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Supergridded cone-beam reconstruction and its application to point-spread function calculation.

In cone-beam computed tomography (CBCT), the volumetric reconstruction may in principle assume an arbitrarily fine grid. The supergridded cone-beam reconstruction refers to reconstructing the object domain or a subvolume thereof with a grid that is finer than the proper computed tomography sampling grid (as determined by gantry geometry and detector discreteness). This technique can naturally reduce the voxelization effect, thereby retaining more details for object reproduction. The grid refinement is usually limited to two or three refinement levels because the detail pursuit is eventually limited by the detector discreteness. The volume reconstruction is usually targeted to a local volume of interest due to the cubic growth in a three-dimensional (3D) array size. As an application, we used this technique for 3D point-spread function (PSF) measurement of a CBCT system by reconstructing edge spread profiles in a refined grid. Through an experiment with a Teflon ball on a CBCT system, we demonstrated the supergridded volume reconstruction (based on a Feldcamp algorithm) and the CBCT PSF measurement (based on an edge-blurring technique). In comparison with a postreconstruction image refinement technique (upsampling and interpolation), the supergridded reconstruction could produce better PSFs (in terms of a smaller FWHM and PSF fitting error).

Algorithms↗

[A multistage metrologic approach to the problem of evaluation of the results of the quantitative enzyme immunoassay determination of antitoxic antibodies].

To evaluate a kit for the enzyme immunoassay (ELISA), the metrological approach was used: the total error of the method for the quantitative determination of antibodies, regarded as a multistage process, was determined as the result of the accumulation of errors made in measurements at different stages. The proposed algorithm made it possible to attest the positive control serum, to determine the total error of measurements, to mark a linear section in a limited range of values on a graduation diagram. This led to obtaining well-grounded results, comparable with the results of the reaction of neutralization at good correlation (lc = 0.9).

Algorithms↗

Diagnostic strategies using myoglobin measurement in myocardial infarction.

Myoglobin, a low molecular-weight heme protein (17800 D) present in both cardiac and skeletal muscle, is an old test with new perspectives. Advantages and disadvantages of myoglobin determination are well known. Myoglobin is the earliest known, commercially available, biochemical marker of acute myocardial infarction (AMI) and its rapid kinetics make it an early, good marker of reperfusion. However, since myoglobin is present in both skeletal and cardiac muscle, any damage to these muscle types results in its release into blood. Serum myoglobin levels are falsely elevated in conditions unrelated to AMI as skeletal muscle and neuromuscular disorders, renal failure, intramuscular injection, strenuous exercise, and after several toxins and drugs intake. New strategies for myoglobin measurement may resolve this limitation. These strategies include both the combined measurement of myoglobin and a skeletal specific marker (carbonic anhydrase III) or a cardiac specific marker (troponin I), as well as the myoglobin evaluation on serial samples. In particular, the diagnostic algorithm based on the combined measurement of myoglobin and troponin I, assuring a satisfactory analytical turnaround time, significantly improves the diagnostic efficiency of laboratory assessment of suspected AMI patients, allowing the successive monitoring of coronary reperfusion.

Biomarkers↗

Electrical impedance tomography. Determination of the boundary of an object inserted into a water-filled cylinder.

In order to circumvent the electrode position determination problem in static electrical impedance tomography, it is possible to insert the object to be imaged into a water-filled cylinder on which the electrodes are at fixed and known positions. It has previously been shown that if the boundary of the internally placed object and the conductivity of the salty water in the cylinder are known, then a significant improvement in the conductivity image of the object is obtained. An algorithm for finding the boundary of an internally placed object is developed based on the finite element method (FEM). The boundary is assumed to obey a parametric model and the parameters are estimated by inverting a matrix representing the sensitivity of the boundary voltage measurements to parameter variations. The algorithm assumes that the object's internal conductivity is uniform and known. Simulation studies show that if the internal conductivity is not uniform to the extent found in the arm cross-sections, up to 9% error in the boundary, as measured from a centrally placed reference point, may result. It is also shown that if previous knowledge about the boundary shape is used to model the boundary with fewer numbers of parameters, then the boundary may be found with less error.

