Super-global distortion correction for a rotational C-arm x-ray image intensifier

Magnetically Controlled Growing Rods: Influence on Intraoperative Fluoroscopic Imaging: A Case Report

CASE

A 7-year-old boy with severe congenital scoliosis and impending thoracic insufficiency syndrome underwent uneventful single magnetically controlled growing rod (MCGR) insertion and removal of his ipsilateral rib-based distraction implants at our institution. Intraoperative fluoroscopy imaging revealed an artifactual bend (S-distortion) of the rod actuator after placement. This artifact was eliminated by moving the image intensifier further from the patient.

CONCLUSION

We attributed the S-distortion to influences of magnetic fields within the MCGR actuator onto the image intensifier. Surgeons should be aware of such implications which can lead to misleading imaging artifacts. This is a first reported case of such incident with MCGR.

36M-pixel synchrotron radiation micro-CT for whole secondary pulmonary lobule visualization from a large human lung specimen

A micro-CT system was developed using a 36M-pixel digital single-lens reflex camera as a cost-effective mode for large human lung specimen imaging. Scientific grade cameras used for biomedical x-ray imaging are much more expensive than consumer-grade cameras. During the past decade, advances in image sensor technology for consumer appliances have spurred the development of biomedical x-ray imaging systems using commercial digital single-lens reflex cameras fitted with high megapixel CMOS image sensors. This micro-CT system is highly specialized for visualizing whole secondary pulmonary lobules in a large human lung specimen. The secondary pulmonary lobule, a fundamental unit of the lung structure, reproduces the lung in miniature. The lung specimen is set in an acrylic cylindrical case of 36 mm diameter and 40 mm height. A field of view (FOV) of the micro-CT is 40.6 mm wide × 15.1 mm high with 3.07 μm pixel size using offset CT scanning for enlargement of the FOV. We constructed a 13,220 × 13,220 × 4912 voxel image with 3.07 μm isotropic voxel size for three-dimensional visualization of the whole secondary pulmonary lobule. Furthermore, synchrotron radiation has proved to be a powerful high-resolution imaging tool. This micro-CT system using a single-lens reflex camera and synchrotron radiation provides practical benefits of high-resolution and wide-field performance, but at low cost.

Influence of multi-angle input of intraoperative fluoroscopic images on the spatial positioning accuracy of the C-arm calibration-based algorithm of a CAOS system

Intraoperative fluoroscopic images, as one of the most important input data for computer-assisted orthopedic surgery (CAOS) systems, have a significant influence on the positioning accuracy of CAOS system. In this study, we proposed to use multi-angle intraoperative fluoroscopy images as input based on real clinical scenario, and the aim was to analyze the positioning accuracy and the error propagation rules with multi-angle input images compared with traditional two input images. In the experiment, the positioning accuracy of the C-arm calibration-based algorithm was studied, respectively, using two, three, four, five, and six intraoperative fluoroscopic images as input data. Moreover, the error propagation rules of the positioning error were analyzed by the Monte Carlo method. The experiment result showed that increasing the number of multi-angle input fluoroscopic images could reduce the positioning error of CAOS system, which has dropped from 1.01 to 0.61 mm. The Monte Carlo simulation analysis showed that for random input errors subject to normal distribution (μ = 0, σ = 1), the image positioning error dropped from 0.29 to 0.23 mm, and the staff gauge positioning error dropped from 1.36 to 1.19 mm, while the tracking device positioning error dropped from 3.41 to 2.13 mm. In addition, the results showed that image positioning error and staff gauge positioning error were all nonlinear error for the whole system, but tracker device positioning error was a strictly linear error. In conclusion, using multi-angle fluoroscopy images was helpful for clinic, which could improve the positioning accuracy of the CAOS system by nearly 30%. Graphical abstract The experiment process and Monte Carlo analysis of spatial positioning accuracy (A: Setup for the experiment; B: The process of Monte Carlo analysis; C: Results).

