Dynamic Respiratory Motion Imaging of the Pulmonary Parenchyma Using 320-row ADCT

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1 Dynamic Respiratory Motion Imaging of the Pulmonary Parenchyma Using 320-row ADCT Poster No.: C-1241 Congress: ECR 2013 Type: Educational Exhibit Authors: H. Moriya; Fukushima-city/JP Keywords: Lung, Respiratory system, Thorax, CT, Cone beam CT, Diagnostic procedure, Computer Applications-3D, Chronic obstructive airways disease, Cancer DOI: /ecr2013/C-1241 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 25

2 Learning objectives To illustrate the technique of dynamic respiratory scanning using 320-row ADCT. To demonstrate the dose reduction techniques, Adaptive Iterative Dose Reduction (AIDR3D) and a new image-reconstruction method using consecutive temporal images (PhyZiodynamics). To visualize the movements of the pulmonary parenchyma and the techniques of quantify respiratory kinetics. Background With the advent of 320-row ADCT, dynamic volume scanningis now available. However, an increase in radiation exposure is an issue. (fig.1 two types of CT scanning) Recently, the dose reduction techniques, the scanning condition setting for decrease exposure dose, Adaptive Iterative Dose Reduction (AIDR3D) and a post-processed method using non-rigid registration (PhyZiodynamics), has been developed. Therefore, image quality using low-dose scanning is greatly improved, and dynamic respiratory motion images are able to obtain. fig.2 dynamic respiratory scanning images of pig lung phantom fig.3 video images of fig.2 Movements of each lobular structure can be observed during the breathing: expansion and collapse of each lobule. Images for this section: Page 2 of 25

3 Fig. 1: Two types of CT scanning Page 3 of 25

4 Fig. 2: Dynamic respiratory scanning of pig lung phantom Page 4 of 25

5 Fig. 3: Dynamic respiratory motion imaging of pig lung phantom Page 5 of 25

6 Imaging findings OR Procedure details Clinical scanning protocols for respiratory motion In clinical imaging, there are three main methods considered from the viewpoint of reducing radiation exposure dose. (fig.4 Clinical scanning protocols for respiratory motion) 1. Continuous scan: 120 kv, 10 ma, 0.35 s, 1 mm x 160, continuous scan, one breath 2. Intermittent scan: 120 kv, 10-40mA, 0.35 s, 1 mm x 160, x 6 scans, one breath 3. Respiration-gated scan: depending on the number of scans fig.5 dynamic movie of right lung cancer Techniques of radiation dose reduction 1. AIDR3D# Adaptive Iterative Dose Reduction Algorithm (fig.6) AIDR 3D is a noise reduction technique in the raw data space and image data space. Using the AIDR 3D technique can improve image quality in reduced- or low-dose CT scans on patients with pulmonary diseases. Decrease radiation dose by 90-50%. fig.7 ultra-low-dose CT using AIDR3D 2. PhyZiodynamics: Increase image frames and noise reduction using voxel tracking algorithm (fig.8 fig.9) The voxel-to-voxel mapping enables the employment of additional algorithms that reduce noise, improve motion coherence, and measure kinematic function. fig.10 noise reduction effects using voxel tracking algorithm fig.11 increase image frames using voxel tracking algorithm fig.12 repiratory movement usuing original CT data (6 frames) fig.13 repiratory movement usuing voxel tracking algorithm (30 frames) Page 6 of 25

7 Clinical cases fig.14 Ground-grass type Adenocarcinoma fig.15 Solid type Squamous cell carcinoma fig.16 Emphysema: parenchymal movement and air trapping are clearly depicted. fig.17 Chest wall adhesion of lung cancer fig.18 Velocity map of the lung: Velocity of local lung parenchyma can be visualized. These parametric map overlaid on the volume rendered images can be manipulated while in motion. These functional images may be correlated with the lung stiffness. fig.19 case of normal lung function fig.20 case of COPD Images for this section: Page 7 of 25

8 Fig. 4: Clinical scanning protocols for respiratory motion Fig. 5: Dynamic respiratory motion imaging of lung cancer patient Page 8 of 25

