Motion Freeze for Respiration Motion Correction in PET/CT: A Preliminary Investigation with Lung Cancer Patient Data

Purpose. Respiratory motion presents significant challenges for accurate PET/CT. It often introduces apparent increase of lesion size, reduction of measured standardized uptake value (SUV), and the mismatch in PET/CT fusion images. In this study, we developed the motion freeze method to use 100% of the counts collected by recombining the counts acquired from all phases of gated PET data into a single 3D PET data, with correction of respiration by deformable image registration. Methods. Six patients with diagnosis of lung cancer confirmed by oncologists were recruited. PET/CT scans were performed with Discovery STE system. The 4D PET/CT with the Varian real-time position management for respiratory motion tracking was followed by a clinical 3D PET/CT scan procedure in the static mode. Motion freeze applies the deformation matrices calculated by optical flow method to generate a single 3D effective PET image using the data from all the 4D PET phases. Results. The increase in SUV and decrease in tumor size with motion freeze for all lesions compared to the results from 3D and 4D was observed in the preliminary data of lung cancer patients. In addition, motion freeze substantially reduced tumor mismatch between the CT image and the corresponding PET images. Conclusion. Motion freeze integrating 100% of the PET counts has the potential to eliminate the influences induced by respiratory motion in PET data

Cerebrospinal fluid shunt surgery reduces the risk of developing dementia and Alzheimer’s disease in patients with idiopathic normal pressure hydrocephalus: a nationwide population-based propensity-weighted cohort study

Abstract Background Patients with idiopathic normal-pressure hydrocephalus (iNPH) are predisposed to developing dementing disorders. Cerebrospinal fluid (CSF) shunt implantation is a treatment used to improve the motor and cognitive disabilities of these patients; however, its effect on the risk of developing dementing disorders remains unclear. We conducted a population-based propensity-weighted cohort study to investigate whether CSF shunt surgery may reduce the risk of subsequently developing dementia, Alzheimer’s disease (AD), and vascular dementia in iNPH patients. Methods Patients aged ≥ 60 years who were diagnosed with iNPH (n = 2053) between January 2001 and June 2018 were identified from the Taiwan National Health Insurance Research Database. Various demographic characteristics (age, sex, and monthly income) and clinical data (incidence year, comorbidities, and Charlson comorbidity index) were collected and divided into the shunt surgery group (SSG) and the non-shunt surgery group (NSSG). Stabilized inverse probability of treatment weighting by using the propensity score was performed to achieve a balanced distribution of confounders across the two study groups. The cumulative incidence rate and risk of dementing disorders were estimated during a 16-year follow-up period. Results After weighting, the data of 375.0 patients in SSG and 1677.4 patients in NSSG were analyzed. Kaplan–Meier curve analysis indicated that the cumulative incidence rate of AD (p = 0.009), but not dementia (p = 0.241) and vascular dementia (p = 0.761), in SSG was significantly lower than that in NSSG over the 16-year follow-up period. Cox proportional hazards regression analysis revealed that SSG had a reduced hazard ratio (HR) for developing AD [HR (95% CI) 0.17 (0.04–0.69)], but not for dementia [HR (95% CI) 0.83 (0.61–1.12)] and vascular dementia [HR (95% CI) 1.18 (0.44–3.16)], compared with NSSG. Further Fine–Gray hazard regression analysis with death as a competing event demonstrated that SSG had a reduced subdistribution HR (sHR) for developing dementia [sHR (95% CI) 0.74 (0.55–0.99)] and AD [sHR (95% CI) 0.15 (0.04–0.61)], but not for vascular dementia [sHR (95% CI) 1.07 (0.40–2.86)]. Conclusion CSF shunt surgery is associated with reduced risks of the subsequent development of dementia and AD in iNPH patients. Our findings may provide valuable information for assessing the benefit-to-risk profile of CSF shunt surgery

Modulating the line shape of magnetoconductance by varying the charge injection in polymer light-emitting diodes

We fabricate the phenyl-substituted poly(p-phenylene vinylene) copolymer (super yellow, SY-PPV)-based polymer light-emitting diodes (PLEDs) with different device architectures to modulate the injection of opposite charge carriers and investigate the corresponding magnetoconductance (MC) responses. At the first glance, we find that all PLEDs exhibit the positive MC responses. By applying the mathematical analysis to fit the curves with two empirical equations of a non-Lorentzian and a Lorentzian function, we are able to extract the hidden negative MC component from the positive MC curve. We attribute the growth of the negative MC component to the reduced interaction of the triplet excitons with charges to generate the free charge carriers as modulated by the applied magnetic field, known as the triplet exciton-charge reaction, by analyzing MC responses for PLEDs of the charge-unbalanced and hole-blocking device configurations. The negative MC component causes the broadening of the line shape in MC curves

