Multidetector-row computed tomography in the preoperative diagnosis of intestinal complications caused by clinically unsuspected ingested dietary foreign bodies: a case series emphasizing the use of volume rendering techniques

Objective The present study was aimed at describing a case series where a preoperative diagnosis of intestinal complications secondary to accidentally ingested dietary foreign bodies was made by multidetector-row computed tomography (MDCT), with emphasis on complementary findings yielded by volume rendering techniques (VRT) and curved multiplanar reconstructions (MPR). Materials and Methods The authors retrospectively assessed five patients with surgically confirmed intestinal complications (perforation and /or obstruction) secondary to unsuspected ingested dietary foreign bodies, consecutively assisted in their institution between 2010 and 2012. Demographic, clinical, laboratory and radiological data were analyzed. VRT and curved MPR were subsequently performed. Results Preoperative diagnosis of intestinal complications was originally performed in all cases. In one case the presence of a foreign body was not initially identified as the causal factor, and the use of complementary techniques facilitated its retrospective identification. In all cases these tools allowed a better depiction of the entire foreign bodies on a single image section, contributing to the assessment of their morphology. Conclusion Although the use of complementary techniques has not had a direct impact on diagnostic performance in most cases of this series, they may provide a better depiction of foreign bodies' morphology on a single image section.

3-D volume rendering maxillofacial analysis of angular measurements by multislice CT

Objective. This study was designed to determine the precision and accuracy of angular measurements using three-dimensional computed tomography (3D-CT) volume rendering by computer systems. Study design. The study population consisted of 28 dried skulls that were scanned with a 64-row multislice CT, and 3D-CT images were generated. Angular measurements, (n = 6) based upon conventional craniometric anatomical landmarks (n = 9), were identified independently in 3D-CT images by 2 radiologists, twice each, and were then performed by 3D-CT imaging. Subsequently, physical measurements were made by a third examiner using a Beyond Crysta-C9168 series 900 device. Results. The results demonstrated no statistically significant difference between interexaminer and intraexaminer analysis. The mean difference between the physical and 3-D-based angular measurements was -1.18% and -0.89%, respectively, for both examiners, demonstrating high accuracy. Conclusion. Maxillofacial analysis of angular measurements using 3D-CT volume rendering by 64-row multislice CT is established and can be used for orthodontic and dentofacial orthopedic applications.

Development and applications of three-dimensional gamma ray tomography system using ray casting volume rendering techniques

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Image registration and image interpolation in volume rendering of cross sections

We outline a method for registration of images of cross sections using the concepts of The Generalized Hough Transform (GHT). The approach may be useful in situations where automation should be a concern. To overcome known problems of noise of traditional GHT we have implemented a slight modified version of the basic algorithm. The modification consists of eliminating points of no interest in the process before the application of the accumulation step of the algorithm. This procedure minimizes the amount of accumulation points while reducing the probability of appearing of spurious peaks. Also, we apply image warping techniques to interpolate images among cross sections. This is needed where the distance of samples between sections is too large. Then it is suggested that the step of registration with GHT can help the interpolation automation by simplifying the correspondence between points of images. Some results are shown.

3D virtual rendering before laparoscopic partial splenectomy in children.

INTRODUCTION: Partial splenectomy in children is a good surgical option for hematological diseases and focal splenic tumors because it allows the preservation of the spleen's immunological function. Furthermore, it can be performed by laparoscopy in children as it is a safe procedure, offering the benefits of a minimally invasive approach. MATERIALS AND METHODS: The software VR-render LE version 0.81 is a system that enables the visualization of bidimentional 3D images with magnification of anatomical details. We have applied this system to five cases of non-parasitic splenic cysts before laparoscopic partial splenectomy. RESULTS: The images obtained with VR rendering software permitted the preoperative reconstruction of the vascularization of the splenic hilum, allowing the surgeon safe vessel control during laparoscopic procedures. All five partial splenectomies were carried out with no complications or major blood loss. CONCLUSIONS: Laparoscopic partial splenectomy should be a first choice procedure because it is feasible, reproducible, and safe for children; furthermore, it preserves enough splenic tissue thereby preventing post-splenectomy infections. Volume rendering provides high anatomical resolution and can be useful in guiding the surgical procedure.

