Central Region Of Interest Research Articles

399 Source Localization of Burst Suppression in Post-Cardiac Arrest Patients

OBJECTIVES/GOALS: Burst suppression is a neurophysiological marker associated with severe hypoxic-ischemic injury following cardiac arrest. The goal of this study is to identify the anatomical regions of the brain associated with burst suppression post-cardiac arrest. METHODS/STUDY POPULATION: 86 comatose patients post-cardiac arrest admitted to the neurological-ICU from Massachusetts General Hospital and Brigham and Women’s Hospital were included in this study. EEG data after return of spontaneous circulation were preprocessed and artifact was rejected. Burst segments were extracted for source localization analysis from epochs with burst suppression. Four bursts for each patients were manually selected. The source of the bursts were obtained using the Champagne algorithm and mapped on the Desikan-Killiany atlas. The source for each burst was defined as any region of interest (ROI) with power > = 75th percentile relative to all ROIs. The power of the bursts at each source was correlated with the burden of brain injury measured using apparent diffusion coefficient (ADC) per ROI. RESULTS/ANTICIPATED RESULTS: 48 (56%) patients had burst suppression. 5 (10.4%) of patients with burst suppression were independent at the time of hospital discharge. Preliminary analyses was performed on 6 patients (24 bursts in total). ROI’s determined to be sources in a majority of the burst (>=13) were bilateral superior frontal, rostral middle frontal, parstriangularis precentral, superior parietal, inferior parietal, right post central, superior temporal, lateral occipital, and left middle temporal ROI. A lower mean ADC intensity was associated with a higher EEG power in the bilateral superior frontal (r = -0.80, p < 0.0001; r = -0.677, p < 0.001, respectively), left superior parietal (r = -0.53, p = 0.009), left middle temporal (r = -0.43, p = 0.042) ROI. DISCUSSION/SIGNIFICANCE: The source of bursts in patients post-cardiac arrest experiencing burst suppression is not well defined. This study will improve our understanding of how burst suppression is a measure of cortical injury, how it may relate to the burden of injury found on ADC imaging, and patient outcomes.

Investigation of advanced mindfulness meditation “cessation” experiences using EEG spectral analysis in an intensively sampled case study

Mindfulness meditation is a contemplative practice informed by Buddhism that targets the development of present-focused awareness and non-judgment of experience. Interest in mindfulness is burgeoning, and it has been shown to be effective in improving mental and physical health in clinical and non-clinical contexts. In this report, for the first time, we used electroencephalography (EEG) combined with a neurophenomenological approach to examine the neural signature of “cessation” events, which are dramatic experiences of complete discontinuation in awareness similar to the loss of consciousness, which are reported to be experienced by very experienced meditators, and are proposed to be evidence of mastery of mindfulness meditation. We intensively sampled these cessations as experienced by a single advanced meditator (with over 23,000 h of meditation training) and analyzed 37 cessation events collected in 29 EEG sessions between November 12, 2019, and March 11, 2020. Spectral analyses of the EEG data surrounding cessations showed that these events were marked by a large-scale alpha-power decrease starting around 40 s before their onset, and that this alpha-power was lowest immediately following a cessation. Region-of-interest (ROI) based examination of this finding revealed that this alpha-suppression showed a linear decrease in the occipital and parietal regions of the brain during the pre-cessation time period. Additionally, there were modest increases in theta power for the central, parietal, and right temporal ROIs during the pre-cessation timeframe, whereas power in the Delta and Beta frequency bands were not significantly different surrounding cessations. By relating cessations to objective and intrinsic measures of brain activity (i.e., EEG power) that are related to consciousness and high-level psychological functioning, these results provide evidence for the ability of experienced meditators to voluntarily modulate their state of consciousness and lay the foundation for studying these unique states using a neuroscientific approach.

20P Spatial analysis of residual tumor tissue provides new clues for post-neoadjuvant treatment approaches in triple-negative breast cancer

