Maximum Intensity Projection Algorithm Research Articles

Three-dimensional magnetic resonance imaging after ultrasonography for assessment of fetal gastroschisis

A 24-year-old woman (Gravida I, Para I) at estimated 32 weeks of pregnancy was referred to our department for evaluation of a suspected fetal gastroschisis. Ultrasound scan revealed multiple loops of dilated bowel outside the fetal abdomen and absence of membrane surrounding the herniated loops of the intestines. Three-dimensional (3D) magnetic resonance imaging was performed to obtain more information on the bowel both outside and inside the abdomen. Images were constructed with T1-weighted fat-suppressed 3D fast low-angle shot sequences using a maximum intensity projection algorithm. The 3D images made possible the realization of fetal bowel conditions with greater definition and accuracy.

Sci-PM Thurs - 03: 3-D angiography: Effect of the maximum intensity projection on the measurement of artery diameters

Our goal was to determine the impact of the maximum intensity projection (MIP) algorithm on quantitative analysis used for diagnosis and treatment planning of extracranial arterial disease. We performed 3-D computed rotational angiography (CRA) on 26 consecutive symptomatic patients to verify an internal carotid artery (ICA) stenosis originally found using duplex ultrasound. These volumes of data were visualized using two different post-processing projection techniques: MIP and digitally reconstructed radiographic (DRR) projection. A DRR is a radiographic image simulating a conventional digitally subtracted angiogram (DSA), but it is derived computationally from the same CRA dataset as the MIP. By visualizing a single volume with two different projection techniques, the post-processing effect of the MIP algorithm is isolated. Vessel measurements were made, according to the NASCET guidelines, and percentage stenosis grades were calculated. The NASCET-type stenosis grades tended to be underestimated on average by 2.4% with the MIP algorithm, although this was not statistically significant (P=0.09). Moreover, the vessel measurements from the MIPs were consistently 0.17 mm larger than those from DRRs (P<0.0001). Thus, when applied to high-contrast, high-resolution CRA images, the MIP algorithm slightly increased the apparent dimensions of the arteries. This difference is not clinically relevant, due to the fact that it is only a fraction of the 0.38 mm voxel spacing. Moreover, the MIP dimensions could actually represent the truth, and that it is the sharp decrease near the edge of the intensity profile of the radiographic images that causes an underestimation of the absolute dimensions.

Phenotypic Characteristics of Absent and Hypoplastic Nasal Bones in Fetuses With Down Syndrome

To determine the frequency and clinical significance of bilateral and unilateral hypoplastic nasal bones for the detection of Down syndrome by 3-dimensional ultrasonography. Thirty-seven volumes of the fetal skull from fetuses with Down syndrome and 37 from fetuses without abnormalities were analyzed by 1 investigator blinded to fetal karyotype. The maximum intensity projection algorithm was used to reconstruct nasal bones. Ossification patterns were identified in anteroposterior and profile views. Sensitivity, false-positive rates (FPRs), and likelihood ratios (LRs) for detection of Down syndrome were calculated. After exclusions (coronal acquisition [n = 11], hand in front of the face [n = 4], poor imaging [n = 2], incomplete follow-up [n = 2], and anomalies detected after delivery [n = 2]), 53 volumes were analyzed (26 fetuses with Down syndrome and 27 without abnormalities; median gestational age, 21 6/7 weeks [interquartile range, 19 6/7-25 2/7 weeks]). Rendered profile views revealed absent nasal bones in 18.9% (10 of 53) of the fetuses, and, among these, 90% (9 of 10) had Down syndrome (sensitivity, 34.6% [9 of 26]; FPR, 3.7% [1 of 27]; LR, 9.3 [95% confidence interval (CI), 1.3-68.7]). Three ossification patterns were identified in anteroposterior views: (1) normally developed, (2) delayed ossification, and (3) absent nasal bones. Sensitivity, FPR, and LR of absent nasal bones for detecting Down syndrome were 34.6% (9 of 26), 3.7% (1 of 27), and 9.0 (95% CI, 1.3-68.7), respectively. Sensitivity, FPR, and LR of delayed ossification for detecting Down syndrome were 42.3% (11 of 26), 22% (6 of 27), and 1.83 (95% CI, 0.8-4.4). Absence of nasal bones is associated with the highest risk of Down syndrome. Delayed ossification is associated with a lower risk of Down syndrome than absent nasal bones. These ossification patterns may be indistinguishable on 2-dimensional ultrasonography.

