Med Phys
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Assessment of bone tissue mineral density (TMD) may provide information critical to the understanding of mineralization processes and bone biomechanics. High-resolution three-dimensional assessment of TMD has recently been demonstrated using synchrotron radiation microcomputed tomography (SRmuCT); however, this imaging modality is relatively inaccessible due to the scarcity of SR facilities. Conventional desktop muCT systems are widely available and have been used extensively to assess bone microarchitecture. ⋯ Spatially resolved comparisons highlighted substantial geometric nonuniformity in the muCT data, which were reduced (but not eliminated) using the 1200 mg HA/cm3 beam hardening correction, and did not exist in the SRmuCT data. This study represents the first quantitative comparison of muCT mineralization evaluation against SRnuCT and gravimetry. Our results indicate that muCT mineralization measures are underestimated but well-correlated with SRmuCT and gravimetric data, particularly when volume fraction groups are considered individually.
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Letter Clinical Trial
Digital tomosynthesis of the chest for lung nodule detection: interim sensitivity results from an ongoing NIH-sponsored trial.
The authors report interim clinical results from an ongoing NIH-sponsored trial to evaluate digital chest tomosynthesis for improving detectability of small lung nodules. Twenty-one patients undergoing computed tomography (CT) to follow up lung nodules were consented and enrolled to receive an additional digital PA chest radiograph and digital tomosynthesis exam. Tomosynthesis was performed with a commercial CsI/a-Si flat-panel detector and a custom-built tube mover. ⋯ Nodules were scored as: definitely visible, uncertain, or not visible. 175 nodules (diameter range 3.5-25.5 mm) were seen by CT and grouped according to size: < 5, 5-10, and > 10 mm. When considering as true positives only nodules that were scored definitely visible, sensitivities for all nodules by tomosynthesis and PA radiography were 70% (+/- 5%) and 22% (+/- 4%), respectively, (p < 0.0001). Digital tomosynthesis showed significantly improved sensitivity of detection of known small lung nodules in all three size groups, when compared to PA chest radiography.
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Needle tip visualization is of high importance in magnetic resonance imaging (MRI) guided interventional procedures, for example for taking biopsies from suspicious lesions in the liver or kidney. The exact position of the needle tip is often obscured by image artifacts arising from the magnetic properties of the needle. The authors investigated two special biopsy needle tip designs using diamagnetic coatings. ⋯ Furthermore, the size of the biopsy probe can be estimated from the artifact. In using needles with a properly designed tip coating, taking biopsies under MR control is beginning to be greatly simplified. The approach to design artifacts using diamagnetic material in combination with paramagnetic material paves the way toward new instruments and implants, suitably tailored to the needs of the interventional radiologist.
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The purpose of this work was to investigate the applicability and appropriateness of Monte Carlo-derived normalized data to provide accurate estimations of patient dose from computed tomography (CT) exposures. Monte Carlo methodology and mathematical anthropomorphic phantoms were used to simulate standard patient CT examinations of the head, thorax, abdomen, and trunk performed on a multislice CT scanner. Phantoms were generated to simulate the average adult individual and two individuals with different body sizes. ⋯ However, the use of Monte Carlo conversion coefficients for the estimation of patient dose from a CT examination involves a remarkable inaccuracy when the body size of the mathematical anthropomorphic phantom used in Monte Carlo simulation differs from the body of the patient. Therefore, separate sets of Monte Carlo dosimetric CT data shall be generated for different patient body sizes. Besides calculation of different sets of Monte Carlo data for each commercially available scanner is not necessary, since scanner specific data may be derived with acceptable accuracy from the Monte Carlo data calculated for a specific scanner appropriately modified for the different CTDI(W)/CTDI(air) ratio.
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Image-guided needle biopsies are currently used to provide a definitive diagnosis of breast cancer; however, difficulties in tumor targeting exist as the ultrasound (US) scan plane and biopsy needle must remain coplanar throughout the procedure to display the actual needle tip position. The additional time associated with aligning and maintaining this coplanar relationship results in increased patient discomfort. Biopsy procedural efficiency is further hindered since needle pathway interpretation is often difficult, especially for needle insertions at large depths that usually require multiple reinsertions. ⋯ Procedure times were compared based on experience and the technique performed. Using a pair-wise t test, lower biopsy procedure times were observed when using the guidance system versus the free-hand technique (t = 12.59, p < 0.001). The authors believe that with this improved biopsy guidance they will be able to reduce the "false negative" rate of biopsies, especially in the hands of less experienced physicians.