Intensity Of Artifacts Research Articles

Reducing blood flow pulsation artifacts in 3D time-of-flight angiography by locally scrambling the order of the acquisition at 3 T and 7 T.

Non-contrast-enhanced time of flight (TOF) is a standard method for magnetic resonance angiography used to depict vessel morphology. TOF is commonly performed with a 3D steady-state acquisition, employing a short repetition time to support high resolution imaging. At 7 T, TOF exhibits substantial increase in SNR and contrast, improving its clinical value. However, one of the remaining challenges, exacerbated at 7 T, is the presence of artifacts due to pulsatile blood flow, especially near major blood vessels. In this study we examine a method to significantly reduce these artifacts. We recently introduced a new "local-scrambling" approach that semi-randomizes the acquisition order of the phase encodes, to achieve a controllable cutoff frequency above which the artifacts are drastically reduced. With this approach, artifacts resulting from fast local fluctuations such as cardiac pulsation are significantly reduced. In this study, we explore the ability of this local-scrambling approach to reduce pulsatile blood flow artifacts in a 3D TOF acquisition. Cartesian line-by-line and center-out ordering, with and without local-scrambling, were compared in simulations and in human brain imaging at 3 and 7 T scanners. In the simulations the artifact intensity showed a 10-fold reduction using local-scrambling compared to line-by-line and 4-fold compared to center-out ordering. In vivo results show that artifacts are much more pronounced at 7 T compared to 3 T, and in both cases they are effectively reduced by local-scrambling. Local-scrambling improves image quality for both line-by-line and center-out ordering. This approach can easily be implemented in the scanner without any changes to the reconstruction.

The Impact of AI on Metal Artifacts in CBCT Oral Cavity Imaging.

This study aimed to assess the impact of artificial intelligence (AI)-driven noise reduction algorithms on metal artifacts and image quality parameters in cone-beam computed tomography (CBCT) images of the oral cavity. This retrospective study included 70 patients, 61 of whom were analyzed after excluding those with severe motion artifacts. CBCT scans, performed using a Hyperion X9 PRO 13 × 10 CBCT machine, included images with dental implants, amalgam fillings, orthodontic appliances, root canal fillings, and crowns. Images were processed with the ClariCT.AI deep learning model (DLM) for noise reduction. Objective image quality was assessed using metrics such as the differentiation between voxel values (ΔVVs), the artifact index (AIx), and the contrast-to-noise ratio (CNR). Subjective assessments were performed by two experienced readers, who rated overall image quality and artifact intensity on predefined scales. Compared with native images, DLM reconstructions significantly reduced the AIx and increased the CNR (p < 0.001), indicating improved image clarity and artifact reduction. Subjective assessments also favored DLM images, with higher ratings for overall image quality and lower artifact intensity (p < 0.001). However, the ΔVV values were similar between the native and DLM images, indicating that while the DLM reduced noise, it maintained the overall density distribution. Orthodontic appliances produced the most pronounced artifacts, while implants generated the least. AI-based noise reduction using ClariCT.AI significantly enhances CBCT image quality by reducing noise and metal artifacts, thereby improving diagnostic accuracy and treatment planning. Further research with larger, multicenter cohorts is recommended to validate these findings.

Photon-counting detector step-wedge calibration enabling water and iodine material decomposition

Photon-counting detector computed tomography (PCD-CT) has demonstrated improvements in conventional image quality compared to energy integrating detector (EID) CT. PCD-CT has the advantage of being able to operate in conventional and spectral mode simultaneously by sorting photons according to selected energy thresholds. However, to reconstruct spectral images PCD-CT requires extensive calibration and specifically fine-tuning a spectral response. This response is then used to perform material decomposition (MD). We propose a step-wedge phantom made of water and iodine to calibrate a prototype PCD-CT system. Four methods were tested and compared based on calibration accuracy and CT image quality. The exhaustive PCD response was not well calibrated, but a reduced model was defined that was able to perform accurate water/iodine MD and to reduce the ring artifact intensity. The impact of the number of energy bins (from two to seven) was also studied. The number of bins did not affect the spectral accuracy. However, compared to the two energy bin configuration, the seven bin configuration decreased the noise by 10% and 15% in the water and iodine maps, respectively. The model was tested on ex-vivo tissue samples injected with iodine to demonstrate the results of the water/iodine MD on biological materials.