Multiresolution maximum intensity volume rendering by morphological adjunction pyramids

We describe a multiresolution extension to maximum intensity projection (MIP) volume rendering, allowing progressive refinement and perfect reconstruction. The method makes use of morphological adjunction pyramids. The pyramidal analysis and synthesis operators are composed of morphological 3-D erosion and dilation, combined with dyadic downsampling for analysis and dyadic upsampling for synthesis. In this case the MIP operator can be interchanged with the synthesis operator. This fact is the key to an efficient multiresolution MIP algorithm, because it allows the computation of the maxima along the line of sight on a coarse level, before applying a two-dimensional synthesis operator to perform reconstruction of the projection image to a finer level. For interpolation and resampling of volume data, which is required to deal with arbitrary view directions, morphological sampling is used, an interpolation method well adapted to the nonlinear character of MIP. The structure of the resulting multiresolution rendering algorithm is very similar to wavelet splatting, the main differences being that (i) linear summation of voxel values is replaced by maximum computation, and (ii) linear wavelet filters are replaced by nonlinear morphological filters.

Fast maximum intensity projection algorithm using shear warp factorization and reduced resampling.

Maximal intensity projection (MIP) is routinely used to view MRA and other volumetric angiographic data. The straightforward implementation of MIP is ray casting that traces a volumetric data set in a computationally expensive manner. This article reports a fast MIP algorithm using shear warp factorization and reduced resampling that drastically reduced the redundancy in the computations for projection, thereby speeding up MIP by more than 10 times.

Isotropic resolution diffusion tensor imaging with whole brain acquisition in a clinically acceptable time.

Our objective was to develop a diffusion tensor MR imaging pulse sequence that allows whole brain coverage with isotropic resolution within a clinically acceptable time. A single-shot, cardiac-gated MR pulse sequence, optimized for measuring the diffusion tensor in human brain, was developed to provide whole-brain coverage with isotropic (2.5 x 2.5 x 2.5 mm) spatial resolution, within a total imaging time of approximately 15 min. The diffusion tensor was computed for each voxel in the whole volume and the data processed for visualization in three orthogonal planes. Anisotropy data were further visualized using a maximum-intensity projection algorithm. Finally, reconstruction of fiber-tract trajectories i.e., "tractography" was performed. Images obtained with this pulse sequence provide clear delineation of individual white matter tracts, from the most superior cortical regions down to the cerebellum and brain stem. Because the data are acquired with isotropic resolution, they can be reformatted in any plane and the sequence can therefore be used, in general, for macroscopic neurological or psychiatric neuroimaging investigations. The 3D visualization afforded by maximum intensity projection imaging and tractography provided easy visualization of individual white matter fasciculi, which may be important sites of neuropathological degeneration or abnormal brain development. This study has shown that it is possible to obtain robust, high quality diffusion tensor MR data at 1.5 Tesla with isotropic resolution (2.5 x 2.5 x 2.5 mm) from the whole brain within a sufficiently short imaging time that it may be incorporated into clinical imaging protocols.

Drug-induced MR Urography: The effects of Furosemide and Intravenous Saline Injection on MR Urography of Obstructed and Non-obstructed Urinary Tract

Purpose: To determine the usefulness of MR urography technique for the evaluation of urinary systems in patients with obstructed urinary tract and normal volunteers with non-obstructed urinary tract after intravenous normal saline and diuretic injection. Materials and Methods: Three normal volunteers and 12 patients with urinary tract obstruction [ureteral calculi( n=8), extraurinary mass(n=1), ureteral tumor invasion(n=3)] underwent MR urography using a 1.0T scanner and a 2D non-breath-hold heavily T2-weighted fast spin-echo sequence. These acquisition were post-processed with a maximum intensity projection (MIP) algorithm. Two acquisitions were performed, the first prior to saline solution infusion following standard MR urography procedures, and the second, within 2 -3 minutes of the infusion of 250 ml saline solution followed by 20 mg of Lasix administered intravenously. For this latter, drug-induced MR urography procedures were followed. Results: In healthy volunteers (n=3) and those experiencing partial obstruction (n=4) by a urinary stone, drug-induced MR urography provided better images of the urinary tract than did standard MR urography. In those in whom a urinary stone or tumor had caused complete obstruction (n=8), standard MR urography provided good images, as did drug-induced MR urography. Conclusion: In patients with a partially or non-obstructed urinary tract, drug-induced MR urography provided better anatomic and functional details of the kidney and urinary tract than did standard MR urography. In those experiencing complete obstruction of the urinary tract, however, standard or drug-induced MR urography permitted very adequate evaluation of the tract, and drug-induced MR urography was unnecessary.

