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Biomedical subjects

Kenneth R Hoffmann

Publications and source records attributed to Kenneth R Hoffmann.

13 recordsLinked to original sources

Microcatheter tip enhancement in fluoroscopy: a comparison of techniques.

We compared three techniques for enhancement of microcatheter tips in fluoroscopic images: conventional subtraction technique (CST); averaged image subtraction technique (AIST), which we have developed; and double average filtering (DAF) technique, which uses nonlinear background estimates. A pulsed fluoroscopic image sequence was obtained as a microcatheter was passed through a carotid phantom that was on top of a head phantom. The carotid phantom was a silicone cylinder containing a simulated vessel with the shape and curvatures of the internal carotid artery. The three techniques were applied to the images of the sequence, then the catheter tip was manually identified in each image, and 100 x 100 pixel images, centered at the indicated microcatheter tip positions, were extracted for the evaluations. The signal-to-noise ratio (SNR) was calculated in each of the extracted images from which the mean value of the SNR and its standard deviation (SD) were calculated for each technique. The mean values and the standard deviations were 4.36 (SD 3.40) for CST, 6.34 (SD 3.62) for AIST, and 3.55 (SD 1.27) for DAF. AIST had a higher SNR compared to CST in almost all frames. Although DAF yielded the smallest mean SNR value, it yielded the best SNR in those frames in which the microcatheter tip did not move between frames. We conclude that AIST provides the best SNR for a moving microcatheter tip and that DAF is optimal for a temporarily stationary microcatheter tip.

Carotid Artery, Internal↗

Towards a theory of a solution space for the biplane imaging geometry problem.

Biplane angiographic imaging is a primary method for visual and quantitative assessment of the vasculature. In order to reliably reconstruct the three-dimensional (3D) position, orientation, and shape of the vessel structure, a key problem is to determine the rotation matrix R and the translation vector t which relate the two coordinate systems. This so-called Imaging Geometry Determination problem is well studied in the medical imaging and computer vision communities and a number of interesting approaches have been reported. Each such technique determines a solution which yields 3D vasculature reconstructions with errors comparable to other techniques. From the literature, we see that different techniques with different optimization strategies yield reconstructions with equivalent errors. We have investigated this behavior, and it appears that the error in the input data leads to this equivalence effectively yielding what we call the solution space of feasible geometries, i.e., geometries which could be solutions given the error or uncertainty in the input image data. In this paper, we lay the theoretical framework for this concept of a solution space of feasible geometries using simple schematic constructions, deriving the underlying mathematical relationships, presenting implementation details, and discussing implications and applications of the proposed idea. Because the solution space of feasible geometries encompasses equivalent solutions given the input error, the solution space approach can be used to evaluate the precision of calculated geometries or 3D data based on known or estimated uncertainties in the input image data. We also use the solution space approach to calculate an imaging geometry, i.e., a solution.

Algorithms↗

Optimization of three-dimensional angiographic data obtained by self-calibration of multiview imaging.

Stroke is one of the leading causes of death in the U.S. The treatment of stroke often involves vascular interventions in which devices are guided to the intervention site often through tortuous vessels based on two-dimensional (2-D) angiographic images. Three dimensional (3-D) vascular information may facilitate these procedures. Methods have been proposed for the self-calibrating determination of 3-D vessel trees from biplane and multiple plane images and the geometric relationships between the views (imaging geometries). For the biplane analysis, four or more corresponding points must be identified in the biplane images. For the multiple view technique, multiple vessels must be indicated and only the translation vectors relating the geometries are calculated. We have developed methods for the calculation of the 3-D vessel data and the full transformations relating the multiple views (rotations and translations) obtained during interventional procedures, and the technique does not require indication of corresponding points, but only the indication of a single vessel, e.g., the vessel of interest. Multiple projection views of vessel trees are obtained and transferred to the analysis computer. The vessel or vessels of interest are indicated by the user. Using the initial imaging geometry determined from the gantry information, 3-D vessel centerlines are calculated using the indicated centerlines in pairs of images. The imaging geometries are then iteratively adjusted and 3-D centerlines recalculated until the root-mean-square (rms) difference between the calculated 3-D centerlines is minimized. Simulations indicate that the 3-D centerlines can be accurately determined (to within 1 mm) even for errors in indication of the vessel endpoints as large as 5 mm. In phantom studies, the average rms difference between the pairwise calculated 3-D centerlines is approximately 7.5 mm prior to refinement (i.e., using the gantry information alone), whereas the average rms difference is usually below 1 mm after refinement. Accuracies and reliabilities of better than 1 mm were also determined by comparing centerlines determined using multiview and rotational angiography reconstruction and clinical data sets. These results indicate that the multiview approach will provide accurate and reliable 3-D centerlines for indicated vessel(s) without increasing the dose to the patient.