PPG heart rate extraction algorithm based on the motion artifact intensity Classification and removal framework

When heart rate is extracted by wearable PPG, motion artifact noise causes serious interference. Since the accuracy of PPG heart rate extraction tends to be positively correlated with the complexity of heart rate extraction algorithm, it is challenging to extract heart rate via wearable PPG throughout the day by taking into account both algorithmic complexity and the accuracy of heart rate extraction. In this paper, a PPG heart rate extraction algorithm is proposed under the motion artifact intensity classification and removal (MAICR) framework. Firstly, it evaluates the motion artifact intensity using acceleration time-domain information and PPG frequency-domain information. Then, different heart rate estimation methods are selected according to motion artifact intensity, in ascending order. This corresponds to the use of the frequency-domain direct extraction method, the MNLMS adaptive filtering method, and the joint sparse spectral reconstruction method. Additionally, the overall framework of the algorithm (MAICR) is developed by considering the performance of various methods. Finally, experiments are conducted on the public dataset to demonstrate that the proposed algorithm is applicable to reduce the algorithmic complexity effectively while maintaining the accuracy in heart rate extraction at a certain degree.

Potential of photon counting computed tomography derived spectral reconstructions to reduce beam-hardening artifacts in chest CT

PurposeAim of the recent study is to point out a method to optimize quality of CT scans in oncological patients with port systems. This study investigates the potential of photon counting computed tomography (PCCT) for reduction of beam hardening artifacts caused by port-implants in chest imaging by means of spectral reconstructions. MethodIn this retrospective single-center study, 8 ROIs for 19 spectral reconstructions (polyenergetic imaging, monoenergetic reconstructions from 40 to 190 keV as well as iodine maps and virtual non contrast (VNC)) of 49 patients with pectoral port systems undergoing PCCT of the chest for staging of oncologic disease were measured. Mean values and standard deviation (SD) Hounsfield unit measurements of port-chamber associated hypo- and hyperdense artifacts, bilateral muscles and vessels has been carried out. Also, a structured assessment of artifacts and imaging findings was performed by two radiologists. ResultsA significant association of keV with iodine contrast as well as artifact intensity was noted (all p < 0.001). In qualitative assessment, utilization of 120 keV monoenergetic reconstructions could reduce severe and pronounced artifacts completely, as compared to lower keV reconstructions (p < 0.001). Regarding imaging findings, no significant difference between monoenergetic reconstructions was noted (all p > 0.05). In cases with very high iodine concentrations in the subclavian vein, image distortions were noted at 40 keV images (p < 0.01). ConclusionsThe present study demonstrates that PCCT derived spectral reconstructions can be used in oncological imaging of the thorax to reduce port-derived beam-hardening artefacts. When evaluating image data sets within a staging, it can be particularly helpful to consider the 120 keV VMIs, in which the artefacts are comparatively low.

Total signal intensity of ultrasound laboratory vertical artifacts: A semi-quantitative tool

Quantitative approaches to improve lung ultrasound (LUS) vertical artifacts (VA) interpretation using total signal intensity (ITOT) are not widely available for clinical practice. In this study, we aimed to i) develop a mathematical algorithm to extract ITOT as a post-hoc LUS analysis and ii) confirm ITOT utility by conducting laboratory VA research using an in vitro model with different acoustic channels.The ITOT was extracted from static and conventional LUS imaging recorded from in vitro models after varying the amount of water content or the pores size of the phantom, compared to a control condition.The defined algorithm was able to calculate the ITOT from all phantoms. Mean ITOT showed statistically significantly different values across phantom categories.We demonstrate that ITOT may be able to differentiate the in vitro acoustic channels formed by increased water content from those with small size pores. However, the utility of this semi-quantitative tool in clinical practice or other LUS imaging data sets remains unclear.

Evaluation of computed tomography metal artifact and CyberKnife fiducial recognition for novel size fiducial markers.