Small vessel enhancement in MRA images using local maximum mean processing

The enhancement of small vessels in MRA imaging is an important problem. In this paper, we propose using local maximum mean (LMM) processing to enhance the detectability of small vessels. At each voxel in the original three-dimensional (3-D) data set, the LMM over the line segments in the cube centered at the voxel is taken and used to form the 3-D LMM data set. The maximum intensity projection (MIP) is then applied to the LMM data to produce the two-dimensional (2-D) LMM-MIP image. Through LMM processing, the variance of background tissue is reduced, thus increasing the detectability of small vessels. Moreover, the single bright voxels are suppressed and the disconnected small vessels can be connected. However, the LMM processing widens the larger, brighter vessels. To keep the advantages provided by both the LMM-MIP and MIP images, it is proposed that weight functions be used to combine them. The performance of the LMM-MIP algorithm is analyzed and compared with the performance of the MIP algorithm under three measures: The vessel voxel projection probability, the vessel receiver operating characteristic (ROC) curve and the vessel-tissue contrast-to-noise ratio (CNR). Closed forms of the three measures are obtained. It is shown that the LMM-MIP algorithm improves the detectability of small vessels under all three measures. The longer the projection path and the larger the CNR of the original data, then the greater the improvement. Confirming the theoretical analysis, results of an experiment utilizing practical MRA data demonstrate the improved visual quality of small vessels.

Interactive High‐Quality Maximum Intensity Projection

Maximum Intensity Projection (MIP) is a volume rendering technique which is used to visualize high‐intensity structures within volumetric data. At each pixel the highest data value, which is encountered along a corresponding viewing ray is depicted. MIP is, for example, commonly used to extract vascular structures from medical data sets (angiography). Due to lack of depth information in MIP images, animation or interactive variation of viewing parameters is frequently used for investigation. Up to now no MIP algorithms exist which are of both interactive speed and high quality. In this paper we present a high‐quality MIP algorithm (trilinear interpolation within cells), which is up to 50 times faster than brute‐force MIP and at least 20 times faster than comparable optimized techniques. This speed‐up is accomplished by using an alternative storage scheme for volume cells (sorted by value) and by removing cells which do not contribute to any MIP projection (regardless of the viewing direction) in a preprocessing step. Also, a fast maximum estimation within cells is used to further speed up the algorithm.

Magnetic resonance anatomic study of iliocava junction and left iliac vein positions related to L5-S1 disc.

An in vivo anatomic study analyzing the venous anatomy in the lumbosacral area was performed. To obtain in vivo data concerning iliocava junction and left common iliac vein positions at L5-S1. The left common iliac vein and the iliocava junction are at risk during L5-S1 anterior lumbar interbody fusion. Anatomic studies have demonstrated great interindividual variability in this vascular anatomy. Magnetic resonance angiography was used to study 134 patients. Image processing was carried out with maximum intensity projection algorithm and the maximum intensity projection and addition algorithm. Iliocava junction position was measured in the maximum intensity projection and addition image. Four groups of junction position were established: very high, high, low, and very low. The left common iliac vein position was measured in axial magnetic resonance images, and three groups were established: lateral, intermediate, and medial. To describe the operative window delimited by the venous structures at L5-S1, the study population was classified into 12 configurations by combining junction position and vein position values. Very high lateral included 3.76% of the patients, high lateral 48.12%, high intermediate 10.53%, high medial 0.75%, low lateral 15.04%, low intermediate 4.51%, low medial 6.77%, very low lateral 0.75%, very low intermediate 2.26%, and very low medial 7.52%. Medial vein position was significantly more frequent in men. In 18.05% of the study population, the venous structures overlapped the center of the L5-S1 disc, reducing the operative window.

