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To provide our oncology-specific adult abdominal-pelvic CT reference levels for image noise and radiation dose from a high-volume, oncologic, tertiary referral center.The portal venous phase abdomen-pelvis acquisition was assessed for image noise and radiation dose in 13,320 contrast-enhanced CT examinations. Patient size (effective diameter) and radiation dose (CTDIThe noise reference level was 11.25 HU with a reference range of 10.25-12.25 HU. The dose reference level at a median effective diameter of 30.7 cm was 26.7 mGy with a reference range of 19.6-37.0 mGy. Dose increased with patient size; however, image noise remained approximately constant within the noise reference range. The doses were 2.1-2.5 times than the doses in the ACR DIR registry for corresponding patient sizes. The image noise was 0.63-0.75 times the previously published reference level in abdominal-pelvic CT examinations.Our oncology-specific abdominal-pelvic CT dose reference levels are higher than in the ACR dose index registry and our oncology-specific image noise reference levels are lower than previously proposed image noise reference levels.This study reports reference image noise and radiation dose levels appropriate for the indication of abdomen-pelvis CT examination for cancer diagnosis and staging. The difference in these reference levels from non-oncology-specific CT examinations highlight a need for indication-specific, dose index and image quality reference registries.

Purpose Assessment of image quality directly in clinical image data is an important quality control objective as phantom-based testing does not fully represent image quality across patient variation. Computer algorithms for automatically measuring noise in clinical computed tomography (CT) images have been introduced, but the accuracy of these algorithms is unclear. This work benchmarks the accuracy of the global noise (GN) algorithm for automatic noise measurement in contrast-enhanced abdomen CT exams in comparison to precise reference noise measurements. The GN algorithm was further optimized compared to the previous report in the literature. Methods Reference values of noise were established in a public image dataset of 82 contrast-enhanced abdomen CT exams. The reference noise values were obtained by manual regions-of-interest measurements of pixel standard deviation in the liver parenchyma according to an instruction protocol. Noise measurements taken by six observers were averaged together to improve reference noise statistical precision. The GN algorithm was used to automatically measure noise in each image set. The accuracy of the GN algorithm was determined in terms of RMS error compared to reference noise. The GN algorithm was optimized by conducting 1000 trials with random algorithm parameter values. The trial with the lowest RMS error was used to select optimum algorithm parameters. Results The range of noise across CT image sets was 8.8-28.8 HU. Reference noise measurements were made with a precision of ±0.78 HU (95% confidence interval). The RMS error of automatic noise measurement was 0.93 HU (0.77-1.19 HU 95% confidence interval). The automatic noise measurements were equally accurate across image sets of varying noise magnitude. Optimum GN algorithm parameter values were: a kernel size of 7 pixels, and soft tissue lower and upper thresholds of 0 and 170 HU, respectively. Conclusions The performance of automatic noise measurement was benchmarked in a large clinical CT dataset. The study provides a framework for thorough validation of automatic clinical image quality measurement methods. The GN algorithm was optimized and validated for automatic measurement of soft-tissue noise in abdomen CT exams.

Introduction: Recognition of Vehicle License Number Plates (VLNP) is an important task. It is valuable in numerous applications, such as entrance admission, security, parking control, road traffic control, and speed control. An ANPR (Automatic Number Plate Recognition) is a system in which the image of the vehicle is captured through high definition cameras. The image is then used to detect vehicles of any type (car, van, bus, truck, and bike, etc.), its’ color (white, black, blue, etc.), and its’ model (Toyota Corolla, Honda Civic etc.). Furthermore, this image is processed using segmentation and OCR techniques to get the vehicle registration number in form of characters. Once the required information is extracted from VLNP, this information is sent to the control center for further processing. Aim: ANPR is a challenging problem, especially when the number plates have varying sizes, the number of lines, fonts, background diversity, etc. Different ANPR systems have been suggested for different countries, including Iran, Malaysia, and France. However, only a limited work exists for Pakistan vehicles. Therefore, in this study, we aim to propose a novel ANPR framework for Pakistan VLNP recognition. Methods: The proposed ANPR system functions in three different steps: (i) - Number Plate Localization (NPL); (ii)- Character Segmentation (CS); and (iii)- Optical Character Recognition (OCR), involving template-matching mechanism. The proposed ANPR approach scans the number plate and instantly checks against database records of vehicles of interest. It can further extract the real=time information of driver and vehicle, for instance, license of the driver and token taxes of vehicles are paid or not, etc. Results: Finally, the proposed ANPR system has been evaluated on several real-time images from various formats of number plates practiced in Pakistan territory. In addition to this, the proposed ANPR system has been compared with the existing ANPR systems proposed specifically for Pakistani licensed number plates. Conclusion: The proposed ANPR Model has both time and money-saving profit for law enforcement agencies and private organizations for improving homeland security. There is a need to expand the types of vehicles that can be detected: trucks, buses, scooters, bikes. This technology can be further improved to detect the crashed vehicle’s number plate in an accident and alert the closest hospital and police station about the accident, thus saving lives.

Purpose X-ray fluorescence computed tomography (XFCT) is an emerging molecular imaging modality for preclinical and clinical applications with high atomic number contrast agents. XFCT allows detection of molecular biomarkers at tissue depths of 4-9 mm at L-shell energies and several centimeters for K-shell energies, while maintaining high spatial resolution. This is typically not possible for other molecular imaging modalities. The purpose of this study is to demonstrate XFCT imaging with reduced acquisition times. To accomplish this, x-ray focusing polycapillary optics are utilized to simultaneously increase x-ray fluence rate and spatial resolution in L-shell XFCT imaging. Materials and methods A prototype imaging system using a polycapillary focusing optic was demonstrated. The optic, which was custom-designed for this prototype, provided a high fluence rate with a focal spot size of 2.6 mm at a source to isocenter distance of 3 cm with a ten times higher fluence rate compared to standard collimation. The study evaluates three different phantoms to explore different trade-offs and limitations of L-shell XFCT imaging. A low-contrast gold phantom and a high-contrast gold phantom, each with three target regions with gold concentrations of 60, 80, and 100 μg ml - 1 for low contrast and 200, 600, and 1000 μg ml - 1 for high contrast, and a mouse-sized water phantom with gold concentrations between 300 and 500 μg ml - 1 were imaged. X-ray fluorescence photons were measured using a silicon drift detector (SDD) with an energy resolution of 180 eV FWHM at an x-ray energy of 11 keV. Images were reconstructed with an iterative image reconstruction algorithm and analyzed for contrast to noise ratio (CNR) and signal to noise ratio (SNR). Results The XFCT data acquisition could be reduced from 17 h to under 1 h. The polycapillary x-ray optic increases the x-ray fluence rate and lowers the amount of background scatter which leads to reduced imaging time and improved sensitivity. The quantitative analysis of the reconstructed images validates that concentrations of 60 μg ml - 1 of gold can be visualized with L-shell XFCT imaging. For a mouse-sized phantom, a concentration of 300 μg ml - 1 gold was detected within a 66 min measurement. Conclusions With a high fluence rate pencil beam from a polycapillary x-ray source, a reduction in signal integration time is achieved. It is presented that subtle amounts of contrast agents can be detected with L-shell XFCT within biologically relevant time frames. Our basic measurements show that the polycapillary x-ray source technology is appropriate to realize preclinical L-shell XFCT imaging. The integration of more SDDs into the system will lower the dose and increase the sensitivity.