Algorithms↗

Wave-front sensing and deformable-mirror control in strong scintillation

Recent studies of coherent wave propagation through turbulence have shown that under conditions where scintillation is significant a continuous phase function does not in general exist, owing to the presence of branch points in the complex optical field. Because of branch points and the associated branch cuts, least-squares approaches to wave-front reconstruction and deformable-mirror control can have large errors. Branch-point reconstructors are known to provide superior performance to least-squares reconstructors, but they require that branch points be explicitly detected. Detecting branch points is a significant practical impediment owing to spatial sampling and measurement noise in real wave-front sensors. Branch points are associated with real zeros in an optical field, and hence information about the phase of the field is encoded in the amplitude of the wave. We present a new wave-front-sensor processing algorithm that exploits this observation in the wave-front-reconstruction and deformable-mirror-control process. This algorithm jointly processes three intensity measurements by using light from the beacon field to develop a set of deformable-mirror actuator commands that are maximally consistent with three intensity measurements: (1) the entire wave-front-sensor image, (2) a pupil intensity image, and (3) a conventional image. Owing to the nonlinear nature of the resulting algorithm, we have used a simulation to evaluate performance. We find that in a focused laser beam projection paradigm that uses a point-source beacon, the new algorithm provides significantly improved performance over that of conventional Hartmann sensor least-squares deformable-mirror control based on centroid processing of wave-front-sensor outputs. The performance of the new algorithm approaches, the performance of an idealized branch-point reconstructor that requires pointwise phase differences for operation.

Journal Article↗

A Monte Carlo based three-dimensional dose reconstruction method derived from portal dose images.

The verification of intensity-modulated radiation therapy (IMRT) is necessary for adequate quality control of the treatment. Pretreatment verification may trace the possible differences between the planned dose and the actual dose delivered to the patient. To estimate the impact of differences between planned and delivered photon beams, a three-dimensional (3-D) dose verification method has been developed that reconstructs the dose inside a phantom. The pretreatment procedure is based on portal dose images measured with an electronic portal imaging device (EPID) of the separate beams, without the phantom in the beam and a 3-D dose calculation engine based on the Monte Carlo calculation. Measured gray scale portal images are converted into portal dose images. From these images the lateral scattered dose in the EPID is subtracted and the image is converted into energy fluence. Subsequently, a phase-space distribution is sampled from the energy fluence and a 3-D dose calculation in a phantom is started based on a Monte Carlo dose engine. The reconstruction model is compared to film and ionization chamber measurements for various field sizes. The reconstruction algorithm is also tested for an IMRT plan using 10 MV photons delivered to a phantom and measured using films at several depths in the phantom. Depth dose curves for both 6 and 10 MV photons are reconstructed with a maximum error generally smaller than 1% at depths larger than the buildup region, and smaller than 2% for the off-axis profiles, excluding the penumbra region. The absolute dose values are reconstructed to within 1.5% for square field sizes ranging from 5 to 20 cm width. For the IMRT plan, the dose was reconstructed and compared to the dose distribution with film using the gamma evaluation, with a 3% and 3 mm criterion. 99% of the pixels inside the irradiated field had a gamma value smaller than one. The absolute dose at the isocenter agreed to within 1% with the dose measured with an ionization chamber. It can be concluded that our new dose reconstruction algorithm is able to reconstruct the 3-D dose distribution in phantoms with a high accuracy. This result is obtained by combining portal dose images measured prior to treatment with an accurate dose calculation engine.

Algorithms↗

Finding flexible patterns in unaligned protein sequences.

We present a new method for the identification of conserved patterns in a set of unaligned related protein sequences. It is able to discover patterns of a quite general form, allowing for both ambiguous positions and for variable length wildcard regions. It allows the user to define a class of patterns (e.g., the degree of ambiguity allowed and the length and number of gaps), and the method is then guaranteed to find the conserved patterns in this class scoring highest according to a significance measure defined. Identified patterns may be refined using one of two new algorithms. We present a new (nonstatistical) significance measure for flexible patterns. The method is shown to recover known motifs for PROSITE families and is also applied to some recently described families from the literature.

