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Hsu WC, Kang KT, Yao CCJ, Chou CH, Weng WC, Lee PL, Chen YJ. Evaluation of Upper Airway in Children with Obstructive Sleep Apnea Using Cone-Beam Computed Tomography. Laryngoscope 2020; 131:680-685. [PMID: 33070361 DOI: 10.1002/lary.28863] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/19/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Cone-beam computed tomography (CBCT) offers three-dimensional structures in assessing upper airway of patients. This study aims to compare the cone-beam computerized tomography scan measurements between children with obstructive sleep apnea (OSA) and primary snoring. STUDY DESIGN Case-control study. METHODS This prospective study was conducted in a tertiary referral center. Thirty-six children with moderate-to-severe OSA (with apnea-hypopnea index [AHI] > 5 events/hour) and 36 age-, gender-, and obesity-matched children with primary snoring (AHI <1) were enrolled. The measurements in CBCT parameters were compared between children with moderate-to-severe OSA and primary snorers by conditional logistic regression model. RESULTS A total of 72 children (mean age, 7.9 ± 2.8 years; 64% male) were included. Children with moderate-to-severe OSA had a significantly smaller nasopharyngeal (2900 ± 1400 vs. 3800 ± 1800 mm3 , P = .017) and oropharyngeal airway volume (5600 ± 2700 vs. 7400 ± 4000 mm3 , P = .026) than those with primary snoring. Children with moderate-to-severe OSA, as compared to primary snorers, also had a significantly smaller minimal airway area in nasopharynx (77.4 ± 37.7 vs. 107.7 ± 52.0 mm2 , P = .006) and oropharynx (66.6 ± 61.9 vs. 101.6 ± 65.8 mm2 , P = .023). Moreover, the airway length was not significantly different between children with moderate-to-severe OSA and primary snoring. CONCLUSIONS The three-dimensional CBCT airway analysis could be used as a useful tool to evaluate upper airway in children with OSA. LEVEL OF EVIDENCE 3 Laryngoscope, 131:680-685, 2021.
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Affiliation(s)
- Wei-Chung Hsu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Kun-Tai Kang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Chung-Chen Jane Yao
- Sleep Center, National Taiwan University Hospital, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Han Chou
- Department of Otolaryngology, National Taiwan University Hospital Yun-Lin branch, Yunlin County, Taiwan
| | - Wen-Chin Weng
- Sleep Center, National Taiwan University Hospital, Taipei, Taiwan.,Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Lin Lee
- Sleep Center, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yunn-Jy Chen
- Sleep Center, National Taiwan University Hospital, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
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Yu S, Dai G, Wang Z, Li L, Wei X, Xie Y. A consistency evaluation of signal-to-noise ratio in the quality assessment of human brain magnetic resonance images. BMC Med Imaging 2018; 18:17. [PMID: 29769079 PMCID: PMC5956758 DOI: 10.1186/s12880-018-0256-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 04/30/2018] [Indexed: 01/08/2023] Open
Abstract
Background Quality assessment of medical images is highly related to the quality assurance, image interpretation and decision making. As to magnetic resonance (MR) images, signal-to-noise ratio (SNR) is routinely used as a quality indicator, while little knowledge is known of its consistency regarding different observers. Methods In total, 192, 88, 76 and 55 brain images are acquired using T2*, T1, T2 and contrast-enhanced T1 (T1C) weighted MR imaging sequences, respectively. To each imaging protocol, the consistency of SNR measurement is verified between and within two observers, and white matter (WM) and cerebral spinal fluid (CSF) are alternately used as the tissue region of interest (TOI) for SNR measurement. The procedure is repeated on another day within 30 days. At first, overlapped voxels in TOIs are quantified with Dice index. Then, test-retest reliability is assessed in terms of intra-class correlation coefficient (ICC). After that, four models (BIQI, BLIINDS-II, BRISQUE and NIQE) primarily used for the quality assessment of natural images are borrowed to predict the quality of MR images. And in the end, the correlation between SNR values and predicted results is analyzed. Results To the same TOI in each MR imaging sequence, less than 6% voxels are overlapped between manual delineations. In the quality estimation of MR images, statistical analysis indicates no significant difference between observers (Wilcoxon rank sum test, pw ≥ 0.11; paired-sample t test, pp ≥ 0.26), and good to very good intra- and inter-observer reliability are found (ICC, picc ≥ 0.74). Furthermore, Pearson correlation coefficient (rp) suggests that SNRwm correlates strongly with BIQI, BLIINDS-II and BRISQUE in T2* (rp ≥ 0.78), BRISQUE and NIQE in T1 (rp ≥ 0.77), BLIINDS-II in T2 (rp ≥ 0.68) and BRISQUE and NIQE in T1C (rp ≥ 0.62) weighted MR images, while SNRcsf correlates strongly with BLIINDS-II in T2* (rp ≥ 0.63) and in T2 (rp ≥ 0.64) weighted MR images. Conclusions The consistency of SNR measurement is validated regarding various observers and MR imaging protocols. When SNR measurement performs as the quality indicator of MR images, BRISQUE and BLIINDS-II can be conditionally used for the automated quality estimation of human brain MR images.
