0000000000060524

AUTHOR

Oliver Weinheimer

Quantification and Characterization of Pulmonary Emphysema in Multislice-CT

The new technology of the Multislice-CT provides volume data sets with approximately isotropic resolution, which permits a non invasive measurement of diffuse lung diseases like emphysema in the 3D space. The aim of our project is the development of a full automatic 3D CAD (Computer Aided Diagnosis) software tool for detection, quantification and characterization of emphysema in a thoracic CT data set. It should supply independently an analysis of an image data set to support the physician in clinical daily routine. In this paper we describe the developed 3D algorithms for the segmentation of the tracheo-bronchial tree, the lungs and the emphysema regions. We present different emphysema des…

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Influence of pixel size on quantification of airway wall thickness in computed tomography.

Objectives: The purpose of this study was to determine the point where a further decrease in voxel size does not result in better automatic quantification of the bronchial wall thickness by using 2 different assessment techniques. Materials and Methods: The results from the commonly used full-width-at-half-maximum (FWHM) principle and a new technique (integral-based method [IBM]) were compared for thin-section multidetector computed tomography (MDCT) data sets from an airway phantom containing 10 different tubular airway phantoms and in a human subsegmental bronchus in vivo. Correlation with the actual wall thickness and comparison of the wall thicknesses assessed for different voxel sizes …

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Pulmonary emphysema in cystic fibrosis detected by densitometry on chest multidetector computed tomography.

BackgroundHistopathological studies on lung specimens from patients with cystic fibrosis (CF) and recent results from a mouse model indicate that emphysema may contribute to CF lung disease. However, little is known about the relevance of emphysema in patients with CF. In the present study, we used computationally generated density masks based on multidetector computed tomography (MDCT) of the chest for non-invasive characterization and quantification of emphysema in CF.MethodsVolumetric MDCT scans were acquired in parallel to pulmonary function testing in 41 patients with CF (median age 20.1 years; range 7-66 years) and 21 non-CF controls (median age 30.4 years; range 4-68 years), and subj…

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Quantification of Lung Volume at Different Tidal Volumes and Positive End-Expiratory Pressures in a Porcine Model by Using Retrospective Respiratory Gated 4D-Computed Tomography

PURPOSE: This feasibility study in healthy animals should prove the concept that it is possible to quantitatively assess the effects of different ventilatory settings on the lung parenchyma during ongoing ventilation in respiratory gated 4-dimensional (D)-computed tomography (CT). For this purpose, the influence of different tidal volumes and positive end-expiratory pressure (PEEP) on quantitative assessment of lung volumes (LVs) and lung compartments was analyzed. METHODS: Five anesthetized and ventilated (20 breaths/min, inspiratory/expiratory ratio of 1:2) healthy pigs underwent 16-row multidetector CT with retrospective respiratory gating using a noncontact charge-coupled device camera …

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Quantitative analysis of emphysema in 3D using MDCT: Influence of different reconstruction algorithms

Abstract Purpose The aim of the study was to compare the influence of different reconstruction algorithms on quantitative emphysema analysis in patients with severe emphysema. Material and methods Twenty-five patients suffering from severe emphysema were included in the study. All patients underwent inspiratory MDCT (Aquilion-16, slice thickness 1/0.8 mm). The raw data were reconstructed using six different algorithms: bone kernel with beam hardening correction (BHC), soft tissue kernel with BHC; standard soft tissue kernel, smooth soft tissue kernel (internal reference standard), standard lung kernel, and high-convolution kernel. The only difference between image data sets was the algorith…

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Software for automated application of a reference-based method fora posterioridetermination of the effective radiographic imaging geometry

Objectives: Presentation and validation of software developed for automated and accurate application of a reference-based algorithm (reference sphere method: RSM) inferring the effective imaging geometry from quantitative radiographic image analysis. Methods: The software uses modern pattern recognition and computer vision algorithms adapted for the particular application of automated detection of the reference sphere shadows (ellipses) with subpixel accuracy. It applies the RSM algorithm to the shadows detected, thereby providing threedimensional Cartesian coordinates of the spheres. If the three sphere centres do not lie on one line, they uniquely determine the imaging geometry. Accuracy …

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About Objective 3-D Analysis of Airway Geometry in Computerized Tomography

