Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture.On this basis,the study aimed to investigate if dual-energy spectral computed tomography can predi...Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture.On this basis,the study aimed to investigate if dual-energy spectral computed tomography can predict ureteral hardening caused by impacted stones and to explore the relationship between different types of ureteral lesions and the risk of ureteral stricture.Methods This prospective study collected data of 93 patients with impacted stones from hospital automation system during January 2018 to October 2019.They underwent an abdominal scan on a dual-energy spectral computed tomography.During surgery,the operator used ureteroscopy to identify ureteral lesions,which were classified into four categories:edema,polyps,pallor,and hardening.Seven months later,90 patients were reviewed for the degree of hydronephrosis.Results Endoscopic observations revealed 38(41%)cases of ureteral edema,20(22%)cases of polyps,13(14%)cases of pallor,and 22(24%)cases of hardening.There were significant differences in hydronephrosis,the period of impaction,the calcium concentration of the ureter,and the slope of the spectral Hounsfield unit curve between the four groups.After that,we evaluated the factors associated with ureteral hardening and found that the calcium concentration of the ureter and hydronephrosis remained independent predictors of ureteral hardening.Receiver operating characteristic curve analysis showed that 5.3 mg/cm^(3)calcium concentration of the ureter is an optimal cut-off value to predict ureteral hardening.The result of follow-up showed that 80 patients had complete remission of hydronephrosis,with a complete remission rate of 61.9%(13/21)in the hardening group and 97.1%(67/69)in the non-hardening group(p<0.001).Conclusion Calcium concentration of the ureter is an independent predictor of ureteral hardening.Patients with ureteral hardening have more severe hydronephrosis after ureteroscopic lithotripsy.When the calcium concentration of the ureter is less than 5.3 mg/cm^(3),ureteral lesions should be actively treated.展开更多
To improve spectral X-ray CT reconstructed image quality, the energy-weighted reconstructed image xbins^W and the separable paraboloidal surrogates（SPS） algorithm are proposed for the prior image constrained compres...To improve spectral X-ray CT reconstructed image quality, the energy-weighted reconstructed image xbins^W and the separable paraboloidal surrogates（SPS） algorithm are proposed for the prior image constrained compressed sensing（PICCS）-based spectral X-ray CT image reconstruction. The PICCS-based image reconstruction takes advantage of the compressed sensing theory, a prior image and an optimization algorithm to improve the image quality of CT reconstructions.To evaluate the performance of the proposed method, three optimization algorithms and three prior images are employed and compared in terms of reconstruction accuracy and noise characteristics of the reconstructed images in each energy bin.The experimental simulation results show that the image xbins^W is the best as the prior image in general with respect to the three optimization algorithms; and the SPS algorithm offers the best performance for the simulated phantom with respect to the three prior images. Compared with filtered back-projection（FBP）, the PICCS via the SPS algorithm and xbins^W as the prior image can offer the noise reduction in the reconstructed images up to 80. 46%, 82. 51%, 88. 08% in each energy bin,respectively. M eanwhile, the root-mean-squared error in each energy bin is decreased by 15. 02%, 18. 15%, 34. 11% and the correlation coefficient is increased by 9. 98%, 11. 38%,15. 94%, respectively.展开更多
Objective： This study investigated the capability of dual-energy spectral computed tomography （CT） to quantitatively evaluate lung perfusion defects that are induced by central lung cancer. Methods： Thirty-two pat...Objective： This study investigated the capability of dual-energy spectral computed tomography （CT） to quantitatively evaluate lung perfusion defects that are induced by central lung cancer. Methods： Thirty-two patients with central lung cancer underwent CT angiography using spectral imaging. A univariate general linear model was conducted to analyze the variance of iodine concentration/CT value with three factors of lung fields. A paired t-test was used to compare iodine concentrations and CT values between the distal end of