A Review of Medical Imaging Innovations that Impacted Patient Care in Recent Decades as Link to Future Trends

Background: Medical Imaging has witnessed a revolution in technological advancement, being in the forefront among other disciplines in the health sector. Most of the earlier modalities that were largely analogue and mechanical have been replaced by automated and digitized technology. Objective: To track the developments and innovations in certain aspects of medical imaging that have impacted positively on patient care. Methods: Relevant literature were searched physically and online for both old and modern technological innovations in medical imaging and patient care. Results: There have been new technologies such as computed tomography, magnetic resonance imaging and the various ramifications of ultrasonography. Innovations in imaging modalities have brought increased diagnostic accuracy, much as examination time has been drastically shortened and radiation dose levels minimized or completely dispensed with. Manufacturing of portable equipment means that technology can now be taken to the patient and more time is dedicated to patient care. Introduction of digital radiography and Picture Archiving and Communication Systems have further impacted positively on efficiency and effectiveness of service delivery. Graduate degree programmes have invigorated radiographers’ drive for the discovery of new and better ways of diagnosis and treatment through research. Conclusion: Innovations in technology have led to miniaturization of equipment making it possible to take services to the critically ill patients, thereby improving patients’ accessibility to medical care. Also patients’ exposure to ionizing radiation has reduced due to improvement in research and development of new modalities using radiant energies other than ionizing radiation.&nbsp

New Directions in 3D Medical Modeling: 3D-Printing Anatomy and Functions in Neurosurgical Planning

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesThis paper illustrates the feasibility and utility of combining cranial anatomy and brain function on the same 3D-printed model, as evidenced by a neurosurgical planning case study of a 29-year-old female patient with a low-grade frontal-lobe glioma. We herein report the rapid prototyping methodology utilized in conjunction with surgical navigation to prepare and plan a complex neurosurgery. The method introduced here combines CT and MRI images with DTI tractography, while using various image segmentation protocols to 3D model the skull base, tumor, and five eloquent fiber tracts. This 3D model is rapid-prototyped and coregistered with patient images and a reported surgical navigation system, establishing a clear link between the printed model and surgical navigation. This methodology highlights the potential for advanced neurosurgical preparation, which can begin before the patient enters the operation theatre. Moreover, the work presented here demonstrates the workflow developed at the National University Hospital of Iceland, Landspitali, focusing on the processes of anatomy segmentation, fiber tract extrapolation, MRI/CT registration, and 3D printing. Furthermore, we present a qualitative and quantitative assessment for fiber tract generation in a case study where these processes are applied in the preparation of brain tumor resection surgery.Icelandic Innovation Fund RANNIS company Ossur University Hospital Landspital

Lung segments from anatomy to surgery

Bronchopulmonary segments are of increasing interest to clinicians because surgical procedures are emerging that maintain as much pulmonary function as possible. The conventional textbook borders between these segments, their many anatomical variations, and their numerous lymphatic or blood vessels, make them challenging for surgeons, especially thoracic surgeons. Fortunately, because imaging techniques such as 3D-CT are developing further, we can see the anatomical structure of the lungs in detail. Moreover, segmentectomy is now seen as an alternative to a more radical lobectomy, especially for lung cancer. This review explores the connection between the anatomical structure of the lungs, especially their segments, and surgical procedures. Further research on minimally invasive surgical procedures is timely as we can diagnose lung cancer and other diseases ever earlier. In this article, we will look at the latest trends in thoracic surgery. Importantly, we propose a classification of lung segments in reference to surgery difficulties due to their anatomy

