Prospective Estimation of Radiation Dose and Image Quality for Optimized CT Performance

X-ray computed tomography (CT) is a non-invasive medical imaging technique that generates cross-sectional images by acquiring attenuation-based projection measurements at multiple angles. Since its first introduction in the 1970s, substantial technical improvements have led to the expanding use of CT in clinical examinations. CT has become an indispensable imaging modality for the diagnosis of a wide array of diseases in both pediatric and adult populations [1, 2]. Currently, approximately 272 million CT examinations are performed annually worldwide, with nearly 85 million of these in the United States alone [3]. Although this trend has decelerated in recent years, CT usage is still expected to increase mainly due to advanced technologies such as multi-energy [4], photon counting [5], and cone-beam CT [6].

Despite the significant clinical benefits, concerns have been raised regarding the population-based radiation dose associated with CT examinations [7]. From 1980 to 2006, the effective dose from medical diagnostic procedures rose six-fold, with CT contributing to almost half of the total dose from medical exposure [8]. For each patient, the risk associated with a single CT examination is likely to be minimal. However, the relatively large population-based radiation level has led to enormous efforts among the community to manage and optimize the CT dose.

As promoted by the international campaigns Image Gently and Image Wisely, exposure to CT radiation should be appropriate and safe [9, 10]. It is thus a responsibility to optimize the amount of radiation dose for CT examinations. The key for dose optimization is to determine the minimum amount of radiation dose that achieves the targeted image quality [11]. Based on such principle, dose optimization would significantly benefit from effective metrics to characterize radiation dose and image quality for a CT exam. Moreover, if accurate predictions of the radiation dose and image quality were possible before the initiation of the exam, it would be feasible to personalize it by adjusting the scanning parameters to achieve a desired level of image quality. The purpose of this thesis is to design and validate models to quantify patient-specific radiation dose prospectively and task-based image quality. The dual aim of the study is to implement the theoretical models into clinical practice by developing an organ-based dose monitoring system and an image-based noise addition software for protocol optimization.

More specifically, Chapter 3 aims to develop an organ dose-prediction method for CT examinations of the body under constant tube current condition. The study effectively modeled the anatomical diversity and complexity using a large number of patient models with representative age, size, and gender distribution. The dependence of organ dose coefficients on patient size and scanner models was further evaluated. Distinct from prior work, these studies use the largest number of patient models to date with representative age, weight percentile, and body mass index (BMI) range.

With effective quantification of organ dose under constant tube current condition, Chapter 4 aims to extend the organ dose prediction system to tube current modulated (TCM) CT examinations. The prediction, applied to chest and abdominopelvic exams, was achieved by combining a convolution-based estimation technique that quantifies the radiation field, a TCM scheme that emulates modulation profiles from major CT vendors, and a library of computational phantoms with representative sizes, ages, and genders. The prospective quantification model is validated by comparing the predicted organ dose with the dose estimated based on Monte Carlo simulations with TCM function explicitly modeled.

Chapter 5 aims to implement the organ dose-estimation framework in clinical practice to develop an organ dose-monitoring program based on a commercial software (Dose Watch, GE Healthcare, Waukesha, WI). In the first phase of the study we focused on body CT examinations, and so the patient’s major body landmark information was extracted from the patient scout image in order to match clinical patients against a computational phantom in the library. The organ dose coefficients were estimated based on CT protocol and patient size as reported in Chapter 3. The exam CTDIvol, DLP, and TCM profiles were extracted and used to quantify the radiation field using the convolution technique proposed in Chapter 4.

With effective methods to predict and monitor organ dose, Chapters 6 aims to develop and validate improved measurement techniques for image quality assessment. Chapter 6 outlines the method that was developed to assess and predict quantum noise in clinical body CT images. Compared with previous phantom-based studies, this study accurately assessed the quantum noise in clinical images and further validated the correspondence between phantom-based measurements and the expected clinical image quality as a function of patient size and scanner attributes.