PURPOSE The global noise (GN) algorithm has been previously introduced as a method for automatic noise measurement in clinical CT images. The accuracy of the GN algorithm has been assessed in abdomen CT examinations, but not in any other body part until now. This work assesses the GN algorithm accuracy in automatic noise measurement in head CT examinations. METHODS A publicly available image dataset of 99 head CT examinations was used to evaluate the accuracy of the GN algorithm in comparison to reference noise values. Reference noise values were acquired using a manual noise measurement procedure. The procedure used a consistent instruction protocol and multiple observers to mitigate the influence of intra- and interobserver variation, resulting in precise reference values. Optimal GN algorithm parameter values were determined. The GN algorithm accuracy and the corresponding statistical confidence interval were determined. The GN measurements were compared across the six different scan protocols used in this dataset. The correlation of GN to patient head size was also assessed using a linear regression model, and the CT scanner's X-ray beam quality was inferred from the model fit parameters. RESULTS Across all head CT examinations in the dataset, the range of reference noise was 2.9-10.2 HU. A precision of ±0.33 HU was achieved in the reference noise measurements. After optimization, the GN algorithm had a RMS error 0.34 HU corresponding to a percent RMS error of 6.6%. The GN algorithm had a bias of +3.9%. Statistically significant differences in GN were detected in 11 out of the 15 different pairs of scan protocols. The GN measurements were correlated with head size with a statistically significant regression slope parameter (p

The purpose of this study is to explore how Self-esteem and self-interest affect health and wellbeing. For this, we propose a theoretical framework contending that self-esteem increase happiness and then job satisfaction. And this will affect wellbeing and health. Wellbeing is measured by Psychological, Social, Subjective, and Workplace Wellbeing. We also propose a moderating role of self-efficacy in the effect of self-esteem on its outcomes, in a way that higher self-efficacy would increase the effect of self-esteem on happiness, job satisfaction, health, and wellbeing. The data sample of 400 employees was collected through a survey questionnaire, on the Likert scale. Data was analyzed SEM-PLS along with 5 direct relations and 3 moderating relations. Factor analysis confirmed the relative independence of the eight JSS subscales. Any expenses will be divided equally between supervision and payment. Although the three scales have reasonable internal consistency, conditional rewards seem to make use of the other two scales. The evaluation and approval of employees may be regarded as aspects of supervision, while generally conditional services are regarded as money.

Purpose 4D cone-beam CT (CBCT) has potential applications in soft tissue alignment and tumor motion verification at the time of radiation treatment. However, prominent streak artifacts with conventional image reconstructions have limited its clinical use and alternative reconstructions are generally too computationally expensive for the time available. We propose an iterative volume of interest based (I4D VOI) reconstruction technique, where 4D reconstruction is only performed within a VOI, to limit streak artifacts with limited added computation time. Methods The I4D VOI technique is compared to standard cone-beam filtered back projection (FDK), an FDK VOI technique, and unconstrained total variation (TV) minimization by comparing tumor motion quantification errors and image quality. 14 long CBCT scans (6.5 to 12 minutes) of patients receiving radiation treatment for lung cancer were used for the comparison. Rigid registration between phase images of FDK reconstructions using all projections were used to quantify the gold standard motion. Projections were removed to simulate 2 minute scans and these new projection sets were used for each of the test reconstructions. Results Excluding 2 patients where registration failed, the average root mean square (RMS) error for each method was as follows: 1.5 ± 0.2 mm for FDK, 1.4 ± 0.2 mm for FDK VOI, 1.3 ± 0.2 mm for I4D VOI, 1.7 ± 0.4 mm for low regularization TV minimization, and 1.1 ± 0.2 mm for high regularization TV minimization. No significant difference was observed between RMS error for I4D VOI and the other methods, except for unsmoothed FDK VOI (p=0.02). An increase in RMS error difference between I4D VOI and smoothed FDK VOI was observed going from 2 minute to 1 minute scans (0.1 mm to 0.3 mm, p=0.20 to p=0.09). Conclusions I4D VOI and FDK VOI reconstruction measured tumor trajectories with equivalent accuracy as TV minimization with improved bony anatomy image quality and computation time (I4D VOI was approximately 15 and 95 times faster than low and high regularization TV minimization, respectively). Within the VOI, streak artifact reduction compared to FDK VOI may be beneficial for tumor visualization and motion measurement, but requires further study. This article is protected by copyright. All rights reserved.

Purpose To review available evidence for use of cone-beam CT during transcatheter arterial chemoembolization in hepatocellular carcinoma (HCC) for detection of tumor and feeding arteries. Materials and Methods Literature searches were conducted from inception to May 15, 2016, in PubMed (MEDLINE), Scopus, and Cochrane Central Register of Controlled Trials. Searches included "cone beam," "CBCT," "C-arm," "CACT," "cone-beam CT," "volumetric CT," "volume computed tomography," "volume CT," AND "liver," "hepatic*," "hepatoc*." Studies that involved adults with HCC specifically and treated with transcatheter arterial chemoembolization that used cone-beam CT were included. Results Inclusion criteria were met by 18 studies. Pooled sensitivity of cone-beam CT for detecting tumor was 90% (95% confidence interval [CI], 82%–95%), whereas pooled sensitivity of digital subtraction angiography (DSA) for tumor detection was 67% (95% CI, 51%–80%). Pooled sensitivity of cone-beam CT for detecting tumor feeding arteries was 93% (95% CI, 91%–95%), whereas pooled sensitivity of DSA was 55% (95% CI, 36%–74%). Conclusions Cone-beam CT can significantly increase detection of tumors and tumor feeding arteries during transcatheter arterial chemoembolization. Cone-beam CT should be considered as an adjunct tool to DSA during transcatheter arterial chemoembolization treatments of HCC.

Purpose To identify computational and qualitative features derived from dual-phase cone-beam CT that predict short-term response in patients undergoing transarterial chemoembolization for hepatocellular carcinoma (HCC). Materials and Methods This retrospective study included 43 patients with 59 HCCs. Six features were extracted, including intensity of tumor enhancement on both phases and characteristics of the corona on the washout phase. Short-term response was evaluated by modified Response Evaluation Criteria in Solid Tumors on follow-up imaging, and extracted features were correlated to response using univariate and multivariate analyses. Results Univariate and multivariate analyses did not reveal a correlation between absolute and relative tumor enhancement characteristics on either phase with response (arterial P = .21; washout P = .40; ∆ P = .90). On multivariate analysis of qualitative characteristics, the presence of a diffuse corona was an independent predictor of incomplete response ( P = .038) and decreased the odds ratio of objective response by half regardless of tumor size. Conclusions Computational features extracted from contrast-enhanced dual-phase cone-beam CT are not prognostic of response to transarterial chemoembolization in patients with HCC. HCCs that demonstrate a diffuse, patchy corona have reduced odds of achieving complete response after transarterial chemoembolization and should be considered for additional treatment with an alternative modality.