9 Fig. 6: AIDR 3D(Adaptive Iterative Dose Reduction 3D) Page 9 of 25

10 Fig. 7: Ultra-low-dose CT using AIDR 3D Page 10 of 25

11 Fig. 8: PhyZiodynamics: 4D registration and voxel tracking algorithm Page 11 of 25

12 Fig. 9: Generation of additional frames by voxel tracking and noise reduction effect Page 12 of 25

13 Fig. 10: Noise reduction effect of PhyZiodynamics Page 13 of 25

14 Fig. 11: PhyZiodynamics: Smooth movement and noise reduction can be obtained Page 14 of 25

15 Fig. 12: Original: 6 frames Page 15 of 25

16 Fig. 13: AIDR3D+PhyZiodynamic: 30 frames Page 16 of 25

17 Fig. 14: Ground-grass PhyZiodynamics type Adenocarcinoma: Smooth movements using Page 17 of 25

18 Fig. 15: Solid PhyZiodynamics type Squamous cell carcinoma: Smooth movements using Page 18 of 25

19 Fig. 16: Emphysema: enhancement of air trapping at expiratory phase Page 19 of 25

20 Fig. 17: Chest wall adhesion of lung cancer: Pendulum movement around the area of invasion or adhesion Page 20 of 25

21 Fig. 18: Velocity map of the lung Page 21 of 25

22 Fig. 19: Normal lung function (hot: moving area, dark: firm area) Page 22 of 25

23 Fig. 20: COPD lung (hot: moving area, dark: firm area) Page 23 of 25

24 Conclusion row ADCT allows dynamic motion images to be obtained in a single breath. These 4D-images are visualized the movements of lung parenchyma. Thus, these dynamic images are useful for the diagnosis of the adhesion/invasion of lung cancer, COPD and many other diseases. 2. The exposure dose can be reduced by employing low-dose (5-20mAs) intermittent scanning using AIDR3D and PhyZiodynamics. 3. Acceptable image quality can be obtained, without any substantial artifacts affecting diagnostic acceptability. And, techniques of quantify respiratory kinetics have been developed. 4. Dynamic respiratory motion Imaging using 320-row ADCT is a respiratory functional imaging that can be clinically applied to many pulmonary diseases. References Arakawa H et al Air trapping on expiratory high-resolution CT scans in the absence of inspiratory scan abnormalities: correlation with pulmonary function tests and differential diagnosis. AJR May 1998 vol. 170 no Nishino, Mizuki Excessive Collapsibility of Bronchi in Bronchiectasis: Evaluation on Volumetric Expiratory High-Resolution CT Journal of Computer Assisted Tomography:May/June Volume 30 - Issue 3 - pp Seiko Shibata, et al Swallowing maneuver analysis using 320-row area detector computed tomography (320-ADCT) Jpn J Compr Rehabil Sci Vol 2, 2011 Acknowledgments Noboru Fujii, Tsunemitsu Horie, Yasuyoshi Satou (Department of Radiology, Ohara General Hospital) Mitsunori Goto, Mitsuya Abe, Tsuyoshi Arai, Jungo Maruichi, Fumio Yamada, Yuuji Kaga, (Department of Radiology, Sendai Kousei Hospital) Keitarou Inazawa (Department of Respiratory Surgery, Sendai Kousei Hospital) Akira Taniguchi, Hiroyasu Inokawa (Toshiba Medical Systems) Tsuyoshi Nagata, Kingo Shichinohe (Ziosoft and Amin Co. Ltd.) Yuusuke Yonemura (Harada Corporation) Page 24 of 25

25 Personal Information H.Moriya, MD, Department of Radiology, Ohara Medical Center, Fukushima, Fukushima, Japan. mail to: Page 25 of 25

CT findings in Differential Diagnosis between Tuberculous Pleurisy and Malignant Effusion

CT findings in Differential Diagnosis between Tuberculous Pleurisy and Malignant Effusion Poster No.: E-0084 Congress: ESTI 2012 Type: Scientific Exhibit Authors: S. S. Shim, Y. Kim; Seoul/KR Keywords: