation of the table-top IGCT scanner, which is based on the NexRay Scanning-Beam Digital X-ray system (NexRay, Inc., Los Gatos, CA) and an investigation of the system performance. The alignment and flat-field calibration procedures are described, along with a summary of the reconstruction algorithm. The resolution and noise performance of the prototype IGCT system are studied through experiments and further supported by analytical predictions and simulations. To study the presence of cone-beam artifacts, a "Defrise" phantom was scanned on both the prototype IGCT scanner and a micro CT system with a +/-5 cone angle for a 4.5-cm volume thickness. Images of inner ear specimens are presented and compared to those from clinical CT systems. Results showed that the prototype IGCT system has a 0.25-mm isotropic resolution and that noise comparable to that from a clinical scanner with equivalent spatial resolution is achievable. The measured MTF and noise values agreed reasonably well with theoretical predictions and computer simulations. The IGCT system was able to faithfully reconstruct the laminated pattern of the Defrise phantom while the micro CT system suffered severe cone-beam artifacts for the same object. The inner ear acquisition verified that the IGCT system can image a complex anatomical object, and the resulting images exhibited more high-resolution details than the clinical CT acquisition. Overall, the successful implementation of the prototype system supports the IGCT concept for single-rotation volumetric scanning free from cone-beam artifacts.

Algorithms↗

PubMed2006

Compatibility of interventional x-ray and magnetic resonance imaging: feasibility of a closed bore XMR (CBXMR) system.

A next-generation interventional guidance system is proposed that will enable intraprocedural access to both x-ray and magnetic resonance imaging (MRI) modalities. This closed bore XMR (CBXMR) system is comprised of a conventional radiographic rotating anode x-ray tube and a direct conversion flat panel detector on a rotating gantry positioned adjacent to the bore of a 1.5 T MRI. To assess the feasibility of such a system, we have investigated the degree of compatibility between the x-ray components and the MRI. For /-->B(ext)/ < 200 G the effect on the radiographic tube motor was negligible regardless of the orientation of -->B(ext) with respect to the motor axis of rotation--the frequency of anode rotation remained within 6% of the 3400 rpm frequency measured at 0 G. For /-->B(ext)/ >2400 G the anode slowed down to below 2400 rpm at all orientations. At intermediate B(ext), the frequency of rotation varied between 2400 and 3200 rpm, showing a strong dependence on orientation, with -->B(ext) perpendicular to the tube axis having a much stronger effect on the rotation frequency than -->B(ext) parallel to the tube axis. In contrast to the effect of -->B(ext) on the induction motor, parallel -->B(ext) had a stronger detrimental effect on the cathode-anode electron beam, whose path was at 16 degrees to the tube axis, than the perpendicular -->B(ext). Parallel -->B(ext) of several hundred Gauss had a defocusing effect on the x-ray focal spot. -->B(ext) perpendicular to the electron beam shifted the beam without significant defocusing. We have determined that the direct conversion flat panel detector (FPD) technology is not intrinsically sensitive to -->B(ext), and that the modifications required to make the proposed FPDs MRI compatible are minimal. The homogeneity of the MRI signal in the normal field of view was not significantly degraded by the presence of these x-ray components in the vicinity of the MRI bore entrance.

Equipment Design↗

PubMed2005

Co-registration of x-ray and MR fields of view in a hybrid XMR system.

PURPOSE: To validate one possible function of a real-time x-ray/MR (XMR) interface in a hybrid XMR system using x-ray images as "scouts" to prescribe the MR slices. MATERIALS AND METHODS: The registration process consists of two steps: 1) calibration, in which the system's geometric parameters are found from fiducial-based registration; and 2) application, in which the x-ray image of a target structure and the estimated geometric parameters are used to prescribe an MR slice to observe the target structure. Errors from the noise in the location of the fiducial markers, and MR gradient nonlinearity were studied. Computer simulations were used to provide guidelines for fiducial marker placement and tolerable error estimation. A least-squares-based correction method was developed to reduce errors from gradient nonlinearity. RESULTS: In simulations with both sources of errors and the correction for gradient nonlinearity, the use of 16 fiducial markers yielded a mean error of about 0.4 mm over a 7200 cm(3) volume. Phantom scans showed that the prescribed target slice hit most of the target line, and that the length visualized was improved with the least-squares correction. CONCLUSION: The use of 16 fiducial markers to co-register XMR FOVs can offer satisfactory accuracy in both simulations and experiments.

Algorithms↗

PubMed2005

X-ray compatible radiofrequency coil for magnetic resonance imaging.

The range of RF coils that can be used in combined X-ray/MR (XMR) systems is limited because many conventional coils contain highly X-ray attenuating materials that are visible in the X-ray images and potentially obscure patient anatomy. In this study, an X-ray compatible coil design that has minimal X-ray attenuation in the field of view (FOV) of the X-ray image is presented. In this design, aluminum is used for the loop conductor and discrete elements of the coil are eliminated from the X-ray FOV. A surface coil and an abdominal phased array coil were built using the X-ray compatible design. X-ray attenuation and MR imaging properties of the coils were evaluated and compared to conventional coils. The X-ray compatible phased array coil was used to image patients during two interventional procedures in the XMR system. The X-ray compatible coils allowed for fluoroscopic X-ray image acquisition, without degradation by the coil, while maintaining excellent MR imaging qualities.