Efficacy of targeted CT angiography in evaluation of intracranial internal carotid artery disease

This study evaluated the efficacy of targeted computed tomographic (CT) angiography in the diagnosis of intracranial internal carotid artery (ICA) disease and compared the results of routine and targeted CT angiography. Fifty-four patients (24 male and 30 female patients aged 2 months to 87 years) were examined with CT angiography. Digital subtraction angiography (DSA) was performed in 42. CT angiograms were reconstructed with the maximum-intensity projection (MIP) algorithm. Targeted CT angiography was performed by individually reconstructing a single ICA territory. Each ICA was divided into four segments, and findings of routine MIP CT angiography, routine MIP plus targeted CT angiography, and DSA were reviewed independently by two neuroradiologists for vascular lesions involving each segment. Routine and targeted CT angiograms were also evaluated to determine how well both ICAs were visualized. Routine CT angiography was rated good or excellent for ICA visualization in 64% of cases, compared with 81% for targeted CT angiography (P = .0005). The overall agreement between routine CT angiography and DSA and between routine plus targeted CT angiography and DSA was 92% and 94%, respectively. There was no statistically significant difference between the percentages of vascular lesions detected with routine CT angiography alone and with routine plus targeted CT angiography. Both methods tended to show false-positive findings of steno-occlusive disease, but targeted CT angiography showed details of aneurysms and stenotic lesions that were easily overlooked with routine CT angiography alone. Routine plus targeted CT angiography, while providing superior image quality, did not have much clinical effect; further assessment may be needed.

Gadolinium-enhanced Excretory MR Urography: Comparison with MR Urography Using HASTE Technique

Purpose: To compare the feasibility of gadolinium-enhanced excretory MR urography(GEMRU) and conven-tional MR urography using the half-Fourier acquisition single-shot turbo spin-echo(HASTE) sequence in patients with hydronephrosis or non-visualized kidney. Materials and Methods: Fifteen patients with hydronephrosis or non-visualized kidney, as demonstrated by ultrasonography or intravenous urography, were enrolled in this study. Nine were men and six were women, and their age ranged from 18 to 77 (mean, 60.6) years. For all MR examinations, a 1.5-T MR unit was employed. For breath-hold MR urography, the HASTE technique(MRU) was used, and reconstruction involved the use of a maximum intensity-projection (MIP) algorithm. For gadolinium-enhanced excretory MR urography, the fast low angle shot(FLASH) 3-D method was used and images were obtained at 5, 10, 20, and 30 minutes, and reconstruction again involved the use of an MIP algorithm. In some cases, additional GEMRU was obtained 24 hours after contrast material injection, and an MIP algorithm was used for reconstruction. MRU and GEMRU were independently interpreted by two radiologists who for quantitative analysis compared SNR with CNR, and at each anatomic level qualitatively analysed morphologic accuracy and diagnostic value of the lesions. Results: In quantitative analysis, SNR and CNR differences between the two sequences at the renal pelvis and the level of the ureter were not significant (p0.05). In qualitative analysis, GEMRU was superior to M-RU for the assessment of evaluated ureter at each level(p0.05), anatomic anomaly and intrinsic tumor. Ureteral stones, however, were more easily diagnosed with MRU. Conclusion: For assessment of the ureter GEMRU is superior to MRU and has the advantage of evaluating renal function. We believe that for evaluation of the urinary tract, especially the distal ureter, GEMRU may be a valuable adjunct to routine MR urography.

Preliminary clinical application of contrast-enhanced MR portography.

