3D Imaging for Planning of Minimally Invasive Surgical Procedures

Novel minimally invasive surgeries are used for treating cardiovascular diseases and are performed under 2D fluoroscopic guidance with a C-arm system. 3D multidetector row computed tomography (MDCT) images are routinely used for preprocedural planning and postprocedural follow-up. For preprocedural planning, the ability to integrate the MDCT with fluoroscopic images for intraprocedural guidance is of clinical interest. Registration may be facilitated by rotating the C-arm to acquire 3D C-arm CT images. This dissertation describes the development of optimal scan and contrast parameters for C-arm CT in 6 swine. A 5-s ungated C-arm CT acquisition during rapid ventricular pacing with aortic root injection using minimal contrast (36 mL), producing high attenuation (1226), few artifacts (2.0), and measurements similar to those from MDCT (p\u3e0.05) was determined optimal. 3D MDCT and C-arm CT images were registered to overlay the aortic structures from MDCT onto fluoroscopic images for guidance in placing the prosthesis. This work also describes the development of a methodology to develop power equation (R2\u3e0.998) for estimating dose with C-arm CT based on applied tube voltage. Application in 10 patients yielded 5.48┬▒177 2.02 mGy indicating minimal radiation burden. For postprocedural follow-up, combinations of non-contrast, arterial, venous single energy CT (SECT) scans are used to monitor patients at multiple time intervals resulting in high cumulative radiation dose. Employing a single dual-energy CT (DECT) scan to replace two SECT scans can reduce dose. This work focuses on evaluating the feasibility of DECT imaging in the arterial phase. The replacement of non-contrast and arterial SECT acquisitions with one arterial DECT acquisition in 30 patients allowed generation of virtual non-contrast (VNC) images with 31 dose savings. Aortic luminal attenuation in VNC (32┬▒177 2 HU) was similar to true non-contrast images (35┬▒177 4 HU) indicating presence of unattenuated blood. To improve discrimination between c

3D Imaging for Planning of Minimally Invasive Surgical Procedures

Novel minimally invasive surgeries are used for treating cardiovascular diseases and are performed under 2D fluoroscopic guidance with a C-arm system. 3D multidetector row computed tomography (MDCT) images are routinely used for preprocedural planning and postprocedural follow-up. For preprocedural planning, the ability to integrate the MDCT with fluoroscopic images for intraprocedural guidance is of clinical interest. Registration may be facilitated by rotating the C-arm to acquire 3D C-arm CT images. This dissertation describes the development of optimal scan and contrast parameters for C-arm CT in 6 swine. A 5-s ungated C-arm CT acquisition during rapid ventricular pacing with aortic root injection using minimal contrast (36 mL), producing high attenuation (1226), few artifacts (2.0), and measurements similar to those from MDCT (p\u3e0.05) was determined optimal. 3D MDCT and C-arm CT images were registered to overlay the aortic structures from MDCT onto fluoroscopic images for guidance in placing the prosthesis. This work also describes the development of a methodology to develop power equation (R2\u3e0.998) for estimating dose with C-arm CT based on applied tube voltage. Application in 10 patients yielded 5.48┬▒177 2.02 mGy indicating minimal radiation burden. For postprocedural follow-up, combinations of non-contrast, arterial, venous single energy CT (SECT) scans are used to monitor patients at multiple time intervals resulting in high cumulative radiation dose. Employing a single dual-energy CT (DECT) scan to replace two SECT scans can reduce dose. This work focuses on evaluating the feasibility of DECT imaging in the arterial phase. The replacement of non-contrast and arterial SECT acquisitions with one arterial DECT acquisition in 30 patients allowed generation of virtual non-contrast (VNC) images with 31 dose savings. Aortic luminal attenuation in VNC (32┬▒177 2 HU) was similar to true non-contrast images (35┬▒177 4 HU) indicating presence of unattenuated blood. To improve discrimination between c

