Evaluation of the dosimetry and centralization of scout-view function in CBCT

Abstract This study evaluated the centralization of the region of interest (ROI) in acquisition of the CBCT images, when the freely positionable scout-view (SV) function is applied. Additionally, the dosimetry of the acquired images was assessed in the SV function alone as well as in complete tomographic image in two different fields of view (FOV) (50x50 and 78x150mm). A three-location device was created to accommodate the dosimeters and the specimens, in the right, middle and left location during image acquisition. For dose assessment, thermoluminescent dosimeters were irradiated within the FOV and analyzed in a portable reader. For ROI evaluation, three specimens of gutta-percha stick were placed on the same device and the CT scans were acquired (CBCT OP 300 Maxio device, 90kV, 13mA, 85 µm voxel size, FOV of 50X50mm), with and without the SV, in three positions (3-9, 1-7 and 5-11 o'clock), simulating different regions of the mouth. Two image evaluations were performed, an objective and subjective. There was a slight percentage increase (1.36% to 1.40%) of the radiation dose with the use of SV. The distances were significantly greater in the images acquired without SV (p < 0.05). Every image obtained with SV was classified as being at the FOV's center. In conclusion, the results demonstrated that SVs function is effective to centralize the ROI in the FOV, increasing the scan precision and avoiding repetitions due to positioning errors.

Resumo Este estudo avaliou a centralização da região de interesse (ROI) na aquisição das imagens de TCFC, quando a função scout-view (SV) posicionável livremente é aplicada. Adicionalmente, a dosimetria das imagens adquiridas foi avaliada isoladamente na presença da função SV, bem como após aquisição de imagem tomográfica completa em dois diferentes campos de visão (FOV) (50x50 e 78x150mm). Um dispositivo de três localizações foi criado para acomodar os dosímetros e os espécimes, na localização direita, central e esquerda, durante a aquisição das imagens. Para avaliação da dose, dosímetros termoluminescentes foram irradiados dentro dos campos de visão e analisados em leitor portátil. Para avaliação da ROI, três espécimes de guta percha foram colocados no mesmo aparelho e as tomografias foram adquiridas (CBCT OP 300 Maxio, 90kV, 13mA, 85 μm tamanho de voxel, FOV de 50X50mm), com e sem a SV, em três posições (3-9, 1-7 e 5-11 horas), simulando diferentes regiões da boca. Foram realizadas duas avaliações de imagem, uma objetiva e outra subjetiva. Houve um leve aumento percentual (1,36% para 1,40%) da dose de radiação com o uso de SV. As distâncias foram significativamente maiores nas imagens adquiridas sem SV (p < 0,05). Todas as imagens obtidas com SV foram classificadas como sendo do centro do FOV. Em conclusão, os resultados do presente estudo demonstraram que a função scout view é eficaz para centralizar a ROI no FOV, aumentando a precisão do escaneamento e evitando repetições devido a erros de posicionamento.

Zero-profile anterior cervical ROI-C cage versus traditional fusion cage combined with titanium plate in treatment of two-level cervical spondylotic myelopathy / 中国组织工程研究

