Phantom Measurements Research Articles

Technical assessment of resolution of handheld ultrasound devices and clinical implications.

Since handheld ultrasound devices are becoming increasingly ubiquitous, objective criteria to determine image quality are needed. We therefore conducted a comparison of objective quality measures and clinical performance. A comparison of handheld devices (Butterfly IQ+, Clarius HD, Clarius HD3, Philips Lumify, GE VScan Air) and workstations (GE Logiq E10, Toshiba Aplio 500) was performed using a phantom. As a comparison, clinical investigations were performed by two experienced ultrasonographers by measuring the resolution of anatomical structures in the liver, pancreas, and intestine in ten subjects. Axial full width at half maximum resolution (FWHM) of 100µm phantom pins at depths between one and twelve cm ranged from 0.6-1.9mm without correlation to pin depth. Lateral FWHM resolution ranged from 1.3-8.7mm and was positively correlated with depth (r=0.6). Axial and lateral resolution differed between devices (p<0.001) with the lowest median lateral resolution observed in the E10 (5.4mm) and the lowest axial resolution (1.6mm) for the IQ+ device. Although devices showed no significant differences in most clinical applications, ultrasonographers were able to differentiate a median of two additional layers in the wall of the sigmoid colon and one additional structure in segmental portal fields (p<0.05) using cartwheel devices. While handheld devices showed superior or similar performance in the phantom and routine measurements, workstations still provided superior clinical imaging and resolution of anatomical substructures, indicating a lack of objective measurements to evaluate clinical ultrasound devices.

A novel AP/PA total body irradiation technique using abutting IMRT fields at extended SSD.

To develop a Total Body Irradiation (TBI) technique using IMRT at extended SSD that can be performed in any size Linac room. Patients studied were placed on a platform close to the floor, directly under the gantry with cranial-caudal axis parallel to the gantry rotation plane and at SSD ∼200cm. Two abutting fields with the same external isocenter at gantry angles of±21˚, collimator angle of 90˚, and field size of 25×40 cm2 are employed for both supine and prone positions. An iterative optimization algorithm was developed to generate a uniform dose at the patient mid-plane with adequate shielding to critical organs such as lungs and kidneys. The technique was validated in both phantom and patient CT images for treatment planning, and dose measurement and QA were performed in phantom. A uniform dose distribution in the mid-plane within±5% of the prescription dose was reached after a few iterations. This was confirmed with ion-chamber measurements in phantom. The mean dose to lungs and kidneys can be adjusted according to clinical requirements and can be as low as ∼25% of the prescription dose. For a typical prescription dose of 200 cGy/fraction, the total MU was ∼2400/1200 for the superior/inferior field. The overall treatment time for both supine/prone positions was ∼54 min to meet the maximum absorbed dose rate criteria of 15 cGy/min. IMRT QA with portal dosimetry shows excellent agreement. We have developed a promising TBI technique using abutting IMRT fields at extended SSD. The patient is in a comfortable recumbent position with good reproducibility and less motion during treatment. An additional benefit of this technique is that full 3D dose distribution is available from the TPS with a DVH summary for organs of interest. The technique allows precise sparing of lungs and kidneys and can be executed in any linac room.

Improvements in Between-Vendor MRI Harmonization of Renal T2 Mapping using Stimulated Echo Compensation.

T2 mapping is valuable to evaluate pathophysiology in kidney disease. However, variations in T2 relaxation time measurements across MR scanners and vendors may occur requiring additional correction. To harmonize renal T2 measurements between MR vendor platforms, and use an extended-phase-graph-based fitting method ("StimFit") to correct stimulated echoes and reduce between-vendor variations. Prospective. 8 healthy "travelling" volunteers (37.5% female, 32 ± 6 years) imaged on four MRI systems across three vendors at four sites, 10 healthy volunteers (50% female, 32 ± 8 years) scanned multiple times on a given MR scanner for repeatability evaluation. ISMRM/NIST system phantom scanned for evaluation of T2 accuracy. 3T, multiecho spin-echo sequence. T2 images fit using conventional monoexponential fitting and "StimFit." Mean absolute percentage error (MAPE) of phantom measurements with reference T2 values. Average cortex and medulla T2 values compared between MR vendors, with masks obtained from T2-weighted images and T1 maps. Full-width-at-half-maximum (FWHM) T2 distributions to evaluate local homogeneity of measurements. Coefficient of variation (CV), linear mixed-effects model, analysis of variance, student's t-tests, Bland-Altman plots, P-value <0.05 considered statistically significant. In the ISMRM/NIST phantom, "StimFit" reduced the MAPE from 4.9%, 9.1%, 24.4%, and 18.1% for the four sites (three vendors) to 3.3%, 3.0%, 6.6%, and 4.1%, respectively. In vivo, there was a significant difference in kidney T2 measurements between vendors using a monoexponential fit, but not with "StimFit" (P = 0.86 and 0.92, cortex and medulla, respectively). The intervendor CVs of T2 measures were reduced from 8.0% to 2.6% (cortex) and 7.1% to 2.8% (medulla) with StimFit, resulting in no significant differences for the CVs of intravendor repeat acquisitions (P = 0.13 and 0.05). "StimFit" significantly reduced the FWHM of T2 distributions in the cortex and whole kidney. Stimulated-echo correction reduces renal T2 variation across MR vendor platforms. 2 TECHNICAL EFFICACY: Stage 1.

