1
|
Luu MH, Walsum TV, Mai HS, Franklin D, Nguyen TTT, Le TM, Moelker A, Le VK, Vu DL, Le NH, Tran QL, Chu DT, Trung NL. Automatic scan range for dose-reduced multiphase CT imaging of the liver utilizing CNNs and Gaussian models. Med Image Anal 2022; 78:102422. [PMID: 35339951 DOI: 10.1016/j.media.2022.102422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/27/2021] [Accepted: 03/11/2022] [Indexed: 12/24/2022]
Abstract
Multiphase CT scanning of the liver is performed for several clinical applications; however, radiation exposure from CT scanning poses a nontrivial cancer risk to the patients. The radiation dose may be reduced by determining the scan range of the subsequent scans by the location of the target of interest in the first scan phase. The purpose of this study is to present and assess an automatic method for determining the scan range for multiphase CT scans. Our strategy is to first apply a CNN-based method for detecting the liver in 2D slices, and to use a liver range search algorithm for detecting the liver range in the scout volume. The target liver scan range for subsequent scans can be obtained by adding safety margins achieved from Gaussian liver motion models to the scan range determined from the scout. Experiments were performed on 657 multiphase CT volumes obtained from multiple hospitals. The experiment shows that the proposed liver detection method can detect the liver in 223 out of a total of 224 3D volumes on average within one second, with mean intersection of union, wall distance and centroid distance of 85.5%, 5.7 mm and 9.7 mm, respectively. In addition, the performance of the proposed liver detection method is comparable to the best of the state-of-the-art 3D liver detectors in the liver detection accuracy while it requires less processing time. Furthermore, we apply the liver scan range generation method on the liver CT images acquired from radiofrequency ablation and Y-90 transarterial radioembolization (selective internal radiation therapy) interventions of 46 patients from two hospitals. The result shows that the automatic scan range generation can significantly reduce the effective radiation dose by an average of 14.5% (2.56 mSv) compared to manual performance by the radiographer from Y-90 transarterial radioembolization, while no statistically significant difference in performance was found with the CT images from intra RFA intervention (p = 0.81). Finally, three radiologists assess both the original and the range-reduced images for evaluating the effect of the range reduction method on their clinical decisions. We conclude that the automatic liver scan range generation method is able to reduce excess radiation compared to the manual performance with a high accuracy and without penalizing the clinical decision.
Collapse
Affiliation(s)
- Manh Ha Luu
- AVITECH, University of Engineering and Technology, VNU, Hanoi, Vietnam; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands; FET, University of Engineering and Technology, VNU, Hanoi, Vietnam.
| | - Theo van Walsum
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Hong Son Mai
- Department of Nuclear Medicine, Hospital 108, Hanoi, Vietnam
| | - Daniel Franklin
- School of Electrical and Data Engineering, University of Technology Sydney, Sydney, Australia
| | | | - Thi My Le
- Department of Radiology and Nuclear Medicine, Vinmec Hospital, Hanoi, Vietnam
| | - Adriaan Moelker
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Van Khang Le
- Radiology Center, Bach Mai Hospital, Hanoi, Vietnam
| | - Dang Luu Vu
- Radiology Center, Bach Mai Hospital, Hanoi, Vietnam
| | - Ngoc Ha Le
- Department of Nuclear Medicine, Hospital 108, Hanoi, Vietnam
| | - Quoc Long Tran
- FIT, University of Engineering and Technology, VNU, Hanoi, Vietnam
| | - Duc Trinh Chu
- FET, University of Engineering and Technology, VNU, Hanoi, Vietnam
| | - Nguyen Linh Trung
- AVITECH, University of Engineering and Technology, VNU, Hanoi, Vietnam
| |
Collapse
|
2
|
Nadjiri J, Geith T, Waggershauser T, Heuser L, Morhard D, Bücker A, Paprottka PM. [Comparison of radiation exposure in common hepatic interventions : A retrospective analysis of DeGIR registry data]. Radiologe 2021; 61:80-86. [PMID: 32816049 PMCID: PMC7810650 DOI: 10.1007/s00117-020-00737-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Hintergrund Die transarterielle Chemoembolisation (TACE) oder auch Gallenganginterventionen stellen häufige Leberinterventionen dar. Ziel der Arbeit In dieser retrospektiven Studie soll die Strahlenexposition der Patienten mit einem hepatischen Eingriff in Abhängigkeit von Art und Feinziel der Intervention analysiert und verglichen werden. Material und Methoden Dies ist eine Analyse von 7003 DeGIR-Registerdatensätzen aus den Jahren 2016 bis 2018 für TACE und Gallenganginterventionen. Das Dosisflächenprodukt (DFP) und die Durchleuchtungszeit (DL) sowie die Interventionsart und das anatomisch definierte Feinziel der Interventionen wurden erfasst. Ergebnisse Insgesamt lagen Dosiswerte für 4985 durchgeführte TACE und 2018 Gallenganginterventionen vor. Bei Gallenganginterventionen lag der Median des DFP bei 2594 (Interquartilbereich [IQR] = 1174–5858) cGy*cm2. Bei der TACE betrug der Median des DFP 11.632 [IQR = 5530–22.800] cGy*cm2 und lag damit signifikant höher als bei Gallenganginterventionen (p < 0,0001). Gallengangeingriffe mit dem höchsten DFP sind Interventionen am Ductus hepaticus, während Eingriffe mit der längsten DL an der Hepatikusgabel stattfinden. Diskussion Die individuelle Strahlendosis für einen Patienten bei einer Leberintervention hängt weniger von der Komplexität des Eingriffs bzw. Durchleuchtungszeit ab, sondern von der Art des Eingriffs und vom Feinziel der Intervention. Die vorliegenden Dosisdaten können eine Hilfe sein, die Strahlenexposition bei einer Leberintervention bereits vor dem Eingriff grob abzuschätzen.
Collapse
Affiliation(s)
- Jonathan Nadjiri
- Sektion für Interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, München, Deutschland.
| | - Tobias Geith
- Sektion für Interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, München, Deutschland
| | - Tobias Waggershauser
- Sektion für Interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, München, Deutschland
| | | | - Dominik Morhard
- Radiologie und Neuroradiologie, Leopoldina Krankenhaus Schweinfurt, Schweinfurt, Deutschland
| | - Arno Bücker
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum der Universität des Saarlandes, Homburg /Saar, Deutschland
| | - Philipp M Paprottka
- Sektion für Interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, München, Deutschland
| |
Collapse
|
3
|
Burgmans MC, den Harder JM, Meershoek P, van den Berg NS, Chan SXJM, van Leeuwen FWB, van Erkel AR. Phantom Study Investigating the Accuracy of Manual and Automatic Image Fusion with the GE Logiq E9: Implications for use in Percutaneous Liver Interventions. Cardiovasc Intervent Radiol 2017; 40:914-923. [PMID: 28204959 PMCID: PMC5409927 DOI: 10.1007/s00270-017-1607-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/03/2017] [Indexed: 01/05/2023]
Abstract
Purpose To determine the accuracy of automatic and manual co-registration methods for image fusion of three-dimensional computed tomography (CT) with real-time ultrasonography (US) for image-guided liver interventions. Materials and Methods CT images of a skills phantom with liver lesions were acquired and co-registered to US using GE Logiq E9 navigation software. Manual co-registration was compared to automatic and semiautomatic co-registration using an active tracker. Also, manual point registration was compared to plane registration with and without an additional translation point. Finally, comparison was made between manual and automatic selection of reference points. In each experiment, accuracy of the co-registration method was determined by measurement of the residual displacement in phantom lesions by two independent observers. Results Mean displacements for a superficial and deep liver lesion were comparable after manual and semiautomatic co-registration: 2.4 and 2.0 mm versus 2.0 and 2.5 mm, respectively. Both methods were significantly better than automatic co-registration: 5.9 and 5.2 mm residual displacement (p < 0.001; p < 0.01). The accuracy of manual point registration was higher than that of plane registration, the latter being heavily dependent on accurate matching of axial CT and US images by the operator. Automatic reference point selection resulted in significantly lower registration accuracy compared to manual point selection despite lower root-mean-square deviation (RMSD) values. Conclusion The accuracy of manual and semiautomatic co-registration is better than that of automatic co-registration. For manual co-registration using a plane, choosing the correct plane orientation is an essential first step in the registration process. Automatic reference point selection based on RMSD values is error-prone.
Collapse
Affiliation(s)
- Mark Christiaan Burgmans
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
| | - J Michiel den Harder
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Philippa Meershoek
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.,Interventional and Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nynke S van den Berg
- Interventional and Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Shaun Xavier Ju Min Chan
- Department of Interventional Radiology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Fijs W B van Leeuwen
- Interventional and Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arian R van Erkel
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| |
Collapse
|