BACKGROUND: Self-locking self-stabilizing zero-profile cage ROI-C is advanced from the traditional titanium plate fusion cage, but the systematic studies on ROI-C internal fixation system applied in the comprehensive evaluation of two-level cervical spondylotic myelopathy are few. OBJECTIVE: To comprehensively evaluate the clinical efficacy of small-incision anterior cervical self-locking self-stabilizing zero-profile cage ROI-C in the treatment of two-level cervical spondylotic myelopathy. METHODS: Fifty-seven patients with two-level cervical spondylotic myelopathy at the First Affiliated Hospital of Guangdong Pharmaceutical University from September 2016 to March 2018 were selected, including 30 males and 27 females, aged 34-77 years old. Of which, 33 patients underwent small-incision anterior cervical self-locking self-stabilizing zero-profile fusion cage ROI-C implantation (observation group), and another 24 patients received small-incision cervical anterior titanium internal fixation (control group). The JOA score, Neck Disability Index, Odom criteria, Visual Analogue Scale score, dysphagia degree, Cobb angle of cervical lordosis, angle of fusion segment, and disc height and cervical fusion rate were assessed at 2 weeks and 1, 3, 6, and 12 months after surgery. The study was approved by the Ethics Committee of the First Affiliated Hospital of Guangdong Pharmaceutical University. RESULTS AND CONCLUSION: (1) There was no significant difference in the Odoms criteria between two groups (P > 0.05). All 57 patients were followed up for 12 months after surgery. No internal fixation loosening or vertebral structure changes were found. No complications such as loosen and broken of titanium plate occurred. (2) Postoperative JOA score, Neck Disability Index, and Visual Analogue Scale in the two groups were significantly improved compared with those before surgery (P 0.05). (3) The incidence of dysphagia at 2 weeks and 1 month in the observation group was significantly lower than that in the control group (P 0.05). (4) The Cobb angle of cervical lordosis, angle of fusion segment, and disc height were significantly improved in both groups after surgery (P 0.05). (5) The cervical fusion rate at the last follow-up in both groups was > 95%, and the fusion effect was good. There was no significant difference in the fusion rate at different time points between two groups (P > 0.05). (6) These results indicate that the small-incision anterior cervical self-locking self-stabilizing Zero-profile interbody fusion ROI-C and anterior titanium plate internal fixation exert significant effects in the treatment of two-level cervical spondylotic myelopathy. However, ROI-C can reduce the incidence of postoperative dysphagia.

Effects of ROI-C Cervical Implantation on Biomechanics of Cervical Vertebra / 医用生物力学

Objective To investigate the influence of ROI-C cervical implantation in the C5-6 segment on the C3-7 range-of-motion (ROM), biomechanical properties of the intervertebral disc and the vertebral body, and the mode of force transmission. Methods Two types of surgeries, ROI-C implantation and autograft fusion with plate fixation, were considered to establish the finite element model of cervical C5-6 segment degeneration. The ROM of C3-7 during flexion, extension, lateral bending, and axial rotation, as well as stress distributions on the adjacent discs, vertebral body, and implanted devices under two procedures, were analyzed. Results ROI-C implantation had a relatively small influence on the ROM of the adjacent segment. The stress on the vertebral discs was reduced, but the stress on the vertebral body increased significantly, with the C5 vertebral body stress increasing by 251%. In the fusion surgery model, the ROM of the surgical segment was reduced by 86%-91%, while the ROM of the adjacent segments and the stress on the vertebral disc and vertebral body increased significantly. Conclusions ROI-C implantation surgery has a relatively small influence on the cervical ROM and the intervertebral disc, and it has a greater impact on the vertebral body. The research findings provide a theoretical basis for the design of operation plans and clinical studies on ROI-C implantation and autograft fusion with plate fixation.

Interregional correlations of glucose metabolism between the basal ganglia and different cortical areas: an ultra-high resolution PET/MRI fusion study using 18F-FDG

Basal ganglia have complex functional connections with the cerebral cortex and are involved in motor control, executive functions of the forebrain, such as the planning of movement, and cognitive behaviors based on their connections. The aim of this study was to provide detailed functional correlation patterns between the basal ganglia and cerebral cortex by conducting an interregional correlation analysis of the 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) data based on precise structural information. Fifteen participants were scanned with 7-Tesla magnetic resonance imaging (MRI) and high resolution research tomography (HRRT)-PET fusion system using 18F-FDG. For detailed interregional correlation analysis, 24 subregions of the basal ganglia including pre-commissural dorsal caudate, post-commissural caudate, pre-commissural dorsal putamen, post-commissural putamen, internal globus pallidus, and external globus pallidus and 80 cerebral regions were selected as regions of interest on the MRI image and their glucose metabolism were calculated from the PET images. Pearson's product-moment correlation analysis was conducted for the interregional correlation analysis of the basal ganglia. Functional correlation patterns between the basal ganglia and cerebral cortex were not only consistent with the findings of previous studies, but also showed new functional correlation between the dorsal striatum (i.e., caudate nucleus and putamen) and insula. In this study, we established the detailed basal ganglia subregional functional correlation patterns using 18F-FDG PET/MRI fusion imaging. Our methods and results could potentially be an important resource for investigating basal ganglia dysfunction as well as for conducting functional studies in the context of movement and psychiatric disorders.

