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ABSTRACT: Cone-beam rotational angiography (CBRA) is widely used in the modern clinical settings. In a number of procedures, the area of interest is often considerably smaller than the field of view (FOV) of the detector, subjecting the patient to potentially unnecessary x-ray dose. The authors therefore propose a filter-based method to reduce the dose in the regions of low interest, while supplying high image quality in the region of interest (ROI).
For such procedures, the authors propose a method of filtered region of interest (FROI)-CBRA. In the authors' approach, a gadolinium filter with a circular central opening is placed into the x-ray beam during image acquisition. The central region is imaged with high contrast, while peripheral regions are subjected to a substantial lower intensity and dose through beam filtering. The resulting images contain a high contrast/intensity ROI, as well as a low contrast/intensity peripheral region, and a transition region in between. To equalize the two regions' intensities, the first projection of the acquisition is performed with and without the filter in place. The equalization relationship, based on Beer's law, is established through linear regression using corresponding filtered and nonfiltered data. The transition region is equalized based on radial profiles.
Evaluations in 2D and 3D show no visible difference between conventional FROI-CBRA projection images and reconstructions in the ROI. CNR evaluations show similar image quality in the ROI, with a reduced CNR in the reconstructed peripheral region. In all filtered projection images, the scatter fraction inside the ROI was reduced. Theoretical and experimental dose evaluations show a considerable dose reduction; using a ROI half the original FOV reduces the dose by 60% for the filter thickness of 1.29 mm.
These results indicate the potential of FROI-CBRA to reduce the dose to the patient while supplying the physician with the desired image detail inside the ROI.
Medical Physics 02/2010; 37(2):694-703. · 2.83 Impact Factor
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ABSTRACT: Treatment of vascular disease often involves endovascular interventions which use the vascular system for delivering treatment devices via a previously inserted guidewire to the diseased site. Previous studies show relative reproducibility of guidewire position after insertion, indicating that the guidewire position is constrained and could be represented by an energy minimization approach. Such representation would support the surgeon's decision process in guidewire selection.
In this paper, we determine the guidewire position using a k-level graph based on 3D vessel information. Guidewire properties are incorporated into the graph as edge weights given by the local bending energy related to the local bending angle. The optimal path through this weighted directed graph is determined using a shortest path algorithm. Volumetric data of two different internal carotid artery phantoms (Ø 3.5-4.6 mm) was acquired. Two guidewires (Ø 0.33 mm) of different material properties (stainless steel, plastic-coated steel core) were inserted into the phantoms.
The average RMS distance between actual and simulated guidewire positions varies from 0.9 mm (plastic coated) to 1.3 mm (stainless steel); the computation time to determine the position was <2s.
The results indicate that the proposed technique yields reproducible and accurate guidewire positions within a short, clinically relevant time frame. These calculated positions may be useful in facilitating neurovascular interventions.
International Journal of Computer Assisted Radiology and Surgery 11/2009; 4(6):597-608. · 1.48 Impact Factor
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ABSTRACT: Endovascular treatment of stroke, a leading cause of death in the United States, involves guidance of devices to the intervention site often through tortuous vessels. Typically, these interventions are performed under two- dimensional (2D) fluoroscopy. To facilitate these procedures, we developed and previously presented a multiple-view self-calibration method involving two steps: (1) calibration of the imaging geometry, and (2) reconstruction of the 3D vessel centerline. Only those 2D angiograms obtained during the procedure are used for reconstruction. In this manuscript, we evaluate this technique on a large set (117 cases) of clinical data obtained over a 12-month period.
We evaluated the technique using (1) the RMS difference between the calculated 3D centerlines and the average centerline (before and after application of our method), (2) the difference between the projected 3D centerlines and the 2D indicated centerlines, (3) the translations and rotations calculated by our technique, and (4) intra- and inter-user variations.
Our approach (1) reduces the RMS 3D differences by a factor of 10, (2) increases the number of projected 3D centerline points lying within 1 mm of the indicated 2D centerline points by over a factor of 2 (from 28 to 71%), (3) provides an assessment of the variations in the gantry geometry as provided by the imaging system, and (4) is insensitive to user variations in indication (<1 mm differences in 3D are seen).
These results indicate that this technique will provide more reliable vessel centerlines in the clinical setting without requiring additional acquisitions or increasing dose to the patient.
