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VoE 057 - Physics in Medical Imaging
Physics in Medical Imaging
Saturday, March 2, 14:00 - 15:00
Type of session: The Voice of EPOS
Topic: Physics in Medical Imaging
Moderator: J. Heverhagen (Bern/CH)


C-0254
Evaluation of radioprotective drape to reduce radiation exposure of interventional radiologists
E. Tzanis, J. Damilakis, D. Tsetis; Iraklion, Crete/GR

Aims and objectives:
Interventional radiologists are exposed to scattered radiation. Exposure in chronic low dose radiation, can cause stochastic and deterministic effects [1]. The use of efficient radioprotective equipment is necessary to further reduce interventional radiologist’s radiation exposure. The motivation of[...]
Methods and materials:
Α 0.25 mm Pb equivalent drape (Ecolab, Saint Paul, Minnesota, USA) with dimensions of 41 cm by 41 cm was evaluated (Figure 1). Experiments were performed using two physical anthropomorphic phantoms (Rando – Alderson Research Labs, CA, USA). The phantom - operator was placed in the position of the [...]
Results:
The results of this study show that the drapes considerably contribute to the primary operator’s radioprotection. Specifically, a reduction up to 75% for the abdominal area of the primary operator was recorded (Table 1). Moreover, radiation exposure of eye lenses, thyroid and genitals was reduced by[...]
Conclusion:
Radiation exposure of the primary interventionalist can be reduced considerably using a radioprotective drape. However, the use of the drape needs caution as its misplacement could lead to higher doses for the patients and the operators.
Personal information:
Eleftherios Tzanis1 MSc John Damilakis2 PhD Dimitrios Tsetis3 MD, PhD 1Department of Medical Physics, Medical School, University of Crete, P.O. Box 2208, Heraklion 71003, Crete, Greece. 2Department of Medical Physics, University Hospital of Heraklion, Medical School, University of Crete, Cr[...]
References:
[1] E. Picanto, E. Vano, L. Domenici, M. Bottai, I. Thierry. Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure BMC Cancer, 12:157, 2012

C-1311
GLINT: Establishing reproducible APT-, NOE- and gluco-CEST measurement at 3 T - evaluated at 3 clinical sites
A. Deshmane1, M. Zaiss2, K. Herz1, M. Rivlin3, A. Kujawa4, M. Kim4, G. Navon3, X. Golay4, K. Scheffler2; 1Tuebingen/DE 2Tübingen/DE 3Tel Aviv/IL 4London/UK

Aims and objectives:
Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) allows for indirect detection of diluted molecules via their saturation transfer to the abundant water pool [1-3]. Many different diluted solutes were reported to be detectable with CEST, including endogenous solutes such [...]
Methods and materials:
MRI was performed at 3 T (Prisma, Siemens Healthcare) in three healthy subjects, each at a different clinical site: University College London (UCL), Max Planck Institute (MPI) for Biological Cybernetics in Germany, and Tel Aviv University (TAU) in Israel. In addition, one patient with one brain tum[...]
Results:
All three sites produced similar CEST contrasts with stable signal distribution over all slices. APT-weighted images exhibited the expected low contrast in healthy tissues (Figure 2). Spectrally selective amide- and NOE-CEST maps (Figure 3) showed gray- and white-matter contrast comparable to that r[...]
Conclusion:
At clinical field strengths, CEST effects are spectrally broadened and lower in magnitude, and therefore harder to isolate compared to experiments at ultra-high magnetic field strengths. Translation of CEST imaging to clinical field strengths is therefore challenging. In this study, a fast 3D snap[...]
Personal information:
Anagha Deshmane, PhD Department of High-Field Magnetic Resonace Max Planck Institute for Biological Cybernetics Max-Planck-Ring 11 72076 Tuebingen Germany email: anagha.deshmane@tuebingen.mpg.de
References:
S. Forsen and R. A. Hoffman, “Study of Moderately Rapid Chemical Exchange Reactions by Means of Nuclear Magnetic Double Resonance,” J. Chem. Phys., vol. 39, no. 11, pp. 2892–2901, 1963. K.A. Ward et al., “A New Class of Contrast Agents for MRI Based on Proton Chemical Exchange Dependent Saturation T[...]

