TSE-GAN: strain elastography using generative adversarial network for thyroid disease diagnosis.

Over the past 35 years, studies conducted worldwide have revealed a threefold increase in the incidence of thyroid cancer. Strain elastography is a new imaging technique to identify benign and malignant thyroid nodules due to its sensitivity to tissue stiffness. However, there are certain limitations of this technique, particularly in terms of standardization of the compression process, evaluation of results and several assumptions used in commercial strain elastography modes for the purpose of simplifying imaging analysis. In this work, we propose a novel conditional generative adversarial network (TSE-GAN) for automatically generating thyroid strain elastograms, which adopts a global-to-local architecture to improve the ability of extracting multi-scale features and develops an adaptive deformable U-net structure in the sub-generator to apply effective deformation. Furthermore, we introduce a Lab-based loss function to induce the networks to generate realistic thyroid elastograms that conform to the probability distribution of the target domain. Qualitative and quantitative assessments are conducted on a clinical dataset provided by Shanghai Sixth People's Hospital. Experimental results demonstrate that thyroid elastograms generated by the proposed TSE-GAN outperform state-of-the-art image translation methods in meeting the needs of clinical diagnostic applications and providing practical value.

Development and tuning of models for accurate simulation of CT spatial resolution using CatSim.

Objective. We sought to systematically evaluate CatSim's ability to accurately simulate the spatial resolution produced by a typical 64-detector-row clinical CT scanner in the projection and image domains, over the range of clinically used x-ray techniques.Approach.Using a 64-detector-row clinical scanner, we scanned two phantoms designed to evaluate spatial resolution in the projection and image domains. These empirical scans were performed over the standard clinically used range of x-ray techniques (kV, and mA). We extracted projection data from the scanner, and we reconstructed images. For the CatSim simulations, we developed digital phantoms to represent the phantoms used in the empirical scans. We developed a new, realistic model for the x-ray source focal spot, and we empirically tuned a published model for the x-ray detector temporal response. We applied these phantoms and models to simulate scans equivalent to the empirical scans, and we reconstructed the simulated projections using the same methods used for the empirical scans. For the empirical and simulated scans, we qualitatively and quantitatively compared the projection-domain and image-domain point-spread functions (PSFs) as well as the image-domain modulation transfer functions. We reported four quantitative metrics and the percent error between the empirical and simulated results.Main Results.Qualitatively, the PSFs matched well in both the projection and image domains. Quantitatively, all four metrics generally agreed well, with most of the average errors substantially less than 5% for all x-ray techniques. Although the errors tended to increase with decreasing kV, we found that the CatSim simulations agreed with the empirical scans within limits required for the anticipated applications of CatSim.Significance.The new focal spot model and the new detector temporal response model are significant contributions to CatSim because they enabled achieving the desired level of agreement between empirical and simulated results. With these new models and this validation, CatSim users can be confident that the spatial resolution represented by simulations faithfully represents results that would be obtained by a real scanner, within reasonable, known limits. Furthermore, users of CatSim can vary parameters including but not limited to system geometry, focal spot size/shape and detector parameters, beyond the values available in physical scanners, and be confident in the results. Therefore, CatSim can be used to explore new hardware designs as well as new scanning and reconstruction methods, thus enabling acceleration of improved CT scan capabilities.

XCIST-an open access x-ray/CT simulation toolkit.

Objective. X-ray-based imaging modalities including mammography and computed tomography (CT) are widely used in cancer screening, diagnosis, staging, treatment planning, and therapy response monitoring. Over the past few decades, improvements to these modalities have resulted in substantially improved efficacy and efficiency, and substantially reduced radiation dose and cost. However, such improvements have evolved more slowly than would be ideal because lengthy preclinical and clinical evaluation is required. In many cases, new ideas cannot be evaluated due to the high cost of fabricating and testing prototypes. Wider availability of computer simulation tools could accelerate development of new imaging technologies. This paper introduces the development of a new open-access simulation environment for x-ray-based imaging. The main motivation of this work is to publicly distribute a fast but accurate ray-tracing x-ray and CT simulation tool along with realistic phantoms and 3D reconstruction capability, building on decades of developments in industry and academia.Approach. The x-ray-based Cancer Imaging Simulation Toolkit (XCIST) is developed in the context of cancer imaging, but can more broadly be applied. XCIST is physics-based, written in Python and C/C++, and currently consists of three major subsets: digital phantoms, the simulator itself (CatSim), and image reconstruction algorithms; planned future features include a fast dose-estimation tool and rigorous validation. To enable broad usage and to model and evaluate new technologies, XCIST is easily extendable by other researchers. To demonstrate XCIST's ability to produce realistic images and to show the benefits of using XCIST for insight into the impact of separate physics effects on image quality, we present exemplary simulations by varying contributing factors such as noise and sampling.Main results. The capabilities and flexibility of XCIST are demonstrated, showing easy applicability to specific simulation problems. Geometric and x-ray attenuation accuracy are shown, as well as XCIST's ability to model multiple scanner and protocol parameters, and to attribute fundamental image quality characteristics to specific parameters.Significance. This work represents an important first step toward the goal of creating an open-access platform for simulating existing and emerging x-ray-based imaging systems. While numerous simulation tools exist, we believe the combined XCIST toolset provides a unique advantage in terms of modeling capabilities versus ease of use and compute time. We publicly share this toolset to provide an environment for scientists to accelerate and improve the relevance of their research in x-ray and CT.

