Multimodality image registration plays a crucial role in various clinical and research applications. The aim of this study is to present an optimized MR to CT whole‐body deformable image registration algorithm and its validation using clinical studies. A 3D intermodality registration technique based on B‐spline transformation was performed using optimized parameters of the elastix package based on the Insight Toolkit (ITK) framework. Twenty‐eight (17 male and 11 female) clinical studies were used in this work. The registration was evaluated using anatomical landmarks and segmented organs. In addition to 16 anatomical landmarks, three key organs (brain, lungs, and kidneys) and the entire body volume were segmented for evaluation. Several parameters — such as the Euclidean distance between anatomical landmarks, target overlap, Dice and Jaccard coefficients, false positives and false negatives, volume similarity, distance error, and Hausdorff distance — were calculated to quantify the quality of the registration algorithm. Dice coefficients for the majority of patients (>75%) were in the 0.8–1 range for the whole body, brain, and lungs, which satisfies the criteria to achieve excellent alignment. On the other hand, for kidneys, Dice coefficients for volumes of 25% of the patients meet excellent volume agreement requirement, while the majority of patients satisfy good agreement criteria (>0.6). For all patients, the distance error was in 0–10 mm range for all segmented organs. In summary, we optimized and evaluated the accuracy of an MR to CT deformable registration algorithm. The registered images constitute a useful 3D whole‐body MR‐CT atlas suitable for the development and evaluation of novel MR‐guided attenuation correction procedures on hybrid PET‐MR systems.PACS number: 07.05.Pj
Adjuvant yttrium-90 radiosynovectomy after surgical excision in the treatment of DPVNS is a reliable and efficient treatment method with successful clinical results. RS treatment can be considered for cases with DPVNS.
Hypoxia, a condition of insufficient oxygen availability to support metabolism, occurs when the vascular supply is interrupted, as in stroke. The identification of the hypoxic and viable tissue in stroke as compared with irreversible lesions (necrosis) has relevant implications for the treatment of ischemic stroke. Traditionally, imaging by positron emission tomography (PET), using 15O-based radiotracers, allowed the measurement of perfusion and oxygen extraction in stroke, providing important insights in its pathophysiology. However, these multitracer evaluations are of limited applicability in clinical settings. More recently, specific tracers have been developed, which accumulate with an inverse relationship to oxygen concentration and thus allow visualizing the hypoxic tissue non invasively. These belong to two main groups: nitroimidazoles, and among these the 18F-Fluoroimidazole (18F-FMISO) is the most widely used, and the copper-based tracers, represented mainly by Cu-ATSM. While these tracers have been at first developed and tested in order to image hypoxia in tumors, they have also shown promising results in stroke models and preliminary clinical studies in patients with cardiovascular disorders, allowing the detection of hypoxic tissue and the prediction of the extent of subsequent ischemia and clinical outcome. These tracers have therefore the potential to select an appropriate subgroup of patients who could benefit from a hypoxia-directed treatment and provide prognosis relevant imaging. The molecular imaging of hypoxia made important progress over the last decade and has a potential for integration into the diagnostic and therapeutic workup of patients with ischemic stroke.
The use of coronary calcium scoring (CaScCT) for attenuation correction (AC) of (13)N-ammonia PET/CT studies (NH3) is still being debated. We compare standard ACCT to CaScCT using various respiratory phases and co-registration methods for AC. Forty-one patients underwent a stress/rest NH3. Standard ACCT scans and CaScCT acquired during inspiration (CaScCTinsp, 26 patients) or expiration (CaScCTexp, 15 patients) were used to correct PET data for photon attenuation. Resulting images were compared using Pearson's correlation and Bland-Altman (BA) limits of agreement (LA) on segmental relative and absolute coronary blood flow (CBF) using both manual and automatic co-registration methods (rigid-body and deformable). For relative perfusion, CaScCTexp correlates better than CaScCTinsp with ACCT when using manual co-registration (r = 0.870; P < 0.001 and r = 0.732; P < 0.001, respectively). Automatic co-registration provides the best correlation between CaScCTexp and ACCT for relative perfusion (r = 0.956; P < 0.001). Both CaScCTinsp and CaScCTexp yielded excellent correlations with ACCT for CBF when using manual co-registration (r = 0.918; P < 0.001; BA mean bias 0.05 ml/min/g; LA: -0.42 to +0.3 ml/min/g and r = 0.97; P < 0.001; BA mean bias 0.1 ml/min/g; LA: -0.65 to +0.5 ml/min/g, respectively). The use of CaScCTexp and deformable co-registration is best suited for AC to quantify relative perfusion and CBF enabling substantial radiation dose reduction.
Objective:To investigate the prevalence of Helicobacter pylori (Hp) infection in pre-school and school age children with C-14 urea breath test, and to explore its association with age and socioeconomic factors in Turkey.Methods:Hp infection status was determined by using Urea Breath Test (UBT). Patients who had previous gastric surgery, Hp eradication treatment or equivocal UBT results were excluded. A questionnaire was administered to elicit information on gender, age, ABO/Rh blood group type, presence of gastric disease in the family, domestic animal in the household, and treatment for idiopathic Iron Deficiency Anemia (IDA).Results:This retrospective study included 500 pediatric patients (179 boys, 321 girls, mean age 10.7±4.3 years) of whom 62 (12.4%) were aged ≤6 years and 438 (87.6%) were aged 7 to 16 years. Helicobacter pylori (Hp) was positive in 245 (49%) cases. In the pre-school age group, 21/62 cases (34%) had positive UBT while in the school age group 224/438 children (51%) had positive UBT. A family history of dyspepsia and pet ownership were not associated with Hp positivity. Hp positive 76 (29.8%) children were on IDA treatment but this was not statistically significant.Conclusion:The Hp infection positivity rate was 49% in the pediatric age study group. The positivity rate was significantly lower at preschool age than school age, and it increased with age. There was no association with gender, ABO/Rh blood groups, presence of domestic pets, IDA, or history of gastric disease in the family.
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