Geometric calibration and correction for a lens-coupled detector in x-ray phase-contrast imaging

A lens-coupled x-ray camera with a tilted phosphor collects light emission from the x-ray illuminated (front) side of phosphor. Experimentally, it has been shown to double x-ray photon capture efficiency and triple the spatial resolution along the phosphor tilt direction relative to the same detector at normal phosphor incidence. These characteristics benefit grating-based phase-contrast methods, where linear interference fringes need to be clearly resolved. However, both the shallow incident angle on the phosphor and lens aberrations of the camera cause geometric distortions. When tiling multiple images of limited vertical view into a full-field image, geometric distortion causes blurring due to image misregistration. Here, we report a procedure of geometric correction based on global polynomial transformation of image coordinates. The corrected image is equivalent to one obtained with a single full-field flat panel detector placed at the sample plane. In a separate evaluation scan, the position deviations in the horizontal and vertical directions were reduced from 0.76 and 0.028 mm, respectively, to 0.006 and 0.009 mm, respectively, by the correction procedure, which were below the 0.028-mm pixel size of the imaging system. In a demonstration of a phase-contrast imaging experiment, the correction reduced blurring of small structures.

Multimodality calibration for simultaneous fluoroscopic and nuclear imaging

Background

Simultaneous real-time fluoroscopic and nuclear imaging could benefit image-guided (oncological) procedures. To this end, a hybrid modality is currently being developed by our group, by combining a c-arm with a gamma camera and a four-pinhole collimator. Accurate determination of the system parameters that describe the position of the x-ray tube, x-ray detector, gamma camera, and collimators is crucial to optimize image quality. The purpose of this study was to develop a calibration method that estimates the system parameters used for reconstruction.

A multimodality phantom consisting of five point sources was created. First, nuclear and fluoroscopic images of the phantom were acquired at several distances from the image intensifier. The system parameters were acquired using physical measurement, and multimodality images of the phantom were reconstructed. The resolution and co-registration error of the point sources were determined as a measure of image quality. Next, the system parameters were estimated using a calibration method, which adjusted the parameters in the reconstruction algorithm, until the resolution and co-registration were optimized. For evaluation, multimodality images of a second set of phantom acquisitions were reconstructed using calibrated parameter sets. Subsequently, the resolution and co-registration error of the point sources were determined as a measure of image quality. This procedure was performed five times for different noise simulations. In addition, simultaneously acquired fluoroscopic and nuclear images of two moving syringes were obtained with parameter sets from before and after calibration.

Results

The mean FWHM was significantly lower after calibration than before calibration for 21 out of 25 point sources. The mean co-registration error was significantly lower after calibration than before calibration for all point sources. The simultaneously acquired fluoroscopic and nuclear images showed improved co-registration after calibration as compared with before calibration.

Conclusions

A calibration method was presented that improves the resolution and co-registration of simultaneously acquired hybrid fluoroscopic and nuclear images by estimating the geometric parameter set as compared with a parameter set acquired by direct physical measurement.

Electronic supplementary material

The online version of this article (doi:10.1186/s40658-016-0156-1) contains supplementary material, which is available to authorized users.

Image intensifier distortion correction for fluoroscopic RSA: the need for independent accuracy assessment

Fluoroscopic images suffer from multiple modes of image distortion. Therefore, the purpose of this study was to compare the effects of correction using a range of two-dimensional polynomials and a global approach. The primary measure of interest was the average error in the distances between four beads of an accuracy phantom, as measured using RSA. Secondary measures of interest were the root mean squared errors of the fit of the chosen polynomial to the grid of beads used for correction, and the errors in the corrected distances between the points of the grid in a second position. Based upon the two-dimensional measures, a polynomial of order three in the axis of correction and two in the perpendicular axis was preferred. However, based upon the RSA reconstruction, a polynomial of order three in the axis of correction and one in the perpendicular axis was preferred. The use of a calibration frame for these three-dimensional applications most likely tempers the effects of distortion. This study suggests that distortion correction should be validated for each of its applications with an independent "gold standard" phantom.