Semiempirical, parameterized spectrum estimation for x-ray computed tomography.

PURPOSE: To develop a tool to produce accurate, well-validated x-ray spectra for standalone use or for use in an open-access x-ray/CT simulation tool. Spectrum models will be developed for tube voltages in the range of 80 kVp through 140 kVp and for anode takeoff angles in the range of 5° to 9°. METHODS: Spectra were initialized based on physics models, then refined using empirical measurements, as follows. A new spectrum-parameterization method was developed, including 13 spline knots to represent the bremsstrahlung component and 4 values to represent characteristic lines. Initial spectra at 80, 100, 120, and 140 kVp and at takeoff angles from 5° to 9° were produced using physics-based spectrum estimation tools XSPECT and SpekPy. Empirical experiments were systematically designed with careful selection of attenuator materials and thicknesses, and by reducing measurement contamination from scatter to <1%. Measurements were made on a 64-row CT scanner using the scanner's detector and using multiple layers of polymethylmethacrylate (PMMA), aluminum, titanium, tin, and neodymium. Measurements were made at 80, 100, 120, and 140 kVp and covering the entire 64-row detector (takeoff angles from 5° to 9°); a total of 6,144 unique measurements were made. After accounting for the detector's energy response, parameterized representations of the initial spectra were refined for best agreement with measurements using two proposed optimization schemes: based on modulation and based on gradient descent. X-ray transmission errors were computed for measurements vs calculations using the nonoptimized and optimized spectra. Half-value, tenth-value, and hundredth-value layers for PMMA, Al, and Ti were calculated. RESULTS: Spectra before and after parameterization were in excellent agreement (e.g., R2 values of 0.995 and 0.997). Empirical measurements produced smoothly varying curves with x-ray transmission covering a range of up to 3.5 orders of magnitude. Spectra from the two optimization schemes, compared with the unoptimized physic-based spectra, each improved agreement with measurements by twofold through tenfold, for both postlog transmission data and for fractional value layers. CONCLUSION: The resulting well-validated spectra are appropriate for use in the open-access x-ray/CT simulator under development, the x-ray-based Cancer Imaging Toolkit (XCIST), or for standalone use. These spectra can be readily interpolated to produce spectra at arbitrary kVps over the range of 80 to 140 kVp and arbitrary takeoff angles over the range of 5° to 9°. Furthermore, interpolated spectra over these ranges can be obtained by applying the standalone Matlab function available at https://github.com/xcist/documentation/blob/master/XCISTspectrum.m.

Model-based dose reconstruction for CT dose estimation.

PURPOSE: Our goal is to develop a model-based approach for CT dose estimation. We previously presented a CT dose estimation method that offered good accuracy in soft tissue regions but lower accuracy in bone regions. In this work, we propose an improved physic-based approach to achieve high accuracy for any materials and realistic clinical anatomies. METHODS: Like Monte Carlo techniques, we start from a model or image of the patient and we model all relevant x-ray interaction processes. Unlike Monte Carlo techniques, we do not track each individual photon, but we compute the average behavior of the x-ray interactions, combining pencil-beam calculations for the first-order interactions and kernels for the higher order interactions. The new algorithm more accurately models the variation of materials in the human body, especially for higher attenuation materials such as bone, as well as the various x-ray attenuation processes. We performed validation experiments with analytic phantoms and a polychromatic x-ray spectrum, comparing to Monte Carlo simulation (GEANT4) as the ground truth. RESULTS: The results show that the proposed method has improved accuracy in both soft tissue region and bone region: less than 6% voxel-wise errors and less than 3.2% ROI-based errors in an anthropomorphic phantom. The computational cost is on the order of a low-resolution filtered backprojection reconstruction. CONCLUSIONS: We introduced improved physics-based models in a fast CT dose reconstruction approach. The improved approach demonstrated quantitatively good correspondence to a Monte Carlo gold standard in both soft tissue and bone regions in a chest phantom with a realistic polychromatic spectrum and could potentially be used for real-time applications such as patient- and organ-specific scan planning and organ dose reporting.

