The impact of audio-visual biofeedback on 4D PET images: results of a phantom study.
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ABSTRACT:
SUBMITTER: Yang J
PROVIDER: S-EPMC3281973 | biostudies-other | 2012 Feb
REPOSITORIES: biostudies-other
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Project description:Precise radiation therapy (RT) for abdominal lesions is complicated by respiratory motion and suboptimal soft tissue contrast in 4D CT. 4D MRI offers improved con-trast although long scan times and irregular breathing patterns can be limiting. To address this, visual biofeedback (VBF) was introduced into 4D MRI. Ten volunteers were consented to an IRB-approved protocol. Prospective respiratory-triggered, T2-weighted, coronal 4D MRIs were acquired on an open 1.0T MR-SIM. VBF was integrated using an MR-compatible interactive breath-hold control system. Subjects visually monitored their breathing patterns to stay within predetermined tolerances. 4D MRIs were acquired with and without VBF for 2- and 8-phase acquisitions. Normalized respiratory waveforms were evaluated for scan time, duty cycle (programmed/acquisition time), breathing period, and breathing regularity (end-inhale coefficient of variation, EI-COV). Three reviewers performed image quality assessment to compare artifacts with and without VBF. Respiration-induced liver motion was calculated via centroid difference analysis of end-exhale (EE) and EI liver contours. Incorporating VBF reduced 2-phase acquisition time (4.7 ± 1.0 and 5.4 ± 1.5 min with and without VBF, respectively) while reducing EI-COV by 43.8% ± 16.6%. For 8-phase acquisitions, VBF reduced acquisition time by 1.9 ± 1.6 min and EI-COVs by 38.8% ± 25.7% despite breathing rate remaining similar (11.1 ± 3.8 breaths/min with vs. 10.5 ± 2.9 without). Using VBF yielded higher duty cycles than unguided free breathing (34.4% ± 5.8% vs. 28.1% ± 6.6%, respectively). Image grading showed that out of 40 paired evaluations, 20 cases had equivalent and 17 had improved image quality scores with VBF, particularly for mid-exhale and EI. Increased liver excursion was observed with VBF, where superior-inferior, anterior-posterior, and left-right EE-EI displacements were 14.1± 5.8, 4.9 ± 2.1, and 1.5 ± 1.0 mm, respectively, with VBF compared to 11.9 ± 4.5, 3.7 ± 2.1, and 1.2 ± 1.4 mm without. Incorporating VBF into 4D MRI substantially reduced acquisition time, breathing irregularity, and image artifacts. However, differences in excursion were observed, thus implementation will be required throughout the RT workflow.
| S-EPMC5690930 | biostudies-literature
Project description:The purpose of this study was to evaluate the impact of tumor motion on maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) measurements in both 3-dimensional and respiratory-correlated, 4-dimensional positron emission tomography (PET) imaging. We also evaluated the effect of implementing different attenuation correction methods in 4-dimensional PET image reconstruction on SUVmax and MTV.An anthropomorphic thorax phantom with a spherical ball as a surrogate for a tumor was used. Different types of motion were imposed on the ball to mimic a patient's breathing motion. Three-dimensional PET imaging of the phantom without tumor motion was performed and used as the reference. The ball was then set in motion with different breathing motion traces and imaged with both 3- and 4-dimensional PET methods. The clinical 4-dimensional PET imaging protocol was modified so that 3 different types of attenuation correction images were used for reconstructions: the same free-breathing computed tomography (CT) for all PET phases, the same average intensity projection CT for all PET phases, and 4-dimensional CT for phase-matched attenuation correction. Tumor SUVmax and MTV values that were measured from the moving phantom were compared with the reference values.SUVmax that was measured in 3-dimensional PET imaging was different from the reference value by 20.4% on average for the motions that were investigated; this difference decreased to 2.6% with 4-dimensional PET imaging. The measurement of MTV in 4-dimensional PET also showed a similar magnitude of reduction of deviation compared with 3-dimensional PET. Four-dimensional PET with use of phase-matched 4-dimensional CT for attenuation correction showed less variation in SUVmax and MTV among phases compared with 4-dimensional PET with free-breathing CT or average intensity projection CT for attenuation correction.Four-dimensional PET imaging reduces the impact of motion on measured SUVmax and MTV when compared with 3-dimensional PET imaging. Clinical 4-dimensional PET imaging protocols should consider phase-matched 4-dimensional CT imaging for attenuation correction to achieve more accurate measurements.