Distortion, Orientation, and Translation Corrections of Tiled EMCCD Detectors for the New Solid State X-ray Image Intensifier (SSXII)

We report on the technology of imaging corrections for a new solid state x-ray image intensifier (SSXII) with enhanced resolution and fluoroscopic imaging capabilities, made of a mosaic of modules (tiled-array) each consisting of CsI(Tl) phosphor coupled using a fiber-optic taper or minifier to an electron multiplier charge coupled device (EMCCD). Generating high quality images using this EMCCD tiled-array system requires the determination and correction of the individual EMCCD sub-images with respect to relative rotations and translations as well as optical distortions due to the fiber optic tapers. The image corrections procedure is based on comparison of resulting (distorted) images with the known square pattern of a wire mesh phantom. The mesh crossing point positions in each sub-image are automatically identified. With the crossing points identified, the mapping between distorted and an undistorted array is determined. For each pixel in a distorted sub-image, the corresponding location in the corrected sub-image is calculated using bilinear interpolation. For the rotation corrections between sub-images, the orientation of the vectors between respective mesh crossing points in the various sub-images are determined and each sub-image is appropriately rotated with the pixel values again determined using bilinear interpolation. Image translation corrections are performed using reference structures at known locations. According to our estimations, the distortion corrections are accurate to within 1%; the rotations are determined to within 0.1 degree, and translation corrections are accurate to well within 1 pixel. This technology will provide the basis for generating single composite images from tiled-image configurations of the SSXII regardless of how many modules are used to form the images.

A practical global distortion correction method for an image intensifier based x-ray fluoroscopy system

X-ray images acquired on systems with image intensifiers (II) exhibit characteristic distortion which is due to both external and internal factors. The distortion is dependent on the orientation of the II, a fact particularly relevant to II's mounted on C arms which have several degrees of freedom of motion. Previous descriptions of distortion correction strategies have relied on a dense sampling of the C-arm orientation space, and as such have been limited mostly to a single arc of the primary angle, alpha. We present a new method which smooths the trajectories of the segmented vertices of the grid phantom as a function of a prior to solving the two-dimensional warping problem. It also shows that the same residual errors of distortion correction could be achieved without fitting the trajectories of the grid vertices, but instead applying the previously described global method of distortion correction, followed by directly smoothing the values of the polynomial coefficients as functions of the C-arm orientation parameters. When this technique was applied to a series of test images at arbitrary alpha, the root-mean-square (RMS) residual error was 0.22 pixels. The new method was extended to three degrees of freedom of the C-arm motion: the primary angle, alpha; the secondary angle, beta; and the source-to-intensifier distance, lambda. Only 75 images were used to characterize the distortion for the following ranges: alpha, +/- 45 degrees (Deltaalpha = 22.5 degrees); beta, +/- 36 degrees (Deltabeta = 18 degrees); lambda, 98-118 cm (Deltalambda = 10 cm). When evaluated on a series of test images acquired at arbitrary (alpha, beta, lambda), the RMS residual error was 0.33 pixels. This method is targeted at applications such as guidance of catheter-based interventions and treatment planning for brachytherapy, which require distortion-corrected images over a large range of C-arm orientations.

Predictive sensor based x-ray calibration using a physical model

Many computer assisted surgery systems are based on intraoperative x-ray images. To achieve reliable and accurate results these images have to be calibrated concerning geometric distortions, which can be distinguished between constant distortions and distortions caused by magnetic fields. Instead of using an intraoperative calibration phantom that has to be visible within each image resulting in overlaying markers, the presented approach directly takes advantage of the physical background of the distortions. Based on a computed physical model of an image intensifier and a magnetic field sensor, an online compensation of distortions can be achieved without the need of an intraoperative calibration phantom. The model has to be adapted once to each specific image intensifier through calibration, which is based on an optimization algorithm systematically altering the physical model parameters, until a minimal error is reached. Once calibrated, the model is able to predict the distortions caused by the measured magnetic field vector and build an appropriate dewarping function. The time needed for model calibration is not yet optimized and takes up to 4 h on a 3 GHz CPU. In contrast, the time needed for distortion correction is less than 1 s and therefore absolutely acceptable for intraoperative use. First evaluations showed that by using the model based dewarping algorithm the distortions of an XRII with a 21 cm FOV could be significantly reduced. The model was able to predict and compensate distortions by approximately 80% to a remaining error of 0.45 mm (max) (0.19 mm rms).