Triple-negative breast cancer (TNBC) is a very heterogeneous disease with high metastatic recurrence risk. We showed (PMID 34535679) that TNBCs relapsing rapidly (RR) after NACT (in ≤ 12 months) are highly proliferative, immune-cold, often with large residual cancer burden (RCB) and fatal outcome. No specific biomarkers or therapeutic targets are known for this clinical category. In this study we performed spatial molecular analysis of the RR and the RCB3 TNBCs, with the aim to help improving treatment of the TNBC patients with the poorest prognosis. We analyzed residual tumor tissue samples of TNBC patients treated by standard NACT from 01/01/2009 to 31/12/2021. The cases were classified into RR, standardly-relapsing (SR, 1-5 years post-NACT) and without recurrences (NR). The amount of tumor-infiltrating lymphocytes (TILs) was determined by optical microscopy (H&E). Tissue protein expression was spatially resolved by GeoMx® Digital Spatial Profiler (NanoString Technology). Sixteen, 17 and 47 RR, SR and NR cases were analyzed, respectively. GeoMx analysis included 216 Region-of-Interest (ROIs) of tumor microenvironment (TME) and 207 of tumor cells (TC), with balanced (∼50/50) numbers of peripheral (P) and central (C) ROIs. Tumors and ROIs were classified into TIL-rich (LR) and TIL-poor (LP) using cut-off of 10% TILs. The RR TNBCs showed higher Ki67, cleaved caspase 9, granzyme B (GZMB), FoxP3 and fibronectin (FBNCT) in TME-P-LR ROIs but higher GADPH, TIM-3, PD-L1 and IDO in TME-P-LP ROIs. Compared to TNBC-SR, the RR had higher GZMB and CD34 in TME-P-LR ROIs. In TME-C-LR ROIs of the RRs, CD8 expression was low, as well as the one of CD45, CD3 and CD8 in TME-C-LP. The RCB3 category contained 9, 8 and 10 RR, SR and NR cases, respectively. Although most RCB3 cases were TIL-poor, the NR cases showed significantly higher expression of CD3, CD8, GZMA, CD4, CD56, CD95, LAG3, HLA-DR, BIM and BCL6 than the RR cases. By this study we revealed several potential therapeutic targets (fibronectin, IDO, TIM-3, CD34 /angiogenesis) in the RR TNBCs. Interestingly, we also showed that some RCB3 cases have immune-activated TME and good prognosis. Spatial tissue analysis was crucial for these discoveries.

P.58 MRI muscle segmentation in Duchenne muscular dystrophy (DMD): Stepwise region of interest (ROI) contractions to minimize fat fraction variability

MRI proton density fat fraction (MRI-PDFF) to quantify fatty infiltration is a key efficacy endpoint in DMD and other neuromuscular clinical trials. We have previously shown that fat fraction variability can be reduced by contracting the ROI to eliminate noise from non-muscle tissue due to small segmentation errors. Multiple muscles are of interest due to progressive involvement in DMD, and the ideal contraction may vary depending on the muscle size or location. We tested a strategy for optimizing the segmentation of muscles of varying sizes and depths, designed to minimize the variability of fat fraction measurements while maximizing the volume of the contracted ROI. The vastus lateralis (VL) and soleus muscle bellies were segmented by two technologists from T1-weighted images and the center 3 slices were computed for the MRI-PDFF ROI (VL: N=13; soleus: N=14). Uniform axial contractions between 0 mm to 2 mm (in steps of 0.2 mm) were applied to the ROI and the resulting segmentations were registered to PDFF maps to obtain the fat fraction at every step. The minimal detectable change (MDC) for each contracted ROI was computed from the appropriate intraclass correlation coefficient (2-way or 1-way, random-effects, single-rating, absolute agreement) and pooled standard deviation. The Dice coefficient was used to record how much of the original volume is represented at each contraction. The variability approached a minimum as the Dice coefficient neared 0.9 for both muscles. The fat fraction MDC was reduced by 75% in the VL when a 1.2 mm contraction was applied (MDC=1.0%; Dice 0.91) and by 29% in the soleus when a 1.0 mm contraction was applied (MDC=1.3%; Dice 0.90). Further contracting the muscles had minimal effects on MDC. Therefore, we conclude that an axial contraction of the central ROI that represents 90% of the segmented muscle area is optimal for maximizing the interrogated muscle volume and the ability to demonstrate efficacy of disease-modifying therapeutics.

