Gert Van Gompel

Objective. To investigate dynamic shuttle-mode xenon (Xe)-enhanced dual-energy CT (Xe-DECT) imaging for a regional assessment of ventilation in in vivo rabbit lungs. Approach. Four mechanically ventilated rabbits were scanned during the washout of a 70% xenon in 30% oxygen gas mixture using dynamic shuttle-mode DECT at baseline and during methacholine (MCh)-induced bronchoconstriction (post-MCh). Material decomposition was applied to generate xenon and tissue density images (mg ml ⁻¹ ). A tissue-based correction was used to isolate the xenon concentration ( C _Xe ) in the gas phase of the xenon density images. The resultant C _Xe images were used to investigate regional ventilation defects (VDs) by comparing the VD fraction (VDF, expressed as percentage) between baseline and post-MCh conditions. Additionally, regional ventilation efficiency within the VDs and surrounding (non-VD) areas was quantified as specific ventilation ( s V ˙ in min ⁻¹ ). Ventilation was also qualitatively assessed by evaluating ventilation distributions during washout. Main results. MCh-induced bronchoconstriction resulted in an increase in VDF. The average VDF at baseline was 13.8 ± 8.5%, compared to an average post-MCh VDF of 29.6 ± 7.7%, p = 0.026. The VDs at baseline did not reveal a reduced ventilation efficiency ( s V ˙ V D : 8.4 ± 2.7 min ⁻¹ ), compared to non-VD areas ( s V ˙ n o n − V D : 7.0 ± 3.1 min ⁻¹ ), p = 0.306. In contrast, MCh-induced VDs were found to have a reduced ventilation efficiency ( s V ˙ V D : 4.9 ± 2.3 min ⁻¹ ), compared to non-VD areas ( s V ˙ n o n − V D : 6.4 ± 2.3 min ⁻¹ ), p = 0.004 . Significance. Dynamic shuttle-mode Xe-DECT during washout enabled regional evaluation of ventilation in healthy and pathological in vivo rabbit lungs. As traditional lung function tests offer only global assessments of respiratory impairment, there is a growing interest in pulmonary functional imaging to enable quantitative evaluation of regional lung function.

Background: In this study, stent appearance in a novel silicon-based photon-counting computed tomography (Si-PCCT) prototype was compared with a conventional energy-integrating detector CT (EIDCT) system. Methods: An ex vivo phantom was created, consisting of a 2% agar-water mixture, in which human-resected and stented arteries were individually embedded. Using similar technique parameters, helical scan data was acquired using a novel prototype Si-PCCT and a conventional EIDCT system at a volumetric CT dose index (CTDI_vol) of 9 mGy. Reconstructions were made at 50² and 150² mm² field-of-views (FOVs) using a bone kernel and adaptive statistical iterative reconstruction with 0% blending. Using a 5-point Likert scale, reader evaluations were performed on stent appearance, blooming and inter-stent visibility. Quantitative image analysis was performed on stent diameter accuracy, blooming and inter-stent distinction. Qualitative and quantitative differences between Si-PCCT and EIDCT systems were tested with a Wilcoxon signed-rank test and a paired samples t-test, respectively. Inter- and intra-reader agreement was assessed using the intraclass correlation coefficient (ICC). Results: Qualitatively, Si-PCCT images were rated higher than EIDCT images at 150-mm FOV, based on stent appearance (p = 0.026) and blooming (p = 0.015), with a moderate inter- (ICC = 0.50) and intra-reader (ICC = 0.60) agreement. Quantitatively, Si-PCCT yielded more accurate diameter measurements (p = 0.001), reduced blooming (p < 0.001) and improved inter-stent distinction (p < 0.001). Similar trends were observed for the images reconstructed at 50-mm FOV. Conclusions: When compared to EIDCT, the improved spatial resolution of Si-PCCT yields enhanced stent appearance, more accurate diameter measurements, reduced blooming and improved inter-stent distinction. Key points: • This study evaluated stent appearance in a novel silicon-based photon-counting computed tomography (Si-PCCT) prototype. • Compared to standard CT, Si-PCCT resulted in more accurate stent diameter measurements. • Si-PCCT also reduced blooming artefacts and improved inter-stent visibility.