The technology of multislice X-ray computed tomography (MSCT) provides volume data sets with approximately isotropic resolution, which permits a noninvasive 3-D measurement and quantification of airway geometry. In different diseases, like emphysema, chronic obstructive pulmonary disease (COPD), or cystic fribrosis, changes in lung parenchyma are associated with an increase in airway wall thickness. In this paper, we describe an objective measuring method of the airway geometry in the 3-D space. The limited spatial resolution of clinical CT scanners in comparison to thin structures like airway walls causes difficulties in the measurement of the density and the thickness of these structures.…

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LATE-BREAKING ABSTRACT: Comparative studies on bronchuswall-thickness by histologic and computed tomographic measurements of porcine lungs

Aims: Histologic slides are commonly used as template in the evaluation and development of medical imaging methods.Diseases like Asthma and COPD show characteristic changes in airway morphology and airway measurement by computed tomography is a promising diagnostic approach.However,shrinkage caused by fixation and histological processing is known in lung tissue.In this study,the thickness of bronchus walls in paraffin and frozen sections as well as in CT and MicroCT were compared. Methods: Airway measurements of swine lungs were performed after freezing in ventilated condition in liquid nitrogen by measuring the wall thickness of 7 bronchi via CT and MicroCT as well as in frozen and paraffi…

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Differences of airway dimensions between patients with and without bronchiolitis obliterans syndrome after lung transplantation-Computer-assisted quantification of computed tomography.

Abstract Background The aim of our retrospective study was to determine whether a dedicated software for assessment of airway morphology can detect differences in airway dimensions between patients with and without bronchiolitis obliterans syndrome (BOS), regarded as the clinical correlate of chronic lung allograft rejection. Methods 12 patients with and 14 patients without diagnosis of BOS were enrolled in the study. Evaluation of bronchial wall area percentage (WA%) and bronchial wall thickness (WT) in all follow-up CT scans was performed using a semiautomatic airway assessment tool. We assessed temporal changes (ΔWA%, ΔWT) and compared these morphological parameters with forced expirator…

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Contrast enhanced CT-scans are not comparable to non-enhanced scans in emphysema quantification.

Systemic, interventional and surgical treatments have gone new ways in treatment of emphysema. For longitudinal therapy monitoring and as end-points for clinical trials, quantification of the disease is necessary. Sensitive, easy to measure, as well as stable and reproducible parameters have to be characterized. One parameter that might affect emphysema quantification is IV contrast enhancement, which might also be indicated. Whether or not the contrast enhanced scan is also suited for emphysema quantification or an additional scan is necessary, a retrospective analysis of 12 adult patients undergoing clinically indicated both, a non-enhanced and enhanced thin section MSCT within a week (me…

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Paired Inspiratory/Expiratory Volumetric Thin-Slice CT Scan for Emphysema Analysis

Purpose: The aim of the study was to use three-dimensional high-resolution CT scan data sets in inspiration and expiration for the quantitative evaluation of emphysema. Using an advanced dedicated semiautomatic analysis tool, the functional inspiratory/expiratory shifts of emphysema volume and clusters were quantified. The pulmonary function test (PFT) served as the clinical “gold standard.” Materials and methods: Thirty-one patients (9 women and 22 men; mean [± SD] age, 60 ± 8 years) who had severe emphysema due to COPD (Global Initiative for Chronic Obstructive Lung Disease [GOLD] class III and IV) were included in the study. All patients underwent paired inspiratory/expiratory multidetec…

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Accurate registration of random radiographic projections based on three spherical references for the purpose of few-view 3D reconstruction

Precise registration of radiographic projection images acquired in almost arbitrary geometries for the purpose of three-dimensional (3D) reconstruction is beset with difficulties. We modify and enhance a registration method [R. Schulze, D. D. Bruellmann, F. Roeder, and B. d'Hoedt, Med. Phys. 31, 2849-2854 (2004)] based on coupling a minimum amount of three reference spheres in arbitrary positions to a rigid object under study for precise a posteriori pose estimation. Two consecutive optimization procedures (a, initial guess; b, iterative coordinate refinement) are applied to completely exploit the reference's shadow information for precise registration of the projections. The modification h…

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Accuracy of automatic airway morphometry in computed tomography-correlation of radiological-pathological findings.

