Biological effects of human lung cells MRC-5 in CBCT positioning for image-guided radiotherapy

Image-guided radiotherapy(IGRT) provides precise positioning for the tumor target, but it may bring extra irradiation dose in the target positioning with a cone beam CT(CBCT) which has been increasingly used in IGRT. In this work, we focused on biological effects of the low-dose irradiation in IGRT, which have not been considered so far. Primary human fibroblasts cells from the lung and MRC-5 were irradiated by a CBCT. DNA doublestrand breaks(c-H2 AX foci) and micronucleus frequency of the irradiated samples were analyzed. Compared to the control, the c-H2 AX foci yields of the samples irradiated to 16 m Gy increased significantly, and the micronuclei rate of the samples irradiated for 3 days increased notably. The dose by imaging guidance device can be genotoxic to normal tissue cells, suggesting a potential risk of a secondary cancer. The effects, if confirmed by clinical studies,should be considered prudentially in designing IGRT treatment plans for the radiosensitive population, especially for children.

Image-Guided Radiotherapy Dose Escalation in Intermediate and High Risk Cancer Prostate Patients and Its Effect on Treatment Toxicity

Purpose: To study the effect of escalating radiation dose;in intermediate and high risk prostate cancer patients;via online image-guidance on acute toxicities. Patients and Methods: thirty-eight prostate cancer patients were treated by using simultaneous integrated boost-intensity modulated radiation therapy (SIB-IMRT) with online image guided correction via kilo voltage cone beam computed tomography (KV-CBCT)/electronic portal imaging device (EPID) of trans-rectal ultrasound (TRUS)-inserted intraprostatic gold fiduciary markers. High-risk patients received a median dose of 80.5 Gy to prostate and 56 Gy to pelvic nodes in 35 fractions over 7 weeks. Intermediate-risk patients received a similar prostate dose over the same overall treatment time. Acute toxicity (bladder, rectal and bowel symptoms) was reported once weekly during the radiation course and up to 3 months from the end of the radiation course. Results: The image guided (IG)-IMRT allows escalating the radiation dose delivered to the prostate through minimizing the margin of setup error to less than 0.5 cm with subsequent sparing of nearby organs at risk. Out of thirty-eight patients, no patient developed >grade 1 acute rectal toxicity, 7.9% of patients experienced grade 3 urinary toxicity and there was no reported small intestinal toxicity. Conclusion: Escalating the radiation dose more than 80 Gy in intermediate and high risk prostate cancer patients was safe and not associated with grade 3 - 4 RTOG toxicity when guided by online verification of intra-prostatic fiducial markers.

Multi-source image fusion algorithm based on fast weighted guided filter

In last few years,guided image fusion algorithms become more and more popular.However,the current algorithms cannot solve the halo artifacts.We propose an image fusion algorithm based on fast weighted guided filter.Firstly,the source images are separated into a series of high and low frequency components.Secondly,three visual features of the source image are extracted to construct a decision graph model.Thirdly,a fast weighted guided filter is raised to optimize the result obtained in the previous step and reduce the time complexity by considering the correlation among neighboring pixels.Finally,the image obtained in the previous step is combined with the weight map to realize the image fusion.The proposed algorithm is applied to multi-focus,visible-infrared and multi-modal image respectively and the final results show that the algorithm effectively solves the halo artifacts of the merged images with higher efficiency,and is better than the traditional method considering subjective visual consequent and objective evaluation.

Evaluation of axis alignment and refractive results of toric phakic IOL using image-guided system

AIM: To evaluate accuracy of axis alignment and refractive results of toric phakic intraocular lens(IOL) implantation using a digital imaging system. METHODS: This retrospective study investigated toric implantable collamer lens(ICL) implantation in 30 eyes of 21 patients with myopic astigmatism more than 2.0 D guided with digital imaging system. Data were collected during the first week after phakic IOL implantation.RESULTS: Thirty eyes of 21 patients were included in our study. Patients includes 9 males and 12 females. The mean age of the patients was 26.5±7.1(range 21-44)y. The mean preoperative manifest astigmatism was 3.2±1.7(range from 2.25 to 4.75) D. The mean postoperative uncorrected distance visual acuity(UCDVA) were 0.07±0.07(range from 0.1 to 0.0) log MAR. The mean postoperative residual refractive cylinder was 0.25±0.29(range 0-0.75) D. Eyes with postoperative residual refractive cylinder of 0.5 D or less represented 80%(24 eyes). The mean postoperative toric IOL misalignment measured by the OPD scan III was 1.9°±1.45°(range from 0 to 5°). CONCLUSION: Image guided system allows accurate alignment of toric ICL. This is associated with good postoperative visual acuity and low residual refractive astigmatism which correlates with the precision of toric phakic IOL alignment.