The coax monopole antenna: A flexible end-fed antenna for ultrahigh field transmit/receive arrays.

The coax monopole antenna is presented for body imaging at 7 T. The antenna is fed at one end, eliminating the possibility of cable-coil coupling and simplifying cable routing. Additionally, its flexibility improves loading to the subject. Like the coax dipole antenna, an interruption in the shield of the coaxial cable allows the current to extend to the outside of the shield, generating a B1 + field. Matching is achieved using a single inductor at the distal side, and a cable trap enforces the desired antenna length. Finite difference time domain simulations are employed to optimize the design parameters. Phantom measurements are conducted to determine the antenna's B1 + efficiency and to find the S-parameters in straight and bent positions. Eight-channel simulations and measurements are performed for prostate imaging. The optimal configuration is a length of 360 mm with a gap position of 40 mm. Simulation data show higher B1 + levels for the coax monopole (20% in the prostate), albeit with a 5% lower specific absorbance rate efficiency, compared to the fractionated dipole antenna. The S11 of the coax monopole exhibits remarkable robustness to loading changes. In vivo prostate imaging demonstrates B1 + levels of 10-14 μT with an input power of 8 × 800 W, which is comparable to the fractionated dipole antenna. High-quality images and acceptable coupling levels were achieved. The coax monopole is a novel, flexible antenna for body imaging at 7 T. Its simple design incorporates a single inductor at the distal side to achieve matching, and one-sided feeding greatly simplifies cable routing.

Assessing the Accuracy of Fetal Aortic Valve Range Phantom Measurements

Assessing the Accuracy of Fetal Aortic Valve Range Phantom Measurements

Optimization of flip angle and radiofrequency pulse phase to maximize steady-state magnetization in three-dimensional missing pulse steady-state free precession.

Missing pulse (MP) steady-state free precession (SSFP) is a magnetic resonance imaging (MRI) pulse sequence that is highly tolerant to the magnetic field inhomogeneity. In this study, optimal flip angle and radiofrequency (RF) phase scheduling in three-dimensional (3D) MP-SSFP is introduced to maximize the steady-state magnetization while keeping broadband excitation to cover widely distributed frequencies generated by inhomogeneous magnetic fields. Numerical optimization based on extended phase graph (EPG) simulation was performed to maximize the MP-SSFP steady-state magnetization. To limit the specific absorption rate (SAR) associated with the broadband excitation in 3D MP-SSFP, SAR constraint was introduced in the numerical optimization. Optimized flip angle and RF phase settings were experimentally tested by introducing a linear inhomogeneous magnetic field in a range of 10-20 mT/m and using a phantom with known T1/T2 relaxation and diffusion parameters at 3 T. The experimental results were validated through comparisons with EPG simulation. Image contrasts and molecular diffusion effects were investigated in in vivo human brain imaging with 3D MP-SSFP with the optimal flip angle and RF phase settings. In the phantom measurements, the optimal flip angle and RF phase settings improved the MP-SSFP steady-state magnetization/signal-to-noise ratio by up to 41% under the fixed SAR conditions, which matched well with EPG simulation results. In vivo brain imaging with the optimal RF pulse settings provided T2-like image contrasts. Diffusion effects were relatively minor with the linear inhomogeneous field of 10-20 mT/m for white and gray matter, but cerebrospinal fluid showed conspicuous signal intensity attenuation as the linear inhomogeneous field increased. Numerical optimization achieved significant improvement in the steady-state magnetization in MP-SSFP compared with the RF pulse settings used in previous studies. The proposed flip angle and RF phase optimization is promising to improve 3D MP-SSFP image quality for MRI in inhomogeneous magnetic fields.