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Project description:Background and purposeA novel method of retrospective liver modeling was developed based on four-dimensional magnetic resonance (4D-MR) images. The 4D-MR images will be utilized in generation of the subject-specific deformable liver model to be used in radiotherapy planning (RTP). The purpose of this study was to test and validate the developed 4D-magnetic resonance imaging (MRI) method with extensive phantom tests. We also aimed to build a motion model with image registration methods from liver simulating phantom images.Materials and methodsA deformable phantom was constructed by combining deformable tissue-equivalent material and a programmable 4D CIRS-platform. The phantom was imaged in 1.5 T MRI scanner with T2-weighted 4D SSFSE and T1-weighted Ax dual-echo Dixon SPGR sequences, and in computed tomography (CT). In addition, geometric distortion of the 4D sequence was measured with a GRADE phantom. The motion model was developed; the phases of the 4D-MRI were used as surrogate data, and displacement vector fields (DVF's) were used as a motion measurement. The motion model and the developed 4D-MRI method were evaluated and validated with extensive tests.ResultThe 4D-MRI method enabled an accuracy of 2 mm using our deformable phantom compared to the 4D-CT. Results showed a mean accuracy of <2 mm between coordinates and DVF's measured from the 4D images. Three-dimensional geometric accuracy results with the GRADE phantom were: 0.9-mm mean and 2.5 mm maximum distortion within a 100 mm distance, and 2.2 mm mean, 5.2 mm maximum distortion within a 150 mm distance from the isocenter.ConclusionsThe 4D-MRI method was validated with phantom tests as a necessary step before patient studies. The subject-specific motion model was generated and will be utilized in the generation of the deformable liver model of patients to be used in RTP.
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Project description:PurposeBiofeedback training (BT) was adapted to idiopathic infantile nystagmus syndrome (IINS) cases to enhance visual functions and quality of life (QoL).Methods10 patients (age 9 ± 3.2 years) treated with the audio-visual BT module of the MAIA microperimeter (Centervue, Padova, Italy) were assessed in two baseline visits and 1week post-BT (BT 80 min in total). The outcomes were distance and near binocular best corrected visual acuity (BBCVA), fixation stability, reading speed, contrast sensitivity, stereopsis and Children's Visual Function Questionnaire. One-way repeated measured ANOVA and paired t-tests were used.ResultsDistance BBCVA improved from 0.46 ± 0.21 and 0.43 ± 0.18 pre-BT to 0.33 ± 0.2 logMAR post-BT (F (2,27) = 13.75, p = 0.0002). Post-BT was better than baseline (p = 0.0001) and pre-BT (p = 0.001). Near BBCVA improved from 0.23 ± 0.09 and 0.21 ± 0.14 pre-BT to 0.04 ± 0.08 post-BT (F (2,27) = 22.12, p = 0.000014), post-BT was better than baseline (p = 0.0001) and pre-BT (p = 0.0006). Stereopsis improved from 283 ± 338″ to 39 ± 32.2″ (p = 0.04), contrast sensitivity from 0.26 ± 0.17 to 0.08 ± 0.12 log units (p = 0.01), and reading speed improved from 74.7 ± 51.2 wpm to 104.7 ± 53.6 wpm (p = 0.0006). Fixation stability improved from 33.6 ± 28.1 to 14.3 ± 10.1 sq. QoL increased from 23.8 ± 2.2 to 26.3 ± 2.3 units (p = 0.001).ConclusionBT benefited all visual functions and QoL in this pilot study, heralding a new possibility for Low Vision Rehabilitation in IINS.
