Iterative image reconstruction algorithm analysis for optical CT radiochromic gel dosimetry

Background.Modern radiation therapy technologies aim to enhance radiation dose precision to the tumor and utilize hypofractionated treatment regimens. Verifying the dose distributions associated with these advanced radiation therapy treatments remains an active research area due to the complexity of delivery systems and the lack of suitable three-dimensional dosimetry tools. Gel dosimeters are a potential tool for measuring these complex dose distributions. A prototype tabletop solid-tank fan-beam optical CT scanner for readout of gel dosimeters was recently developed. This scanner does not have a straight raypath from source to detector, thus images cannot be reconstructed using filtered backprojection (FBP) and iterative techniques are required.Purpose.To compare a subset of the top performing algorithms in terms of image quality and quantitatively determine the optimal algorithm while accounting for refraction within the optical CT system. The following algorithms were compared: Landweber, superiorized Landweber with the fast gradient projection perturbation routine (S-LAND-FGP), the fast iterative shrinkage/thresholding algorithm with total variation penalty term (FISTA-TV), a monotone version of FISTA-TV (MFISTA-TV), superiorized conjugate gradient with the nonascending perturbation routine (S-CG-NA), superiorized conjugate gradient with the fast gradient projection perturbation routine (S-CG-FGP), superiorized conjugate gradient with with two iterations of CG performed on the current iterate and the nonascending perturbation routine (S-CG-2-NA).Methods.A ray tracing simulator was developed to track the path of light rays as they traverse the different mediums of the optical CT scanner. Two clinical phantoms and several synthetic phantoms were produced and used to evaluate the reconstruction techniques under known conditions. Reconstructed images were analyzed in terms of spatial resolution, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), signal non-uniformity (SNU), mean relative difference (MRD) and reconstruction time. We developed an image quality based method to find the optimal stopping iteration window for each algorithm. Imaging data from the prototype optical CT scanner was reconstructed and analysed to determine the optimal algorithm for this application.Results.The optimal algorithms found through the quantitative scoring metric were FISTA-TV and S-CG-2-NA. MFISTA-TV was found to behave almost identically to FISTA-TV however MFISTA-TV was unable to resolve some of the synthetic phantoms. S-CG-NA showed extreme fluctuations in the SNR and CNR values. S-CG-FGP had large fluctuations in the SNR and CNR values and the algorithm has less noise reduction than FISTA-TV and worse spatial resolution than S-CG-2-NA. S-LAND-FGP had many of the same characteristics as FISTA-TV; high noise reduction and stability from over iterating. However, S-LAND-FGP has worse SNR, CNR and SNU values as well as longer reconstruction time. S-CG-2-NA has superior spatial resolution to all algorithms while still maintaining good noise reduction and is uniquely stable from over iterating.Conclusions.Both optimal algorithms (FISTA-TV and S-CG-2-NA) are stable from over iterating and have excellent edge detection with ESF MTF 50% values of 1.266 mm-1and 0.992 mm-1. FISTA-TV had the greatest noise reduction with SNR, CNR and SNU values of 424, 434 and 0.91 × 10-4, respectively. However, low spatial resolution makes FISTA-TV only viable for large field dosimetry. S-CG-2-NA has better spatial resolution than FISTA-TV with PSF and LSF MTF 50% values of 1.581 mm-1and 0.738 mm-1, but less noise reduction. S-CG-2-NA still maintains good SNR, CNR, and SNU values of 168, 158 and 1.13 × 10-4, respectively. Thus, S-CG-2-NA is a well rounded reconstruction algorithm that would be the preferable choice for small field dosimetry.

Iterative image reconstruction with polar coordinate discretized system matrix for optical CT radiochromic gel dosimetry

BACKGROUND

Gel dosimeters are a potential tool for measuring the complex dose distributions that characterize modern radiotherapy. A prototype tabletop solid-tank fan-beam optical CT scanner for readout of gel dosimeters was recently developed. This scanner does not have a straight raypath from source to detector, thus images cannot be reconstructed using filtered backprojection (FBP) and iterative techniques are required. Iterative image reconstruction requires a system matrix that describes the geometry of the imaging system. Stored system matrices can become immensely large, making them impractical for storage on a typical desktop computer.

PURPOSE

Here we develop a method to reduce the storage size of optical CT system matrices through use of polar coordinate discretization while accounting for the refraction in optical CT systems.

