Our solution for fusion of simultaneusly acquired whole body scintigrams and optical images, as usesful tool in clinical practice in patients with differentiated thyroid carcinomas after radioiodine therapy. A useful tool in clinical practice.

Objective: After radioiodine therapy of differentiated thyroid cancer (DTC) patients, whole body scintigraphy (WBS) is standard procedure before releasing the patient from the hospital. A common problem is the precise localization of regions where the iod-avide tissue is located. Sometimes is practically impossible to perform precise topographic localization of such regions.

Method: In order to face this problem, we have developed a low-cost Vision-Fusion system for web-camera image acquisition simultaneously with routine scintigraphic whole body acquisition including the algorithm for fusion of images given from both cameras. For image acquisition in the gamma part of the spectra we used e.cam dual head gamma camera (Siemens, Erlangen, Germany) in WBS modality, with matrix size of 256×1024 pixels and bed speed of 6cm/min, equipped with high energy collimator. For optical image acquisition in visible part of spectra we have used web-camera model C905 (Logitech, USA) with Carl Zeiss® optics, native resolution 1600×1200 pixels, 34 field of view, 30g weight, with autofocus option turned "off" and auto white balance turned "on". Web camera is connected to upper head of gamma camera (GC) by a holder of lightweight aluminum rod and a plexiglas adapter. Our own Vision-Fusion software for image acquisition and coregistration was developed using NI LabVIEW programming environment 2015 (National Instruments, Texas, USA) and two additional LabVIEW modules: NI Vision Acquisition Software (VAS) and NI Vision Development Module (VDM). Vision acquisition software enables communication and control between laptop computer and web-camera. Vision development module is image processing library used for image preprocessing and fusion. Software starts the web-camera image acquisition before starting image acquisition on GC and stops it when GC completes the acquisition. Web-camera is in continuous acquisition mode with frame rate f depending on speed of patient bed movement v (f=v/∆, where ∆ is a displacement step that can be changed in Settings option of Vision-Fusion software; by default, ∆ is set to 1cm corresponding to ∆=15 pixels). All images captured while patient's bed is moving are processed. Movement of patient's bed is checked using cross-correlation of two successive images. After each image capturing, algorithm extracts the central region of interest (ROI) of the image, with the same width as captured image (1600 pixels) and the height that is equal to the ∆ displacement in pixels. All extracted central ROI are placed next to each other in the overall whole-body image. Stacking of narrow central ROI introduces negligible distortion in the overall whole-body image. The first step for fusion of the scintigram and the optical image was determination of spatial transformation between them. We have made an experiment with two markers (point radioactivity sources of Tc pertechnetate 1MBq) visible in both images (WBS and optical) to find transformation of coordinates between images. The distance between point markers is used for spatial coregistration of the gamma and optical images. At the end of coregistration process, gamma image is rescaled in spatial domain and added to the optical image (green or red channel, amplification changeable from user interface).

Subjects: We tested our system for 10 patients with DTC who received radioiodine therapy (8 women and two men, with average age of 50.10±12.26 years). Five patients received 5.55Gbq, three 3.70GBq and two 1.85GBq. Whole-body scintigraphy and optical image acquisition were performed 72 hours after application of radioiodine therapy.

Conclusion: Based on our first results during clinical testing of our system, we can conclude that our system can improve diagnostic possibility of whole body scintigraphy to detect thyroid remnant tissue in patients with DTC after radioiodine therapy.