Gingival shape analysis using surface curvature estimation of the intraoral scans

BackgroundDespite many advances in dentistry, no objective and quantitative method is available to evaluate gingival shape. The surface curvature of the optical scans represents an unexploited possibility. The present study aimed to test surface curvature estimation of intraoral scans for objective evaluation of gingival shape.MethodsThe method consists of four main steps, i.e., optical scanning, surface curvature estimation, region of interest (ROI) definition, and gingival shape analysis. Six different curvature measures and three different diameters were tested for surface curvature estimation on central (n = 78) and interdental ROI (n = 88) of patients with advanced periodontitis to quantify gingiva with a novel gingival shape parameter (GS). The reproducibility was evaluated by repeating the method on two consecutive intraoral scans obtained with a scan-rescan process of the same patient at the same time point (n = 8).ResultsMinimum and mean curvature measures computed at 2 mm diameter seem optimal GS to quantify shape at central and interdental ROI, respectively. The mean (and standard deviation) of the GS was 0.33 ± 0.07 and 0.19 ± 0.09 for central ROI using minimum, and interdental ROI using mean curvature measure, respectively, computed at a diameter of 2 mm. The method’s reproducibility evaluated on scan-rescan models for the above-mentioned ROI and curvature measures was 0.02 and 0.01, respectively.ConclusionsSurface curvature estimation of the intraoral optical scans presents a precise and highly reproducible method for the objective gingival shape quantification enabling the detection of subtle changes. A careful selection of parameters for surface curvature estimation and curvature measures is required.

Differential beta desynchronisation responses to dynamic emotional facial expressions are attenuated in higher trait anxiety and autism

Daily life demands that we differentiate between a multitude of emotional facial expressions (EFEs). The mirror neuron system (MNS) is becoming increasingly implicated as a neural network involved with understanding emotional body expressions. However, the specificity of the MNS’s involvement in emotion recognition has remained largely unexplored. This study investigated whether six basic dynamic EFEs (anger, disgust, fear, happiness, sadness, and surprise) would be differentiated through event-related desynchronisation (ERD) of sensorimotor alpha and beta oscillatory activity, which indexes sensorimotor MNS activity. We found that beta ERD differentiated happy, fearful, and sad dynamic EFEs at the central region of interest, but not at occipital regions. Happy EFEs elicited significantly greater central beta ERD relative to fearful and sad EFEs within 800 - 2,000 ms after EFE onset. These differences were source-localised to the primary somatosensory cortex, which suggests they are likely to reflect differential sensorimotor simulation rather than differential attentional engagement. Furthermore, individuals with higher trait anxiety showed less beta ERD differentiation between happy and sad faces. Similarly, individuals with higher trait autism showed less beta ERD differentiation between happy and fearful faces. These findings suggest that the differential simulation of specific affective states is attenuated in individuals with higher trait anxiety and autism. In summary, the MNS appears to support the skills needed for emotion processing in daily life, which may be influenced by certain individual differences. This provides novel evidence for the notion that simulation-based emotional skills may underlie the emotional difficulties that accompany affective disorders, such as anxiety.

Electrophysiological Measures of Tactile and Auditory Processing in Children With Autism Spectrum Disorder.

Behavioral differences in responding to tactile and auditory stimuli are widely reported in individuals with autism spectrum disorder (ASD). However, the neural mechanisms underlying distinct tactile and auditory reactivity patterns in ASD remain unclear with theories implicating differences in both perceptual and attentional processes. The current study sought to investigate (1) the neural indices of early perceptual and later attentional factors underlying tactile and auditory processing in children with and without ASD, and (2) the relationship between neural indices of tactile and auditory processing and ASD symptomatology. Participants included 14, 6–12-year-olds with ASD and 14 age- and non-verbal IQ matched typically developing (TD) children. Children participated in an event-related potential (ERP) oddball paradigm during which they watched a silent video while being presented with tactile and auditory stimuli (i.e., 80% standard speech sound/a/; 10% oddball speech sound/i/; 10% novel vibrotactile stimuli on the fingertip with standard speech sound/a/). Children’s early and later ERP responses to tactile (P1 and N2) and auditory stimuli (P1, P3a, and P3b) were examined. Non-parametric analyses showed that children with ASD displayed differences in early perceptual processing of auditory (i.e., lower amplitudes at central region of interest), but not tactile, stimuli. Analysis of later attentional components did not show differences in response to tactile and auditory stimuli in the ASD and TD groups. Together, these results suggest that differences in auditory responsivity patterns could be related to perceptual factors in children with ASD. However, despite differences in caregiver-reported sensory measures, children with ASD did not differ in their neural reactivity to infrequent touch-speech stimuli compared to TD children. Nevertheless, correlational analyses confirmed that inter-individual differences in neural responsivity to tactile and auditory stimuli were related to social skills in all children. Finally, we discuss how the paradigm and stimulus type used in the current study may have impacted our results. These findings have implications for everyday life, where individual differences in responding to tactile and auditory stimuli may impact social functioning.