Fully Automatic Danger Zone Determination for SBRT in NSCLC

Lung cancer is the major cause of cancer death worldwide. The most common form of lung cancer is non-small cell lung cancer(NSCLC). Stereotactic body radiation therapy (SBRT) has emerged as a good alternative to surgery in patients with peripheralstage I NSCLC, demonstrating favorable tumor control and low toxicity. Due to spatial relationship to several critical organs atrisk, SBRT of centrally located lesions is associated with more severe toxicity and requires modification in dose application andfractionation, which is currently evaluated in clinical trials. Therefore a classification of lung tumors into central or peripheralis required. In this work we present a novel, highly versatile, mulitmodality tool for tumor classification which requires no userinteraction. Furthermore the tool can automatically segment the trachea, proximal bronchial tree, mediastinum, gross target volumeand internal target volume. The proposed work is evaluated on 19 cases with different image modalities assessing segmentationquality as well as classification accuracy. Experiments showed a good segmentation quality and a classification accuracy of 95 %.These results suggest the use of the proposed tool for clinical trials to assist clinicians in their work and to fasten up the workflowin NSCLC patients treatment

Imaging and Treatment of Bronchiectasis:Chest computed tomography to diagnose bronchiectasis and to optimise inhalation treatment

This thesis covers image analysis of bronchiectasis and treatment with inhalation antibiotics

Focal Spot, Summer/Fall 2004

https://digitalcommons.wustl.edu/focal_spot_archives/1097/thumbnail.jp

Functional lung imaging with synchrotron radiation : Methods and preclinical applications

Many lung disease processes are characterized by structural and functional heterogeneity that is not directly appreciable with traditional physiological measurements. Experimental methods and lung function modeling to study regional lung function are crucial for better understanding of disease mechanisms and for targeting treatment. Synchrotron radiation offers useful properties to this end: coherence, utilized in phase-contrast imaging, and high flux and a wide energy spectrum which allow the selection of very narrow energy bands of radiation, thus allowing imaging at very specific energies. K-edge subtraction imaging (KES) has thus been developed at synchrotrons for both human and small animal imaging. The unique properties of synchrotron radiation extend X-ray computed tomography (CT) capabilities to quantitatively assess lung morphology, and also to map regional lung ventilation, perfusion, inflammation and biomechanical properties, with microscopic spatial resolution. Four-dimensional imaging, allows the investigation of the dynamics of regional lung functional parameters simultaneously with structural deformation of the lung as a function of time. This review summarizes synchrotron radiation imaging methods and overviews examples of its application in the study of disease mechanisms in preclinical animal models, as well as the potential for clinical translation both through the knowledge gained using these techniques and transfer of imaging technology to laboratory X-ray sources.Peer reviewe

Structural and functional alterations of the tracheobronchial tree after left upper pulmonary lobectomy for lung cancer

© 2019 The Author(s). Background: Pulmonary lobectomy has been a well-established curative treatment method for localized lung cancer. After left upper pulmonary lobectomy, the upward displacement of remaining lower lobe causes the distortion or kink of bronchus, which is associated with intractable cough and breathless. However, the quantitative study on structural and functional alterations of the tracheobronchial tree after lobectomy has not been reported. We sought to investigate these alterations using CT imaging analysis and computational fluid dynamics (CFD) method. Methods: Both preoperative and postoperative CT images of 18 patients who underwent left upper pulmonary lobectomy are collected. After the tracheobronchial tree models are extracted, the angles between trachea and bronchi, the surface area and volume of the tree, and the cross-sectional area of left lower lobar bronchus are investigated. CFD method is further used to describe the airflow characteristics by the wall pressure, airflow velocity, lobar flow rate, etc. Results: It is found that the angle between the trachea and the right main bronchus increases after operation, but the angle with the left main bronchus decreases. No significant alteration is observed for the surface area or volume of the tree between pre-operation and post-operation. After left upper pulmonary lobectomy, the cross-sectional area of left lower lobar bronchus is reduced for most of the patients (15/18) by 15-75%, especially for 4 patients by more than 50%. The wall pressure, airflow velocity and pressure drop significantly increase after the operation. The flow rate to the right lung increases significantly by 2-30% (but there is no significant difference between each lobe), and the flow rate to the left lung drops accordingly. Many vortices are found in various places with severe distortions. Conclusions: The favorable and unfavorable adaptive alterations of tracheobronchial tree will occur after left upper pulmonary lobectomy, and these alterations can be clarified through CT imaging and CFD analysis. The severe distortions at left lower lobar bronchus might exacerbate postoperative shortness of breath