Positron emission tomography (PET) tumor segmentation and quantification: Development of new algorithms

Tumor functional volume (FV) and its mean activity concentration (mAC) are the quantities derived from positron emission tomography (PET). These quantities are used for estimating radiation dose for a therapy, evaluating the progression of a disease and also use it as a prognostic indicator for predicting outcome. PET images have low resolution, high noise and affected by partial volume effect (PVE). Manually segmenting each tumor is very cumbersome and very hard to reproduce. To solve the above problem I developed an algorithm, called iterative deconvolution thresholding segmentation (IDTS) algorithm; the algorithm segment the tumor, measures the FV, correct for the PVE and calculates mAC. The algorithm corrects for the PVE without the need to estimate camera's point spread function (PSF); also does not require optimizing for a specific camera. My algorithm was tested in physical phantom studies, where hollow spheres (0.5-16 ml) were used to represent tumors with a homogeneous activity distribution. It was also tested on irregular shaped tumors with a heterogeneous activity profile which were acquired using physical and simulated phantom. The physical phantom studies were performed with different signal to background ratios (SBR) and with different acquisition times (1-5 min). The algorithm was applied on ten clinical data where the results were compared with manual segmentation and fixed percentage thresholding method called T50 and T60 in which 50% and 60% of the maximum intensity respectively is used as threshold. The average error in FV and mAC calculation was 30% and -35% for 0.5 ml tumor. The average error FV and mAC calculation were ~5% for 16 ml tumor. The overall FV error was ∼10% for heterogeneous tumors in physical and simulated phantom data. The FV and mAC error for clinical image compared to manual segmentation was around -17% and 15% respectively. In summary my algorithm has potential to be applied on data acquired from different cameras as its not dependent on knowing the camera's PSF. The algorithm can also improve dose estimation and treatment planning.^

Motion Correction Algorithm of Lung Tumors for Respiratory Gated PET Images

Respiratory gating in lung PET imaging to compensate for respiratory motion artifacts is a current research issue with broad potential impact on quantitation, diagnosis and clinical management of lung tumors. However, PET images collected at discrete bins can be significantly affected by noise as there are lower activity counts in each gated bin unless the total PET acquisition time is prolonged, so that gating methods should be combined with imaging-based motion correction and registration methods. The aim of this study was to develop and validate a fast and practical solution to the problem of respiratory motion for the detection and accurate quantitation of lung tumors in PET images. This included: (1) developing a computer-assisted algorithm for PET/CT images that automatically segments lung regions in CT images, identifies and localizes lung tumors of PET images; (2) developing and comparing different registration algorithms which processes all the information within the entire respiratory cycle and integrate all the tumor in different gated bins into a single reference bin. Four registration/integration algorithms: Centroid Based, Intensity Based, Rigid Body and Optical Flow registration were compared as well as two registration schemes: Direct Scheme and Successive Scheme. Validation was demonstrated by conducting experiments with the computerized 4D NCAT phantom and with a dynamic lung-chest phantom imaged using a GE PET/CT System. Iterations were conducted on different size simulated tumors and different noise levels. Static tumors without respiratory motion were used as gold standard; quantitative results were compared with respect to tumor activity concentration, cross-correlation coefficient, relative noise level and computation time. Comparing the results of the tumors before and after correction, the tumor activity values and tumor volumes were closer to the static tumors (gold standard). Higher correlation values and lower noise were also achieved after applying the correction algorithms. With this method the compromise between short PET scan time and reduced image noise can be achieved, while quantification and clinical analysis become fast and precise.

Reorientação da formação em saúde: a contribuição do programa PET-Saúde

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Continuous innovation in food and beverage packaging design. Progetto di tutorial per lo studio di nuove forme di contenitore in PET.

Mi sono occupato di confezionamento di bevande, un settore che utilizza largamente il PET. Il progetto di tesi consiste in un processo che serve a ideare nuove forme di contenitore in PET attraverso strumenti di ricerca e innovazione.