Algorithms↗

Contrast settling in cerebral aneurysm angiography.

During angiography, blood flow is visualized with a radiopaque contrast agent, which is denser than blood. In complex vasculature, such as cerebral saccular aneurysms, the density difference may produce an appreciable gravity effect, where the contrast material separates from blood and settles along the gravity direction. Although contrast settling has been occasionally reported before, the fluid mechanics behind it have not been explored. Furthermore, the severity of contrast settling in cerebral aneurysms varies significantly from case to case. Therefore, a better understanding of the physical principles behind this phenomenon is needed to evaluate contrast settling in clinical angiography. In this study, flow in two identical groups of sidewall aneurysm models with varying parent-vessel curvature was examined by angiography. Intravascular stents were deployed into one group of the models. To detect contrast settling, we used lateral view angiography. Time-intensity curves were analysed from the angiographic data, and a computational fluid dynamic analysis was conducted. Results showed that contrast settling was strongly related to the local flow dynamics. We used the Froude number, a ratio of flow inertia to gravity force, to characterize the significance of gravity force. An aneurysm with a larger vessel curvature experienced higher flow, which resulted in a larger Froude number and, thus, less gravitational settling. Addition of a stent reduced the aneurysmal flow, thereby increasing the contrast settling. We found that contrast settling resulted in an elevated washout tail in the time-intensity curve. However, this signature is not unique to contrast settling. To determine whether contrast settling is present, a lateral view should be obtained in addition to the anteroposterior (AP) view routinely used clinically so as to rule out contrast settling and hence to enable a valid time-intensity curve analysis of blood flow in the aneurysm.

Algorithms↗

Efficient Algorithms for Determining 3-D Bi-Plane Imaging Geometry.

Biplane projection imaging is one of the primary methods for imaging and visualizing the cardiovascular system in medicine. A key problem in such a technique is to determine the imaging geometry (i.e., the relative rotation and translation) of two projections so that the interested 3-D structures can be accurately reconstructed. Based on interesting observations and efficient geometric techniques, we present in this paper new algorithmic solutions for this problem. Comparing with existing optimization-based approaches, our techniques yield better accuracy, have bounded execution time, and thus are more suitable for on-line applications. Our techniques can easily detect outliers to further improve the accuracy.

Journal Article↗

Generalizing the MTF and DQE to include x-ray scatter and focal spot unsharpness: application to a new microangiographic system.

Detector characterization with modulation transfer function (MTF) and detective quantum efficiency (DQE) inadequately predicts image quality when the imaging system includes focal spot unsharpness and patient scatter. The concepts of MTF, noise power spectrum, noise equivalent quanta and DQE were referenced to the object plane and generalized to include the effect of geometric unsharpness due to the finite size of the focal spot and the effect of the spatial distribution and magnitude of x-ray scatter due to the patient. The generalized quantities provide performance characteristics that consider the complete imaging system, but reduce to a description of the detector properties without magnification or scatter. We have evaluated a new neurovascular angiography imaging system based on a region of interest (ROI) microangiographic detector using these generalized quantities. A uniform head-equivalent phantom was used as a filter and x-ray scatter source. This allowed the study of all properties of the detector under clinically relevant x-ray spectra and x-ray scatter conditions. Realistic focal spots (0.8 mm nominal), beam energies (60-100 kVp), and detector exposures (0.8-2.3 mR) were used, and the effects of different scatter fractions (0-0.62) resulting from changing the beam size (0-100 cm2) were investigated. The generalized MTF and DQE were found to have very little dependence on the tube voltage and the detector entrance exposure. Magnification, with the focal spot used, results in a large decrease of the generalized DQE at higher frequencies (about 100-fold at 10 cycles/mm), but a significantly smaller decrease at lower frequencies. Scatter on the other hand, causes a constant drop in the generalized DQE (factor of 3 for scatter fraction 0.3) for all frequencies. Our results show that there are tradeoffs in the choice of the different system parameters; therefore this methodology of studying the imaging system as a whole could provide guidance in system design.

Angiography↗

Effects of point configuration on the accuracy in 3D reconstruction from biplane images.