X-ray fluorescence imaging is a promising imaging technique able to depict the spatial distributions of low amounts of molecular agents in vivo. Currently, the translation of the technique to preclinical and clinical applications is hindered by long scanning times as objects are scanned with flux-limited narrow pencil beams. The study presents a novel imaging approach combining x-ray fluorescence imaging with Compton imaging. Compton cameras leverage the imaging performance of XFCT and abolish the need for pencil beam excitation. The study examines the potential of this new imaging approach on the base of Monte-Carlo simulations. In the work, it is first presented that the particular option of slice/fan-beam x-ray excitation has advantages in image reconstruction in regard of processing time and image quality compared to traditional volumetric Compton imaging. In a second experiment, the feasibility of the approach for clinical applications with tracer agents made from gold nano-particles is examined in a simulated lung scan scenario. The high energy of characteristic x-ray photons from gold is advantageous for deep tissue penetration and has lower angular blurring in the Compton camera. It is found that Doppler broadening in the first detector stage of the Compton camera adds the largest contribution on the angular blurring; physically limiting the spatial resolution. Following the analysis of the results from the spatial resolution test, resolutions in the order of one centimeter are achievable with the approach in the center of the lung. The concept of Compton imaging allows one to distinguish to some extent between scattered photons and x-ray fluorescent photons based on their difference in emission position. The results predict that molecular sensitivities down to 240 pM l-1 for 5 mm diameter lesions at 15 mGy for 50 nm diameter gold nano-particles are achievable. A 45-fold speed up time for data acquisition compared to traditional pencil beam XFCT could be achieved for lung imaging at the cost of a small sensitivity decrease.

Purpose In the last years, dual-energy CT imaging has shown clinical value, thanks to its ability to differentiate materials based on their atomic number and to exploit different properties of images acquired at two different energies. C-arm CT systems are used to guide procedures in the interventional suite. Until now, there are no commercially available systems that employ dual-energy material decomposition. This paper explores the feasibility of implementing a fast kV-switching technique on a clinically available angiographic system for acquiring dual-energy C-arm CT images. Methods As an initial proof of concept, a fast kV-switching approach was implemented on an angiographic C-arm system and the peak tube voltage during 3D rotational scans was measured. The tube voltage measurements during fast kV-switching scans were compared to corresponding measurements on kV-constant scans. Additionally, to prove stability of the requested exposure parameters, the accuracy of the delivered tube current and pulse width were also recorded and compared. In a first phantom experiment, the voxel intensity values of the individual tube voltage components of the fast kV-switching scans were compared to their corresponding kV-constant scans. The same phantom was used for a simple material decomposition between different iodine concentrations and pure water using a fast kV-switching protocol of 81 and 125 kV. In the last experiment, the same kV-switching protocol as in the phantom scan was used in an in vivo pig study to demonstrate the clinical feasibility. Results During rapid kV-switching acquisitions, the measured tube voltage of the x-ray tube during fast switching scans has an absolute deviation of 0.23 ± 0.13 kV compared to the measured tube voltage produced during kV-constant acquisitions. The stability of the peak tube voltage over different scan requests was about 0.10 kV for the low and 0.46 for the high energy kV-switching scans and less than 0.1 kV for kV-constant scans, indicating slightly lower stability for kV-switching scans. The tube current resulted in a relative deviation of −1.6% for the low and 6.6% overestimation for the high tube voltage of the kV-switching scans compared to the kV-constant scans. The pulse width showed no deviation for the longer pulse width and only minor deviations (0.02 ± 0.02 ms) for the shorter pulse widths compared to the kV-constant scans. The phantom experiment using different iodine concentrations showed an accurate correlation (R2 > 0.99) between the extracted intensity values in the kV-switching and kV-constant reconstructed volumes, and allows for an automatic differentiation between contrast concentration down to 10% (350 mg/ml iodine) and pure water under low-noise conditions. Preliminary results of iodine and soft tissue separation showed also promising results in the first in vivo pig study. Conclusions The feasibility of dual-energy imaging using a fast kV-switching method on an angiographic C-arm CT system was investigated. Direct measurements of beam quality in the x-ray field demonstrate the stability of the kV-switching method. Phantom and in vivo experiments showed that images did not deviate from those of corresponding kV-constant scans. All performed experiments confirmed the capability of performing fast kV-switching scans on a clinically available C-arm CT system. More complex material decomposition tasks and postprocessing steps will be part of future investigations.

Purpose: Range verification in proton therapy using the proton-acoustic signal induced in the Bragg peak was investigated for typical clinical scenarios. The signal generation and detection processes were simulated in order to determine the signal-to-noise limits. Methods: An analytical model was used to calculate the dose distribution and local pressure rise (per proton) for beams of different energy (100 and 160 MeV) and spot widths (1, 5, and 10 mm) in a water phantom. In this method, the acoustic waves propagating from the Bragg peak were generated by the general 3D pressure wave equation implemented using a finite element method. Various beam pulse widths (0.1–10 μs) were simulated by convolving the acoustic waves with Gaussian kernels. A realistic PZT ultrasound transducer (5 cm diameter) was simulated with a Butterworth bandpass filter with consideration of random noise based on a model of thermal noise in the transducer. The signal-to-noise ratio on a per-proton basis was calculated, determining the minimum number of protons required to generate a detectable pulse. The maximum spatial resolution of the proton-acoustic imaging modality was also estimated from the signal spectrum. Results: The calculated noise in the transducer was 12–28 mPa, depending on the transducer central frequency (70–380more » kHz). The minimum number of protons detectable by the technique was on the order of 3–30 × 10{sup 6} per pulse, with 30–800 mGy dose per pulse at the Bragg peak. Wider pulses produced signal with lower acoustic frequencies, with 10 μs pulses producing signals with frequency less than 100 kHz. Conclusions: The proton-acoustic process was simulated using a realistic model and the minimal detection limit was established for proton-acoustic range validation. These limits correspond to a best case scenario with a single large detector with no losses and detector thermal noise as the sensitivity limiting factor. Our study indicated practical proton-acoustic range verification may be feasible with approximately 5 × 10{sup 6} protons/pulse and beam current.« less

Purpose: To compare the choice and placement of virtual dental implants in the posterior edentulous bounded regions using the full cross-sectional and transaxial capabilities of cone beam computed tomography (CBCT) vs reformatted panoramic images and three-dimensional (3D) virtual models. Materials and Methods: Fifty-two cases with posterior bounded edentulous regions (61 dental implant sites) were identified from a retrospective audit of 4,014 radiographic volumes. Two image sets were created from selected CBCT data: (1) a combination of reformatted panoramic imaging and a 3D model (PIref/3D), and (2) the full 3D power in CBCT image volume analyses (XS). One virtual implant was placed by consensus of three prosthodontists in each image set: PIref/3D and XS. The choice of implant length and the perceived need for ridge augmentation were recorded for implant placement in both test situations. All the virtual implant placements from both PIref/3D and XS image sets were inspected retrospectively using virtual 3D models, and the number of exposed threads on both the buccal and lingual/palatal aspects of the virtual dental implant was evaluated. The chi-square and paired t tests were used with the level of significance set at  = .05. Results: Shorter implants were chosen more often using XS than PIref/3D (P = .001). Fewer threads were exposed when placed with XS than with PIref/3D (P = .001). The use of XS reduced the perceived need for ridge augmentation compared with PIref/3D (P = .001). Conclusion: The use of the full 3D power of CBCT (including cross-sectional images in all three orthagonal planes and transaxially) provides supplemental information that significantly changes the choice of virtual implant length and vertical position of the implant, and reduces the frequency of perceived need for ridge augmentation before implant placement.

