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Biomedical subjects

C A Pelizzari

Publications and source records attributed to C A Pelizzari.

47 records · Page 3Linked to original sources

The brain: integrated three-dimensional display of MR and PET images.

Three patients with intractable epilepsy, two with brain tumors, and one with encephalitis were imaged with magnetic resonance (MR) and positron emission tomography (PET). MR data were used to construct a three-dimensional (3D) computer model of the brain surface depicting the precentral (movement), postcentral (sensation), left inferior frontal (speech), and left superior temporal (hearing) gyri. PET-derived measurements of average surface metabolism were encoded as colors and mapped onto the 3D model by means of a retrospective technique for registering the two scans. The integrated 3D model depicted the location of PET-detected metabolic abnormalities with respect to the gyral anatomy visualized with MR. In each case, the predicted relationships were confirmed intraoperatively by means of inspection of the brain and electroencephalography. Multimodality 3D displays are likely to be particularly valuable for interpreting PET studies of epileptic patients and others with normal MR anatomy.

Brain↗

Retrospective geometric correlation of MR, CT, and PET images.

Magnetic resonance imaging, computed tomographic, and positron emission tomographic studies of the brain provide complementary information, and many patients undergo more than one of these studies during the course of their diagnostic workup and treatment. A new technique for quantitative geometric correlation of such studies makes it possible to create integrated multimodality images by mapping features from one image onto an image obtained with another modality. The coordinate transformation between any pair of images is found by a semiautomatic algorithm for matching models of the patient's external surface as depicted in the two data sets. The resultant hybrid images, which combine complementary features of different studies, are often more useful for diagnosis and treatment planning than are the original single-modality images. The algorithm can also be used for spatial registration of baseline studies with follow-up images created with the same modality, which allows tracking of a lesion to detect subtle interval changes in size and shape. This technique can be applied to images acquired in routine clinical practice, since it is completely retrospective and does not necessitate special positioning or landmarking of the patient.

Adolescent↗

Retrospective registration of X-ray angiograms with MR images by using vessels as intrinsic landmarks.

Conventional x-ray angiography (XRA) images are projections of the vasculature with high spatial and temporal resolution, while magnetic resonance (MR) angiography (MRA) and MR imaging data show the three-dimensional locations of vessels relative to brain parenchyma. The authors have developed a retrospective method of registering these studies, which makes it practical to produce multimodality displays of this complementary information. Registration was performed by matching vessels seen on both XRA and MRA images. First, the authors determined the coordinates of the center lines of a few "landmark" vessels on the XRA image and the three-dimensional locations of the corresponding intraluminal voxels in the MRA volume. Registration was performed by rotating and translating the MRA-MR imaging volume until the perspective projection of the MRA landmark vessels matched the corresponding vessel center lines on the XRA image. Experiments with phantoms and patients indicated that the two studies were registered with an average error of less than 2 mm. A linked-cursor display was developed to show correspondence between points on the registered XRA and MRA-MR images.

Angiography↗

Image correlation techniques in radiation therapy treatment planning.

A technique to spatially correlate multi-modality or serial imaging studies of the head is described. Surface fitting of a well defined structure in different imaging studies is used to determine the optimal three dimensional transformation between the coordinate systems. The transformation is then used to map volumes of interest between studies or to reslice the studies along comparable planes. The approach is feasible in the presence of variations in slice thickness, pixel size, imaging plane, or head position, and for correlations between different modalities. Correlations have been performed between serial CT, CT/MRI, and PET/CT/MRI studies. Phantom studies and clinical cases are presented. Accuracy is typically on the order of the sum of the pixel sizes between studies. Applications in radiation therapy treatment planning are described.

Brain Neoplasms↗

Accurate three-dimensional registration of CT, PET, and/or MR images of the brain.