Stereotactic radiotherapy and the potential role of magnetic resonance-guided adaptive techniques for pancreatic cancer

BACKGROUND Pancreatic cancer is a malignancy with one of the poorest prognoses amongst all cancers.Patients with unresectable tumours either receive palliative care or undergo various chemoradiotherapy regimens.Conventional techniques are often associated with acute gastrointestinal toxicities,as adjacent critical structures such as the duodenum ultimately limits delivered doses.Stereotactic body radiotherapy(SBRT)is an advanced radiation technique that delivers highly ablative radiation split into several fractions,with a steep dose fall-off outside target volumes.AIM To discuss the latest data on SBRT and whether there is a role for magnetic resonance-guided techniques in multimodal management of locally advanced,unresectable pancreatic cancer.METHODS We conducted a search on multiple large databases to collate the latest records on radiotherapy techniques used to treat pancreatic cancer.Out of 1229 total records retrieved from our search,36 studies were included in this review.RESULTS Studies indicate that SBRT is associated with improved clinical efficacy and toxicity profiles compared to conventional radiotherapy techniques.Further dose escalation to the tumour with SBRT is limited by the poor soft-tissue visualisation of computed tomography imaging during radiation planning and treatment delivery.Magnetic resonance-guided techniques have been introduced to improve imaging quality,enabling treatment plan adaptation and re-optimisation before delivering each fraction.CONCLUSION Therefore,SBRT may lead to improved survival outcomes and safer toxicity profiles compared to conventional techniques,and the addition of magnetic resonance-guided techniques potentially allows dose escalation and conversion of unresectable tumours to operable cases.

SAR image de-noising via grouping-based PCA and guided filter

A novel synthetic aperture radar(SAR)image de-noising method based on the local pixel grouping(LPG)principal component analysis(PCA)and guided filter is proposed.This method contains two steps.In the first step,we process the noisy image by coarse filters,which can suppress the speckle effectively.The original SAR image is transformed into the additive noise model by logarithmic transform with deviation correction.Then,we use the pixel and its nearest neighbors as a vector to select training samples from the local window by LPG based on the block similar matching.The LPG method ensures that only the similar sample patches are used in the local statistical calculation of PCA transform estimation,so that the local features of the image can be well preserved after coefficients shrinkage in the PCA domain.In the second step,we do the guided filtering which can effectively eliminate small artifacts left over from the coarse filtering.Experimental results of simulated and real SAR images show that the proposed method outstrips the state-of-the-art image de-noising methods in the peak signalto-noise ratio(PSNR),the structural similarity(SSIM)index and the equivalent number of looks(ENLs),and is of perceived image quality.

Static-shift suppression and anti-interference signal processing for CSAMT based on Guided Image Filtering

Shallow conductive heterogeneity can lead to static shifts ain the apparent resistivity sounding curve of controlled-source audio-frequency magnetotellurics(CSAMT).The static effect will shift the apparent resistivity curves along with axial log-log coordinates.Such an effect,if not properly processed,can distort the resistivity of rock formation and the depth of interfaces,and even make the geological structures unrecognizable.In this paper,we discuss the reasons and characteristics of the static shift and summarize the previous studies regarding static shift correction.Then,we propose the Guided Image Filtering algorithm to suppress static shifts in CSAMT.In detail,we use the multi-window superposition method to superimpose 1D signals into a 2D matrix image,which is subsequently processed with Guided Image Filtering.In the synthetic model study and field examples,the Guided Image Filtering algorithm has effectively corrected and suppressed static shifts,and finally improved the precision of data interpretation.

Image-guided lens extraction surgery: a systematic review

A systematic review of the recent literature regarding the current image-guided systems used for cataract surgery or refractive lens exchange was performed based on the PubMed and Google Scholar databases in March 2018. Literature review returned 21 eligible studies. These studies compared image-guided systems with other keratometric devices regarding their accuracy, repeatability and reproducibility in measurement of keratometric values, astigmatism magnitude and axis, as well as in IOL power calculation. Additionally, the image-guided systems were compared with conventional manual ink-marking techniques for the alignment of toric IOLs. In conclusion, image-guided systems seem to be an accurate and reliable technology with measurements of high repeatability and reproducibility regarding the keratometry and IOL power calculation, but not yet interchangeable with the current established and validated keratometric devices. However, they are superior over the conventional manual inkmarking techniques for toric IOL alignment.