Two or more angiograms are being used frequently in medical imaging to reconstruct locations in three-dimensional (3D) space, e.g., for reconstruction of 3D vascular trees, implanted electrodes, or patient positioning. A number of techniques have been proposed for this task. In this simulation study, we investigate the effect of the shape of the configuration of the points in 3D (the "cloud" of points) on reconstruction errors for one of these techniques developed in our laboratory. Five types of configurations (a ball, an elongated ellipsoid (cigar), flattened ball (pancake), flattened cigar, and a flattened ball with a single distant point) are used in the evaluations. For each shape, 100 random configurations were generated, with point coordinates chosen from Gaussian distributions having a covariance matrix corresponding to the desired shape. The 3D data were projected into the image planes using a known imaging geometry. Gaussian distributed errors were introduced in the x and y coordinates of these projected points. Gaussian distributed errors were also introduced into the gantry information used to calculate the initial imaging geometry. The imaging geometries and 3D positions were iteratively refined using the enhanced-Metz-Fencil technique. The image data were also used to evaluate the feasible R-t solution volume. The 3D errors between the calculated and true positions were determined. The effects of the shape of the configuration, the number of points, the initial geometry error, and the input image error were evaluated. The results for the number of points, initial geometry error, and image error are in agreement with previously reported results, i.e., increasing the number of points and reducing initial geometry and/or image error, improves the accuracy of the reconstructed data. The shape of the 3D configuration of points also affects the error of reconstructed 3D configuration; specifically, errors decrease as the "volume" of the 3D configuration increases, as would be intuitively expected, and shapes with larger spread, such as spherical shapes, yield more accurate reconstructions. These results are in agreement with an analysis of the solution volume of feasible geometries and could be used to guide selection of points for reconstruction of 3D configurations from two views.

Coronary Angiography↗

Measurement of flow modification in phantom aneurysm model: comparison of coils and a longitudinally and axially asymmetric stent--initial findings.

Dye-dilution imaging sequences were performed and time-density curves were constructed in elastomer vessel aneurysm models to demonstrate the effectiveness of coils and an asymmetric stent in disrupting standard vortex flow. Compared with the use of coils, the use of stents led to marked flow modification, as seen with imaging sequences, and substantially slower inflow, as indicated by time-density curves, owing to the low-porosity region of the stent that covers the aneurysm orifice. These flow examination results indicate that potentially favorable flow modification features can be created by using the described asymmetric stent design, the use of which may lead to alternative methods of image-guided endovascular cerebral aneurysm therapy.

Blood Vessel Prosthesis Implantation↗

A prototype virtual reality system for preoperative planning of neuro-endovascular interventions.

This paper describes our efforts at creating a system with real time acquisition and geometric processing of the patients vascular anatomy, supplemented by a framework to simulate catheter vasculature interaction. Our system uses biplane angiograms coupled with an algorithm for generation of 3D vascular trees for patient data acquisition. Surface reconstruction and processing of this data is performed to provide novel decision aids to the interventionalist. The processed data can be loaded in a virtual environment to simulate guidance of the catheter through the patient's vasculature. With our combination of techniques, a patient specific visualization and simulation environment can be prepared within the narrow time window available for this procedure.

Algorithms↗

Vessel size measurements in angiograms: manual measurements.

Vessel size measurement is perhaps the most often performed quantitative analysis in diagnostic and interventional angiography. Although automated vessel sizing techniques are generally considered to have good accuracy and precision, we have observed that clinicians rarely use these techniques in standard clinical practice, choosing to indicate the edges of vessels and catheters to determine sizes and calibrate magnifications, i.e., manual measurements. Thus, we undertook an investigation of the accuracy and precision of vessel sizes calculated from manually indicated edges of vessels. Manual measurements were performed by three neuroradiologists and three physicists. Vessel sizes ranged from 0.1-3.0 mm in simulation studies and 0.3-6.4 mm in phantom studies. Simulation resolution functions had full-widths-at-half-maximum (FWHM) ranging from 0.0 to 0.5 mm. Phantom studies were performed with 4.5 in., 6 in., 9 in., and 12 in. image intensifier modes, magnification factor = 1, with and without zooming. The accuracy and reproducibility of the measurements ranged from 0.1 to 0.2 mm, depending on vessel size, resolution, and pixel size, and zoom. These results indicate that manual measurements may have accuracies comparable to automated techniques for vessels with sizes greater than 1 mm, but that automated techniques which take into account the resolution function should be used for vessels with sizes smaller than 1 mm.

Anatomy, Cross-Sectional↗

Micro-angiography for neuro-vascular imaging. I. Experimental evaluation and feasibility.

