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Design And Evaluation Of A Catheter Contact-Force Controller For Cardiac Ablation Therapy., Daniel Gelman, Allan C Skanes, Mohammad A Tavallaei, Maria Drangova

Medical Biophysics Publications

GOAL: Maintaining a constant contact force (CF) of an ablation catheter during cardiac catheter ablation therapy is clinically challenging due to inherent myocardial motion, often resulting in poor ablation of arrhythmogenic substrates. To enable a prescribed contact force to be applied during ablation, a catheter contact force controller (CCFC) was developed.

METHODS: The system includes a hand-held device attached to a commercial catheter and steerable sheath. A compact linear motor assembly attaches to an ablation catheter and autonomously controls its relative position within the shaft of the steerable sheath. A closed-loop control system is implemented within embedded electronics to enable …

Effect Of Left Atrial Wall Thickness On Radiofrequency Ablation Success., Jiro Inoue, Allan C Skanes, Lorne J Gula, Maria Drangova

Medical Biophysics Publications

INTRODUCTION: Radiofrequency (RF) ablation in thicker regions of the left atrium (LA) may require increased ablation energy in order to achieve effective transmural lesions. Consequently, many cases of recurrent atrial fibrillation (AF) postablation may be due to thicker-than-normal atrial tissue. The aim of this study was to test the hypotheses that patients with recurrent AF have thicker tissue overall and that electrical reconnection is more likely in regions of thicker tissue.

METHODS AND RESULTS: Retrospective analysis was performed on 86 CT images acquired preoperatively from a cohort of 119 patients who had undergone RF ablation for AF. Of these, 33 …

Postediting Prostate Magnetic Resonance Imaging Segmentation Consistency And Operator Time Using Manual And Computer-Assisted Segmentation: Multiobserver Study, Maysam Shahedi, Derek W. Cool, Cesare Romagnoli, Glenn S. Bauman, Matthew Bastian-Jordan, George Rodrigues, Belal Ahmad, Michael Lock, Aaron Fenster, Aaron D. Ward

Medical Biophysics Publications

Prostate segmentation on T2w MRI is important for several diagnostic and therapeutic procedures for prostate cancer. Manual segmentation is time-consuming, labor-intensive, and subject to high interobserver variability. This study investigated the suitability of computer-assisted segmentation algorithms for clinical translation, based on measurements of interoperator variability and measurements of the editing time required to yield clinically acceptable segmentations. A multioperator pilot study was performed under three pre-and postediting conditions: manual, semiautomatic, and automatic segmentation. We recorded the required editing time for each segmentation and measured the editing magnitude based on five different spatial metrics. We recorded average editing times of 213, …

Carotid Artery Atherosclerosis In Patients With Active Rheumatoid Arthritis: Predictors Of Plaque Occurrence And Progression Over 24 Weeks, Janet E Pope, Tatiana Nevskaya, Lillian Barra, Grace Parraga

Medical Biophysics Publications

INTRODUCTION: This study evaluated the prevalence and progression of subclinical carotid artery atherosclerosis in active rheumatoid arthritis (RA).

METHODS: Carotid arteries of RA patients were scanned using 3D ultrasound at baseline and 24 weeks for total plaque area, vessel wall volume, and intima-media thickness (IMT), as well as arterial stiffness measured using pulse wave velocity. Variables related to inflammation, lipids and cardiovascular (CV) risk were assessed for associations with plaque progression. Of 195 screened patients, 31 met inclusion criteria (66 Swollen joint count (SJC) plus 68 Tender joint count (TJC)≥8 OR SJC plus TJC≥4 with elevated acute phase reactants) and …

Design, Development And Evaluation Of A Compact Telerobotic Catheter Navigation System., Mohammad Ali Tavallaei, Daniel Gelman, Michael Konstantine Lavdas, Allan C Skanes, Douglas L Jones, Jeffrey S Bax, Maria Drangova

Medical Biophysics Publications

BACKGROUND: Remote catheter navigation systems protect interventionalists from scattered ionizing radiation. However, these systems typically require specialized catheters and extensive operator training.

METHODS: A new compact and sterilizable telerobotic system is described, which allows remote navigation of conventional tip-steerable catheters, with three degrees of freedom, using an interface that takes advantage of the interventionalist's existing dexterity skills. The performance of the system is evaluated ex vivo and in vivo for remote catheter navigation and ablation delivery.