Algorithms↗

Image processing for IMRT QA dosimetry.

We have automated the determination of the placement location of the dosimetry ion chamber within intensity-modulated radiotherapy (IMRT) fields, as part of streamlining the entire IMRT quality assurance process. This paper describes the mathematical image-processing techniques to arrive at the appropriate measurement locations within the planar dose maps of the IMRT fields. A specific spot within the found region is identified based on its flatness, radiation magnitude, location, area, and the avoidance of the interleaf spaces. The techniques used include applying a Laplacian, dilation, erosion, region identification, and measurement point selection based on three parameters: the size of the erosion operator, the gradient, and the importance of the area of a region versus its magnitude. These three parameters are adjustable by the user. However, the first one requires tweaking in extremely rare occasions, the gradient requires rare adjustments, and the last parameter needs occasional fine-tuning. This algorithm has been tested in over 50 cases. In about 5% of cases, the algorithm does not find a measurement point due to the extremely steep and narrow regions within the fluence maps. In such cases, manual selection of a point is allowed by our code, which is also difficult to ascertain, since the fluence map does not yield itself to an appropriate measurement point selection.

Algorithms↗

[Crisis of computer diagnosis and ways of its overcoming].

Despite a widespread application of computer technologies in medicine, there is currently a lack of diagnostic computer programs, meeting neurological needs. Most of the existing programs depend on some subjective factors. The authors propose their own computer program named "indicated diagnosis", and demonstrate its potential for diagnosis of peripheral monoparesis. Indicated diagnosis included testing and structuring of clinical and anatomical traits, along with the data of instrumental examination of the patients, ranging from patients complaints to establishing topic and nosologic diagnosis. Indicated diagnostics algorithm may be used for measuring of the lesions of nerves, plexuses, terminals and spinal cord segments involved in limb innervation.

Algorithms↗

Noninvasive estimation of serum bilirubin.

OBJECTIVE: The aim of this study was to evaluate the accuracy and clinical usefulness of a new computer-driven, hand-held device (Chromatics Colormate III) to estimate serum bilirubin from skin-reflectance (skin color) of neonates. STUDY DESIGN: A total of 2441 infants (both term and premature) at two hospitals had repeated measurements of transcutaneous bilirubin. Of these infants, 900 had one or more laboratory determinations of serum bilirubin. Many of the infants had early measurements of skin color before the onset of jaundice. A visual estimate of the degree of jaundice was made by a health care worker when the laboratory study was drawn. A subgroup of 61 infants was also studied while undergoing phototherapy with a total of 284 comparisons obtained. The reproducibility of the instrument was assessed separately using standardized color tiles and repeated measurements by multiple operators. RESULTS: The range of serum bilirubin measurements that had concurrent skin color measurements was 3.22 to 338.1 micromol/L (0.2 to 21 mg/dL). The linear regression indicated an r = 0.956, and 95% of the skin color measurements were within 32.2 micromol/L (2.0 mg/dL). There was no interference with the accuracy of the device because of infant race or weight, or because of the use of phototherapy. The device provided reproducible information when infants were tested repeatedly over 30 minutes; the coefficient of variation for the transcutaneous bilirubin measurement was 3.1% around a mean estimate of 135.32 micromol/L (8.4 mg/dL). CONCLUSION: The Chromatics Colormate III allows for a clinically useful estimate of serum bilirubin in a wide variety of infants. By using a color discrimination algorithm and obtaining a skin measurement before the onset of icterus, this instrument can provide valuable clinical information that obviates the need for serum bilirubin determinations. Its use in newborn nurseries may allow physicians to shorten length of stay more safely and decrease the use of invasive blood tests.

Algorithms↗

Dynamic QT interval analysis in uraemic patients receiving chronic haemodialysis.