A Stereoscopic Volume Rendered Brain Atlas

The anatomy of the human brain is organized as a complex arrangement of interrelated structures in three dimensional space. To facilitate the understanding of both structure and function, we have created a volume rendered brain atlas (VRBA) with an intuitive interface that allows real-time stereoscopic rendering of brain anatomy. The VRBA incorporates 2-dimensional and 3-dimensional texture mapping to display segmented brain anatomy co-registered with a T1 MRI. The interface allows the user to remove and add any of the 62 brain structures, as well as control the display of the MRI dataset. The atlas also contains brief verbal and written descriptions of the different anatomical regions to correlate structure with function. A variety of stereoscopic projection methods are supported by the VRBA and provide an abstract, yet simple, way of visualizing brain anatomy and 3-dimensional relationships between different nuclei.

Hybrid PET/MRI in the assessment of cardiac viability: added value compared to PET/CT

Purpose: We evaluated the potential for hybrid PET/MRI devices to provide integrated metabolic, functional and anatomic characterisation of patients with suspected coronary artery disease.Methods and Materials: Ten patients (5 with suspected hibernating myocardium and 5 healthy volunteers) performed an imaging study using a hybrid PET/MRI (Philips). Viability assessed by 18F-FDG was performed in diseased patients along with MRI anatomic and functional study and reassessed within 30 minutes by conventional PET/CT. Non-contrast right coronary artery (RCA) targeted and whole heart 3D coronary angio-MRI using ECG-gating and respiratory navigator was performed in healthy volunteers with reconstruction performed using MPR and volume rendering. The extent of metabolic defect (MD) using PET/MRI and PET/CT was compared in patients and coronary territories (LAD, CX, RCA). Assessability of coronary lumen was judged as good, sub-optimal or non-assessable using a 16-segments coronary model.Results: Metabolic assessment was successful in all patients with MD being 19.2% vs 18.3% using PET/MRI and PET/CT, respectively (P=ns). The MD was 10.2%, 6 %, and 3 % vs 9.3%, 6 % and 3 % for LAD, CX and RCA territories, respectively (P= ns). Coronary angio-MRI was successful in all volunteers with 66 coronary segments visualised overall. The RCA was fully visualised in 4/5 volunteers and the left coronary arteries in 4/5 volunteers. Assessability in visualised segments was good, sub-optimal and non-assessable in 88 %, 2 % and 10 %, respectively.Conclusion: Hybrid PET/MRI devices may enable metabolic evaluation comparable to PET/CT with additional value owing to accurate functional and anatomical information including coronary assessment.

A semi-automatic method for segmentation and 3D modeling of glioma tumors from brain MRI

This work presents an efficient method for volume rendering of glioma tumors from segmented 2D MRI Datasets with user interactive control, by replacing manual segmentation required in the state of art methods. The most common primary brain tumors are gliomas, evolving from the cerebral supportive cells. For clinical follow-up, the evaluation of the pre- operative tumor volume is essential. Tumor portions were automatically segmented from 2D MR images using morphological filtering techniques. These seg- mented tumor slices were propagated and modeled with the software package. The 3D modeled tumor consists of gray level values of the original image with exact tumor boundary. Axial slices of FLAIR and T2 weighted images were used for extracting tumors. Volumetric assessment of tumor volume with manual segmentation of its outlines is a time-consuming proc- ess and is prone to error. These defects are overcome in this method. Authors verified the performance of our method on several sets of MRI scans. The 3D modeling was also done using segmented 2D slices with the help of a medical software package called 3D DOCTOR for verification purposes. The results were validated with the ground truth models by the Radi- ologist.