The laser wakefield-driven plasma wave in a low-density plasma is seen to be susceptible to the oscillating two-stream instability (OTSI). The plasma wave couples to two short wavelength plasma wave sidebands. The pump plasma wave and sidebands exert a ponderomotive force on the electrons driving a low-frequency quasimode. The electron density perturbation associated with this mode couples with the pump-driven electron oscillatory velocity to produce nonlinear currents driving the sidebands. At large pump amplitude, the instability grows faster than the ion plasma frequency and ions do not play a significant role. The growth rate of the quasimode, at large pump amplitude scales faster than linear. The growth rate is maximum for an optimum wave number of the quasimode and also increases with pump amplitude. Nonlocal effects, however reduce the growth rate by about half.

Purpose: To demonstrate the feasibility of proton-induced x-ray fluorescence CT (pXFCT) imaging of gold in a small animal sized object by means of experiments and Monte Carlo (MC) simulations. Methods: First, proton-induced gold x-ray fluorescence (pXRF) was measured as a function of gold concentration. Vials of 2.2 cm in diameter filled with 0%–5% Au solutions were irradiated with a 220 MeV proton beam and x-ray fluorescence induced by the interaction of protons, and Au was detected with a 3 × 3 mm2 CdTe detector placed at 90° with respect to the incident proton beam at a distance of 45 cm from the vials. Second, a 7-cm diameter water phantom containing three 2.2-diameter vials with 3%–5% Au solutions was imaged with a 7-mm FWHM 220 MeV proton beam in a first generation CT scanning geometry. X-rays scattered perpendicular to the incident proton beam were acquired with the CdTe detector placed at 45 cm from the phantom positioned on a translation/rotation stage. Twenty one translational steps spaced by 3 mm at each of 36 projection angles spaced by 10° were acquired, and pXFCT images of the phantom were reconstructed with filtered back projection. A simplified geometry of the experimental data acquisition setup was modeled with the MC TOPAS code, and simulation results were compared to the experimental data. Results: A linear relationship between gold pXRF and gold concentration was observed in both experimental and MC simulation data (R 2 > 0.99). All Au vials were apparent in the experimental and simulated pXFCT images. Specifically, the 3% Au vial was detectable in the experimental [contrast-to-noise ratio (CNR) = 5.8] and simulated (CNR = 11.5) pXFCT image. Due to fluorescence x-ray attenuation in the higher concentration vials, the 4% and 5% Au contrast were underestimated by 10% and 15%, respectively, in both the experimental and simulated pXFCT images. Conclusions: Proton-induced x-ray fluorescence CT imaging of 3%–5% gold solutions in a small animal sized water phantom has been demonstrated for the first time by means of experiments and MC simulations.

Purpose: 4D CT imaging in mice is important in a variety of areas including studies of lung function and tumor motion. A necessary step in 4D imaging is obtaining a respiratory signal, which can be done through an external system or intrinsically through the projection images. A number of methods have been developed that can successfully determine the respiratory signal from cone-beam projection images of humans, however only a few have been utilized in a preclinical setting and most of these rely on step-and-shoot style imaging. The purpose of this work is to assess and make adaptions of several successful methods developed for humans for an image-guided preclinical radiation therapy system. Methods: Respiratory signals were determined from the projection images of free-breathing mice scanned on the X-RAD system using four methods: the so-called Amsterdam shroud method, a method based on the phase of the Fourier transform, a pixel intensity method, and a center of mass method. The Amsterdam shroud method was modified so the sharp inspiration peaks associated with anesthetized mouse breathing could be detected. Respiratory signals were used to sort projections into phase bins and 4D images were reconstructed. Error and standard deviation in the assignment of phase bins for the four methods compared to a manual method considered to be ground truth were calculated for a range of region of interest (ROI) sizes. Qualitative comparisons were additionally made between the 4D images obtained using each of the methods and the manual method. Results: 4D images were successfully created for all mice with each of the respiratory signal extraction methods. Only minimal qualitative differences were noted between each of the methods and the manual method. The average error (and standard deviation) in phase bin assignment was 0.24 ± 0.08 (0.49 ± 0.11) phase bins for the Fourier transform method, 0.09 ± 0.03 (0.31 ± 0.08) phase bins for the modified Amsterdam shroud method, 0.09 ± 0.02 (0.33 ± 0.07) phase bins for the intensity method, and 0.37 ± 0.10 (0.57 ± 0.08) phase bins for the center of mass method. Little dependence on ROI size was noted for the modified Amsterdam shroud and intensity methods while the Fourier transform and center of mass methods showed a noticeable dependence on the ROI size. Conclusions: The modified Amsterdam shroud, Fourier transform, and intensity respiratory signal methods are sufficiently accurate to be used for 4D imaging on the X-RAD system and show improvement over the existing center of mass method. The intensity and modified Amsterdam shroud methods are recommended due to their high accuracy and low dependence on ROI size.

Using the Urey–Bradley force field and Wilson's GF matrix method as modified by Higgs, normal modes of vibration and their dispersions in poly(3-methylthiophene) have been obtained. They provide a detailed interpretation of its I.R. and Raman spectra. Characteristic features of the dispersion curves, such as regions of high density-of-states, repulsion, and character mixing of dispersive modes, are discussed. Predictive values of the heat capacity as a function of temperature have been calculated.

We have designed two metal–organic frameworks (MOFs) to efficiently convert X-ray to visible-light luminescence. The MOFs are constructed from M6(μ3-O)4(μ3-OH)4(carboxylate)12 (M = Hf or Zr) secondary building units (SBUs) and anthracene-based dicarboxylate bridging ligands. The high atomic number of Zr and Hf in the SBUs serves as effective X-ray antenna by absorbing X-ray photons and converting them to fast electrons through the photoelectric effect. The generated electrons then excite multiple anthracene-based emitters in the MOF through inelastic scattering, leading to efficient generation of detectable photons in the visible spectrum. The MOF materials thus serve as efficient X-ray scintillators via synergistic X-ray absorption by the metal-cluster SBUs and optical emission by the bridging ligands.

To study the effect of short term (2 wk) zinc supplementation on hemoglobin and iron status of children with acute diarrhea. This study was a prospective, open label, single arm interventional trial conducted from June 2008 through October 2009 in a teaching hospital of North India. Three to sixty months old children presenting with acute diarrhea participated in the study. Subjects were supplemented with recommended doses of oral zinc gluconate for 2 wk. Changes in levels of hemoglobin, serum iron, total iron binding capacity, and serum ferritin were the main outcome measures. Sixty-two patients completed the study successfully. The prevalence of anemia before and after 2 wk of zinc supplementation remained unchanged. However, a small decline (p > 0.05) was observed in mean hemoglobin (from 8.95 ± 1.4 to 8.73 ± 1.43 g/dL), serum iron (79.56 ± 45.81 to 78.61 ± 44.41 μg/dL) and ferritin (84.77 ± 45.35 to 83.55 ± 44.10 ng/mL) levels. Total iron binding capacity increased from 331.60 ± 109.72 to 341.30 ± 119.90 μg/dL post supplementation (p > 0.05). Even though statistically insignificant, the small change observed in the levels of hemoglobin, and indicators of iron status following short term zinc supplementation might assume significance in some settings in developing countries where children receive short courses of zinc repeatedly for frequent diarrheal episodes.