Quantitative Analysis of Three-Dimensional Cone-Beam Computed Tomography Using Image Quality Phantoms

In the clinical setting, weight-bearing static 2D radiographic imaging and supine 3D radiographic imaging modalities are used to evaluate radiographic changes such as, joint space narrowing, subchondral sclerosis, and osteophyte formation. These respective imaging modalities cannot distinguish between tissues with similar densities (2D imaging), and do not accurately represent functional joint loading (supine 3D imaging). Recent advances in cone-beam CT (CBCT) have allowed for scanner designs that can obtain weight-bearing 3D volumetric scans. The purpose of this thesis was to analyze, design, and implement advanced imaging techniques to quantify image quality parameters of reconstructed image volumes generated by a commercially-available CBCT scanner, and a novel ceiling-mounted CBCT scanner. In addition, imperfections during rotation of the novel ceiling-mounted CBCT scanner were characterized using a 3D printed calibration object with a modification to the single marker bead method, and prospective geometric calibration matrices

Virtual clinical trials in medical imaging: a review

The accelerating complexity and variety of medical imaging devices and methods have outpaced the ability to evaluate and optimize their design and clinical use. This is a significant and increasing challenge for both scientific investigations and clinical applications. Evaluations would ideally be done using clinical imaging trials. These experiments, however, are often not practical due to ethical limitations, expense, time requirements, or lack of ground truth. Virtual clinical trials (VCTs) (also known as in silico imaging trials or virtual imaging trials) offer an alternative means to efficiently evaluate medical imaging technologies virtually. They do so by simulating the patients, imaging systems, and interpreters. The field of VCTs has been constantly advanced over the past decades in multiple areas. We summarize the major developments and current status of the field of VCTs in medical imaging. We review the core components of a VCT: computational phantoms, simulators of different imaging modalities, and interpretation models. We also highlight some of the applications of VCTs across various imaging modalities

Ionizing Radiation in Medical Imaging and Efforts in Dose Optimization

Medical-related radiation is the largest source of controllable radiation exposure to humans and it accounts for more than 95% of radiation exposure from man-made sources. Its direct benefits in modern day medical practices are beyond doubt but risks-benefits ratios need to be constantly monitored as the use of ionizing radiation is increasing rapidly. From 1980 to 2006, the per-capita effective dose from diagnostic and interventional medical procedures in the United States increased almost six fold, from 0.5 to 3.0mSv, while contributions from other sources remained static (NCRP report no 160, 2009). This chapter will review radiation exposure from medical imaging initially starting from a historical viewpoint as well as discussing innovative technologies on the horizon. The challenges for the medical community in addressing the increasing trend of radiation usage will be discussed as well as the latest research in dose justification and optimization.link_to_OA_fulltex

The management of imaging dose during imageâ guided radiotherapy: Report of the AAPM Task Group 75

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134823/1/mp5667.pd

Medical Imaging of Microrobots: Toward In Vivo Applications

Medical microrobots (MRs) have been demonstrated for a variety of non-invasive biomedical applications, such as tissue engineering, drug delivery, and assisted fertilization, among others. However, most of these demonstrations have been carried out in in vitro settings and under optical microscopy, being significantly different from the clinical practice. Thus, medical imaging techniques are required for localizing and tracking such tiny therapeutic machines when used in medical-relevant applications. This review aims at analyzing the state of the art of microrobots imaging by critically discussing the potentialities and limitations of the techniques employed in this field. Moreover, the physics and the working principle behind each analyzed imaging strategy, the spatiotemporal resolution, and the penetration depth are thoroughly discussed. The paper deals with the suitability of each imaging technique for tracking single or swarms of MRs and discusses the scenarios where contrast or imaging agent's inclusion is required, either to absorb, emit, or reflect a determined physical signal detected by an external system. Finally, the review highlights the existing challenges and perspective solutions which could be promising for future in vivo applications