Studio di contenitori in PET per riempimento a caldo nitro-hot-fill

Lo scopo di questa attività è approfondire le conoscenze sul processo di riempimento a caldo noto come nitro-hot-fill (NHF) utilizzato per contenitori in PET. Il nostro obiettivo è quello di simulare su scala di laboratorio il processo industriale al fine di ottimizzarne i parametri e aumentare la stabilità dei contenitori anche attraverso l’utilizzo di materie prime con caratteristiche migliorate utilizzando formulazioni adatte ai trattamenti a caldo. Il processo consiste nel riempimento della bottiglia ad una temperatura tra gli 80°/85°C, successivo al quale vi è l’iniezione di azoto al fine di evitare l’implosione durante il raffreddamento fino a temperatura ambiente. Questo settore del mercato è in forte crescita, molte bevande infatti hanno la necessità di un contenitore asettico; il processo di NHF ha il vantaggio di utilizzare il calore del prodotto stesso al fine di rendere la bottiglia sterile. Da qui nascono le criticità legate al processo, occorre prendere diversi accorgimenti al fine di rendere processabile in questo modo una bottiglia, infatti l’aumento di pressione interna dovuto all’iniezione di azoto si accompagna una temperatura vicina alla temperatura di transizione vetrosa. La nostra attività di ricerca ha focalizzato la propria attenzione sul design della bottiglia, sul processo di stiro-soffiaggio, sull’influenza dell’umidità assorbita nel PET, sul materiale utilizzato e su altri parametri di processo al fine di produrre contenitori in grado di resistere al riempimento NHF.

The use of PET-CT in the assessment of patients with colorectal carcinoma.

Colorectal cancer is the third most commonly diagnosed cancer, accounting for 53,219 deaths in 2007 and an estimated 146,970 new cases in the USA during 2009. The combination of FDG PET and CT has proven to be of great benefit for the assessment of colorectal cancer. This is most evident in the detection of occult metastases, particularly intra- or extrahepatic sites of disease, that would preclude a curative procedure or in the detection of local recurrence. FDG PET is generally not used for the diagnosis of colorectal cancer although there are circumstances where PET-CT may make the initial diagnosis, particularly with its more widespread use. In addition, precancerous adenomatous polyps can also be detected incidentally on whole-body images performed for other indications; sensitivity increases with increasing polyp size. False-negative FDG PET findings have been reported with mucinous adenocarcinoma, and false-positive findings have been reported due to inflammatory conditions such as diverticulitis, colitis, and postoperative scarring. Therefore, detailed evaluation of the CT component of a PET/CT exam, including assessment of the entire colon, is essential.

Data-Driven Motion Detection and Characterization in PET Brain Scans Using List Mode

Head motion during a Positron Emission Tomography (PET) brain scan can considerably degrade image quality. External motion-tracking devices have proven successful in minimizing this effect, but the associated time, maintenance, and workflow changes inhibit their widespread clinical use. List-mode PET acquisition allows for the retroactive analysis of coincidence events on any time scale throughout a scan, and therefore potentially offers a data-driven motion detection and characterization technique. An algorithm was developed to parse list-mode data, divide the full acquisition into short scan intervals, and calculate the line-of-response (LOR) midpoint average for each interval. These LOR midpoint averages, known as “radioactivity centroids,” were presumed to represent the center of the radioactivity distribution in the scanner, and it was thought that changes in this metric over time would correspond to intra-scan motion.

Several scans were taken of the 3D Hoffman brain phantom on a GE Discovery IQ PET/CT scanner to test the ability of the radioactivity to indicate intra-scan motion. Each scan incrementally surveyed motion in a different degree of freedom (2 translational and 2 rotational). The radioactivity centroids calculated from these scans correlated linearly to phantom positions/orientations. Centroid measurements over 1-second intervals performed on scans with ~1mCi of activity in the center of the field of view had standard deviations of 0.026 cm in the x- and y-dimensions and 0.020 cm in the z-dimension, which demonstrates high precision and repeatability in this metric. Radioactivity centroids are thus shown to successfully represent discrete motions on the submillimeter scale. It is also shown that while the radioactivity centroid can precisely indicate the amount of motion during an acquisition, it fails to distinguish what type of motion occurred.