Spinal cord biological safety of image-guided radiation therapy versus conventional radiation therapy

Tumor models were simulated in purebred Beagles at the T9-10 levels of the spinal cord and treated with spinal image-guided radiation therapy or conventional radiation therapy with 50 or 70 Gy total radiation. Three months after radiation, neuronal injury at the T9-10 levels was observed, including reversible injury induced by spinal image-guided radiation therapy and apoptosis induced by conventional radiation therapy. The number of apoptotic cells and expression of the proapoptotic protein Fas were significantly reduced, but expression of the anti-apoptotic protein heat shock protein 70 was significantly increased after image-guided radiation therapy compared with the conventional method of the same radiation dose. Moreover, the spinal cord cell apoptotic index positively correlated with the ratio of Fas/heat shock protein 70. These findings indicate that 3 months of radiation therapy can induce a late response in the spinal cord to radiation therapy; image-guided radiation therapy is safer and results in less neuronal injury compared with conventional radiation therapy.

Research on Search Laws of Image Guided Missile

When image guided missile adopts guided search and common search law to search ground targets, under some conditions the movement of image on the monitor screen will be dissymmetrical, which is harmful for shooter to acquire and capture targets. To remove the dissymmetry of the image movement, such common search laws as parallel search law, ＂X＂ style search law, search law of one-dimension visual effect and cone search law are improved and designed again. Simulation results show that the dissymmetry can be removed by adopting all the above four improved search laws, but the search track of improved cone search law has serious transmutation compared with the original search track. The other three improved search laws have little transmutation of the search track, and they all can keep the main characters of the original search law. Study resuits are helpful for image guided missile in adopting guided search to choose appropriate search law.

Value of MR contrast media in image-guided body interventions

In the past few years,there have been multiple advances in magnetic resonance (MR) instrumentation,in vivo devices,real-time imaging sequences and interventional procedures with new therapies.More recently,interventionists have started to use minimally invasive image-guided procedures and local therapies,which reduce the pain from conventional surgery and increase drug effectiveness,respectively.Local therapy also reduces the systemic dose and eliminates the toxic side effects of some drugs to other organs.The success of MR-guided procedures depends on visualization of the targets in 3D and precise deployment of ablation catheters,local therapies and devices.MR contrast media provide a wealth of tissue contrast and allows 3D and 4D image acquisitions.After the development of fast imaging sequences,the clinical applications of MR contrast media have been substantially expanded to include pre-during-and post-interventions.Prior to intervention,MR contrast media have the potential to localize and delineate pathologic tissues of vital organs,such as the brain,heart,breast,kidney,prostate,liver and uterus.They also offer other options such as labeling therapeutic agents or cells.During intervention,these agents have the capability to map blood vessels and enhance the contrast between the endovascular guidewire/catheters/devices,blood and tissues as well as direct therapies to the target.Furthermore,labeling therapeutic agents or cells aids in visualizing their delivery sites and tracking their tissue distribution.After intervention,MR contrast media have been used for assessing the efficacy of ablation and therapies.It should be noted that most image-guided procedures are under preclinical research and development.It can be concluded that MR contrast media have great value in preclinical and some clinical interventional procedures.Future applications of MR contrast media in image-guided procedures depend on their safety,tolerability,tissue specificity and effectiveness in demonstrating success of the interventions and therapies.

Underwater Diver Image Enhancement via Dual-Guided Filtering

The scattering and absorption of light propagating underwater cause the underwater images to present lowcontrast,color deviation,and loss of details,which in turn make human posture recognition challenging.To address these issues,this study introduced the dual-guided filtering technique and developed an underwater diver image improvement method.First,the color distortion of the underwater diver image was solved using white balance technology to obtain a color-corrected image.Second,dual-guided filtering was applied to the white balanced image to correct the distorted color and enhance its details.Four feature weight maps of the two images were then calculated,and two normalizedweightmapswere constructed formulti-scale fusion using normalization.To better preserve the obtained image details,the fusion image was histogram-stretched to obtain the final enhanced result.The experimental results validated that this method has improved the accuracy of underwater human posture recognition.

