Evaluation of the Positional Accuracy and Dosimetric Properties of a Three-dimensional Printed Device for Head and Neck Immobilization.

Our aim was to investigate the feasibility of a three-dimensional (3D) -printed head-and-neck (HN) immobilization device by comparing its positional accuracy and dosimetric properties with those of a conventional immobilization device (CID). We prepared a 3D-printed immobilization device (3DID) consisting of a mask and headrest with acrylonitrile-butadiene-styrene resin developed from the computed tomography data obtained by imaging a HN phantom. For comparison, a CID comprising a thermoplastic mask and headrest was prepared using the same HN phantom. We measured the setup error using the ExacTrac X-ray image system. Furthermore, using the ionization chamber and the water-equivalent phantom, we measured the changes in the dose due to the difference in the immobilization device material from the photon of 4 MV and 6 MV. The positional accuracy of the two devices were almost similar in each direction except in the vertical, lateral, and pitch directions (t-test, p<0.0001), and the maximum difference was 1 mm, and 1°. The standard deviations were not statistically different in each direction except in the longitudinal (F-test, p=0.034) and roll directions (F-test, p<0.0001). When the thickness was the same, the dose difference was almost similar at a 50 mm depth. At a 1 mm depth, the 3DID-plate had a 2.9-4.2% lower dose than the CID-plate. This study suggested that the positional accuracy and dosimetric properties of 3DID were almost similar to those of CID.

Aliased noise in X-ray CT images and band-limiting processing as a preventive measure.

X-ray CT projection data often include components with frequencies that are markedly higher than the pixel Nyquist frequency f PN, which is determined by the pixel size. Noise components higher than f PN are folded back into a region lower than f PN through the backprojection process, thereby creating aliased noise. With clinical CT scanners, we evaluated the aliased noise using an aliasing prevention measure, band-limiting processing (BLP), which suppresses frequency components higher than f PN in the projection data. Indices we used to evaluate improvement by BLP were the noise power spectrum (NPS), modulation transfer function (MTF), signal-to-noise-ratio (SNR) spectrum, matched filter SNR (MF SNR), and two-alternative forced-choice (2-AFC) test. With BLP, the NPS was decreased not only beyond f PN, but also within f PN. The same level of MTF was maintained as that without BLP within f PN. No remarkable reduction in spatial resolution was observed. The SNR spectrum and the MF SNR of the BLP image nearly agreed with those of an ideal state without aliased noise. A notable improvement in the visuoperceptual image quality by BLP was recognized with a reconstruction field of view (FOV) of more than 45 cm. We then applied BLP to clinical data and confirmed that significant aliased noise of a large FOV image was removed without notable side effects. The results showed that at least some CTs suffering from aliased noise can be improved by proper band-limiting.

Comparison of dose at an interventional reference point between the displayed estimated value and measured value.

Today, interventional radiology (IR) X-ray units are required for display of doses at an interventional reference point (IRP) for the operator (IR physician). The dose displayed at the IRP (the reference dose) of an X-ray unit has been reported to be helpful for characterizing patient exposure in real time. However, no detailed report has evaluated the accuracy of the reference doses displayed on X-ray equipment. Thus, in this study, we compared the displayed reference dose to the actual measured value in many IR X-ray systems. Although the displayed reference doses of many IR X-ray systems agreed with the measured actual values within approximately 15%, the doses of a few IR units were not close. Furthermore, some X-ray units made in Japan displayed reference doses quite different from the actual measured value, probably because the reference point of these units differs from the International Electrotechnical Commission standard. Thus, IR physicians should pay attention to the location of the IRP of the displayed reference dose in Japan. Furthermore, physicians should be aware of the accuracy of the displayed reference dose of the X-ray system that they use for IR. Thus, regular checks of the displayed reference dose of the X-ray system are important.

Comparison of the radiation dose in a cardiac IVR X-ray system.

In this study, the entrance surface dose rates received by a phantom during cineangiography and fluoroscopy were compared. The X-ray conditions used in the measurements were those normally used in facilities performing percutaneous coronary intervention. Although, today, the entrance surface doses (cineangiography and fluoroscopy) of X-ray equipment used for cardiac interventional radiology (IVR) tends to be lower than they were previously, some equipment produces a high radiation dose. Therefore, the X-ray equipment used for cardiac IVR procedures must be maintained in good repair and must be carefully calibrated. In addition, periodic measurement of the radiation dose from the X-ray equipment used for both cineangiography and fluoroscopy for cardiac IVR is necessary. If the radiation dose of the X-ray system in use is too high, the IVR staff should determine the reason and make an effort to reduce it. Hence, the IVR staff must be adequately trained in radiation protection.

Evaluating the performance of a MOSFET dosimeter at diagnostic X-ray energies for interventional radiology.