Optimization of three-dimensional angiographic data obtained by self-calibration of multiview imaging

Stroke is one of the leading causes of death in the U.S. The treatment of stroke often involves vascular interventions in which devices are guided to the intervention site often through tortuous vessels based on two-dimensional (2-D) angiographic images. Three dimensional (3-D) vascular information may facilitate these procedures. Methods have been proposed for the self-calibrating determination of 3-D vessel trees from biplane and multiple plane images and the geometric relationships between the views (imaging geometries). For the biplane analysis, four or more corresponding points must be identified in the biplane images. For the multiple view technique, multiple vessels must be indicated and only the translation vectors relating the geometries are calculated. We have developed methods for the calculation of the 3-D vessel data and the full transformations relating the multiple views (rotations and translations) obtained during interventional procedures, and the technique does not require indication of corresponding points, but only the indication of a single vessel, e.g., the vessel of interest. Multiple projection views of vessel trees are obtained and transferred to the analysis computer. The vessel or vessels of interest are indicated by the user. Using the initial imaging geometry determined from the gantry information, 3-D vessel centerlines are calculated using the indicated centerlines in pairs of images. The imaging geometries are then iteratively adjusted and 3-D centerlines recalculated until the root-mean-square (rms) difference between the calculated 3-D centerlines is minimized. Simulations indicate that the 3-D centerlines can be accurately determined (to within 1 mm) even for errors in indication of the vessel endpoints as large as 5 mm. In phantom studies, the average rms difference between the pairwise calculated 3-D centerlines is approximately 7.5 mm prior to refinement (i.e., using the gantry information alone), whereas the average rms difference is usually below 1 mm after refinement. Accuracies and reliabilities of better than 1 mm were also determined by comparing centerlines determined using multiview and rotational angiography reconstruction and clinical data sets. These results indicate that the multiview approach will provide accurate and reliable 3-D centerlines for indicated vessel(s) without increasing the dose to the patient.

A system for real-time XMR guided cardiovascular intervention

The hybrid magnetic resonance (MR)/X-ray suite (XMR) is a recently introduced imaging solution that provides new possibilities for guidance of cardiovascular catheterization procedures. We have previously described and validated a technique based on optical tracking to register MR and X-ray images obtained from the sliding table XMR configuration. The aim of our recent work was to extend our technique by providing an improved calibration stage, real-time guidance during cardiovascular catheterization procedures, and further off-line analysis for mapping cardiac electrical data to patient anatomy. Specially designed optical trackers and a dedicated calibration object have resulted in a single calibration step that can be efficiently checked and updated before each procedure. An X-ray distortion model has been implemented that allows for distortion correction for arbitrary c-arm orientations. During procedures, the guidance system provides a real-time combined MR/X-ray image display consisting of live X-ray images with registered recently acquired MR derived anatomy. It is also possible to reconstruct the location of catheters seen during X-ray imaging in the MR derived patient anatomy. We have applied our registration technique to 13 cardiovascular catheterization procedures. Our system has been used for the real-time guidance of ten radiofrequency ablations and one aortic stent implantation. We demonstrate the real-time guidance using two exemplar cases. In a further two cases we show how off-line analysis of registered image data, acquired during electrophysiology study procedures, has been used to map cardiac electrical measurements to patient anatomy for two different types of mapping catheters. The cardiologists that have used the guidance system suggest that real-time XMR guidance could have substantial value in difficult interventional and electrophysiological procedures, potentially reducing procedure time and delivered radiation dose. Also, the ability to map measured electrical data to patient specific anatomy provides improved visualization and a path to investigation of cardiac electromechanical models.