Aluminum↗

PubMed2005

Fully truncated cone-beam reconstruction on Pi lines using prior CT.

C-arms are well suited for obtaining cone-beam projections intra-operatively. Due to the compact size of the detector used, the data are usually truncated within the field of view. As a result, direct application of a standard cone-beam reconstruction algorithm gives rise to undesirable artifacts and incorrect values in the reconstructed image volume. When prior information such as a pre-operative CT scan is available, fully truncated cone-beam projections can be used to recover the change within a small region of interest without such artifacts. A method for integrating prior CT is developed using the concept of pi-lines and tested on real flat-panel and simulated cone-beam data.

Algorithms↗

PubMed2005

Truly hybrid X-ray/MR imaging: toward a streamlined clinical system.

RATIONALE AND OBJECTIVE: We have installed an improved X-ray/MR (XMR) truly hybrid system with higher imaging signal-to-noise ratio (SNR) and versatility than our first prototype. In our XMR design, a fixed anode X-ray fluoroscopy system is positioned between the two donut-shaped magnetic poles of a 0.5T GE Signa-SP magnet (SP-XMR). This paper describes the methods for increased compatibility between the upgraded x-ray and MR systems that have helped improve patient management. MATERIALS AND METHODS: A GE OEC 9800 system (GE OEC Salt Lake City, UT) was specially reconfigured for permitting X-ray fluoroscopy inside the interventional magnet. A higher power X-ray tube, a new permanent tube mounting system, automatic exposure control (AEC), remote controlled collimators, choice of multiple frame rates, DICOM image compatibility, magnetically shimmed X-ray detector, X-ray compatible MR coil, and better RF shielding are the highlights of the new system. A total of 23 clinical procedures have been conducted with SP-XMR guidance of which five were performed using the new system. RESULTS: The 70% increased power for fluoroscopy, and a new 6 times higher power single frame imaging mode, has improved imaging capability. The choice of multiple imaging frame rates, AEC, and collimator control allow reduction in X-ray exposure to the patient. The DICOM formatting has permitted easy transfer of clinical images over the hospital PACS network. The increased MR compatibility of the detector and the X-ray transparent MR coil has enabled faster switching between X-ray and MR imaging modes. CONCLUSION: The improvements introduced in our SP-XMR system have further streamlined X-ray/MR hybrid imaging. Additional clinical procedures could benefit from the new SP-XMR imaging.

Equipment Design↗

PubMed2005

MR-guided transjugular intrahepatic portosystemic shunt creation with use of a hybrid radiography/MR system.

PURPOSE: To evaluate the performance of a combined hybrid radiography/magnetic resonance (MR) unit to guide portal vein (PV) puncture during human transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS: Fourteen patients undergoing TIPS creation were studied during standard clinical applications. Patients were anesthetized and then positioned in an open MR unit containing a flat-panel radiographic fluoroscopic unit. With use of a combination of fluoroscopy and MR imaging, the PV was accessed and the TIPS procedure was performed. A noncovered nitinol stent or a covered stent-graft was placed in the TIPS tract. Number of punctures required, total procedure time, fluoroscopy time, procedural success rate, complications, and ultrasonographic and clinical follow-up were recorded. RESULTS: Clinical success was obtained in 13 of 14 patients. In one patient, extrahepatic puncture of the PV occurred, resulting in hemorrhage and requiring placement of a covered stent to control the bleeding. The mean number of punctures required to access the PV was 2.6 +/- 1.7, and the total procedure time was 2.5 hours +/- 0.6. Mean fluoroscopy time was 22.3 minutes +/- 5.5. Results of clinical and ultrasonographic follow-up compare favorably to previously published reports. CONCLUSION: TIPS creation with a combination hybrid radiography/MR unit is feasible and may reduce the number of needle passes required and radiation exposure, with similar overall outcomes compared with studies reported in the literature.

Alloys↗

PubMed2005

Correction of XRII geometric distortion using a liquid-filled grid and image subtraction.

X-ray image intensifier (XRII) geometric distortion reduces the accuracy of image-guided procedures and quantitative image reconstructions. Due to the dependence of this error on the earth's magnetic field, the required correction is angle dependent, and calibration data should ideally be acquired simultaneously with clinical image data, at a specific orientation. We describe a technique to correct XRII geometric image distortion at any angular position during a stereotactic procedure. This approach uses a machined plastic grid, which contains channels that can be filled with iodinated contrast agent and subsequently flushed with water, providing contrast and mask images, respectively, of a geometric calibration grid. The standard image subtraction capabilities of conventional digital subtraction angiography devices can then be used to create a subtraction image of the iodine-filled channels, without any confounding anatomical structure. Grid-line intersection points are used to determine the control points that are required for a global polynomial correction algorithm, creating a correction map that is specific to the current angular position and XRII field of view (FOV). Tests with a clinical C-arm based XRII show that control points can be obtained with a precision of +/-0.053 mm, resulting in geometric correction accuracy of +/-0.152 mm, at a nominal FOV of 40 cm. While the precision and accuracy are both poorer than that achieved with a high-contrast steel-bead grid, the fact that the liquid grid can remain rigidly attached to the XRII during an entire procedure results in the establishment of an absolute detector coordinate system (referenced to the liquid-filled correction grid). The design of the liquid-filled channels allows the required control points to be introduced into the image or removed in about 30 s, avoiding the appearance of obscuring or confounding markers during clinical image acquisition, with a concurrent increase in patient dose of about 8% in the current design. Applications for this technique include stereotactic surgery, radiosurgery, x-ray stereogrammetry, and other image-guided procedures.