Substantial disagreement exists over appropriate PET segmentation techniques for non‐small cell lung cancer. Currently, no segmentation algorithm explicitly considers tumor motion in determining tumor borders. We developed an automatic PET segmentation model as a function of target volume, motion extent, and source‐to‐background ratio (the VMSBR model). The purpose of this work was to apply the VMSBR model and six other segmentation algorithms to a sample of lung tumors. PET and 4D CT were performed in the same imaging session for 23 patients (24 tumors) for radiation therapy planning. Internal target volumes (ITVs) were autosegmented on maximum intensity projection (MIP) of cine CT. ITVs were delineated on PET using the following methods: 15%, 35%, and 42% of maximum activity concentration, standardized uptake value (SUV) of 2.5 g/mL, 15% of mean activity concentration plus background, a linear function of mean SUV, and the VMSBR model. Predicted threshold values from each method were compared to measured optimal threshold values, and resulting volume magnitudes were compared to cine‐CT‐derived ITV Correlation between predicted and measured threshold values ranged from slopes of 0.29 for the simplest single‐threshold techniques to 0.90 for the VMSBR technique. R2 values ranged from 0.07 for the simplest single‐threshold techniques to 0.86 for the VMSBR technique. The VMSBR segmentation technique that included volume, motion, and source‐to‐background ratio, produced accurate ITVs in patients when compared with cine‐CT‐derived ITV. PACS number: 87.57.nm

Landmark point-pairs provide a strategy to assess deformable image registration (DIR) accuracy in terms of the spatial registration of the underlying anatomy depicted in medical images. In this study, we propose to augment a publicly available database (www.dir-lab.com) of medical images with large sets of manually identified anatomic feature pairs between breath-hold computed tomography (BH-CT) images for DIR spatial accuracy evaluation. Ten BH-CT image pairs were randomly selected from the COPDgene study cases. Each patient had received CT imaging of the entire thorax in the supine position at one-fourth dose normal expiration and maximum effort full dose inspiration. Using dedicated in-house software, an imaging expert manually identified large sets of anatomic feature pairs between images. Estimates of inter- and intra-observer spatial variation in feature localization were determined by repeat measurements of multiple observers over subsets of randomly selected features. 7298 anatomic landmark features were manually paired between the 10 sets of images. Quantity of feature pairs per case ranged from 447 to 1172. Average 3D Euclidean landmark displacements varied substantially among cases, ranging from 12.29 (SD: 6.39) to 30.90 (SD: 14.05) mm. Repeat registration of uniformly sampled subsets of 150 landmarks for each case yielded estimates of observer localization error, which ranged in average from 0.58 (SD: 0.87) to 1.06 (SD: 2.38) mm for each case. The additions to the online web database (www.dir-lab.com) described in this work will broaden the applicability of the reference data, providing a freely available common dataset for targeted critical evaluation of DIR spatial accuracy performance in multiple clinical settings. Estimates of observer variance in feature localization suggest consistent spatial accuracy for all observers across both four-dimensional CT and COPDgene patient cohorts.

Patient respiratory signal associated with the cone beam CT (CBCT) projections is important for lung cancer radiotherapy. In contrast to monitoring an external surrogate of respiration, such signal can be extracted directly from the CBCT projections. In this paper, we propose a novel local principle component analysis (LPCA) method to extract the respiratory signal by distinguishing the respiration motion-induced content change from the gantry rotation-induced content change in the CBCT projections. The LPCA method is evaluated by comparing with three state-of-the-art projection-based methods, namely, the Amsterdam Shroud (AS) method, the intensity analysis (IA) method, and the Fourier-transform based phase analysis (FT-p) method. The clinical CBCT projection data of eight patients, acquired under various clinical scenarios, were used to investigate the performance of each method. We found that the proposed LPCA method has demonstrated the best overall performance for cases tested and thus is a promising technique for extracting respiratory signal. We also identified the applicability of each existing method., 21 pages, 11 figures, submitted to Phys. Med. Biol

Purpose This article presents the implementation and assessment of photon-counting dual-energy x-ray detector technology for angiographic C-arm systems in interventional radiology. Methods A photon-counting detector was successfully integrated into a clinical C-arm CT system. Detector performance was assessed using image uniformity metrics in both 2D projections and 3D cone-beam computed tomography (CBCT) images. Uniform exposure fields were acquired to analyze projection images and scans of a homogeneous cylinder phantom were taken to analyze 3D reconstructions. Image uniformity was assessed over a broad range of imaging parameters. Results Detector calibration greatly improved image uniformity, reducing image variation from 8.8% to 0.5% in an ideal scenario, but image uniformity degraded when imaging parameters varied strongly from values set at calibration: the tube voltage, low-high energy threshhold, and tube current had the greatest impact. Material discrimination and dynamic angiography capabilities were successfully demonstrated in separate phantom and in vivo experiments. Conclusion The uniformity results identified major factors degrading image quality. The quantitative results will guide selection of calibration points to mitigate the loss of uniformity. The unique combination of dual-energy and fluoroscopy imaging capabilities with a flat-panel photon-counting detector may enable new applications in interventional radiology.

X-ray fluorescence CT (XFCT) imaging is a promising molecular imaging modality with high spatial resolution and non-radioactive high atomic number tracers for medical imaging. While dozens of bench-top experiments proofed the concept of the approach, scalability for clinical systems with high molecular sensitivity at acceptable doses is not yet accomplished. This study compares a spectroscopic CdTe detector which was used for XFCT measurements beforehand to a CZT detector with scalable active area. The results show that the CZT detector is able to provide better image quality due to higher detection efficiency even with a significantly reduced energy resolution and absorbing enclosure.

XFCT is a promising new molecular imaging modality which is able to measure non-radioactive tracer molecules even in deep tissues. Unrestricted spatial resolution imaging with pencil beam x-ray excitation is possible but cannot be translated easily to clinical applications as scanning times are at least several hours. The spatial information accessed with Compton cameras (CCs) overcomes this drawback as fan or cone-beams can boost the measurement process. The spatial resolution and sensitivity performance of this new approach are studied on the basis of Monte-Carlo simulations. The results show that molecular sensitivities of 560 pM l−1 are accessible at 30 mGy for the demonstrated lung scan scenario and FWHM below 6 mm for lesion diameters of 1 mm. The scanning time was reduced by a factor of 45 for the given example.

Introduction: Conflicting reports are available on the relationship of Iron Deficiency Anaemia (IDA) and iron therapy with oxidative stress. Aim: To study the levels of markers of oxidative stress and antioxidant status in children with IDA and to assess the effect of iron therapy on the same. Materials and Methods: This prospective, single centre, hospital based study was a sub-study of a randomized controlled trial conducted in the Department of Paediatrics, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh in collaboration with the Department of Biochemistry (of the same institution) between October 2009 to February 2011. The sub-study was conducted in two parts: in the first part, levels of a biomarker of oxidative stress {Malondialdehyde (MDA)} and anti-oxidant enzymes {Superoxide Dismutase (SOD), Catalase (CAT), Glutathione Peroxidase (GPx)} were assessed and compared between 67 children with IDA and 31 non-anaemic controls; in the second part, the effect of oral iron (6mg/kg/day) for eight weeks on these markers was studied in a subset of 35 children with IDA. The Bivariate correlations procedure was used to compute pair wise associations for a set of variables. T-tests (Independent samples t-test/Paired sample t-test) and Non-parametric tests (Mann–Whitney test/Wilcoxon signed-rank test) were applied as applicable for normally and non-normally distributed data, respectively. Results: Levels of anti-oxidant enzymes were significantly lower (p

Absorption based CT imaging has been an invaluable tool in medical diagnosis, biology and materials science. However, CT requires a large set of projection data and high radiation dose to achieve superior image quality. In this letter, we report a new imaging modality, X-ray Induced Acoustic Tomography (XACT), which takes advantages of high sensitivity to X-ray absorption and high ultrasonic resolution in a single modality. A single projection X-ray exposure is sufficient to generate acoustic signals in 3D space because the X-ray generated acoustic waves are of a spherical nature and propagate in all directions from their point of generation. We demonstrate the successful reconstruction of gold fiducial markers with a spatial resolution of about 350 μm. XACT reveals a new imaging mechanism and provides uncharted opportunities for structural determination with X-ray.

Purpose: Under-sampling artifacts are a major problem in four-dimensional cone-beam computed tomography (4D-CBCT) and may compromise evaluation of target motion. Several studies have addressed scan parameter selection for minimizing under-sampling artifacts; however, the role of the target characteristics in scan parameter selection has not been investigated. In this work, the authors evaluated 4D-CBCT performance by assessing the accuracy of target motion measurements for various target sizes and motions. The results may serve as patient-specific guidelines for scan parameters selection in 4D-CBCT. Methods: The authors acquired 4D-CBCT scans of a moving phantom consisting of six water-filled sphere targets of sizes 10–37 mm, using various scan times ranging from 30 s to 3 min., setting the motion to 3-s and 6-s periods. The authors used automatic image registration to extract the target motion trajectories and evaluated these measurements for various target sizes and motions over various combinations of scan parameters including scan time, detector configuration, number of respiration phases, and reconstruction filters. Results: The most important object parameter to 4D-CBCT performance was the period of motion. Measurements for the 6-s motion were always systematically less accurate than measurements for the 3-s motion for 34 of 36 objects of various sizes and periods of motion. The 6-s motion required a greater scan time than the 3-s motion for equivalent measurement accuracy. The second most influential parameter was the target size. For the 3-s period of motion, objects larger than 13 mm were tracked with sub-millimeter accuracy with a 1-min scan time. For the 6-s period of motion, objects larger than 22-mm were tracked with sub-millimeter accuracy with a 1.5-min scan time. For all sizes and motions, temporal blurring was observed when the number of phases was fewer than 8. Offset detector configuration provided the same performance as centered detector except for small targets (20 mm.) at short scan times (≤1 min). Finally, reconstruction filtering and number of respiratory phases did not affect performance. Conclusions: Scan time should be set according to target size and motion. The authors have provided figures that provide the minimum scan time needed to achieve the particular motion measurement accuracy for a particular size and motion period.

Purpose: Data sufficiency are a major problem in four-dimensional cone-beam computed tomography (4D-CBCT) on linear accelerator-integrated scanners for image-guided radiotherapy. Scan times must be in the range of 4-6 min to avoid undersampling artifacts. Various image reconstruction algorithms have been proposed to accommodate undersampled data acquisitions, but these algorithms are computationally expensive, may require long reconstruction times, and may require algorithm parameters to be optimized. The authors present a novel reconstruction method, 4D volume-of-interest (4D-VOI) reconstruction which suppresses undersampling artifacts and resolves lung tumor motion for undersampled 1-min scans. The 4D-VOI reconstruction is much less computationally expensive than other 4D-CBCT algorithms. Methods: The 4D-VOI method uses respiration-correlated projection data to reconstruct a four-dimensional (4D) image inside a VOI containing the moving tumor, and uncorrelated projection data to reconstruct a three-dimensional (3D) image outside the VOI. Anatomical motion is resolved inside the VOI and blurred outside the VOI. The authors acquired a 1-min. scan of an anthropomorphic chest phantom containing a moving water-filled sphere. The authors also used previously acquired 1-min scans for two lung cancer patients who had received CBCT-guided radiation therapy. The same raw data were used to test and compare the 4D-VOI reconstruction with the standard 4D reconstructionmore » and the McKinnon-Bates (MB) reconstruction algorithms. Results: Both the 4D-VOI and the MB reconstructions suppress nearly all the streak artifacts compared with the standard 4D reconstruction, but the 4D-VOI has 3-8 times greater contrast-to-noise ratio than the MB reconstruction. In the dynamic chest phantom study, the 4D-VOI and the standard 4D reconstructions both resolved a moving sphere with an 18 mm displacement. The 4D-VOI reconstruction shows a motion blur of only 3 mm, whereas the MB reconstruction shows a motion blur of 13 mm. With graphics processing unit hardware used to accelerate computations, the 4D-VOI reconstruction required a 40-s reconstruction time. Conclusions: 4D-VOI reconstruction effectively reduces undersampling artifacts and resolves lung tumor motion in 4D-CBCT. The 4D-VOI reconstruction is computationally inexpensive compared with more sophisticated iterative algorithms. Compared with these algorithms, our 4D-VOI reconstruction is an attractive alternative in 4D-CBCT for reconstructing target motion without generating numerous streak artifacts.« less

Dose calculation for thoracic radiotherapy is commonly performed on a free-breathing helical CT despite artifacts caused by respiratory motion. Four-dimensional computed tomography (4D-CT) is one method to incorporate motion information into the treatment planning process. Some centers now use the respiration-averaged CT (RACT), the pixel-by-pixel average of the ten phases of 4D-CT, for dose calculation. This method, while sparing the tedious task of 4D dose calculation, still requires 4D-CT technology. The authors have recently developed a means to reconstruct RACT directly from unsorted cine CT data from which 4D-CT is formed, bypassing the need for a respiratory surrogate. Using RACT from cine CT for dose calculation may be a means to incorporate motion information into dose calculation without performing 4D-CT. The purpose of this study was to determine if RACT from cine CT can be substituted for RACT from 4D-CT for the purposes of dose calculation, and if increasing the cine duration can decrease differences between the dose distributions. Cine CT data and corresponding 4D-CT simulations for 23 patients with at least two breathing cycles per cine duration were retrieved. RACT was generated four ways: First from ten phases of 4D-CT, second, from 1 breathing cycle of images, third, from 1.5 breathing cycles of images, and fourth, from 2 breathing cycles of images. The clinical treatment plan was transferred to each RACT and dose was recalculated. Dose planes were exported at orthogonal planes through the isocenter (coronal, sagittal, and transverse orientations). The resulting dose distributions were compared using the gamma (γ) index within the planning target volume (PTV). Failure criteria were set to 2%∕1mm. A follow-up study with 50 additional lung cancer patients was performed to increase sample size. The same dose recalculation and analysis was performed. In the primary patient group, 22 of 23 patients had 100% of points within the PTV pass γ criteria. The average maximum and mean γ indices were very low (well below 1), indicating good agreement between dose distributions. Increasing the cine duration generally increased the dose agreement. In the follow-up study, 49 of 50 patients had 100% of points within the PTV pass the γ criteria. The average maximum and mean γ indices were again well below 1, indicating good agreement. Dose calculation on RACT from cine CT is negligibly different from dose calculation on RACT from 4D-CT. Differences can be decreased further by increasing the cine duration of the cine CT scan.

