Norbert Strobel

Dose and image quality for a cone‐beam C‐arm CT system

We assess dose and image quality of a state-of-the-art angiographic C-arm system (Axiom Artis dTA, Siemens Medical Solutions, Forchheim, Germany) for three-dimensional neuro-imaging at various dose levels and tube voltages and an associated measurement method. Unlike conventional CT, the beam length covers the entire phantom, hence, the concept of computed tomography dose index (CTDI) is not the metric of choice, and one can revert to conventional dosimetry methods by directly measuring the dose at various points using a small ion chamber. This method allows us to define and compute a new dose metric that is appropriate for a direct comparison with the familiar CTDIw of conventional CT. A perception study involving the CATPHAN 600 indicates that one can expect to see at least the 9 mm inset with 0.5% nominal contrast at the recommended head-scan dose (60 mGy) when using tube voltages ranging from 70 kVp to 125 kVp. When analyzing the impact of tube voltage on image quality at a fixed dose, we found that lower tube voltages gave improved low contrast detectability for small-diameter objects. The relationships between kVp, image noise, dose, and contrast perception are discussed.

Joint audio-video object localization and tracking

There has been a tremendous amount of research on object localization either involving microphone arrays or video cameras. Considerable less attention has been paid, however, to object localization and tracking based on joint audio-video processing thus far. This may be related to the lack of suitable algorithms for object localization simultaneously using multimicrophone outputs and color image sequences. In this article, we propose a solution to this problem. Before elaborating on joint audio-video processing, we review some previous work the areas of audio and video object localization. Then a recursive sensor fusion method based on decentralized Kalman filtering is introduced. Unfortunately, the decentralized Kalman filter cannot be directly used for joint audio-video object localization due to specific properties of the audio sensor. By properly adjusting the local audio position estimator, however, we manage to keep the overall architecture. We stress the general methodology.

Respiratory motion compensation by model-based catheter tracking during EP procedures.

In many cases, radio-frequency catheter ablation of the pulmonary veins attached to the left atrium still involves fluoroscopic image guidance. Two-dimensional X-ray navigation may also take advantage of overlay images derived from static pre-operative 3D volumetric data to add anatomical details otherwise not visible under X-ray. Unfortunately, respiratory motion may impair the utility of static overlay images for catheter navigation. We developed a novel approach for image-based 3D motion estimation and compensation as a solution to this problem. It is based on 3D catheter tracking which, in turn, relies on 2D/3D registration. To this end, a bi-plane C-arm system is used to take X-ray images of a special circumferential mapping catheter from two directions. In the first step of the method, a 3D model of the device is reconstructed. Three-dimensional respiratory motion at the site of ablation is then estimated by tracking the reconstructed catheter model in 3D based on bi-plane fluoroscopy. Phantom data and clinical data were used to assess model-based catheter tracking. Our phantom experiments yielded an average 2D tracking error of 1.4mm and an average 3D tracking error of 1.1mm. Our evaluation of clinical data sets comprised 469 bi-plane fluoroscopy frames (938 monoplane fluoroscopy frames). We observed an average 2D tracking error of 1.0 + or - 0.4mm and an average 3D tracking error of 0.8 + or - 0.5mm. These results demonstrate that model-based motion-compensation based on 2D/3D registration is both feasible and accurate.

3D Imaging with Flat-Detector C-Arm Systems

Three-dimensional (3D) C-arm computed tomography is a new and innovative imaging technique. It uses two-dimensional (2D) X-ray projections acquired with a flat-panel detector C-arm angiography system to generate CT-like images. To this end, the C-arm system performs a sweep around the patient, acquiring up to several hundred 2D views. They serve as input for 3D cone-beam reconstruction. Resulting voxel data sets can be visualized either as cross-sectional images or as 3D data sets using different volume rendering techniques. Initially targeted at 3D high-contrast neurovascular applications, 3D C-arm imaging has been continuously improved over the years and is now capable of providing CT-like soft-tissue image quality. In combination with 2D fluoroscopic or radiographic imaging, information provided by 3D C-arm imaging can be valuable for therapy planning, guidance, and outcome assessment all in the interventional suite.

X-ray scatter correction for cone-beam CT using moving blocker array

Scatter correction is an active research topic in cone beam computed tomography (CBCT) because CBCT (especially flat-panel detector (FPD) based) systems have large scatter-to-primary ratios. Scatter produces artifact and contrast reduction, and is difficult to model accurately. Direct measurement using a beam blocker array provides accurate scatter estimates. However, since the blocker array also blocks primary radiation, imaging requires a second (or subsequent) scan without the blocker array in place. This approach is inefficient in terms of scanning time and patient dose. To combine accurate scatter estimation and reconstruction into one single scan, a new approach based on an array of moving blockers has been developed. The blocker array moves from projection to projection, such that every detector pixel is not consecutively blocked during the data acquisition, and the missing primary data in the blocker shadows are estimated by interpolation. Using different blocker array trajectories, the algorithm has been evaluated through software phantom studies using Monte Carlo simulations and image processing techniques. Results show that this approach is able to greatly reduce the effect of scatter in the reconstruction. By properly choosing blocker distance and primary data interpolation method, the mean square error of the reconstructed image decreases from 32.3% to 1.13%, and the induced visual artifacts are significantly reduced when a raster-scanning blocker array trajectory is used. Further analysis also shows that artifact arises mostly due to inaccurate scatter estimates, rather than due to interpolation of the primary data.

