| 1. |
- Andersson, Mats, et al.
(författare)
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Adaptiv filtering of 4D-heart CT for image denoising and patient safety
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this medical image science project is to increase patient safety in terms of improved image quality and reduced exposure to ionizing radiation in CT. The means to achieve these goals is to develop and evaluate an efficient adaptive filtering (denoising/image enhancement) method that fully explores true 4D image acquisition modes. Four-dimensional (4D) medical image data are captured as a time sequence of image volumes. During 4D image acquisition, a 3D image of the patient is recorded at regular time intervals. The resulting data will consequently have three spatial dimensions and one temporal dimension. Increasing the dimensionality of the data impose a major increase the computational demands. The initial linear filtering which is the cornerstone in all adaptive image enhancement algorithms increase exponentially with the dimensionality. On the other hand the potential gain in Signal to Noise Ratio (SNR) also increase exponentially with the dimensionality. This means that the same gain in noise reduction that can be attained by performing the adaptive filtering in 3D as opposed to 2D can be expected to occur once more by moving from 3D to 4D. The initial tests on on both synthetic and clinical 4D images has resulted in a significant reduction of the noise level and an increased detail compared to 2D and 3D methods. When tuning the parameters for adaptive filtering is extremely important to attain maximal diagnostic value which not necessarily coincide with an an eye pleasing image for a layman. Although this application focus on CT the resulting adaptive filtering methods will be beneficial for a wide range of 3D/4D medical imaging modalities e.g. shorter acquisition time in MRI and improved elimination of noise in 3D or 4D ultrasound datasets.
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| 2. |
- Borgen, Lars, et al.
(författare)
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Application of adaptive non-linear 2D and 3D postprocessing filters for reduced dose abdominal CT
- 2012
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Ingår i: Acta Radiologica. - : Informa Healthcare / Wiley-Blackwell / Royal Society of Medicine Press. - 0284-1851 .- 1600-0455. ; 53:3, s. 335-342
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Tidskriftsartikel (refereegranskat)abstract
- Background: Abdominal computed tomography (an is a frequently performed imaging procedure, resulting in considerable radiation doses to the patient population. Postprocessing filters are one of several dose reduction measures that might help to reduce radiation doses without loss of image quality. less thanbrgreater than less thanbrgreater thanPurpose: To assess and compare the effect of two- and three-dimensional (2D, 3D) non-linear adaptive filters on reduced dose abdominal CT images. less thanbrgreater than less thanbrgreater thanMaterial and Methods: Two baseline abdominal CT image series with a volume computer tomography dose index (CTDI (vol)) of 12 mGy and 6 mGy were acquired for 12 patients. Reduced dose images were postprocessed with 2D and 3D filters. Six radiologists performed blinded randomized, side-by-side image quality assessments. Objective noise was measured. Data were analyzed using visual grading regression and mixed linear models. less thanbrgreater than less thanbrgreater thanResults: All image quality criteria were rated as superior for 3D filtered images compared to reduced dose baseline and 2D filtered images (P andlt; 0.01). Standard dose images had better image quality than reduced dose 3D filtered images (P andlt; 0.01), but similar image noise. For patients with body mass index (BMI) andlt; 30 kg/m(2) however, 3D filtered images were rated significantly better than normal dose images for two image criteria (P andlt; 0.05), while no significant difference was found for the remaining three image criteria (P andgt; 0.05). There were no significant variations of objective noise between standard dose and 2D or 3D filtered images. less thanbrgreater than less thanbrgreater thanConclusion: The quality of 3D filtered reduced dose abdominal CT images is superior compared to reduced dose unfiltered and 2D filtered images. For patients with BMI andlt; 30 kg/m(2), 3D filtered images are comparable to standard dose images.