Background: Unoptimized coronary CT angiography (CTA) exams typically result in a highly variable arterial enhancement (HU_a) across patients. This study aimed at harmonizing arterial enhancement by implementing a patient‐, contrast‐ and kV‐tailored injection protocol.Methods: First, the optimal body size metric to predict HU_a was identified by retrospectively analysing images of 76 patients, acquired with 70 ml contrast media (G1). Second, using phantom experiments, correction factors for the effect of kV and contrast concentration on HU_a were determined. Third, a model was developed, prescribing the optimal contrast dose to be injected to obtain a diagnostically appropriate arterial target enhancement HU_target. The model was then validated on 278 prospectively collected patients, in two groups with two different HU_target: 525 HU (207 patients, G2A) and 425 HU (71 patients, G2B). The HU_a histograms were compared among groups and to the target enhancement through their mean and standard deviation (SD) at 100 kVp reference level. Also, signal‐to‐noise ratio was obtained and compared among the groups.Results: Fat free mass (FFM) showed the highest correlation with HU_a (r = 0.69). KVp correction factors ranged from 0.65 at 70 kVp to 1.22 at 140 kVp. The obtained model reduced the group heterogeneity (SD) from 101HU for reference G1 to 75HU (p < 0.001) for G2A and 68HU (p < 0.001) for G2B. The mean HU_a of 506HU in G2A was slightly below HU_target = 525HU (p = 0.01) whereas in G2B, the mean HU_a of 414HU was not significantly different from HU_target = 425HU (p = 0.54). The total iodine dose was lowered from 19.5 g‐I to 17.6 g‐I and 14.2 g‐I from G1 to G2A and G2B, on average.Conclusion: A contrast injection model, based on patient's fat free mass and accounting for the contrast agent concentration and the planned CT‐scan tube voltage, harmonized arterial enhancement among patients towards a predefined target enhancement in coronary CTA scanning, without affecting the bolus timing.

Dynamic computer tomography (CT) is an emerging modality to analyze in-vivo joint kinematics at the bone level, but it requires manual bone segmentation and, in some instances, landmark identification. The objective of this study is to present an automated workflow for the assessment of three-dimensional in vivo joint kinematics from dynamic musculoskeletal CT images. The proposed method relies on a multi-atlas, multi-label segmentation and landmark propagation framework to extract bony structures and detect anatomical landmarks on the CT dataset. The segmented structures serve as regions of interest for the subsequent motion estimation across the dynamic sequence. The landmarks are propagated across the dynamic sequence for the construction of bone embedded reference frames from which kinematic parameters are estimated. We applied our workflow on dynamic CT images obtained from 15 healthy subjects on two different joints: thumb base (n = 5) and knee (n = 10). The proposed method resulted in segmentation accuracies of 0.90 ± 0.01 for the thumb dataset and 0.94 ± 0.02 for the knee as measured by the Dice score coefficient. In terms of motion estimation, mean differences in cardan angles between the automated algorithm and manual segmentation, and landmark identification performed by an expert were below 1°. Intraclass correlation (ICC) between cardan angles from the algorithm and results from expert manual landmarks ranged from 0.72 to 0.99 for all joints across all axes. The proposed automated method resulted in reproducible and reliable measurements, enabling the assessment of joint kinematics using 4DCT in clinical routine.

OBJECTIVE. The purpose of this study is to investigate the contributing effect of contrast media (CM) iodine dose on radiation-induced DNA damage in blood lymphocytes during a cardiac CT scan. MATERIALS AND METHODS. The minipigs were exposed 12 times in total to a fixed cardiac CT scan protocol. An unenhanced and two CM injection protocols were considered, the latter with 50% saline diluted (160 mg I/mL) and standard iodixanol. Blood samples were collected before and after CT, and radiation-induced DNA double-strand breaks were assessed using γ-H2AX (H2A histone family member X) immunofluorescent staining of the blood lymphocytes. Significant differences in foci numbers were investigated with an independent sample t test. In addition, a numeric dosimetry model was applied that simulates the cardiac CT scan, with the heart represented by a blood volume containing a mixture of six iodine concentrations (0, 10, 20, 30, 40, and 50 mg I/mL). RESULTS. Compared with the unenhanced (0 mg I/mL) protocol, the numbe...