Improving 3D image quality of x-ray C-arm imaging systems by using properly designed pose determination systems for calibrating the projection geometry

C-arm volume reconstruction has become increasingly popular over the last years. These imaging systems generate 3D data sets for various interventional procedures such as endovascular treatment of aneurysms or orthopedic applications. Due to their open design and mechanical instability, C-arm imaging systems acquire projections along non-ideal scan trajectories. Volume reconstruction from filtered 2D X-ray projections requires a very precise knowledge of the imaging geometry. We show that the 3D image quality of C-arm cone beam imaging devices can be improved by proper design of the calibration phantom.

3-D Respiratory Motion Compensation during EP Procedures by Image-Based 3-D Lasso Catheter Model Generation and Tracking

Radio-frequency catheter ablation of the pulmonary veins attached to the left atrium is usually carried out under fluoroscopy guidance. Two-dimensional X-ray navigation may involve overlay images derived from a static pre-operative 3-D volumetric data set to add anatomical details. However, respiratory motion may impair the utility of static overlay images for catheter navigation. We developed a system for image-based 3-D motion estimation and compensation as a solution to this problem for which no previous solution is yet known. It is based on 3-D catheter tracking involving 2-D/3-D registration. A biplane X-ray C-arm system is used to image a special circumferential (lasso) catheter from two directions. In the first step of the method, a 3-D model of the device is reconstructed. 3-D respiratory motion at the site of ablation is then estimated by tracking the reconstructed model in 3-D from biplane fluoroscopy. In our experiments, the circumferential catheter was tracked in 231 biplane fluoro frames (462 monoplane fluoro frames) with an average 2-D tracking error of 1.0 mm +/- 0.5 mm.

Classification of time delay estimates for robust speaker localization

This paper proposes a solution to the problem of robust speaker localization under adverse acoustic conditions. The approach is based on the classification of time delay estimates. Two classification techniques are investigated in detail: maximum likelihood (ML) classification and classification based on histogram comparison. Their performance under adverse acoustic conditions is compared to outcomes obtained with the traditional approach which uses time delay estimates directly to infer speaker positions. Experiments indicate that the ML classification method provides little improvement over the traditional method. On the other hand, using histogram classification, we can improve the probability of correct speaker localization by more than 60% compared to either the traditional approach or the ML classification technique.

Learning-based hypothesis fusion for robust catheter tracking in 2D X-ray fluoroscopy

Catheter tracking has become more and more important in recent interventional applications. It provides real time navigation for the physicians and can be used to control a motion compensated fluoro overlay reference image for other means of guidance, e.g. involving a 3D anatomical model. Tracking the coronary sinus (CS) catheter is effective to compensate respiratory and cardiac motion for 3D overlay navigation to assist positioning the ablation catheter in Atrial Fibrillation (Afib) treatments. During interventions, the CS catheter performs rapid motion and non-rigid deformation due to the beating heart and respiration. In this paper, we model the CS catheter as a set of electrodes. Novelly designed hypotheses generated by a number of learning-based detectors are fused. Robust hypothesis matching through a Bayesian framework is then used to select the best hypothesis for each frame. As a result, our tracking method achieves very high robustness against challenging scenarios such as low SNR, occlusion, foreshortening, non-rigid deformation, as well as the catheter moving in and out of ROI. Quantitative evaluation has been conducted on a database of 13221 frames from 1073 sequences. Our approach obtains 0.50mm median error and 0.76mm mean error. 97.8% of evaluated data have errors less than 2.00mm. The speed of our tracking algorithm reaches 5 frames-per-second on most data sets. Our approach is not limited to the catheters inside the CS but can be extended to track other types of catheters, such as ablation catheters or circumferential mapping catheters.

Transjugular Intrahepatic Portosystemic Shunt Creation in a Polycystic Liver Facilitated by Hybrid Cross-sectional/Angiographic Imaging

Polycystic liver disease (PCLD) has long been considered to represent a contraindication to transjugular intrahepatic portosystemic shunt (TIPS) creation, primarily because of the risk of hemorrhage. Three-dimensional (3D) navigation within the enlarged and potentially disorienting parenchyma can now be performed during the procedure with the development of C-arm cone-beam computed tomography, which relies on the same equipment already used for angiography. Such a hybrid 3D reconstruction-enabled angiography system was used for safe image guidance of a TIPS procedure in a patient with PCLD. This technology has the potential to expedite any image-guided procedure that requires 3D navigation.