Recorte volumétrico usando técnicas de interação 2D e 3D

A visualização de conjuntos de dados volumétricos é comum em diversas áreas de aplicação e há já alguns anos os diversos aspectos envolvidos nessas técnicas vêm sendo pesquisados. No entanto, apesar dos avanços das técnicas de visualização de volumes, a interação com grandes volumes de dados ainda apresenta desafios devido a questões de percepção (ou isolamento) de estruturas internas e desempenho computacional. O suporte do hardware gráfico para visualização baseada em texturas permite o desenvolvimento de técnicas eficientes de rendering que podem ser combinadas com ferramentas de recorte interativas para possibilitar a inspeção de conjuntos de dados tridimensionais. Muitos estudos abordam a otimização do desempenho de ferramentas de recorte, mas muito poucos tratam das metáforas de interação utilizadas por essas ferramentas. O objetivo deste trabalho é desenvolver ferramentas interativas, intuitivas e fáceis de usar para o recorte de imagens volumétricas. Inicialmente, é apresentado um estudo sobre as principais técnicas de visualização direta de volumes e como é feita a exploração desses volumes utilizando-se recorte volumétrico. Nesse estudo é identificada a solução que melhor se enquadra no presente trabalho para garantir a interatividade necessária. Após, são apresentadas diversas técnicas de interação existentes, suas metáforas e taxonomias, para determinar as possíveis técnicas de interação mais fáceis de serem utilizadas por ferramentas de recorte. A partir desse embasamento, este trabalho apresenta o desenvolvimento de três ferramentas de recorte genéricas implementadas usando-se duas metáforas de interação distintas que são freqüentemente utilizadas por usuários de aplicativos 3D: apontador virtual e mão virtual. A taxa de interação dessas ferramentas é obtida através de programas de fragmentos especiais executados diretamente no hardware gráfico. Estes programas especificam regiões dentro do volume a serem descartadas durante o rendering, com base em predicados geométricos. Primeiramente, o desempenho, precisão e preferência (por parte dos usuários) das ferramentas de recorte volumétrico são avaliados para comparar as metáforas de interação empregadas. Após, é avaliada a interação utilizando-se diferentes dispositivos de entrada para a manipulação do volume e ferramentas. A utilização das duas mãos ao mesmo tempo para essa manipulação também é testada. Os resultados destes experimentos de avaliação são apresentados e discutidos.

Computed tomographic-dacryocystography (CT-DCG) of the normal canine nasolacrimal drainage system with three-dimensional reconstruction

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Uso de renderização volumétrica e realidade virtual para problemas de percolação na engenharia

In the recovering process of oil, rock heterogeneity has a huge impact on how fluids move in the field, defining how much oil can be recovered. In order to study this variability, percolation theory, which describes phenomena involving geometry and connectivity are the bases, is a very useful model. Result of percolation is tridimensional data and have no physical meaning until visualized in form of images or animations. Although a lot of powerful and sophisticated visualization tools have been developed, they focus on generation of planar 2D images. In order to interpret data as they would be in the real world, virtual reality techniques using stereo images could be used. In this work we propose an interactive and helpful tool, named ZSweepVR, based on virtual reality techniques that allows a better comprehension of volumetric data generated by simulation of dynamic percolation. The developed system has the ability to render images using two different techniques: surface rendering and volume rendering. Surface rendering is accomplished by OpenGL directives and volume rendering is accomplished by the Zsweep direct volume rendering engine. In the case of volumetric rendering, we implemented an algorithm to generate stereo images. We also propose enhancements in the original percolation algorithm in order to get a better performance. We applied our developed tools to a mature field database, obtaining satisfactory results. The use of stereoscopic and volumetric images brought valuable contributions for the interpretation and clustering formation analysis in percolation, what certainly could lead to better decisions about the exploration and recovery process in oil fields

Contributo dei sistemi di fusione d'immagine mediante ecografia combinata con TAC e o RMN nella diagnosi del piccolo epatocarcinoma (< 2 cm) in pazienti con epatopatia cronica