Phase unwrapping for MHz optical coherence elastography and application to brain tumor tissue.

During neuro-oncologic surgery, phase-sensitive optical coherence elastography (OCE) can be valuable for distinguishing between healthy and diseased tissue. However, the phase unwrapping process required to retrieve the original phase signal is a challenging and critical task. To address this issue, we demonstrate a one-dimensional unwrapping algorithm that recovers the phase signal from a 3.2 MHz OCE system. With a processing time of approximately 0.11 s per frame on the GPU, multiple 2π wraps are detected and corrected. By utilizing this approach, exact and reproducible information on tissue deformation can be obtained with pixel accuracy over the entire acquisition time. Measurements of brain tumor-mimicking phantoms and human ex vivo brain tumor samples verified the algorithm's reliability. The tissue samples were subjected to a 200 ms short air pulse. A correlation with histological findings confirmed the algorithm's dependability.

No-wait inversion—a novel model for T1 mapping from inversion recovery measurements without the waiting times

Introduction: Quantification of longitudinal relaxation time T1 gained interest as an important MR-inducible tissue property for tissue characterization. Standard inversion recovery (IR) measurements for T1 determination take a prohibitively long time, and signal models assume a perfect inversion. Acceleration is possible by using the Look–Locker (LL) technique or other accelerated, model-based algorithms. However, the calculation of real T1 values from LL acquisitions necessitates the knowledge of equilibrium magnetization M0. Thus, usually, a waiting time to allow for free relaxation between global inversion pulses must be implemented. This study aims to introduce a novel model-based fitting approach for T1 mapping without the need for such waiting times.Methods: Single-inversion spiral LL spoiled gradient echo acquisitions were performed in a phantom and eight healthy volunteers using a 1.5T magnetic resonance imaging (MRI) scanner. The measurements comprised two parts, one without magnetization preparation and a second featuring a global inversion pulse preparation before each of the 35 slices. Acquisition was performed without any waiting time in between slices, i.e., before the inversion pulses. T1 maps were calculated based on an iterative model-based reconstruction algorithm which combines the information from these two measurements, with and without inversion.Results: Accurate T1 maps were obtained in phantom and volunteer measurements. ROI-based mean T1 values differ by an average of 1.5% in the phantom and 5% in vivo between reference measurements and the proposed method. The combined fit benefits from both the information obtained in the inversion prepared and the unprepared measurements. The former provides a large dynamic range for accurate model-based fitting of the relaxation process, while the latter provides equilibrium magnetization M0, necessary to obtain accurate T1 values from a LL-like acquisition.Conclusion: The proposed model of a combined fit of an inversion-prepared and an unprepared measurement allows for robust fast T1 mapping, even in cases of imperfect inversion due to skipped waiting times for magnetization recovery. Thus, it can render long waiting times in between inversion pulses redundant.

Reducing windmill artifacts in clinical spiral CT using a deep learning-based projection raw data upsampling: Method and robustness evaluation.

Multislice spiral computed tomography (MSCT) requires an interpolation between adjacent detector rows during backprojection. Not satisfying the Nyquist sampling condition along the z-axis results in aliasing effects, also known as windmill artifacts. These image distortions are characterized by bright streaks diverging from high contraststructures. The z-flying focal spot (zFFS) is a well-established hardware-based solution that aims to double the sampling rate in longitudinal direction and therefore reduce aliasing artifacts. However, given the technical complexity of the zFFS, this work proposes a deep learning-based approach as an alternativesolution. We propose a supervised learning approach to perform a mapping between input projections and the corresponding rows required for double sampling in the z-direction. We present a comprehensive evaluation using both a clinical dataset obtained using raw data from 40 real patient scans acquired with zFFS and a synthetic dataset consisting of 100 simulated spiral scans using a phantom specifically designed for our problem. For the clinical dataset, we utilized 32 scans as training set and 8 scans as validation set, whereas for the synthetic dataset, we used 80 scans for training and 20 scans for validation purposes. Both qualitative and quantitative assessments are conducted on a test set consisting of nine real patient scans and six phantom measurements to validate the performance of our approach. A simulation study was performed to investigate the robustness against different scan configurations in terms of detector collimation and pitchvalue. In the quantitative comparison based on clinical patient scans from the test set, all network configurations show an improvement in the root mean square error (RMSE) of approximately 20% compared to neglecting the doubled longitudinal sampling by the zFFS. The results of the qualitative analysis indicate that both clinical and synthetic training data can reduce windmill artifacts through the application of a correspondingly trained network. Together with the qualitative results from the test set phantom measurements it is emphasized that a training of our method with synthetic data resulted in superior performance in windmill artifactreduction. Deep learning-based raw data interpolation has the potential to enhance the sampling in z-direction and thus minimize aliasing effects, as it is the case with the zFFS. Especially a training with synthetic data showed promising results. While it may not outperform zFFS, our method represents a beneficial solution for CT scanners lacking the necessary hardware components forzFFS.

