Special issue on medical imaging

The purpose of this article is to study the added value of model-based iterative reconstruction (MBIR) on metal artifact reduction on CT compared with standard filtered back projection (FBP). Ex vivo imaging was performed on several metal implants. Datasets were reconstructed with standard FBP and MBIR algorithms. The sizes of the artifacts surrounding the metal implant were recorded and compared. In vivo imaging was performed on 62 patients with metal implants. Each dataset was reconstructed with FBP and MBIR algorithms. Objective image quality was assessed by measuring the size of the artifact generated by the metal implant. Subjective image quality was graded on a 3-point scale, taking into account the visibility of the bone-metal interface, as well as the visibility of the neighboring soft tissues. Ex vivo analysis yielded a reduction of 82% in the size of the artifact when using the MBIR algorithm, compared with the FBP algorithm. The mean (SD) size of the artifacts was 1.4 ± 0.8 and 0.25 ± 0.06 cm(2) with FBP and MBIR, respectively. In vivo, the mean size of the artifacts decreased from 7.3 ± 1.5 cm(2) to 4.0 ± 0.9 cm(2) for FBP and MBIR, respectively (p = 0.012). The subjective image quality analysis showed an equal or better bone-metal interface of MBIR algorithm in 85% of cases. Visibility of the soft tissue surrounding the metal implant was determined to be equal or better in 97% of cases in which MBIR was used. This study shows that the MBIR algorithm allows a clear reduction of metal artifacts on CT images and, hence, a better analysis of the soft tissue surrounding the metal implant compared with FBP.

Filtered back-projection (FBP) is the most commonly used reconstruction method for PET images, which are usually noisy. The iterative reconstruction segmented attenuation correction (IRSAC) algorithm improves image quality without reducing image resolution. The standardized uptake value (SUV) is the most clinically utilized quantitative parameter of [fluorine-18]fluoro-2-deoxy-D-glucose (FDG) accumulation. The objective of this study was to obtain a table of SUVs for several normal anatomical structures from both routinely used FBP and IRSAC reconstructed images and to compare the data obtained with both methods. Twenty whole-body PET scans performed in consecutive patients with proven or suspected non-small cell lung cancer were retrospectively analyzed. Images were processed using both IRSAC and FBP algorithms. Nonquantitative or gaussian filters were used to smooth the transmission scan when using FBP or IRSAC algorithms, respectively. A phantom study was performed to evaluate the effect of different filters on SUV. Maximum and average SUVs (SUVmax and SUVavg) were calculated in 28 normal anatomical structures and in one pathological site. The phantom study showed that the use of a nonquantitative smoothing filter in the transmission scan results in a less accurate quantification and in a 20% underestimation of the actual measurement. Most anatomical structures were identified in all patients using the IRSAC images. On average, SUVavg and SUVmax measured on IRSAC images using a gaussian filter in the transmission scan were respectively 20% and 8% higher than the SUVs calculated from conventional FBP images. Scatterplots of the data values showed an overall strong relationship between IRSAC and FBP SUVs. Individual scatterplots of each site demonstrated a weaker relationship for lower SUVs and for SUVmax than for higher SUVs and SUVavg. A set of reference values was obtained for SUVmax and SUVavg of normal anatomical structures, calculated with both IRSAC and FBP image reconstruction algorithms. The use of IRSAC and a gaussian filter for the transmission scan seems to give more accurate SUVs than are obtained from conventional FBP images using a nonquantitative filter for the transmission scan.

The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today`s more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

The discovery of X-ray in 1895 initiated the era of medical imaging diagnostics. Since then, medical imaging systems have realized unprecedented advancements. These systems have also turned out to be invaluable tools in the practice of diagnostic medicine. However, despite the significant development in medical imaging technologies, processing medical images still pose a substantial challenge especially when it comes to image segmentation. That problem is gradually being alleviated by the implementation of digital medical image processing, especially in the diagnosis and treatment of brain tumors. But the capability of most of the contemporary image delineating algorithms remains limited. Therefore, there is a need to come up with the new medical image segmentation programs to fully utilize the power of digital image processing. In light that, this article reviews some of the contemporary algorithmic protocols for brain tumor delineation systems and how effective they are.

In this paper, we aim at a polychromatic physics model of dual-energy medical x-ray imaging and present a corresponding computation method, which includes two steps: first, bd(s, theta), i.e. the parameter used for expressing the component of Compton scatter, and bp(s, theta), i.e. the parameter used for expressing the component of Photoemission Effect, are decided by solving a nonlinear equation system; then a FBP ( Filtered Back Projection ) algorithm is used to reconstruct the decomposition images from the sinograms of bp(s, theta) and bp(s, theta). It is noticed that the first step is the most time-consuming, so it is very important to find out a high-speed and effective iteration computation method. In this paper, we propose a Newton iteration method with an effective estimation strategy of initial value for quickly solving the nonlinear equation system. A CT simulation experiment was implemented to validate the effectiveness of the whole procedure.