OBJECTIVE: To analyse the duration of the QT interval and its relationship with heart rate changes in patients with uraemia, before and during haemodialysis. METHODS: QT and RR intervals were measured automatically using a dedicated algorithm with 24-h Holter recordings in 29 patients (15 women) receiving chronic haemodialysis. QT corrected for heart rate (QTc) and the slope of QT/RR linear regression were calculated. Arterial blood pressure (ABP) was measured before and during haemodialysis. Plasma concentrations of K+, Mg2+ and Ca2+ were assessed before and after haemodialysis. RESULTS: ABP decreased significantly from baseline (102.7 +/- 11.0 mmHg) during the first (100.6 +/- 8.8 mmHg, P < 0.05), second (95.6 +/- 10.6 mmHg, P < 0.05), and third (94.9 +/- 10.3 mmHg, P < 0.05) hours of haemodialysis. QTc was longer during haemodialysis than during a 4-h period of no dialysis (447 +/- 28 ms compared with 429 +/- 22 ms, P < 0.001), and increased progressively during haemodialysis, with the greatest value during the last hour of haemodialysis (454 +/- 32 ms compared with 426 +/- 22 ms, P < 0.001). QT/RR slopes and correlation coefficients were lower during haemodialysis than during the period of no dialysis (0.13 +/- 0.08 compared with 0.20 +/- 0.07, P < 0.001 and 0.48 +/- 0.30 compared with 0.81 +/- 0.20, respectively; P < 0.001), suggesting a reduced ability to adapt the QT interval in response to changes in heart rate. The effects of haemodialysis on QT interval and the QT/RR relationship were greater in women than in men. QTc variations during dialysis were not correlated with changes in ABP, but were inversely related to changes in Ca2+ concentration (r2 = 0.35; P = 0.001). CONCLUSIONS: In patients with uraemia, the haemodialysis session induces a progressive increase in QT interval and modifies its relationship with heart rate. These effects may predispose some individuals to ventricular arrhythmias at the end of and immediately after the haemodialysis session.

Aged↗

Inference from clustering with application to gene-expression microarrays.

There are many algorithms to cluster sample data points based on nearness or a similarity measure. Often the implication is that points in different clusters come from different underlying classes, whereas those in the same cluster come from the same class. Stochastically, the underlying classes represent different random processes. The inference is that clusters represent a partition of the sample points according to which process they belong. This paper discusses a model-based clustering toolbox that evaluates cluster accuracy. Each random process is modeled as its mean plus independent noise, sample points are generated, the points are clustered, and the clustering error is the number of points clustered incorrectly according to the generating random processes. Various clustering algorithms are evaluated based on process variance and the key issue of the rate at which algorithmic performance improves with increasing numbers of experimental replications. The model means can be selected by hand to test the separability of expected types of biological expression patterns. Alternatively, the model can be seeded by real data to test the expected precision of that output or the extent of improvement in precision that replication could provide. In the latter case, a clustering algorithm is used to form clusters, and the model is seeded with the means and variances of these clusters. Other algorithms are then tested relative to the seeding algorithm. Results are averaged over various seeds. Output includes error tables and graphs, confusion matrices, principal-component plots, and validation measures. Five algorithms are studied in detail: K-means, fuzzy C-means, self-organizing maps, hierarchical Euclidean-distance-based and correlation-based clustering. The toolbox is applied to gene-expression clustering based on cDNA microarrays using real data. Expression profile graphics are generated and error analysis is displayed within the context of these profile graphics. A large amount of generated output is available over the web.

Computational Biology↗

Geometric quantitative coronary arteriography. A comparison of unsubtracted and dual energy-subtracted images.