Feasibility of 177Lu activity quantification using a small portable CZT-based gamma-camera

BackgroundIn image processing for activity quantification, the end goal is to produce a metric that is independent of the measurement geometry. Photon attenuation needs to be accounted for and can be accomplished utilizing spectral information, avoiding the need of additional image acquisitions. The aim of this work is to investigate the feasibility of 177Lu activity quantification with a small CZT-based hand-held gamma-camera, using such an attenuation correction method.MethodsA previously presented dual photopeak method, based on the differential attenuation for two photon energies, is adapted for the three photopeaks at 55 keV, 113 keV, and 208 keV for 177Lu. The measurement model describes the count rates in each energy window as a function of source depth and activity, accounting for distance-dependent system sensitivity, attenuation, and build-up. Parameter values are estimated from characterizing measurements, and the source depth and activity are obtained by minimizing the difference between measured and modelled count rates. The method is applied and evaluated in phantom measurements, in a clinical setting for superficial lesions in two patients, and in a pre-clinical setting for one human tumour xenograft. Evaluation is made for a LEHR and an MEGP collimator.ResultsFor phantom measurements at clinically relevant depths, the average (and standard deviation) in activity errors are 17% ± 9.6% (LEHR) and 2.9% ± 3.6% (MEGP). For patient measurements, deviations from activity estimates from planar images from a full-sized gamma-camera are 0% ± 21% (LEHR) and 16% ± 18% (MEGP). For mouse measurements, average deviations of − 16% (LEHR) and − 6% (MEGP) are obtained when compared to a small-animal SPECT/CT system. The MEGP collimator appears to be better suited for activity quantification, yielding a smaller variability in activity estimates, whereas the LEHR results are more severely affected by septal penetration.ConclusionsActivity quantification for 177Lu using the hand-held camera is found to be feasible. The readily available nature of the hand-held camera may enable more frequent activity quantification in e.g., superficial structures in patients or in the pre-clinical setting.

Using Phase Difference Information to Detect Errors in the Flip Angle Measured with Actual Flip Angle Imaging at 7T.

Flip angle (FA) measurements using the actual flip angle imaging (AFI) method may induce significant errors in ultrahigh fields. We aimed to develop a method for detecting errors in FA measurements using phase information at 7 tesla. We performed computer simulations to elucidate the relationship between the FA calculation errors and the phase difference between the two AFI source images. We then examined whether a method based on the phase difference could detect FA calculation errors and determine the prescribed nominal FA of the scanner for accurate measurements in phantoms and healthy volunteers. The simulations confirmed that the calculated FA values erroneously decreased when the longitudinal magnetization and phase in one of the source images were inverted. Tests on phantoms and human subjects demonstrated that the phase difference information between the source images with a cut-off of 90° could readily detect FA calculation errors in the AFI method.

Comparing Lesion Conspicuity and ADC Reliability in High-resolution Diffusion-weighted Imaging of the Breast.