lung cancer and the corresponding area in the contralateral normal lung. Results： Iodine concentrations increased progressively in the far, intermediate and near ground sides in the normal lung fields at 0.60±0.28, 0.93±0.27 and 1.25±0.38 mg/mL, respectively （P〈0.001）. The same trend was observed for the CT values [-（840.64±49.08）, -（812.66±50.85） and -（760.83±89.17） HU, P〈0.001]. The iodine concentration （0.70±0.42 mg/mL） of the lung field in the distal end of lung cancer was significantly lower than the corresponding area in the contralateral normal lung （1.19±0.62 mg/mL） （t=-7.23, P〈0.001）. However, the CT value of lung field in the distal end of lung cancer was significantly higher than the corresponding area in the contralateral normal lung [-（765.29±93.34） HU vs. -（800.07±76.18） HU, t=3.564, P=0.001]. Conclusions： Spectral CT imaging based on the spectral differentiation of iodine is feasible and can quantitatively evaluate pulmonary perfusion and identify perfusion defects that are induced by central lung cancer. Spectral CT seems to be a promising technique for the simultaneous evaluation of both morphological and functional lung information.展开更多
Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations ...Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations of lesions(ICLs) in the arterial phase(ICLa)and venous phase(ICLv), normalized IC in the aorta(NICa/NICv), slope of the spectral HU curve(λHUa/λHUv)and monochromatic CT number enhancement on 40 keV and 70 keV images(CT40 keVa/v, CT70keVa/v)] in 34 lung adenocarcinomas were analyzed, and common molecular markers, including the Ki-67 labeling index, were detected with immunohistochemistry. Different Ki-67 labeling indexes were measured and grouped into four grades according to the number of positive-stained cells(grade 0, ≤1%;1%<grade 1≤10%;10%<grade 2≤30%;and grade 3, >30%). One-way analysis of variance(ANOVA) was used to compare the four different grades, and the Bonferroni method was used to correct the P value for multiple comparisons. A Spearman correlation analysis was performed to further research a quantitative correlation between the Ki-67 labeling index and spectral CT imaging parameters.Results: CT40keVa, CT40 keVv, CT70keVa and CT70keVv increased as the grade increased, and CT70keVa and CT70keVv were statistically significant(P<0.05). These four parameters and the Ki-67 labeling index showed a moderate positive correlation with lung adenocarcinoma nodules. ICL, NIC and λHU in the arterial and venous phases were not significantly different among the four grades.Conclusions: The spectral CT imaging parameters CT40keVa, CT40keVv, CT70keVa and CT70keVv gradually increased with Ki-67 expression and showed a moderate positive correlation with lung adenocarcinomas.Therefore, spectral CT imaging parameter-enhanced monochromatic CT numbers at 70 keV may indicate the extent of proliferation of lung adenocarcinomas.展开更多
Spectral computed tomography(CT) based on photon counting detectors(PCDs) is a well-researched topic in the field of X-ray imaging. When PCD is applied in a spectral CT system, the PCD energy thresholds must be carefu...Spectral computed tomography(CT) based on photon counting detectors(PCDs) is a well-researched topic in the field of X-ray imaging. When PCD is applied in a spectral CT system, the PCD energy thresholds must be carefully selected, especially for K-edge imaging, which is an important spectral CT application. This paper presents a threshold selection method that yields better-quality images in K-edge imaging. The main idea is to optimize the energy thresholds ray-by-ray according to the targeted component coefficients, followed by obtaining an overall optimal energy threshold by frequency voting. A low-dose pre-scan is used in practical implementations to estimate the line integrals of the component coefficients for the basis functions. The variance of the decomposed component coefficients is then minimized using the Cramer–Rao lower bound method with respect to the energy thresholds. The optimal energy thresholds are then used to take a full scan and gain better image reconstruction with less noise than would be given by a full scan using the non-optimal energy thresholds. Simulations and practical experiments on imaging iodine and gadolinium solutions, which are commonly used as contrast agents in medical applications, were used to validate the method. The noise was significantly reduced with the same dose relative to the non-optimal energy thresholds in both simulations and in practical experiments.展开更多