To evaluate the image quality and radiation dose reduction in pelvic computed tomography (CT) achieved with an adaptive iterative dose reduction 3-dimensional (AIDR 3D) algorithm using a phantom model. Two phantoms were scanned using a 320-detector row CT scanner with 8 tube current levels, and the images were reconstructed with a standard filtered back projection (FBP) algorithm and with an AIDR 3D algorithm. Compared with FBP, AIDR 3D reduced image noise and improved contrast-to-noise ratios. The diagnostic performance for detection of low-contrast targets of AIDR 3D images obtained with 100 mA at 120 kVp was almost as good as that of the FBP images obtained with 200 mA. The AIDR 3D algorithm substantially reduced image noise and improved the image quality of pelvic CT images compared with those obtained with the FBP algorithm and can thus be considered a promising technique for low-dose pelvic CT examinations.

The practice of medicine has become extremely technology dependent, and this is especially the case for radiology [1]. Advances in medical imaging and information systems technologies have transformed radiology practice through the creation of new medical imaging techniques (e.g., molecular imaging), data delivery and presentation [e.g., picture archival and communication system (PACS)], and clinical decision support (e.g., CAD). Yet, despite the long-standing history of medical imaging and information technology (IT) innovation, the past few years have been relatively barren. This recent lack of innovation has led to a trend towards commoditization, which is particularly evident in information system technologies, such as PACS and RIS, which just a decade ago, were viewed as groundbreaking and innovative technologies [2]. The recent economic decline has served as a deterrent to R & D expenditures, further perpetuating the cycle of innovation decline [3]. In order to combat this trend in declining innovation, it is necessary to understand the principles of innovation, learn from past successes and failures, and proactively apply this knowledge to ongoing trends in medical practice and economics for guiding future innovation.

To explore the application value of the reconstruction algorithm based on an iterative algorithm in the analysis of CT image and analyze the therapeutic effect of honey-fried Herba Ephedrae combined with Western medicine on acute exacerbation chronic obstructive pulmonary disease (AECOPD), a total of 96 AECOPD patients admitted to our hospital from January 2018 to December 2019 were selected as research subjects. According to a different treatment method, the subjects were divided into a control group (Ctrl group, conventional therapy) and an observation group (OG, conventional therapy + honey-fried Herba Ephedrae), with 48 in each group. The CT image algorithm was established based on the iterative algorithm, and the CT dose indexes of the reconstruction algorithm and the Filtered Back Projection (FBP) algorithm under the same conditions were compared ( P < 0.05 ). After using CT to confirm the diagnosis of the subjects, the difference in indicators of forced expiratory volume in one second (FEV1), forced expiratory volume in one second to forced vital capacity ratio (FEV1%), and forced vital capacity (FVC), inflammatory factors of serum interleukin-8 (IL-8), serum interleukin-10 (IL-10), and tumor necrosis factor (TNF-α), the bronchial wall area, and the total treatment efficiency before and after different treatment was analyzed. The results suggested that the Computed Tomography Dose Index (CTDI) of iterative reconstruction (IR) algorithm when scanning different parts was higher than that of the FBP algorithm. The pulmonary function indexes and the expression of IL-8 and TNF-α in the OG were higher than those in the Ctrl group ( P < 0.05 ); the bronchial wall area, bronchial wall area percentage, and IL-10 expression in the OG were all lower than those in the Ctrl group ( P < 0.05 ). The effectiveness and improvement rates of the Ctrl group were 47.92% and 25%, respectively, significantly lower than those in the OG group, 56.25% and 31.25% ( P < 0.05 ), and the total efficiency of the observation group was 87.5%, which was significantly higher than that in the Ctrl group (72.92%) ( P < 0.05 ). In conclusion, based on the iterative algorithm, a CT reconstruction algorithm with better noise reduction performance was established, and the use of honey-fried Herba Ephedrae combined with Western medicine can improve the effective rate of treatment.