Louis XIV's Ginseng: Shaping of Knowledge on an Herbal Medicine in the Late 17th and the Early 18th Century France / 의사학

This article aims to investigate the shaping of knowledge and discourse on ginseng, especially among physicians and botanists, since its introduction to France from the 17th century until the early 18th century. In France, knowledge on herbal medicine, including that of ginseng, was shaped under the influence of the modern state's policy and institution: mercantilism and the Académie royale des sciences. The knowledge of herbal medicine developed as an important part of the mercantilist policy supported systematically by the Académie. The East Asian ginseng, renowned as a panacea, was first introduced into France in the 17th century, initially in a roundabout way through transportation and English and Dutch publications of travel tales from various foreign countries. The publication activity was mainly conducted by Thévenot company with the intention to meet the needs of French mercantilism promoted by Colbert. It also implied interests on medicine in order to bolster the people's health. The Thévenot company's activity thus offered vital information on plants and herbs abroad, one of which was ginseng. Furthermore, with Louis XIV's dispatching of the Jesuit missionaries to East Asia, the Frenchmen were able to directly gather information on ginseng. These information became a basis for research of the Académie. In the Académie, founded in 1666 by Colbert, the king's physicians and botanists systematically and collectively studied on exotic plants and medical herbs including ginseng. They were also key figures of the Jardin du Roi. These institutions bore a striking contrast to the faculty of medicine at the University of Paris which has been a center of the traditional Galenic medicine. The research of the Académie on ginseng was greatly advanced, owing much to the reports and samples sent from China and Canada by Jartoux, Sarrazin, and Lapitau. From the early 18th century, the conservative attitude of the University of Paris, which was a stronghold of conservative Galenic Medicine, began to change with its new interest on foreign medicine herbs, including Chinese medicine. In our opinion, this change is exemplified in a paper, that is to say in a thése de licence or thése quolibétique in French, submitted to the Faculty of Medicine in 1736 by Folliot de Saint-Vast under the direction of Jacques-François Vendermonde. During this period, the knowledge of Chinese Materia Medica was introduced, despite of textual adaptation and interpolation, through the "translation" of Chinese medicale books such as Bencao Gangmu. The Chinese medical books were presented to the French academic public by doctors and Jesuit missionaries active in China. The assessment of the ginseng was generally favorable yet, although physicians and doctors began to take more caution on considering it as a panacea.

Preliminary study of iFlow application in lower extremity vascular disease / 中华胸心血管外科杂志

Objective The purpose of this study was to evaluate the practicability and efficiency of iFlow assistant function in lower extremity vascular disease angioplasty.Methods Retrospective analysis to 22 patients with lower extremity vascular disease in our single center from Septmber 2013 to November 2013, 19 males and 3 females with mean age(66.31 ± 7.46)years, iFlow technology was utilized to analyze the Region Of Interest(ROI) Peak Time(PeakTime) in pre-and post-angioplasty of lower extremity artery and assessed the state of vessel stenosis and blood flow perfusion, as well Doppler ultrasound in postoperative was used to double identify iFlow results.The results of vessel lesion, such as state of stenosis and occlusion were diagnosed by two senior doctors individually, as well as ROI Peak Time was recorded by technician.Results The iFlow technique performed that the ROI PeakTime in the region of interest was significantly decreased in postoperative in comparison to pre-angioplasty [(0.48 ± 0.39) s vs.(1.32 ± 0.60) s, t =8.836, P ＜ 0.001].The Doppler ultrasound in postoperative showed that the ankle-brachial index was significantly increased compared within preoperative (0.97 ± 0.16 vs.0.49 ± 0.11, t =-10.205, P ＜ 0.001).The results of iFlow technique in intraoperative were consistent with those of Doppler ultrasound in postoperative.Conclusion iFlow technique is effective to evaluate hemodynamic change of blood flow in vessel lesion in pre-and postangioplasty, which is assistive technique to assess the efficiency and prognosis in angioplasty.

