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An error-reduction-based algorithm for cone-beam computed tomography.

Image reconstruction from cone-beam projections collected along a single circular source trajectory is commonly done using the Feldkamp algorithm, which performs well only with a small cone angle. In this report, we propose an error-reduction-based algorithm to increase the cone angle by several folds to achieve satisfactory image quality at the same radiation dose. In our scheme, we first reconstruct the object using the Feldkamp algorithm. Then, we synthesize cone-beam projection data from the reconstructed volume in the same geometry, and reconstruct the volume again from the synthesized projections. Finally, these two reconstruction results are combined to reduce the reconstruction error and produce a superior image volume. The merit of this algorithm is demonstrated in numerical simulation.

Algorithms↗

Optimized interstitial PDT prostate treatment planning with the Cimmino feasibility algorithm.

The primary aim of this study was to determine whether optimized photodynamic therapy (PDT) treatment planning (seeking optimized positions, lengths, and strengths of the light sources to satisfy a given dose prescription) can improve dose coverage to the prostate and the sparing of critical organs relative to what can be achieved by the standard PDT plan. The Cimmino algorithm and search procedures based on that algorithm were tested for this purpose. A phase I motexafin lutetium (MLu)-mediated photodynamic therapy protocol is ongoing at the University of Pennsylvania. PDT for the prostate is performed with cylindrical diffusing fibers of various lengths inserted perpendicular to a base plate to obtain longitudinal coverage by a matrix of parallel catheters. The standard plan for the protocol uses sources of equal strength with equal spaced (1-cm) loading. Uniform optical properties were assumed. Our algorithms produce plans that cover the prostate and spare the urethra and rectum with less discrepancy from the dose prescription than the standard plan. The Cimmino feasibility algorithm is fast enough that changes to the treatment plan may be made in the operating room before and during PDT to optimize light delivery.

Algorithms↗

An improved MLC segmentation algorithm and software for step-and-shoot IMRT delivery without tongue-and-groove error.

We present an improved multileaf collimator (MLC) segmentation algorithm, denoted by SLS(NOTG) (static leaf sequencing with no tongue-and-groove error), for step-and-shoot intensity-modulated radiation therapy (IMRT) delivery. SLS(NOTG) is an improvement over the MLC segmentation algorithm called SLS that was developed by Luan et al. [Med. Phys. 31(4), 695-707 (2004)], which did not consider tongue-and-groove error corrections. The aims of SLS(NOTG) are (1) shortening the treatment times of IMRT plans by minimizing their numbers of segments and (2) minimizing the tongue-and-groove errors of the computed IMRT plans. The input to SLS(NOTG) is intensity maps (IMs) produced by current planning systems, and its output is (modified) optimized leaf sequences without tongue-and-groove error. Like the previous SLS algorithm [Luan et al., Med. Phys. 31(4), 695-707 (2004)], SLS(NOTG) is also based on graph algorithmic techniques in computer science. It models the MLC segmentation problem as a weighted minimum-cost path problem, where the weight of the path is the number of segments and the cost of the path is the amount of tongue-and-groove error. Our comparisons of SLS(NOTG) with CORVUS indicated that for the same intensity maps, the numbers of segments computed by SLS(NOTG) are up to 50% less than those by CORVUS 5.0 on the Elekta LINAC system. Our clinical verifications have shown that the dose distributions of the SLS(NOTG) plans do not have tongue-and-groove error and match those of the corresponding CORVUS plans, thus confirming the correctness of SLS(NOTG). Comparing with existing segmentation methods, SLS(NOTG) also has two additional advantages: (1) SLS(NOTG) can compute leaf sequences whose tongue-and-groove error is minimized subject to a constraint on the maximum allowed number of segments, which may be desirable in clinical situations where a treatment with the complete correction of tongue-and-groove error takes too much time, and (2) SLS(NOTG) can be used to minimize a more general type of error called the tongue-or-groove error.

Algorithms↗

GLAaS: an absolute dose calibration algorithm for an amorphous silicon portal imager. Applications to IMRT verifications.