Magma intrusions grow to their final geometries by deforming the Earth's crust internally and by displacing the Earth's surface. Interpreting the related displacements in terms of intrusion geometry is key to forecasting a volcanic eruption. While scaled laboratory models enable us to study the relationships between surface displacement and intrusion geometry, past approaches entailed limitations regarding imaging of the laboratory model interior or simplicity of the simulated crustal rheology. Here we apply cutting-edge medical wide beam X-ray Computed Tomography (CT) to quantify in 4D the deformation induced in laboratory models by an intrusion of a magma analog (golden syrup) into a rheologically-complex granular host rock analog (sand and plaster). We extract the surface deformation and we quantify the strain field of the entire experimental volume in 3D over time by using Digital Volume Correlation (DVC). By varying the strength and height of the host material, and intrusion velocity, we observe how intrusions of contrasting geometries grow, and induce contrasting strain field characteristics and surface deformation in 4D. The novel application of CT and DVC reveals that distributed strain accommodation and mixed-mode (opening and shear) fracturing dominates in low-cohesion material overburden, and leads to the growth of thick cryptodomes or cup-shaped intrusions. More localized strain accommodation and opening-mode fracturing dominates in high-cohesion material overburden, and leads to the growth of cone sheets or thin dikes. The results demonstrate how the combination of CT and DVC can greatly enhance the utility of optically non-transparent crustal rock analogs in obtaining insights into shallow crustal deformation processes. This unprecedented perspective on the spatio-temporal interaction of intrusion growth coupled with host material deformation provides a conceptual framework that can be tested by field observations at eroded volcanic systems and by the ever increasing spatial and temporal resolution of geodetic data at active volcanoes.

The objective of the current study was to explore the potential of dynamic computed tomography to detect kinematic changes, induced by sequential sectioning of the lateral collateral ligaments of the ankle, during full motion sequence of the talocrural joint. A custom-made device was used to induce cyclic controlled ankle inversion movement in one fresh frozen cadaver leg. A 256-slice CT scanner was used to investigate four different scenarios. Scenario 1 with all ligaments intact was first investigated followed by sequential section of the anterior talo-fibular ligament (Scenario 2), the calcaneo-fibular ligament (Scenario 3) and posterior talo-fibular ligament (Scenario 4). Off-line image processing based on semi-automatic segmentation and bone rigid registration was performed. Motion parameters such as translation, rotational angles and orientation and position of the axis of rotation were calculated. Differences between scenarios were calculated. Progressive increase of cranio-caudal displacement up to 3.9 mm and flexion up to 10° compared to Scenario 1 were reported. Progressive changes in orientation (up to 20.6°) and position (up to 4.1 mm) of the axis of rotation were also shown. Estimated effective dose of 0.005 mSv (1.9 mGy CTDI_vol) was reported. This study demonstrated that kinematic changes due to the absence of ligament integrity can be detected with 4DCT with minimal radiation exposure. Identifying abnormal kinematic patterns could have future application in helping clinicians to choose patients’ optimal treatment. Therefore, further studies with bigger in vitro sample sizes and consequent investigations in vivo are recommended to confirm the current findings.

The study objective is to investigate the impact of a wide range of contrast media (CM) iodine concentrations on CT enhancement at constant total iodine dose (TID) and iodine delivery rate (IDR). Seven injection protocols, based on different iodine concentrations ranging from 120 to 370 mg I/mL, were assessed on 4 minipigs at a constant TID of 320 mg I/kg and IDR of 0.64 g I/s. Dynamic images were acquired on a clinical 64-slice MDCT scanner for 120 s with the abdominal aorta, vena cava inferior and liver parenchyma in the field-of-view. Maximal enhancement, time-to-peak and peak width were assessed. The enhancement curve characteristics were correlated with CM iodine concentration. In particular, CM with lower iodine concentrations yielded a significant increased maximal enhancement and peak width compared to the standard-of-care concentrations: e.g. in the aorta, 245 HU maximal enhancement and 9.2 s peak width with the 320 mg I/mL iodine concentration increased to 291 HU and 16.1 s with 160 mg I/mL. When maintaining a constant TID and IDR, by compensating injection rate and volume, injection of a CM with reduced iodine concentration results in a diagnostically beneficial higher maximal enhancement and longer enhancement peak duration.