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Affiliation(s)
- Shaode Yu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Guangzhe Dai
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
| | - Zhaoyang Wang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
| | - Leida Li
- School of Information and Control Engineering, Chinese University of Mining and Technology, Xuzhou, China
| | - Xinhua Wei
- Department of Radiology, Guangzhou First Peoples Hospital, Guangzhou Medical University, Guangzhou, China.,The Second Affiliated Hospital, South China University of Technology, Guangzhou, China
| | - Yaoqin Xie
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
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Yu S, Wu S, Zhuang L, Wei X, Sak M, Neb D, Hu J, Xie Y. Efficient Segmentation of a Breast in B-Mode Ultrasound Tomography Using Three-Dimensional GrabCut (GC3D). SENSORS (BASEL, SWITZERLAND) 2017; 17:E1827. [PMID: 28786946 PMCID: PMC5580039 DOI: 10.3390/s17081827] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/01/2017] [Accepted: 08/04/2017] [Indexed: 01/14/2023]
Abstract
As an emerging modality for whole breast imaging, ultrasound tomography (UST), has been adopted for diagnostic purposes. Efficient segmentation of an entire breast in UST images plays an important role in quantitative tissue analysis and cancer diagnosis, while major existing methods suffer from considerable time consumption and intensive user interaction. This paper explores three-dimensional GrabCut (GC3D) for breast isolation in thirty reflection (B-mode) UST volumetric images. The algorithm can be conveniently initialized by localizing points to form a polygon, which covers the potential breast region. Moreover, two other variations of GrabCut and an active contour method were compared. Algorithm performance was evaluated from volume overlap ratios ( T O , target overlap; M O , mean overlap; F P , false positive; F N , false negative) and time consumption. Experimental results indicate that GC3D considerably reduced the work load and achieved good performance ( T O = 0.84; M O = 0.91; F P = 0.006; F N = 0.16) within an average of 1.2 min per volume. Furthermore, GC3D is not only user friendly, but also robust to various inputs, suggesting its great potential to facilitate clinical applications during whole-breast UST imaging. In the near future, the implemented GC3D can be easily automated to tackle B-mode UST volumetric images acquired from the updated imaging system.
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Affiliation(s)
- Shaode Yu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China.
| | - Shibin Wu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China.
| | - Ling Zhuang
- Department of Oncology, the Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA.
| | - Xinhua Wei
- Department of Radiology, Guangzhou first Hospital, Guangzhou Medical University, Guangzhou 510180, China.
| | - Mark Sak
- Department of Oncology, the Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA.
- Delphinus Medical Technologies, Inc., Plymouth, Detroit, MI 46701, USA.
| | - Duric Neb
- Department of Oncology, the Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA.
- Delphinus Medical Technologies, Inc., Plymouth, Detroit, MI 46701, USA.
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, MI 48201, USA.
| | - Yaoqin Xie
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
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Lin HS, Li JD, Chen YJ, Lin CC, Lu TW, Chen MH. Comparison of measurements of mandible growth using cone beam computed tomography and its synthesized cephalograms. Biomed Eng Online 2014; 13:133. [PMID: 25208578 PMCID: PMC4177704 DOI: 10.1186/1475-925x-13-133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 08/30/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current study aimed to compare the measurements of the mandible morphology using 3D cone beam computed tomography (CBCT) images with those using 2D CBCT-synthesized cephalograms; to quantify errors in measurements based on 2D synthesized cephalograms; and to clarify the effects such errors have on the description of the mandibular growth. METHODS Mandibles of six miniature pigs were scanned monthly using CBCT over 12 months and the data were used to reconstruct the 3D bone models. Five anatomical landmarks were identified on each bone model, and the inter-marker distances and monthly distance changes were calculated and taken as the gold standard. Synthetic 2D cephalograms were also generated for each bone model using a digitally reconstructed radiography (DRR)-generation method. Errors in cephalogram measurements were determined as the differences between the calculated variables in cephalograms and the gold standard. The variations between cephalograms and the gold standard were also compared using paired t-tests. RESULTS While the inter-marker distance increases varied among the marker pairs, all marker pairs increased their inter-marker distances gradually every month, reaching 50% of the total annual increases during the fourth and fifth months, and then slowing down in the subsequent months. The 2D measurements significantly underestimated most of the inter-marker distances throughout the monitoring period, in most of the monthly inter-marker distance changes during the first four months, and in the total growth (p < 0.05). CONCLUSIONS Significant errors exist in the measurements using 2D synthesized cephalogram, underestimating the mandibular dimensions and their monthly changes in the early stages of growth, as well as the total annual growth. These results should be considered in dental treatment planning at the beginning of the treatment in order to control more precisely the treatment process and outcome.
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Affiliation(s)
- Hsien-Shu Lin
- />School of Dentistry, National Taiwan University, Taipei City, Taiwan
| | - Jia-Da Li
- />Institute of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Yunn-Jy Chen
- />School of Dentistry, National Taiwan University, Taipei City, Taiwan
| | - Cheng-Chung Lin
- />Institute of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Tung-Wu Lu
- />Institute of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
- />Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Mu-Hsiung Chen
- />Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
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