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Project description:BackgroundImage harmonization has been proposed to minimize heterogeneity in brain PET scans acquired in multi-center studies. However, standard validated methods and software tools are lacking. Here, we assessed the performance of a framework for the harmonization of brain PET scans in a multi-center European clinical trial.MethodHoffman 3D brain phantoms were acquired in 28 PET systems and reconstructed using site-specific settings. Full Width at Half Maximum (FWHM) of the Effective Image Resolution (EIR) and harmonization kernels were estimated for each scan. The target EIR was selected as the coarsest EIR in the imaging network. Using "Hoffman 3D brain Analysis tool," indicators of image quality were calculated before and after the harmonization: The Coefficient of Variance (COV%), Gray Matter Recovery Coefficient (GMRC), Contrast, Cold-Spot RC, and left-to-right GMRC ratio. A COV% ≤ 15% and Contrast ≥ 2.2 were set as acceptance criteria. The procedure was repeated to achieve a 6-mm target EIR in a subset of scans. The method's robustness against typical dose-calibrator-based errors was assessed.ResultsThe EIR across systems ranged from 3.3 to 8.1 mm, and an EIR of 8 mm was selected as the target resolution. After harmonization, all scans met acceptable image quality criteria, while only 13 (39.4%) did before. The harmonization procedure resulted in lower inter-system variability indicators: Mean ± SD COV% (from 16.97 ± 6.03 to 7.86 ± 1.47%), GMRC Inter-Quartile Range (0.040-0.012), and Contrast SD (0.14-0.05). Similar results were obtained with a 6-mm FWHM target EIR. Errors of ± 10% in the DRO activity resulted in differences below 1 mm in the estimated EIR.ConclusionHarmonizing the EIR of brain PET scans significantly reduced image quality variability while minimally affecting quantitative accuracy. This method can be used prospectively for harmonizing scans to target sharper resolutions and is robust against dose-calibrator errors. Comparable image quality is attainable in brain PET multi-center studies while maintaining quantitative accuracy.
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Project description:The effects of asynchrony between audio and visual (A/V) stimuli on the N100m responses of magnetoencephalography in the left hemisphere were compared with those on the psychophysical responses in 11 participants. The latency and amplitude of N100m were significantly shortened and reduced in the left hemisphere by the presentation of visual speech as long as the temporal asynchrony between A/V stimuli was within 100 ms, but were not significantly affected with audio lags of -500 and +500 ms. However, some small effects were still preserved on average with audio lags of 500 ms, suggesting similar asymmetry of the temporal window to that observed in psychophysical measurements, which tended to be more robust (wider) for audio lags; i.e., the pattern of visual-speech effects as a function of A/V lag observed in the N100m in the left hemisphere grossly resembled that in psychophysical measurements on average, although the individual responses were somewhat varied. The present results suggest that the basic configuration of the temporal window of visual effects on auditory-speech perception could be observed from the early auditory processing stage.
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Project description:People can discriminate the synchrony between audio-visual scenes. However, the sensitivity of audio-visual synchrony perception can be affected by many factors. Using a simultaneity judgment task, the present study investigated whether the synchrony perception of complex audio-visual stimuli was affected by audio-visual causality and stimulus reliability. In Experiment 1, the results showed that audio-visual causality could increase one's sensitivity to audio-visual onset asynchrony (AVOA) of both action stimuli and speech stimuli. Moreover, participants were more tolerant of AVOA of speech stimuli than that of action stimuli in the high causality condition, whereas no significant difference between these two kinds of stimuli was found in the low causality condition. In Experiment 2, the speech stimuli were manipulated with either high or low stimulus reliability. The results revealed a significant interaction between audio-visual causality and stimulus reliability. Under the low causality condition, the percentage of "synchronous" responses of audio-visual intact stimuli was significantly higher than that of visual_intact/auditory_blurred stimuli and audio-visual blurred stimuli. In contrast, no significant difference among all levels of stimulus reliability was observed under the high causality condition. Our study supported the synergistic effect of top-down processing and bottom-up processing in audio-visual synchrony perception.
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Project description:BackgroundDigital anthropomorphic phantoms, such as the 4D extended cardiac-torso (XCAT) phantom, are actively used to develop, optimize, and evaluate a variety of imaging applications, allowing for realistic patient modeling and knowledge of ground truth. The XCAT phantom defines the activity and attenuation for a simulated patient, which includes a complete set of organs, muscle, bone, and soft tissue, while also accounting for cardiac and respiratory motion. However, the XCAT phantom does not currently include the lymphatic system, critical for evaluating medical imaging tasks such as sentinel node detection, node density measurement, and radiation dosimetry.PurposeIn this study, we aimed to develop a scalable lymphatic system in the XCAT phantom, to facilitate improved research of the lymphatic system in medical imaging. Using this scalable lymphatic system, we modeled the lymph node conglomerate pathology that is characteristically observed in primary mediastinal B-cell lymphoma (PMBCL). As an extended application, we evaluated positron emission tomography (PET) image quantification of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of these simulated lymphomas, though the phantoms may be applied to other imaging modalities and study design paradigms (e.g., image quality, detection).MethodsA template model for the lymphatic system was developed based on anatomical data from the Visible Human Project of the National Library of Medicine. The segmented nodes and vessels were fit with non-uniform rational basis spline surfaces, and multichannel large deformation diffeomorphic metric mapping was used to propagate the template to different XCAT anatomies. To model conglomerates observed in PMBCL, lymph nodes were enlarged, converged within the mediastinum, and tracer concentration was increased. We used the phantoms as inputs to a PET simulation tool, which generated images using ordered subsets expectation maximization reconstruction with 2-8 mm Gaussian filters. Fixed thresholding (FT) and gradient segmentation were used to determine MTV and TLG. Percent bias (%Bias) and coefficient of variation (COV) were computed as measures of accuracy and precision, respectively, for each MTV and TLG measurement.ResultsUsing the methodology described above, we introduced a scalable lymphatic system in the XCAT phantom, which allows for the radioactivity and attenuation ground truth to be generated in 116 ± 2.5 s using a 2.3 GHz processor. Within the Rhinoceros interface, lymph node anatomy and function were modified to create a cohort of 10 phantoms with lymph node conglomerates. Using the lymphoma phantoms to evaluate PET quantification of MTV, mean %Bias values were -9.3%, -41.3%, and 20.9%, while COV values were 4.08%, 7.6%, and 3.4% using 25% FT, 40% FT, and gradient segmentations, respectively. Comparatively for TLG, mean %Bias values were -27.4%, -45.8%, and -16.0%, while COV values were 1.9%, 5.7%, and 1.4%, for the 25% FT, 40% FT, and gradient segmentations, respectively.ConclusionsIn this work, we upgraded the XCAT phantom to include a lymphatic system, comprised of a network of 276 scalable lymph nodes and corresponding vessels. As an application, we created a cohort of phantoms with lymph node conglomerates to evaluate lymphoma quantification in PET imaging, which highlights an important application of this work.
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Project description:BACKGROUND: Different sources of sensory information can interact, often shaping what we think we have seen or heard. This can enhance the precision of perceptual decisions relative to those made on the basis of a single source of information. From a computational perspective, there are multiple reasons why this might happen, and each predicts a different degree of enhanced precision. Relatively slight improvements can arise when perceptual decisions are made on the basis of multiple independent sensory estimates, as opposed to just one. These improvements can arise as a consequence of probability summation. Greater improvements can occur if two initially independent estimates are summated to form a single integrated code, especially if the summation is weighted in accordance with the variance associated with each independent estimate. This form of combination is often described as a Bayesian maximum likelihood estimate. Still greater improvements are possible if the two sources of information are encoded via a common physiological process. PRINCIPAL FINDINGS: Here we show that the provision of simultaneous audio and visual speech cues can result in substantial sensitivity improvements, relative to single sensory modality based decisions. The magnitude of the improvements is greater than can be predicted on the basis of either a Bayesian maximum likelihood estimate or a probability summation. CONCLUSION: Our data suggest that primary estimates of speech content are determined by a physiological process that takes input from both visual and auditory processing, resulting in greater sensitivity than would be possible if initially independent audio and visual estimates were formed and then subsequently combined.
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Project description:In order to parse the world around us, we must constantly determine which sensory inputs arise from the same physical source and should therefore be perceptually integrated. Temporal coherence between auditory and visual stimuli drives audio-visual (AV) integration, but the role played by AV spatial alignment is less well understood. Here, we manipulated AV spatial alignment and collected electroencephalography (EEG) data while human subjects performed a free-field variant of the "pip and pop" AV search task. In this paradigm, visual search is aided by a spatially uninformative auditory tone, the onsets of which are synchronized to changes in the visual target. In Experiment 1, tones were either spatially aligned or spatially misaligned with the visual display. Regardless of AV spatial alignment, we replicated the key pip and pop result of improved AV search times. Mirroring the behavioral results, we found an enhancement of early event-related potentials (ERPs), particularly the auditory N1 component, in both AV conditions. We demonstrate that both top-down and bottom-up attention contribute to these N1 enhancements. In Experiment 2, we tested whether spatial alignment influences AV integration in a more challenging context with competing multisensory stimuli. An AV foil was added that visually resembled the target and was synchronized to its own stream of synchronous tones. The visual components of the AV target and AV foil occurred in opposite hemifields; the two auditory components were also in opposite hemifields and were either spatially aligned or spatially misaligned with the visual components to which they were synchronized. Search was fastest when the auditory and visual components of the AV target (and the foil) were spatially aligned. Attention modulated ERPs in both spatial conditions, but importantly, the scalp topography of early evoked responses shifted only when stimulus components were spatially aligned, signaling the recruitment of different neural generators likely related to multisensory integration. These results suggest that AV integration depends on AV spatial alignment when stimuli in both modalities compete for selective integration, a common scenario in real-world perception.
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