Region Of Interest Quantification Research Articles

Advancing indocyanine green fluorescence flap perfusion assessment via near infrared signal quantification

IntroductionIntraoperative indocyanine green fluorescence angiography (ICGFA) perfusion assessment has been demonstrated to reduce complications in reconstructive surgery. This study sought to advance ICGFA flap perfusion assessment via quantification methodologies. MethodPatients undergoing pedicled and free flap reconstruction were subjected to intraoperative ICGFA flap perfusion assessment using either an open or endoscopic system. Patient demographics, clinical impact of ICGFA and outcomes were documented. From the ICGFA recordings, fluorescence signal quality, as well as inflow/outflow milestones for the flap and surrounding (control) tissue were computationally quantified post hoc and compared on a region of interest (ROI) level. Further software development intended full flap quantification, metric computation and heatmap generation. ResultsFifteen patients underwent ICGFA assessment at reconstruction (8 head and neck, 6 breast and 1 perineum) including 10 free and 5 pedicled flaps. Visual ICGFA interpretation altered on-table management in 33.3% of cases, with flap edges trimmed in 4 and a re-anastomosis in 1 patient. One patient suffered post-operative flap dehiscence. Laparoscopic camera use proved feasible but recorded a lower quality signal than the open system.Using established and novel metrics, objective ICGFA signal ROI quantification permitted perfusion comparisons between the flap and surrounding tissue. Full flap assessment feasibility was demonstrated by computing all pixels and subsequent outputs summarisation as heatmaps. ConclusionThis trial demonstrated the feasibility and potential for ICGFA with operator based and quantitative flap perfusion assessment across several reconstructive applications. Further development and implementation of these computational methods requires technique and device standardisation.

3D-printed dual holder system for simultaneous rat PET scanning: design and influence on quantification

BackgroundThe low throughout of small animal positron emission tomography (PET) images acquisitions represents a substantial limitation. The aims of this study were (i) to design a low-cost support for simultaneous dynamic PET scanning of two lying rats and (ii) to study its impact on brain image quantification.ResultsAccuracy of concentration measurement was 5.5% for one phantom in the field of view, and 5.7% for two phantoms measured simultaneously. Ratio concentration between phantoms showed an error of 6.7% ± 5.1% for Solo upper position, 6.7% ± 3.7% for Solo lower position, 5.9% ± 4.3% for Duo upper position, and 7.4% ± 6% for Duo lower position 6.7% for separated measures, and 6.6% for simultaneous measures.In vivo distribution profiles showed no difference between solo and duo uptakes. Region of Interest quantification in the whole brain showed 4.4% variability solo and 3.5% duo. The quantified test–retest bias was 8% in solo and 5% in duo, and the Intraclass Correlation Coefficient was comparable in solo and duo (0.969 vs. 0.966).ConclusionsOur results showed that simultaneous scans of two rats in INVEON do not affect quantification. The dual support system will allow us to reduce protocol costs and duration.

Full‐count PET recovery from low‐count image using a dilated convolutional neural network

Positron emission tomography (PET) is an essential technique in many clinical applications that allows for quantitative imaging at the molecular level. This study aims to develop a denoising method using a novel dilated convolutional neural network (CNN) to recover full-count images from low-count images. We adopted similar hierarchical structures as the conventional U-Net and incorporated dilated kernels in each convolution to allow the network to observe larger, more robust features within the image without the requirement of downsampling and upsampling internal representations. Our dNet was trained alongside a U-Net for comparison. Both models were evaluated using a leave-one-out cross-validation procedure on a dataset of 35 subjects (~3500 slabs), which were obtained from an ongoing 18 F-Fluorodeoxyglucose (FDG) study. Low-count PET data (10% count) were generated by randomly selecting one-tenth of all events in the associated listmode file. Analysis was done on the static image from the last 10minutes of emission data. Both low-count PET and full-count PET were reconstructed using ordered subset expectation maximization (OSEM). Objective image quality metrics, including mean absolute percent error (MAPE), peak signal-to-noise ratio (PSNR), and structural similarity index metric (SSIM), were used to analyze the deep learning methods. Both deep learning methods were further compared to a traditional Gaussian filtering method. Further, region of interest (ROI) quantitative analysis was also used to compare U-Net and dNet architectures. Both the U-Net and our proposed network were successfully trained to synthesize full-count PET images from the generated low-count PET images. Compared to low-count PET and Gaussian filtering, both deep learning methods improved MAPE, PSNR, and SSIM. Our dNet also systematically outperformed U-Net on all three metrics (MAPE: 4.99±0.68 vs 5.31±0.76, P<0.01; PSNR: 31.55±1.31dB vs 31.05±1.39, P<0.01; SSIM: 0.9513±0.0154 vs 0.9447±0.0178, P<0.01). ROI quantification showed greater quantitative improvements using dNet over U-Net. This study proposed a novel approach of using dilated convolutions for recovering full-count PET images from low-count PET images.