This study aimed to compare fiducial markers used in CyberKnife treatment in terms of metal artifact intensity observed in CT images and fiducial recognition in the CyberKnife system affected by patient body thickness and type of marker. Five markers, ACCULOC 0.9mm×3mm, Ball type Gold Anchor (GA) 0.28mm×10mm, 0.28mm×20mm, and novel size GA 0.4mm×10mm, 0.4mm×20mm were evaluated. To evaluate metal artifacts of CT images, two types of CT images of water-equivalent gels with each marker were acquired using Aquilion LB CT scanner, one applied SEMAR (SEMAR-on) and the other did not apply this technique (SEMAR-off). The evaluation metric of artifact intensity (MSD ) which represents a variation of CT values were compared for each marker. Next, 5, 15, and 20cm thickness of Tough Water (TW) was placed on the gel under the condition of overlapping the vertebral phantom in the Target Locating System, and the live image of each marker was acquired to compare fiducial recognition. The mean MSD of SEMAR-off was 78.80, 74.50, 97.25, 83.29, and 149.64 HU for ACCULOC, GA0.28mm×10mm, 20mm, and 0.40mm×10mm, 20mm, respectively. In the same manner, that of SEMAR-on was 23.52, 20.26, 26.76, 24.89, and 33.96 HU, respectively. Fiducial recognition decreased in the order of 5, 15, and 20cm thickness, and GA 0.4×20mm showed the best recognition at thickness of 20cm TW. We demonstrated the potential to reduce metal artifacts in the CT image to the same level for all the markers we evaluated by applying SEMAR. Additionally, the fiducial recognition of each marker may vary depending on the thickness of the patient's body. Particularly, we showed that GA 0.40×20mm may have more optimal recognition for CyberKnife treatment in cases of high bodily thickness in comparison to the other markers.

Dynamic controllable residual generative adversarial network for low-dose computed tomography imaging.

Computed tomography (CT) imaging technology has become an indispensable auxiliary method in medical diagnosis and treatment. In mitigating the radiation damage caused by X-rays, low-dose computed tomography (LDCT) scanning is becoming more widely applied. However, LDCT scanning reduces the signal-to-noise ratio of the projection, and the resulting images suffer from serious streak artifacts and spot noise. In particular, the intensity of noise and artifacts varies significantly across different body parts under a single low-dose protocol. To improve the quality of different degraded LDCT images in a unified framework, we developed a generative adversarial learning framework with a dynamic controllable residual. First, the generator network consists of the basic subnetwork and the conditional subnetwork. Inspired by the dynamic control strategy, we designed the basic subnetwork to adopt a residual architecture, with the conditional subnetwork providing weights to control the residual intensity. Second, we chose the Visual Geometry Group Network-128 (VGG-128) as the discriminator to improve the noise artifact suppression and feature retention ability of the generator. Additionally, a hybrid loss function was specifically designed, including the mean square error (MSE) loss, structural similarity index metric (SSIM) loss, adversarial loss, and gradient penalty (GP) loss. The results obtained on two datasets show the competitive performance of the proposed framework, with a 3.22 dB peak signal-to-noise ratio (PSNR) margin, 0.03 SSIM margin, and 0.2 contrast-to-noise ratio margin on the Challenge data and a 1.0 dB PSNR margin and 0.01 SSIM margin on the real data. Experimental results demonstrated the competitive performance of the proposed method in terms of noise decrease, structural retention, and visual impression improvement.

Breath-Hold CBCT-Guided CBCT-to-CT Synthesis via Multimodal Unsupervised Representation Disentanglement Learning.

