Jay Wu

Approaching healthy body mass index norms for children and adolescents from health-related physical fitness.

Current body mass index (BMI) norms for children and adolescents are developed from a reference population that includes obese and slim subjects. The validity of these norms is influenced by the observed secular increase in body weight and BMI. We hypothesized that the performance of children in health‐related physical fitness tests would be negatively related to increased BMIs, and therefore fitness tests might be used as criteria for developing a more appropriate set of BMI norms. We evaluated the existing data from a nation‐wide fitness survey for students in Taiwan (444 652 boys and 433 555 girls) to examine the relationship between BMI and fitness tests. The fitness tests used included: an 800/1600‐m run/walk; a standing long jump; bent‐leg curl‐ups; and a sit‐and‐reach test. The BMI percentiles developed from the subgroup whose test scores were better than the ‘poor’ quartile in all four tests were compared with those of the whole population and linked to the adult criteria for overweight and obesity. The BMIs were significantly related to the results of fitness testing. A total of 43% of students had scores better than the poorest quartile in all of their tests. The upper BMI percentile curves of this fitter subgroup were lower than those of the total population. The 85th and 95th BMI percentile values of the fitter 18‐year‐old‐students (23.7 and 25.5 kg m−2 for boys; 22.6 and 24.6 kg m−2 for girls) linked well with the adult cut‐off points of 23 and 25 kg m−2, which have been recommended as the Asian criteria for adult overweight and obesity. Hence, the BMI norms for children and adolescents could be created from selected subgroups that have better physical fitness. We expect that the new norms based on this approach will be used not only to assess the current status of obesity or overweight, but also to encourage activity and exercise.

A three-dimensional registration method for automated fusion of micro PET-CT-SPECT whole-body images

Micro positron emission tomography (PET) and micro single-photon emission computed tomography (SPECT), used for imaging small animals, have become essential tools in developing new pharmaceuticals and can be used, among other things, to test new therapeutic approaches in animal models of human disease, as well as to image gene expression. These imaging techniques can be used noninvasively in both detection and quantification. However, functional images provide little information on the structure of tissues and organs, which makes the localization of lesions difficult. Image fusion techniques can be exploited to map the functional images to structural images, such as X-ray computed tomography (CT), to support target identification and to facilitate the interpretation of PET or SPECT studies. Furthermore, the mapping of two functional images of SPECT and PET on a structural CT image can be beneficial for those in vivo studies that require two biological processes to be monitored simultaneously. This paper proposes an automated method for registering PET, CT, and SPECT images for small animals. A calibration phantom and a holder were used to determine the relationship among three-dimensional fields of view of various modalities. The holder was arranged in fixed positions on the couches of the scanners, and the spatial transformation matrix between the modalities was held unchanged. As long as objects were scanned together with the holder, the predetermined matrix could register the acquired tomograms from different modalities, independently of the imaged objects. In this work, the PET scan was performed by Concordes microPET R4 scanner, and the SPECT and CT data were obtained using the Gamma Medicas X-SPECT/CT system. Fusion studies on phantoms and animals have been successfully performed using this method. For microPET-CT fusion, the maximum registration errors were 0.21 mm /spl plusmn/ 0.14 mm, 0.26 mm /spl plusmn/ 0.14 mm, and 0.45 mm /spl plusmn/ 0.34 mm in the X (right-left), Y (upper lower), and Z (rostral-caudal) directions, respectively; for the microPET-SPECT fusion, they were 0.24 mm /spl plusmn/ 0.14 mm, 0.28 mm /spl plusmn/ 0.15 mm, and 0.54 mm /spl plusmn/ 0.35 mm in the X, Y, and Z directions, respectively. The results indicate that this simple method can be used in routine fusion studies.

A novel image quality index using Moran I statistics

Measurement of image quality is very important for various applications such as image compression, restoration and enhancement. Conventional methods (e.g., mean squared error; MSE) use error summation to measure quality change pixel by pixel and do not correlate well with subjective quality measurement. This is due to the fact that human eyes extract structural information from the viewing field. In this study a new quality index using a Moran I statistics is proposed. The Moran statistic that measures the sharpness from a local area is a good index of quality as most image processing techniques alter the smoothness of the image. Preliminary results show that the new quality index outperforms the MSE significantly under various types of image distortions.

Quality Degradation in Lossy Wavelet Image Compression

The objective of this study was to develop a method for measuring quality degradation in lossy wavelet image compression. Quality degradation is due to denoising and edge blurring effects that cause smoothness in the compressed image. The peak Moran z histogram ratio between the reconstructed and original images is used as an index for degradation after image compression. The Moran test is applied to images randomly selected from each medical modality, computerized tomography, magnetic resonance imaging, and computed radiography and compressed using the wavelet compression at various levels. The relationship between the quality degradation and compression ratio for each image modality agrees with previous reports that showed a preference for mildly compressed images. Preliminary results show that the peak Moran z histogram ratio can be used to quantify the quality degradation in lossy image compression. The potential for this method is applications for determining the optimal compression ratio (the maximized compression without seriously degrading image quality) of an image for teleradiology.