Iterative algorithms are gaining clinical acceptance in CT. We performed objective phantom-based image quality evaluation of five commercial iterative reconstruction algorithms available on four different multi-detector CT (MDCT) scanners at different dose levels as well as the conventional filtered back-projection (FBP) reconstruction. Using the Catphan500 phantom, we evaluated image noise, contrast-to-noise ratio (CNR), modulation transfer function (MTF) and noise-power spectrum (NPS). The algorithms were evaluated over a CTDIvol range of 0.75-18.7 mGy on four major MDCT scanners: GE DiscoveryCT750HD (algorithms: ASIR™ and VEO™); Siemens Somatom Definition AS+ (algorithm: SAFIRE™); Toshiba Aquilion64 (algorithm: AIDR3D™); and Philips Ingenuity iCT256 (algorithm: iDose4™). Images were reconstructed using FBP and the respective iterative algorithms on the four scanners. Use of iterative algorithms decreased image noise and increased CNR, relative to FBP. In the dose range of 1.3-1.5 mGy, noise reduction using iterative algorithms was in the range of 11%-51% on GE DiscoveryCT750HD, 10%-52% on Siemens Somatom Definition AS+, 49%-62% on Toshiba Aquilion64, and 13%-44% on Philips Ingenuity iCT256. The corresponding CNR increase was in the range 11%-105% on GE, 11%-106% on Siemens, 85%-145% on Toshiba and 13%-77% on Philips respectively. Most algorithms did not affect the MTF, except for VEO™ which produced an increase in the limiting resolution of up to 30%. A shift in the peak of the NPS curve towards lower frequencies and a decrease in NPS amplitude were obtained with all iterative algorithms. VEO™ required long reconstruction times, while all other algorithms produced reconstructions in real time. Compared to FBP, iterative algorithms reduced image noise and increased CNR. The iterative algorithms available on different scanners achieved different levels of noise reduction and CNR increase while spatial resolution improvements were obtained only with VEO™. This study is useful in that it provides performance assessment of the iterative algorithms available from several mainstream CT manufacturers.

In single photon emission computed tomography (SPECT), a varying-focal-length cone-beam collimator can be used to reduce the truncation problem and to maintain sensitivity when imaging the organ of interest. The collimator is constructed so that the collimator holes focus to a circular symmetric, spatially varying, focal point function. The focal length increases radially from the shortest focal length at the centre to the longest focal length at the periphery of the collimator. This paper describes a 3D backprojection-filtering (BF) algorithm for this varying-focal-length cone-beam geometry. The proposed algorithm is compared to an iterative ML-EM (maximum likelihood-expectation maximization) algorithm. The 3D Hoffman brain phantom and Defrise phantom are used in computer simulations. Since the maximum tilt angle of the projection rays is small for most realistic imaging geometries, the proposed algorithm provides a good approximation. When a circular orbit is used, the BF algorithm gives an exact reconstruction of the central slice.

Medical imaging is becoming indispensable for patients' healthcare. Machine learning plays an essential role in the medical imaging field, including computer-aided diagnosis, image segmentation, image registration, image fusion, image-guided therapy, image annotation, and image database retrieval. With advances in medical imaging, new imaging modalities and methodologies such as cone-beam/multislice CT, 3D ultrasound imaging, tomosynthesis, diffusion-weighted magnetic resonance imaging (MRI), positron-emission tomography (PET)/CT, electrical impedance tomography, and diffuse optical tomography, new machine-learning algorithms/applications are demanded in the medical imaging field. Because of large variations and complexityit is generally difficult to derive analytic solutions or simple equations to represent objects such as lesions and anatomy in medical images. Therefore, tasks in medical imaging require “learning from examples” for accurate representation of data and prior knowledge. Because of its essential needs, machine learning in medical imaging is one of the most promising, growing fields. The main aim of this special issue is to help advance the scientific research within the broad field of machine learning in medical imaging. The special issue was planned in conjunction with the International Workshop on Machine Learning in Medical Imaging (MLMI 2010) [1], which was the first workshop on this topic, held at the 13th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI 2010) in September, 2010, in Beijing, China. This special issue is one in a series of special issues of journals on this topic [2]; it focuses on major trends and challenges in this area, and it presents work aimed at identifying new cutting-edge techniques and their use in medical imaging. The quality level of the submissions for this special issue was very high. A total of 17 papers were submitted to this issue in response to the call for papers. Based on a rigorous review process, 10 papers (59%) were accepted for publication in the special issue. The special issue starts by a review of studies on a class of machine-learning techniques, called pixel/voxel-based machine learning, in medical imaging by K. Suzuki. A series of medical imaging applications of machine-learning techniques are presented. A large variety of applications are well represented here, including organ modeling by D. Wang et al. and X. Qiao and Y.-W. Chen, brain function estimation by V. Michel et al., image reconstruction by H. Shouno et al., lesion classification by P. Wighton et al., modality classification by X.-H. Han and Y.-W. Chen, lesion segmentation by M. Zortea et al., organ segmentation by S. Alzubi et al., and visualization of molecular signals by F. Mattoli et al. Also, the issue covers various biomedical imaging modalities, including MRI by D. Wang et al., CT by X. Qiao and Y.-W. Chen and H. Shouno et al., functional MRI by V. Michel et al., dermoscopy by P. Wighton et al. and M. Zortea et al., scintigraphy by X.-H. Han and Y.-W. Chen, ultrasound imaging by X.-H. Han and Y.-W. Chen, radiography by X.-H. Han and Y.-W. Chen, MR angiography by S. Alzubi et al., and microscopy by F. Mattoli et al. as well as a variety of organs, including the kidneys by D. Wang et al., liver by X. Qiao and Y.-W. Chen, brain by V. Michel et al. and F. Mattoli et al., chest by S. Alzubi et al., skin by P. Wighton et al. and M. Zortea et al., and heart by F. Mattoli et al. Various machine-learning techniques were developed/used to solve the respective problems, including structured dictionary learning by D. Wang et al., generalized N-dimensional principal component analysis by X. Qiao et al., multiclass sparse Bayesian regression by V. Michel et al., Bayesian hyperparameter inference by H. Shouno et al., supervised learning of probabilistic models based on maximum aposteriori estimation and conditional random fields by P. Wighton et al., joint kernel equal contribution in support vector classification by X.-H. Han and Y.-W. Chen, and iterative hybrid classification by M. Zortea et al. We are grateful to all authors for their excellent contributions to this special issue and to all reviewers for their reviews and constructive suggestions. We hope that this special issue will inspire further ideas for creative research, advance the field of machine learning in medical imaging, and facilitate the translation of the research from bench to bedside. Kenji Suzuki Pingkun Yan Fei Wang Dinggang Shen