<strong>Objectives:</strong> To evaluate the diagnostic performance of the quantitative iodine parameters, including Iodine Concentration (IC), Normalized Iodine Concentration (NIC), and λ<sub>HU<...<strong>Objectives:</strong> To evaluate the diagnostic performance of the quantitative iodine parameters, including Iodine Concentration (IC), Normalized Iodine Concentration (NIC), and λ<sub>HU</sub>, in distinguishing malignant and benign thyroid nodules. <strong>Methods:</strong> Relevant studies were searched from Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure database and other complementary sources from inception to May 20, 2020. Study selection, data extraction, quality assessment, and data analyses were performed following the Cochrane standards and the PRISMA-DTA guideline. <strong>Results: </strong>Eight studies were included (595 patients with 737 thyroid nodules). The pooled sensitivity, specificity and summary diagnostic odds ratio of IC were 79% (95% CI: 69% - 86%), 76% (95% CI: 65% - 84%) and 11 (95% CI: 5 - 27) respectively;those of NIC were 78% (95% CI: 70% - 85%), 80% (95% CI: 74% - 85%) and 15 (95% CI: 9 - 24) respectively;those of λ<sub>HU</sub> were 80% (95% CI: 71% - 87%), 77% (95% CI: 70% - 83%) and 14 (95% CI: 8 - 24) respectively. <strong>Conclusion: </strong>DECT can be a potential evaluation tool for thyroid nodules. The NIC may be the most sensitive iodine parameter and could be comparable between different DECT machines in thyroid nodule assessment.展开更多
From the point of view of design requirements, influence of the width of the output image of an imaging subsystem in a tomographic imaging spectrometer, namely width of the slit, the grating and the size of the CCD pi...From the point of view of design requirements, influence of the width of the output image of an imaging subsystem in a tomographic imaging spectrometer, namely width of the slit, the grating and the size of the CCD pixel are analyzed. For the tomographic imaging spectrometry, if the amplification ratio of the imaging subsystem is not high enough to make the whole object to be compressed within the slit, then either the slit width should be increased or the slit width kept unchanged but scanned to receive information of the object. While the width-increase method reduces the spectral resolving power and the SNR; the scanning method reduces the SNR. Analysis of the two cases and computer simulation results are given.展开更多
文摘Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture.On this basis,the study aimed to investigate if dual-energy spectral computed tomography can predict ureteral hardening caused by impacted stones and to explore the relationship between different types of ureteral lesions and the risk of ureteral stricture.Methods This prospective study collected data of 93 patients with impacted stones from hospital automation system during January 2018 to October 2019.They underwent an abdominal scan on a dual-energy spectral computed tomography.During surgery,the operator used ureteroscopy to identify ureteral lesions,which were classified into four categories:edema,polyps,pallor,and hardening.Seven months later,90 patients were reviewed for the degree of hydronephrosis.Results Endoscopic observations revealed 38(41%)cases of ureteral edema,20(22%)cases of polyps,13(14%)cases of pallor,and 22(24%)cases of hardening.There were significant differences in hydronephrosis,the period of impaction,the calcium concentration of the ureter,and the slope of the spectral Hounsfield unit curve between the four groups.After that,we evaluated the factors associated with ureteral hardening and found that the calcium concentration of the ureter and hydronephrosis remained independent predictors of ureteral hardening.Receiver operating characteristic curve analysis showed that 5.3 mg/cm^(3)calcium concentration of the ureter is an optimal cut-off value to predict ureteral hardening.The result of follow-up showed that 80 patients had complete remission of hydronephrosis,with a complete remission rate of 61.9%(13/21)in the hardening group and 97.1%(67/69)in the non-hardening group(p<0.001).Conclusion Calcium concentration of the ureter is an independent predictor of ureteral hardening.Patients with ureteral hardening have more severe hydronephrosis after ureteroscopic lithotripsy.When the calcium concentration of the ureter is less than 5.3 mg/cm^(3),ureteral lesions should be actively treated.
