Gongting Wu

Imaging and Elastometry of Blood Clots Using Magnetomotive Optical Coherence Tomography and Labeled Platelets

Improved methods for imaging and assessment of vascular defects are needed for directing treatment of cardiovascular pathologies. In this paper, we employ magnetomotive optical coherence tomography (MMOCT) as a platform both to detect and to measure the elasticity of blood clots. Detection is enabled through the use of rehydrated, lyophilized platelets loaded with superparamagnetic iron oxides (SPIO-RL platelets) that are functional infusion agents that adhere to sites of vascular endothelial damage. Evidence suggests that the sensitivity for detection is improved over threefold by magnetic interactions between SPIOs inside RL platelets. Using the same MMOCT system, we show how elastometry of simulated clots, using resonant acoustic spectroscopy, is correlated with the fibrin content of the clot. Both methods are based upon magnetic actuation and phase-sensitive optical monitoring of nanoscale displacements using MMOCT, underscoring its utility as a broad-based platform to detect and measure the molecular structure and composition of blood clots.

Initial clinical evaluation of stationary digital chest tomosynthesis

Computed Tomography (CT) is the gold standard for image evaluation of lung disease, including lung cancer and cystic fibrosis. It provides detailed information of the lung anatomy and lesions, but at a relatively high cost and high dose of radiation. Chest radiography is a low dose imaging modality but it has low sensitivity. Digital chest tomosynthesis (DCT) is an imaging modality that produces 3D images by collecting x-ray projection images over a limited angle. DCT is less expensive than CT and requires about 1/10th the dose of radiation. Commercial DCT systems acquire the projection images by mechanically scanning an x-ray tube. The movement of the tube head limits acquisition speed. We recently demonstrated the feasibility of stationary digital chest tomosynthesis (s-DCT) using a carbon nanotube (CNT) x-ray source array in benchtop phantom studies. The stationary x-ray source allows for fast image acquisition. The objective of this study is to demonstrate the feasibility of s-DCT for patient imaging. We have successfully imaged 31 patients. Preliminary evaluation by board certified radiologists suggests good depiction of thoracic anatomy and pathology.

Adapted fan-beam volume reconstruction for stationary digital breast tomosynthesis

Digital breast tomosynthesis (DBT) provides 3D images which remove tissue overlapping and enables better cancer detection. Stationary DBT (s-DBT) uses a fixed X-ray source array to eliminate image blur associated with the x-ray tube motion and provides better image quality as well as faster scanning speed. For limited angle tomography, it is known that iterative reconstructions generally produces better images with fewer artifacts. However classical iterative tomosynthesis reconstruction methods are considerably slower than the filtered back-projection (FBP) reconstruction. The linear x-ray source array used in s-DBT enables a computationally more efficient volume reconstruction using adapted fan beam slice sampling, which transforms the 3-D cone beam reconstruction to a series of 2-D fan beam slice reconstructions. In this paper, we report the first results of the adapted fan-beam volume reconstruction (AFVR) for the s-DBT system currently undergoing clinical trial at UNC, using a simultaneous algebraic reconstruction technique (SART). An analytic breast phantom is used to quantitatively analyze the performance of the AFVR. Image quality of a CIRS biopsy phantom reconstructed using the AFVR method are compared to that using FBP algorithm with a commercial package. Our results show a significant reduction in memory usage and an order of magnitude speed increase in reconstructing speed using AFVR compared to that of classical 3-D cone beam reconstruction. We also observed that images reconstructed by AFVR with SART had a better sharpness and contrast compared to that using FBP. Preliminary results on patient images demonstrates the improved detectability of the s-DBT system over the mammography. By utilizing parallel computing with graphics processing unit (GPU), it is expected that the AFVR method will enable iterative reconstruction technique to be practical for clinical applications.