Assessing Corneal Speckle in Optical Coherence Tomography: A New Look at Glaucomatous Eyes.

Optical coherence tomography speckle is used here in an unconventional way as the indirect source of information on tissue microstructure. The study reveals that the corneal speckle of glaucoma suspects has a similar relationship between the parameters of scattering exhibited in glaucoma patients. The purpose of this study was to evaluate the potential of optical coherence tomography imaging of the cornea in early diagnosis of glaucoma. Corneas of 64 subjects of three groups, including 18 primary open-angle glaucoma patients, 24 glaucoma suspects with normal levels of IOP and uncompromised visual field, and 22 age-matched controls, were imaged with spectral optical coherence tomography. A central region of interest in each optical coherence tomography image visualizing the stroma was automatically extracted, and the intensity data within that region were fit with the generalized gamma distribution. Its parameters describe the scatterer cross section and scatterer density and indirectly assess corneal microstructure. In addition, subjects underwent measurements of IOP, visual field, Heidelberg Retinal Tomography, retinal nerve fiber layer thickness, and biometry. Group means of all parameters were tested for equality. Within each group of subjects, correlation was evaluated between the statistical parameters of the corneal speckle. Glaucoma suspects had statistically significantly different IOP, visual field parameters, mean retinal fiber layer thickness, and central corneal thickness from those of glaucoma patients but not from those of the control group. The parameters of the corneal speckle were not significantly different between the groups, but they showed a markedly higher and statistically significant coefficient of determination for glaucoma patients and suspects than that for the control group (0.927 and 0.707 vs. 0.336). The results indicate that glaucoma suspects have similar relationship between the corneal scatterer cross section and scatterer density to that exhibited in the glaucoma patients but markedly different from that of healthy controls.

Alterations in sleep electroencephalography synchrony in combat-exposed veterans with post-traumatic stress disorder.

We assessed whether the synchrony between brain regions, analyzed using electroencephalography (EEG) signals recorded during sleep, is altered in subjects with post-traumatic stress disorder (PTSD) and whether the results are reproducible across consecutive nights and subpopulations of the study. A total of 78 combat-exposed veteran men with (n = 31) and without (n = 47) PTSD completed two consecutive laboratory nights of high-density EEG recordings. We computed a measure of synchrony for each EEG channel-pair across three sleep stages (rapid eye movement [REM] and non-REM stages 2 and 3) and six frequency bands. We examined the median synchrony in 9 region-of-interest (ROI) pairs consisting of 6 bilateral brain regions (left and right frontal, central, and parietal regions) for 10 frequency-band and sleep-stage combinations. To assess reproducibility, we used the first 47 consecutive subjects (18 with PTSD) for initial discovery and the remaining 31 subjects (13 with PTSD) for replication. In the discovery analysis, five alpha-band synchrony pairs during non-REM sleep were consistently larger in PTSD subjects compared with controls (effect sizes ranging from 0.52 to 1.44) across consecutive nights: two between the left-frontal and left-parietal ROIs, one between the left-central and left-parietal ROIs, and two across central and parietal bilateral ROIs. These trends were preserved in the replication set. PTSD subjects showed increased alpha-band synchrony during non-REM sleep in the left frontoparietal, left centro-parietal, and inter-parietal brain regions. Importantly, these trends were reproducible across consecutive nights and subpopulations. Thus, these alterations in alpha synchrony may be discriminatory of PTSD.

Electrophysiological Signature Reveals Laminar Structure of the Porcine Hippocampus.

The hippocampus is integral to working and episodic memory and is a central region of interest in diseases affecting these processes. Pig models are widely used in translational research and may provide an excellent bridge between rodents and nonhuman primates for CNS disease models because of their gyrencephalic neuroanatomy and significant white matter composition. However, the laminar structure of the pig hippocampus has not been well characterized. Therefore, we histologically characterized the dorsal hippocampus of Yucatan miniature pigs and quantified the cytoarchitecture of the hippocampal layers. We then utilized stereotaxis combined with single-unit electrophysiological mapping to precisely place multichannel laminar silicon probes into the dorsal hippocampus without the need for image guidance. We used in vivo electrophysiological recordings of simultaneous laminar field potentials and single-unit activity in multiple layers of the dorsal hippocampus to physiologically identify and quantify these layers under anesthesia. Consistent with previous reports, we found the porcine hippocampus to have the expected archicortical laminar structure, with some anatomical and histological features comparable to the rodent and others to the primate hippocampus. Importantly, we found these distinct features to be reflected in the laminar electrophysiology. This characterization, as well as our electrophysiology-based methodology targeting the porcine hippocampal lamina combined with high-channel-count silicon probes, will allow for analysis of spike-field interactions during normal and disease states in both anesthetized and future awake behaving neurophysiology in this large animal.