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| 3. |
- De Geer, Jakob, 1970-
(författare)
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On the use of computed tomography in cardiac imaging
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundCardiac Computed Tomography Angiography (CCTA) is becoming increasingly useful in the work‐up of coronary artery disease (CAD). Several potential methods for increasing the diagnostic yield of cardiac CT are available.Purpose Study I: To investigate whether the use of a 2‐D, non‐linear adaptive noise reduction filter can improve CCTA image quality.Study II: To evaluate the variation in adenosine stress dynamic CT perfusion (CTP) blood flow as compared to stress 99mTc SPECT. Secondly, to compare the perfusion results from manual and automatic myocardial CTP segmentation.Study III: To evaluate the accuracy of non‐invasive, CCTA‐derived Fractional Flow Reserve (cFFR).Study IV: To evaluate the prognostic value of CCTA in terms of major adverse cardiac events (MACE).Materials and methodsStudy I: Single images from 36 consecutive CCTA exams performed with two different dose levels were used. Image quality in full dose, low‐dose and noise‐reduced low‐dose images was graded using visual grading analysis. Image noise was measured.Study II: CTP and SPECT were performed in 17 patients, and the variation in per AHA‐segment blood flow was evaluated and compared. CTP results from manual and automated image segmentation were compared.Study III: CCTA datasets from 21 patients were processed using cFFR software and the results compared to the corresponding invasively measured FFR (invFFR).Study IV: 1205 consecutive patients with chest pain of unknown origin underwent CCTA. Baseline data and data on subsequent MACE were retrieved from relevant registries. Survival, hazard ratios and the three‐year incidence of cardiac events and readmissions were calculated.Results Study I: There was significant improvement in perceived image quality for all criteria when the filter was applied, and a significant decrease in image noise.Study II: The correlation coefficients for CTP vs. SPECT were 0.38 and 0.41 (p<0.001, for manual and automated segmentation respectively. Mean per patient CTP blood flow in normal segments varied between 94‐183 ml/100 ml tissue/min for manual segmentation, and 104‐196 ml/100 ml tissue/min for automated segmentation. The Spearman rank correlation coefficient for manual vs. automated segmentation CTP was ρ = 0.88 (p<0.001) and the Intraclass Correlation Coefficient (ICC) was 0.93 (p<0.001).Study III: The Spearman rank correlation coefficient for cFFR vs. invFFR was ρ = 0.77 (p<0.001) and the ICC was 0.73 (p<0.001). Sensitivity, specificity, positive predictive value and negative predictive value for significant stenosis (FFR<0.80, per vessel) were 0.83, 0.76, 0.56 and 0.93 respectively.Study IV: The hazard ratio for non‐obstructive CAD vs. normal coronary arteries was 5.13 (95% C.I 1.03‐25.43, p<0.05), and 151.40 (95% C.I 37.03‐619.08, p<0.001) for obstructive CAD vs. normal coronary arteries. The three‐year incidence of MACE was 1.1% for patients with normal vessels on CCTA, 2.5% for patients with non‐obstructive CAD and 42.7% for patients with obstructive CAD (p<0.001).Conclusions:Study I: Image quality and noise levels of low dose images were significantly improved with the filter, even though the improvement was small compared to the image quality of the corresponding diastolic full‐dose images.Study II: Correlation between dynamic CTP and SPECT was positive but weak. There were large variations in CTP blood flow in normal segments on SPECT, rendering the definition of an absolute cut‐off value for normal vs. ischemic myocardium difficult. Manual and automatic segmentation were equally useful.Study III: The correlation between cFFR and invFFR was good, indicating that noninvasively estimated cFFR performs on a similar level as invasively measure FFR. Study IV: The long‐term risk for MACE was very low in patients without obstructive CAD on CCTA, though there seemed to be a substantial increase in the risk for MACE even in patients with non‐obstructive CAD as compared to normal coronary arteries. In addition, even patients with normal coronary arteries or non‐obstructive CAD continued to have a substantial number of readmissions for chest pain or angina pectoris.
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| 4. |
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| 5. |
- de Geer, Jakob, et al.
(författare)
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The efficacy of 2D, non-linear noise reduction filtering in cardiac imaging: a pilot study
- 2011
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Ingår i: Acta Radiologica. - : Informa Healthcare / Wiley-Blackwell / Royal Society of Medicine Press. - 0284-1851 .- 1600-0455. ; 52:7, s. 716-722
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Tidskriftsartikel (refereegranskat)abstract
- Background: Computed tomography (CT) is becoming increasingly popular as a non-invasive method for visualizing the coronary arteries but patient radiation doses are still an issue. Postprocessing filters such as 2D adaptive non-linear filters might help to reduce the dose without loss of image quality. less thanbrgreater than less thanbrgreater thanPurpose: To investigate whether the use of a 2D, non-linear adaptive noise reduction filter can improve image quality in cardiac computed tomography angiography (CCTA). less thanbrgreater than less thanbrgreater thanMaterial and Methods: CCTA examinations were performed in 36 clinical patients on a dual source CT using two patient dose levels: maximum dose during diastole and reduced dose (20% of maximum dose) during systole. One full-dose and one reduced-dose image were selected from each of the examinations. The reduced-dose image was duplicated and one copy postprocessed using a 2D non-linear adaptive noise reduction filter, resulting in three images per patient. Image quality was assessed using visual grading with three criteria from the European guidelines for assessment of image quality and two additional criteria regarding the left main artery and the overall image quality. Also, the HU value and its standard deviation were measured in the ascending and descending aorta. Data were analyzed using Visual Grading Regression and paired t-test. less thanbrgreater than less thanbrgreater thanResult: For all five criteria, there was a significant (P andlt; 0.01 or better) improvement in perceived image quality when comparing postprocessed low-dose images with low-dose images without noise reduction. Comparing full dose images with postprocessed low-dose images resulted in a considerably larger, significant (P andlt; 0.001) difference. Also, there was a significant reduction of the standard deviation of the HU values in the ascending and descending aorta when comparing postprocessed low-dose images with low-dose images without postprocessing. less thanbrgreater than less thanbrgreater thanConclusion: Even with an 80% dose reduction, there was a significant improvement in the perceived image quality when using a 2D noise-reduction filter, though not approaching the quality of full-dose images. This indicates that cardiac CT examinations could benefit from noise-reducing postprocessing with 2D non-linear adaptive filters.