v LIST OF TABLES viii LIST OF FIGURES x INTRODUCTION 1 The Need for Radiography Prior to Dental Implant Placement 3 Previous Research 3 Published Guidelines 4 Considerations for Optimal Placement of Dental Implants in the Edentulous Ridge...11 Summary 12 HYPOTHESIS 13 Objectives 13 Null Hypothesis 14 MATERIALS AND METHODS 15 Hypothesis 15

To demonstrate the feasibility of proton-induced x-ray fluorescence CT (pXFCT) imaging of gold in a small animal sized object by means of experiments and Monte Carlo (MC) simulations.First, proton-induced gold x-ray fluorescence (pXRF) was measured as a function of gold concentration. Vials of 2.2 cm in diameter filled with 0%-5% Au solutions were irradiated with a 220 MeV proton beam and x-ray fluorescence induced by the interaction of protons, and Au was detected with a 3 × 3 mm(2) CdTe detector placed at 90° with respect to the incident proton beam at a distance of 45 cm from the vials. Second, a 7-cm diameter water phantom containing three 2.2-diameter vials with 3%-5% Au solutions was imaged with a 7-mm FWHM 220 MeV proton beam in a first generation CT scanning geometry. X-rays scattered perpendicular to the incident proton beam were acquired with the CdTe detector placed at 45 cm from the phantom positioned on a translation/rotation stage. Twenty one translational steps spaced by 3 mm at each of 36 projection angles spaced by 10° were acquired, and pXFCT images of the phantom were reconstructed with filtered back projection. A simplified geometry of the experimental data acquisition setup was modeled with the MC TOPAS code, and simulation results were compared to the experimental data.A linear relationship between gold pXRF and gold concentration was observed in both experimental and MC simulation data (R(2)0.99). All Au vials were apparent in the experimental and simulated pXFCT images. Specifically, the 3% Au vial was detectable in the experimental [contrast-to-noise ratio (CNR) = 5.8] and simulated (CNR = 11.5) pXFCT image. Due to fluorescence x-ray attenuation in the higher concentration vials, the 4% and 5% Au contrast were underestimated by 10% and 15%, respectively, in both the experimental and simulated pXFCT images.Proton-induced x-ray fluorescence CT imaging of 3%-5% gold solutions in a small animal sized water phantom has been demonstrated for the first time by means of experiments and MC simulations.

Purpose: X-ray radiographic absorption imaging is an invaluable tool in medical diagnostics, biology and materials science. However, the use of conventional CT is limited by two factors: the detection sensitivity to weak absorption material and the radiation dose from CT scanning. The purpose of this study is to explore X-ray induced acoustic computed tomography (XACT), a new imaging modality, which combines X-ray absorption contrast and high ultrasonic resolution to address these challenges. Methods: First, theoretical models was built to analyze the XACT sensitivity to X-ray absorption and calculate the minimal radiation dose in XACT imaging. Then, an XACT system comprised of an ultrashort X-ray pulse, a low noise ultrasound detector and a signal acquisition system was built to evaluate the X-ray induced acoustic signal generation. A piece of chicken bone and a phantom with two golden fiducial markers were exposed to 270 kVp X-ray source with 60 ns exposure time, and the X-ray induced acoustic signal was received by a 2.25MHz ultrasound transducer in 200 positions. XACT images were reconstructed by a filtered back-projection algorithm. Results: The theoretical analysis shows that X-ray induced acoustic signals have 100% relative sensitivity to X-ray absorption, but not to X-ray scattering. Applying this innovative technology to breast imaging, we can reduce radiation dose by a factor of 50 compared with newly FDA approved breast CT. The reconstructed images of chicken bone and golden fiducial marker phantom reveal that the spatial resolution of the built XACT system is 350µm. Conclusion: In XACT, the imaging sensitivity to X-ray absorption is improved and the imaging dose is dramatically reduced by using ultrashort pulsed X-ray. Taking advantage of the high ultrasonic resolution, we can also perform 3D imaging with a single X-ray pulse. This new modality has the potential to revolutionize x-ray imaging applications in medicine and biology.

Purpose: To report our investigations of proton acoustic imaging, including computer simulations and preliminary experimental studies at clinical facilities. The ultimate achievable accuracy, sensitivity and clinical translation challenges are discussed. Methods: The acoustic pulse due to pressure rise was estimated using finite element model. Since the ionoacoustic pulse is highly dependent on the proton pulse width and energy, multiple pulse widths were studied. Based on the received signal spectrum at piezoelectric ultrasound transducer with consideration of random thermal noise, maximum spatial resolution of the proton-acoustic imaging modality was calculated. The simulation studies defined the design specifications of the system to detect proton acoustic signal from Hitachi and Mevion clinical machines. A 500 KHz hydrophone with 100 dB amplification was set up in a water tank placed in front of the proton nozzle A 40 MHz data acquisition was synchronized by a trigger signal provided by the machine. Results: Given 30–800 mGy dose per pulse at the Bragg peak, the minimum number of protons detectable by the proton acoustic technique was on the order of 10×10^6 per pulse. The broader pulse widths produce signal with lower acoustic frequencies, with 10 µs pulses producing signals with frequency less than 100 kHz. As the proton beam pulse width increases, a higher dose rate is required to measure the acoustic signal. Conclusion: We have established the minimal detection limit for protonacoustic range validation for a variety of pulse parameters. Our study indicated practical proton-acoustic range verification can be feasible with a pulse shorter than 10 µs, 5×10^6 protons/pulse, 50 nA beam current and a highly sensitive ultrasonic transducer. The translational challenges into current clinical machines include proper magnetic shielding of the measurement equipment, providing a clean trigger signal from the proton machine, providing a shorter proton beam pulse and higher dose per pulse.