Fast analytical approach of application specific dose efficient spectrum selection for diagnostic CT imaging and PET attenuation correction.

Computed tomography (CT) has been used for a variety of applications, two of which include diagnostic imaging and attenuation correction for PET or SPECT imaging. Ideally, the x-ray tube spectrum should be optimized for the specific application to minimize the patient radiation dose while still providing the necessary information. In this study, we proposed a projection-based analytic approach for the analysis of contrast, noise, and bias. Dose normalized contrast to noise ratio (CNRD), inverse noise normalized by dose (IND) and bias are used as evaluation metrics to determine the optimal x-ray spectrum. Our simulation investigated the dose efficiency of the x-ray spectrum ranging from 40 kVp to 200 kVp. Water cylinders with diameters of 15 cm, 24 cm, and 35 cm were used in the simulation to cover a variety of patient sizes. The effects of electronic noise and pre-patient copper filtration were also evaluated. A customized 24 cm CTDI-like phantom with 13 mm diameter inserts filled with iodine (10 mg ml-1), tantalum (10 mg ml-1), water, and PMMA was measured with both standard (1.5 mGy) and ultra-low (0.2 mGy) dose to verify the simulation results at tube voltages of 80, 100, 120, and 140 kVp. For contrast-enhanced diagnostic imaging, the simulation results indicated that for high dose without filtration, the optimal kVp for water contrast is approximately 100 kVp for a 15 cm water cylinder. However, the 60 kVp spectrum produces the highest CNRD for bone and iodine. The optimal kVp for tantalum has two selections: approximately 50 and 100 kVp. The kVp that maximizes CNRD increases when the object size increases. The trend in the CTDI phantom measurements agrees with the simulation results, which also agrees with previous studies. Copper filtration improved the dose efficiency for water and tantalum, but reduced the iodine and bone dose efficiency in a clinically-relevant range (70-140 kVp). Our study also shows that for CT-based attenuation correction applications for PET or SPECT, a higher-kVp spectrum with copper filtration is preferable. This method is developed based on filter back projection and does not require image reconstruction or Monte Carlo dose estimates; thus, it could potentially be used for patient-specific and task-based on-the-fly protocol optimization.

Acquisition, preprocessing, and reconstruction of ultralow dose volumetric CT scout for organ-based CT scan planning.

PURPOSE: Traditionally, 2D radiographic preparatory scan images (scout scans) are used to plan diagnostic CT scans. However, a 3D CT volume with a full 3D organ segmentation map could provide superior information for customized scan planning and other purposes. A practical challenge is to design the volumetric scout acquisition and processing steps to provide good image quality (at least good enough to enable 3D organ segmentation) while delivering a radiation dose similar to that of the conventional 2D scout. METHODS: The authors explored various acquisition methods, scan parameters, postprocessing methods, and reconstruction methods through simulation and cadaver data studies to achieve an ultralow dose 3D scout while simultaneously reducing the noise and maintaining the edge strength around the target organ. RESULTS: In a simulation study, the 3D scout with the proposed acquisition, preprocessing, and reconstruction strategy provided a similar level of organ segmentation capability as a traditional 240 mAs diagnostic scan, based on noise and normalized edge strength metrics. At the same time, the proposed approach delivers only 1.25% of the dose of a traditional scan. In a cadaver study, the authors' pictorial-structures based organ localization algorithm successfully located the major abdominal-thoracic organs from the ultralow dose 3D scout obtained with the proposed strategy. CONCLUSIONS: The authors demonstrated that images with a similar degree of segmentation capability (interpretability) as conventional dose CT scans can be achieved with an ultralow dose 3D scout acquisition and suitable postprocessing. Furthermore, the authors applied these techniques to real cadaver CT scans with a CTDI dose level of less than 0.1 mGy and successfully generated a 3D organ localization map.

Dose reconstruction for real-time patient-specific dose estimation in CT.