Statistical considerations in the kinetic analysis of PET-FDG brain tumour studies

Dynamic positron emission tomography (PET) imaging can be used to track the distribution of injected radio-labelled molecules over time in vivo. This is a powerful technique, which provides researchers and clinicians the opportunity to study the status of healthy and pathological tissue by examining how it processes substances of interest. Widely used tracers include 18F-uorodeoxyglucose, an analog of glucose, which is used as the radiotracer in over ninety percent of PET scans. This radiotracer provides a way of quantifying the distribution of glucose utilisation in vivo. The interpretation of PET time-course data is complicated because the measured signal is a combination of vascular delivery and tissue retention effects. If the arterial time-course is known, the tissue time-course can typically be expressed in terms of a linear convolution between the arterial time-course and the tissue residue function. As the residue represents the amount of tracer remaining in the tissue, this can be thought of as a survival function; these functions been examined in great detail by the statistics community. Kinetic analysis of PET data is concerned with estimation of the residue and associated functionals such as ow, ux and volume of distribution. This thesis presents a Markov chain formulation of blood tissue exchange and explores how this relates to established compartmental forms. A nonparametric approach to the estimation of the residue is examined and the improvement in this model relative to compartmental model is evaluated using simulations and cross-validation techniques. The reference distribution of the test statistics, generated in comparing the models, is also studied. We explore these models further with simulated studies and an FDG-PET dataset from subjects with gliomas, which has previously been analysed with compartmental modelling. We also consider the performance of a recently proposed mixture modelling technique in this study.

Multiple training interventions significantly improve reproducibility of PET/CT-based lung cancer radiotherapy target volume delineation using an IAEA study protocol

BACKGROUND AND PURPOSE: To assess the impact of a standardized delineation protocol and training interventions on PET/CT-based target volume delineation (TVD) in NSCLC in a multicenter setting.

MATERIAL AND METHODS: Over a one-year period, 11 pairs, comprised each of a radiation oncologist and nuclear medicine physician with limited experience in PET/CT-based TVD for NSCLC from nine different countries took part in a training program through an International Atomic Energy Agency (IAEA) study (NCT02247713). Teams delineated gross tumor volume of the primary tumor, during and after training interventions, according to a provided delineation protocol. In-house developed software recorded the performed delineations, to allow visual inspection of strategies and to assess delineation accuracy.

RESULTS: Following the first training, overall concordance indices for 3 repetitive cases increased from 0.57±0.07 to 0.66±0.07. The overall mean surface distance between observer and expert contours decreased from -0.40±0.03 cm to -0.01±0.33 cm. After further training overall concordance indices for another 3 repetitive cases further increased from 0.64±0.06 to 0.80±0.05 (p=0.01). Mean surface distances decreased from -0.34±0.16 cm to -0.05±0.20 cm (p=0.01).

CONCLUSION: Multiple training interventions improve PET/CT-based TVD delineation accuracy in NSCLC and reduces interobserver variation.

Recente evoluzione delle tecnologie PET-RMN

La PET/RMN è un ibrido delle tecnologie di imaging che incorpora la risonanza magnetica nucleare (RMN), che fornisce un'imaging di tipo morfologico, e la tomografia ad emissione di positroni (PET), che fornisce un'imaging di tipo funzionale. Questa nuova tecnologia trova applicazioni in campo oncologico, cardiovascolare e nello studio del sistema nervoso centrale (SNC). La realizzazione di questa nuova tecnologia ha comportato diverse sfide tecniche per la combinazione delle due apparecchiature, che sono state risolte con diversi approcci. Lo sviluppo futuro della PET/RMN sarà guidato da molteplici fattori tra i quali l'eliminazione degli eventuali disturbi e la necessità di accordi per i rimborsi dell'esame. Tutt'ora esistono tre diversi produttori al mondo : Simens, Philips e GE (General Electric), i quali hanno diverse tecnologie e diversi metodi di analisi. La prima apparecchiatura PET/RMN in Italia è stata acquistata dall'ospedale di Padova nel gennaio 2015, mentre negli altri paesi aveva già fatto la sua comparsa dal 2011.