A surface matching technique has been developed to register multiple imaging scans of the brain in three dimensions, with accuracy on the order of the image pixel sizes. Anatomic information visualized in X-ray CT and magnetic resonance images may be integrated with each other and with functional information from positron emission tomography. Anatomical structures and other volumes of interest may be mapped from one scan to another, and corresponding sections through multiple scans may be directly compared. This capability provides a novel quantitative method to address the fundamental problem of relating structure to function in the brain. Applications include basic and clinical problems in the neurosciences and delivery and assessment of brain tumor therapy.

Brain↗

Retrospective fusion of radiographic and MR data for localization of subdural electrodes.

Prior to epilepsy surgery, subdural electrodes are often implanted and monitored for a few days to identify the focus of abnormal electrical activity. During the implantation and subsequent brain resection, there may be uncertainty about the exact location of the electrodes with respect to features of brain anatomy such as specific gyral convolutions or lesions. In experiments with a phantom and patients, implanted electrodes were imaged with multiplanar skull radiographs (or CT scans). After retrospective registration with preimplantation MR data, the electrodes were mapped from these studies onto an MR-derived three-dimensional brain model. The resulting multimodality displays showed the relationship of the electrodes to brain anatomy. In one patient the position of each electrode with respect to a metabolic lesion was also displayed by mapping preimplantation PET data onto the same brain model. This new display of electrode positions may strengthen the interpretation of subdural electrical recordings and thereby reduce uncertainty in planning the resection of epileptic tissue.

Adult↗

Accuracy of surface fit registration for PET and MR brain images using full and incomplete brain surfaces.

OBJECTIVE: The accuracy of a surface-fitting image registration technique has been investigated for matching [18F]fluorodeoxyglucose (FDG) and [15O]H2O PET brain images with MR images. Use of partial-brain surfaces (a single hemisphere or a limited number of slices) was investigated to simulate cases in which severe brain defects or limited axial field of view would preclude using the entire brain surface. MATERIALS AND METHODS: Three FDG and three H2O scans were performed on five volunteers, in addition to volume MR studies. Fiducial markers were placed on the subjects' scalps to provide references for registration accuracy. The registration procedure was applied to each PET-MR set, using the surfaces defined by locating the brain edge in multiple slices for each set. RESULTS: The surfaces fit well, with only 1% scaling necessary for the best fit. Errors in fiducial marker positions between MRI and transformed PET were < 2 mm in the transverse directions and < 4.5 mm in the axial direction. Fits based on the partial surfaces worked well and gave results very similar to the full-brain fits. CONCLUSION: The surface-fitting technique is accurate for FDG and H2O PET studies, even when part of the brain surface cannot be used.

Algorithms↗

Accuracy of object depiction and opacity transfer function optimization in CT volume-rendered images.

Volume rendering is a visualization technique that has important applications in diagnostic radiology and radiotherapy. A methodology is presented for (a) evaluation of the quantitative accuracy of representation of known objects in volume-rendered scenes and for (b) optimization of the opacity transfer function to achieve the most accurate representation of a particular structure. Results using this methodology are shown for structures representing each of the major tissue interfaces and are discussed.

Algorithms↗

Correlation of projection radiographs in radiation therapy using open curve segments and points.

A method for determining differences in patient position between projection radiographs such as those routinely used in radiation therapy has been developed. Determination of a transformation relating two radiographs permits registration of simulation and portal images and the transfer of information between them. The algorithm is based on spatially registering segments of open curves or points seen on both images, and does not require identification of corresponding curve endpoints. The method as implemented is both fast and accurate. After user definition of the curves or points to be registered, the optimal transformation is calculated in approximately 1 s. Calculational experiments indicate that corresponding points on open curves are registered to better than 2 mm, even when random errors (FWHM 1 mm) in digitization are included. Experiments on the registration of clinical portal and simulation images (pixel size = 0.5 by 0.5 mm) indicate an accuracy on the order of 2 mm or less in translation and 2 deg or less in rotation. Analysis of portal and simulation radiographs of the brain, thorax, and pelvis indicates this algorithm to be robust and clinically applicable. The rapid and accurate registration of portal and simulation images is potentially important in the application of real time portal imaging devices in radiation therapy.

Algorithms↗