Deep Learning and Domain-Specific Knowledge to Segment the Liver from Synthetic Dual Energy CT Iodine Scans.

We map single energy CT (SECT) scans to synthetic dual-energy CT (synth-DECT) material density iodine (MDI) scans using deep learning (DL) and demonstrate their value for liver segmentation. A 2D pix2pix (P2P) network was trained on 100 abdominal DECT scans to infer synth-DECT MDI scans from SECT scans. The source and target domain were paired with DECT monochromatic 70 keV and MDI scans.

Detecting Spurious Correlations With Sanity Tests for Artificial Intelligence Guided Radiology Systems.

Artificial intelligence (AI) has been successful at solving numerous problems in machine perception. In radiology, AI systems are rapidly evolving and show progress in guiding treatment decisions, diagnosing, localizing disease on medical images, and improving radiologists' efficiency. A critical component to deploying AI in radiology is to gain confidence in a developed system's efficacy and safety.

Quality control of radiomic features using 3D-printed CT phantoms.

: The lack of standardization in quantitative radiomic measures of tumors seen on computed tomography (CT) scans is generally recognized as an unresolved issue. To develop reliable clinical applications, radiomics must be robust across different CT scan modes, protocols, software, and systems. We demonstrate how custom-designed phantoms, imprinted with human-derived patterns, can provide a straightforward approach to validating longitudinally stable radiomic signature values in a clinical setting.

Performance of primary diagnostic monitors (PDMs) over time.

In this work, we evaluated the change of primary monitor characteristics in two consecutive years. Sixty-six primary monitors were included in the analysis. The monitors were located at radiology physicians' offices and radiology reading rooms.

The assessment and characterization of the built-in internal photometer of primary diagnostic monitors.

The purpose of this work was to perform the initial evaluation of primary diagnostic monitor (PDM) characteristics following the implementation of New York City quality assurance (NYC QA) regulations on January 1, 2016, and compare the results of the QA measurements performed by an external photometer and the PDM manufacturer's built-in photometer. TG-18 and Society of Motion Picture and Television Engineers test patterns were used to evaluate monitor performance. Overall, 79 PDMs were included in the analysis.

Computed tomography x-ray tube life analysis: a multiyear study.

Purpose: To assess and compare actual computed tomography (CT) x-ray tube life with manufacturer warranty coverage limits because prolonging the tube life helps to lower operating costs.

Methods: Ten GE LightSpeed CT scanners with 40 Performix Ultra tube changes and 3 GE VCT scanners with 10 Performix Pro tube changes were followed for 6 years. CT x-ray tube life measurements were performed by analyzing log files of the units after a tube change.

Limits of Tumor Detectability in Nuclear Medicine and PET.

Objective: Nuclear medicine is becoming increasingly important in the early detection of malignancy. The advantage of nuclear medicine over other imaging modalities is the high sensitivity of the gamma camera. Nuclear medicine counting equipment has the capability of detecting levels of radioactivity which exceed background levels by as little as 2.

Dose uniformity analysis among ten 16-slice same-model CT scanners.

Purpose: With the introduction of multislice scanners, computed tomographic (CT) dose optimization has become important. The patient-absorbed dose may differ among the scanners although they are the same type and model. To investigate the dose output variation of the CT scanners, we designed the study to analyze dose outputs of 10 same-model CT scanners using 3 clinical protocols.

Respiratory motion in positron emission tomography/computed tomography: a review.

The development of positron emission tomography/computed tomography (PET/CT) scanners has allowed not only straightforward but also synergistic fusion of anatomical and functional information. Combined PET/CT imaging yields an increased sensitivity and specificity beyond that which either of the 2 modalities possesses separately and therefore provides improved diagnostic accuracy. Because attenuation correction in PET is performed with the use of CT images, with CT used in the localization of disease, accurate spatial registration of PET and CT image sets is required.

Reproducibility of intratumor distribution of (18)F-fluoromisonidazole in head and neck cancer.