Contrast enhanced imaging with a stationary digital breast tomosynthesis system

Digital breast tomosynthesis (DBT) captures some depth information and thereby improves the conspicuity of breast lesions, compared to standard mammography. Using contrast during DBT may also help distinguish malignant from benign sites. However, adequate visualization of the low iodine signal requires a subtraction step to remove background signal and increase lesion contrast. Additionally, attention to factors that limit contrast, including scatter, noise, and artifact, are important during the image acquisition and post-acquisition processing steps. Stationary DBT (sDBT) is an emerging technology that offers a higher spatial and temporal resolution than conventional DBT. This phantom-based study explored contrast-enhanced sDBT (CE sDBT) across a range of clinically-appropriate iodine concentrations, lesion sizes, and breast thicknesses. The protocol included an effective scatter correction method and an iterative reconstruction technique that is unique to the sDBT system. The study demonstrated the ability of this CE sDBT system to collect projection images adequate for both temporal subtraction (TS) and dual-energy subtraction (DES). Additionally, the reconstruction approach preserved the improved contrast-to-noise ratio (CNR) achieved in the subtraction step. Finally, scatter correction increased the iodine signal and CNR of iodine-containing regions in projection views and reconstructed image slices during both TS and DES. These findings support the ongoing study of sDBT as a potentially useful tool for contrast-enhanced breast imaging and also highlight the significant effect that scatter has on image quality during DBT.

Stationary intraoral tomosynthesis for dental imaging

Despite recent advances in dental radiography, the diagnostic accuracies for some of the most common dental diseases have not improved significantly, and in some cases remain low. Intraoral x-ray is the most commonly used x-ray diagnostic tool in dental clinics. It however suffers from the typical limitations of a 2D imaging modality including structure overlap. Cone-beam computed tomography (CBCT) uses high radiation dose and suffers from image artifacts and relatively low resolution. The purpose of this study is to investigate the feasibility of developing a stationary intraoral tomosynthesis (s-IOT) using spatially distributed carbon nanotube (CNT) x-ray array technology, and to evaluate its diagnostic accuracy compared to conventional 2D intraoral x-ray. A bench-top s-IOT device was constructed using a linear CNT based X-ray source array and a digital intraoral detector. Image reconstruction was performed using an iterative reconstruction algorithm. Studies were performed to optimize the imaging configuration. For evaluation of s-IOT’s diagnostic accuracy, images of a dental quality assurance phantom, and extracted human tooth specimens were acquired. Results show s-IOT increases the diagnostic sensitivity for caries compared to intraoral x-ray at a comparable dose level.

Second generation stationary digital breast tomosynthesis system with faster scan time and wider angular span

Purpose The aim of this study was to characterize a new generation stationary digital breast tomosynthesis system with higher tube flux and increased angular span over a first generation system. Methods The linear CNT x‐ray source was designed, built, and evaluated to determine its performance parameters. The second generation system was then constructed using the CNT x‐ray source and a Hologic gantry. Upon construction, test objects and phantoms were used to characterize system resolution as measured by the modulation transfer function (MTF), and artifact spread function (ASF). Results The results indicated that the linear CNT x‐ray source was capable of stable operation at a tube potential of 49 kVp, and measured focal spot sizes showed source‐to‐source consistency with a nominal focal spot size of 1.1 mm. After construction, the second generation (Gen 2) system exhibited entrance surface air kerma rates two times greater the previous s‐DBT system. System in‐plane resolution as measured by the MTF is 7.7 cycles/mm, compared to 6.7 cycles/mm for the Gen 1 system. As expected, an increase in the z‐axis depth resolution was observed, with a decrease in the ASF from 4.30 mm to 2.35 mm moving from the Gen 1 system to the Gen 2 system as result of an increased angular span. Conclusions The results indicate that the Gen 2 stationary digital breast tomosynthesis system, which has a larger angular span, increased entrance surface air kerma, and faster image acquisition time over the Gen 1 s‐DBT system, results in higher resolution images. With the detector operating at full resolution, the Gen 2 s‐DBT system can achieve an in‐plane resolution of 7.7 cycles per mm, which is better than the current commercial DBT systems today, and may potentially result in better patient diagnosis.