METHODS

A ray tracing simulator was developed to track the path of light rays as they traverse the different mediums of the optical CT scanner. Cartesian coordinate discretized system matrices (CCDSMs) and polar coordinate discretized system matrices (PCDSMs) were generated by discretizing the reconstruction area of the optical CT scanner into a Cartesian pixel grid and a polar coordinate pixel grid, respectively. The length of each ray through each pixel was calculated and used to populate the system matrices. To ensure equal weighting during iterative reconstruction, the radial rings of PCDSMs were asymmetrically spaced such that the area of each polar pixel was constant. Two clinical phantoms and several synthetic phantoms were produced and used to evaluate the reconstruction techniques under known conditions. Reconstructed images were analyzed in terms of spatial resolution, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), signal nonuniformity (SNU), and Gamma map pass percentage.

RESULTS

A storage size reduction of 99.72% was found when comparing a PCDSM to a CCDSM with the same total number of pixels. Images reconstructed with a PCDSM were found to have superior SNR, CNR, SNU, and Gamma (1 mm, 1%) pass percentage compared to those reconstructed with a CCDSM. Increasing spatial resolution in the radial direction with increasing radial distance was found in both PCDSM and CCDSM reconstructions due to the outer regions refracting light more severely. Images reconstructed with a PCDSM showed a decrease in spatial resolution in the azimuthal directions as radial distance increases, due to the widening of the polar pixels. However, this can be mitigated with only a slight increase in storage size by increasing the number of projections. A loss of spatial resolution in the radial direction within 5 mm radially from center was found when reconstructing with a PCDSM, due to the large innermost pixels. However, this was remedied by increasing the number of radial rings within the PCDSM, yielding radial spatial resolution on par with images reconstructed with a CCDSM and a storage size reduction of 99.26%.

CONCLUSIONS

Discretizing the image pixel elements in polar coordinates achieved a system matrix storage size reduction of 99.26% with only minimal reduction in the image quality.

Commissioning of a solid tank design for fan-beam optical CT based 3D radiation dosimetry

Objective.Optical computed tomography (CT) is one of the leading modalities for imaging gel dosimeters used in the verification of complex radiotherapy treatments. In previous work, a novel fan-beam optical CT scanner design was proposed that could significantly reduce the volume of the refractive index baths that are commonly found in optical CT systems. Here, the proposed scanner has been manufactured and commissioned.Approach.Image reconstruction is performed through algebraic reconstruction technique and iterated using the fast iterative shrinkage-thresholding algorithm (FISTA) algorithm. Ray tracing for algebraic reconstruction was performed using an in-house developed ray tracing simulator. A set of Sylgard® 184 phantoms were created to commission spatial resolution, geometric deformity, contrast-to-noise ratio (CNR), and scan settings.Main Results.The scanner is capable of a 0.929 mm-1spatial resolution, observed at 200 iterations, although the spatial resolution is highly dependent on the number of iterations. The geometric distortion, measured by scanning a needle phantom with the prototype scanner as well as a conventional x-ray CT was found to be within <0.25 mm. The CNR was found to peak between 65 and 190 occurring between 50 and 100 iterations and was highly dependent on the region chosen for background noise calculation. The proposed scanner is capable of scanning and reading out slices in less than 1 min per slice.Significance.This work displays the viability of a fan-beam optical CT scanner with minimal index matching using ray-traced algebraic reconstruction.

Superiorization versus regularization: A comparison of algorithms for solving image reconstruction problems with applications in computed tomography

PURPOSE

A system matrix can be built in order to account for the refractions in an optical computed tomography (CT) system. In order to utilize this system matrix, iterative methods are employed to solve the image reconstruction problem. The purpose of this study is to compare potential iterative algorithms to solve this image reconstruction problem. Comparisons examine both solution time and the quality of the reconstructed image. While our work is motivated by optical CT, the results can be extended more generally to CT.

METHODS

A collection of 21 algorithms for solving the image reconstruction problem were evaluated. Specifically, algorithms using (i) superiorization techniques and (ii) regularization to avoid overfitting were compared. Multiple test problems are investigated using 18 different image phantoms, parallel-beam and fan-beam system matrices, and varying noise levels. Comparison of the algorithms is done using performance profiles on three different performance measures.

RESULTS

The results for both the synthetic and clinical test problems show that there is not one single algorithm outperforming all others, but instead a set of top algorithms that give the best values on the performance profiles. When qualitative analyses such as reliance on stopping conditions, number of input parameters, and run time are also considered, FISTA-TV shows slight advantages over the other top algorithms.