A stop codon mutation in the CBFA 1 gene causes cleidocranial dysplasia

Cleidocranial dysplasia, CCD (MIM 119600), is an autosomal-dominant, generalized skeletal dysplasia in humans. It is characterized by defective skull ossification with frontal bossing and open fontanels, clavicular hypoplasia or aplasia, delayed ossification of pelvis, late eruption of permanent teeth, malformed dental roots, supernumerary teeth and normal intelligence (1, 2). Core binding factor-alpha 1, CBFA1, is one of three known mammalian homologues of the Drosophila runt gene. It encodes a transcription factor required for osteoblast cell fate commitment (3, 4). Cbfa 1 was originally cloned from mouse fibroblast (5). Ducy et al. have shown that Cbfa 1 regulates the expression of multiple genes expressed in osteoblasts and that Cbfa 1 is a cis-acting element in the osteocalcin promotor (6). They showed that Cbfa 1 is an osteoblast-specific transcription factor and a regulator osteoblast differentiation. Cbfa 1 knockout mice, however, show a complete lack of bone formation, indicating that Cbfa 1 is an essential transcription factor for bone formation (7, 8). Heterozygous Cbfa 1 mutation mice display all the hallmarks of CCD, including open frontanelles and hypoplastic clavicles, but not the dental anomalies (8). Mundlos et al. established that the CBFA 1 gene is the site of mutations responsible for CCD (9). Lee et al. described two missense mutations in CBFA1 gene in CCD, Met175Arg and Ser191Asn (10). In DNAbinding studies with the mutant polypeptides, they showed that these mutations abolish the DNA-binding ability of CBFA1 to its known target sequence. Recently, two large-scale mutation analyses of CCD were reported (11, 12). The majority of mutations were de novomissense mutations that affected conserved residues in therunt domain and completely abolished both DNA binding and transactivation of a reporter gene. It was also noted that variable loss of function due to alterations in therunt and proline/serine/threoninerich (PST) activation domain of CBFA 1 might give rise to clinical variability. Below, we describe ade novomutation, Arg 391 stop, in the C-terminal PST activation domains of the CBFA 1 gene in a Taiwan Chinese CCD patient with unusual presentation of brachydactyly.

Feasibility study of using PEImager scanner for positron emission mammography

The purpose of this work is to study the feasibility of using PEImager scanner for positron emission mammography (PEM). PEM can be performed by using two opposite detectors. The two-detector positron projection imaging has less depth information, because of the limited number of line of responses (LORs). In this work, an iterative back projection algorithm is employed for reconstruction of projection data. Although the number of LORs are limited, the locations and sizes of hot spots in breast phantom still can be determined from the reconstructed images.

Three-dimensional dosimetry in brachytherapy: A MAGAT study.

This study is to evaluate the influence of using different matrix size of smoothing filter for image post-processing and various slice thickness during MR imaging on dose estimation in Ir-192 HDR brachytherapy via normoxic polymer gel dosimeter. Our results show its sensitive nature in gel dosimeter while changing these parameters, among which the combination of 2mm slice thickness of MR images and [5x5] smoothing filter are considered the optimal parameters to provide accurate dose estimations and isodose curves.

Cortical Bone Morphological and Trabecular Bone Microarchitectural Changes in the Mandible and Femoral Neck of Ovariectomized Rats