L’ecografia è la metodica diagnostica più utilizzata come screening e follow-up nei pazienti epatopatici con o senza lesioni focali e questo grazie alle sue peculiari caratteristiche, che sono date dall’essere real-time, maneggevole, priva di radiazioni ionizzanti e con bassi costi. Tuttavia tale metodica se confrontata con la TC o la RMN, può avere importanti limiti, quali l’impossibilità di visualizzare piccole lesioni localizzate in aree anatomicamente “difficili” o in pazienti obesi, che sono già state identificate con altre tecniche, come la TC o la RMN. Per superare queste limitazioni sono stati introdotti dei sistemi di “fusione d’immagine” che consentono di sincronizzare in tempo reale una metodica real time con bassa risoluzione spaziale come l’ecografia ed una statica ad alta risoluzione come la TC o la RMN. Ciò si ottiene creando attorno al paziente un piccolo campo elettromagnetico costituito da un generatore e da un rilevatore applicato al trasduttore ecografico ed introducendo in un computer abbinato all’ecografo il “volume rendering” dell’addome del paziente ottenuto mediante TC multistrato o RM. Il preciso “ appaiamento spaziale “ delle due metodiche si ottiene individuando in entrambe lo stesso piano assiale di riferimento e almeno 3-4 punti anatomici interni. Tale sistema di fusione d’immagine potrebbe essere molto utile in campo epatologico nella diagnostica non invasiva del piccolo epatocarcinoma, che secondo le ultime linee guida, nei noduli di dimensioni fra 1 e 2 cm, richiede una concordanza nel comportamento contrastografico della lesione in almeno due tecniche d’immagine. Lo scopo del nostro lavoro è stato pertanto quello di valutare, in pazienti epatopatici, il contributo che tale sistema può dare nell’identificazione e caratterizzazione di lesioni inferiori a 20 mm, che erano già state identificate alla TC o alla RMN come noduli sospetti per HCC, ma che non erano stati visualizzati in ecografia convenzionale. L’eventuale re-identificazione con l’ecografia convenzionale dei noduli sospetti per essere HCC, può permettere di evitare, alla luce dei criteri diagnostici non invasivi un’ ulteriore tecnica d’immagine ed eventualmente la biopsia. Pazienti e Metodi: 17 pazienti cirrotici (12 Maschi; 5 Femmine), con età media di 68.9 +/- 6.2 (SD) anni, in cui la TC e la RMN con mezzo di contrasto avevano identificato 20 nuove lesioni focali epatiche, inferiori a 20 mm (13,6 +/- 3,6 mm), sospette per essere epatocarcinomi (HCC), ma non identificate all’ecografia basale (eseguita in cieco rispetto alla TC o alla RMN) sono stati sottoposti ad ecografia senza e con mezzo di contrasto, focalizzata su una zona bersaglio identificata tramite il sistema di fusione d’immagini, che visualizza simultaneamente le immagini della TC e della RMN ricostruite in modalità bidimensionale ( 2D), tridimensionale ( 3 D) e real-time. La diagnosi finale era stata stabilita attraverso la presenza di una concordanza diagnostica, secondo le linee guida internazionali o attraverso un follow-up nei casi di discordanza. Risultati: Una diagnosi non invasiva di HCC è stata raggiunta in 15/20 lesioni, inizialmente sospettate di essere HCC. Il sistema di fusione ha identificato e mostrato un comportamento contrastografico tipico in 12/15 noduli di HCC ( 80%) mentre 3/15 HCC (20%) non sono stati identificati con il sistema di fusione d’immagine. Le rimanenti 5/20 lesioni non sono state visualizzate attraverso i sistemi di fusione d’immagine ed infine giudicate come falsi positivi della TC e della RMN, poiché sono scomparse nei successivi mesi di follow-up e rispettivamente dopo tre, sei, nove, dodici e quindici mesi. Conclusioni: I nostri risultati preliminari mostrano che la combinazione del sistema di fusione dell’immagine associata all’ecografia senza e con mezzo di contrasto (CEUS), migliora il potenziale dell’ecografia nell’identificazione e caratterizzazione dell’HCC su fegato cirrotico, permettendo il raggiungimento di una diagnosi, secondo criteri non invasivi e slatentizzazndo casi di falsi positivi della TC e della RMN.

Analyse zur Auswirkung der irreversiblen Wavelet-Kompression (JPEG2000) auf CT-Bildverarbeitungs- und Darstellungsalgorithmen