CONCLUSIONS

There is a set of top algorithms that all show good results in the performance profiles with a mix of superiorized and regularized model algorithms. As to which of these top algorithms outperforms the rest is undetermined and further research needs to be investigated.

Optimization of solid tank design for fan-beam optical CT based 3D radiation dosimetry

Optical computed tomography (CT) is one of the leading modalities for imaging gel dosimeters for 3D radiation dosimetry. There exist multiple scanner designs that have showcased excellent 3D dose verification capabilities of optical CT gel dosimetry. However, due to multiple experimental and reconstruction based factors there is currently no single scanner that has become a preferred standard. A significant challenge with setup and maintenance can be attributed to maintaining a large refractive index bath (1-15 l). In this work, a prototype solid 'tank' optical CT scanner is proposed that minimizes the volume of refractive index bath to between 10 and 35 ml. A ray-path simulator was created to optimize the design such that the solid tank geometry maximizes light collection across the detector array, maximizes the volume of the dosimeter scanned, and maximizes the collected signal dynamic range. An objective function was created to score possible geometries, and was optimized to find a local maximum geometry score from a set of possible design parameters. The design parameters optimized include the block length x _bl , bore position x _bc , fan-laser position x _lp , lens block face semi-major axis length x _ma , and the lens block face eccentricity x _be . For the proposed design it was found that each of these parameters can have a significant effect on the signal collection efficacy within the scanner. Simulations scores are specific to the attenuation characteristics and refractive index of a simulated dosimeter. It was found that for a FlexyDos3D dosimeter, the ideal values for each of the five variables were: x _bl = 314 mm, x _bc = 6.5 mm, x _lp = 50 mm, x _ma = 66 mm, and x _be = 0. In addition, a ClearView^™ dosimeter was found to have ideal values at: x _bl = 204 mm, x _bc = 13 mm, x _lp = 58 mm, x _ma = 69 mm, and x _be = 0. The ray simulator can also be used for further design and testing of new, unique and purpose-built optical CT geometries.

Electrophysiological and Histological Measures of Retinal Injury in Chronic Ocular Hypertensive Monkeys

PURPOSE

This study was performed to determine whether components of the standard ERG (electroretinogram), multifocal ERG, and flash VECP (visually-evoked cortical potential) response might provide a sensitive measure of retinal ganglion cell injury in a monkey model for chronic ocular hypertension.

METHODS

Argon laser treatment of the aqueous outflow tissue was used to induce chronic elevation of intraocular pressure (IOP) in the right eye of 18 young adult cynomolgous monkeys. At 15 months post- IOP elevation, standard methods were used to record ERG and VECP responses. Multifocal ERG responses were also recorded at this time. Loss of retinal ganglion cells due to ocular hypertensive injury was determined by histological analysis of all retinas.

RESULTS

Ocular hypertensive retinal injury was associated with a loss of retinal ganglion cells. There was no histological or electrophysiological evidence for injury to any other retinal cell type. Correlation of electrophysiological response amplitudes with histological measures of retinal ganglion cell loss/survival yielded results which suggest that activity in retinal ganglion cells makes a substantial contribution to components of the 30 Hz flicker ERG, the flash VECP, and both first and second order multifocal ERG responses. Of the electrophysiological measures used in this study, multifocal ERG response amplitude had the greatest sensitivity to retinal ganglion cell loss.

CONCLUSIONS

Components of the multifocal ERG provide a sensitive measure of ganglion cell injury in a monkey model of chronic ocular hypertension. These same measures may have utility in the clinical diagnosis and management of glaucoma.

Dichotomization: 2 x 2 (x2 x 2 x 2...) categories: infinite possibilities

BACKGROUND

Consumers of epidemiology may prefer to have one measure of risk arising from analysis of a 2-by-2 table. However, reporting a single measure of association, such as one odds ratio (OR) and 95% confidence interval, from a continuous exposure variable that was dichotomized withholds much potentially useful information. Results of this type of analysis are often reported for one such dichotomization, as if no other cutoffs were investigated or even possible.

METHODS

This analysis demonstrates the effect of using different theory and data driven cutoffs on the relationship between body mass index and high cholesterol using National Health and Nutrition Examination Survey data. The recommended analytic approach, presentation of a graph of ORs for a range of cutoffs, is the focus of most of the results and discussion.