A new calibration algorithm (GLAaS) to derive absolute dose maps from images acquired with the Varian PV-aS500 electronic portal imager (based on amorphous silicon detectors) has been developed incorporating the dependence of detector response on primary and transmitted radiation and on field size. Detector calibration and algorithm validation were performed at different depths (10.0, 3.8, 1.5, and 0.8 cm) in solid water to investigate various application possibilities. Calibration data were obtained against ion chamber measurements. Validation experiments were performed on intensity-modulated fields and comparison was carried out against calculated dose maps as well as against film measurements. Split fields were acquired independently and PV-aS500 images were summed offline with the new algorithm allowing complex fields to be verified in conditions most closely resembling clinical conditions. Excellent results were obtained for the 3.8, 1.5, and 0.8 depths on a set of 34 modulated fields including both split and nonsplit fields. Applying the gamma index analysis (with distance to agreement and dose thresholds set to 3 mm and 4%, respectively), only 2.3% of the field area showed gamma > 1 at 1.5 cm depth (8.1%, 3.1%, 2.7% at 10.0, 3.8, and 0.8 and 2.5% with films at 10 cm depth). Tests were also performed to verify GLAaS at gantry angles different from 0 degrees. No statistical differences were obtained for the comparison between split and nonsplit fields and between different gantry angles. Highly significant statistical differences were obtained when comparing independent samples of 240 fields verified either with GLAaS or with film. Fields verified with GLAaS presented a mean area with gamma > 1 of 2.1 +/-1.3% while for film this value was 3.9 +/- 3.4% (p<0.001). Absolute dosimetry proved to be reliable with the PV-aS500 detector with the GLAaS algorithm. The minimal settings at depths of 1.5 or 3.8 cm would allow the use of the detector at any gantry angle without the need for any special fixation tool.

Algorithms↗

A novel algorithm for the edge detection and edge enhancement of medical images.

A novel algorithm, histogram shifting (HS) is presented, which performs edge detection or edge enhancement with the choice of two parameters. The histogram of a region surrounding each pixel is found and translated toward the origin, resulting in the new pixel value. Images from a variety of medical imaging modalities were processed with HS to perform detection and enhancement of edges. Comparison with results obtained from conventional edge detection (e.g., Sobel) and with conventional edge-enhancement algorithms is discussed. HS appears to perform the edge-detection operation without introducing "double-edge" effects often obtained with conventional edge-detection algorithms. HS also appears to perform edge enhancement without introducing extensive noise artifacts, which may be noticeable with many edge-enhancement algorithms.

Algorithms↗

Pseudocorrelation: a fast, robust, absolute, grey-level image alignment algorithm.

A new image alignment algorithm--pseudocorrelation--has been developed based on the application of Monte Carlo techniques to the calculation of a cross-correlation integral for grey-scale images. It has many advantages over cross-correlation: it is at least a factor of 10 faster than fast-Fourier-transform-based cross-correlation, and requires 8 times less memory. Its high speed allows for the search space of geometric transformations between images to include magnification and rotation as well as translations without the search time becoming too long. It allows noise to be taken into account, making calculation of a robust, absolute probability of good alignment possible. It is relatively insensitive to differences in quality between images. This article describes the pseudocorrelation algorithm in detail and presents the results of tests of the effects of contrast enhancement, resolution differences, and noise on the algorithm's performance. These tests show that the algorithm is well suited to the task of automated alignment of very low contrast images from video electronic portal imaging devices.

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Systematic verification of a three-dimensional electron beam dose calculation algorithm.

A three-dimensional electron beam dose calculation algorithm implemented on a commercial radiotherapy treatment planning system is described. The calculation is based on the M. D. Anderson Hospital (M.D.A.H.) pencil beam model, which uses the Fermi-Eyges theory of thick-target multiple Coulomb scattering. To establish the calculation algorithm's accuracy as well as its limitations, it was systematically and extensively tested and evaluated against a set of benchmark measurements. Various levels of dose and spatial tolerances were used to validate the calculation quantitatively. Results are presented in terms of the percentage of data points meeting a specific tolerance level. The algorithm's ability to accurately simulate commonly used clinical setup geometries, including standard or extended SSDs, blocked fields, irregular surfaces, and heterogeneities, is demonstrated. Regions of disagreement between calculations and measurements are also shown. The clinical implication of such disagreements is addressed, and the algorithmic assumptions involved are discussed.

Algorithms↗

A new source localization algorithm with no requirement of one-to-one source correspondence between biplane radiographs.