Chapter 7 aims to develop a practical strategy to generate hybrid CT images and assess the impact of dose reduction on diagnostic confidence for the diagnosis of acute pancreatitis. The general strategy is (1) to simulate synthetic CT images at multiple reduced-dose levels from clinical datasets using an image-based noise addition technique; (2) to develop quantitative and observer-based methods to validate the realism of simulated low-dose images; (3) to perform multi-reader observer studies on the low-dose image series to assess the impact of dose reduction on the diagnostic confidence for multiple diagnostic tasks; and (4) to determine the dose operating point for clinical CT examinations based on the minimum diagnostic performance to achieve protocol optimization.

Chapter 8 concludes the thesis with a summary of accomplished work and a discussion about future research.

Monitoring of Dynamic Bridge Behaviour Using Digital Image Correlation

Bridges are a critical part of North America’s transportation network that need to be assessed frequently to inform bridge management decision making. Visual inspections are usually implemented for this purpose, during which inspectors must observe and report any excess displacements or vibrations. Unfortunately, these visual inspections are subjective and often highly variable and so a monitoring technology that can provide quantitative measurements to supplement inspections is needed. Digital Image Correlation (DIC) is a novel monitoring technology that uses digital images to measure displacement fields without any contact with the bridge. In this research, DIC and accelerometers were used to investigate the dynamic response of a railway bridge reported to experience large lateral displacements. Displacements were estimated using accelerometer measurements and were compared to DIC measurements. It was shown that accelerometers can provide reasonable estimates of displacement for zero-mean lateral displacements. By comparing measurements in the girder and in the piers, it was shown that for the bridge monitored, the large lateral displacements originated in the steel casting bearings positioned above the piers, and not in the piers themselves. The use of DIC for evaluating the effectiveness of rehabilitation of the LaSalle Causeway lift bridge in Kingston, Ontario was also investigated. Vertical displacements were measured at midspan and at the lifting end of the bridge during a static test and under dynamic live loading. The bridge displacements were well within the operating limits, however a gap at the lifting end of the bridge was identified. Rehabilitation of the bridge was conducted and by comparing measurements before and after rehabilitation, it was shown that the gap was successfully closed. Finally, DIC was used to monitor the midspan vertical and lateral displacements in a monitoring campaign of five steel rail bridges. DIC was also used to evaluate the effectiveness of structural rehabilitation of the lateral bracing of a bridge. Simple finite element models are developed using DIC measurements of displacement. Several lessons learned throughout this monitoring campaign are discussed in the hope of aiding future researchers.

Examination of body image among Canadian adolescents: Relations with physical activity and screen time

Background: Adolescence is a period of life associated with self-perceptions of negative body image. Physical activity levels are low and screen time levels are also high during this stage. These perceptions and behaviours are associated with poor health outcomes, making research on their determinants important. With adolescent populations, certain groups may be at higher risk of body dissatisfaction than others, and body dissatisfaction may influence individual physical activity and screen time levels. Objectives: The objectives of this thesis were to: 1) describe body image among young Canadians, examining possible health inequalities 2) estimate the strength and significance of associations between body satisfaction, physical activity and screen time, and 3) examine the potential etiological role of biological sex. Methods: Objective 1: The 2013/2014 Health Behaviour in School-aged Children study was employed. Sex-stratified Rao-Scott chi-square analyses were conducted to examine associations between socio-demographic factors and body satisfaction. Objective 2: The 2005/2006 and 2013/2014 cross-sectional and 2006 longitudinal HBSC data sets were used. Sex-stratified modified Poisson regressions were conducted and risk estimates and associated confidence intervals obtained. Results: Objective 1: Among males, being older, of East and Southeast Asian ethnicity, and reporting low SES all were associated with body dissatisfaction. Among females, being older, of Arab and West Asian or African ethnicity, being born in Canada, and reporting low SES were all associated with being body dissatisfied. Objective 2: Cross-sectionally, males who reported ‘too fat’ body dissatisfaction were more likely to be physically inactive. Adolescents of both sexes who reported ‘too fat’ body dissatisfaction were more likely to engage in high levels of screen time. Data from the longitudinal component supported the idea that male ‘too fat’ body dissatisfaction temporally leads to physical inactivity, but showed an inverse relationship between body dissatisfaction and screen time. Conclusions: Objective 1: Future prevention efforts in Canada should target subgroups to effectively help those at greatest risk of body dissatisfaction, and ameliorate potential inequalities at the population level. Objective 2: The presence of these relationships may inform future interventions as part of a multi-factorial etiology, in order to increase physical activity and decrease screen time among youth.