Evaluation for renal peripheral inflow perfusion in patients with liver cirrhosis by region of interest quantification of color Doppler technique

Objective To evaluate the renal peripheral inflow perfusion in patients with liver cirrhosis by region of interest(ROI) quantification of color Doppler technique. Methods Fifty-eight patients with cirrhosis with normal renal function were selected as the case group, and classified into A grade (10 cases), B grade (23 cases) and C grade (25 cases) according to Child-Pugh classification criteria. Thirty healthy volunteers were selected as the control group.Resistance index (RI) of interlobar artery and interlobular artery were measured in all groups. The blood flow of renal cortical was analyzed using ROI quantification in the corresponding region, and vascular index (VI), flow index (FI), vascularization flow index (VFI) were obtained. Results ①Patients of B grade group and C grade group in the cirrhosis group showed sparser corical blood flow and slender blood vessels. ②No statistical difference were found in the resistance index of the renal interlobaries and interlobular arteries between A grade group and control group (P>0.05), the RI of renal interlobar arteries and interlobular arteries in B grade group and C grade group were significantly higher (P 0.05). ③Compared with the control group, the VI, FI, and VFI of A, B, and C grade groups declined obviously (P<0.05). With the increase of cirrhosis grade, VI, FI and VFI gradually decreased, and the difference among the three groups were statistically significant (P<0.05). Conclusions Patients with cirrhosis have showed a reduction in renal peripheral vascular bed and blood perfusion earlier than laboratory tests for renal dysfunction. ROI quantification of Color Doppler technique can sensitively assess changes of early renal peripheral blood perfusion in patients with cirrhosis. Key words: Ultrasonography, Doppler, color; Technique of region of interest quantification; Liver cirrhosis; Hepatorenal syndrome

Theoretical study of the benefit of long axial field-of-view PET on region of interest quantification

The aim of this study is to evaluate the benefit of long axial field-of-view (AFOV) PET scanners on region of interest (ROI) quantification. We simulated a series of PET scanners with an AFOV ranging from 22 cm to 220 cm. A theoretical framework was used to predict the contrast recovery coefficient (CRC) and the variance of ROI quantification in penalized maximum likelihood (ML) image reconstruction, in which the resolution and noise tradeoff was controlled by a regularization parameter with a quadratic penalty function. The characterization was based on the converged penalized ML reconstruction with an accurate system model. We examined quantification of a 2 mm ROI and 10 mm ROI in a clinically relevant scan range of 110 cm. Multiple bed positions with 50% overlap were used for scanners with shorter AFOV to provide a relatively uniform sensitivity across the 110 cm axial range. A uniform water cylinder of 20 cm in diameter and 230 cm in length was chosen to model the attenuation and background activity. We computed the variance reduction factor at fixed resolution. Effects of different detector capabilities, including TOF (time-of-flight) resolution (320 ps, 500 ps, and non-TOF) and DOI (depth-of-interaction) resolution (4 mm, 10 mm, and no DOI), were evaluated. The results show that at a normal activity level (370 MBq), the 220 cm AFOV scanner offers a ∼17-fold variance reduction for the 2 mm ROI and ∼26-fold variance reduction for the 10 mm ROI (both measured at CRC = 0.5) over the 22 cm AFOV scanner when both using detectors with 500 ps TOF resolution no DOI capability. The variance reduction factors of trues-only are higher than those of including scatters and randoms. Combining 320 ps TOF and 4 mm DOI, the 220 cm long scanner offers a ∼45-fold variance reduction over the 22 cm long reference scanner (500 ps TOF, no DOI) for imaging 2 mm and 10 mm ROIs. The variance reduction factors are higher at a lower activity level due to lower random fraction. In conclusion, our study demonstrates that a long AFOV scanner can greatly improve the quantitative accuracy of PET imaging compared to current state-of-the-art clinical PET scanners.

Anatomically-aided PET reconstruction using the kernel method

This paper extends the kernel method that was proposed previously for dynamic PET reconstruction, to incorporate anatomical side information into the PET reconstruction model. In contrast to existing methods that incorporate anatomical information using a penalized likelihood framework, the proposed method incorporates this information in the simpler maximum likelihood (ML) formulation and is amenable to ordered subsets. The new method also does not require any segmentation of the anatomical image to obtain edge information. We compare the kernel method with the Bowsher method for anatomically-aided PET image reconstruction through a simulated data set. Computer simulations demonstrate that the kernel method offers advantages over the Bowsher method in region of interest quantification. Additionally the kernel method is applied to a 3D patient data set. The kernel method results in reduced noise at a matched contrast level compared with the conventional ML expectation maximization algorithm.

