At our institution, we are using dual-energy digital radiography (DEDR) as a cost-effective screening tool for the
detection of cardiac calcification. We are evaluating DEDR using CT as the gold standard. We are developing image
projection methods for the generation of digitally reconstructed radiography (DRR) from CT image volumes.
Traditional visualization methods include maximum intensity projection (MIP) and average-based projection (AVG) that
have difficulty to show cardiac calcification. Furthermore, MIP can over estimate the calcified lesion as it displays the
maximum intensity along the projection rays regardless of tissue types. For AVG projection, the calcified tissue is
usually overlapped with bone, lung and mediastinum. In order to improve the visualization of calcification on DRR
images, we developed a Gaussian-weighted projection method for this particular application. We assume that the CT
intensity values of calcified tissues have a Gaussian distribution. We then use multiple Gaussian functions to fit the
intensity histogram. Based on the mean and standard deviation parameters, we incorporate a Gaussian weighted function
into the perspective projection and display the calcification exclusively. Our digital and physical phantom studies show
that the new projection method can display tissues selectively. In addition, clinical images show that the Gaussian-weighted
projection method better visualizes cardiac calcification than either the AVG or MIP method and can be used
to evaluate DEDR as a screening tool for the detection of coronary artery diseases.
We are developing in vivo small animal imaging techniques that can measure early effects of photodynamic therapy
(PDT) for prostate cancer. PDT is an emerging therapeutic modality that continues to show promise in the treatment
of cancer. At our institution, a new second-generation photosensitizing drug, the silicon phthalocyanine Pc 4, has been
developed and evaluated at the Case Comprehensive Cancer Center. In this study, we are developing magnetic
resonance imaging (MRI) techniques that provide therapy monitoring and early assessment of tumor response to PDT.
We generated human prostate cancer xenografts in athymic nude mice. For the imaging experiments, we used a highfield
9.4-T small animal MR scanner (Bruker Biospec). High-resolution MR images were acquired from the treated
and control tumors pre- and post-PDT and 24 hr after PDT. We utilized multi-slice multi-echo (MSME) MR
sequences. During imaging acquisitions, the animals were anesthetized with a continuous supply of 2% isoflurane in
oxygen and were continuously monitored for respiration and temperature. After imaging experiments, we manually
segmented the tumors on each image slice for quantitative image analyses. We computed three-dimensional T2 maps
for the tumor regions from the MSME images. We plotted the histograms of the T2 maps for each tumor pre- and
post-PDT and 24 hr after PDT. After the imaging and PDT experiments, we dissected the tumor tissues and used the
histologic slides to validate the MR images. In this study, six mice with human prostate cancer tumors were imaged
and treated at the Case Center for Imaging Research. The T2 values of treated tumors increased by 24 ± 14% 24 hr
after the therapy. The control tumors did not demonstrate significant changes of the T2 values. Inflammation and
necrosis were observed within the treated tumors 24 hour after the treatment. Preliminary results show that Pc 4-PDT
is effective for the treatment of human prostate cancer in mice. The small animal MR imaging provides a useful tool
to evaluate early tumor response to photodynamic therapy in mice.
We are investigating three-dimensional (3D) to two-dimensional (2D) registration methods for computed tomography
(CT) and dual-energy digital radiography (DR) for the detection of coronary artery calcification. CT is an established
tool for the diagnosis of coronary artery diseases (CADs). Dual-energy digital radiography could be a cost-effective
alternative for screening coronary artery calcification. In order to utilize CT as the "gold standard" to evaluate the
ability of DR images for the detection and localization of calcium, we developed an automatic intensity-based 3D-to-2D
registration method for 3D CT volumes and 2D DR images. To generate digital rendering radiographs (DRR) from the
CT volumes, we developed three projection methods, i.e. Gaussian-weighted projection, threshold-based projection, and
average-based projection. We tested normalized cross correlation (NCC) and normalized mutual information (NMI) as
similarity measurement. We used the Downhill Simplex method as the search strategy. Simulated projection images
from CT were fused with the corresponding DR images to evaluate the localization of cardiac calcification. The
registration method was evaluated by digital phantoms, physical phantoms, and clinical data sets. The results from the
digital phantoms show that the success rate is 100% with mean errors of less 0.8 mm and 0.2 degree for both NCC and
NMI. The registration accuracy of the physical phantoms is 0.34 ± 0.27 mm. Color overlay and 3D visualization of the
clinical data show that the two images are registered well. This is consistent with the improvement of the NMI values
from 0.20 ± 0.03 to 0.25 ± 0.03 after registration. The automatic 3D-to-2D registration method is accurate and robust and
may provide a useful tool to evaluate the dual-energy DR images for the detection of coronary artery calcification.
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