The application of dual energy (DE) subtraction techniques to quantitative coronary arteriography (QCA) has the advantage of removing the tissue signal surrounding the vessel profile. We have compared the performance of two geometric QCA algorithms on DE-subtracted and -unsubtracted images to determine, for each, if DE subtraction is advantageous. The two algorithms under study were an edge detection algorithm and a Fourier analysis-based algorithm. For each algorithm, linear regression analysis was performed of measured cross-sectional area (CSA) versus actual CSA of coronary vessel phantoms. The edge detection algorithm was found to have improved precision (P less than .05) when applied to the DE-subtracted images. The Fourier analysis algorithm, however, was not effected by the DE subtraction. Among the unsubtracted image results, the Fourier measurements were more accurate (P less than .05) than the edge detection measurements. We conclude that the benefits to edge detection QCA of DE tissue subtraction outweigh the disadvantages of increased image noise and possible misregistration artifacts. However, the Fourier algorithm is relatively insensitive to tissue signal variations.

Algorithms↗

Has your patient's multiple sclerosis lesion burden or brain atrophy actually changed?

Changes in mean magnetic resonance imaging (MRI)-derived measurements between patient groups are often used to determine outcomes in therapeutic trials and other longitudinal studies of multiple sclerosis (MS). However, in day-to-day clinical practice the changes within individual patients may also be of interest In this paper, we estimated the measurement error of an automated brain tissue quantification algorithm and determined the thresholds for statistically significant change of MRI-derived T2 lesion volume and brain atrophy in individual patients. Twenty patients with MS were scanned twice within 30 min. Brain tissue volumes were measured using the computer algorithm. Brain atrophy was estimated by calculation of brain parenchymal fraction. The threshold of change between repeated scans that represented statistically significant change beyond measurement error with 95% certainty was 0.65 mL for T2 lesion burden and 0.0056 for brain parenchymal fraction. Changes in lesion burden and brain atrophy below these thresholds can be safely (with 95% certainty) explained by measurement variability alone. These values provide clinical neurologists with a useful reference to interpret MRI-derived measures in individual patients.

Algorithms↗

Identifying critical variables of principal components for unsupervised feature selection.

Principal components analysis (PCA) is probably the best-known approach to unsupervised dimensionality reduction. However, axes of the lower-dimensional space, ie., principal components (PCs), are a set of new variables carrying no clear physical meanings. Thus, interpretation of results obtained in the lower-dimensional PCA space and data acquisition for test samples still involve all of the original measurements. To deal with this problem, we develop two algorithms to link the physically meaningless PCs back to a subset of original measurements. The main idea of the algorithms is to evaluate and select feature subsets based on their capacities to reproduce sample projections on principal axes. The strength of the new algorithms is that the computaion complexity involved is significantly reduced, compared with the data structural similarity-based feature evaluation.

Algorithms↗

Generation, description and storage of dendritic morphology data.

It is generally assumed that the variability of neuronal morphology has an important effect on both the connectivity and the activity of the nervous system, but this effect has not been thoroughly investigated. Neuroanatomical archives represent a crucial tool to explore structure-function relationships in the brain. We are developing computational tools to describe, generate, store and render large sets of three-dimensional neuronal structures in a format that is compact, quantitative, accurate and readily accessible to the neuroscientist. Single-cell neuroanatomy can be characterized quantitatively at several levels. In computer-aided neuronal tracing files, a dendritic tree is described as a series of cylinders, each represented by diameter, spatial coordinates and the connectivity to other cylinders in the tree. This 'Cartesian' description constitutes a completely accurate mapping of dendritic morphology but it bears little intuitive information for the neuroscientist. In contrast, a classical neuroanatomical analysis characterizes neuronal dendrites on the basis of the statistical distributions of morphological parameters, e.g. maximum branching order or bifurcation asymmetry. This description is intuitively more accessible, but it only yields information on the collective anatomy of a group of dendrites, i.e. it is not complete enough to provide a precise 'blueprint' of the original data. We are adopting a third, intermediate level of description, which consists of the algorithmic generation of neuronal structures within a certain morphological class based on a set of 'fundamental', measured parameters. This description is as intuitive as a classical neuroanatomical analysis (parameters have an intuitive interpretation), and as complete as a Cartesian file (the algorithms generate and display complete neurons). The advantages of the algorithmic description of neuronal structure are immense. If an algorithm can measure the values of a handful of parameters from an experimental database and generate virtual neurons whose anatomy is statistically indistinguishable from that of their real counterparts, a great deal of data compression and amplification can be achieved. Data compression results from the quantitative and complete description of thousands of neurons with a handful of statistical distributions of parameters. Data amplification is possible because, from a set of experimental neurons, many more virtual analogues can be generated. This approach could allow one, in principle, to create and store a neuroanatomical database containing data for an entire human brain in a personal computer. We are using two programs, L-NEURON and ARBORVITAE, to investigate systematically the potential of several different algorithms for the generation of virtual neurons. Using these programs, we have generated anatomically plausible virtual neurons for several morphological classes, including guinea pig cerebellar Purkinje cells and cat spinal cord motor neurons. These virtual neurons are stored in an online electronic archive of dendritic morphology. This process highlights the potential and the limitations of the 'computational neuroanatomy' strategy for neuroscience databases.