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| 6. |
- Dohlmar, Frida, et al.
(författare)
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Validation of automated post-adjustments of HDR prostate brachytherapy treatment plans by quantitative measures and oncologist observer study
- 2023
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Ingår i: Brachytherapy. - : Elsevier BV. - 1538-4721 .- 1873-1449. ; 22:3, s. 407-415
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim was to evaluate a postprocessing optimization algorithm's ability to improve the spatial properties of a clinical treatment plan while preserving the target coverage and the dose to the organs at risk. The goal was to obtain a more homogenous treatment plan, minimizing the need for manual adjustments after inverse treatment planning. MATERIALS AND METHODS: The study included 25 previously treated prostate cancer pa-tients. The treatment plans were evaluated on dose-volume histogram parameters established clin-ical and quantitative measures of the high dose volumes. The volumes of the four largest hot spots were compared and complemented with a human observer study with visual grading by eight oncologists. Statistical analysis was done using ordinal logistic regression. Weighted kappa and Fleiss' kappa were used to evaluate intra-and interobserver reliability. RESULTS: The quantitative analysis showed that there was no change in planning target volume (PTV) coverage and dose to the rectum. There were significant improvements for the adjusted treatment plan in: V150% and V200% for PTV, dose to urethra, conformal index, and dose nonhomogeneity ratio. The three largest hot spots for the adjusted treatment plan were significantly smaller compared to the clinical treatment plan. The observers preferred the adjusted treatment plan in 132 cases and the clinical in 83 cases. The observers preferred the adjusted treatment plan on homogeneity and organs at risk but preferred the clinical plan on PTV coverage. CONCLUSIONS: Quantitative analysis showed that the postadjustment optimization tool could improve the spatial properties of the treatment plans while maintaining the target coverage.
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| 7. |
- Kataria, Bharti, 1955-, et al.
(författare)
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Assessment of image quality in abdominal computed tomography : Effect of model-based iterative reconstruction, multi-planar reconstruction and slice thickness on potential dose reduction
- 2020
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Ingår i: European Journal of Radiology. - : Elsevier Ireland Ltd. - 0720-048X .- 1872-7727. ; 122
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine the effect of tube load, model-based iterative reconstruction (MBIR) strength and slice thickness in abdominal CT using visual comparison of multi-planar reconstruction images. Method: Five image criteria were assessed independently by four radiologists on two data sets at 42- and 98-mAs tube loads for 25 patients examined on a 192-slice dual-source CT scanner. Effect of tube load, MBIR strength, slice thickness and potential dose reduction was estimated with Visual Grading Regression (VGR). Objective image quality was determined by measuring noise (SD), contrast-to-noise (CNR) ratio and noise-power spectra (NPS). Results: Comparing 42- and 98-mAs tube loads, improved image quality was observed as a strong effect of log tube load regardless of MBIR strength (p < 0.001). Comparing strength 5 to 3, better image quality was obtained for two criteria (p < 0.01), but inferior for liver parenchyma and overall image quality. Image quality was significantly better for slice thicknesses of 2mm and 3mm compared to 1mm, with potential dose reductions between 24%-41%. As expected, with decrease in slice thickness and algorithm strength, the noise power and SD (HU-values) increased, while the CNR decreased. Conclusion: Increasing slice thickness from 1 mm to 2 mm or 3 mm allows for a possible dose reduction. MBIR strength 5 shows improved image quality for three out of five criteria for 1 mm slice thickness. Increasing MBIR strength from 3 to 5 has diverse effects on image quality. Our findings do not support a general recommendation to replace strength 3 by strength 5 in clinical abdominal CT protocols. However, strength 5 may be used in task-based protocols.
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| 8. |
- Kataria, Bharti, 1955-, et al.
