Tian Liu

Dosimetry study of Re-188 liquid balloon for intravascular brachytherapy using polymer gel dosimeters and laser-beam optical CT scanner.

Angioplasty balloons inflated with a solution of the beta-emitter Re-188 have been used for intravascular brachytherapy to prevent restenosis. Coronary stents are in extensive clinical use for the treatment of de novo atherosclerotic stenoses. In this study, the effect of an interposed stent on the dose distribution has been measured for Re-188 balloon sources using the proprietary BANG polymer gel dosimeters and He-Ne laser-beam optical CT scanner. In polymer gels, after ionizing radiation is absorbed, free-radical chain-polymerization of soluble acrylic monomers occurs to form an insoluble polymer. The BANG polymer gel dosimeters used in these measurements allow high resolution, precise, and accurate three-dimensional determination of dosimetry from a given source. Re-188 liquid balloons, with or without an interposed metallic stent, were positioned inside thin walled tubes placed in such a polymer dosimeter to deliver a prescribed dose (e.g., 15 Gy at 0.5 mm). After removing the balloon source, each irradiated sample was mounted in the optical scanner for scanning, utilizing a single compressed He-Ne laser beam and a single photodiode. In the absence of a stent, doses at points along the balloon axis, at radial distance 0.5 mm from the balloon surface and at least 2.5 mm from the balloon ends, are within 90% of the maximum dose. This uniformity of axial dose is independent of the balloon diameter and length. Dose rate and dose uniformity for intravascular brachytherapy with Re-188 balloon are altered by the presence of stent. The dose reduction by the stent is rather constant (13%-15%) at different radial distances. However, dose inhomogeneity caused by the stent decreases rapidly with radial distance.

Ultrasonic tissue characterization using 2-D spectrum analysis and its application in ocular tumor diagnosis.

We are investigating the utility of a new ultrasonic tissue characterization technique, specifically two-dimensional (2-D) spectrum analysis of radio-frequency backscatter signals, which promises to provide quantitative measures of the physical properties of tissue microstructures. Previously successful 1-D spectrum analysis is expanded to 2-D to more fully characterize diagnostically significant features of biological tissue. Two new spectral functions, radially integrated spectral power (RISP) and angularly integrated spectral power (AISP), are defined to quantitatively characterize tissue properties. This new approach is applied to the diagnosis of in vivo ocular melanomas. Our initial results indicate that 2-D spectrum analysis can provide significant new information on tissue anisotropy that are not apparent in 1-D spectra. Acoustic scattering models are applied to relate the 2-D spectral parameters to the physical properties (e.g., size and shape) of biological tissues.

Ultrasonic tissue characterization via 2-D spectrum analysis: Theory and in vitro measurements

A theoretical model is described for application in ultrasonic tissue characterization using a calibrated 2-D spectrum analysis method. This model relates 2-D spectra computed from ultrasonic backscatter signals to intrinsic physical properties of tissue microstructures, e.g., size, shape, and acoustic impedance. The model is applicable to most clinical diagnostic ultrasound systems. Two experiments employing two types of tissue architectures, spherical and cylindrical scatterers, are conducted using ultrasound with center frequencies of 10 and 40 MHz, respectively. Measurements of a tissue-mimicking phantom with an internal suspension of microscopic glass beads are used to validate the theoretical model. Results from in vitro muscle fibers are presented to further elucidate the utility of 2-D spectrum analysis in ultrasonic tissue characterization.