Innovazione nella Diagnostica per Immagini: l’integrazione PET/RMN

Nell'ambito della Diagnostica per Immagini, l'imaging ibrido sta assumendo un ruolo fondamentale in molte applicazioni cliniche, tra cui oncologia, neurologia e cardiologia. La possibilità di integrare informazioni complementari, funzionali e morfologiche, in un'unica immagine, permette di valutare con estrema accuratezza varie tipologie di malattie, diminuendo i tempi di acquisizione e i disagi per i pazienti. La risonanza magnetica, in sostituzione alla TAC nel sistema integrato PET/TC, introduce notevoli vantaggi quali l'acquisizione simultanea dei dati, l'ottimo contrasto dei tessuti molli, l'assenza di radiazioni ionizzanti e la correzione degli artefatti da movimento; ciò migliora l'accuratezza delle immagini e, di conseguenza, il processo diagnostico. Nonostante sia un interessante strumento di diagnostica e l'apice dello sviluppo tecnologico in imaging nucleare, vi sono alcune problematiche che ne impediscono la diffusa adozione, tra cui le interferenze reciproche tra le due modalità, i costi elevati e ancora una ridotta pubblicazione di articoli al riguardo.

GPS - PET : aplicación web para la geolocalización de mascotas

[ES]Este proyecto trata de desarrollar una aplicación web en Ruby on Rails, donde el usuario pueda visualizar en “tiempo real” la ubicación de su animal haciendo uso de su identificador con GPS (microchip con GPS), si existiera tal dispositivo, o un dispositivo de geolocalización GPS incrustado en el collar del perro, para hacer un seguimiento del mismo cuando otra persona que ha sido contratada lo pasea. Al no disponer de microchips o collares con GPS, así como los respectivos animales para hacer el estudio y, por tanto, su posterior seguimiento, se realizará una simulación del mismo, de ahí que el tiempo real esté puesto entre comillas.

Virtual Clinical Trials in PET Imaging for Improved Diagnosis of and Evaluation of Therapies for Cancer

Thesis (Ph.D.)--University of Washington, 2016-08

The Voice of History and the Message of the National Curriculum: Recontextualising History to a Pedagogic Discourse for Upper Secondary VET

In the reform by the liberal-conservative government of Swedish upper secondary education in 2011, history was recognized as an important part of citizenship education and was introduced into the curriculum for vocational education and training (VET) tracks. Through the concepts of classification and framing, this article explores the process of constructing the history syllabus for VET. The data consist of archived material from the working group responsible for the history curriculum under the Swedish National Agency for Education. The analysis shows that there are competing discourses concerning the relative emphasis on competencies and skills and concerning the emphasis on contemporary and modern history. Although historians, history teachers and other agents are invited to respond to the content of the curriculum, the respondents have no influence on the knowledge structure of the curriculum, which is controlled by agents of the dominant educational ideology. From a critical perspective, this article suggests that the curriculum reflects the instrumental and neoconservative message of the reform through strong classification and framing and through the emphasis on general abilities and a contemporary history that has a more direct explanatory value to contemporary society.

“Jag vet faktiskt inte varför ingen vill anställa någon som mig” : En studie om arbetslösas upplevda delaktighet i aktivitet.

Syftet med studien var att beskriva hur arbetslösa personer i tjänsten Stöd och matchning upplever delaktighet i aktivitet. Författaren använde kvalitativ metod med induktiv ansats. Datainsamlingen genomfördes genom intervjuer med bedömningsinstrumentet OCAIRS-S som grund. Fem deltagare rekryterades med bekvämlighetsurval på en mindre ort i Sverige. Författaren spelade in intervjuerna för att sedan transkribera och bearbeta dem genom en kvalitativ innehållsanalys med stöd av komponenter i ICF. Resultatet visade bland annat att deltagarna hade lätt att ge upp och saknade rutiner i sitt vardagsliv. Alla upplevde även att de klarar sig bra på sin inkomst och hade möjlighet att utföra alla aktiviteter de ville och behövde göra. De spenderade mycket tid ensamma och hade några få nära relationer. De flesta trivdes i arbetslösheten och alla såg positivt på framtiden. Ingen av dem letade aktivt efter möjligheter till arbete och de var inte heller initiativtagande. Slutsatserna som gjordes var att deltagarna saknar proaktivitet och motivation till att skaffa arbete. De skulle ha nytta av arbetsterapi för aktivitetsträning och/eller anpassning av aktiviteten ”att söka arbete”. Vidare forskning med större underlag behövs för en djupare förståelse.