Model-based estimation of arterial diameter from X-ray angiograms

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 1996.Includes bibliographical references (leaves 122-124).by Raymond C. Chan.M.S

An Image Processing Approach to Characterizing Choroidal Blood Flow

Indocyanine green (ICG) dye angiography has made possible routine visualization of choroidal blood flow in the human eye; however, to date, its clinical utility has been limited. An overlying layer of densely pigmented tissue and the complex, multilayered vascular structure of the choroid combine to produce angiographic images of low contrast which are difficult to interpret. Conventional image processing can enhance individual images of the blood vessels, but this approach contributes no information about the dynamics of blood flow. Using relatively inexpensive, commercially available personal computer hardware, angiographic image processing algorithms were developed which appear to characterize uniquely a subject choroid in terms of various blood flow parameters. We believe this to be the first successfully demonstrated approach to routinely characterizing the human choroidal circulation in a way that conserves spatial distribution of blood flow dynamics across the entire observed choroidal area. The computer system allows acquisition of digital images from photographic film negatives; alternatively, real-time direct digitization of images from a high-resolution video camera is possible. Once acquired, the digitized data are manipulated according to various algorithms that employ time-sequence analysis to generate two-dimensional curves or three-dimensional surfaces which characterize the choroidal circulation. The unique correspondence of each three-dimensional surface to the subject choroidal circulation from which it was derived is demonstrated. Grouping the characteristic three-dimensional surfaces according to various topographic features in common may provide a basis for discriminating between normal and abnormal choroidal circulations. Invest Ophthalmol Vis Sci 31:629-637,1990 The importance of choroidal blood flow to maintenance of the sensory retina-especially the foveahas long been recognized; however, its role in the etiology of retinal diseases is not well understood. In large part this has resulted from inability to visualize routinely the choroidal vasculature and to differentiate between normal and abnormal blood flow through it. Fluorescein angiography of the choroidal vasculature is hampered by the presence of macular xanthophyll, retinal pigment epithelium, and choroidal pigment-all of which block the visible light wavelengths absorbed and emitted by the dye-and by the rapid extravasation of unbound fluorescein molecules which stain choroidal tissue. Although indocyanine green (ICG) dye angiography permits visualFrom the "Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland; the tWilmer Ophthalmological Institute, Baltimore, Maryland; and the |St. Gallen Eye Clinic, St. Gallen, Switzerland

Efficacy of two different self-expanding nitinol stents for atherosclerotic femoropopliteal arterial disease (SENS-FP trial): study protocol for a randomized controlled trial

BACKGROUND: There have been few randomized control trials comparing the incidence of stent fracture and primary patency among different self-expanding nitinol stents to date. The SMART™ CONTROL stent (Cordis Corp, Miami Lakes, Florida, United States) has a peak-to-valley bridge and inline interconnection, whereas the COMPLETE™-SE stent (Medtronic Vascular, Santa Rosa, California, United States) crowns have been configured to minimize crown-to-crown interaction, increasing the stent's flexibility without compromising radial strength. Further, the 2011 ESC (European society of cardiology) guidelines recommend that dual antiplatelet therapy with aspirin and a thienopyridine such as clopidogrel should be administered for at least one month after infrainguinal bare metal stent implantation. Cilostazol has been reported to reduce intimal hyperplasia and subsequent repeat revascularization. To date, there has been no randomized study comparing the safety and efficacy of two different antiplatelet regimens, clopidogrel and cilostazol, following successful femoropopliteal stenting. METHODS/DESIGN: The primary purpose of our study is to examine the incidence of stent fracture and primary patency between two different major representative self-expanding nitinol stents (SMART™ CONTROL versus COMPLETE™-SE) in stenotic or occlusive femoropopliteal arterial lesion. The secondary purpose is to examine whether there is any difference in efficacy and safety between aspirin plus clopidogrel versus aspirin plus cilostazol for one month following stent implantation in femoropopliteal lesions. This is a prospective, randomized, multicenter trial to assess the efficacy of the COMPLETE™-SE versus SMART™ CONTROL stent for provisional stenting after balloon angioplasty in femoropopliteal arterial lesions. The study design is a 2x2 randomization design and a total of 346 patients will be enrolled. The primary endpoint of this study is the rate of binary restenosis in the treated segment at 12 months after intervention as determined by catheter angiography or duplex ultrasound. DISCUSSION: This trial will provide powerful insight into whether the design of the COMPLETE™-SE stent is more fracture-resistant or effective in preventing restenosis compared with the SMART™ CONTROL stent. Also, it will determine the efficacy and safety of aspirin plus clopidogrel versus aspirin plus cilostazol in patients undergoing stent implantation in femoropopliteal lesions. TRIAL REGISTRATION: Registered on 2 April 2012 with the National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT01570803)

More Homogeneous Capillary Flow and Oxygenation in Deeper Cortical Layers Correlate with Increased Oxygen Extraction

Our understanding of how capillary blood flow and oxygen distribute across cortical layers to meet the local metabolic demand is incomplete. We addressed this question by using two-photon imaging of resting-state microvascular oxygen partial pressure (PO2) and flow in the whisker barrel cortex in awake mice. Our measurements in layers I-V show that the capillary red-blood-cell flux and oxygenation heterogeneity, and the intracapillary resistance to oxygen delivery, all decrease with depth, reaching a minimum around layer IV, while the depth-dependent oxygen extraction fraction is increased in layer IV, where oxygen demand is presumably the highest. Our findings suggest that more homogeneous distribution of the physiological observables relevant to oxygen transport to tissue is an important part of the microvascular network adaptation to local brain metabolism. These results will inform the biophysical models of layer-specific cerebral oxygen delivery and consumption and improve our understanding of the diseases that affect cerebral microcirculation