Densitometría mineral ósea por tomografía computada / Bone mineral densitometry by computed tomography

La tomografía computarizada cuantitativa (QCT) es una técnica de medición real de la densidad ósea (DMO), en forma volumétrica (g/cm3) mediante ROI (región de interés), sin interferencias propias ni externas en el esqueleto axial o periférico. Otros métodos, tales como DXA (de las siglas inglesas Dual Energy X-ray Absorptiometry) sólo proporcionan estimaciones en proyección de la densidad ósea, generando sus resultados en proyección de área (g/cm3), no proporcionando un verdadero valor de la profundidad de la región. La atenuación ultrasónica, tasa de transmisión del ultrasonido (US) sólo pueden reflejar la arquitectura ósea. Esto concluye que la tomografía computarizada cuantitativa (QCT) proporciona predicciones válidas de la masa ósea trabecular, cortical y volumétrica, y de la capacidad mecánica del hueso, con la posibilidad de medición muscular regional (LRM) de gran importancia para la evaluación de la relación músculo/hueso.

Applying ROI Interbody Fusion Cage for Anterior Cervical Intervertebral Disc Resection Arthrodesis Treat Early Cervical Degenerative Disease / 浙江中医药大学学报

[Objective] The objective of the study was to determine the clinical and radiological outcomes of cervical interbody fusion using ROI cages. [Methods] Patients showing degenerative cervical mono- or bi-level pathology were prospectively included. Using AP and lateral radiographs, segmental height of the treated segments was determined quantitatively. Cage characteristics were described qualitatively. Clinical data such as the neck disability in-dex(NDI), numeric rating scale(NRS) were col ected at al time points .[Results] The scores of NDI, NRS were decreased gradual y, and stable after half year;but they were respectively reduced to 8.64 and 1.57 from 23.32 and 8.93, with difference of statistical meaning. The intervertebral angle increased af-ter operation, then decreased gradual y and was stable after half year, was 3.6 °after 1 year. The intervertebral height was maximum after operation, then re-duced gradual y, and was 5.32mm or so after 1 year. 16 patients were al cured after 1 year, with short fusion rate reaching 100%. [Conclusions] The clini-cal and radiological short-term outcome of anterior cervical discectomy and fusion using ROI cage are excel ent.

Nodule Detection in a Lung Region that's Segmented with Using Genetic Cellular Neural Networks and 3D Template Matching with Fuzzy Rule Based Thresholding

OBJECTIVE: The purpose of this study was to develop a new method for automated lung nodule detection in serial section CT images with using the characteristics of the 3D appearance of the nodules that distinguish themselves from the vessels. MATERIALS AND METHODS: Lung nodules were detected in four steps. First, to reduce the number of region of interests (ROIs) and the computation time, the lung regions of the CTs were segmented using Genetic Cellular Neural Networks (G-CNN). Then, for each lung region, ROIs were specified with using the 8 directional search; +1 or -1 values were assigned to each voxel. The 3D ROI image was obtained by combining all the 2-Dimensional (2D) ROI images. A 3D template was created to find the nodule-like structures on the 3D ROI image. Convolution of the 3D ROI image with the proposed template strengthens the shapes that are similar to those of the template and it weakens the other ones. Finally, fuzzy rule based thresholding was applied and the ROI's were found. To test the system's efficiency, we used 16 cases with a total of 425 slices, which were taken from the Lung Image Database Consortium (LIDC) dataset. RESULTS: The computer aided diagnosis (CAD) system achieved 100% sensitivity with 13.375 FPs per case when the nodule thickness was greater than or equal to 5.625 mm. CONCLUSION: Our results indicate that the detection performance of our algorithm is satisfactory, and this may well improve the performance of computer-aided detection of lung nodules.

A research for the relative signal intensity of the retrodiscal tissue in the temporomandibular joint disorder patients on MRI

Expression of inducible nitric oxide synthase, caspase-3 and production of reactive oxygen intermediate on endothelial cells culture (HUVECs) treated with P. falciparum infected erythrocytes and tumour necrosis factor-α.