PURPOSE: Many recent computed tomography (CT) dose reduction approaches belong to one of three categories: statistical reconstruction algorithms, efficient x-ray detectors, and optimized CT acquisition schemes with precise control over the x-ray distribution. The latter category could greatly benefit from fast and accurate methods for dose estimation, which would enable real-time patient-specific protocol optimization. METHODS: The authors present a new method for volumetrically reconstructing absorbed dose on a per-voxel basis, directly from the actual CT images. The authors' specific implementation combines a distance-driven pencil-beam approach to model the first-order x-ray interactions with a set of Gaussian convolution kernels to model the higher-order x-ray interactions. The authors performed a number of 3D simulation experiments comparing the proposed method to a Monte Carlo based ground truth. RESULTS: The authors' results indicate that the proposed approach offers a good trade-off between accuracy and computational efficiency. The images show a good qualitative correspondence to Monte Carlo estimates. Preliminary quantitative results show errors below 10%, except in bone regions, where the authors see a bigger model mismatch. The computational complexity is similar to that of a low-resolution filtered-backprojection algorithm. CONCLUSIONS: The authors present a method for analytic dose reconstruction in CT, similar to the techniques used in radiation therapy planning with megavoltage energies. Future work will include refinements of the proposed method to improve the accuracy as well as a more extensive validation study. The proposed method is not intended to replace methods that track individual x-ray photons, but the authors expect that it may prove useful in applications where real-time patient-specific dose estimation is required.

BRCA1 mislocalization associated with breast carcinogenesis and poor prognosis in Taiwanese women.

We aimed to elucidate whether and how BRCA1 mislocalization [including membranous nuclear (MN) forms and negative patterns] is associated with the occurrence and the prognosis of breast cancer in young Taiwanese women. A case-control study was carried out to enroll 84 patients with breast cancer and 81 patients with benign breast disease. The subcellular localization of BRCA1 was examined using immunofluorescent assays on fresh tissue touch-imprinting slides to classify staining results into diffuse nuclear (DN), MN, and negative staining. Genetic variations of BRCA1 nuclear localization/transportation-related sequences were analyzed by cDNA sequencing of both nuclear localization signals (NLS) and nuclear export signals (NES). The BRCA1 antibody was verified by two other published ones. Comparisons of immunofluorescent assay with immunohistochemical and H&E staining methods were also performed. BRCA1 mislocalization conferred a 3.13-fold [95% confidence interval (CI): 1.31-7.50] risk of developing breast cancer for the MN form and a 5.79-fold (95% CI:1.58-21.23) risk for BRCA1-negative cases compared with DN staining. However, no genetic variant was found in the NES or the NLS region of the BRCA1 gene. In terms of prognosis, BRCA1 mislocalization showed a 3.5-fold (95% CI: 1.20-10.09) increased risk of breast cancer death compared with DN staining after adjusting for tumor node metastasis stage. BRCA1 MN forms and BRCA1-negative patterns led to a higher risk of carcinogenesis and a poor prognosis of breast cancer. Such BRCA1 mislocalization may not be directly caused by the genetic effects of the NLS and NES domains, but stem from nongenetic modifications (such as epigenetic silencing).

[Near infrared distance sensing method for Chang'e-3 alpha particle X-ray spectrometer].

Alpha particle X-ray spectrometer (APXS) is one of the payloads of Chang'E-3 lunar rover, the scientific objective of which is in-situ observation and off-line analysis of lunar regolith and rock. Distance measurement is one of the important functions for APXS to perform effective detection on the moon. The present paper will first give a brief introduction to APXS, and then analyze the specific requirements and constraints to realize distance measurement, at last present a new near infrared distance sensing algorithm by using the inflection point of response curve. The theoretical analysis and the experiment results verify the feasibility of this algorithm. Although the theoretical analysis shows that this method is not sensitive to the operating temperature and reflectance of the lunar surface, the solar infrared radiant intensity may make photosensor saturation. The solutions are reducing the gain of device and avoiding direct exposure to sun light.

[Temperature effect correction for Chang'E-3 alpha particle X-ray spectrometer].

Alpha particle X-ray spectrometer (APXS) is one of the payloads of Chang'E-3 lunar rover of China's Lunar Exploration Project. The present paper introduces briefly the components of APXS, how it works and its working environment on the lunar surface. The environmental temperature effect has been studied with simulations and experiments, and the results show that the temperature of the APXS sensor will be varying during the measuring on the lunar surface. And another experiment reveals that the energy resolution becomes worse if the sensor's temperature is varying. In this paper, a correction method based on Pearson's chi-squared test is presented. The method can improve the energy resolution when the sensor's temperature is varying. We have tested the method with the spectra acquired by APXS in the temperature varying period of Temperature Cycling Test, and the results show that the method is efficient and reliable.