The study of blood flow in human arterial bifurcations by the combination of CFD and MRI

Atherosclero8is represents a major health problem in the western world. The local haemodynamics is believed to be an initiating and localizing factor in this multilactorial disease process. To fully understand this interaction it is important to obtain detailed information about the local haemodynamics in accurate models of the hnrnan vascular system. Because of the complexity of arterial geometry, in mvo velocity measurements are subject to large errors by currently available techniques. It is also difficult to construct the highly irregular arterial bifurcation model for in vitro investigations. By using a combination of two new methodologies,namely magnetic resonance angiography (MRA) and computational fluid dynamics CFD), the precise patterns of flow anticipating the onset of disease at arterial bifurcations can now, in principle, be determined. However, flow simulations based on in vzvo data directly acquired from clinical measurements have rarely been performed, due to difficulties involved in converting medical images into a data set that CFD software packages can accept. ,In this study, a computer modelling technique, which integrates dinically acquired MR angiograms, image processing and CFD, for the reconstruction of 3D blood flow patterns in realistic arterial geometry, was developed. In the procedure, human arteries are scanned non-invasively by MR angiography. With the MR angiograms, image processing and 3D reconstruction are performed and structured numerical grid is generated for the arteries scanned. Together with MR in tnvo measured velocity profiles at the boundary planes of the model, CFD simulations are undertaken. To test the capability and reliability of the whole procedure, two examples are given, of the human abdominal and right carotid bifurcations. The complete haemodynamic patterns obtained allow a full clinical understanding to be gained of individual patient behaviour. Aspects such as wall shear stress variation, secondary flow and flow separations are demonstrated. The problem of quantitative reliability of the predictions is discussed in some depth

Real-time detection and data acquisition system for the left ventricular outline

To automate the data acquisition procedure, a real-time contour detection and data acquisition system for the left ventricular outline was developed using video techniques. The X-ray image of the contrast-filled left ventricle is stored for subsequent processing on film (cineangiogram), video tape or disc. The cineangiogram is converted into video format using a television camera. The video signal from either the TV camera, video tape or disc is the input signal to the system. The contour detection is based on a dynamic thresholding technique. Since the left ventricular outline is a smooth continuous function, for each contour side a narrow expectation window is defined in which the next borderpoint will be detected. A computer interface was designed and built for the online acquisition of the coordinates using a PDP-12 computer. The advantage of this system over other available systems is its potential for online, real-time acquisition of the left ventricular size and shape during angiocardiography

Tumor vasculature and microenvironment during progression and treatment : insights from optical microscopy

Thesis (Ph. D.)--Harvard-MIT Division of Health Sciences and Technology, February 2010.Vita. Cataloged from PDF version of thesis.Includes bibliographical references.In addition to cancer cells, solid tumors consist of a variety of cell types and tissues defining a complex microenvironment that influences disease progression and response to therapy. To fully characterize and probe the tumor microenvironment, new tools are needed to quantitatively assess microanatomical and physiological changes during tumor growth and treatment. Particularly important, is the metabolic microenvironment defined in tumors by hypoxia (low p02) and acidity (low pH). These parameters have been shown to influence response to radiation therapy and chemotherapy. However, very little is known about spatio-temporal changes in p02 and pH during tumor progression and therapy. By modifying the technique of intravital multiphoton microscopy (MPM) to perform phosphorescence quenching microscopy, I developed a non-invasive method to quantify oxygen tension (p02) in living tissue at high three-dimensional resolution. To probe functional changes in the metabolic microenvironment, I measured in vivo P02 during tumor growth and antiangiogenic (vascular targeted) treatment in preclinical tumor models. Nanotechnology is rapidly emerging as an important source of biocompatible tools that may shape the future of medical practice. Fluorescent semiconductor nanocrystals (NCs), also known as quantum dots, are a powerful tool for biological imaging, cellular targeting and molecular sensing.(cont.) I adapted novel fluorescence resonance energy transfer (FRET) -based nanocrystal (NC) biosensors for use with MPM to qualitatively measure in vivo extracellular pH in tumors at high-resolution. While intravital multiphoton microscopy demonstrates utility and adaptability in the study of cancer and response to therapy, the requisite high numerical aperture and exogenous contrast agents result in a limited capacity to investigate substantial tissue volumes or probe dynamic changes repeatedly over prolonged periods. By applying optical frequency domain imaging (OFDI) as an intravital microscopic tool, the technical limitations of multiphoton microscopy can be circumvented providing unprecedented access to previously unexplored, critically important aspects of tumor biology. Using entirely intrinsic mechanisms of contrast within murine tumor models, OFDI is able to simultaneously, rapidly, and repeatedly probe the microvasculature, lymphatic vessels, and tissue microstructure and composition over large volumes. Using OFDI-based techniques, measurements of tumor angiogenesis, lymphangiogenesis, tissue viability and both vascular and cellular responses to therapy were demonstrated, thereby highlighting the potential of OFDI to facilitate the exploration of pathophysiological processes and the evaluation of treatment strategies.by Ryan M. Lanning.Ph.D