Adaptive radiation therapy (ART) aims to deliver radiotherapy accurately and precisely in the presence of anatomical changes, in which the synthesis of computed tomography (CT) from cone-beam CT (CBCT) is an important step. However, because of serious motion artifacts, CBCT-to-CT synthesis remains a challenging task for breast-cancer ART. Existing synthesis methods usually ignore motion artifacts, thereby limiting their performance on chest CBCT images. In this paper, we decompose CBCT-to-CT synthesis into artifact reduction and intensity correction, and we introduce breath-hold CBCT images to guide them. To achieve superior synthesis performance, we propose a multimodal unsupervised representation disentanglement (MURD) learning framework that disentangles the content, style, and artifact representations from CBCT and CT images in the latent space. MURD can synthesize different forms of images using the recombination of disentangled representations. Also, we propose a multipath consistency loss to improve structural consistency in synthesis and a multidomain generator to improve synthesis performance. Experiments on our breast-cancer dataset show that MURD achieves impressive performance with a mean absolute error of 55.23±9.94 HU, a structural similarity index measurement of 0.721±0.042, and a peak signal-to-noise ratio of 28.26±1.93 dB in synthetic CT. The results show that compared to state-of-the-art unsupervised synthesis methods, our method produces better synthetic CT images in terms of both accuracy and visual quality.

Messing up to clean up: Semi-randomized frequency selective space-filling curves to suppress physiological signal fluctuations in MRI.

Rapid 3D steady-state sequences are widely used but are also known to be sensitive to semi-periodic physiological signal fluctuations due to, for example, cardiac pulsation, breathing, and eye/eyelids movement. This semi-periodicity results in repeating artifacts in the image whose intensity depends on the scan parameters. The purpose of this study is to design a reordering of the 2D phase encodes (within the 3D acquisition) that reduces these artifacts. A randomized order of the phase encodes can suppress repeating artifact but may also introduce its own apparent noise, for example, in cases of slow subject movement or gradual changes in eddy currents. In a new design a semi-randomized space-filling curve is generated by scrambling the local order of the phase encodes to achieve a controlled frequency selective effect, that is, eliminating artifacts above a chosen (fluctuation) frequency threshold while leaving lower frequencies untouched, thus overcoming the limitations of a randomized order. The method was characterized in simulations and substantiated by human brain imaging at 7 T using two steady-state gradient echo variants that suffer from pulsation, either near blood vessels or near the ventricles. The simulations with a point source show that the maximum artifact intensity can be reduced by factors of 10-50 depending on the scan parameters. In human scanning, the new approach drastically reduced physiologically induced artifacts and was superior in this regard to both full randomization and a generalized Hilbert curve, another semi-randomized approach. The phase-encodes reordering presented here effectively removes artifacts arising from local fluctuations.

Noise and blur removal from corrupted X-ray computed tomography scans: A multilevel and multiscale deep convolutional framework approach with synthetic training data (BAM SynthCOND)

Regardless of the experimental care practiced in acquiring X-ray computed tomography (XCT) data, artifacts might still exist, such as noise and blur. This is typical for fast XCT data acquisitions (e.g., in-situ investigations), or low-dose XCT. Such artifacts can complicate subsequent analysis of the data. Digital filters can moderately cure extensive artifacts. The selection of filter type, intensity, and order of application is not always straightforward. To tackle these problems, a complete sequential multilevel, multi-scale framework: BAM SynthCOND, employing newly designed deep convolutional neural networks (DCNNs), was formulated. Although data conditioning with neural networks is not uncommon, the main complication is that completely artifact-free XCT data for training do not exist. Thus, training data were acquired from an in-house developed library (BAM SynthMAT) capable of generating synthetic XCT material microstructures. Some novel DCNN architectures were introduced (2D/3D ACEnet_Denoise, 2D/3D ACEnet_Deblur) along with the concept of Assertive Contrast Enhancement (ACE) training, which boosts the performance of neural networks trained with continuous loss functions. The proposed methodology accomplished very good generalization from low resemblance synthetic training data. Indeed, denoising, sharpening (deblurring), and even ring artifact removal performance were achieved on experimental post-CT scans of challenging multiphase Al-Si Metal Matrix Composite (MMC) microstructures. The conditioning efficiencies were: 92% for combined denoising/sharpening, 99% for standalone denoising, and 95% for standalone sharpening. The results proved to be independent of the artifact intensity. We believe that the novel concepts and methodology developed in this work can be directly applied on the CT projections prior to reconstruction, or easily be extended to other imaging techniques such as: Microscopy, Neutron Tomography, Ultrasonics, etc.