基金The National Natural Science Foundation of China(No.51575256)the Fundamental Research Funds for the Central Universities(No.NP2015101,XZA16003)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)
文摘To improve spectral X-ray CT reconstructed image quality, the energy-weighted reconstructed image xbins^W and the separable paraboloidal surrogates（SPS） algorithm are proposed for the prior image constrained compressed sensing（PICCS）-based spectral X-ray CT image reconstruction. The PICCS-based image reconstruction takes advantage of the compressed sensing theory, a prior image and an optimization algorithm to improve the image quality of CT reconstructions.To evaluate the performance of the proposed method, three optimization algorithms and three prior images are employed and compared in terms of reconstruction accuracy and noise characteristics of the reconstructed images in each energy bin.The experimental simulation results show that the image xbins^W is the best as the prior image in general with respect to the three optimization algorithms; and the SPS algorithm offers the best performance for the simulated phantom with respect to the three prior images. Compared with filtered back-projection（FBP）, the PICCS via the SPS algorithm and xbins^W as the prior image can offer the noise reduction in the reconstructed images up to 80. 46%, 82. 51%, 88. 08% in each energy bin,respectively. M eanwhile, the root-mean-squared error in each energy bin is decreased by 15. 02%, 18. 15%, 34. 11% and the correlation coefficient is increased by 9. 98%, 11. 38%,15. 94%, respectively.
基金supported by National Natural Science Foundation of China(Grant No.81071129,30970825)the National Basic Research Program of China(973 Program)(Grant No.2011CB707705)
文摘Objective： This study investigated the capability of dual-energy spectral computed tomography （CT） to quantitatively evaluate lung perfusion defects that are induced by central lung cancer. Methods： Thirty-two patients with central lung cancer underwent CT angiography using spectral imaging. A univariate general linear model was conducted to analyze the variance of iodine concentration/CT value with three factors of lung fields. A paired t-test was used to compare iodine concentrations and CT values between the distal end of lung cancer and the corresponding area in the contralateral normal lung. Results： Iodine concentrations increased progressively in the far, intermediate and near ground sides in the normal lung fields at 0.60±0.28, 0.93±0.27 and 1.25±0.38 mg/mL, respectively （P〈0.001）. The same trend was observed for the CT values [-（840.64±49.08）, -（812.66±50.85） and -（760.83±89.17） HU, P〈0.001]. The iodine concentration （0.70±0.42 mg/mL） of the lung field in the distal end of lung cancer was significantly lower than the corresponding area in the contralateral normal lung （1.19±0.62 mg/mL） （t=-7.23, P〈0.001）. However, the CT value of lung field in the distal end of lung cancer was significantly higher than the corresponding area in the contralateral normal lung [-（765.29±93.34） HU vs. -（800.07±76.18） HU, t=3.564, P=0.001]. Conclusions： Spectral CT imaging based on the spectral differentiation of iodine is feasible and can quantitatively evaluate pulmonary perfusion and identify perfusion defects that are induced by central lung cancer. Spectral CT seems to be a promising technique for the simultaneous evaluation of both morphological and functional lung information.
基金supported by National Natural Science Foundation of China (No. 91959116)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. ZYLX 201803)+1 种基金“Beijing Hospitals Authority” Ascent Plan (No. DFL20191103)National Key R&D Program of China (No. 2017YFC1309101, 2017YFC1309104).
