IMPROVING QUANTITATIVE TREATMENT RESPONSE MONITORING WITH DEFORMABLE IMAGE REGISTRATION

Quantitative imaging with 18F-FDG PET/CT has the potential to provide an in vivo assessment of response to radiotherapy (RT). However, comparing tissue tracer uptake in longitudinal studies is often confounded by variations in patient setup and potential treatment induced gross anatomic changes. These variations make true response monitoring for the same anatomic volume a challenge, not only for tumors, but also for normal organs-at-risk (OAR). The central hypothesis of this study is that more accurate image registration will lead to improved quantitation of tissue response to RT with 18F-FDG PET/CT. Employing an in-house developed “demons” based deformable image registration algorithm, pre-RT tumor and parotid gland volumes can be more accurately mapped to serial functional images. To test the hypothesis, specific aim 1 was designed to analyze whether deformably mapping tumor volumes rather than aligning to bony structures leads to superior tumor response assessment. We found that deformable mapping of the most metabolically avid regions improved response prediction (P<0.05). The positive predictive power for residual disease was 63% compared to 50% for contrast enhanced post-RT CT. Specific aim 2 was designed to use parotid gland standardized uptake value (SUV) as an objective imaging biomarker for salivary toxicity. We found that relative change in parotid gland SUV correlated strongly with salivary toxicity as defined by the RTOG/EORTC late effects analytic scale (Spearman’s ρ = -0.96, P<0.01). Finally, the goal of specific aim 3 was to create a phenomenological dose-SUV response model for the human parotid glands. Utilizing only baseline metabolic function and the planned dose distribution, predicting parotid SUV change or salivary toxicity, based upon specific aim 2, became possible. We found that the predicted and observed parotid SUV relative changes were significantly correlated (Spearman’s ρ = 0.94, P<0.01). The application of deformable image registration to quantitative treatment response monitoring with 18F-FDG PET/CT could have a profound impact on patient management. Accurate and early identification of residual disease may allow for more timely intervention, while the ability to quantify and predict toxicity of normal OAR might permit individualized refinement of radiation treatment plan designs.

Evaluation of deformable image registration for improved 4D CT-derived ventilation for image guided radiotherapy

Recent treatment planning studies have demonstrated the use of physiologic images in radiation therapy treatment planning to identify regions for functional avoidance. This image-guided radiotherapy (IGRT) strategy may reduce the injury and/or functional loss following thoracic radiotherapy. 4D computed tomography (CT), developed for radiotherapy treatment planning, is a relatively new imaging technique that allows the acquisition of a time-varying sequence of 3D CT images of the patient's lungs through the respiratory cycle. Guerrero et al. developed a method to calculate ventilation imaging from 4D CT, which is potentially better suited and more broadly available for IGRT than the current standard imaging methods. The key to extracting function information from 4D CT is the construction of a volumetric deformation field that accurately tracks the motion of the patient's lungs during the respiratory cycle. The spatial accuracy of the displacement field directly impacts the ventilation images; higher spatial registration accuracy will result in less ventilation image artifacts and physiologic inaccuracies. Presently, a consistent methodology for spatial accuracy evaluation of the DIR transformation is lacking. Evaluation of the 4D CT-derived ventilation images will be performed to assess correlation with global measurements of lung ventilation, as well as regional correlation of the distribution of ventilation with the current clinical standard SPECT. This requires a novel framework for both the detailed assessment of an image registration algorithm's performance characteristics as well as quality assurance for spatial accuracy assessment in routine application. Finally, we hypothesize that hypo-ventilated regions, identified on 4D CT ventilation images, will correlate with hypo-perfused regions in lung cancer patients who have obstructive lesions. A prospective imaging trial of patients with locally advanced non-small-cell lung cancer will allow this hypothesis to be tested. These advances are intended to contribute to the validation and clinical implementation of CT-based ventilation imaging in prospective clinical trials, in which the impact of this imaging method on patient outcomes may be tested.