For reducing the risk of skin injury during interventional radiology (IR) procedures, it has been suggested that physicians track patients' exposure doses. The metal-oxide semiconductor field effect transistor (MOSFET) dosimeter is designed to measure patient exposure dose during radiotherapy applications at megavoltage photon energies. Our purpose in this study was to evaluate the feasibility of using a MOSFET dosimeter (OneDose system) to measure patients' skin dose during exposure to diagnostic X-ray energies used in IR. The response of the OneDose system was almost constant at diagnostic X-ray energies, although the sensitivity was higher than that at megavoltage photon energies. We found that the angular dependence was minimal at diagnostic X-ray energies. The OneDose is almost invisible on X-ray images at diagnostic energies. Furthermore, the OneDose is easy to handle. The OneDose sensor performs well at diagnostic X-ray energies, although real-time measurements are not feasible. Thus, the OneDose system may prove useful in measuring patient exposure dose during IR.

[Evaluation of non-linear adaptive smoothing filter by digital phantom].

As a result of the development of multi-slice CT, diagnoses based on three-dimensional reconstruction images and multi-planar reconstruction have spread. For these applications, which require high z-resolution, thin slice imaging is essential. However, because z-resolution is always based on a trade-off with image noise, thin slice imaging is necessarily accompanied by an increase in noise level. To improve the quality of thin slice images, a non-linear adaptive smoothing filter has been developed, and is being widely applied to clinical use. We developed a digital bar pattern phantom for the purpose of evaluating the effect of this filter and attempted evaluation from an addition image of the bar pattern phantom and the image of the water phantom. The effect of this filter was changed in a complex manner by the contrast and spatial frequency of the original image. We have confirmed the reduced effect of image noise in the low frequency component of the image, but decreased contrast or increased quantity of noise in the image of the high frequency component. This result represents the effect of change in the adaptation of this filter. The digital phantom was useful for this evaluation, but to understand the total effect of filtering, much improvement of the shape of the digital phantom is required.

[Use of the keyhole technique for 3.0T MRI dynamic imaging].

We studied the feasibility of high spatial and temporally resolved imaging by a combination of keyhole imaging, which is a fast imaging method, and a 3.0T MRI system which inherently has a high signal-to-noise ratio (SNR). In keyhole imaging, full k-space reference data are collected, followed by repeated dynamic acquisition of the central low-frequency data alone, and this makes dynamic acquisition faster. The purpose of our article is to describe the effects of the reference data on the reconstructed dynamic images with the assumption of vessel visualization. For efficient use of keyhole imaging, it is important to optimize the keyhole percentage and timing of reference data acquisition for the object of interest.

Neural basis of temporal context memory: a functional MRI study.

Temporal context information is crucial to understanding human episodic memory. Human lesion and neuroimaging data indicate that prefrontal regions are important for retrieving temporal context memory, although the exact nature of their involvement is still unclear. We employed functional magnetic resonance imaging (fMRI) to elucidate the neural basis of two kinds of temporal context memory: the temporal order of items between lists and within a list. On the day of the fMRI experiment, subjects memorized a list of 30 pictures in the morning and another list of 30 pictures in the afternoon. During the scanning session, the subjects performed three tasks. In a between-lists task, they were asked to judge the temporal order between two items that had been presented in different lists. In a within-list task, they were asked to judge the temporal order between two items that had been presented in a single list. We found bilateral prefrontal activities during these two temporal context memory tasks compared with a simple item-recognition task. Furthermore, in direct comparison between these two tasks, we found differential prefrontal activities. Thus, right prefrontal activity was associated with temporal order judgment of items between lists, whereas left prefrontal activity was related to temporal order judgment of items within a list. These results indicate that retrieval processes of two kinds of temporal context memory are supported by different, but overlapping, sets of cerebral regions. We speculate that this reflects different cognitive processes for retrieving temporal context memory between separate episodes and within a single episode.

Neural basis of the retrieval of people's names: evidence from brain-damaged patients and fMRI.

The aim of this study was to identify the neuroanatomical basis of the retrieval of people's names. Lesion data showed that patients with language-dominant temporal lobectomy had impairments in their ability to retrieve familiar and newly learned people's names, whereas patients with language-nondominant temporal lobectomy had difficulty retrieving newly learned people's names. Functional magnetic resonance imaging experiments revealed activations in the left temporal polar region during the retrieval of familiar and newly learned people's names, and in the right superior temporal and bilateral prefrontal cortices during the retrieval of newly learned information from face cues. These data provide new evidence that the left anterior temporal region is crucial for the retrieval of people's names irrespective of their familiarity and that the right superior temporal and bilateral prefrontal areas are crucial for the process of associating newly learned people's faces and names.