Cytoadherence of P. falciparum infected erythrocytes on endothelial cells is a key factor in development of severe malaria. This process may associated with the activation of local immune that was enhanced by tumour necrosis factor-α (TNF-α). This study was conducted to see the influence of P.falciparum infected erythrocytes cytoadherence and TNF-α treatment in inducing endothelial cells activation in vitro. inducible nitric oxide synthase (iNOS) and caspase-3 expression, also reactive oxygen intermediate (ROI) production were used as parameters. An Experimental laboratory study had been done to observe endothelial cells activation (HUVECs) after treatment with TNF-α for 20 hours or P. falciparum infected erythrocytes for 1 hour or both of them. Normal endothelial cells culture had been used as a control. Using immunocytochemistry local immune activation of endothelial cells was determined by iNOS and caspase-3 expression. Nitro Blue Tetrazolium reduction-assay was conducted to see the ROI production semi quantitatively. inducible nitric oxide synthase expression only found on endothelial cells culture treated with P. falciparum infected erythrocytes or both P. falciparum infected erythrocytes and TNF-α. Caspase-3 expression found slightly on normal endothelial cells culture. This expression increased significantly on endothelial cells culture treated with both P.falciparum infected erythrocytes and TNF-α (p=0.000). The normal endothelial cells release low level of ROI in the presence of non-specific trigger, PMA. In the presence of P. falciparum infected erythrocytes or TNF-α or both of them, some cells showed medium to high levels of ROI. Cytoadherence of P. falciparum infected erythrocytes and TNF α treatment on endothelial cells can induce activation of local immune marked by increase inducible nitric oxide synthase and release of free radicals that cause cell damage.

The relative signal intensity of retrodiscal tissue in TMJ using a T2-weighted MRI

A Study on the ROI Optimizing Technique for Accurate Breath Measurements in Sleep Apnea / 대한의료정보학회지

OBJECTIVE: A sleep apnea is the most frequent symptom among sleep disorders. As the number of aged people are increasing, research activities are also increasing to monitor sleeping disorders of the elderly who lives alone. We proposed a new processing algorithm to measure the quantity of breaths accurately. METHODS: We improved the conventional center-of-mass method and further apply the projection profile method. RESULTS: In this study a system that can monitors respiration non-invasively and automatically, by identifying the movement of the chest and abdomen using image processing technique during sleep, was implemented. We can see breathing status in real time based on the acquired breathing waves. To verify the designed system, the values from the polysomnography were compared and analyzed to validate the system accuracy. As a result, the mean accuracy is 96%. CONCLUSION: We can simply monitor the sleep apnea with no sleep interferences.

Research on medical image compression based on shape-self-adapted ROI / 医疗卫生装备

Objective To conduct lossless compression to medical images with lossless regions of interest.Methods Firstly,the shape information of interest regions were segmented and pick up.Then,the self-adaptive wavelet transform was performed to transform interest regions.At last,the modulus of the interest regions and the rest were coded respectively before being stored or transmitted.Results A method for medical image compression based on shape-self-adapted ROI was raised.Conclusion The whole image can be highly compressed with high fidelity

The Effect of Methylphenidate on Relative Cerebral Blood Flow in Subjects with Attention Deficit/Hyperactivity Disorder: Using SPECT Region of Interest Method / 신경정신의학

OBJECTIVES: This study was conducted to find out topographic changes of cerebral perfusion between pretreatment and posttreatmet state via region of interest method by Single Photon Emission Computed Tomography(SPECT). METHOD: By DSM-IV criteria, we selected 32 patients with pure Attention Deficit Hyperactivity Disorder (ADHD) through various assessment scales, psychometric tools and neuropsychological batteries. All the patients with ADHD were studied by Tc99m-HMPAO Brain SPECT, before methylphenidate(MPND) treatment and after 6 weeks treatment. Three transaxial brain slices delineating anatomically defined region of interest at approximately 20, 40, 60mm above the orbitomeatal line(OML) were used, with the average number of counts for each region of interest normalized to the area of cerebellar maximal uptake. RESULTS: In the plane 20mm above OML, None of areas showed significant perfusion changes. In the plane 40mm above OML, left and right prefrontal areas, caudate and thalamic areas showed increased relative perfusion compared to pretreatment state. In the plane 60mm above OML, there were no increases in all regions of interest. CONCLUSION: The MPND treament improved cerebral blood flow in some specific brain regions: prefrontal lobe, caudate and thalamic area. We found neuroanatomical action sites of MPND might be the pathophysiologic sites of ADHD which had been proved in previous studies. These findings implied that MPND treatment could correct the underlying pathologic brain dysfunction of ADHD.