Planning Lung Radiotherapy Incorporating Motion Freeze PET/CT Imaging

Motion Freeze (MF), which integrates 100% of the signal of each respiratory phase in four-dimensional positron emission tomography (4D-PET) images and creates the MF-PET, is capable of eliminate the influences induced by respiratory motion and dispersing from three-dimensional PET (3D-PET) and 4D-PET images. In this study, the effectiveness of respiratory gated radiotherapy applying MF-PET (MF-Plan) in lung cancer patient was investigated and compared with three-dimensional intensity modulated radiotherapy (3D-Plan) and routine respiratory gated radiotherapy (4D-Plan) on the impact of target volume and dosimetry. Thirteen lung cancer patients were enrolled. The internal target volumes were generated with 40% of maximum standardized uptake value. The 3D-Plan, 4D-Plan, and MF-Plan were created for each patient to study the radiation to the targets and organs at risk. MF-Plans were associated with significant reductions in lung, heart, and spinal cord doses. The median reductions in lung V20, lung mean, heart mean doses, and spinal cord maximum dose compared with 3D-Plans were improved. When compared with 4D-Plans, the median reductions in lung V20, lung mean dose, heart mean dose, and spinal cord maximum dose were improved. Our results indicate that the MF-Plan may improve critical organ sparing in the lung, heart, and spinal cord, while maintaining high target coverage

Quantitative Motion Analysis of Tai Chi Chuan: The Upper Extremity Movement

The quantitative and reproducible analysis of the standard body movement in Tai Chi Chuan (TCC) was performed in this study. We aimed to provide a reference of the upper extremities for standardizing TCC practice. Microsoft Kinect was used to record the motion during the practice of TCC. The preparation form and eight essential forms of TCC performed by an instructor and 101 practitioners were analyzed in this study. The instructor completed an entire TCC practice cycle and performed the cycle 12 times. An entire cycle of TCC was performed by practitioners and images were recorded for statistics analysis. The performance of the instructor showed high similarity (Pearson correlation coefficient (r)=0.71~0.84) to the first practice cycle. Among the 9 forms, lay form had the highest similarity (rmean=0.90) and push form had the lowest similarity (rmean=0.52). For the practitioners, ward off form (rmean=0.51) and roll back form (rmean=0.45) had the highest similarity with moderate correlation. We used Microsoft Kinect to record the spatial coordinates of the upper extremity joints during the practice of TCC and the data to perform quantitative and qualitative analysis of the joint positions and elbow joint angle

Automatic Detection of Calcaneal-Fifth Metatarsal Angle Using Radiograph: A Computer-Aided Diagnosis of Flat Foot for Military New Recruits in Taiwan.

Flatfoot (pes planus) is one of the most important physical examination items for military new recruits in Taiwan. Currently, the diagnosis of flatfoot is mainly based on radiographic examination of the calcaneal-fifth metatarsal (CA-MT5) angle, also known as the arch angle. However, manual measurement of the arch angle is time-consuming and often inconsistent between different examiners. In this study, seventy male military new recruits were studied. Lateral radiographic images of their right and left feet were obtained, and mutual information (MI) registration was used to automatically calculate the arch angle. Images of two critical bones, the calcaneus and the fifth metatarsal bone, were isolated from the lateral radiographs to form reference images, and were then compared with template images to calculate the arch angle. The result of this computer-calculated arch angle was compared with manual measurement results from two radiologists, which showed that our automatic arch angle measurement method had a high consistency. In addition, this method had a high accuracy of 97% and 96% as compared with the measurements of radiologists A and B, respectively. The findings indicated that our MI registration measurement method cannot only accurately measure the CA-MT5 angle, but also saves time and reduces human error. This method can increase the consistency of arch angle measurement and has potential clinical application for the diagnosis of flatfoot

Bidens pilosa Formulation Improves Blood Homeostasis and β-Cell Function in Men: A Pilot Study

B. pilosa has long been purported to have antidiabetes activity, but despite the advancement in phytochemistry and animal models of diabetes, no human clinical trials have been conducted to date. Here, we evaluated the effect of a B. pilosa formulation on fasting blood glucose (FBG), fasting serum insulin, and glycosylated hemoglobin A1c (HbA1c) in diabetic subjects. The B. pilosa formulation reduced the level of FBG and HbA1c in diabetics but increased fasting serum insulin in healthy subjects. Moreover, combination of B. pilosa formulation with antidiabetic drugs had better glycemic control in diabetics. The homeostatic model assessment (HOMA) data suggested that the antidiabetic activity of this formulation was via improvement of β-cell function. We also tested the safety of the B. pilosa formulation in healthy subjects and observed no obvious side effects. We conclude that B. pilosa has potential as an antidiabetes treatment