C-1543
Patient Irradiation and Tissue Reactions in a Quaternary Interventional Cardiology Center: 2007-2017
S. Balter, S. Myoung, Y. Grossberg, M. Collins, D. Doshi, D. Karmpaliotis, A. Kirtane, J. Moses; New York/US

Aims and objectives:
The prevalence of tissue reactions, such as skin burns, from Fluoroscopically Guided Interventional procedures (FGI) is poorly known. To provide a one-point estimate of tissue-reaction frequency and severity, we performed a retrospective analysis of radiation use and tissue reactions from interventi[...]
Methods and materials:
The database contains >90,000 cases (all non-EP procedures performed in the lab between 2006 and 2017). Data was cleaned by removing incomplete or grossly inaccurate cases, yielding approximately 82,000 procedures for further analysis. Substantial Dose Procedures (SDP) are defined as individual[...]
Results:
Overall time-trends from this study are shown in Figures 1 and 2. Median fluoroscopic time was essentially constant over this period indicating that the median procedure complexity did not change. This is an oversimplification because the diversity of the procedures increased over time. While t[...]
Conclusion:
The apparent discrepancy between the expectation of observing a high-fraction of tissue-reactions at 30 days with a skin-dose of 5 Gy, and the very low frequency of actual effects when Ka,r exceeded 5 or even 10 Gy is partially explained by the fundamental difference between these two metrics. The d[...]
Personal information:
Corresponding Author S Balter, Ph.D. Departments of Radiology and Medicine Columbia University Medical Center New York, NY, 10021 USA sb2455@cumc.columbia.edu Other Authors S. Myoung, Y. Grossberg, M. Collins, D. Doshi, D. Karmpaliotis, A. Kirtane, J. Moses Interventiona[...]
References:
1.NCRP, Report 168: Radiation Dose Management for Fluoroscopically Guided Interventional Medical Procedures. 2010(Report 168). 2. Balter, S., et al., Novel radiation dose reduction fluoroscopic technology facilitates chronic total occlusion percutaneous coronary interventions. EuroIntervention, 2017[...]

C-2033
Quality assurance in diffusion-weighted MRI: a phantom based on water-in-oil emulsions and polymer solutions.
K. Sergunova, K. Akhmad, A. Petraikin, D. Semenov, S. Kivasev, S. Morozov, A. Vladzymyrskyy; Moscow/RU

Aims and objectives:
Diffusion-weighted magnetic resonance imaging (DW-MRI) is widely implemented in scanning protocols for various organs and systems, including whole-body magnetic resonance imaging. Calculated values obtained through the mathematical processing of DWI data, such as apparent diffusion coefficient (ADC)[...]
Methods and materials:
We suggested including in quality assurance phantom the control substances with hindered [4] and restriction diffusion [5]. We used polymer – polyvinylpyrrolidone - water solution (PVP-WS) for increasing viscosity of the solution and for hindering of water molecule motion. PVP-WS may be used to mod[...]
Results:
The applied control substances presented the regular distribution of the ADC values, which is expressed in exponential dependence with various parameter (Fig. 3). It is apparent that the signal attenuations for PVP-WS have the mono-exponential dependency, which indicates the restricted diffusion mod[...]
Conclusion:
We developed a phantom for ADC quality assurance in DW-MRI using the polymer solutions and water-in-oil emulsions. During the test period, these substances showed structural stability. The developed phantom can be used to enhance DW-MRI in oncology. Over half on the MR scanners test resulted that th[...]
Personal information:
Sergunova Kristina A., Head of Technical Monitoring & QA Development Department, Research and Practical Center of Medical Radiology (Healthcare Moscow Department) ska@rpcmr.org.ru Dr. Petraikin Alexey V., PhD, MD Research and Practical Center of Medical Radiology (Healthcare Moscow Departmen[...]
References:
1. Bihan D. L. What can we see with IVIM MRI? NeuroImage. 2017. DOI: https://doi.org/10.1016/j.neuroimage.2017.12.062. 2. Nguyen H.T., Grebenkov D., Nguyen D. V., et al. Parameter estimation using macroscopic diffusion MRI signal models. Physics in Medicine & Biology. 2015. No. 60. P. 3389. [...]

C-2040
Accuracy improvement method for quasi-monochromatic images of dual-energy cone-beam CT
R. Baba1, A. Yoneyama2; 1Tokyo/JP 2Tosu/JP

Aims and objectives:
The imaging function of cone-beam CT (CBCT) is used in radiation therapy for positioning a treatment target in three-dimensional space. However, it is difficult to target a tumor because its contrast is low, and the CBCT images have artifacts caused by beam hardening of polychromatic X-rays (Fig. 1)[...]
Methods and materials:
Our novel imaging method uses metal filters to adjust the energy spectrum of X-rays incident on a subject. The information of the energy spectra is considered in the CBCT reconstruction process to accurately calculate the quasi-monochromatic images (Fig. 2) [2]. The method was verified on the [...]
Results:
A sample containing four elements (Ca, I, Al, and Acryl) were observed with our CBCT experimental apparatus using polychromatic X-rays with an energy of 10–40 keV. The quasi-monochromatic images of various energies were calculated from images measured with dual energies of about 22 keV and 31 keV (F[...]
Conclusion:
The novel DE-CBCT imaging method uses metal filters, and the information of the filters' energy spectra is considered in the reconstruction process to calculate the quasi-monochromatic images. The calculated quasi-monochromatic images are similar to the monochromatic images without artifacts cau[...]
Personal information:
Rika BABA Hitachi, Ltd. Research & Development Group 1-280, Higashi-koigakubo, Kokubunji-shi, Tokyo, 185-8601 Japan e-mail: rika.baba.rh@hitachi.com
References:
1. C. H. MacGillavry and G. D. Rieck, “International Tables For X-ray Crystallography”, vol. 3, Kynoch Press, 1968. 2. A. Yoneyama and R. Baba, “Quantitative evaluation of novel dual-energy computer tomography using monochromatic and polychromatic synchrotron radiation”, submitted to ECR, 2019. 3. A[...]