This study investigated the breast lesion conspicuity and apparent diffusion coefficient (ADC) reliability for three different diffusion-weighted imaging (DWI) protocols: spatiotemporal encoding (SPEN), single-shot echo-planar imaging (SS-EPI), and readout segmentation of long variable echo-trains (RESOLVE). Sixty-five women suspected of having breast tumors were included in this study, with 44 lesions (36 malignant, 8 benign) analyzed further. Breast MRI was performed on a 3 Tesla (3T) system (MAGNETOM Prisma, Siemens) equipped with a dedicated 18-channel breast array coil for a phantom and patients. Three DWI protocols-SPEN, SS-EPI, and RESOLVE-were used. SS-EPI was acquired with an in-plane resolution of 2 × 2 mm2, a slice thickness of 3 mm, and b-values of 0 and 1000 s/mm2. SPEN had a higher in-plane resolution of 1 × 1 mm2, a slice thickness of 1.5 mm, and b-values of 0, 850, and 1500 s/mm2. RESOLVE was acquired with an in-plane resolution of 1 × 1 mm2, a slice thickness of 1.5 mm, and b-values of 0 and 850 s/mm2. Lesion conspicuity and ADC values were evaluated. The average lesion conspicuity scores were significantly higher for RESOLVE (3.54 ± 0.65) than for SPEN (3.07 ± 0.91) or SS-EPI (2.48 ± 0.78) (P < 0.01). The SPEN score was significantly higher than the SS-EPI score (P < 0.01). Phantom measurements indicated marginally lower ADC values for SPEN compared to SS-EPI and RESOLVE across all concentrations. The results revealed that SPEN (b = 0, 850, 1500 sec/mm2) yielded significantly lower ADC values compared to SPEN (b = 0, 850 sec/mm2) in malignant lesions (P < 0.01), with no significant difference observed between SPEN (b = 0, 850 sec/mm2), SS-EPI, and RESOLVE. For benign lesions, no significant difference in ADC values was found between SPEN (b = 0, 850 sec/mm2), SPEN (b = 0, 850, 1500 sec/mm2), SS-EPI, and RESOLVE. RESOLVE provided the highest lesion conspicuity, and ADC values in breast lesions were not significantly different among sequences ranging b values 850-1000 sec/mm2. SPEN with higher b-values (0, 850, 1500 vs. 0, 850 sec/mm2) yielded significantly lower ADC values in malignant lesions, highlighting the importance of b-value selection in ADC quantification.

Evaluation of RADIANCE Monte Carlo algorithm for treatment planning in electron based Intraoperative Radiotherapy (IOERT)

PurposeTo perform experimental as well as independent Monte Carlo (MC) evaluation of the MC algorithm implemented in RADIANCE version 4.0.8, a dedicated treatment planning system (TPS) for 3D electron dose calculations in intraoperative radiation therapy (IOERT). Methods and materialsThe MOBETRON 2000 (IntraOp Medical Corporation, Sunnyvale, CA) IOERT accelerator was employed. PDD and profiles for five cylindrical plastic applicators with 50–90 mm diameter and 0°, 30° beveling were measured in a water phantom, at nominal energies of 6, 9 and 12 MeV. Additional PDD measurements were performed for all the energies without applicator. MC modeling of the MOBETRON was performed with the user code BEAMnrc and egs_chamber of the MC simulation toolkit EGSnrc. The generated phase space files of the two 0°-bevel applicators (50 mm, 80 mm) and three energies in both RADIANCE and BEAMnrc, were used to determine PDD and profiles in various set-ups of virtual water phantoms with air and bone inhomogeneities. 3D dose distributions were also calculated in image data sets of an anthropomorphic tissue-equivalent pelvis phantom. Image acquisitions were realized with a CT scanner (Philips Big Bore CT, Netherlands). Gamma analysis was applied to quantify the deviations of the RADIANCE calculations to the measurements and EGSnrc calculations. Gamma criteria normalized to the global maximum were investigated between 2%, 2 mm and 3%, 3 mm. ResultsRADIANCE MC calculations satisfied the gamma criteria of 3%, 3 mm with a tolerance limit of 85% passing rate compared to in- water phantom measurements, except for the dose profiles of the 30° beveled applicators. Mismatches lay in surface doses, in umbra regions and in the beveled end of the 30° applicators. A very good agreement to the EGSnrc calculations in heterogeneous media was observed. Deviations were more pronounced for the larger applicator diameter and higher electron energy. In 3D dose comparisons in the anthropomorphic phantom, gamma passing rates were higher than 96 % for both simulated applicators. ConclusionsRADIANCE MC algorithm agrees within 3%, 3 mm criteria with in-water phantom measurements and EGSnrc MC dose distributions in heterogeneous media for 0°-bevel applicators. The user should be aware of missing scattering components and the 30° beveled applicators should be used with attention.

Underestimation of Flow Velocity in 2-D Super-Resolution Ultrasound Imaging.