Usability of Deformable Image Registration for Adaptive Radiotherapy in Head and Neck Cancer and an Automatic Prediction of Replanning

Deformable image registration (DIR) has been an important component in adaptive radiotherapy (ART). Our goal was to examine the accuracy of ART using the dice similarity coefficient (DSC) and to determine the optimal timing of replanning. A total of 22 patients who underwent volume modulated arc therapy (VMAT) for head and neck (H&N) cancers were prospectively analyzed. The planning target volume (PTV) was to receive a total of 70 Gy in 33 fractions. A second planning CT scan (rescan) was performed at the 15th fraction. The DSC was calculated for each structure on both CT scans. The continuous variables to predict the need for replanning were assessed. The optimal cut-off value was determined using receiver operating characteristic (ROC) curve analysis. In the correlation between body weight loss and DSC of each structure, weight loss correlated negatively with DSC of the whole face (rs = -0.45) and the face surface (rs = -0.51). Patients who required replanning tended to have experienced rapid weight loss. The threshold DSC was 0.98 and 0.60 in the whole face and the face surface, respectively. Patients who showed low DSC in the whole face and the face surface required replanning at a significantly high rate (P < 0.05 and P < 0.01). Weight loss correlated with DSC in both the whole face and the face surface (P < 0.05 and P < 0.05). The DSC values in the face predicted the need for replanning. In addition, weight loss tended to correlate with DSC. DIR during ART was found to be a useful tool for replanning.

Assessment of Radiotherapy Treatment Field on Portal Film Using Image Processing

Many factors contribute to the accuracy of delivered dose to patients in external-beam radiotherapy (EBRT). Although some of these factors can be checked by implementing suitable quality control procedures, the main aim was to assess the radiotherapy treatment filed on portal film using image processing technique in order to increase the accuracy of treatment delivery to the tumor by measuring the actual F/S, dose uniformity and penumbra size using portal film. This research is conducted at radiation therapy department, Khartoum Oncology Center (RICK), Khartoum state, Sudan, from July-2014 up to December-2014. The field size of each type of radiotherapy Co60 is measured as (9.4 × 9.4) cm and (9.1 × 9.1) cm, for linear accelerator machines it was 10 × 10 cm exactly as the reference field size, and there is no area reduced in linacs. The penumbra size for the two types of Co60 machine was measured also and it was 1.2 cm and 1.0 cm, and penumbra size of the linear accelerator machines was found to be 4 mm. The area of the field that received radiation by 100% was measured and it was 94.1% and 91.1% in Co60 and 100% for linear accelerator machine and that means linacs deliver the 100% of the dose to the useful field size. The dose percentage in the field for Co60 was 98.0% and 94.1% and thus the dose in the border of field 83.1% and 89.0% and it’s different in linacs because the dose percentage in the field was 78.4% and 78.4% and there is no measurable dose outside its field. Penumbra Co60 machines are relatively large which increase radiation dose to normal tissue and reduce the TCP, so calculation and accuracy of such calculation are necessary to the patient in term of NTCP.

Accuracy of combined PET/CT in image-guided interventions of liver lesions: An ex-vivo study

AIM： Positioning of interventional devices in liver lesions is a challenging task if only CT is available. We investigated the potential benefit of combined PET/CT images for localization of interventional devices in interventional liver studies. METHODS： Thirty lesions each of hyperdense, isodense and hypodense attenuation compared to normal liver parenchyma were injected into 15 ex-vivo pig livers. All lesions were composed of the same amounts of gelatine containing 0.5 MBq of ^18F-FDG. Following lesion insertion, an interventional needle was placed in each lesion under CT-guidance solely. After that, a PET/CT study was performed. The localization of the needle within the lesion was assessed for CT alone and PET/CT and the root mean square （RMS） was calculated. Results were compared with macroscopic measurements after lesion dissection serving as the standard of reference. RESULTS： In hypo- and isodense lesions PET/CT proved more accurate in defining the position of the interventional device when compared with CT alone. The mean RMS for CT and PET/CT differed significantly in isodense and hypodense lesions. No significant difference was found for hyperdense lesions. CONCLUSION： Combined FDG-PET/CT imaging provides more accurate information than CT alone concerning the needle position in FDG-PET positive liver lesions. Therefore combined PET/CT might be potentially beneficial not only for localization of an interventional device, but may also be beneficial for guidance in interventional liver procedures.