Purpose: Hypoxia is one of the main causes of the failure to achieve local control using radiotherapy. This is due to the increased radioresistance of hypoxic cells. (18)F-fluoromisonidazole ((18)F-FMISO) positron emission tomography (PET) is a noninvasive imaging technique that can assist in the identification of intratumor regions of hypoxia.

Design of respiration averaged CT for attenuation correction of the PET data from PET/CT.

Our previous patient studies have shown that the use of respiration averaged computed tomography (ACT) for attenuation correction of the positron emission tomography (PET) data from PET/CT reduces the potential misalignment in the thorax region by matching the temporal resolution of the CT to that of the PET. In the present work, we investigated other approaches of acquiring ACT in order to reduce the CT dose and to improve the ease of clinical implementation. Four-dimensional CT (4DCT) data sets for ten patients (17 lung/esophageal tumors) were acquired in the thoracic region immediately after the routine PET/CT scan.

Deep-inspiration breath-hold PET/CT: clinical findings with a new technique for detection and characterization of thoracic lesions.

Unlabelled: Respiratory motion during PET/CT acquisition can cause misregistration and inaccuracies in calculation of standardized uptake values (SUVs). Our aim was to compare the detection and characterization of thoracic lesions on PET/CT with and without a deep-inspiration protocol.

Methods: We studied 15 patients with suspected pulmonary lesions who underwent clinical PET/CT, followed by deep-inspiration breath-hold (BH) PET/CT.

Radiation dose reduction at a price: the effectiveness of a male gonadal shield during helical CT scans.

Background: It is estimated that 60 million computed tomography (CT) scans were performed during 2006, with approximately 11% of those performed on children age 0-15 years. Various types of gonadal shielding have been evaluated for reducing exposure to the gonads. The purpose of this study was to quantify the radiation dose reduction to the gonads and its effect on image quality when a wrap-around male pediatric gonad shield was used during CT scanning.

Deep-inspiration breath-hold PET/CT of the thorax.

Unlabelled: The goal of this study was to describe our initial experience with the deep-inspiration breath-hold (DIBH) technique in combined PET/CT of the thorax. This article presents particular emphasis on the technical aspects required for clinical implementation.

Methods: In the DIBH technique, the patient is verbally coached and brought to a reproducible deep inspiration breath-hold level.

18F-FDG PET/CT for detecting nodal metastases in patients with oral cancer staged N0 by clinical examination and CT/MRI.

Unlabelled: (18)F-FDG PET has a high accuracy in staging head and neck cancer, but its role in patients with clinically and radiographically negative necks (N0) is less clear. In particular, the value of combined PET/CT has not been determined in this group of patients.

Methods: In a prospective study, 31 patients with oral cancer and no evidence of lymph node metastases by clinical examination or CT/MRI underwent (18)F-FDG PET/CT before elective neck dissection.

Validation of GATE Monte Carlo simulations of the GE Advance/Discovery LS PET scanners.

The recently developed GATE (GEANT4 application for tomographic emission) Monte Carlo package, designed to simulate positron emission tomography (PET) and single photon emission computed tomography (SPECT) scanners, provides the ability to model and account for the effects of photon noncollinearity, off-axis detector penetration, detector size and response, positron range, photon scatter, and patient motion on the resolution and quality of PET images. The objective of this study is to validate a model within GATE of the General Electric (GE) Advance/Discovery Light Speed (LS) PET scanner. Our three-dimensional PET simulation model of the scanner consists of 12 096 detectors grouped into blocks, which are grouped into modules as per the vendor's specifications.

Attenuation correction of PET images with respiration-averaged CT images in PET/CT.

Unlabelled: Attenuation correction (AC) of PET images with helical CT (HCT) in PET/CT matches only the spatial resolution of CT and PET, not the temporal resolution. We therefore proposed the use of respiration-averaged CT (ACT) to match the temporal resolution of CT and PET and evaluated the improvement of tumor quantification in PET images of the thorax with ACT.

