Simplified approach to estimation of organ absorbed doses for patients undergoing abdomen and pelvis CT examination.

The volumetric computed tomography (CT) dose index (CTDIvol) is the measure of output displayed on CT consoles relating to dose within a standard phantom. This gives a false impression of doses levels within the tissues of smaller patients in Southeast Asia. A size-specific dose estimate (SSDE) can be calculated from the CTDIvolto provide an assessment of doses at specific positions within a scan using size-specific conversion factors. SSDE is derived using the water equivalent diameter (Dw) of the patient, but calculation ofDwrequires sophisticated computer software. This study aimed to evaluate relationships betweenDWand effective diameter (DEff), which can be measured more readily, in order to estimate SSDE at various positions within a routine clinical abdomen and pelvis CT examination for Thai patients. An in-house ImageJ algorithm was developed to measureDw, effective diameter (DEff), and SSDE on CT slices located at the heart, liver, kidneys, colon, and bladder, on 181 CT examinations of abdomen and pelvis. Relationships betweenDEffandDwwere determined, and values of organ absorbed dose usingDEffwere estimated. This approach was validated using a second cohort of 54 patients scanned on a different CT scanner. The results revealed that ratios betweenDEffandDwat the heart level were 1.11-1.13 and those for the others were about 1.00. Additionally, the SSDE/CTDIvolratio was estimated for each organ in terms of exponential functions using the relationships betweenDwandDEfffor individual organs. In summary, this study proposed a simple method for estimation of organ absorbed doses for Southeast Asian patients undergoing abdomen and pelvis CT examinations where sophisticated computer software is not available.

Atherosclerotic Carotid Plaque Composition: A 3T and 7T MRI-Histology Correlation Study.

BACKGROUND AND PURPOSE: Carotid artery atherosclerotic plaque composition may influence plaque stability and risk of thromboembolic events, and noninvasive plaque imaging may therefore permit risk stratification for clinical management. Plaque composition was compared using noninvasive in vivo (3T) and ex vivo (7T) MRI and histopathological examination. METHODS: Thirty-three endarterectomy cross-sections, from 13 patients, were studied. The data sets consisted of in vivo 3T MRI, ex vivo 7T MRI, and histopathology. Semiautomated segmentation methods were used to measure areas of different plaque components. Bland-Altman plots and mean difference with 95% confidence interval were carried out. RESULTS: There was general quantitative agreement between areas derived from semiautomated segmentation of MRI data and histology measurements. The mean differences and 95% confidence bounds in the relative to total plaque area between 3T versus Histology were: fibrous tissue 4.99%(-4.56 to 14.56), lipid-rich/necrotic core (LR/NC) with hemorrhage -1.81%(-14.11 to 10.48), LR/NC without hemorrhage -2.43%(-13.04 to 8.17), and calcification -3.18%(-11.55 to 5.18). The mean differences and 95% confidence bounds in the relative to total plaque area between 7T and histology were: fibrous tissue 3.17%(-3.17 to 9.52), LR/NC with hemorrhage -0.55%(-9.06 to 7.95), LR/NC without hemorrhage -12.62%(-19.8 to -5.45), and calcification -2.43%(-9.97 to 4.73). CONCLUSIONS: This study provides evidence that semiautomated segmentation of 3T/7T MRI techniques can help to determine atherosclerotic plaque composition. In particular, the high resolution of ex vivo 7T data was able to highlight greater detail in the atherosclerotic plaque composition. High-field MRI may therefore have advantages for in vivo carotid plaque MRI.

Relationships between patient size, dose and image noise under automatic tube current modulation systems.

Automatic tube current modulation (ATCM) systems are now used for the majority of CT scans. The principles of ATCM operation are different in CT scanners from different manufacturers. Toshiba and GE scanners base the current modulation on a target noise setting, while Philips and Siemens scanners use reference image and reference mAs concepts respectively. Knowledge of the relationships between patient size, dose and image noise are important for CT patient dose optimisation. In this study, the CT patient doses were surveyed for 14 CT scanners from four different CT scanner manufacturers. The patient cross sectional area, the tube current modulation and the image noise from the CT images were analysed using in-house software. The Toshiba and GE scanner results showed that noise levels are relatively constant but tube currents are dependent on patient size. As a result of this there is a wide range in tube current values across different patient sizes, and doses for large patients are significantly higher in these scanners. In contrast, in the Philips and Siemens scanners, tube currents are less dependent on patient size, the range in tube current is narrower, and the doses for larger patients are not as high. Image noise is more dependent on the patient size.

Conductivity measurements in a shear-banding wormlike micellar system.

Shear banding in the cetylpyridinium chloride/sodium salicylate micellar system is investigated using electrical conductivity measurements parallel to the velocity and parallel to the vorticity in a cylindrical Couette cell. The measurements show that the conductivity parallel to the velocity (vorticity) increases (decreases) monotonically with applied shear rate. The shear-induced anisotropy is over one order of magnitude lower than the anisotropy of the N(c) nematic phase. The steady-state conductivity measurements indicate that the anisotropy of the shear induced low-viscosity (high shear rate) phase is not significantly larger than the anisotropy of the high viscosity (low shear rate) phase. We estimate that the micelles in the shear induced low viscosity band are relatively short, with a characteristic length to diameter ratio of 5-15. The relaxation behavior following the onset of shear is markedly different above and below the first critical value γ1, in agreement with results obtained by other methods. The transient measurements show that the overall anisotropy of the sample decreases as the steady state is approached, i.e., the micellar length/the degree of order decrease.

Rheo-NMR phenomena of wormlike micelles.

Using a combination of rheology and nuclear magnetic resonance (NMR) spectroscopy/velocimetry we demonstrate the existence of shear banding fluctuations under Couette flow of the micellar system 10% w/v cetylpyridinium chloride and sodium salicylate (CPyCl-NaSal) molar ratio 2 : 1 in 0.5 M NaCl in either HO or HO, using both time-averaged and real-time measurements. These shear banding fluctuations are consistent not only with the shear stress fluctuations observed in rheological measurements but also with fluctuations in the change of the constrained fraction of the amphiphile chain (Δ) observed in H-NMR spectroscopy experiments. Using H-NMR spectroscopy on a deuterated probe molecule (-decane) located in the wormlike micellar interior, direct measurement of the shear-induced nematic phase transition is reported.

Shear banding fluctuations and nematic order in wormlike micelles.

Using rapid NMR velocimetry we demonstrate the existence of shear band fluctuations in the Couette flow of the wormlike micelle system, 10% w/v cetylpyridinium chloride and sodium salicylate (molar ratio 2:1) in 0.5 M 2H2O NaCl brine. We show that the fluctuations may be either quasirandom or periodic, the fluctuation spectrum being similar to that observed in the stress. Despite the equilibrium fluid being far from an isotropic-nematic transition, deuterium NMR shows that the onset of shear banding is associated with a nematic micellar state whose order parameter depends on shear rate.