Correction of XRII geometric distortion using a liquid-filled grid and image subtraction

X-ray image intensifier (XRII) geometric distortion reduces the accuracy of image-guided procedures and quantitative image reconstructions. Due to the dependence of this error on the earth's magnetic field, the required correction is angle dependent, and calibration data should ideally be acquired simultaneously with clinical image data, at a specific orientation. We describe a technique to correct XRII geometric image distortion at any angular position during a stereotactic procedure. This approach uses a machined plastic grid, which contains channels that can be filled with iodinated contrast agent and subsequently flushed with water, providing contrast and mask images, respectively, of a geometric calibration grid. The standard image subtraction capabilities of conventional digital subtraction angiography devices can then be used to create a subtraction image of the iodine-filled channels, without any confounding anatomical structure. Grid-line intersection points are used to determine the control points that are required for a global polynomial correction algorithm, creating a correction map that is specific to the current angular position and XRII field of view (FOV). Tests with a clinical C-arm based XRII show that control points can be obtained with a precision of +/-0.053 mm, resulting in geometric correction accuracy of +/-0.152 mm, at a nominal FOV of 40 cm. While the precision and accuracy are both poorer than that achieved with a high-contrast steel-bead grid, the fact that the liquid grid can remain rigidly attached to the XRII during an entire procedure results in the establishment of an absolute detector coordinate system (referenced to the liquid-filled correction grid). The design of the liquid-filled channels allows the required control points to be introduced into the image or removed in about 30 s, avoiding the appearance of obscuring or confounding markers during clinical image acquisition, with a concurrent increase in patient dose of about 8% in the current design. Applications for this technique include stereotactic surgery, radiosurgery, x-ray stereogrammetry, and other image-guided procedures.

Fluoroscopy-Based 3-D Reconstruction of Femoral Bone Cement: A New Approach for Revision Total Hip Replacement

In revision total hip replacement the removal of the distal femoral bone cement can be a time consuming and risky operation due to the difficulty in determining the three-dimensional (3-D) boundary of the cement. We present a new approach to reconstruct the bone cement volume by using just a small number of calibrated multiplanar X-ray images. The modular system design allows the surgeon to react intraoperatively to problems arising during the individual situation. When encountering problems during conventional cement removal, the system can be used on demand to acquire a few calibrated X-ray images. After a semi-automatic segmentation and 3-D reconstruction of the cement with a deformable model, the system guides the surgeon through a free-hand navigated or robot-assisted cement removal. The experimental evaluation using plastic test implants cemented into anatomic specimen of human femoral bone has shown the potential of this method with a maximal error of 1.2 mm (0.5 mm RMS) for the distal cement based on just 4-5 multiplanar X-ray images. A first test of the complete system, comparing the 3-D-reconstruction with a computed tompgraphy data set, confirmed these results with a mean error about 1 mm.

On the use of C-arm fluoroscopy for treatment planning in high dose rate brachytherapy

Treatment planning for brachytherapy requires the acquisition of geometrical information of the implant applicator and the patient anatomy. This is typically done using a simulator or a computed tomography scanner. In this study, we present a different method by which orthogonal images from a C-arm fluoroscopic machine is used for high dose rate brachytherapy treatment planning. A typical C-arm is not isocentric, and it does not have the mechanical accuracy of a simulator. One solution is to place a reconstruction box with fiducial markers around the patient. However, with the limited clearance of the C-arm this method is very cumbersome to use, and is not suitable for all patients and implant sites. A different approach is adopted in our study. First, the C-arm movements are limited to three directions only between the two orthogonal images: the C-orbital rotation, the vertical column, and the horizontal arm directions. The amounts of the two linear movements and the geometric parameters of the C-arm orbit are used to calculate the location of the crossing point of the two beams and thus the magnification factors of the two images. Second, the fluoroscopic images from the C-arm workstation are transferred in DICOM format to the planning computer through a local area network. Distortions in the fluoroscopic images, with its major component the "pincushion" effect, are numerically removed using a software program developed in house, which employs a seven-parameter polynomial filter. The overall reconstruction accuracy using this method is found to be 2 mm. This filmless process reduces the overall time needed for treatment planning, and greatly improves the workflow for high dose rate brachytherapy procedures. Since its commissioning nearly three years ago, this system has been used extensively at our institution for endobronchial, intracavitary, and interstitial brachytherapy planning with satisfactory results.