The clinical application of contrast enhanced (CE) MR was evaluated. A total of 66 CE MR portograms were obtained by performing fast imaging with steady procession (FISP) technique on a 1.5-T Siemens magnetom vision. A maximum intensity projection algorithm was also employed to include all vessels in a single image. The patency of portal venous system, the presence and extent of varices were also evaluated. The results showed that all images had diagnostic quality. Main portal vein (MPV) and its 4th-6th level intrahepatic branches were visualized in 10 normal persons serving as control. The diameter of MPV, splenic vein and superior mesenteric vein was 1.02 +/- 0.21, 0.8 +/- 0.15, 0.8 +/- 0.26 cm respectively, which were significantly lower than that in portal hypertension patients (1.38 +/- 0.27, 1.26 +/- 0.18, 1.24 +/- 0.18 cm, respectively). In 23 preoperative cases of portal hypertension, dilated portal vein and tortuous enlarged splenic vein were found in 23 cases; esophageal and coronary varices in 12 and 19 cases, respectively. In 7 postoperative re-examined cases with portal hypertension, the flow velocity and flow of MPV were decreased in all cases and esophageal varices could still be observed in 3 cases. New vessels appeared in the great curvature of stomach in 2 cases. In 20 cases of liver carcinoma, occlusion of MPV or its intrahepatic branches were showed in 14, compression and dislocation of intrahepatic portal vein were found in 6. In other 6 cases, 2 were splenic venous thrombosis and 4 were tumors in the intestine or retro-peritoneum. It is concluded that three-dimensional CE MR portography is an accurate technique for evaluating the portal venous system. It is a reliable and noninvasive technique that can provide important information for the evaluation of patients' condition before TIPSS and liver transplantation.

MR cholangiopancreatography: value of axial and coronal fast Spin-Echo fat-suppressed T2-weighted sequences

Objective: To compare axial and coronal fast Spin-Echo fat-suppressed T2-weighted sequences with three-dimensional (3D) maximum intensity projection (MIP) images in patients with suspected pancreaticobiliary obstruction. Material and methods: MR cholangiopancreatography (MRCP) was performed in 108 consecutive patients with a non-breath-hold, fat-suppressed, 2D, heavily T2-weighted fast spin-echo sequence in coronal plane. Axial T1- and T2-weighted images were previously obtained. In addition, 3D reconstructions of the coronal images were analysed separately by using a MIP algorithm. Both two-dimensional (2D) (axial and coronal) and 3D MIP images were separately evaluated by two readers in conference and their results were compared with that of endoscopic retrograde cholangiopancreatography, percutaneous trans-hepatic cholangiography, surgery and/or imaging follow-up. Statistical analysis of 2D and 3D MRCP images in diagnosing the level and probable cause of pancreaticobiliary obstruction were separately calculated. Results: 106/108 of MRCP examinations were judged diagnostic by the two reviewers for adequacy of visualisation of the biliary and pancreatic ducts. Sensitivity, specificity, positive predictive value, negative predictive value and global diagnostic accuracy of 2D (axial and coronal) and 3D MRCP images in diagnosing the pancreaticobiliary obstruction were 94 and 57%, 95 and 93%, 97 and 92%, 91 and 60%, 94 and 72%, respectively. Conclusion: Our results do indicate a higher global accuracy for axial and coronal fast Spin-Echo fat-suppressed T2-weighted sequences versus 3D MIP images in diagnosis of the level and probable cause of pancreaticobiliary obstruction and stress the limitations of 3D images in depiction of small intraductal pathology such as calculi and biliary neoplastic lesions.

Magnetic Resonance Angiography

Magnetic Resonance Angiography

Digitally reconstructed radiographs from abdominal CT scans as a new tool for radiotherapy planning.

Abdominal extended field radiotherapy requires exact field shaping. Conventional treatment planning is difficult to adapt to individual anatomy, whereas three-dimensional planning is time-consuming. The authors introduce a method with digitally reconstructed radiographs of spiral CT data to facilitate radiotherapy planning. Twenty-two patients underwent imaging with a standardized CT protocol, and digitally reconstructed radiographs were calculated in central beam projection using a maximum intensity projection algorithm (MIP-DRR). For comparison, the expected error from parallel projection was calculated depending on object thickness and field length. The contrast-enhanced protocol used in spiral CT produces a good rendition of all relevant structures. The resulting MIP images have a geometry identical to standard simulation films and to the linear accelerator, whereas standard MIPs with parallel projection show significant distortion compared to the treatment process. Because of the integration of the geometry of the radiotherapy treatment, the described central beam projection method might be used as a new tool for abdominal radiotherapy planning. The CT protocol offers sufficient contrast enhancement in all relevant structures and provides all necessary anatomic information for individual beam shaping.

