Positron emission tomography (PET) has emerged as an important diagnostic tool in the management of lung cancers. Although PET is sensitive in detection of lung cancer, but FDG (2-deoxy-2- 18 fluro-D-glucose) is not tumor specific and may accumulate in a variety of nonmalignant conditions occasionally giving false positive result. Addition of CT to PET improves specificity foremost, but also sensitivity in tumor imaging. Thus, PET/CT fusion images are a more accurate test than either of its individual components and are probably also better than side-by-side viewing of images from both modalities. PET/CT fusion images are useful in differentiating between malignant and benign disease, fibrosis and recurrence, staging and in changing patient management to more appropriate therapy. With analysis and discussion it appears that PET/ CT fusion images have the potential to dramatically improve our ability to manage the patients with lung cancer and is contributing to our understanding of cancer cell biology and in development of new therapies.
Computed tomography (CT) is widely used in assessing clinically stable patients with blunt abdominal trauma. In these patients, liver is one of the commonest organs being injured and CT can accurately identify and assess the extent of the injury. The CT features of blunt liver trauma include laceration, subcapsular or parenchymal haematomas, active haemorrhage and vascular injuries. Widespread use of CT has notably influenced the management of blunt liver injury from routine surgical to nonsurgical management. We present pictorial illustrations of various liver injuries depicted on CT in patients with blunt trauma.
Effects of different boundary conditions prescribed across the boundaries of radiofrequency ablation (RFA) models of liver cancer are investigated for the case where the tumour is at the liver boundary. Ground and Robin-type conditions (electrical field) and body temperature and thermal insulation (thermal field) conditions are examined. 3D models of the human liver based on publicly-available CT images of the liver are developed. An artificial tumour is placed inside the liver at the boundary. Simulations are carried out using the finite element method. The numerical results indicated that different electrical and thermal boundary conditions led to different predictions of the electrical potential, temperature and thermal coagulation distributions. Ground and body temperature conditions presented an unnatural physical conditions around the ablation site, which results in more intense Joule heating and excessive heat loss from the tissue. This led to thermal damage volumes that are smaller than the cases when the Robin type or the thermal insulation conditions are prescribed. The present study suggests that RFA simulations in the future must take into consideration the choice of the type of electrical and thermal boundary conditions to be prescribed in the case where the tumour is located near to the liver boundary.
Purpose: This study aimed to evaluate the effects of various computed tomography (CT) acquisition parameters and metal artifacts on CT number measurement for CT thermometry during CT-guided thermal ablation. Methods: The effects of tube voltage (100-140 kVp), tube current (20-250 mAs), pitch (0.6-1.5) and gantry rotation time (0.5, 1.0 s) as well as metal artifacts from a radiofrequency ablation (RFA) needle on CT number were evaluated using liver tissue equivalent polyacrylamide (PAA) phantom. The correlation between CT number and temperature from 37 to 80 °C was studied on PAA phantom using optimum CT acquisition parameters. Results: No statistical significant difference (p > 0.05) was found on CT numbers under the variation of different acquisition parameters for the same temperature setting. On the other hand, the RFA needle has induced metal artifacts on the CT images of up to 8 mm. The CT numbers decreased linearly when the phantom temperature increased from 37 to 80 °C. A linear regression analysis on the CT numbers and temperature suggested that the CT thermal sensitivity was -0.521 ± 0.061 HU/°C (R2 = 0.998). Conclusion: CT thermometry is feasible for temperature assessment during RFA with the current CT technology, which produced a high CT number reproducibility and stable measurement at different CT acquisition parameters. Despite being affected by metal artifacts, the CT-based thermometry could be further developed as a tissue temperature monitoring tool during CT-guided thermal ablation.