Visual and quantitative assessment of hip implant-related metal artifacts at low field MRI: a phantom study comparing a 0.55-T system with 1.5-T and 3-T systems

BackgroundTo investigate hip implant-related metal artifacts on a 0.55-T system compared with 1.5-T and 3-T systems.MethodsTotal hip arthroplasty made of three different alloys were evaluated in a water phantom at 0.55, 1.5, and 3 T using routine protocols. Visually assessment (VA) was performed by three readers using a Likert scale from 0 (no artifacts) to 6 (extremely severe artifacts). Quantitative assessment (QA) was performed using the coefficient of variation (CoV) and the fraction of voxels within a threshold of the mean signal intensity compared to an automatically defined region of interest (FVwT). Agreement was evaluated using intra/inter-class correlation coefficient (ICC).ResultsInterreader agreement of VA was strong-to-moderate (ICC 0.74−0.82). At all field strengths (0.55-T/1.5-T/3-T), artifacts were assigned a lower score for titanium (Ti) alloys (2.44/2.9/2.7) than for stainless steel (Fe-Cr) (4.1/3.9/5.1) and cobalt-chromium (Co-Cr) alloys (4.1/4.1/5.2) (p < 0.001 for both). Artifacts were lower for 0.55-T and 1.5-T than for 3-T systems, for all implants (p ≤ 0.049). A strong VA-to-QA correlation was found (r = 0.81; p < 0.001); CoV was lower for Ti alloys than for Fe-Cr and Co-Cr alloys at all field strengths. The FVwT showed a negative correlation with VA (-0.68 < r < -0.84; p < 0.001).ConclusionsArtifact intensity was lowest for Ti alloys at 0.55 T. For other alloys, it was similar at 0.55 T and 1.5 T, higher at 3 T. Despite an inferior gradient system and a larger bore width, the 0.55-T system showed the same artifact intensity of the 1.5-T system.

The effects of different metal posts, cements, and exposure parameters on cone-beam computed tomography artifacts.

This study assessed the intensity of artifacts produced by 2 metal posts, 2 cements, and different exposure parameters using 2 cone-beam computed tomography (CBCT) units. The sample was composed of 20 single-rooted premolars, divided into 4 groups: Ni-Cr/zinc phosphate, Ni-Cr/resin cement, Ag-Pd/zinc phosphate, and Ag-Pd/resin cement. Samples were scanned before and after post insertion and cementation using a CS9000 3D scanner with 4 exposure parameters (85/90 kV and 6.3/10 mA) and an i-CAT scanner with 120 kV and 5 mA. The presence of artifacts was assessed subjectively by 2 observers and objectively by a trained observer using ImageJ software. The Mann-Whitney, Wilcoxon, weighted kappa, and chi-square tests were used to assess data at a 95% confidence level (α<0.05). In the subjective analyses, AgPd presented more hypodense and hyperdense lines than NiCr (P<0.05), and more hypodense halos were found using i-CAT (P<0.05) than using CS9000 3D. More hypodense halos, hypodense lines, and hyperdense lines were observed at 10 mA than at 6.3 mA (P<0.05). More hypodense halos were observed at 85 kV than at 90 kV (P<0.05). CS9000 3D presented more hypodense and hyperdense lines than i-CAT (P<0.05). In the objective analyses, AgPd presented higher percentages of hyperdense and hypodense artifacts than NiCr (P<0.05). Zinc phosphate cement presented higher hyperdense artifact percentages on CS9000 3D scans (P<0.05). CS9000 3D presented higher artifact percentages than i-CAT (P<0.05). High-atomic-number alloys, higher tube current, and lower tube voltage may increase the artifacts present in CBCT images.

The effect of attenuation inside the acoustic traps on the configuration of vertical artifacts in lung ultrasound: an experimental study with simple models.

