Relationship between primary liver hepatocellular carcinoma volumes on portal-venous phase CT imaging

The liver is an important organ in the body. It is located under the rib cage on the right side. The liver performs many important functions, it processes food for nutrients that the body requires and also helps in the detoxification of harmful materials. Like any organ in the body, the liver is susceptible to diseases such as liver cancer. Liver cancer is the growth and spread of unhealthy cells of the liver. There are several risk factor for liver cancer, these are: Cirrhosis (scarring of the liver), long term hepatitis B and hepatitis C infection and diabetes patients with long term drinking problem. Hepatocellular Carcinoma is the most common form of liver cancer in adult population which begins in the main type of liver cell (hepatocyte). Because Hepatocellular carcinoma starts from the primary liver cell itself (hepatocytes), as such it is a primary liver cancer. About 30,000 Americans are diagnosed with primary liver cancer yearly, making it an important disease that plaques our society and therefore needs proper diagnosis. In clinical evaluation of primary liver cancer such as HCC, the use of medical imaging technology has been commonplace. Most medical facilities across the country and globally typically use Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI) in the diagnosis and treatment follow up of Hepatocellular carcinoma. The medical imaging devices are used to determine the extent and volume of the tumor of the cancerous liver cells. In clinical trials involving the imaging of HCC tumors, the typical protocol used in the CT imaging of HCC involves the use of contrast enhanced dual phase acquisition. This approach is based on the physiology of the blood flow through the liver. Since HCC tumors are hypervascular in nature, it would thus be more apparent in the arterial phase of an acquired CT image. The aforementioned characteristic was tested with a volume paradigm which measure and compare the volume of both the arterial phase and portal venous phase acquired images in the experiment. Overall this study helps in furthering goals to reduce the patient dose from the x-ray tubes during clinical trials. The results of the experiments (n = 19, t = 0.67, p = 0.26), indicates no significant difference between the volume of the HCC tumor images acquired both in the AP and PVP

Quantifying the Tibiofemoral Joint Space Using X-ray Tomosynthesis

Purpose: Digital x-ray tomosynthesis (DTS) has the potential to provide 3D information about the knee joint in a load-bearing posture, which may improve diagnosis and monitoring of knee osteoarthritis compared with projection radiography, the current standard of care. Manually quantifying and visualizing the joint space width (JSW) from 3D tomosynthesis datasets may be challenging. This work developed a semiautomated algorithm for quantifying the 3D tibiofemoral JSW from reconstructed DTS images. The algorithm was validated through anthropomorphic phantom experiments and applied to three clinical datasets. Methods: A user-selected volume of interest within the reconstructed DTS volume was enhanced with 1D multiscale gradient kernels. The edge-enhanced volumes were divided by polarity into tibial and femoral edge maps and combined across kernel scales. A 2D connected components algorithm was performed to determine candidate tibial and femoral edges. A 2D joint space width map (JSW) was constructed to represent the 3D tibiofemoral joint space. To quantify the algorithm accuracy, an adjustable knee phantom was constructed, and eleven posterior–anterior (PA) and lateral DTS scans were acquired with the medial minimum JSW of the phantom set to 0–5 mm in 0.5 mm increments (VolumeRadTM, GE Healthcare, Chalfont St. Giles, United Kingdom). The accuracy of the algorithm was quantified by comparing the minimum JSW in a region of interest in the medial compartment of the JSW map to the measured phantom setting for each trial. In addition, the algorithm was applied to DTS scans of a static knee phantom and the JSW map compared to values estimated from a manually segmented computed tomography (CT) dataset. The algorithm was also applied to three clinical DTS datasets of osteoarthritic patients. Results: The algorithm segmented the JSW and generated a JSW map for all phantom and clinical datasets. For the adjustable phantom, the estimated minimum JSW values were plotted against the measured values for all trials. A linear fit estimated a slope of 0.887 (R2¼0.962) and a mean error across all trials of 0.34 mm for the PA phantom data. The estimated minimum JSW values for the lateral adjustable phantom acquisitions were found to have low correlation to the measured values (R2¼0.377), with a mean error of 2.13 mm. The error in the lateral adjustable-phantom datasets appeared to be caused by artifacts due to unrealistic features in the phantom bones. JSW maps generated by DTS and CT varied by a mean of 0.6 mm and 0.8 mm across the knee joint, for PA and lateral scans. The tibial and femoral edges were successfully segmented and JSW maps determined for PA and lateral clinical DTS datasets. Conclusions: A semiautomated method is presented for quantifying the 3D joint space in a 2D JSW map using tomosynthesis images. The proposed algorithm quantified the JSW across the knee joint to sub-millimeter accuracy for PA tomosynthesis acquisitions. Overall, the results suggest that x-ray tomosynthesis may be beneficial for diagnosing and monitoring disease progression or treatment of osteoarthritis by providing quantitative images of JSW in the load-bearing knee