Conventional source localization algorithms require a one-to-one source correspondence between films. This requirement makes source localization cumbersome and error prone because multiple sources must be carefully digitized and some sources can be obscured or missed. A new source localization algorithm is described in this paper. The algorithm fits a ribbon or needle image on film to a linear-quadratic equation, then analytically determines the 3-D ribbon locus by its image on the other projection, and finally localizes the sources in the ribbon by tracing along the ribbon image. Only three points per ribbon per film are required, and corresponding points need not be identified on the other film. Phantom experiments and tests on clinical cases demonstrate that the source localization algorithm can increase the efficiency by a factor of up to 5, improve accuracy to about 1 mm, and reconstruct obscured or shifted sources without decreased accuracy and efficiency. The simplicity and minimal entry of data make this technique desirable for clinical use.

Algorithms↗

A Fourier based algorithm for tracking SPAMM tags in gated magnetic resonance cardiac images.

A method is described for automatically tracking spatial modulation of magnetization tag lines on gated cardiac images. The method differs from previously reported methods in that it uses Fourier based spatial frequency and phase information to separately track horizontal and vertical tag lines. Use of global information from the frequency spectrum of an entire set of tag lines was hypothesized to result in a robust algorithm with decreased sensitivity to noise. The method was validated in several ways: first, actual tagged cardiac images at end diastole were deformed known amounts, and the algorithm's predictions compared to the known deformations. Second, tagged, gated images of the thigh muscle (assumed to have similar signal to noise characteristics as cardiac images, but to not deform with time) were created. Again the algorithmic predictions could be compared to the known (zero magnitude) deformations and to thigh images which had been artificially deformed. Finally, actual cardiac tagged images were acquired, and comparisons made between manual, visual, determinations of tag line locations, and those predicted by the algorithm. At 0.5 T, the mean bias of the method was < 0.34 mm even at large deformations and at late (noisy) times. The standard deviation of the method, estimated from the tagged thigh images, was < 0.7 mm even at late times. The method may be expected to have even lower error at higher field strengths.

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Decision theoretic steering and genetic algorithm optimization: application to stereotactic radiosurgery treatment planning.

Treatment planning for stereotactic radiosurgery and fractionated radiotherapy is currently a labor intensive, operator-dependent process. Many degrees of freedom exist to make rigorous optimization intractable except by computationally intelligent techniques. The quality of a given plan is determined by an aggregate of clinical objectives, most of which are subject to competing tradeoffs. In this work, we present an autonomous scheme that couples decision theoretic guidance with a genetic algorithm for optimization. Ordinal ranking among a population of viable treatment plans is based on a generalized distance metric, which promotes a decreasing hyperfrontier of the efficient solution set. The solution set is driven toward efficiency by the genetic algorithm, which uses the tournament selection mechanism based on the ordinal ranking. Goals and satisficing conditions can be defined to signal the ultimate and the minimum achievement levels in a given objective. A conventionally challenging case in radiosurgery was used to demonstrate the practical utility and the problem-solving power of the decision theoretic genetic algorithm. Treatment plans with one isocenter and four isocenters were derived under the autonomous scheme and compared to the actual treatment plan manually optimized by the expert planner. Quality assessment based on dose-volume histograms and normal tissue complication probabilities suggested that computational optimization could be driven to offer varying degrees of dosimetric improvement over a human-guided optimization effort. Furthermore, it was possible to achieve a high degree of isodose conformity to the target volume in computational optimization by increasing the degree of freedom in the treatment parameters. The time taken to derive an efficient planning solution was comparable and usually shorter than in the manual planning process, and can be scaled down almost linearly with the number of processors. Overall, the autonomous genetic algorithm scheme was found to be powerful and versatile as a computationally intelligent counterpart to human-guided strategies in treatment optimization for stereotactic radiosurgery and radiotherapy.

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Extension of a numerical algorithm to proton dose calculations. I. Comparisons with Monte Carlo simulations.

A numerical algorithm originally developed for electron dose calculations [Med. Phys. 21, 1591 (1994)] has been modified for use with proton beams. The algorithm recursively propagates the proton distribution in energy, angle, and space from one level in an absorbing medium to another at slightly greater depth until all protons stop. Vavilov's theory is used to predict, at any point in the absorber, the broadening of the primary proton energy-spectrum. Moliere's theory is applied to describe the angular distribution, and it is shown that the Gaussian first term of Moliere's series expansion is of sufficient accuracy for dose calculations. These multiple scattering and energy loss distributions are sampled using equal probability spacing to optimize computational speed while maintaining calculational accuracy. Inelastic nuclear collisions along the proton trajectories are modeled by a simple exponential extinction. Predictions of the algorithm for absolute dose deposition by a 160 MeV initially monoenergetic proton beam are compared with the results of Monte Carlo simulations performed with the PTRAN code. The excellent level of agreement between the results of these two methods of dose calculation (< 5% dose and < 3 mm spatial deviations) demonstrate that dose deposition from proton beams may be computed to high accuracy using this algorithm without the need for extensive empirical measurement as input.