C-2165
In vitro visualization of nasal deposition with iodine-based aerosol using Dual-Energy CT – a feasibility study
T. D. J. Sartoretti, M. Zadory, M. Mannil, J. M. Fröhlich, A. Boss, H. Alkadhi; Zurich/CH
C-2454
Air gap compensation in gridless interventional procedures using digital substraction angiography
P. Saldaña, R. Martín Vaello, E. Alba Rey, C. Picón Olmos; Barcelona/ES

Aims and objectives:
DSA procedures impart the highest dose rates to patients among all x-ray modalities. Two of the reasons for these large dose rates are, first, the fact that the system is configured in a higher dose per frame setting to try to compensate for the noise in the final subtracted image [1], and second, d[...]
Methods and materials:
Phantom: An IEC 61223-3-3, DIN 6868/Parts 8, (2007) and 54 compliant phantom (Pro-RTG DSA, Pro-Project, Okszów, Poland) was used in this study [5-6]. The total PMMA thickness of the phantom in the test area was 57 mm. It contains a seven-step copper wedge of thicknesses ranging from 0.2 to 1.4 mm ([...]
Results:
Contrast-to-noise ratio (figures 4, 5, 6 and 7): CNRs always decreased when the grid was removed. When the air gap technique was used, CNR only improved when no additional scattering material was employed. Table 1 shows that this improvement varied from 54% for the 0.4 mm strip and 5% for the 0.05 m[...]
Conclusion:
The aim of this work was to verify if the decrease in image quality of DSA gridless series could be compensated using air gap techniques. As the results showed, there was a noticeable improvement in CNR, CNRdif, and visibility only when no additional scatter material was used. When added scatter mat[...]
Personal information:
P. Saldaña, MSc Catalan Institute of Oncology, Medical Physics Department Gran Vía de Hospitalet, 199-203 08908 Hospitalet de Llobregat, Barcelona, Spain Phone: + 34932607805 e-mail : psaldana@iconcologia.net
References:
1. Jones K, Balter s, Rauch P, Wagner LK (2014) Medical imaging using ionizing radiation: optimization of dose and image quality in fluoroscopy. Med Phys.41(1):014301. 2. Liu X, Shaw CC (2007) Rejection and redistribution of scattered radiation in digital radiography (SEDR): simulation with spot ima[...]

C-2547
Digital Tomosynthesis: The Next Generation
S. PHILLIPS1, K. Schmiedehausen2, S. Wells2; 1Cardiff/UK 2Oxford/UK

Learning objectives:
Review current Digital Tomosynthesis (DT) technologies Describe emerging DT technologies using compact cold cathode emitters Understand the evolving clinical applications of current and future DT imaging
Background:
Digital Tomosynthesis (DT) has been adopted as a valuable clinical tool, ranging from mammography to musculoskeletal and thoracic imaging (Fig 2). Conventional DT systems work by physically moving an X-ray tube through a range of positions in order to capture multiple ultra-low dose projection imag[...]
Findings and procedure details:
The Technology "Cold cathode" emitters rely on a process called field emission unlike conventional cathodes that use heat to excite electrons so that they can be fired into the vacuum. Field emission relies on sharp tips on the cathode where the field gradients at the tip are strong enough to pull[...]
Conclusion:
Arrays of "cold cathode" field emitters are an evolving technology with the potential to widen access to digital tomosynthesis. Compact and lightweight designs, particularly with the low input power requirements if a flat panel source is used, could widen the access of tomosynthesis technology. Thi[...]
Personal information:
Dr Siân Phillips Presenter: Voice of EPOS Session: Physics in Medical Imaging Saturday, March 2, 2019, 14.00-15.00 Consultant Radiologist sian.phillips5@wales.nhs.uk drsianphillips@gmail.com Dr Kristin Schmiedehausen kristin.schmiedehausen@adaptiximaging.com Dr Steve Wells steve.wells@ada[...]
References:
Dobbins III, JT.: Tomosynthesis imaging: At a translational crossroads, Med Phys (2009); 36(6): 1956–1967 Machida, H., Yuhara, T., Tamura, M. et al: Whole-Body Clinical Applications of Digital Tomosynthesis, RadioGraphics (2016); 36:735–750 Sharpe Jr., RE., Venkataraman, S., Phillips, J. et al: Inc[...]

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