Embedded ubiquitous services on hospital information systems.

A Hospital Information Systems (HIS) have turned a hospital into a gigantic computer with huge computational power, huge storage and wired/wireless local area network. On the other hand, a modern medical device, such as echograph, is a computer system with several functional units connected by an internal network named a bus. Therefore, we can embed such a medical device into the HIS by simply replacing the bus with the local area network. This paper designed and developed two embedded systems, a ubiquitous echograph system and a networked digital camera. Evaluations of the developed systems clearly show that the proposed approach, embedding existing clinical systems into HIS, drastically changes productivity in the clinical field. Once a clinical system becomes a pluggable unit for a gigantic computer system, HIS, the combination of multiple embedded systems with application software designed under deep consideration about clinical processes may lead to the emergence of disruptive innovation in the clinical field.

High-accuracy and robust localization of large control markers for geometric camera calibration.

Accurate measurement of the position of features in an image is subject to a fundamental compromise: The features must be both small, to limit the effect of nonlinear distortions, and large, to limit the effect of noise and discretization. This constrains both the accuracy and the robustness of image measurements, which play an important role in geometric camera calibration as well as in all subsequent measurements based on that calibration. In this paper, we present a new geometric camera calibration technique that exploits the complete camera model during the localization of control markers, thereby abolishing the marker size compromise. Large markers allow a dense pattern to be used instead of a simple disc, resulting in a significant increase in accuracy and robustness. When highly planar markers are used, geometric camera calibration based on synthetic images leads to true errors of 0.002 pixels, even in the presence of artifacts such as noise, illumination gradients, compression, blurring, and limited dynamic range. The camera parameters are also accurately recovered, even for complex camera models.

Shortened protocol in practical [11C]SA4503-PET studies for sigma1 receptor quantification.

In practical positron emission tomography (PET) diagnosis, a shortened protocol is preferred for patients with brain disorders. In this study, the applicability of a shortened protocol as an alternative to the 90-min PET scan with [(11)C]SA4503 for quantitative sigma(1) receptor measurement was investigated. Tissue time-activity curves of 288 regions of interest in the brain from 32 [(11)C]SA4503-PET scans of 16 healthy subjects prior to and following administration of a selective serotonin reuptake inhibitor (fluvoxamine or paroxetine) were applied to two algorithms of quantitative analysis; binding potential (BP) was derived from compartmental analysis based on nonlinear estimation, and total distribution volume (tDV) was derived from Logan plot analysis. As a result, although both BP and tDV tended to be underestimated by the shortened method, the estimates from the shortened protocol had good linear relationships with those of the full-length protocol. In conclusion, if approximately 10% differences in the estimated results are acceptable for a specific purpose, then a 60-min measurement protocol is capable of providing reliable results.

Mapping of human cerebral sigma1 receptors using positron emission tomography and [11C]SA4503.

The objective of this study was to establish the kinetic analysis for mapping sigma(1) receptors (sigma1Rs) in the human brain by positron emission tomography (PET) with [(11)C]SA4503. The sigma1Rs are considered to be involved in various neurological and psychiatric diseases. [(11)C]SA4503 is a recently developed radioligand with high and selective affinity for sigma1Rs, and we have first applied it to clinical studies. Nine healthy male subjects each underwent a dynamic 90-min PET scan after injection of [(11)C]SA4503. In addition to the baseline measurement, three of the nine subjects underwent a second [(11)C]SA4503-PET after partial blockade of sigma1Rs by oral administration of haloperidol, a sigma receptor antagonist. Full kinetic analysis using two times nonlinear estimations was applied for fitting a two-tissue three-compartment model to determine the binding potential (BP) and total distribution volume (tDV) of [(11)C]SA4503. Graphical analysis with a Logan plot was also applied for estimations of tDV. The regional distribution patterns of BP and tDV in 11 regions were compatible with those of previously reported sigma1Rs in vitro. The reduced binding sites of sigma1Rs by haloperidol were appropriately evaluated. The tDVs derived from the two methods matched each other well. The Logan plot offered images of the tDV, which reflected sigma1R densities, and the tDV in the images decreased after haloperidol loading. Moreover, comparison of BPs calculated with and without metabolite correction for plasma input function indicated that the metabolite correction could be omitted. We concluded that this method enables the quantitative analysis of sigma1Rs in the human brain.

Quantification of adenosine A2A receptors in the human brain using [11C]TMSX and positron emission tomography.