Algorithms↗

An active set algorithm for treatment planning optimization.

An active set algorithm for optimization of radiation therapy dose planning by intensity modulated beams has been developed. The algorithm employs a conjugate-gradient routine for subspace minimization in order to achieve a higher rate of convergence than the widely used constrained steepest-descent method at the expense of a negligible amount of overhead calculations. The performance of the new algorithm has been compared to that of the constrained steepest-descent method for various treatment geometries and two different objectives. The active set algorithm is found to be superior to the constrained steepest descent, both in terms of its convergence properties and the residual value of the cost functions at termination. Its use can significantly accelerate the design of conformal plans with intensity modulated beams by decreasing the number of time-consuming dose calculations.

Algorithms↗

A proton dose calculation algorithm for conformal therapy simulations based on Molière's theory of lateral deflections.

An algorithm is developed for computing proton dose distributions in the therapeutic energy range (100-250 MeV). The goal is to provide accurate pencil beam dose distributions for two-dimensional or three-dimensional simulations of possible intensity-modulated proton therapy delivery schemes. The algorithm is based on Molière's theory of lateral deflections, which accurately describes the distribution of lateral deflections suffered by incident charged particles. The theory is applied to nonuniform targets through the usual pencil beam approximation which assumes that all protons from a given pencil beam pass through the same material at each depth. Fluence-to-dose conversion is made via Monte Carlo calculated broad-field central-axis depth-dose curves, which accounts for attenuation due to nuclear collisions and range straggling. Calculation speed is enhanced by using a best-fit Gaussian approximation of the radial distribution function at depth. Representative pencil beam and spread-out Bragg-peak computations are presented at 250 MeV and 160 MeV in water. Computed lateral full-widths-at-half-maximum's in water, at the Bragg peak, agree with the expected theoretical lateral values to within 1% at 160 MeV and to within 3% at 250 MeV. This algorithm differs from convolution methods in that the effect of the depth of any inhomogeneities in density or atomic composition are accounted for in a rigorous fashion. The algorithm differs from Fermi-Eyges based methods by accounting in a rigorous way for the effect of nonsmall-angle scattering and screening due to atomic electrons. The computational burden is only slightly greater than that expected using the less-rigorous Fermi-Eyges theory.

Algorithms↗

Comparison of commercially available three-dimensional treatment planning algorithms for monitor unit calculations in the presence of heterogeneities.

This study uses an anthropomorphic phantom and its computed tomography (CT) data set to evaluate monitor unit (MU) calculations using the CMS Focus Clarkson, the CMS Focus Multigrid Superposition Model, the CMS Focus FFT Convolution Model, and the ADAC Pinnacle Collapsed Cone Convolution Superposition Algorithms. Using heterogeneity corrections, a treatment plan and corresponding MU calculations were generated for several typical clinical situations. A diode detector, placed in an anthropomorphic phantom, was used to compare the treatment planning algorithms' predicted doses with measured data. Differences between diode measurements and the algorithms' calculations were within reasonable levels of acceptability as recommended by Van Dyk et al. [Int. J. Rad. Onc. Biol. Phys. 26, 261-273 (1993)], except for the CMS Clarkson algorithm, which predicted too few MU for delivery of the intended dose to chest wall fields.

Algorithms↗

A parameter optimization algorithm for intensity-modulated radiotherapy prostate treatment planning.

An iterative algorithm has been developed to analytically determine patient specific input parameters for intensity-modulated radiotherapy prostate treatment planning. The algorithm starts with a generic set of inverse planning parameters that include dose and volume constraints for the target and surrounding critical structures. The overlap region between the target volume and the rectum is used to determine the optimized target volume coverage goal. Sequential iterations are performed to vary the numerous parameters individually or in sets while other parameters remain fixed. A coarse grid search is first used to avoid convergence on a local maximum. Linear interpolation is then used to define a region for a fine grid search. Selected parameters are also tested for possible improvements in target coverage. In several representative test cases investigated the coverage of the planning target volume improved with the use of the algorithm while still meeting the clinical acceptability criteria for critical structures. The algorithm avoids time-consuming random trial and error variations that are often associated with difficult cases and also eliminates lengthy user learning curves. The methodology described in this paper can be applied to any treatment planning system that requires the user to select the input optimization parameters.