Method to evaluate the noise of 3D intra-oral scanner.

In dentistry, 3D intra-oral scanners are gaining increasing popularity essentially for the production of dental prostheses.However, there is no normalized procedure to evaluate their basic performance and enable comparisons among intra-oral scanners. The noise value highlights the trueness of a 3D intra-oral scanner and its capacity to plan prosthesis with efficient clinical precision. The aim of the present study is to develop a reproducible methodology for determining the noise of an intra-oral scanner. To this aim, and as a reference, an ultra-flat and ultra-smooth alumina wafer is used as a blank test. The roughness is calculated using an AFM (atomic force microscope) and interferometric microscope measurements to validate this ultra-flat characteristic. Then, two intra-oral scanners (Carestream CS3500 and Trios 3Shape) are used. The wafer is imaged by the two intra-oral scanners with three different angles and two different directions, 10 times for each parameter, given a total of 50 3D-meshes per intra-oral scanner. RMS (root mean square), representing the noise, is evaluated and compared for each angle/direction and each intra-oral scanner, for the whole mesh, and then in a central ROI (region of interest). In this study, we obtained RMS values ranging between 5.29 and 12.58 micrometers. No statistically significant differences were found between the mean RMS of the two intra-oral scanners, but significant differences in angulation and orientations were found between different 3D intra-oral scanners. This study shows that the evaluation of RMS can be an indicator of the value of the noise, which can be easily assessed by applying the present methodology.

A coupled finite and boundary spectral element method for linear water-wave propagation problems

• A coupled finite and boundary spectral element method for linear water-wave propagation problems is proposed. • Boundary spectral element method (BSEM) is a new technique that combines the advantages of the spectral approach and the BEM. • BSEM has been applied to the mild-slope equation with variable bathymetry in one direction. • A convergence study has been made for the BSEM alone and coupled with finite spectral elements. • The proposed formulation has been validated by solving classical water-wave propagation problems. A coupled boundary spectral element method (BSEM) and spectral element method (SEM) formulation for the propagation of small-amplitude water waves over variable bathymetries is presented in this work. The wave model is based on the mild-slope equation (MSE), which provides a good approximation of the propagation of water waves over irregular bottom surfaces with slopes up to 1:3. In unbounded domains or infinite regions, space can be divided into two different areas: a central region of interest, where an irregular bathymetry is included, and an exterior infinite region with straight and parallel bathymetric lines. The SEM allows us to model the central region, where any variation of the bathymetry can be considered, while the exterior infinite region is modelled by the BSEM which, combined with the fundamental solution presented by Cerrato et al. [A. Cerrato, J. A. González, L. Rodríguez-Tembleque, Boundary element formulation of the mild-slope equation for harmonic water waves propagating over unidirectional variable bathymetries, Eng. Anal. Boundary Elem. 62 (2016) 22–34.] can include bathymetries with straight and parallel contour lines. This coupled model combines important advantages of both methods; it benefits from the flexibility of the SEM for the interior region and, at the same time, includes the fulfilment of the Sommerfeld’s radiation condition for the exterior problem, that is provided by the BSEM. The solution approximation inside the elements is constructed by high order Legendre polynomials associated with Legendre–Gauss–Lobatto quadrature points, providing a spectral convergence for both methods. The proposed formulation has been validated in three different benchmark cases with different shapes of the bottom surface. The solutions exhibit the typical p -convergence of spectral methods.

SU‐C‐206‐03: Metal Artifact Reduction in X‐Ray Computed Tomography Based On Local Anatomical Similarity