CT Image Electron Density Quantification in Regions with Metal Implants: Implications for Radiotherapy Treatment Planning

In radiotherapy planning, computed tomography (CT) images are used to quantify the electron density of tissues and provide spatial anatomical information. Treatment planning systems use these data to calculate the expected spatial distribution of absorbed dose in a patient. CT imaging is complicated by the presence of metal implants which cause increased image noise, produce artifacts throughout the image and can exceed the available range of CT number values within the implant, perturbing electron density estimates in the image. Furthermore, current dose calculation algorithms do not accurately model radiation transport at metal-tissue interfaces. Combined, these issues adversely affect the accuracy of dose calculations in the vicinity of metal implants. As the number of patients with orthopedic and dental implants grows, so does the need to deliver safe and effective radiotherapy treatments in the presence of implants. The Medical Physics group at the Cancer Centre of Southeastern Ontario and Queen's University has developed a Cobalt-60 CT system that is relatively insensitive to metal artifacts due to the high energy, nearly monoenergetic Cobalt-60 photon beam. Kilovoltage CT (kVCT) images, including images corrected using a commercial metal artifact reduction tool, were compared to Cobalt-60 CT images throughout the treatment planning process, from initial imaging through to dose calculation. An effective metal artifact reduction algorithm was also implemented for the Cobalt-60 CT system. Electron density maps derived from the same kVCT and Cobalt-60 CT images indicated the impact of image artifacts on estimates of photon attenuation for treatment planning applications. Measurements showed that truncation of CT number data in kVCT images produced significant mischaracterization of the electron density of metals. Dose measurements downstream of metal inserts in a water phantom were compared to dose data calculated using CT images from kVCT and Cobalt-60 systems with and without artifact correction. The superior accuracy of electron density data derived from Cobalt-60 images compared to kVCT images produced calculated dose with far better agreement with measured results. These results indicated that dose calculation errors from metal image artifacts are primarily due to misrepresentation of electron density within metals rather than artifacts surrounding the implants.

Bodies in Nature: Associations between Exposure to Nature, Connectedness to Nature, and Body Image

Here, we sought to replicate previous work showing a relationship between connectedness to nature and body appreciation, and extend it by examining associations between exposure to natural environments and other body image-related variables. An online sample of 399 U.S. women and men (Mage = 34.55 years) completed measures of body appreciation, connectedness to nature, nature exposure, appearance investment, sociocultural attitudes toward appearance, and self-esteem. Path analysis showed that nature exposure and connectedness to nature, respectively, were associated with body appreciation in women and men, both directly and indirectly via self-esteem. Connectedness to nature also mediated the link between nature exposure and body appreciation. In men, but not women, the link between connectedness to nature and body appreciation was also mediated by appearance investment and internalisation of a muscular ideal. These results may point to novel methods for promoting more positive body image in adults through engagement with nature.

Deep Corals, Deep Learning: Moving the Deep Net Towards Real-Time Image Annotation

The mismatch between human capacity and the acquisition of Big Data such as Earth imagery undermines commitments to Convention on Biological Diversity (CBD) and Aichi targets. Artificial intelligence (AI) solutions to Big Data issues are urgently needed as these could prove to be faster, more accurate, and cheaper. Reducing costs of managing protected areas in remote deep waters and in the High Seas is of great importance, and this is a realm where autonomous technology will be transformative.