Der technische Fortschritt konfrontiert die medizinische Bildgebung wie keine andere Sparte der Medizin mit einem rasanten Anstieg zu speichernder Daten. Anschaffung, Wartung und Ausbau der nötigen Infrastruktur entwickeln sich zunehmend zu einem ökonomischen Faktor. Ein Verfahren, welches diesem Trend etwas entgegensetzten könnte ist die irreversible Bilddatenkompression. Sie ist seit über 10 Jahren Gegenstand vieler Studien, deren Ergebnisse sich wiederum in Empfehlungen zum Einsatz irreversibler Kompression mehrerer nationaler und internationaler Organisation, wie CAR, DRG, RCR und ESR wiederspiegeln. Tenor dieser Empfehlungen ist, dass der Einsatz von moderater irreversibler Bilddatenkompression sicher und sinnvoll ist. Teil dieser Empfehlungen sind auch Angaben über das Maß an Kompression, ausgedrückt in Kompressionsraten, welche je nach Untersuchung und anatomischer Region als sicher anwendbar gelten und keinen diagnostisch relevanten Verlust der komprimierten Bilder erzeugen.rnVerschiedene Kompressionsalgorithmen wurden vorgeschlagen. Letztendlich haben sich vor allem die beiden weit verbreiteten Algorithmen JPEG und JPEG2000 bewährt. Letzterer erfährt in letzter Zeit zunehmen Anwendung, aufgrund seiner einfacheren Handhabung und seiner umfangreichen Zusatzfunktionen.rnAufgrund rechtlich-ethischer Bedenken hat die irreversible Kompression keine breite praktische Anwendung finden können. Dafür verantwortlich ist unter anderem auch die Unklarheit, wie sich irreversible Kompression auf Nach- und Weiterverarbeitung (sog. Postprocessing) medizinischer Bilder, wie Segmentierung, Volumetrie oder 3D-Darstellung, auswirkt. Bisherige Studien zu diesem Thema umfassen vier verschiedene Postprocessing-Algorithmen. Die untersuchten Algorithmen zeigten sich bei verlustbehafteter Kompression im Bereich der erwähnten, publizierten Kompressionsraten weitgehend unbeeinflusst. Lediglich die computergestützte Messung von Stenosegraden in der digitalen Koronarangiographie kollidiert mit den in Großbritannien geltenden Empfehlungen. Die Verwendung unterschiedlicher Kompressionsalgorithmen schränkt die allgemeinernAussagekraft dieser Studienergebnisse außerdem ein.rnZur Erweiterung der Studienlage wurden vier weitere Nach- und Weiterverarbeitungsalgorithmen auf ihre Kompressionstoleranz untersucht. Dabei wurden die Kompressionsraten von 8:1, 10:1 und 15:1 verwendet, welche um die empfohlenen Kompressionsraten von CAR, DRG, RCR und ESR liegen und so ein praxisnahes Setting bieten. Als Kompressionsalgorithmus wurde JPEG2000 verwendet, aufgrund seiner zunehmenden Nutzung in Studien sowie seiner bereits erwähnten Vorzüge in Sachen Handhabung und Zusatzfunktionen. Die vier Algorithmen umfassten das 3D-Volume rendering von CT-Angiographien der Becken-Bein-Gefäße, die Computer-assistierte Detektion von Lungenrundherden, die automatisierte Volumetrie von Leberrundherden und die funktionelle Bestimmung der Ejektionsfraktion in computertomographischen Aufnahmen des Herzens.rnAlle vier Algorithmen zeigten keinen Einfluss durch irreversibler Bilddatenkompression in denrngewählten Kompressionsraten (8:1, 10:1 und 15:1). Zusammen mit der bestehenden Literatur deuten die Ergebnisse an, dass moderate irreversible Kompression im Rahmen aktueller Empfehlungen keinen Einfluss auf Nach- und Weiterverarbeitung medizinischer Bilder hat. Eine explizitere Vorhersage zu einem bestimmten, noch nicht untersuchten Algorithmus ist jedoch aufgrund der unterschiedlichen Funktionsweisen und Programmierungen nicht sicher möglich.rnSofern ein Postprocessing Algorithmus auf komprimiertes Bildmaterial angewendet werden soll, muss dieser zunächst auf seine Kompressionstoleranz getestet werden. Dabei muss der Test eine rechtlich-ethische Grundlage für den Einsatz des Algorithmus bei komprimiertem Bildmaterial schaffen. Es sind vor allem zwei Optionen denkbar, die Testung institutsintern, eventuell unter Zuhilfenahme von vorgefertigten Bibliotheken, oder die Testung durch den Hersteller des Algorithmus.

Getting in touch-3D printing in Forensic Imaging

With the increasing use of medical imaging in forensics, as well as the technological advances in rapid prototyping, we suggest combining these techniques to generate displays of forensic findings. We used computed tomography (CT), CT angiography, magnetic resonance imaging (MRI) and surface scanning with photogrammetry in conjunction with segmentation techniques to generate 3D polygon meshes. Based on these data sets, a 3D printer created colored models of the anatomical structures. Using this technique, we could create models of bone fractures, vessels, cardiac infarctions, ruptured organs as well as bitemark wounds. The final models are anatomically accurate, fully colored representations of bones, vessels and soft tissue, and they demonstrate radiologically visible pathologies. The models are more easily understood by laypersons than volume rendering or 2D reconstructions. Therefore, they are suitable for presentations in courtrooms and for educational purposes.