In this work, we demonstrated that an optimized detector angular configuration based on the anisotropic energy distribution of background scattered X-rays improves X-ray fluorescence computed tomography (XFCT) detection sensitivity. We built an XFCT imaging system composed of a bench-top fluoroscopy X-ray source, a CdTe X-ray detector, and a phantom motion stage. We imaged a 6.4-cm-diameter phantom containing different concentrations of gold solution and investigated the effect of detector angular configuration on XFCT image quality. Based on our previous theoretical study, three detector angles were considered. The X-ray fluorescence detector was first placed at 145 $^{\circ}$ (approximating back-scatter) to minimize scatter X-rays. XFCT image quality was compared to images acquired with the detector at 60 $^{\circ}$ (forward-scatter) and 90 $^{\circ}$ (side-scatter). The datasets for the three different detector positions were also combined to approximate an isotropically arranged detector. The sensitivity was optimized with detector in the 145 $^{\circ}$ back-scatter configuration counting the 78-keV gold ${\rm K}\beta 1$ X-rays. The improvement arose from the reduced energy of scattered X-ray at the 145 $^{\circ}$ position and the large energy separation from gold ${\rm K} \beta 1$ X-rays. The lowest detected concentration in this configuration was 2.5 mgAu/mL (or 0.25% Au with SNR $ = 4.3$ ). This concentration could not be detected with the 60 $^{\circ}$ , 90 $^{\circ}$ , or isotropic configurations (SNRs $ = 1.3$ , 0, 2.3, respectively). XFCT imaging dose of 14 mGy was in the range of typical clinical X-ray CT imaging doses. To our knowledge, the sensitivity achieved in this experiment is the highest in any XFCT experiment using an ordinary bench-top X-ray source in a phantom larger than a mouse ( ${>} 3$ cm).

Here, we demonstrate that biomolecule-directed metal clusters are applicable in the study of hard X-ray excited optical luminescence, promising a new direction in the development of novel X-ray-activated imaging probes.

Purpose: To experimentally demonstrate the feasibility of L-shell x-ray fluorescence CT (XFCT) imaging of gold contrast. Methods: We have built an experimental L-shell XFCT imaging system consisting of two photon-counting detectors, a silicon drift detector (SDD) and a CdTe detector, a miniature x-ray tube, and a programmable translation/rotation stage. A 2.8-mm diameter water phantom containing 4-mm vials with gold solutions of 0.06%, 0.08%, and 0.1% Au located at 4mm depth was constructed. The phantom was imaged with the L-shell XFCT system in 1st generation CT geometry with a 1-mm 50-kV x-ray beam. XFCT data was acquired with both detectors placed at ±120° with respect to the excitation beam at 30 translation and 36 rotation steps. L-shell XFCT images were reconstructed with maximum-likelihood expectation-maximization using gold Lα and Lβ fluorescence x-rays for both detectors. Results: SDD L- shell x-ray fluorescence (XRF) signal was approximately 13 times higher than CdTe XRF signal due to the higher measured SDD energy resolution of 220eV @ 14keV compared to the CdTe energy resolution of 660eV. While all 0.06–0.1% Au vials were detectable in the SDD L-shell XFCT image, none of the vials were visible in the CdTe L-shell XFCT image. The contrast-to-noise ratio of the 0.1% Au vial was 87.1 and 3.2 in the SDD and CdTe L-shell XFCT images, respectively. SDD L-shell XFCT signal was linear with Au concentration (R2>0.99). The detectability limits of the presented L-shell XFCT imaging setup were 0.007% and 0.126% Au for L-shell XFCT imaging performed with the SDD and CdTe detector, respectively. Conclusion: We have demonstrated the feasibility of L- shell XFCT imaging of gold located at shallow depths inside a small animal sized phantom. The very high sensitivity of L-shell XFCT, permitting detection of Au concentrations as low as 0.06%, has not previously been achieved experimentally using conventional K-shell XFCT.

Cell-tracking method has an important role in detection of metastatic circulating tumor cells (CTCs) and cell-based therapies. Label-free imaging techniques are desirable for cell-tracking because they enable long time observations without photobleaching in living cells or tissues where labeling is not always possible. Photoacoustic microscopy is a label-free imaging technique that offers rich contrast based on nonfluorescent cellular optical absorption associated with intrinsic chromophores and pigments. We show here that photoacoustic imaging is feasible for detecting very low numbers (x 104) of melanoma cells without labeling because of the strong instinct optical absorption of melanin in near-infrared wavelength. Flowing melanoma cells are imaged with micrometerresolution (40 μm) and penetration depths of centimeters (13 mm) in real-time. Photoacoustic imaging as a new cell-tracking method provides a novel modality for cancer screening and offers insights into the underlying biological process of cancer growth and metastasis and cell therapy.

X-ray fluorescence computed tomography (XFCT) imaging has been focused on the detection of K-shell X-rays. The potential utility of L-shell x-ray XFCT is, however, not well studied. Here we report the first Monte Carlo (MC) simulation of preclinical L-shell XFCT imaging of Cisplatin. We built MC models for both L- and K-shell XFCT with different excitation energies (15 and 30 keV for L-shell and 80 keV for K-shell XFCT). Two small-animal sized imaging phantoms of 2-cm and 4-cm diameter containing a series of objects of 0.6 to 2.7 mm in diameter at 0.7 to 16 mm depths with 10 to 250 μg/mL concentrations of Pt are used in the study. Transmitted and scattered x-rays were collected with photon-integrating transmission detector and photon-counting detector arc, respectively. Collected data were rearranged into XFCT and transmission CT sinograms for image reconstruction. XFCT images were reconstructed with filtered back-projection (FBP) and with iterative maximum-likelihood expectation maximization (ML-EM) without and with attenuation correction. While K-shell XFCT was capable of providing accurate measurement of Cisplatin concentration, its sensitivity was 4.4 and 3.0 times lower than that of L-shell XFCT with 15 keV excitation beam for the 2-cm and 4-cm diameter phantom, respectively. With inclusion of excitation and fluorescence beam attenuation correction, we found that L-shell XFCT was capable of providing fairly accurate information of Cisplatin concentration distribution. With a dose of 29 and 58 mGy, clinically relevant Cisplatin Pt concentrations of 10 μg/mg could be imaged with L-shell XFCT inside a 2-cm and 4-cm diameter object, respectively.

Purpose: 4D CBCT can allow evaluation of tumor motion immediately prior to radiation therapy, but suffers from heavy artifacts that limit its ability to track tumors. Various iterative and compressed sensing reconstructions have been proposed to reduce these artifacts, but are costly time-wise and can degrade the image quality of bony anatomy for alignment with regularization. We have previously proposed an iterative volume of interest (I4D VOI) method which minimizes reconstruction time and maintains image quality of bony anatomy by focusing a 4D reconstruction within a VOI. The purpose of this study is to test the tumor tracking accuracy of this method compared to existing methods. Methods: Long scan (8–10 mins) CBCT data with corresponding RPM data was collected for 12 lung cancer patients. The full data set was sorted into 8 phases and reconstructed using FDK cone beam reconstruction to serve as a gold standard. The data was reduced in way that maintains a normal breathing pattern and used to reconstruct 4D images using FDK, low and high regularization TV minimization (λ=2,10), and the proposed I4D VOI method with PTVs used for the VOI. Tumor trajectories were found using rigid registration within the VOI for each reconstruction and compared to the gold standard. Results: The root mean square error (RMSE) values were 2.70mm for FDK, 2.50mm for low regularization TV, 1.48mm for high regularization TV, and 2.34mm for I4D VOI. Streak artifacts in I4D VOI were reduced compared to FDK and images were less blurred than TV reconstructed images. Conclusion: I4D VOI performed at least as well as existing methods in tumor tracking, with the exception of high regularization TV minimization. These results along with the reconstruction time and outside VOI image quality advantages suggest I4D VOI to be an improvement over existing methods. Funding support provided by CPRIT grant RP110562-P2-01