Implementation and validation of an ultrasonic tissue characterization technique for quantitative assessment of normal-tissue toxicity in radiation therapy

The goal of this study was to implement and validate a noninvasive, quantitative ultrasonic technique for accurate and reproducible measurement of normal-tissue toxicity in radiation therapy. The authors adapted an existing ultrasonic tissue characterization (UTC) technique that used a calibrated 1D spectrum based on region-of-interest analysis. They modified the calibration procedure by using a reference phantom instead of a planar reflector. This UTC method utilized ultrasonic radiofrequency echo signals to generate spectral parameters related to the physical properties (e.g., size, shape, and relative acoustic impedance) of tissue microstructures. Three spectral parameters were investigated for quantification of normal-tissue injury: Spectral slope, intercept, and midband fit. They conducted a tissue-mimicking phantom study to verify the reproducibility of UTC measurements and initiated a clinical study of radiation-induced breast-tissue toxicity. Spectral parameter values from measurements on two phantoms were reproducible within 1% of each other. Eleven postradiation breast-cancer patients were studied and significant differences between the irradiated and untreated (contralateral) breasts were observed for spectral intercept (p = 0.003) and midband fit (p < 0.001) but not for slope (p = 0.14). In comparison to the untreated breast, the average difference in the spectral intercept was 2.99 +/- 0.75 dB and the average difference in the midband fit was 3.99 +/- 0.65 dB. The preliminary clinical study demonstrated the feasibility of using the quantitative ultrasonic method to evaluate normal-tissue toxicity in radiation therapy.

Computer-aided diagnosis of breast lesions using a multifeature analysis procedure

We have developed a family of objective features in order to provide non-invasive, reliable means of distinguishing benign from malignant breast lesions. These include acoustic features (echogenicity, heterogeneity, shadowing) and morphometric features (area, aspect ratio, border irregularity, margin definition). These quantitative descriptors are designed to be independent of instrument properties and physician expertise. Our analysis included manual tracing of lesion boundaries and adjacent areas on grayscale images generated from RF data. To derive quantitative acoustic features, we computed spectral parameter maps of radio-frequency (RF) echo signals (calibrated with system transfer function and corrected for diffraction) within these areas. We quantified morphometric features by geometric and fractal analysis of traced lesion boundaries. Although no single parameter can reliably discriminate cancerous from non-cancerous breast lesions, multifeature analysis provides excellent discrimination of cancerous and non-cancerous lesions. RF echo-signal data used in this study were acquired during routine ultrasonic examinations of biopsy-scheduled patients at three clinical sites. Our data analysis for 130 patients produced an ROC-curve area of 0.9164 +/- 0.0346. Among the quantitative descriptors, lesion heterogeneity, aspect ratio, and a border irregularity descriptor were the most useful; some morphometric features (such as the border irregularity descriptor) were particularly effective in lesion classification.

Measurements of Radiation-Induced Skin Changes in Breast-Cancer Radiation Therapy Using Ultrasonic Imaging

Skin injury is a common side effect of breast- cancer radiation therapy. Although physicians often observe skin toxicity, quantifying its severity remains a challenge. We present a novel quantitative ultrasonic technique to evaluate skin changes associated with radiotherapy. An in vivo study with twelve breast- cancer patients was conducted. All patients received a standard course of post-surgery radiation therapy. Each patient received ultrasound scans to the irradiated breast and the untreated (contra-lateral) breast. Radio-frequency (RF) backscatter signals and B-mode images were acquired simultaneously. To quantify the severity of skin injury, two metrics were calculated from the RF signals: skin thickness and Pearson correlation coefficient of the subcutaneous layer. Comparing to the non-irradiated skin, the average thickness of the irradiated skin increased by 40% (p=0.005) and the average correlation coefficient of the irradiated hypodermis decreased by 35% (p=0.02). This study demonstrates the feasibility of using a non-invasive ultrasonic technique to detect and quantify radiation-induced skin changes.

Three-dimensional ultrasonic parametric and tissue-property imaging for tissue evaluation, treatment planning, therapy guidance, and efficacy assessment

Two- and three-dimensional depictions of ultrasound echo signal data have potential for helping to detect and diagnose disease and to plan and monitor therapy. The utilization of very-high-frequency ultrasound and spectrum analysis of radio- frequency echo signals extends the capabilities of ultrasonic imaging for these purposes. Images generated using these techniques can present tissue architecture with exquisite resolution and can provide information on underlying properties of scatterers in the tissue. Changes in properties over time can be used to monitor disease progression or response to therapy. Relating tissue echo-signal parameters obtained from unknown tissue to database values of known tissue types can provide means of characterizing tissue for the purposes of detection or diagnosis and treatment planning. These potential applications are illustrated using examples from plaque, ophthalmic, skin, and prostate studies.