RESULTS

These cutoff variations resulted in ORs between 1.1 and 1.9. This allows investigators to select a result that either strongly supports or provides negligible support for an association; a choice that is invisible to readers. The OR curve presents readers with more information about the exposure disease relationship than a single OR and 95% confidence interval.

CONCLUSION

As well as offering results for additional cutoffs that may be of interest to readers, the OR curve provides an indication of whether the study focuses on a reasonable representation of the data or outlier results. It offers more information about trends in the association as the cutoff changes and the implications of random fluctuations than a single OR and 95% confidence interval.

Efficacy and Safety of Memantine, an NMDA-Type Open-Channel Blocker, for Reduction of Retinal Injury Associated with Experimental Glaucoma in Rat and Monkey

Glutamatergic excitotoxicity has been implicated as a mechanism for injury in a variety of central nervous system pathologies, including glaucoma. Memantine, an NMDA-type glutamatergic open-channel blocker, has pharmacologic properties that make its efficacy greater under excitotoxic conditions, but lesser under normal conditions. Daily oral dosing for approximately 15 months with 4.0 mg/kg memantine in monkeys yielded plasma concentrations similar to those found in patients who received memantine treatment for Parkinson's disease. This same dose of memantine was not associated with any evidence of an effect on the normal function of the retina and central visual pathways, as indicated by measures of the electroretinogram (ERG) and visually-evoked cortical potential (VECP). Amplitude of the VECP response was reduced in eyes with experimentally induced glaucoma. When compared to vehicle-treated control animals, memantine-treated glaucoma eyes suffered significantly less reduction of VECP amplitude. Preliminary results in a rat model for experimental glaucoma also show that, when compared to control animals, systemic treatment with memantine (10 mg/kg/day) was associated with a significant reduction in glaucoma-induced loss of retinal ganglion cells.

Relationship of optic disc topography to optic nerve fiber number in glaucoma

OBJECTIVE

To assess the relationship between in vivo measurements of optic disc topography and histomorphometric measurements of optic nerve fiber number in glaucoma.

METHODS

Both eyes of 10 monkeys (Macaca fascicularis) with laser-induced glaucoma in the right eye were studied. Optic disc topography was measured in vivo with a confocal scanning laser ophthalmoscope. Histomorphometry was performed on optic nerve cross sections using bright-field microscopy with camera lucida. Nerve fiber density was estimated by unbiased random sampling. Nerve fiber number was estimated for each sector by multiplying nerve fiber density with neuroglial area. Nerve fiber count was compared with each of 13 global optic disc topographic parameters.

RESULTS

For neuroretinal measurements in the glaucomatous eyes, rim area, retinal nerve fiber layer (RNFL) cross-sectional area, rim volume, and RNFL thickness correlated significantly with optic nerve fiber number. Differences in nerve fiber count between control and glaucomatous optic nerves showed the strongest correlation with differences in mean height contour; this was followed by RNFL cross-sectional area, RNFL thickness, rim volume, and differences in rim area. For cup measurements in the glaucomatous eyes, cup volume below reference, cup area, mean cup depth, the ratio of cup area to disc area, and cup shape correlated significantly with nerve fiber number. Differences in nerve fiber number between control and glaucomatous optic nerves showed the strongest correlation with differences in cup shape; this was followed by mean cup depth, cup volume below reference, the ratio of cup area to disc area, cup area, and differences in cup volume below surface. No association was found between optic nerve fiber number and optic disc area in glaucomatous eyes.

CONCLUSIONS

In experimental glaucoma, most optic disc topography measures correlated significantly with optic nerve fiber number. The results of this histomorphometric study support the use of confocal scanning laser ophthalmoscopy to evaluate optic nerve damage in glaucoma.

A serious source of error in antiglobulin testing

The investigation of a failure of proficiency showed that certain saline solutions are inappropriate for use in blood group serology tests. In particular, it was found that solutions of unexpectedly low pH and/or those autoclaved and stored in plastic containers could severely compromise the sensitivity of the antiglobulin test when used as wash solutions. The observed loss of sensitivity ranged from a reduction in titration score to a complete failure in the detection of clinically significant blood group antibodies. It is suggested that careful consideration should be given to the source, pH, and storage container of saline solutions intended for use in serological tests and that improved standardization and sensitivity could be achieved by using phosphate-buffered saline pH 7.0 to 7.2 for all such purposes. It is recommended that unbuffered saline solutions of pH less than 6.0 should not be used for serological testing.