文摘Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations of lesions(ICLs) in the arterial phase(ICLa)and venous phase(ICLv), normalized IC in the aorta(NICa/NICv), slope of the spectral HU curve(λHUa/λHUv)and monochromatic CT number enhancement on 40 keV and 70 keV images(CT40 keVa/v, CT70keVa/v)] in 34 lung adenocarcinomas were analyzed, and common molecular markers, including the Ki-67 labeling index, were detected with immunohistochemistry. Different Ki-67 labeling indexes were measured and grouped into four grades according to the number of positive-stained cells(grade 0, ≤1%;1%<grade 1≤10%;10%<grade 2≤30%;and grade 3, >30%). One-way analysis of variance(ANOVA) was used to compare the four different grades, and the Bonferroni method was used to correct the P value for multiple comparisons. A Spearman correlation analysis was performed to further research a quantitative correlation between the Ki-67 labeling index and spectral CT imaging parameters.Results: CT40keVa, CT40 keVv, CT70keVa and CT70keVv increased as the grade increased, and CT70keVa and CT70keVv were statistically significant(P<0.05). These four parameters and the Ki-67 labeling index showed a moderate positive correlation with lung adenocarcinoma nodules. ICL, NIC and λHU in the arterial and venous phases were not significantly different among the four grades.Conclusions: The spectral CT imaging parameters CT40keVa, CT40keVv, CT70keVa and CT70keVv gradually increased with Ki-67 expression and showed a moderate positive correlation with lung adenocarcinomas.Therefore, spectral CT imaging parameter-enhanced monochromatic CT numbers at 70 keV may indicate the extent of proliferation of lung adenocarcinomas.
基金supported by Grants from National key research and development program(No.2016YFF0101304)the National Natural Science Foundation of China(Nos.61771279,11435007)
文摘Spectral computed tomography(CT) based on photon counting detectors(PCDs) is a well-researched topic in the field of X-ray imaging. When PCD is applied in a spectral CT system, the PCD energy thresholds must be carefully selected, especially for K-edge imaging, which is an important spectral CT application. This paper presents a threshold selection method that yields better-quality images in K-edge imaging. The main idea is to optimize the energy thresholds ray-by-ray according to the targeted component coefficients, followed by obtaining an overall optimal energy threshold by frequency voting. A low-dose pre-scan is used in practical implementations to estimate the line integrals of the component coefficients for the basis functions. The variance of the decomposed component coefficients is then minimized using the Cramer–Rao lower bound method with respect to the energy thresholds. The optimal energy thresholds are then used to take a full scan and gain better image reconstruction with less noise than would be given by a full scan using the non-optimal energy thresholds. Simulations and practical experiments on imaging iodine and gadolinium solutions, which are commonly used as contrast agents in medical applications, were used to validate the method. The noise was significantly reduced with the same dose relative to the non-optimal energy thresholds in both simulations and in practical experiments.
文摘<strong>Objectives:</strong> To evaluate the diagnostic performance of the quantitative iodine parameters, including Iodine Concentration (IC), Normalized Iodine Concentration (NIC), and λ<sub>HU</sub>, in distinguishing malignant and benign thyroid nodules. <strong>Methods:</strong> Relevant studies were searched from Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure database and other complementary sources from inception to May 20, 2020. Study selection, data extraction, quality assessment, and data analyses were performed following the Cochrane standards and the PRISMA-DTA guideline. <strong>Results: </strong>Eight studies were included (595 patients with 737 thyroid nodules). The pooled sensitivity, specificity and summary diagnostic odds ratio of IC were 79% (95% CI: 69% - 86%), 76% (95% CI: 65% - 84%) and 11 (95% CI: 5 - 27) respectively;those of NIC were 78% (95% CI: 70% - 85%), 80% (95% CI: 74% - 85%) and 15 (95% CI: 9 - 24) respectively;those of λ<sub>HU</sub> were 80% (95% CI: 71% - 87%), 77% (95% CI: 70% - 83%) and 14 (95% CI: 8 - 24) respectively. <strong>Conclusion: </strong>DECT can be a potential evaluation tool for thyroid nodules. The NIC may be the most sensitive iodine parameter and could be comparable between different DECT machines in thyroid nodule assessment.
文摘From the point of view of design requirements, influence of the width of the output image of an imaging subsystem in a tomographic imaging spectrometer, namely width of the slit, the grating and the size of the CCD pixel are analyzed. For the tomographic imaging spectrometry, if the amplification ratio of the imaging subsystem is not high enough to make the whole object to be compressed within the slit, then either the slit width should be increased or the slit width kept unchanged but scanned to receive information of the object. While the width-increase method reduces the spectral resolving power and the SNR; the scanning method reduces the SNR. Analysis of the two cases and computer simulation results are given.