PURPOSE: [7-methyl-(11)C]-(E)-8-(3,4,5-trimethoxystyryl)-1,3,7-trimethylxanthine ([(11)C]TMSX) is a positron-emitting adenosine A(2A) receptor (A2AR) antagonist for visualisation of A2AR distribution by positron emission tomography (PET). The aims of this paper were to use a kinetic model to analyse the behaviour of [(11)C]TMSX in the brain and to examine the applicability of the Logan plot. We also studied the applicability of a simplified Logan plot by omitting metabolite correction and arterial blood sampling. METHODS: The centrum semiovale was used as a reference region on the basis of a post-mortem study showing that it has a negligibly low density of A2ARs. Compartmental analysis was performed in five normal subjects. Parametric images of A2AR binding potential (BP) were also generated using a Logan plot with or without metabolite correction and with or without arterial blood sampling. To omit arterial blood sampling, we applied a method to extract the plasma-related information using independent component analysis (EPICA). RESULTS: The estimated K (1)/k (2) was confirmed to be common in the centrum semiovale and main cortices. The three-compartment model was well fitted to the other regions using the fixed value of K (1)/k (2) estimated from the centrum semiovale. The estimated BPs using the Logan plot matched those derived from compartment analysis. Without the metabolite correction, the estimate of BP underestimated the true value by 5%. The estimated BPs agreed regardless of arterial blood sampling. CONCLUSION: A three-compartment model with a reference region, the centrum semiovale, describes the kinetic behaviour of [(11)C]TMSX PET images. A2ARs in the human brain can be visualised as a BP image using [(11)C]TMSX PET without arterial blood sampling.

A feasibility study of [11C]SA4503-PET for evaluating sigmal receptor occupancy by neuroleptics: the binding of haloperidol to sigma1 and dopamine D2-like receptors.

We investigated feasibility of positron emission tomography (PET) with [11C]SA4503 for evaluating the sigma1 receptor occupancy rate by neuroleptics. Haloperidol, which is well known to bind dopamine D2-like receptor (D2R) as well as to be a representative non-selective antagonist for sigma1 receptor (sigma1R), was selected as a model drug. Three healthy male subjects underwent 60-min [11C]raclopride-PET and 90-min [11C]SA4503-PET scans successively at a 120-min interval twice in a day for baseline measurement and on another day for haloperidol-loading measurement 16 hours after peroral administration of 3 mg of haloperidol. Binding potential (BP) of [11C]raclopride and [11C]SA4503 was quantitatively evaluated and the sigma1R and D2R occupancy rates were determined. D2R occupancy rates by haloperidol were 64% and 62% in the caudate and putamen, respectively, 16 h after the administration, while sigma1R occupancy rates were approximately 80% in all seven regions investigated including the caudate, putamen and cerebellum 18 h after the administration, suggesting that the sigma1R receptor occupancy rate by haloperidol was slightly larger than the D2R receptor occupancy rate. We concluded that [11C]SA4503-PET can be used for evaluating the sigma1R occupancy rates by neuroleptics or other drugs.

Omission of serial arterial blood sampling in neuroreceptor imaging with independent component analysis.

We have previously proposed a statistical method for extracting a plasma time-activity curve (pTAC) from dynamic PET images, named EPICA, for kinetic analysis of cerebral glucose metabolism. We assumed that the dynamic PET images consist of a blood-related component and a tissue-related component which are spatially independent in a statistical sense. The aim of this study is to investigate the utility of EPICA in imaging total distribution volume (DVt) and binding potential (BP) with Logan plots in a neuroreceptor mapping study. We applied EPICA to dynamic [(11)C]MPDX PET images in 25 subjects, including healthy subjects and patients with brain diseases, and validated the estimated pTACs. [11C]MPDX is a newly developed radiopharmaceutical for mapping cerebral adenosine A1 receptors. EPICA successfully extracted pTAC for all 25 subjects. Parametric images of DVts were estimated by applying Logan plots with the EPICA-estimated pTAC and then used to define a reference region. The BPs estimated using EPICA were evaluated in 18 subjects by ROI-based comparison with those obtained using the nonlinear least squares method (NLSM). The calculated BPs were identical to the estimates using NLSM in each subject. We conclude that EPICA is a promising technique that generates parametric images of DVt and BP in neuroreceptor mapping without requiring arterial blood sampling.

Measurement of in vivo local shear modulus using MR elastography multiple-phase patchwork offsets.

Magnetic resonance elastography (MRE) is a method that can visualize the propagating and standing shear waves in an object being measured. The quantitative value of a shear modulus can be calculated by estimating the local shear wavelength. Low-frequency mechanical motion must be used for soft, tissue-like objects because a propagating shear wave rapidly attenuates at a higher frequency. Moreover, a propagating shear wave is distorted by reflections from the boundaries of objects. However, the distortions are minimal around the wave front of the propagating shear wave. Therefore, we can avoid the effect of reflection on a region of interest (ROI) by adjusting the duration of mechanical vibrations. Thus, the ROI is often shorter than the propagating shear wavelength. In the MRE sequence, a motion-sensitizing gradient (MSG) is synchronized with mechanical cyclic motion. MRE images with multiple initial phase offsets can be generated with increasing delays between the MSG and mechanical vibrations. This paper proposes a method for measuring the local shear wavelength using MRE multiple initial phase patchwork offsets that can be used when the size of the object being measured is shorter than the local wavelength. To confirm the reliability of the proposed method, computer simulations, a simulated tissue study and in vitro and in vivo studies were performed.