Velocity estimation in ultrasound imaging is a technique to measure the speed and direction of blood flow. The flow velocity in small blood vessels, i.e., arterioles, venules, and capillaries, can be estimated using super-resolution ultrasound imaging (SRUS). However, the vessel width in SRUS is relatively small compared with the full-width-half-maximum of the ultrasound beam in the elevation direction (FWHMy), which directly impacts the velocity estimation. By taking into consideration the small vessel widths in SRUS, it is hypothesized that the velocity is underestimated in 2-D super-resolution ultrasound imaging when the vessel diameter is smaller than the FWHMy. A theoretical model is introduced to show that the velocity of a 3-D parabolic velocity profile is underestimated by up to 33% in 2-D SRUS, if the width of the vessel is smaller than the FWHMy. This model was tested using Field II simulations and 3-D printed micro-flow hydrogel phantom measurements. A Verasonics Vantage 256™ scanner and a GE L8-18i-D linear array transducer with FWHMy of approximately 770 μm at the elevation focus were used in the simulations and measurements. Simulations of different parabolic velocity profiles showed that the velocity underestimation was 36.8%±1.5% (mean±standard deviation). The measurements showed that the velocity was underestimated by 30%±6.9%. Moreover, the results of vessel diameters, ranging from 0.125×FWHMy to 3×FWHMy, indicate that velocities are estimated according to the theoretical model. The theoretical model can, therefore, be used for the compensation of velocity estimates under these circumstances.

Inter-scanner Aβ-PET harmonization using barrel phantom spatial resolution matching.

The standardized uptake value ratio (SUVR) is used to measure amyloid beta-positron emission tomography (Aβ-PET) uptake in the brainDifferences in PET scanner technologies and image reconstruction techniques can lead to variability in PET images across scanners. This poses a challenge for Aβ-PET studies conducted in multiple centers. The aim of harmonization is to achieve consistent Aβ-PET measurements across different scanners. In this study, we proposean Aβ-PET harmonization methodof matching spatial resolution, as measured viaabarrel phantom, across PET scanners. Our approach wasvalidated using paired subject data, for whichpatients were imaged on multiple scanners. In this study, three different PET scanners were evaluated: the Siemens Biograph Vision 600, Siemens Biograph molecular computed tomography (mCT), and Philips Gemini TF64. A total of five, eight, and five subjects were each scanned twice with [18F]-NAV4694 across Vision-mCT, mCT-Philips, and Vision-Philips scanner pairs. The Vision and mCT scans were reconstructed using various iterations, subsets, and post-reconstruction Gaussian smoothing, whereas only one reconstruction configuration was used for the Philips scans. The full-width at half-maximum (FWHM) of each reconstruction configuration was calculated using [18F]-filled barrel phantom scans with the Society of Nuclear Medicine and Molecular Imaging (SNMMI) phantom analysis toolkit. Regional SUVRs were calculated from 72 brain regions using the automated anatomical labelling atlas 3 (AAL3) atlas for each subject and reconstruction configuration. Statistical similarity between SUVRs was assessed using paired (within subject) t-tests for each pair of reconstructions across scanners; the higher the p-value, the greater the similarity between the SUVRs. Vision-mCT harmonization: Vision reconstruction with FWHM=4.10mm and mCT reconstruction with FWHM=4.30mm gave the maximal statistical similarity (maximum p-value) between regional SUVRs. Philips-mCT harmonization: The FWHM of the Philips reconstruction was 8.2mm and the mCT reconstruction with the FWHM of 9.35mm, which gave the maximal statistical similarity between regional SUVRs. Philips-Vision harmonization: The Vision reconstruction with an FWHM of 9.1mm gave the maximal statistical similarity between regional SUVRs when compared with the Philips reconstruction of 8.2mm and were selected as the harmonized for each scanner pair. Based on data obtained from three sets of participants, each scanned on a pair of PET scanners, it has been verified that using reconstruction configurations that produce matched-barrel, phantom spatial resolutions results in maximally harmonized Aβ-PET quantitation between scanner pairs. This finding is encouraging for the use of PET scanners in multi-center trials or updates during longitudinal studies. Question: Does the process of matching the barrel phantom-derived spatial resolution between scanners harmonize amyloid beta-standardized uptake value ratio (Aβ-SUVR) quantitation? Pertinent findings: It has been validated that reconstruction pairs with matched barrel phantom-derived spatial resolution maximize the similarity between subjects paired Aβ-PET (positron emission tomography) SUVR values recorded on two scanners. Implications for patient care: Harmonization between scanners in multi-center trials and PET camera updates in longitudinal studies can be achieved using a simple and efficient phantom measurement procedure, beneficial for the validity of Aβ-PET quantitation measurements.

A practical method for assessing quantitative scanner accuracy with long-lived radionuclides: The ARTnet insert.