Estimating scatter from sparsely measured primary signal

Abstract. Scatter radiation severely degrades the image quality. Measurement-based scatter correction methods sample the scatter signal at sparsely distributed points, from which the scatter profile is estimated and deterministically removed from the projection image. The estimation of the scatter profile is generally done through a spline interpolation and the resulting scatter profile is quite smooth. Consequently, the noise is intact and the signal-to-noise ratio is reduced in the projection image after scatter correction, leading to image artifacts and increased noise in the reconstruction images. We propose a simple and effective method, referred to as filtered scatter-to-primary ratio (f-SPR) estimation, to estimate the scatter profile using the sparsely sampled scatter signal. Using the primary sampling device and the stationary digital tomosynthesis systems previously developed in our lab, we evaluated and compared the f-SPR method in comparison with existing methods in terms of contrast ratio, signal difference-to-noise ratio, and modulation transfer function. A significant improvement in image quality is observed in both the projection and the reconstruction images using the proposed method.

Prospective gated chest tomosynthesis using CNT X-ray source array

Chest tomosynthesis is a low-dose 3-D imaging modality that has been shown to have comparable sensitivity as CT in detecting lung nodules and other lung pathologies. We have recently demonstrated the feasibility of stationary chest tomosynthesis (s-DCT) using a distributed CNT X-ray source array. The technology allows acquisition of tomographic projections without moving the X-ray source. The electronically controlled CNT x-ray source also enables physiologically gated imaging, which will minimize image blur due to the patient’s respiration motion. In this paper, we investigate the feasibility of prospective gated chest tomosynthesis using a bench-top s-DCT system with a CNT source array, a high- speed at panel detector and realistic patient respiratory signals captured using a pressure sensor. Tomosynthesis images of inflated pig lungs placed inside an anthropomorphic chest phantom were acquired at different respiration rate, with and without gating for image quality comparison. Metal beads of 2 mm diameter were placed on the pig lung for quantitative measure of the image quality. Without gating, the beads were blurred to 3:75 mm during a 3 s tomosynthesis acquisition. When gated to the end of the inhalation and exhalation phase the detected bead size reduced to 2:25 mm, much closer to the actual bead size. With gating the observed airway edges are sharper and there are more visible structural details in the lung. Our results demonstrated the feasibility of prospective gating in the s-DCT, which substantially reduces image blur associated with lung motion.

Validation study toward measuring the mechanical properties of blood clots using resonant acoustic spectroscopy with optical vibrometry

Clot elastic modulus (CEM) has recently been shown to correlate with various hemostatic and thrombotic disorders and may be an important diagnostic parameter in cardiovascular diseases. Current methods of CEM measurement lack repeatability and require large sample volume. We present a novel method named resonant acoustic spectroscopy with optical vibrometry (RASOV) that has the potential to assess CEM with higher accuracy and speed, and lower sample volume. To validate RASOV, we measured the acoustic spectrum of agarose gel with varied concentrations in openfaced rectangular wells. Results showed a linear relationship between the natural resonant frequency and agarose content within a concentration range of 4 to 12 mg/mL. Furthermore, we observed that the resonant frequencies decrease with increasing transducer mass. As a highly accurate, resonance-based method, RASOV has great potential for biomechanical properties measurement, especially for human blood.

Optimizing magnetomotive contrast of SPIO-labeled platelets for thrombosis imaging in optical coherence tomography

Rehydratable, lyophilized platelets loaded with superparamagnetic iron oxides (SPIOs) has the potential to provide magnetomotive imaging contrast to sites of vascular damage, including thrombosis complicating atherosclerosis and hemorrhage. Magnetomotive optical coherence tomography (MMOCT) contrasts SPIO-platelets based on their nanoscale, magnetically-induced motion. We report improvements in MMOCT imaging contrast and sensitivity by optimizing the magnetic properties and SPIO loading of the platelets. SPIO-platelets have been shown to specifically adhere to sites of vascular damage in porcine arteries ex vivo. This may lead to new methods for detecting internal bleeding and monitoring the formation of blood clots using infused SPIO-platelets.