Algorithms↗

A spectral color correction framework for medical applications.

This paper presents a new spectral approach to color correction for medical image analysis applications. Linear estimation with regularization by a constrained principal eigenvector method is used for calibration of the camera system and estimation of the illumination spectrum while spectral surface reflectivities are determined by Wiener inverse estimation. Nonlinear devices are handled by piecewise linear interpolation and any linear color preprocessing inside the camera is explicitly modeled. All measurement and estimation processes are combined into a spectral calibration framework for practical application in computer-assisted image analysis. The novelty of our approach lies in the generalization of the image formation model allowing for linear preprocessing inside the camera system. Such transforms would lead to erroneous results with positivity constraint based algorithms or a monochromator based measurement. We provide experimental results from a comprehensive set of reference measurements acquired with a video endoscopy system for gastroscopic application.

Algorithms↗

Quantitative bone metastases analysis based on image segmentation.

UNLABELLED: Preliminary evidence indicates that the fraction of bone containing metastatic lesions is a strong prognostic indicator of survival longevity for prostate and breast cancer. Our current approach to quantify metastatic bone lesions, called the Bone Scan Index, is based on an inspection of the bone scan, estimating visually the fraction of each bone involved and then summing across all bones to determine the percentage of total skeletal involvement. This approach, however, is time consuming, subjective and dependent on individual interpretation. METHODS: To overcome these problems, a semiautomated image segmentation program was developed for the quantitation of metastases from planar whole-body bone scans. The user is required to insert a seed point into each metastatic region on the image. The algorithm then connects pixels to the seed pixel in all directions until a contrast-dependent threshold is reached. The optimal threshold for cessation of the region growing is determined from phantom studies. On the images, lesion delineation and size measurements were performed by the algorithm. Each delineated lesion is associated with a bone site using pull-down menus. The program then computes the fraction of lesion involvement in each bone based on look-up-tables containing the relationship of bone mass with race, sex, height and age. These look-up-tables were obtained by multiple regression of the skeletal mass measurements in humans. The total fraction of skeletal involvement is then obtained from the individual fractional masses. For individual fractional mass, values given in International Commission on Radiation Protection Publication No. 23 were used. RESULTS: The bone metastases analysis system has been used on 11 scans from 6 patients. The correlation was high (r = 0.83) between conventional (manually drawn region-of-interest) and this analysis system. Bone metastases analysis results in consistently lower estimates of fractional involvement in bone compared with the conventional region-of-interest drawing or visual estimation method. This is due to the apparent broadening of objects at and below the limits of resolution of the gamma camera. CONCLUSION: Image segmentation reduces the delineation and quantitation time of lesions by at least two compared with manual region-of-interest drawing. The objectivity of this technique allows the detection of small variations in follow-up patient scans for which the manual region-of-interest method may fail, due to performance variability of the user. This method preserves the diagnostic skills of the nuclear medicine physician to select which bony structures contain lesions, yet combines it with an objective delineation of the lesion.

Adolescent↗