PurposeUsing simple experimental models for lung ultrasound, we evaluated the relationship of the attenuation inside the sources of vertical artifacts to the echo intensity and attenuation of artifacts.MethodsAs sources of artifacts, we made 10 different hemispherical gel objects with two different mediums (pure agar or agar containing graphite with an attenuation coefficient of 0.5 dB/cm · MHz) and five different diameters (3.6, 5.6, 7.5, 9.5, or 11.4 mm). Ten of each hemispherical gel object were prepared for the statistical analyses. Each object was placed onto a chest wall phantom as the plane of the hemisphere was placed in an upward position. The echo intensity and attenuation of the artifact generated from each object was measured and compared.ResultsFor all sizes, the intensity and attenuation of the artifacts in the objects made of agar containing graphite were significantly lower and larger, respectively, than those in the objects made of pure agar. In the objects containing graphite, the intensity decreased when the frequency was changed from 5 to 9 MHz.ConclusionBased on this experiment, assessing the intensity and attenuation of vertical artifacts may help estimate the physical composition of sources of vertical artifacts in lung ultrasound.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10396-022-01244-0.

Qualitative Assessment of Titanium versus Carbon Fiber/Polyetheretherketone Pedicle Screw–Related Artifacts: A Cadaveric Study

Dorsal instrumentation and decompression are the mainstays of spinal tumor treatment. Replacing titanium screws with carbon fiber-reinforced polyetheretherketone (CFRP) screws can reduce imaging artifacts on neural structures and perturbations of radiation dose. Further reduction of metal content in such screws might enhance the benefit. The aim of this study was to assess the artifacts produced by all-titanium screws (Ti-Ti), CFRP thread-titanium screw heads (C-Ti), and all-CFRP screws (C-C). A cadaveric spine was used to place Ti-Ti, C-Ti, and C-C consecutively from T2 to S1. Computed tomography and 1.5T and 3T magnetic resonance imaging were performed for each screw system. Axial T1- and T2-weighted sequences of representative thoracic and lumbar regions were assessed for artifacts. The artifacts were classified as not relevant, considerable, or severe. We evaluated 92 screws and made 178 artifact assessments. The artifacts were clearly visible in computed tomography scans but did not influence the visualization of intraspinal structures. Severe magnetic resonance imaging artifacts were found in 28% (17/60, mostly in the thoracic spine) of Ti-Ti, 2% (1/60, all T1 sequences) of C-Ti, and 0% of C-C, and considerable artifacts were found in 47% (28/60) of Ti-Ti, 10% (6/60, only 1 T2 sequence) of C-Ti, and 0% of C-C screws (P < 0.001). CFRP pedicle screws reduced the artifact intensity in spinal structures compared with titanium screws, and may be beneficial for planning radiotherapy and for follow-up imaging. C-C demonstrated an enhanced effect on dorsal structures.

Artifact reduction in contrast-enhanced mammography

ObjectiveTo evaluate the effectiveness of a new algorithm developed to reduce artifacts in dual-energy subtraction (DES) contrast-enhanced mammography (CEM) images while preserving contrast enhancement of possible lesions.MethodsA retrospective multi-reader paired study was performed by using 134 CEM studies obtained from the first 134 women enrolled in a prospective clinical study aiming to compare the clinical performance of CEM to those of breast MRI in screening of women at increased risk of breast cancer. Four experienced readers compared independently the standard (STD) DES images with those obtained by reprocessing the raw images by a new algorithm (NEW), expected to reduce the DES artifact intensity. The intensity of three types of artifacts (breast-in-breast, ripple, and skinfold enhancement) and the intensity of possible contrast uptake were assessed visually and rated using a categorical ordinal scale. Proportions of images rated by the majority of readers as “Absent”, “Weak”, “Medium”, “Strong” in each artifact intensity category were compared between the two algorithms. P-values lower than 0.05 were considered statistically significant.ResultsThe NEW algorithm succeeded in eliminating 84.5% of breast-in-breast artifacts, 84.2% of ripple artifacts, and 56.9% of skinfold enhancement artifacts versus STD DES images, and reduced the artifact intensity in 12.1%, 13.0%, and 28.8% of the images, respectively. The visibility of lesion contrast uptake was the same with the STD and the NEW algorithms.ConclusionThe new dual-energy subtraction algorithm demonstrated to be effective in reducing/eliminating CEM-related artifacts while preserving lesion contrast enhancement.

