Reference phantom selection in pediatric computed tomography using data from a large, multicenter registry

Background Radiation dose metrics vary by the calibration reference phantom used to report doses. By convention, 16-cm diameter cylindrical polymethyl-methacyrlate phantoms are used for head imaging and 32-cm diameter phantoms are used for body imaging in adults. Actual usage patterns in children remain under-documented. Objective This study uses the University of California San Francisco International CT Dose Registry to describe phantom selection in children by patient age, body region and scanner manufacturer, and the consequent impact on radiation doses. Materials and methods For 106,837 pediatric computed tomography (CT) exams collected between Jan. 1, 2015, and Nov. 2, 2020, in children up to 17 years of age from 118 hospitals and imaging facilities, we describe reference phantom use patterns by body region, age and manufacturer, and median and 75th-percentile dose–length product (DLP) and volume CT dose index (CTDIvol) doses when using 16-cm vs. 32-cm phantoms. Results There was relatively consistent phantom selection by body region. Overall, 98.0% of brain and skull examinations referenced 16-cm phantoms, and 95.7% of chest, 94.4% of abdomen and 100% of cervical-spine examinations referenced 32-cm phantoms. Only GE deviated from this practice, reporting chest and abdomen scans using 16-cm phantoms with some frequency in children up to 10 years of age. DLP and CTDIvol values from 16-cm phantom-referenced scans were 2–3 times higher than 32-cm phantom-referenced scans. Conclusion Reference phantom selection is highly consistent, with a small but significant number of abdomen and chest scans (~5%) using 16-cm phantoms in younger children, which produces DLP values approximately twice as high as exams referenced to 32-cm phantoms

Co-registration Comparison of On-Scalp Magnetoencephalography and Magnetic Resonance Imaging

Magnetoencephalography (MEG) can non-invasively measure the electromagnetic activity of the brain. A new type of MEG, on-scalp MEG, has attracted the attention of researchers recently. Compared to the conventional SQUID-MEG, on-scalp MEG constructed with optically pumped magnetometers is wearable and has a high signal-to-noise ratio. While the co-registration between MEG and magnetic resonance imaging (MRI) significantly influences the source localization accuracy, co-registration error requires assessment, and quantification. Recent studies have evaluated the co-registration error of on-scalp MEG mainly based on the surface fit error or the repeatability error of different measurements, which do not reflect the true co-registration error. In this study, a three-dimensional-printed reference phantom was constructed to provide the ground truth of MEG sensor locations and orientations relative to MRI. The co-registration performances of commonly used three devices—electromagnetic digitization system, structured-light scanner, and laser scanner—were compared and quantified by the indices of final co-registration errors in the reference phantom and human experiments. Furthermore, the influence of the co-registration error on the performance of source localization was analyzed via simulations. The laser scanner had the best co-registration accuracy (rotation error of 0.23° and translation error of 0.76 mm based on the phantom experiment), whereas the structured-light scanner had the best cost performance. The results of this study provide recommendations and precautions for researchers regarding selecting and using an appropriate device for the co-registration of on-scalp MEG and MRI.

Patient-Specific Phantomless Estimation of Bone Mineral Density and Its Effects on Finite Element Analysis Results: A Feasibility Study

Objectives. This study proposes a regression model for the phantomless Hounsfield units (HU) to bone mineral density (BMD) conversion including patient physical factors and analyzes the accuracy of the estimated BMD values. Methods. The HU values, BMDs, circumferences of the body, and cross-sectional areas of bone were measured from 39 quantitative computed tomography images of L2 vertebrae and hips. Then, the phantomless HU-to-BMD conversion was derived using a multiple linear regression model. For the statistical analysis, the correlation between the estimated BMD values and the reference BMD values was evaluated using Pearson’s correlation test. Voxelwise BMD and finite element analysis (FEA) results were analyzed in terms of root-mean-square error (RMSE) and strain energy density, respectively. Results. The HU values and circumferences were statistically significant (p<0.05) for the lumbar spine, whereas only the HU values were statistically significant (p<0.05) for the proximal femur. The BMD values estimated using the proposed HU-to-BMD conversion were significantly correlated with those measured using the reference phantom: Pearson’s correlation coefficients of 0.998 and 0.984 for the lumbar spine and proximal femur, respectively. The RMSEs of the estimated BMD values for the lumbar spine and hip were 4.26 ± 0.60 (mg/cc) and 8.35 ± 0.57 (mg/cc), respectively. The errors of total strain energy were 1.06% and 0.91%, respectively. Conclusions. The proposed phantomless HU-to-BMD conversion demonstrates the potential of precisely estimating BMD values from CT images without the reference phantom and being utilized as a viable tool for FEA-based quantitative assessment using routine CT images.