Abstract Objectives Airway morphology shows characteristic changes in different pathologies. This study assesses the accuracy of a current automatic airway assessment technique by correlating CT images of porcine airways to histological slices of the same localization. Materials and methods Four isolated and ventilated porcine lungs were frozen in a liquid nitrogen bath and examined with a CT scanner (MDCT). This technique both preserved normal radiomorphological appearance and made it possible to slice the specimens for histological examination for subsequent correlation. The parameters wall thickness (WT), wall percentage (WP), and total diameter (TD) were assessed by computer-aided measu…

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Total Variation Regularization in Digital Breast Tomosynthesis

We developed an iterative algebraic algorithm for the reconstruction of 3D volumes from limited-angle breast projection images. Algebraic reconstruction is accelerated using the graphics processing unit. We varied a total variation (TV)-norm parameter in order to verify the influence of TV regularization on the representation of small structures in the reconstructions. The Barzilai-Borwein algorithm is used to solve the inverse reconstruction problem. The quality of our reconstructions was evaluated with the Quart Mam/Digi Phantom, which features so-called Landolt ring structures to verify perceptibility limits. The evaluation of the reconstructions was done with an automatic LR detection a…

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Extraction of Airways from CT (EXACT'09)

Contains fulltext : 107854.pdf (Publisher’s version ) (Open Access) This paper describes a framework for establishing a reference airway tree segmentation, which was used to quantitatively evaluate fifteen different airway tree extraction algorithms in a standardized manner. Because of the sheer difficulty involved in manually constructing a complete reference standard from scratch, we propose to construct the reference using results from all algorithms that are to be evaluated. We start by subdividing each segmented airway tree into its individual branch segments. Each branch segment is then visually scored by trained observers to determine whether or not it is a correctly segmented part o…

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Vollautomatische Detektion und Quantifizierung des Lungenemphysems in Dünnschicht-MD-CT des Thorax durch eine neue, speziell entwickelte Software

Purpose: Introduction of a novel software tool (YACTA - yet another CT analyzer) for detection and quantification of pulmonary emphysema in thin-slice chest MDCT data sets. Materials and Methods: Consisting of grey-level threshold-based algorithms (e. g., region-growing), expert rules and morphological image postprocessing YACTA segments the tracheobronchial tree prior to the detection and quantification of pulmonary emphysema. In addition to general parameters, such as the mean lung density (MLD) and the emphysema index (EI - also described as pixel index PI), the previously described bullae index (BI) is transformed into a three-dimensional parameter for a morphological description of emp…

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Tissue expansion of lung bronchi due to tissue processing for histology – A comparative analysis of paraffin versus frozen sections in a pig model

Tissue shrinking due to fixation and processing is well known. However, the degree of shrinking varies significantly with the tissue type as well as the processing method and is not well studied in various tissues. In daily pathological routine workflow, histological specimens from frozen and paraffin sections are performed from the same tissue. In the present study we compared the thickness of bronchus walls obtained from paraffin and frozen sections.Pig lungs were frozen in ventilated condition in liquid nitrogen and 36 bronchi were isolated after dissection. Frozen sections of 5 μm thickness were performed and the remaining tissue was fixed and embedded in paraffin after fixation in 4% f…

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Comparison of histological and computed tomographic measurements of pig lung bronchi.

Aim Light microscopy is used as template in the evaluation and further development of medical imaging methods. Tissue shrinkage caused by histological processing is known to influence lung tissue dimensions. In diagnosis of COPD, computed tomography (CT) is widely used for automated airway measurement. The aim of this study was to compare histological and computed tomographic measurements of pig lung bronchi. Methods Airway measurements of pig lungs were performed after freezing under controlled inflation pressure in a liquid nitrogen bath. The wall thickness of seven bronchi was measured via Micro-CT and CT using the integral-based method (IBM) and the full-width-at-half-maximum method (FW…

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Assessment of the relationship between lung parenchymal destruction and impaired pulmonary perfusion on a lobar level in patients with emphysema.

Abstract Purpose To assess the relationship between lung parenchymal destruction and impaired pulmonary perfusion on a lobar level using CT and MRI in patients with emphysema. Material and methods Forty-five patients with severe emphysema (GOLD III and IV) underwent inspiratory 3D-HRCT and contrast-enhanced MR-perfusion (1.5T; 3.5 mm × 1.9 mm × 4 mm). 3D-HRCT data was analyzed using a software for detection and visualization of emphysema. Emphysema was categorized in four clusters with different volumes and presented as overlay on the CT. CT and lung perfusion were visually analyzed for three lobes on each side using a four-point-score to grade the abnormalities on CT (1: predominantly smal…

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Analyse von Bronchien in der Multislice-CT

Es wird eine Methode zum objektiven Bestimmen der Wanddicke und des Gesamt durchmessers von Bronchien in der 3-dimensionalen Computertomographie vorgestellt. Die Methode wurde erfolgreich an Phantomen evaluiert. Erste Studien sowohl an tierischen als auch an menschlichen Bronchien verliefen erfolgversprechend.

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