Algorithms↗

PubMed2005

Robust x-ray tubes for use within magnetic fields of MR scanners.

A hybrid system that combines an x-ray fluoroscopic system and a magnetic resonance (MR) system can provide physicians with the synergy of exquisite soft tissue contrast (from MR) and high temporal and spatial resolutions (from x ray), which may significantly benefit a number of image-guided interventional procedures. However, the system configuration may require the x-ray tube to be placed in a magnetic field, which can hinder the proper functioning of the x-ray tube by deflecting its electron beam. From knowledge of how the magnetic field affects the electron trajectories, we propose creating another magnetic field along the cathode-anode axis using either solenoids or permanent magnets to reduce the deflection of the electron beam for two cases: a strong and slightly misaligned field or a weak field that is arbitrary in direction. Theoretical analysis is presented and the electron beam is simulated in various external magnetic fields with a finite element modeling program. Results show that both correction schemes enhance the robustness of the x-ray tube operation in an externally applied magnetic field.

Computer-Aided Design↗

PubMed2005

A three-dimensional reconstruction algorithm for an inverse-geometry volumetric CT system.

An inverse-geometry volumetric computed tomography (IGCT) system has been proposed capable of rapidly acquiring sufficient data to reconstruct a thick volume in one circular scan. The system uses a large-area scanned source opposite a smaller detector. The source and detector have the same extent in the axial, or slice, direction, thus providing sufficient volumetric sampling and avoiding cone-beam artifacts. This paper describes a reconstruction algorithm for the IGCT system. The algorithm first rebins the acquired data into two-dimensional (2D) parallel-ray projections at multiple tilt and azimuthal angles, followed by a 3D filtered backprojection. The rebinning step is performed by gridding the data onto a Cartesian grid in a 4D projection space. We present a new method for correcting the gridding error caused by the finite and asymmetric sampling in the neighborhood of each output grid point in the projection space. The reconstruction algorithm was implemented and tested on simulated IGCT data. Results show that the gridding correction reduces the gridding errors to below one Hounsfield unit. With this correction, the reconstruction algorithm does not introduce significant artifacts or blurring when compared to images reconstructed from simulated 2D parallel-ray projections. We also present an investigation of the noise behavior of the method which verifies that the proposed reconstruction algorithm utilizes cross-plane rays as efficiently as in-plane rays and can provide noise comparable to an in-plane parallel-ray geometry for the same number of photons. Simulations of a resolution test pattern and the modulation transfer function demonstrate that the IGCT system, using the proposed algorithm, is capable of 0.4 mm isotropic resolution. The successful implementation of the reconstruction algorithm is an important step in establishing feasibility of the IGCT system.

Algorithms↗

PubMed2004

An inverse-geometry volumetric CT system with a large-area scanned source: a feasibility study.

We propose an inverse-geometry volumetric CT system for acquiring a 15-cm volume in one rotation with negligible cone-beam artifacts. The system uses a large-area scanned source and a smaller detector array. This note describes two feasibility investigations. The first examines data sufficiency in the transverse planes. The second predicts the signal-to-noise ratio (SNR) compared to a conventional scanner. Results showed sufficient sampling of the full volume in less than 0.5 s and, when compared to a conventional scanner operating at 24 kW with a 0.5-s voxel illumination time (e.g., 0.5-s gantry rotation and pitch of one), predicted a relative SNR of 76%.

Algorithms↗

PubMed2003

Pair of resonant fiducial markers for localization of endovascular catheters at all catheter orientations.

PURPOSE: To test wireless resonance circuits (RC) to be used as fiducial marker of endovascular catheters during MR-guided interventions. Current markers loose their signal enhancement for certain catheter orientations. The purpose of this study was to test a marker setup which overcomes this orientation problem. MATERIALS AND METHODS: The markers were constructed from a pair of two RCs. The RCs were individually tuned and the coil axes were oriented perpendicular to each other in order to decouple the two RCs. The markers were mounted on the tip of endovascular catheters and tested in vitro and in one porcine in vivo experiment. RESULTS: An intense MR signal at similar signal levels was noted at all catheter orientations. In the in vivo experiment the markers allowed for fast and reliable MR guidance of the catheters. CONCLUSION: A pair of two individually tuned and decoupled RCs is well suited for MR guidance of endovascular catheters.

Animals↗