To address the problem of using large volumes of long-lived radionuclides in test phantoms to check calibration accuracy of PET and SPECT systems we have developed a test object which (a) contains less radioactivity, (b) has a low total volume, and (c) is easier to store than currently used phantoms, while still making use of readily-available "standardised" test objects. We have designed a hollow acrylic cylindrical insert compatible with the NEMA/IEC PET Body Image Quality (IQ) phantom used in NU 2 performance testing of PET systems. The insert measures 90 mm internal diameter and 70 mm internal height and so is sufficiently large to not be subject to partial volume effects in PET or SPECT imaging. The volume of the insert is approximately 500 mL. It has been designed as a replacement for the standard long cylindrical "lung insert" in the IQ phantom without needing to remove the fillable hollow spheres of the phantom. The insert been tested with 18F, 68Ga and 124I PET/CT and 99mTc, 131I and 177Lu SPECT/CT on scanners that had previously been calibrated for these radionuclides. The scanners were found to produce accurate image reconstructions in the insert with 5% of the true value without any confounding uncertainty from partial volume effects when compared to NEMA NU 2-2018 Phantom measurement. The "ARTnet Insert" is simple to use, inexpensive, compatible with current phantoms and is suitable for both PET and SPECT systems. It does not suffer from significant partial volume losses permitting its use even with the poor spatial resolution of high-energy imaging with 131I SPECT. Furthermore, it uses less radioactivity in a smaller volume than would be required to fill the entire phantom as is usually done. Long-term storage is practical while allowing radioactive decay of the insert contents.

Development of a High‐Frequency Ophthalmic Real‐Time Ultrasound Imaging System Based on a 20 MHz Annular‐Array Transducer

Objective. Ophthalmic ultrasound imaging is a widely used diagnostic method for examining ophthalmic diseases in the clinic. A single‐element transducer is adopted in the traditional ophthalmic ultrasound imaging systems. Although full depth focusing can be achieved using a linear‐array transducer, it is unsuitable for ophthalmic imaging due to its inability to be tightly coupled to the eyeball and its higher cost. Annular‐array‐based systems provide an alternative, striking a balance between image quality and cost. Methods. Here, we present a newly developed high‐frequency ophthalmic real‐time ultrasound imaging system based on an annular‐array transducer. This system uses a custom‐made five‐element, 20 MHz annular‐array transducer encapsulated in a stainless steel housing and mounted in a commercially available handheld mechanical probe designed specifically for clinical ophthalmic imaging. The system uses a printed circuit board scheme and FPGA as the core to complete the hardware system design and realize the ultrasonic echo signal processing and system timing management. Full depth dynamic focusing of each scanning beam was achieved by designing the transmit and receive beamforming. Combined with advanced integrated circuits, the miniaturization and low cost of the overall system are realized. Results. Extensive tests, including hardware, wire phantom, and tissue mimicking phantom measurements, were conducted to demonstrate good performance of the system. The results showed that the designed system can effectively improve the imaging resolution and enhance the depth of field of the image, particularly reducing the blind area of the near‐field. Conclusion. The high‐frequency ophthalmic real‐time ultrasound imaging system based on an annular‐array transducer meets the needs of clinical diagnosis and has a good clinical application prospect.

Development and validation of the low-cost pregnant female physical phantom for fetal dosimetry in MV photon radiotherapy.

Monte Carlo (MC) simulations or measurements in anthropomorphic phantoms are recommended for estimating fetal dose in pregnant patients in radiotherapy. Among the many existing phantoms, there is no commercially available physical phantom representing the entire pregnant woman. In this study, the development of a low-cost, physical pregnant female phantom was demonstrated using commercially available materials. This phantom is based on the previously published computational phantom. Three tissue substitution materials (soft tissue, lung and bone tissue substitution) were developed. To verify Tena's substitution tissue materials, their radiation properties were assessed and compared to ICRP and ICRU materials using MC simulations in MV radiotherapy beams. Validation of the physical phantom was performed by comparing fetal doses obtained by measurements in the phantom with fetal doses obtained by MC simulations in computational phantom, during an MV photon breast radiotherapy treatment. Materials used for building Tena phantom are matched to ICRU materials using physical density, radiation absorption properties and effective atomic number. MC simulations showed that percentage depth doses of Tena and ICRU material comply within 5% for soft and lung tissue, up to 25cm depth. In the bone tissue, the discrepancy is higher, but again within 5% up to the depth of 5cm. When the phantom was used for fetal dose measurements in MV photon breast radiotherapy, measured fetal doses complied with fetal doses calculated using MC simulation within 15%. Physical anthropomorphic phantom of pregnant patient can be manufactured using commercial materials and with low expenses. The files needed for 3D printing are now freely available. This enables further studies and comparison of numerical and physical experiments in diagnostic radiology or radiotherapy.