An MRI-Derived Definition of MCI-to-AD Conversion for Long-Term, Automati c Prognosis of MCI Patients

Alzheimer's disease (AD) and mild cognitive impairment (MCI), continue to be widely studied. While there is no consensus on whether MCIs actually "convert" to AD, the more important question is not whether MCIs convert, but what is the best such definition. We focus on automatic prognostication, nominally using only a baseline image brain scan, of whether an MCI individual will convert to AD within a multi-year period following the initial clinical visit. This is in fact not a traditional supervised learning problem since, in ADNI, there are no definitive labeled examples of MCI conversion. Prior works have defined MCI subclasses based on whether or not clinical/cognitive scores such as CDR significantly change from baseline. There are concerns with these definitions, however, since e.g. most MCIs (and ADs) do not change from a baseline CDR=0.5, even while physiological changes may be occurring. These works ignore rich phenotypical information in an MCI patient's brain scan and labeled AD and Control examples, in defining conversion. We propose an innovative conversion definition, wherein an MCI patient is declared to be a converter if any of the patient's brain scans (at follow-up visits) are classified "AD" by an (accurately-designed) Control-AD classifier. This novel definition bootstraps the design of a second classifier, specifically trained to predict whether or not MCIs will convert. This second classifier thus predicts whether an AD-Control classifier will predict that a patient has AD. Our results demonstrate this new definition leads not only to much higher prognostic accuracy than by-CDR conversion, but also to subpopulations much more consistent with known AD brain region biomarkers. We also identify key prognostic region biomarkers, essential for accurately discriminating the converter and nonconverter groups

Methods, systems, and devices for pairing vagus nerve stimulation with motor therapy in stroke patients

A method of treating motor deficits in a stroke patient, comprising assessing a patient's motor deficits, determining therapeutic goals for the patient, based on the patient's motor deficits, selecting therapeutic tasks based on the therapeutic goals, performing each of the selected therapeutic tasks repetitively, observing the performance of the therapeutic tasks, initiating the stimulation of the vagus nerve manually at approximately a predetermined moment during the performance of the therapeutic tasks, stimulating the vagus nerve of the patient during the performance of the selected therapeutic tasks, and improving the patient's motor deficits.Board of Regents, University of Texas Syste

Methods, systems, and devices for pairing vagus nerve stimulation with motor therapy in stroke patients

A method of treating motor deficits in a stroke patient, comprising assessing a patient's motor deficits, determining therapeutic goals for the patient, based on the patient's motor deficits, selecting therapeutic tasks based on the therapeutic goals, performing each of the selected therapeutic tasks repetitively, observing the performance of the therapeutic tasks, initiating the stimulation of the vagus nerve manually at approximately a predetermined moment during the performance of the therapeutic tasks, stimulating the vagus nerve of the patient during the performance of the selected therapeutic tasks, and improving the patient's motor deficits.Board of Regents, University of Texas Syste