Imaged guided surgery during arteriovenous malformation of gastrointestinal stromal tumor using hyperspectral and indocyanine green visualization techniques:A case report

BACKGROUND This case report demonstrates the simultaneous development of a gastrointestinal stromal tumour(GIST)with arteriovenous malformations(AVMs)within the jejunal mesentery.A 74-year-old male presented to the department of surgery at our institution with a one-month history of abdominal pain.Contrast-enhanced computed tomography revealed an AVM.During exploratory laparotomy,hyperspectral imaging(HSI)and indocyanine green(ICG)fluorescence were used to evaluate the extent of the tumour and determine the resection margins.Intraoperative imaging confirmed AVM,while histopathological evaluation showed an epithelioid,partially spindle cell GIST.CASE SUMMARY This is the first case reporting the use of HSI and ICG to image GIST intermingled with an AVM.The resection margins were planned using intraoperative analysis of additional optical data.Image-guided surgery enhances the clinician’s knowledge of tissue composition and facilitates tissue differentiation.CONCLUSION Since image-guided surgery is safe,this procedure should increase in popularity among the next generation of surgeons as it is associated with better postoperative outcomes.

Dehazing for Image and Video Using Guided Filter

Poor visibility in bad weather, such as haze and fog, is a major problem for many applications of computer vision. Thus, haze removal is highly required for receiving high performance of the vision algorithm. In this paper, we propose a new fast dehazing method for real-time image and video processing. The transmission map estimated by an improved guided filtering scheme is smooth and respect with depth information of the underlying image. Results demonstrate that the proposed method achieves good dehazeing effect as well as real-time performance. The proposed algorithm, due to its speed and ability to improve visibility, may be used with advantages as pre-processing in many systems ranging from surveillance, intelligent vehicles, to remote sensing.

A new projection model based robust 2D-3D registration method on Fourier-Mellin space for image guided intervention

An automatic method is proposed to solve the registration problem,which aligns a single 2D fluoroscopic image to a 3D image volume without demanding any additional media like calibration plate or user interactions.First,a mathematic projection model is designed which can reduce the influence of projection distortion on parameter optimization and improve the registration accuracy.Then,a two stage optimization method is proposed,which enables a robust registration in a wide parameter space.Furthermore,an automatic registration framework is proposed based on the FourierMellin robust image comparison descriptor.Experimental results show that the registration method has a high accuracy with average rotation error of 0.6 degree and average translation error of 1.4mm.

Diffusion-weighted imaging and variable flip angle T1 mapping: a supplement for image-guided biopsy in follow-up analysis of liver fibrosis

Purpose To evaluate the performance of diffusion-weighted imaging(DWI) and variable flip angle(VFA) T1 mapping as a supplement to image-guided biopsy in follow-up analysis of liver fibrosis. Materials and Methods This prospective study was approved by the institution's committee on human research, and written informed consent was provided from the enrolled patients. We investigated five MRI parameters of DWI and VFA T1 mapping, collected from 11 patients who underwent serial ultrasound image-guided biopsy with follow-up MRI within 1.5 years after treatment for liver fibrosis/cirrhosis. For each patient, four consecutive MRI examinations were conducted, including baseline MRI before treatment and three follow-up MRI examinations after treatment at each 0.5-year interval. ADC values at four b values and T1 relaxation times were correlated to pathology-confirmed liver fibrosis stages, which were subsequently divided into two groups, stages F2–3 and F4. The receiver operating characteristic(ROC) analysis and repeated measurement analysis of variance were used for statistical analysis. Results Among these ADC parameters, ADC value(b = 500 s/mm^2) was the most consistent in differentiating between stage F2–3 and F4 liver fibrosis. Repeated measurement analysis showed that the intra-group and inter-group differences were 0.447 and 0.024, respectively. T1 relaxation time could not consistently differentiate between the F2–3 and F4 groups; however, it was repeatable, and the intra-group and inter-group differences were 0.410 and 0.042, respectively. Conclusion MRI-ADC value at a b value of 500 s/mm^2 can be a promising biomarker for differentiating stages F2–3 and F4 liver fibrosis. A combination of this biomarker with repeatable T1 relaxation time may function as a non-invasive tool for follow-up liver fibrosis in patients who reject repeated image-guided biopsy.