Mapping of Submerged Aquatic Vegetation in Rivers From Very High Resolution Image Data, Using Object Based Image Analysis Combined with Expert Knowledge

The use of remote sensing for monitoring of submerged aquatic vegetation (SAV) in fluvial environments has been limited by the spatial and spectral resolution of available image data. The absorption of light in water also complicates the use of common image analysis methods. This paper presents the results of a study that uses very high resolution (VHR) image data, collected with a Near Infrared sensitive DSLR camera, to map the distribution of SAV species for three sites along the Desselse Nete, a lowland river in Flanders, Belgium. Plant species, including Ranunculus aquatilis L., Callitriche obtusangula Le Gall, Potamogeton natans L., Sparganium emersum L. and Potamogeton crispus L., were classified from the data using Object-Based Image Analysis (OBIA) and expert knowledge. A classification rule set based on a combination of both spectral and structural image variation (e.g. texture and shape) was developed for images from two sites. A comparison of the classifications with manually delineated ground truth maps resulted for both sites in 61% overall accuracy. Application of the rule set to a third validation image, resulted in 53% overall accuracy. These consistent results show promise for species level mapping in such biodiverse environments, but also prompt a discussion on assessment of classification accuracy.

Business Signage Control in Seattle's Chinatown International District, Pursuing Healthy Balance of Preservation and Commercial Vitalization in a Historic Commercial Districts

Thesis (Master's)--University of Washington, 2016-06

Image classification accuracy from LANDSAT data for tropical rain forest in Sumatra: An evaluation of ERDAS imagine software

Abstract not available

STRESS AND INTERNATIONAL ENTREPRENEURHSIP: The dark side of international entrepreneurship

Entrepreneurship attracts people with high job satisfaction and financial independence. Unfortunately, being deceived by this image, people do not pay attention to side effects of entrepreneurship. This ignorance usually turns into devastating results for entrepreneur’s health and venture performance. Therefore, it is required to seek ways to avoid these situations. The interest of the study lies in understanding of stress influence on international entrepreneurs by considering stress as a negative side effect of international entrepreneurship. To cover the concept of entrepreneurial stress completely, the study was divided into three section presented by following research questions: 1. What are the antecedents of entrepreneurial stress? 2. What are the consequences of entrepreneurial stress? 3. What coping strategies are applied to address entrepreneurial stress? Systematic literature review has been chosen as scientific approach to answer above questions due to the reason that it enables to minimise inconsistencies of both concepts of international entrepreneurship and stress. This method has afforded an opportunity to distinguish such stress causes as role conflict, overload, and ambiguity. Additionally, the study has covered the notion of stress moderators. The author argues that entrepreneurial traits, venture environment, and social support can have influence on degree of stress perception. Further, it has been proven that unaddressed stress could lead to reduction of entrepreneur’s psychological and physiological health. It should be taken into consideration that degree of both job satisfaction and performance would depend on the level of perceived stress. The last part of study emphasises the coping strategies. The author argues that it is important for an international entrepreneur to comprehend his or her and others’ emotions in order to overcome negative consequences of stress. In addition, the author suggests that an international entrepreneur needs to practise job sharing to reduce the amount of work to be completed. Moreover, it is believed that job sharing can help to overcome work-family conflict that prevails among entrepreneurs. The author anticipates that results of study can be beneficial for entrepreneurs who aim to achieve great results.

Sexual self-awareness and body Image

broadly describes the internal representations of the body structure and the physical appearance of the individual in regards him/herself and others. Sexual self-awareness (ACS) can be understood as the evaluation that each of us makes of his/her feelings and actions related to his/her sexuality and sexual behaviour, describing what each of us thinks about sex and what we feel about behaviours. Objective: Identify dimensions of sexual self-awareness and body image in sexual satisfaction of the young. Methods Correlational descriptive study, a convenience sample of 84 students of a health school (29.8 % male, 20.2 % female), with ages between 19 and 34 years. As data collection instrument a poll through questionnaire, incorporating a Body Image Satisfaction and a Multidimensional Sexual Self-awareness scale, was used. Results The majority of the sample subjects indicate having a partner (59.5 %), perceive themselves as having the ideal weight (75.0 %), the ideal height (65.5 %) and a normal appearance (76.2 %). Globally a high and statistically significant ACS was observed (t-Student = 12.520; GL = 83; p-value < 0.001) and significant statistical differences exist between having/not having a partner and the ACS (Student t = 2,965; GL = 82; p-value = 0.004) showing that those who mention having a partner have a higher average ACS (average = 3.812; SD = 0.412) compared to those without (average = 3.496; SD = 0.563). No statistically significant correlations were observed between ACS and Body Image.