For a range of doses familiarly incurred in computed tomography (CT), study is made of the performance of Germanium (Ge)-doped fibre dosimeters formed into cylindrical and flat shapes. Indigenously fabricated 2.3 mol% and 6 mol% Ge-dopant concentration preforms have been used to produce flat- and cylindrical-fibres (FF and CF) of various size and diameters; an additional 4 mol% Ge-doped commercial fibre with a core diameter of 50 μm has also been used. The key characteristics examined include the linearity index f(d), dose sensitivity and minimum detectable dose (MDD), the performance of the fibres being compared against that of lithium-fluoride based TLD-100 thermoluminescence (TL) dosimeters. For doses in the range 2-40 milligray (mGy), delivered at constant potential of 120 kilovoltage (kV), both the fabricated and commercial fibres demonstrate supralinear behaviours at doses 4 mGy. In terms of dose sensitivity, all of the fibres show superior TL sensitivity when compared against TLD-100, the 2.3 mol% and 6 mol% Ge-doped FF demonstrating the greatest TL sensitivity at 84 and 87 times that of TLD-100. The TL yields for the novel Ge-doped silica glass render them appealing for use within the present medical imaging dose range, offering linearity at high sensitivity down to less than 2 mGy.
Contrast is a distinctive visual attribute that indicates the quality of an image. Computed Tomography (CT) images are often characterized as poor quality due to their low-contrast nature. Although many innovative ideas have been proposed to overcome this problem, the outcomes, especially in terms of accuracy, visual quality and speed, are falling short and there remains considerable room for improvement. Therefore, an improved version of the single-scale Retinex algorithm is proposed to enhance the contrast while preserving the standard brightness and natural appearance, with low implementation time and without accentuating the noise for CT images. The novelties of the proposed algorithm consist of tuning the standard single-scale Retinex, adding a normalized-ameliorated Sigmoid function and adapting some parameters to improve its enhancement ability. The proposed algorithm is tested with synthetically and naturally degraded low-contrast CT images, and its performance is also verified with contemporary enhancement techniques using two prevalent quality evaluation metrics-SSIM and UIQI. The results obtained from intensive experiments exhibited significant improvement not only in enhancing the contrast but also in increasing the visual quality of the processed images. Finally, the proposed low-complexity algorithm provided satisfactory results with no apparent errors and outperformed all the comparative methods.
Although the diagnosis of thymolipoma has improved with the introduction of computerized tomography (CT), variations in CT appearance are still being described; this paper describes a case which resembled a lipoma. The CT features of thymolipoma are discussed with special reference to the differential diagnosis. Surgical excision should be considered for patients who are found to exhibit a fatty intrathoracic mass on CT.
A successful excision of a giant cerebral mycotic anuerysm in a young girl with endocarditis is presented. The clinical pictures can be confused with a cerebral abscess. C.T. Scan and angiography are essential in the diagnosis. Rupture of the aneurysm is associated with high mortality and morbidity which can be averted by prompt neurosurgical treatment.
Central nervous system involvement in melioidosis is rare. We describe a 48 year old woman who developed septicaemia and a brain abscess due to Pseudomonas pseudomallei. Since there is a continuing practical problem in bacteriological confirmation of the aetiological agent, diagnosis of melioidosis has to be made on clinical suspicion.
Two cases of late second trimester extrauterine pregnancy are presented--intraabdominal pregnancy in one and an ampullary pregnancy in another. In the former the diagnosis was made only after attempts at induction of labour for fetal death with prostaglandins failed and in the latter only at laparotomy. The diagnostic and surgical problems encountered are discussed.
Thyroid and gonads are radiosensitive organs which requires radiation shield to reduce the dose received. However,
radiation shielding is not widely used in radionuclide imaging because it is heavy, uncomfortable and can cause pain
in the spine. Therefore, a research was carried out to determine the ability of thyroid and gonad radiation shield
which is thinner and lighter in reducing radiation dose. A study was conducted in Hospital Putrajaya to determine
the radiation dose received by the thyroid and gonads during a complete Positron Emission Tomography-Computed
Tomography (PET-CT) procedure with and without radiation shield. A total of six male staffs have been chosen as subject
and data from 33 complete PET-CT procedures have been collected. For every PET-CT procedure, the subject’s thyroid
and gonad were shielded using 0.5-mm thick radiation shielded, model Mavig 615 (USA) and Shielding International
(USA) respectively. Thermal luminescent dosimeter (TLD) chips were used as radiation dose detector. The average 18FFDG radioactivity administered to the patient was 387 MBq and the average scan time is 9.224 ± 1.797 minutes. The
results showed that the mean equivalent dose received by the thyroid with and without shielding were 0.080 ± 0.033
mSv and 0.078 ± 0.039 mSv respectively. The mean equivalent dose received by gonad with and without shielding
were 0.059 ± 0.040 mSv and 0.061 ± 0.030 mSv respectively. Radiation shield with 0.5 mm thickness is unable to
reduce radiation dose received by the thyroid (p = 0.76) and gonads (p = 0.79) because it is too thin to resist the
high-energy radiation during PET-CT procedures. Thyroid receive higher radiation dose of 0.016 m Sv compared to
the gonads (p < 0.05) because the thyroid’s position is more exposed to radiation sources which are 18F-FDG during
radiopharmaceutical preparation and patients after administered with 18F-FDG during PET-CT procedure.