Unconscious word stem completion priming in a mirror-masking paradigm

The aim of this study was to investigate unconscious priming by the use of a spatial mirror-masking paradigm. Words and nonwords with no under-length letters are mirrored at their horizontal axis. The results are figures of geometric-like forms that contain letters in their upper part. In the three experiments reported in this study, a priming procedure used such mirrored words and nonwords as primes. Participants were ignorant of the nature of the construction of the stimuli. Perceptual reports of the participants revealed that they did not realize that words were hidden in the primes. Nevertheless, they showed priming in all three experiments. Priming effects were replicated with prime–target SOAs of between 1 and 3 s. Functional dissociations were found between ignorant and informed participants. Informed groups showed perceptual and semantic priming, while ignorant groups showed only perceptual priming.

Veil: Mirror of Identity

The Islamic headscarf has become the subject of heated legal and political debate. France and Germany have legislated against it, and even the UK, long a champion of multiculturalism, has recently restricted the veil proper. Ever since home-grown Islamic terrorism struck Europe, these debates have become even more prominent, impassioned and wide-ranging, with vital global importance. In this concise and beautifully written introduction to the politics of the veil in modern societies, Christian Joppke examines why a piece of clothing could have led to such controversy. He dissects the multiple meanings of the Islamic headscarf, and explores its links with the global rise of Islam, Muslim integration, and the retreat from multiculturalism. He argues that the headscarf functions as a mirror of identity, but one in which national and liberal identities overlap, exposing the paradox that while it may be an affront to liberal values, its suppression is equally illiberal.

Magneto-optic current sensor with Faraday mirror for linear birefringence compensation

Fiber optic sensors have some advantages in subjects related with electrical current and magnetic field measurement. In spite of the optical fiber utilization advantages we have to take into account undesirable effects, which are present in real non-ideal optical fibers. In telecommunication and sensor application fields the presence of inherent and induced birefringence is crucial. The presence of birefringence may cause an undesirable change in the polarization state. In order to compensate the linear birefringence a promising method has been chosen. This method employs orthogonal polarization conjugation in the back propagation direction of the light wave in the fiber. A study and a simulation of an experimental setup are realized with the advantage of a significant sensitivity improvement.

1000x shadow-free mirror-based Köhler concentrator

A new design for a photovoltaic concentrator, the most recent advance based on the Kohler concept, is presented. The system is mirror-based, and with geometry that guaranties a maximum sunlight collection area (without shadows, like those caused by secondary stages or receivers and heat-sinks in other mirror-based systems). Designed for a concentration of 1000x, this off axis system combines both good acceptance angle and good irradiance uniformity on the solar cell. The advanced performance features (concentration-acceptance products ?CAP- about 0.73 and affordable peak and average irradiances) are achieved through the combination of four reflective folds combined with four refractive surfaces, all of them free-form, performing Köhler integration 2 . In Köhler devices, the irradiance uniformity is not achieved through additional optical stages (TIR prisms), thus no complex/expensive elements to manufacture are required. The rim angle and geometry are such that the secondary stage and receivers are hidden below the primary mirrors, so maximum collection is assured. The entire system was designed to allow loose assembly/alignment tolerances (through high acceptance angle) and to be manufactured using already well-developed methods for mass production, with high potential for low cost. The optical surfaces for Köhler integration, although with a quite different optical behavior, have approximately the same dimensions and can be manufactured with the same techniques as the more traditional secondary optical elements used for concentration (typically plastic injection molding or glass molding).

Automatic generation of real-time deformable parametric model of the aorta for a VR-based catheterism guidance system

The purpose of this work is twofold: first, to develop a process to automatically create parametric models of the aorta that can adapt to any possible intraoperative deformation of the vessel. Second, it intends to provide the tools needed to perform this deformation in real time, by means of a non-rigid registration method. This dynamically deformable model will later be used in a VR-based surgery guidance system for aortic catheterism procedures, showing the vessel changes in real time.