Targeted-ROI imaging in electron paramagnetic resonance imaging

This book places an emphasis on the basic principles and recent advances in medical imaging technologies. After an introduction, the rest of the text can be categorized into three main parts. Part 1 provides a comprehensive tutorial on the fundamentals of medical imaging modalities and image processing methodologies. Part 2 highlights the cutting-edge imaging modalities for radiography and the recent developments of information technology in biomedicine. Part 3 provides some case studies and applications in radiation therapy and computer-aided diagnosis along with a perspective on future trends in medical and molecular imaging. The book is well organized and well presented. A concise summary before each chapter highlights the most important points of the text. This book can be used as a textbook for graduate courses and as an excellent reference for radiologists, neurologists, biomedical engineers, and researchers who are interested in imaging processing and modeling.

The purpose of this study was to optimize the monitoring dose, obtained using the conventional filtered back projection (FBP) method and iterative reconstruction algorithms, for the bolus tracking technique. A phantom study was performed to assess the effect of the scan start time in patients grouped according to different body weights. An oval torso phantom was used for simulating the time enhancement curve of the bolus tracking technique. To reproduce image noise levels in the two body weight groups, the phantom diameter was adjusted with a water-equivalent material. The tube currents were 10, 20, 30, and 50mA. The monitoring scan was performed with the conventional FBP method and real-time adaptive iterative dose reduction by three-dimensional processing (AIDR 3D). The results at different doses were compared with those at 50mA. The volume computed tomography dose index was 1.31, 2.65, 3.93, and 6.56mGy at tube currents of 10, 20, 30, and 50mA, respectively. The scan start time, reconstructed using FBP, was significantly faster at 10 and 20mA in group A (50-59kg) and at 20mA in group B (≥80kg). The CT values in the region of interest could not be measured at 10mA because of artifacts. With real-time AIDR 3D, both groups showed no significant differences between the measurements obtained at 30 or 20mA and those obtained at 50mA. Our study demonstrated that the real-time AIDR 3D algorithm improved the accuracy of the CT measurements with the bolus tracking technique.

Filtered backprojection (FBP) algorithms are commonly employed for image reconstruction in optoacoustic tomography (OAT). A limitation of FBP algorithms is that they require the measured acoustic data to be densely sampled, which necessitates expensive ultrasound arrays that possess a large number of elements or increased data-acquisition times if mechnical scanning is employed. Additionally, FBP algorithms are based on idealized imaging models that do not accurately model the response of the transducers and fail to exploit the statistical characteristics of noisy measurement data to minimize noise levels in the reconstructed images. Iterative image reconstruction algorithms can circumvent these difficulties. However, to date, iterative reconstruction algorithms have not been successfully applied to three-dimensional (3D) OAT. In this work we investigate the use of an iterative image reconstruction method in 3D OAT. The large computational burden of 3D iterative image reconstruction is circumvented by implementing the reconstrution algorithm with graphics processing units (GPUs). The ability of the reconstruction algorithm to mitigate artifacts due to incomplete data is demonstrated.