Methods: First, we examined 100 consecutive clinical PET/CT studies for the frequency and magnitude of misalignment at the diaphragm position between the HCT and the PET data.

Effect of motion on tracer activity determination in CT attenuation corrected PET images: a lung phantom study.

Respiratory motion is known to affect the quantitation of 18FDG uptake in lung lesions. The aim of the study was to investigate the magnitude of errors in tracer activity determination due to motion, and its dependence upon CT attenuation at different phases of the motion cycle. To estimate these errors we have compared maximum activity concentrations determined from PET/CT images of a lung phantom at rest and under simulated respiratory motion.

PET/CT in non-small-cell lung cancer: value of respiratory-gated PET.

The use of PET in the staging of patients with NSCLC is cost-effective, mainly due to a reduction in the number of futile operations. The addition of SUVmax to pathologic tumor size identifies a subgroup of patients at highest risk for death as a result of recurrent disease after resection. Tumor staging is more accurate with PET-CT than with CT alone or with PET alone.

Effect of motion on tracer activity determination in CT attenuation corrected PET images: A lung phantom study.

Respiratory motion is known to affect the quantitation of FDG18 uptake in lung lesions. The aim of the study was to investigate the magnitude of errors in tracer activity determination due to motion, and its dependence upon CT attenuation at different phases of the motion cycle. To estimate these errors we have compared maximum activity concentrations determined from PET/CT images of a lung phantom at rest and under simulated respiratory motion.

Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin's lymphoma.

Purpose: (18)Fluorodeoxyglucose positron emission tomography (FDG PET) is widely used for the staging of lymphoma. We investigated whether the intensity of tumor FDG uptake could differentiate between indolent and aggressive disease.

Materials And Methods: PET studies of 97 patients with non-Hodgkin's lymphoma who were untreated or had relapsed and/or persistent disease and had not received treatment within the last 6 months were analyzed, and the highest standardized uptake value (SUV) per study was recorded.

Measurement of lung tumor motion using respiration-correlated CT.

Purpose: We investigate the characteristics of lung tumor motion measured with respiration-correlated computed tomography (RCCT) and examine the method's applicability to radiotherapy planning and treatment.

Methods And Materials: Six patients treated for non-small-cell lung carcinoma received a helical single-slice computed tomography (CT) scan with a slow couch movement (1 mm/s), while simultaneously respiration is recorded with an external position-sensitive monitor. Another 6 patients receive a 4-slice CT scan in a cine mode, in which sequential images are acquired for a complete respiratory cycle at each couch position while respiration is recorded.

The CT motion quantitation of lung lesions and its impact on PET-measured SUVs.

Unlabelled: We previously reported that respiratory motion is a major source of error in quantitation of lesion activity using combined PET/CT units. CT acquisition of the lesion occurs in seconds, rather than the 4-6 min required for PET emission scans. Therefore, an incongruent lesion position during CT acquisition will bias activity estimates using PET.

PET performance measurements for an LSO-based combined PET/CT scanner using the National Electrical Manufacturers Association NU 2-2001 standard.

Unlabelled: Results of performance measurements for a lutetium oxyorthosilicate (LSO)-based PET/CT scanner using new National Electrical Manufacturers Association (NEMA) NU 2-2001 standards are reported.

Methods: Performance measurements following the NU 2-2001 standards were performed on an LSO-based PET/CT scanner. In addition, issues associated with the application of the NEMA standard to LSO-based tomographs in the presence of intrinsic radiation are discussed.

Clinical implications of different image reconstruction parameters for interpretation of whole-body PET studies in cancer patients.

Unlabelled: The standardized uptake value (SUV) is the most commonly used parameter to quantify the intensity of radiotracer uptake in tumors. Previous studies suggested that measurements of (18)F-FDG accumulation in tissue might be affected by the image reconstruction method, but the clinical relevance of these findings has not been assessed.

Methods: Phantom studies were performed and clinical whole-body (18)F-FDG PET images of 85 cancer patients were analyzed.