Distortion correction for digital subtraction angiography imaging: PC based system for radiosurgery planning

We report, the development of a personal computer (PC) based system to correct distortion of digital subtraction angiography (DSA) images. The program was written in INTERACTIVE DATA LANGUAGE (IDL) and implemented on a PC equipped with an Intel Pentium III 450 MHz CPU in the MICROSOFT WINDOWS 98 environment. The system consists of two modules. The coefficient calculation module detects distortions of grid phantom images automatically and determines the distortion correction function. An additional distortion correction module corrects detected distortion using the correction function determined by the coefficient calculation module. The correction program can be used for images taken at arbitrary lateral oblique angle, and about 4 min are required to correct an image. The correction program was verified using phantom and clinical images. After image correction, the root mean square (rms) deviations of the reference points of each image were calculated. The average value of the rms deviation of all phantom images was about 0.1 mm. The residual mean rms deviation of the corrected clinical images (0.34+/-0.19 mm) and maximum error (0.59+/-0.26 mm) were within the acceptable limits of stereotactic radiosurgery. The accuracy, the ability to process lateral oblique angles, and reasonable program running time makes the developed system a valuable tool in clinical practice, for example for the planning of gamma knife radiosurgery.

A novel approach for distortion correction for X-ray image intensifiers

Applications of X-ray image intensifiers in medical imaging, include the use of fluoroscopic projection images to generate three-dimensional tomographic reconstructions. Unfortunately, the inherent distortions on the acquired projections deteriorate the quality of the reconstructed tomograms. Distortion correction can be performed using algorithms that can be classified as global or local according to the method used, both having specific advantages and disadvantages. In this work, a novel approach for distortion correction is proposed which, by combining both global and local correction methods allows good image quality in relatively acceptable time. Correction parameters were obtained using a calibration phantom specially designed for this purpose.

Hierarchical radial basis function networks and local polynomial un-warping for X-ray image intensifier distortion correction: a comparison with global techniques

Global polynomial (GP) methods have been widely used to correct geometric image distortion of small-size (up to 30 cm) X-ray image intensifiers (XRIIs). This work confirms that this kind of approach is suitable for 40 cm XRIIs (now increasingly used). Nonetheless, two local methods, namely 3rd-order local un-warping polynomials (LUPs) and hierarchical radial basis function (HRBF) networks are proposed as alternative solutions. Extensive experimental tests were carried out to compare these methods with classical low-order local polynomial and GP techniques, in terms of residual error (RMSE) measured at points not used for parameter estimation. Simulations showed that the LUP and HRBF methods had accuracies comparable with that attained using GP methods. In detail, the LUP method (0.353 microm) performed worse than HRBF (0.348 microm) only for small grid spacing (15 x 15 control points); the accuracy of both HRBF (0.157 microm) and LUP (0.160 microm) methods was little affected by local distortions (30 x 30 control points); weak local distortions made the GP method poorer (0.320 microm). Tests on real data showed that LUP and HRBF had accuracies comparable with that of GP for both 30 cm (GP: 0.238 microm; LUP: 0.240 microm; HRBF: 0.238 microm) and 40 cm (GP: 0.164 microm; LUP: 0.164 microm; HRBF: 0.164 microm) XRIIs. The LUP-based distortion correction was implemented in real time for image correction in digital tomography applications.

Distortion correction for x-ray image intensifiers: local unwarping polynomials and RBF neural networks