The Cerebral Blood Flow Abnormalities in Children with Attention Deficit /Hyperactivity Disorder: Controlled Study Using SPECT ROI Method / 신경정신의학

OBJECTIVE: This study was conducted to test the hypothesis that children with Attention Deficit Hyperactivity Disorder(ADHD) might have distinctive findings from normal controls in brain Single Photon Emission Computed Tomography(SPECT) and to figure out the possible pathophysiology of this disorder. METHOD: By DSM-IV criteria, we selected 21 pure ADHD through various assessment scales, psychometric tools and neuropsychological battery. All the patients were studied by 99m Tc-HMPAO Brain SPECT. Three transaxial brain slices delineating anatomically defined region of interest at approximately 2, 4, 6cm above the orbitomeatal line were used with the average number of counts for each region of interest normalized to the area of cerebral maximal uptake. Eleven normal controls were recruited from age, sex, IQ- matched children whose previous SPECT findings had been normal. RESULT: Comparing ADHD group and control, we found highly significantly decreased cererbral blood flow in both frontal lobes, caudate nuclei and thalamus in ADHD group. Addtionally, ADHD group showed reduction of blood flow in some parietal and temporal lobe areas compared with normal group, but the statistical significance in parietal and temporal areas was vanished after Bonferrroni correction due to multiple comparison. CONCLUSION: These findings implied that the rCBF reduction in ADHD in frontal lobe, caudate and thalamic areas might be related with the pathophysiogy of ADHD.

Transcranial Doppler CO2 Test as an Indicator of Cerebral Vasoreactivity and Prognosis in Patients with Regional CBF Alteration

The assessment of cerebral vasoreactivity provides information on the reserve capacity of cerebral circulation in patients with cerevrovascular disease. It also allows for the diagnosis of impending ischemia and control of the effect of initiated corrective measures. The authors had performed transcranial doppler(TCD) studies to measure the CO2 reactivity of the entire basal cerebral arteries in 30 cases of age-adjusted control group and 42cases of disease group and 42 cases of disease group between the 3rd and 7th day after insult. The disease group involved 14 cases of head injury, 10 cases of intraventricular hemorrhage, 10 cases of subarachnoid hemorrhage and 8 cases of hydrocephalus. All patients were examined by single photon emission computed tomography(SPECT) and results of the 2 groups were compared with respect to their CO2 reactivities. In the patient group, the mean blood flow velocity(MBFV), pusatility index(PI) and MI index(middle cerebral artery MBFV/internal cerebral artery MBFV) had not changed but the CO2 index was significantly lower than that in the same age group of normal control. The regions showing abnormal ROI(region of interest) on SPECT well corresponded with the regions showing decreased CO2 reactivity on TCD. Both the increase of MBFV and the decrease of Pl were noted in the cerebral arteries with decreased CO2 reactivity. This indicates that the very arterial walls were dilated. As for the relationships between the investigated variables, ROI increased as the clinical status worsen(r=-0.05, p=0.0008). The acute prognosis(prognosis after 3month of insult) had positive correlation with CO2 index(r=0.32, p=0.04) of clinical status, while on the other hand, its correlation with ROI index was negative(r=0.40, p=0.0094). Transcranial doppler CO2 test provides useful information for the understanding of hemodynamic status, prognosis and beneficial effects of specific therapy. It is concluded that CO2 index measured during the subacute stage of insult correlates well with the acute prognosis.

Preliminary clinical utility of ROI volume measurement for the oral and maxillofacial AVM before embolization / 介入放射学杂志

Objective To evaluate the clinical utility of ROI(region of intest)volume measurement for interventional embolization of the oral and maxillofacial AVM before intervention.Methods four patients with oral and maxillofacial AVM were undertaken,ROI volume measurement of AVM by GE AW 4.1 software based on the MRI and MSCT imaging data,and the quantity of embolic agent was administered correspondingly to the measured volume of AVM lesion and then,the therapeutic effect was observed.Results In 3 cases of this series,the volume of AVM lesions obtained by ROI volume measurement based on the imaging data were 7.515 cm3,1.195 cm3 and 10.714 cm3,respectively;gaining all the therapeutic satisfactory effects.However,the volume of the other case was not achieved because of the bilateral diffuse AVM with previous ligation of feeding arteries.Conclusions Soft tissue AVM can be best demonstrated on MRI and MSCT therefore can display AVM of jaw clearly.Pre-embolization of oral and maxillofacial AVM,the quantity of embolic agent(especially the liquid agent) can be estimated correctly by the ROI volume measurement used GE AW 4.1 software.