Objective This study used microcomputed tomography (micro-CT) to evaluate the effects of ovariectomy on the trabecular bone microarchitecture and cortical bone morphology in the femoral neck and mandible of female rats. Materials and Methods Twelve female Wister rats were divided into two groups: the control and ovariectomized groups. The rats in the ovariectomized group received ovariectomy at 8 weeks of age; all the rats were sacrificed at 20 weeks of age, and their mandibles and femurs were removed and scanned using micro-CT. Four microstructural trabecular bone parameters were measured for the region below the first mandibular molar and the femoral neck region: bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular separation (TbSp), and trabecular number (TbN). In addition, four cortical bone parameters were measured for the femoral neck region: total cross-sectional area (TtAr), cortical area (CtAr), cortical bone area fraction (CtAr/TtAr), and cortical thickness (CtTh). The CtTh at the masseteric ridge was used to assess the cortical bone morphology in the mandible. The trabecular bone microarchitecture and cortical bone morphology in the femoral necks and mandibles of the control group were compared with those of the ovariectomized group. Furthermore, Spearman’s correlation (rs) was conducted to analyze the correlation between the osteoporosis conditions of the mandible and femoral neck. Results Regarding the trabecular bone microarchitectural parameters, the BV/TV of the trabecular bone microarchitecture in the femoral necks of the control group (61.199±11.288%, median ± interquartile range) was significantly greater than that of the ovariectomized group (40.329±5.153%). Similarly, the BV/TV of the trabecular bone microarchitecture in the mandibles of the control group (51.704±6.253%) was significantly greater than that of the ovariectomized group (38.486±9.111%). Furthermore, the TbSp of the femoral necks in the ovariectomized group (0.185±0.066 mm) was significantly greater than that in the control group (0.130±0.026mm). Similarly, the TbSp of the mandibles in the ovariectomized group (0.322±0.047mm) was significantly greater than that in the control group (0.285±0.041mm). However, the TbTh and TbN trends for the mandibles and femoral necks were inconsistent between the control and ovariectomized groups. Regarding the cortical bone morphology parameters, the TtAr of the femoral necks in the ovariectomized group was significantly smaller than that in the control group. There was no significant difference in the TtAr, CtAr, or CtTh of the femoral necks between the control and ovariectomized groups, and no significant difference in the CtTh of the mandibles between the control and ovariectomized groups. Moreover, the BV/TV and TbSp of the mandibles were highly correlated with those of the femurs (rs = 0.874 and rs = 0.755 for BV/TV and TbSp, respectively). Nevertheless, the TbTh, TbN, and CtTh of the mandibles were not correlated with those of the femoral necks. Conclusion After the rats were ovariectomized, osteoporosis of the trabecular bone microarchitecture occurred in their femurs and mandibles; however, ovariectomy did not influence the cortical bone morphology. In addition, the parametric values of the trabecular bone microarchitecture in the femoral necks were highly correlated with those of the trabecular bone microarchitecture in the mandibles.

Verification on the Dose Profile Variation of a 3-D—NIPAM Polymer Gel Dosimeter

A gel dosimeter is a three-dimensional (3-D) device that is used in radiotherapy. It is more efficient than traditional one-dimensional and two-dimensional dosimeters because it can be used in complicated radiation therapy applications. However, the achievement of temporal and spatial stabilities for gel dosimeters remains challenging in clinical applications because the fabrication process affects the polymerization reaction during irradiation. This study investigated the dose profile variation of an N-isopropyl acrylamide (NIPAM) polymer gel dosimeter by using the 3-D optical computed tomography scanner OCTOPUSTM 10X (MGS Research Inc.). Two acrylic containers (diameter=10, height=10, and diameter=15, height=15cm ) filled with polymer gel (gelatin: 5%, NIPAM: 5%, Bis: 3%, THPC: 5 mM) were irradiated by using intensity-modulated radiotherapy (SIEMENS Oncor Impression, 6 MV Photo beam). The treatment field was a 3 cm 3 cm square field, and the prescribed dose was 5 Gy. The results of the reconstruction line profile showed that the uncertainty of non-irradiated gel is less than 1.3% when a container with 10 cm diameters cooled in a refrigerator with a water bath. The maximum uncertainties of the irradiated gel at 24 h, 48 h, and 72 h post-irradiation were 2.9%, 2.9%, and 3.1%, respectively. However, the maximum uncertainty of the non-irradiated gel dosimeter increased to 3% when a container with 15 cm diameter was cooled in the same refrigerator. After irradiation, the maximum uncertainties of the irradiated gel at 24 h, 48 h, and 72 h post-irradiation were 13.1%, 13.7%, and 12.95%, respectively. The uncertainty differences for gels at different container sizes were attributed to the different cooling rates that were applied to the gels. The time required for large gel containers to cool in the refrigerator was more than 10 h, whereas the cooling process only took 4.2 h for gels in a small container. The time difference produced different temperature histories for gels and may result in changes in gel sensitivity. Given the thermally induced pre-radiation polymerization, the time difference resulted in a deviation in dose profiles. This study reports that thermal control during gel preparation should be carefully performed for clinical applications to achieve a more accurate dose distribution in 3-D image reconstruction.

Scatter correction for 3D PET using beam stoppers combined with dual-energy window acquisition: a feasibility study.

Fully three-dimensional (3D) positron emission tomography (PET) can achieve high sensitivity of coincidence events, but the absence of inter-slice septa inevitably leads to increased scattered events. The scattered events can represent as much as 50% of the total detected events. In this research, we proposed a scatter correction method for 3D PET based on beam stoppers and dual-energy window acquisition. The beam stoppers were placed surrounding the object to attenuate primary beams. The scatter fractions were directly estimated at those blocked lines of response and then the entire scatter fraction distribution was recovered using the dual-energy window ratio as reference. The performance was evaluated by using Monte Carlo simulations of various digital phantoms. For the Utah phantom study, the proposed method accurately estimated the scatter fraction distribution, and improved image contrast and quantification based on four different quality indices as performance measures. For the non-homogeneous Zubal phantom, the simulated results also demonstrated that the proposed method achieved a better restoration of image contrast than the dual-energy window method. We conclude that the proposed scatter correction method could effectively suppress various kinds of scattered events, including multiple scatter and scatter from outside the field of view.