Algorithms↗

A relative-entropy algorithm for genomic fingerprinting captures host-phage similarities.

The degeneracy of codons allows a multitude of possible sequences to code for the same protein. Hidden within the particular choice of sequence for each organism are over 100 previously undiscovered biologically significant, short oligonucleotides (length, 2 to 7 nucleotides). We present an information-theoretic algorithm that finds these novel signals. Applying this algorithm to the 209 sequenced bacterial genomes in the NCBI database, we determine a set of oligonucleotides for each bacterium which uniquely characterizes the organism. Some of these signals have known biological functions, like restriction enzyme binding sites, but most are new. An accompanying scoring algorithm is introduced that accurately (92%) places sequences of 100 kb with their correct species among the choice of hundreds. This algorithm also does far better than previous methods at relating phage genomes to their bacterial hosts, suggesting that the lists of oligonucleotides are "genomic fingerprints" that encode information about the effects of the cellular environment on DNA sequence. Our approach provides a novel basis for phylogeny and is potentially ideally suited for classifying the short DNA fragments obtained by environmental shotgun sequencing. The methods developed here can be readily extended to other problems in bioinformatics.

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Automated interpretation of disk diffusion antibiotic susceptibility tests with the radial profile analysis algorithm.

An original algorithm referred to as the radial profile analysis algorithm was implemented on a Macintosh Quadra 700 computer to provide an automatic determination of the inhibition zone diameters of antibiotic susceptibility tests performed with the disk diffusion method. After digitization of the petri plate image, each antibiotic disk is recognized and labeled. Pixels of the local zone around each disk are then used for generating a profile pattern that is subjected to decision rules. The resulting estimate of the inhibition zone diameter is then automatically compared with conventional breakpoints for classifying the tested strain in one of the clinical categories of antibiotic susceptibility. The program is also able to request a human reading for some rare plates difficult to interpret. The algorithm accuracy was tested by comparing the results with a combination of independent human measurements performed on the tested plates. The test sample was composed of 98 strains, and 2,552 tests of 40 distinct antibiotics were subjected to the analysis. The difference between the automatic and human diameter estimates was less than 4 mm in 90% of the tests. The agreement between the automatic and human clinical categorizations amounted to 95.5%, and severe (major and very major) disagreements were found in 5.6% of the tests performed with staphylococci but only 0.3% of the tests with gram-negative rods. We conclude that the radial profile analysis algorithm is a solid backbone for an automatic system dedicated to the clinical interpretation of disk diffusion antibiotic susceptibility tests.

Algorithms↗

Sensitivity and specificity of human immunodeficiency virus rapid serologic assays and testing algorithms in an antenatal clinic in Abidjan, Ivory Coast.

To evaluate serologic testing algorithms for human immunodeficiency virus (HIV) based on a combination of rapid assays among persons with HIV-1 (non-B subtypes) infection, HIV-2 infection, and HIV-1-HIV-2 dual infections in Abidjan, Ivory Coast, a total of 1,216 sera with known HIV serologic status were used to evaluate the sensitivity and specificity of four rapid assays: Determine HIV-1/2, Capillus HIV-1/HIV-2, HIV-SPOT, and Genie II HIV-1/HIV-2. Two serum panels obtained from patients recently infected with HIV-1 subtypes B and non-B were also included. Based on sensitivity and specificity, three of the four rapid assays were evaluated prospectively in parallel (serum samples tested by two simultaneous rapid assays) and serial (serum samples tested by two consecutive rapid assays) testing algorithms. All assays were 100% sensitive, and specificities ranged from 99.4 to 100%. In the prospective evaluation, both the parallel and serial algorithms were 100% sensitive and specific. Our results suggest that rapid assays have high sensitivity and specificity and, when used in parallel or serial testing algorithms, yield results similar to those of enzyme-linked immunosorbent assay-based testing strategies. HIV serodiagnosis based on rapid assays may be a valuable alternative in implementing HIV prevention and surveillance programs in areas where sophisticated laboratories are difficult to establish.

AIDS Serodiagnosis↗