Multi-feature analysis for automated breast lesion classification from ultrasonic data

We have developed quantitative descriptors of lesions for reliable, operator-independent breast cancer identification using ultrasound. These include acoustic features as well as morphometric features related to lesion shape. Acoustic features include echogenicity, heterogeneity, and shadowing, computed from radio-frequency (RF) spectral-parameter images of the lesion and surrounding tissue. Morphometric features were computed by geometric and fractal analysis of manually-traced lesion boundaries. Initial results show that no single parameter can precisely identify cancerous breast lesions and that the use of multiple features can substantially improve discrimination. Our analysis produced an ROC-curve area of 0.9164 /spl plusmn/ 0.0346.

Incorporate Imaging Characteristics Into an Arteriovenous Malformation Radiosurgery Plan Evaluation Model

PURPOSEnTo integrate imaging performance characteristics, specifically sensitivity and specificity, of magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) into arteriovenous malformation (AVM) radiosurgery planning and evaluation.nnnMETHODS AND MATERIALSnImages of 10 patients with AVMs located in critical brain areas were analyzed in this retrospective planning study. The image findings were first used to estimate the sensitivity and specificity of MRA and DSA. Instead of accepting the imaging observation as a binary (yes or no) mapping of AVM location, our alternative is to translate the image into an AVM probability distribution map by incorporating imagers sensitivity and specificity, and to use this map as a basis for planning and evaluation. Three sets of radiosurgery plans, targeting the MRA and DSA positive overlap, MRA positive, and DSA positive were optimized for best conformality. The AVM obliteration rate (ORAVM) and brain complication rate served as endpoints for plan comparison.nnnRESULTSnIn our 10-patient study, the specificities and sensitivities of MRA and DSA were estimated to be (0.95, 0.74) and (0.71, 0.95), respectively. The positive overlap of MRA and DSA accounted for 67.8% +/- 4.9% of the estimated true AVM volume. Compared with plans targeting MRA and DSA-positive overlap, plans targeting MRA-positive or DSA-positive improved ORAVM by 4.1% +/- 1.9% and 15.7% +/- 8.3%, while also increasing the complication rate by 1.0% +/- 0.8% and 4.4% +/- 2.3%, respectively.nnnCONCLUSIONSnThe impact of imagers quality should be quantified and incorporated in AVM radiosurgery planning and evaluation to facilitate clinical decision making.

Relationship of 2D ultrasonic spectral parameters to the physical properties of soft tissue scatterers

We have conducted a general study that relates calibrated 2-D ultrasonic spectral parameters to the physical properties of sub-resolution tissue scatterers. Our 2-D spectra are computed form digital radio-frequency echo data obtained as the transducer linearly scans along the cross-range (scan direction) with increments smaller than the half beam width. Acquired data are Fourier transformed with respect to range (beam) and cross-range (scan) directions. To quantitatively measure and classify the physical properties of tissues, we have defined two spectral functions and four spectral parameters. The 2-D spectral functions are: radially integrated spectral power (RISP) and angularly integrated spectral power (AISP). The summary parameters are: peak value and 3-dB width of the RISP, slope and intercept of the AISP. These parameter are understood in terms of the beam properties, transducer parameters and the physical properties of the tissue microstructures including size, shape, orientation, concentration and acoustic impedance. Our theoretical model indicates that 1) the 3-dB width of the RISP is predominantly determined by the scatterer size along the beam direction; 2) the slope of the linear fit of the AISP is predominantly determined by the scatterer size along range direction; 3) the concentration and the relative acoustic impedance fluctuation of the scatterers change the overall spectrum magnitude. The predictions of the theoretical model have been verified using beef muscle fibers examined with 40 MHz center frequency.