Purpose:Metal implants such as orthopedic hardware and dental fillings cause severe bright and dark streaking in reconstructed CT images. These artifacts decrease image contrast and degrade HU accuracy, leading to inaccuracies in target delineation and dose calculation. Additionally, such artifacts negatively impact patient set‐up in image guided radiation therapy (IGRT). In this work, we propose a novel method for metal artifact reduction which utilizes the anatomical similarity between neighboring CT slices.Methods:Neighboring CT slices show similar anatomy. Based on this anatomical similarity, the proposed method replaces corrupted CT pixels with pixels from adjacent, artifact‐free slices. A gamma map, which is the weighted summation of relative HU error and distance error, is calculated for each pixel in the artifact‐corrupted CT image. The minimum value in each pixel's gamma map is used to identify a pixel from the adjacent CT slice to replace the corresponding artifact‐corrupted pixel. This replacement only occurs if the minimum value in a particular pixel's gamma map is larger than a threshold. The proposed method was evaluated with clinical images.Results:Highly attenuating dental fillings and hip implants cause severe streaking artifacts on CT images. The proposed method eliminates the dark and bright streaking and improves the implant delineation and visibility. In particular, the image non‐uniformity in the central region of interest was reduced from 1.88 and 1.01 to 0.28 and 0.35, respectively. Further, the mean CT HU error was reduced from 328 HU and 460 HU to 60 HU and 36 HU, respectively.Conclusions:The proposed metal artifact reduction method replaces corrupted image pixels with pixels from neighboring slices that are free of metal artifacts. This method proved capable of suppressing streaking artifacts, improving HU accuracy and image detectability.

LOR-interleaving image reconstruction for PET imaging with fractional-crystal collimation

Positron emission tomography (PET) has become an important modality in medical and molecular imaging. However, in most PET applications, the resolution is still mainly limited by the physical crystal sizes or the detector’s intrinsic spatial resolution. To achieve images with better spatial resolution in a central region of interest (ROI), we have previously proposed using collimation in PET scanners. The collimator is designed to partially mask detector crystals to detect lines of response (LORs) within fractional crystals. A sequence of collimator-encoded LORs is measured with different collimation configurations. This novel collimated scanner geometry makes the reconstruction problem challenging, as both detector and collimator effects need to be modeled to reconstruct high-resolution images from collimated LORs. In this paper, we present a LOR-interleaving (LORI) algorithm, which incorporates these effects and has the advantage of reusing existing reconstruction software, to reconstruct high-resolution images for PET with fractional-crystal collimation. We also develop a 3D ray-tracing model incorporating both the collimator and crystal penetration for simulations and reconstructions of the collimated PET. By registering the collimator-encoded LORs with the collimator configurations, high-resolution LORs are restored based on the modeled transfer matrices using the non-negative least-squares method and EM algorithm. The resolution-enhanced images are then reconstructed from the high-resolution LORs using the MLEM or OSEM algorithm. For validation, we applied the LORI method to a small-animal PET scanner, A-PET, with a specially designed collimator. We demonstrate through simulated reconstructions with a hot-rod phantom and MOBY phantom that the LORI reconstructions can substantially improve spatial resolution and quantification compared to the uncollimated reconstructions. The LORI algorithm is crucial to improve overall image quality of collimated PET, which can have significant implications in preclinical and clinical ROI imaging applications.

Harmonic analysis for the characterization and correction of geometric distortion in MRI.

Magnetic resonance imaging (MRI) is gaining widespread use in radiation therapy planning, patient setup verification, and real-time guidance of radiation delivery. Successful implementation of these technologies relies on the development of simple and efficient methods to characterize and monitor the geometric distortions arising due to system imperfections and gradient nonlinearities. To this end, the authors present the theory and validation of a novel harmonic approach to the quantification of system-related distortions in MRI. The theory of spatial encoding in MRI is applied to demonstrate that the 3D distortion vector field (DVF) is given by the solution of a second-order boundary value problem (BVP). This BVP is comprised of Laplace's equation and a limited measurement of the distortion on the boundary of a specified region of interest (ROI). An analytical series expansion solving this BVP within a spherical ROI is obtained, and a statistical uncertainty analysis is performed to determine how random errors in the boundary measurements propagate to the ROI interior. This series expansion is then evaluated to obtain volumetric DVF mappings that are compared to reference data obtained on a 3 T full-body scanner. This validation is performed within two spheres of 20 cm diameter (one centered at the scanner origin and the other offset +3 cm along each of the transverse directions). Initially, a high-order mapping requiring measurements at 5810 boundary points is used. Then, after exploring the impact of the boundary sampling density and the effect of series truncation, a reduced-order mapping requiring measurements at 302 boundary points is evaluated. The volumetric DVF mappings obtained from the harmonic analysis are in good agreement with the reference data. Following distortion correction using the high-order mapping, the authors estimate a reduction in the mean distortion magnitude from 0.86 to 0.42 mm and from 0.93 to 0.39 mm within the central and offset ROIs, respectively. In addition, the fraction of points with a distortion magnitude greater than 1 mm is reduced from 35.6% to 2.8% and from 40.4% to 1.5%, respectively. Similarly, following correction using the reduced-order mapping, the mean distortion magnitude reduces to 0.45-0.42 mm within the central and offset ROIs, and the fraction of points with a distortion magnitude greater than 1 mm is reduced to 2.8% and 1.5%, respectively. A novel harmonic approach to the characterization of system-related distortions in MRI is presented. This method permits a complete and accurate mapping of the DVF within a specified ROI using a limited measurement of the distortion on the ROI boundary. This technique eliminates the requirement to exhaustively sample the DVF at a dense 3D array of points, thereby permitting the design of simple, inexpensive phantoms that may incorporate additional modules for auxiliary quality assurance objectives.