Designing a compact high performance brain PET scanner—simulation study

The desire to understand normal and disordered human brain function of upright, moving persons in natural environments motivates the development of the ambulatory micro-dose brain PET imager (AMPET). An ideal system would be light weight but with high sensitivity and spatial resolution, although these requirements are often in conflict with each other. One potential approach to meet the design goals is a compact brain-only imaging device with a head-sized aperture. However, a compact geometry increases parallax error in peripheral lines of response, which increases bias and variance in region of interest (ROI) quantification. Therefore, we performed simulation studies to search for the optimal system configuration and to evaluate the potential improvement in quantification performance over existing scanners. We used the Cramér–Rao variance bound to compare the performance for ROI quantification using different scanner geometries. The results show that while a smaller ring diameter can increase photon detection sensitivity and hence reduce the variance at the center of the field of view, it can also result in higher variance in peripheral regions when the length of detector crystal is 15 mm or more. This variance can be substantially reduced by adding depth-of-interaction (DOI) measurement capability to the detector modules. Our simulation study also shows that the relative performance depends on the size of the ROI, and a large ROI favors a compact geometry even without DOI information. Based on these results, we propose a compact ‘helmet’ design using detectors with DOI capability. Monte Carlo simulations show the helmet design can achieve four-fold higher sensitivity and resolve smaller features than existing cylindrical brain PET scanners. The simulations also suggest that improving TOF timing resolution from 400 ps to 200 ps also results in noticeable improvement in image quality, indicating better timing resolution is desirable for brain imaging.

Quantitative Accuracy of Penalized-Likelihood Reconstruction for ROI Activity Estimation

Estimation of the tracer uptake in a region of interest (ROI) is an important task in emission tomography. ROI quantification is essential for measuring clinical factors such as tumor activity, growth rate, and the efficacy of therapeutic interventions. Accuracy of ROI quantification is significantly affected by image reconstruction algorithms. In penalized maximum-likelihood (PML) algorithm, the regularization parameter controls the resolution and noise tradeoff and, hence, affects ROI quantification. To obtain the optimum performance of ROI quantification, it is desirable to use a moderate regularization parameter to effectively suppress noise without introducing excessive bias. However, due to the non-linear and spatial-variant nature of PML reconstruction, choosing a proper regularization parameter is not an easy task. Our previous theoretical study [1] has shown that the bias-variance characteristic for ROI quantification task depends on the size and activity distribution of the ROI. In this work, we design physical phantom experiments to validate these predictions in a realistic situation. We found that the phantom data results match well the theoretical predictions. The good agreement between the phantom results and theoretical predictions shows that the theoretical expressions can be used to predict the accuracy of ROI activity quantification.

Theoretical study of penalized-likelihood image reconstruction for region of interest quantification

Region of interest (ROI) quantification is an important task in emission tomography (e.g., positron emission tomography and single photon emission computed tomography). It is essential for exploring clinical factors such as tumor activity, growth rate, and the efficacy of therapeutic interventions. Statistical image reconstruction methods based on the penalized maximum-likelihood (PML) or maximum a posteriori principle have been developed for emission tomography to deal with the low signal-to-noise ratio of the emission data. Similar to the filter cut-off frequency in the filtered backprojection method, the regularization parameter in PML reconstruction controls the resolution and noise tradeoff and, hence, affects ROI quantification. In this paper, we theoretically analyze the performance of ROI quantification in PML reconstructions. Building on previous work, we derive simplified theoretical expressions for the bias, variance, and ensemble mean-squared-error (EMSE) of the estimated total activity in an ROI that is surrounded by a uniform background. When the mean and covariance matrix of the activity inside the ROI are known, the theoretical expressions are readily computable and allow for fast evaluation of image quality for ROI quantification with different regularization parameters. The optimum regularization parameter can then be selected to minimize the EMSE. Computer simulations are conducted for small ROIs with variable uniform uptake. The results show that the theoretical predictions match the Monte Carlo results reasonably well.

Comparison of Lesion Detection and Quantification in MAP Reconstruction with Gaussian and Non-Gaussian Priors

Statistical image reconstruction methods based on maximum a posteriori (MAP) principle have been developed for emission tomography. The prior distribution of the unknown image plays an important role in MAP reconstruction. The most commonly used prior are Gaussian priors, whose logarithm has a quadratic form. Gaussian priors are relatively easy to analyze. It has been shown that the effect of a Gaussian prior can be approximated by linear filtering a maximum likelihood (ML) reconstruction. As a result, sharp edges in reconstructed images are not preserved. To preserve sharp transitions, non-Gaussian priors have been proposed. However, their effect on clinical tasks is less obvious. In this paper, we compare MAP reconstruction with Gaussian and non-Gaussian priors for lesion detection and region of interest quantification using computer simulation. We evaluate three representative priors: Gaussian prior, Huber prior, and Geman-McClure prior. We simulate imaging a prostate tumor using positron emission tomography (PET). The detectability of a known tumor in either a fixed background or a random background is measured using a channelized Hotelling observer. The bias-variance tradeoff curves are calculated for quantification of the total tumor activity. The results show that for the detection and quantification tasks, the Gaussian prior is as effective as non-Gaussian priors.