International Journal of Computer Assisted Radiology and Surgery 09/2009; 4(5):497-508. · 1.48 Impact Factor
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ABSTRACT: The use of cone beam computed tomography (CBCT) is growing in the clinical arena due to its ability to provide 3D information during interventions, its high diagnostic quality (sub-millimeter resolution), and its short scanning times (60 s). In many situations, the short scanning time of CBCT is followed by a time-consuming 3D reconstruction. The standard reconstruction algorithm for CBCT data is the filtered backprojection, which for a volume of size 256(3) takes up to 25 min on a standard system. Recent developments in the area of Graphic Processing Units (GPUs) make it possible to have access to high-performance computing solutions at a low cost, allowing their use in many scientific problems. We have implemented an algorithm for 3D reconstruction of CBCT data using the Compute Unified Device Architecture (CUDA) provided by NVIDIA (NVIDIA Corporation, Santa Clara, California), which was executed on a NVIDIA GeForce GTX 280. Our implementation results in improved reconstruction times from minutes, and perhaps hours, to a matter of seconds, while also giving the clinician the ability to view 3D volumetric data at higher resolutions. We evaluated our implementation on ten clinical data sets and one phantom data set to observe if differences occur between CPU and GPU-based reconstructions. By using our approach, the computation time for 256(3) is reduced from 25 min on the CPU to 3.2 s on the GPU. The GPU reconstruction time for 512(3) volumes is 8.5 s.
Computer methods and programs in biomedicine 09/2009; 98(3):271-7. · 1.14 Impact Factor
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ABSTRACT: Stroke is one of the leading causes of death in the U.S. The treatment of stroke often involves vascular interventions in which devices are guided to the intervention site often through tortuous vessels based on two-dimensional (2-D) angiographic images. Three dimensional (3-D) vascular information may facilitate these procedures. Methods have been proposed for the self-calibrating determination of 3-D vessel trees from biplane and multiple plane images and the geometric relationships between the views (imaging geometries). For the biplane analysis, four or more corresponding points must be identified in the biplane images. For the multiple view technique, multiple vessels must be indicated and only the translation vectors relating the geometries are calculated. We have developed methods for the calculation of the 3-D vessel data and the full transformations relating the multiple views (rotations and translations) obtained during interventional procedures, and the technique does not require indication of corresponding points, but only the indication of a single vessel, e.g., the vessel of interest. Multiple projection views of vessel trees are obtained and transferred to the analysis computer. The vessel or vessels of interest are indicated by the user. Using the initial imaging geometry determined from the gantry information, 3-D vessel centerlines are calculated using the indicated centerlines in pairs of images. The imaging geometries are then iteratively adjusted and 3-D centerlines recalculated until the root-mean-square (rms) difference between the calculated 3-D centerlines is minimized. Simulations indicate that the 3-D centerlines can be accurately determined (to within 1 mm) even for errors in indication of the vessel endpoints as large as 5 mm. In phantom studies, the average rms difference between the pairwise calculated 3-D centerlines is approximately 7.5 mm prior to refinement (i.e., using the gantry information alone), whereas the average rms difference is usually below 1 mm after refinement. Accuracies and reliabilities of better than 1 mm were also determined by comparing centerlines determined using multiview and rotational angiography reconstruction and clinical data sets. These results indicate that the multiview approach will provide accurate and reliable 3-D centerlines for indicated vessel(s) without increasing the dose to the patient.
Medical Physics 11/2006; 33(10):3901-11. · 2.83 Impact Factor
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ABSTRACT: A new microangiographic system (MA) integrated into a c-arm gantry has been developed allowing precise placement of a MA at the exact same angle as the standard x-ray image intensifier (II) with unchanged source and object position. The MA can also be arbitrarily moved about the object and easily moved into the field of view (FOV) in front of the lower resolution II when higher resolution angiographic sequences are needed. The benefits of this new system are illustrated in a neurovascular study, where a rabbit is injected with contrast media for varying oblique angles. Digital subtraction angiographic (DSA) images were obtained and compared using both the MA and II detectors for the same projection view. Vessels imaged with the MA appear sharper with smaller vessels visualized. Visualization of ~100 μm vessels was possible with the MA whereas not with the II. Further, the MA could better resolve vessel overlap. Contrast to noise ratios (CNR) were calculated for vessels of varying sizes for the MA versus the II and were found to be similar for large vessels, approximately double for medium vessels, and infinitely better for the smallest vessels. In addition, a 3D reconstruction of selected vessel segments was performed, using multiple (three) projections at oblique angles, for each detector. This new MA/II integrated system should lead to improved diagnosis and image guidance of neurovascular interventions by enabling initial guidance with the low resolution large FOV II combined with use of the high resolution MA during critical parts of diagnostic and interventional procedures.
Proceedings - Society of Photo-Optical Instrumentation Engineers 01/2006; 6142.
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CARS 2004. Computer Assisted Radiology and Surgery. Proceedings of the 18th International Congress and Exhibition, Chicago, USA, June 23-26, 2004; 01/2004
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CARS 2004. Computer Assisted Radiology and Surgery. Proceedings of the 18th International Congress and Exhibition, Chicago, USA, June 23-26, 2004; 01/2004