Investigating the link between intensity of lung ultrasound vertical artifacts and penetration depth of ultrasound waves, in silico study

Lung ultrasound (LUS) is nowadays widely applied for lung surface evaluation. In particular, LUS is often based on the analysis of vertical artifacts, which correlate with various pathologies but whose genesis is not fully comprehended yet. To better understand the phenomena causing these artifacts' appearance, numerical simulations can represent a powerful tool. Specifically, we present a simulation study (k-Wave MATLAB toolbox) that investigates whether a link exists between the intensity of these artifacts and the penetration depth of ultrasound waves through the lung parenchyma. The size of the simulated numerical domain is 4 cm × 2 cm, with the simulated lung surface located at a depth of 2 cm. Different alveolar structures were modeled by varying the alveolar diameter (from 40 to 800 μm), the inter-alveolar axial-spacing (from 40 to 790 μm) and inter-alveolar lateral-spacing (from 10 to 100 μm). For each configuration, Gaussian pulses (with bandwidth equal to 0.5 MHz at −6 dB) having different center frequencies (from 1 to 5 MHz) were transmitted without focusing (plane wave imaging). Results highlight how the artifacts' intensity seems to be independent from waves' penetration depth.

The Mechanisms Underlying Vertical Artifacts in Lung Ultrasound and Their Proper Utilization for the Evaluation of Cardiogenic Pulmonary Edema.

The recent advances in lung ultrasound for the diagnosis of cardiogenic pulmonary edema are outstanding; however, the mechanism of vertical artifacts known as B-lines used for the diagnosis has not yet been fully elucidated. The theory of “acoustic trap” is useful when considering the generation of vertical artifacts. Basic research in several studies supports the theory. Published studies with pilot experiments indicate that clarification of the relationship between the length and intensity of vertical artifacts and physical or acoustic composition of sources may be useful for differentiating cardiogenic pulmonary edema from lung diseases. There is no international consensus with regard to the optimal settings of ultrasound machines even though their contribution to the configuration of vertical artifacts is evident. In the clinical setting, the configuration is detrimentally affected by the use of spatial compound imaging, the placement of the focal point at a deep level, and the use of multiple focus. Simple educational materials using a glass microscope slide also show the non-negligible impact of the ultrasound machine settings on the morphology of vertical artifacts.

Deciphering the Network Effects of Deep Brain Stimulation in Parkinson's Disease.

IntroductionDeep brain stimulation of the subthalamic nucleus (STN-DBS) is an established therapy for Parkinson's disease (PD). However, a more detailed characterization of the targeted network and its grey matter (GM) terminals that drive the clinical outcome is needed. In this direction, the use of MRI after DBS surgery is now possible due to recent advances in hardware, opening a window for the clarification of the association between the affected tissue, including white matter fiber pathways and modulated GM regions, and the DBS-related clinical outcome. Therefore, we present a computational framework for reconstruction of targeted networks on postoperative MRI.MethodsWe used a combination of preoperative whole-brain T1-weighted (T1w) and diffusion-weighted MRI data for morphometric integrity assessment and postoperative T1w MRI for electrode reconstruction and network reconstruction in 15 idiopathic PD patients. Within this framework, we made use of DBS lead artifact intensity profiles on postoperative MRI to determine DBS locations used as seeds for probabilistic tractography to cortical and subcortical targets within the motor circuitry. Lastly, we evaluated the relationship between brain microstructural characteristics of DBS-targeted brain network terminals and postoperative clinical outcomes.ResultsThe proposed framework showed robust performance for identifying the DBS electrode positions. Connectivity profiles between the primary motor cortex (M1), supplementary motor area (SMA), and DBS locations were strongly associated with the stimulation intensity needed for the optimal clinical outcome. Local diffusion properties of the modulated pathways were related to DBS outcomes. STN-DBS motor symptom improvement was highly associated with cortical thickness in the middle frontal and superior frontal cortices, but not with subcortical volumetry.ConclusionThese data suggest that STN-DBS outcomes largely rely on the modulatory interference from cortical areas, particularly M1 and SMA, to DBS locations.

Comparison of artifact intensity after implantation of thoracolumbar titanium vs. carbon-fibre/PEEK pedicle screws

Comparison of artifact intensity after implantation of thoracolumbar titanium vs. carbon-fibre/PEEK pedicle screws