In this paper we present two novel techniques, namely a local unwarping polynomial (LUP) and a hierarchical radial basis function (HRBF) network, to correct geometric distortions in XRII images. The two techniques have been implemented and compared, in terms of residual error measured at control and intermediate points, with local and global methods reported in the previous literature. In particular, LUP rests on a locally optimized 3rd degree polynomial applied within each quadrilateral cell on the rectilinear calibration grid of points. HRBF, based on a feed-forward neural network paradigm, is constituted by a set of hierarchical layers at increasing cut-off frequency, each characterized by a set of Gaussian functions. Extensive experiments have been performed both on simulated and real data. In simulation, we tested the effect of pincushion, sigmoidal and local distortions, along with the number of calibration points. Provided that a sufficient number of cells of the calibration grid is available, the obtained accuracy for both LUP and HRBF is comparable to or better than that of global polynomial technique. Tests on real data, carried out by using two different (12 in. and 16 in.) XRIIs, showed that the global polynomial accuracy (0.16+/-0.08 pixels) is slightly worse than that of LUP (0.07+/-0.05 pixels) and HRBF (0.08+/-0.04 pixels). The effects of the discontinuity at the border of the local areas and the decreased accuracy at intermediate points, typical of local techniques, have been proved to be smoothed for both LUP and HRBF.

C-Arm imaging for brachytherapy source reconstruction: geometrical accuracy

We study the accuracy of brachytherapy source reconstruction using C-Arm images. We use a phantom embedded with dummy ribbons in a regular pattern, placed at the rotation center of the C-Arm. With a commercial reconstruction jig, radiographic films are taken without the image intensifier. The average error in reconstructed seed coordinates is 0.1 cm. However, the jig is inconvenient for patient procedures. For C-Arm reconstruction without the jig, the magnifications of the image intensifier along orthogonal directions are different. We "stretch" the image to equalize the magnifications. Afterward, seed reconstruction has an average error of 0.1 cm in all directions.

Multiplanar reconstructions and three-dimensional imaging (computed rotational osteography) of complex fractures by using a C-arm system: initial results

With use of a calibrated angiographic C-arm system and a postprocessing workstation, the authors acquired volume data sets from two-dimensional digital projection images obtained during a C-arm rotation around the patient axis. Multiplanar reconstruction and three-dimensional images of complex fractures were reconstructed and compared with spiral computed tomographic studies in a cadaveric pig study and in eight patients. Computed rotational osteography provided high-resolution multiplanar reconstruction and three-dimensional images of complex fractures.

Clinical use of a non-isocentric C-arm unit for on-line filmless reconstruction of brachytherapy applicators

PURPOSE

In this paper it is described how a mobile non-isocentric C-arm can be used to reconstruct brachytherapy applicators using an 'isocentric' imaging set-up without using an orthogonal reconstruction box.

METHODS

The images are on-line digitally transferred to the treatment planning system. In order to determine the physical dimensions of the C-arm a simple method is presented that makes use of the relation between the magnification factor and the translational degrees of freedom of the C-arm. A phantom has been used to determine the overall reconstruction accuracy.

RESULTS

The accuracy in the reconstruction of the distance between two points is better than 2 mm when using radiographs. If digital images are used the maximum error in reconstructed distances equals 3.6 mm for points located in the corners of the field of view, whereas in the central part of the field the errors are less than 2 mm.

Comparison of geometric distortion in digital angiography with and without a correction program

✓ This study was conducted to evaluate the geometric distortion of angiographic images created from a commonly used digital x-ray imaging system and the performance of a commercially available distortion-correction computer program.

A 12 × 12 × 12—cm wood phantom was constructed. Lead shots, 2 mm in diameter, were attached to the surfaces of the phantom. The phantom was then placed inside the angiographic localizer. Cut films (frontal and lateral analog films) of the phantom were obtained. The films were analyzed using GammaPlan target series 4.12. The same procedure was repeated with a digital x-ray imaging system equipped with a computer program to correct the geometric distortion. The distortion of the two sets of digital images was evaluated using the coordinates of the lead shots from the cut films as references.

The coordinates of all lead shots obtained from digital images and corrected by the computer program coincided within 0.5 mm of those obtained from cut films. The average difference is 0.28 mm with a standard deviation of 0.01 mm. On the other hand, the coordinates obtained from digital images with and without correction can differ by as much as 3.4 mm. The average difference is 1.53 mm, with a standard deviation of 0.67 mm.

The investigated computer program can reduce the geometric distortion of digital images from a commonly used x-ray imaging system to less than 0.5 mm. Therefore, they are suitable for the localization of arteriovenous malformations and other vascular targets in gamma knife radiosurgery.