Quantitative 31P magnetic resonance imaging on pathologic rat bones by ZTE at 7T

BackgroundOsteoporosis is characterized by low bone mineral density (BMD), which predisposes individuals to frequent fragility fractures. Quantitative BMD measurements can potentially help distinguish bone pathologies and allow clinicians to provide disease-relieving therapies. Our group has developed non-invasive and non-ionizing magnetic resonance imaging (MRI) techniques to measure bone mineral density quantitatively. Dual-energy X-ray Absorptiometry (DXA) is a clinically approved non-invasive modality to diagnose osteoporosis but has associated disadvantages and limitations. PurposeEvaluate the clinical feasibility of phosphorus (31P) MRI as a non-invasive and non-ionizing medical diagnostic tool to compute bone mineral density to help differentiate between different metabolic bone diseases. Materials and methodsFifteen ex-vivo rat bones in three groups [control, ovariectomized (osteoporosis), and vitamin-D deficient (osteomalacia - hypo-mineralized) were scanned to compute BMD. A double-tuned (1H/31P) transmit-receive single RF coil was custom-designed and in-house-built with a better filling factor and strong radiofrequency (B1) field to acquire solid-state 31P MR images from rat femurs with an optimum signal-to-noise ratio (SNR). Micro-computed tomography (μCT) and gold-standard gravimetric analyses were performed to compare and validate MRI-derived bone mineral densities. ResultsThree-dimensional 31P MR images of rat bones were obtained with a zero-echo-time (ZTE) sequence with 468 μm spatial resolution and 12–17 SNR on a Bruker 7 T Biospec having multinuclear capability. BMD was measured quantitatively on cortical and trabecular bones with a known standard reference. A strong positive correlation (R = 0.99) and a slope close to 1 in phantom measurements indicate that the densities measured by 31P ZTE MRI are close to the physical densities in computing quantitative BMD. The 31P NMR properties (resonance linewidth of 4 kHz and T1 of 67 s) of ex-vivo rat bones were measured, and 31P ZTE imaging parameters were optimized. The BMD results obtained from MRI are in good agreement with μCT and gravimetry results. ConclusionQuantitative measurements of BMD on ex-vivo rat femurs were successfully conducted on a 7 T preclinical scanner. This study suggests that quantitative measurements of BMD are feasible on humans in clinical MRI with suitable hardware, RF coils, and pulse sequences with optimized parameters within an acceptable scan time since human femurs are approximately ten times larger than rat femurs. As MRI provides quantitative in-vivo data, various systemic musculoskeletal conditions can be diagnosed potentially in humans.

Potential radiation dose reduction in clinical photon-counting CT by the small pixel effect: ultra-high resolution (UHR) acquisitions reconstructed to standard resolution

ObjectiveTo assess the potential dose reduction achievable with clinical photon-counting CT (PCCT) in ultra-high resolution (UHR) mode compared to acquisitions using the standard resolution detector mode (Std).Materials and methodsWith smaller detector pixels, PCCT achieves far higher spatial resolution than energy-integrating (EI) CT systems. The reconstruction of UHR acquisitions to the lower spatial resolution of conventional systems results in an image noise and radiation dose reduction. We quantify this small pixel effect in measurements of semi-anthropomorphic abdominal phantoms of different sizes as well as in a porcine knuckle in the first clinical PCCT system by using the UHR mode (0.2 mm pixel size at isocenter) in comparison to the standard resolution mode (0.4 mm). At different slice thicknesses (0.4 up to 4 mm) and dose levels between 4 and 12 mGy, reconstructions using filtered backprojection were performed to the same target spatial resolution, i.e., same modulation transfer function, using both detector modes. Image noise and the resulting potential dose reduction was quantified as a figure of merit.ResultsImages acquired using the UHR mode yield lower noise in comparison to acquisitions using standard pixels at the same resolution and noise level. This holds for sharper convolution kernels at the spatial resolution limit of the standard mode, e.g., up to a factor 3.2 in noise reduction and a resulting potential dose reduction of up to almost 90%.ConclusionUsing sharper convolution kernels, UHR acquisitions allow for a significant dose reduction compared to acquisitions using the standard detector mode.Clinical relevanceAcquisitions should always be performed using the ultra-high resolution detector mode, if possible, to benefit from the intrinsic noise and dose reduction.Key Points• Ionizing radiation used in computed tomography examinations is a concern to public health.• The ultra-high resolution of novel photon-counting systems can be invested towards a noise and dose reduction if only a spatial resolution below the resolution limit of the detector is desired.• Acquisitions should always be performed in ultra-high resolution mode, if possible, to benefit from an intrinsic dose reduction.