SU‐E‐J‐81: Interplay Effect in Non‐Gated Dynamic Treatment Delivery of a Lung Phantom with Simulated Respiratory Motion

Purpose:To quantify the interplay effect in non‐gated VMAT external beam delivery using realistic, clinically relevant 3D motion in an anthropomorphic lung phantom, and to determine if adding margins is sufficient to account for motion or if gating is required in all cases.Methods:A 4D motion stage was used to move a Virtual Water (VW) lung target containing a piece of radiochromic EBT3 film in an anthropomorphic chest phantom. A five‐arc stereotactic body radiation therapy (SBRT) treatment was planned using a CT scan of the phantom in its stationary position, using planning parameters chosen to push the optimizer to achieve a highly‐modulated plan. Two scenarios were delivered using a Varian TrueBeam: the first was delivered with the phantom and target both stationary and the second was delivered with the phantom stationary but the target moving in a realistic, irregular 3D elliptical pattern. A single piece of 4×4 cm2 film was used per fraction, located in the central coronal plane of the target. Film was calibrated on a 6 MV beam with dose values from 0.20 to 20 Gy.Results:Preliminary test films were analyzed in ImageJ and MatLab software. Dose maps were calculated on a central region of interest (ROI) delineated on both the motion‐induced and stationary films. Both static and dynamic film dose maps agreed with planning values within acceptable uncertainty.Conclusion:Including a large number of arcs in a clinically realistic SBRT treatment could reduce the effect of motion interplay due to averaging. Because all clinics do not employ multiple arcs for SBRT lung treatments, it is still important to consider the effects of motion on treatment delivery. Further analysis on the treatment films, as well as a broader investigation other planning parameters, will be conducted.

Measurement of tumor blood flow in head and neck squamous cell carcinoma by pseudo‐continuous arterial spin labeling: Comparison with dynamic contrast‐enhanced MRI

To investigate the feasibility of tumor blood flow (TBF) measurement in head and neck squamous cell carcinoma (HNSCC) using pseudo-continuous arterial spin labeling (pCASL) in a comparison with dynamic contrast-enhanced (DCE) perfusion. We prospectively scanned 18 patients with HNSCC using 3T magnetic resonance imaging (MRI) with both pCASL and DCE perfusion. Quantitative TBF value in the whole-tumor region of interest (ROI), and regional TBF in the ROIs of the central and peripheral areas in the tumor were respectively measured. Relative TBF value in the whole-tumor ROI was also calculated. We determined the correlation and agreement between each measured TBF by pCASL and DCE perfusion using Pearson's correlation coefficients, intraclass correlation coefficients (ICC), and Bland-Altman analysis. In the whole-tumor ROIs, significant correlation was observed between the absolute TBF values (r = 0.72, P < 0.01), with an ICC of 0.72; moreover, higher correlation was observed in the relative TBF (r = 0.79). The correlation was higher in the peripheral ROI (r = 0.70) than the central ROI (r = 0.65), with an ICC of 0.62 and 0.54, respectively. Bland-Altman plots revealed the underestimation of TBF by pCASL in central ROIs. TBF measurement by pCASL was feasible in patients with HNSCC.