Keywords: equivalent dose, radiation shield, TLD
The purpose of this study was to determine the dimensional accuracy of the skull models produced by Rapid prototyping technology using stereolithography apparatus. Computed tomography images were captured from four dry normal adult human skulls. The resultant 2-D images were stored in Digital Imaging and Communications in Medicine (DICOM) format. The segmentation of the images was prepared in MIMICS software. The slice files were then exported to a stereolithography apparatus (SLA) to produce the replica of each skull. Eight linear measurements were repeatedly made between identified landmarks on each of the original skull and its replica model using an electronic digital calliper. Each of the linear measurements was repeated 5 times and the average was taken to determine the absolute difference and percent difference between the original skull and its replica model. The overall absolute difference between the four human adult skulls and its replica models was 0.23 mm with a standard deviation of 1.37 mm. The percent difference was 0.08% with a standard deviation of 1.25%. The degree of error established by this system seems affordable in clinical applications when these models are used in the field of dental surgery for surgical treatment planning.
Paediatric facial traumas are often accompanied by other intracranial and non-head injuries. Use of
Computed Tomography (CT) has increased diagnostic accuracy when compared to plain radiographs alone. Coexisting anomalies can sometimes be a chance finding from the imagings and this highlights the need of a formalreporting by a radiologist. We report a case of a traumatic unilateral condylar fracture with a coexisting life-threatening abnormality detected from careful assessment of the imagings.
Emphysematous aortitis is a rare condition that manifests through the presence of air within or surrounding the inflamed aorta. Aortic inflammation may result from either an infective or a non-infective cause. Recognition of this rare condition is important as the resultant clinical deterioration may be rapid and lead to inevitable death. Cross-sectional imaging, with its relatively wide availability, proves an important tool in the diagnosis and subsequent management of this condition. We report two such cases encountered in our centre, with particular focus on the imaging findings on CT.
This paper presents the application of active contours region-based method of image segmentation to Computed Tomography (CT) images. Previous researchers applied this region based method on Magnetic Resonance Image (MRI), in vivo images and synthetic images which contain intensity inhomogeneities. In this paper, a different modality known as Computed Tomography (CT) scan was applied. CT scan also produces images containing intensity inhomogeneity, and it is predicted that this method provide good segmentation results. The main objective of applying this method is to check its applicability on CT images. The segmentation process begins by finding the area of interest (black region). Results from this experiment are then used in estimating time of death. Experimental results show that this method has successfully segmented the black region when some parameters changed, provided that the regions are closed to each other. If the black regions are located far from each other, then this method will only segment certain areas.
Computed Tomography (CT) images are widely used for the identification of abnormal brain tissues following infarct and hemorrhage of a stroke. The treatment of this medical condition mainly depends on doctors' experience. While manual lesion delineation by medical doctors is currently considered as the standard approach, it is time-consuming and dependent on each doctor's expertise and experience. In this study, a case-control comparison brain lesion segmentation (CCBLS) method is proposed to segment the region pertaining to brain injury by comparing the voxel intensity of CT images between control subjects and stroke patients. The method is able to segment the brain lesion from the stacked CT images automatically without prior knowledge of the location or the presence of the lesion. The aim is to reduce medical doctors' burden and assist them in making an accurate diagnosis. A case study with 300 sets of CT images from control subjects and stroke patients is conducted. Comparing with other existing methods, the outcome ascertains the effectiveness of the proposed method in detecting brain infarct of stroke patients.