Easy detection of tumor in oncologic whole-body PET by projection reconstruction images with maximum intensity projection algorithm.

Whole-body PET scanning for an oncology study produces a large number of transaxial images by data acquisition over multiple bed positions. The sagittal and coronal reformatted images are often used for better understanding of radioisotope distribution. We reduced the number of PET images by calculating projection images and evaluated the merit of additional data processing for the visualization and detection of tumors. After reconstructing whole-body 18F-FDG PET images (6-8 bed positions) of eight cancer patients, antero-posterior and lateral projection images were calculated by the maximum intensity projection (MIP) algorithm, the standard deviation projection (SD) algorithm and the summed voxel projection (SUM) algorithm. The projection images were compared with 2D whole-body images for visualizing foci. The focal uptakes of various positions in original whole-body PET data (294-392 transaxial images) were visualized on only two MIP reformatted images when superimposition of hot spots did not occur. Even if one hot spot was superimposed over the other hot spot, we could recognize the existence of at least one focus and determine the true positions of the hot spots from corresponding transaxial images. The SD image was found inferior for showing a contrast of small foci to the corresponding MIP images in the neck, mediastinum and abdomen. The SUM image failed to visualize many metastatic lesions. MIP is a promising technique for the easy preliminary assessment of tumor distribution in oncologic whole-body PET study.

Performance analysis of maximum intensity projection algorithm for display of MRA images.

The maximum intensity projection (MIP) is a popularly used algorithm for display of MRA images, but its performance has not been rigorously analyzed before. In this paper, four measures are proposed for the performance of the MIP algorithm and the quality of images projected from three-dimensional (3-D) data, which are vessel voxel projection probability, vessel detection probability, false vessel probability, and vessel-tissue contrast-to-noise ratio (CNR). As side products, vessel-missing probability, vessel receiver operating characteristics (ROC's), and mean number of false vessels are also studied. Based on the assumptions that the intensities of vessel, tissue, and noise along a projection path are independent Gaussian, these measures are derived and obtained all in closed forms. All the measures are functions of explicit parameters: vessel-to-tissue noise ratio (VTNR) and CNR of 3-D data prior to the MIP, vessel diameter, and projection length. It is shown that the MIP algorithm increases the CNR of large vessels whose CNR prior to the MIP is high and whose diameters are large. The increase in CNR increases with projection path length. On the other hand, all the proposed measures indicate that the small vessels that have low CNR prior to the MIP and small diameters suffer from the MIP. The performance gets worse as projection path length increases. All measures demonstrate a better performance when the vessel diameter is larger. Other properties and possible applications of the derived measures are also discussed.

Maximum Intensity Projection Using Splatting in Sheared Object Space

In this paper we present a new Maximum Intensity Projection (MIP) algorithm which was implemented employing splatting in a shear‐warp context. This algorithm renders a MIP image by first splatting each voxel on two intermediate spaces called "worksheet" and "shear image". Then, the maximum value is evaluated between worksheet and shear image. Finally, shear image is warped on the screen to generate the result image. Different footprints implementing different quality modes are discussed. In addition, we introduced a line encoded indexing speed‐up method to obtain interactive speed. This algorithm allows for a quantitative, predictable trade‐off between interactivity and image quality.

L'Angio-TC delle biforcazioni carotidee

Computed Tomography (CT) now offers detailed information on the carotid bifurcation with short acquisition times and high spatial resolution. With new spiral acquisition devices it is possible to improve the quality of images and subsequent reconstruction with Multiplanar, Shaded Surface Display and Maximum Intensity Projection algorithms. In patients with atherosclerotic occlusive and stenotic disease CT clearly identifies the site and the type of plaque, distinguishing high density “hard” calcified plaque from soft fibrolipid build up which is hypodense with respect to the contrast enhanced lumen. In case of mixed plaque both components are well displayed as is their arrangement along the vessel wall. The endoluminal surface of the plaque is easily explored, sometimes disclosing small surface ulcerations resulting in emboli. CT is also able to measure the degree of lumen stenosis both applying the NASCET criteria and by calculating the ratio between total vessel area and residual lumen. Finally multiplanar and three-dimensional reconstructions offer a longitudinal view of the vessel and further information on the arrangement and size of the atheroma.