Comparison of Contrast-to-Noise Ratios of Transmission and Dark-Field Signal in Grating-Based X-ray Imaging for Healthy Murine Lung Tissue

PurposeAn experimental comparison of the contrast-to-noise ratio (CNR) between transmission and dark-field signals in grating-based X-ray imaging for ex-vivo murine lung tissue. Materials and MethodsLungs from three healthy mice were imaged ex vivo using a laser-driven compact synchrotron X-ray source. Background noise of transmission and dark-field signal was quantified by measuring the standard deviation in a region of interest (ROI) placed in a homogeneous area outside the specimen. Image contrast was quantified by measuring the signal range in rectangular ROIs placed in central and peripheral lung parenchyma. The relative contrast gain (RCG) of dark-field over transmission images was calculated as CNRDF / CNRT. ResultsIn all images, there was a trend for contrast-to-noise ratios of dark-field images (CNRDF) to be higher than for transmission images (CNRT) for all ROIs (median 61 vs. 38, p=0.10), but the difference was statistically significant only for peripheral ROIs (61 vs. 32, p=0.03). Median RCG was >1 for all ROIs (1.84). RCG values were significantly smaller for central ROIs than for peripheral ROIs (1.34 vs. 2.43, p=0.03). ConclusionThe contrast-to-noise ratio of dark-field images compares more favorably to the contrast-to-noise ratio of transmission images for peripheral lung regions as compared to central regions. For any specific specimen, a calculation of the RCG allows comparing which X-ray modality (dark-field or transmission imaging) produces better contrast-to-noise characteristics in a well-defined ROI.

MO-G-BRA-02: Microdosimetry of Simulated Heterogeneous 177Lu and 90Y Activity Distributions

Purpose: The aim of this study was to determine the dosimetric impact of heterogeneous cellular uptake of Lu-177 and Y-90 labelled compounds in targeted radionuclide therapy (TRT). Methods: Fine resolution voxel S values (VSVs) were generated for Lu-177 and Y-90 using Monte Carlo simulation with the EGSnrc user-code DOSXYZnrc. The VSVs were generated to be 20 microns on edge for Lu-177 and 100 microns for Y-90. To simulate varying degrees of heterogeneous uptake, activity was randomly assigned to percentages ranging from 1% to 80% of voxels in cubic volumes chosen to be large enough so that a central region, 30×30×30 voxels in size could receive a cross dose from the maximum beta range of Lu-177 and Y- 90. The resulting dose distributions were determined using the VSV approach where each target voxel dose is calculated by summing the product of the activity and corresponding voxel-to-voxel S value from each source voxel. Results: For the simulated Y-90 activity distribution, when 80% of the 100 micron voxels were labelled, the minimum and maximum voxel doses in the central region of interest were within 2.2% and 1.3% of the mean voxel dose, respectively. A percent difference of less than 10% was maintained between the minimum/maximum and mean voxel dose all the way down to 20% labelling. At 80% labelling of Lu-177, the minimum and maximum voxel doses were within 11.1% and 5.4% of the mean voxel dose, respectively, and at 20% labelling these values increased to 21% and 40%. Conclusions: This study indicates the impact of nonuniform activity distributions of two commonly used radionuclides in TRT. Even with low percentage labelling, the relatively long range of Y-90 emissions helps to significantly smooth out the dose. The calculated dose distributions were not as uniform for Lu-177 due to the shorter range of its emitted betas.

Line plus arc source trajectories and their R-line coverage for long-object cone-beam imaging with a C-arm system

Cone-beam imaging with C-arm systems has become a valuable tool in interventional radiology. Currently, a simple circular trajectory is used, but future applications should use more sophisticated source trajectories, not only to avoid cone-beam artifacts but also to allow extended volume imaging. One attractive strategy to achieve these two goals is to use a source trajectory that consists of two parallel circular arcs connected by a line segment, possibly with repetition. In this work, we address the question of R-line coverage for such a trajectory. More specifically, we examine to what extent R-lines for such a trajectory cover a central cylindrical region of interest (ROI). An R-line is a line segment connecting any two points on the source trajectory. Knowledge of R-line coverage is crucial because a general theory for theoretically exact and stable image reconstruction from axially truncated data is only known for the points in the scanned object that lie on R-lines. Our analysis starts by examining the R-line coverage for the elemental trajectories consisting of (i) two parallel circular arcs and (ii) a circular arc connected orthogonally to a line segment. Next, we utilize our understanding of the R-lines for the aforementioned elemental trajectories to determine the R-line coverage for the trajectory consisting of two parallel circular arcs connected by a tightly fit line segment. For this trajectory, we find that the R-line coverage is insufficient to completely cover any central ROI. Because extension of the line segment beyond the circular arcs helps to increase the R-line coverage, we subsequently propose a trajectory composed of two parallel circular arcs connected by an extended line. We show that the R-lines for this trajectory can fully cover a central ROI if the line extension is long enough. Our presentation includes a formula for the minimum line extension needed to achieve full R-line coverage of an ROI with a specified size, and also includes a preliminary study on the required detector size, showing that the R-lines added by the line extension are not constraining.