Minimally invasive image-guided neuro-vascular interventions require very high image-resolution and quality, specifically over regions-of-interest (ROI) crucial to the procedure. ROI imaging or micro-angiography, allows limited patient integral radiation dose while permitting rapid frame transfer of high-resolution images. The design and performance of a charge coupled device (CCD) based x-ray detector or micro-angiographic camera was assessed for neuro-vascular procedures. The detector consists of a 250-microm-thick CsI(Tl) phosphor fiber-optically coupled through a 1.8:1 taper to a CCD chip, with an effective image pixel size of 50 microm and a frame rate of 5 fps in the 2:1 pixel-binned mode. The characteristics of the camera including the modulation transfer function (MTF), the noise equivalent quanta, the detective quantum efficiency, observer studies, and the effect of geometric magnification were evaluated. The MTF was found to have nonzero (1.7%) value at the Nyquist frequency of 10 cycles/mm, while the DQE(0) had a value of approximately 55%. All values were measured using head equivalent attenuating material in the beam at 80 kVp. Human observer studies performed using the 2 Alternative Forced Choice method revealed that iodinated vessels with inner diameter of 100 microm and 2 cm in length can be seen with a confidence level greater than 75%. The observer studies included a comparison with ideal observer performance calculations based on the integral signal to noise ratio in the image. Probabilities of visualization of various objects of interest in a neuro-intervention, such as stents, were assessed. A geometric magnification of 1 was found to be best for imaging under neuro-angiographic conditions. The detector appeared to satisfy all the demands of neuro-angiography and showed promise as an improvement over existing angiographic detectors.

Angiography↗

Micro-angiography for neuro-vascular imaging. II. Cascade model analysis.

A micro-angiographic detector was designed and its performance was previously tested to evaluate its feasibility as an improvement over current x-ray detectors for neuro-interventional imaging. The detector was shown to have a modulation transfer function value of about 2% at the Nyquist frequency of 10 cycles/mm and a zero frequency detective quantum efficiency [DQE(0)] value of about 55%. An assessment of the system was required to evaluate whether the current system was performing at its full potential and to determine if any of its components could be optimized to further improve the output. For the purpose, in this study, the parallel cascade theory was used to analyze the performance of the detector under neuro-angiographic conditions by studying the output at the various stages in the imaging chain. A simple model for the spread of light in the CsI(Tl) entrance phosphor was developed and the resolution degradation due to K-fluorescence absorption was calculated. The total gain of the system was found to result in 21 e(-) (rms) detected at the charge coupled device per absorbed x-ray photon. The gain and the spread of quanta in the imaging chain were used to calculate theoretically the DQE using the parallel cascade model. The results of the model-based calculations matched fairly well with the experimental data previously obtained. This model was then used to optimize the phosphor thickness for the detector. The results showed that the area under the DQE curve had a maximum value at 150 microm of CsI(Tl), though when weighted by the squared signal in frequency space of a 100-microm-diam iodinated vessel, the integral DQE reached a maximum at 250 microm of CsI(Tl). Further, possible locations for gain increase in the imaging chain were determined, and the output of the improved system was simulated. Thus a theoretical analysis for the micro-angiographic detector was performed to better assess its potential.

Algorithms↗

Vessel size measurements in angiograms: a comparison of techniques.

As interventional procedures become more complicated, the need for accurate quantitative vascular information increases. In response to this need, many commercial vendors provide techniques for measurement of vessel sizes, usually based on derivative techniques. In this study, we investigate the accuracy of several techniques used in the measurement of vessel size. Simulated images of vessels having circular cross sections were generated and convolved with various focal spot distributions taking into account the magnification. These vessel images were then convolved with Gaussian image detector line spread functions (LSFs). Additionally, images of a phantom containing vessels with a range of diameters were acquired for the 4.5", 6", 9", and 12" modes of an image intensifier-TV (II-TV) system. Vessel sizes in the images were determined using a first-derivative technique, a second-derivative technique, a linear combination of these two measured sizes, a thresholding technique, a densitometric technique, and a model-based technique. For the same focal spot size, the shape of the focal spot distribution does not affect measured vessel sizes except at large magnifications. For vessels with diameters larger than the full-width-at-half-maximum (FWHM) of the LSF, accurate vessel sizes (errors approximately 0.1 mm) could be obtained by using an average of sizes determined by the first and second derivatives. For vessels with diameters smaller than the FWHM of the LSF, the densitometric and model-based techniques can provide accurate vessel sizes when these techniques are properly calibrated.

Angiography↗