(författare)
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Assessment of image quality in abdominal CT : potential dose reduction with model-based iterative reconstruction
- 2018
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Ingår i: European Radiology. - Heidelberg : SPRINGER. - 0938-7994 .- 1432-1084. ; 28:6, s. 2464-2473
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Tidskriftsartikel (refereegranskat)abstract
- To estimate potential dose reduction in abdominal CT by visually comparing images reconstructed with filtered back projection (FBP) and strengths of 3 and 5 of a specific MBIR. A dual-source scanner was used to obtain three data sets each for 50 recruited patients with 30, 70 and 100% tube loads (mean CTDIvol 1.9, 3.4 and 6.2 mGy). Six image criteria were assessed independently by five radiologists. Potential dose reduction was estimated with Visual Grading Regression (VGR). Comparing 30 and 70% tube load, improved image quality was observed as a significant strong effect of log tube load and reconstruction method with potential dose reduction relative to FBP of 22-47% for MBIR strength 3 (p < 0.001). For MBIR strength 5 no dose reduction was possible for image criteria 1 (liver parenchyma), but dose reduction between 34 and 74% was achieved for other criteria. Interobserver reliability showed agreement of 71-76% (kappa (w) 0.201-0.286) and intra-observer reliability of 82-96% (kappa (w) 0.525-0.783). MBIR showed improved image quality compared to FBP with positive correlation between MBIR strength and increasing potential dose reduction for all but one image criterion. aEuro cent MBIR's main advantage is its de-noising properties, which facilitates dose reduction. aEuro cent MBIR allows for potential dose reduction in relation to FBP. aEuro cent Visual Grading Regression (VGR) produces direct numerical estimates of potential dose reduction. aEuro cent MBIR strengths 3 and 5 dose reductions were 22-34 and 34-74%. aEuro cent MBIR strength 5 demonstrates inferior performance for liver parenchyma.
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| 9. |
- Kataria, Bharti, et al.
(författare)
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Image quality and pathology assessment in CT Urography : when is the low-dose series sufficient?
- 2019
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Ingår i: BMC Medical Imaging. - : BMC. - 1471-2342. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Our aim was to compare CT images from native, nephrographic and excretory phases using image quality criteria as well as the detection of positive pathological findings in CT Urography, to explore if the radiation burden to the younger group of patients or patients with negative outcomes can be reduced. Methods This is a retrospective study of 40 patients who underwent a CT Urography examination on a 192-slice dual source scanner. Image quality was assessed for four specific renal image criteria from the European guidelines, together with pathological assessment in three categories: renal, other abdominal, and incidental findings without clinical significance. Each phase was assessed individually by three radiologists with varying experience using a graded scale. Certainty scores were derived based on the graded assessments. Statistical analysis was performed using visual grading regression (VGR). The limit for significance was set at p = 0.05. Results For visual reproduction of the renal parenchyma and renal arteries, the image quality was judged better for the nephrogram phase (p < 0.001), whereas renal pelvis/calyces and proximal ureters were better reproduced in the excretory phase compared to the native phase (p < 0.001). Similarly, significantly higher certainty scores were obtained in the nephrogram phase for renal parenchyma and renal arteries, but in the excretory phase for renal pelvis/calyxes and proximal ureters. Assessment of pathology in the three categories showed no statistically significant differences between the three phases. Certainty scores for assessment of pathology, however, showed a significantly higher certainty for renal pathology when comparing the native phase to nephrogram and excretory phase and a significantly higher score for nephrographic phase but only for incidental findings. Conclusion Visualisation of renal anatomy was as expected with each post-contrast phase showing favourable scores compared to the native phase. No statistically significant differences in the assessment of pathology were found between the three phases. The low-dose CT (LDCT) seems to be sufficient in differentiating between normal and pathological examinations. To reduce the radiation burden in certain patient groups, the LDCT could be considered a suitable alternative as a first line imaging method. However, radiologists should be aware of its limitations.
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| 10. |
- Kataria, Bharti, 1955-, et al.
(författare)
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Image Quality and Potential Dose Reduction Using Advanced Modeled Iterative Reconstruction (Admire) in Abdominal Ct : A Review
- 2021
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Ingår i: Radiation Protection Dosimetry. - : Oxford University Press. - 0144-8420 .- 1742-3406. ; 195:3-4, s. 177-187
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Forskningsöversikt (refereegranskat)abstract
- Traditional filtered back projection (FBP) reconstruction methods have served the computed tomography (CT) community wellfor over 40 years. With the increased use of CT during the last decades, efforts to minimise patient exposure, while maintainingsufficient or improved image quality, have led to the development of model-based iterative reconstruction (MBIR) algorithms fromseveral vendors. The usefulness of the advanced modeled iterative reconstruction (ADMIRE) (Siemens Healthineers) MBIR inabdominal CT is reviewed and its noise suppression and/or dose reduction possibilities explored. Quantitative and qualitativemethods with phantom and human subjects were used. Assessment of the quality of phantom images will not always correlatepositively with those of patient images, particularly at the higher strength of the ADMIRE algorithm. With few exceptions,ADMIRE Strength 3 typically allows for substantial noise reduction compared to FBP and hence to significant (≈30%) patientdose reductions. The size of the dose reductions depends on the diagnostic task.
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