RESULTS: The system has absolute errors of 0.1 ± 0.1 mm and 7 ± 6° over 100 mm of axial motion and 360° of …

Hyperpolarized 3he Magnetic Resonance Imaging Ventilation Defects In Asthma: Relationship To Airway Mechanics, Del Leary, Sarah Svenningsen, Fumin Guo, Swati Bhatawadekar, Grace Parraga, Geoffrey N Maksym

Medical Biophysics Publications

In patients with asthma, magnetic resonance imaging (MRI) provides direct measurements of regional ventilation heterogeneity, the etiology of which is not well-understood, nor is the relationship of ventilation abnormalities with lung mechanics. In addition, respiratory resistance and reactance are often abnormal in asthmatics and the frequency dependence of respiratory resistance is thought to reflect ventilation heterogeneity. We acquiredMRIventilation defect maps, forced expiratory volume in one-second (FEV1), and airways resistance (Raw) measurements, and used a computational airway model to explore the relationship of ventilation defect percent (VDP) with simulated measurements of respiratory system resistance (Rrs) and reactance (Xrs).MRIventilation defect maps were …

Enumerating Pelvic Recurrence Following Radical Cystectomy For Bladder Cancer: A Canadian Multi-Institutional Study, Libni J. Eapen, Edward Jones, Wassim Kassouf, Carole Lambert, Scott C. Morgan, Madeleine Moussa, Robert Nam, Matthew Parliament, Laurie Russell, Fred Saad, D. Robert Siemens, Luis Souhami, Ewa Szumacher, Scott Tyldesley, Yan Xu, Ingrid Zbieranowski, Rodney H. Breau, Eric Belanger, Peter Black, Eric Estey, Julie Bowan, Bishwajit Bora, Michael Brundage, Peter Chung, Neil Fleshner, Andrew Evans, Glenn Bauman, Jonathan Izawa, Chris Davidson, Fadi Brimo

Medical Biophysics Publications

Introduction: We aimed to enumerate the rate of pelvic recurrence following radical cystectomy at university-affiliated hospitals in Canada. Methods: Canadian, university-affiliated hospitals were invited to participate. They were asked to identify the first 10 consecutive patients undergoing radical cystectomy starting January 1, 2005, who had urothelial carcinoma stages pT3/T4 N0-2 M0. The first 10 consecutive cases starting January 1, 2005 who met these criteria were the patients submitted by that institution with information regarding tumour stage, age, number of nodes removed, and last known clinical status in regard to recurrence and patterns of failure. Results: Of the 111 patients, 80% …

Evaluation Of Ct Perfusion Biomarkers Of Tumor Hypoxia, Qi Qi, Timothy Pok Chi Yeung, Ting Yim Lee, Glenn Bauman, Cathie Crukley, Laura Morrison, Lisa Hoffman, Slav Yartsev

Medical Biophysics Publications

Background Tumor hypoxia is associated with treatment resistance to cancer therapies. Hypoxia can be investigated by immunohistopathologic methods but such procedure is invasive. A noninvasive method to interrogate tumor hypoxia is an attractive option as such method can provide information before, during, and after treatment for personalized therapies. Our study evaluated the correlations between computed tomography (CT) perfusion parameters and immunohistopathologic measurement of tumor hypoxia. Methods Wistar rats, 18 controls and 19 treated with stereotactic radiosurgery (SRS), implanted with the C6 glioma tumor were imaged using CT perfusion on average every five days to monitor tumor growth. A final CT …

Pulmonary Ct And Mri Phenotypes That Help Explain Chronic Pulmonary Obstruction Disease Pathophysiology And Outcomes, Eric A Hoffman, David A Lynch, R Graham Barr, Edwin J R Van Beek, Grace Parraga

Medical Biophysics Publications

Pulmonary x-ray computed tomographic (CT) and magnetic resonance imaging (MRI) research and development has been motivated, in part, by the quest to subphenotype common chronic lung diseases such as chronic obstructive pulmonary disease (COPD). For thoracic CT and MRI, the main COPD research tools, disease biomarkers are being validated that go beyond anatomy and structure to include pulmonary functional measurements such as regional ventilation, perfusion, and inflammation. In addition, there has also been a drive to improve spatial and contrast resolution while at the same time reducing or eliminating radiation exposure. Therefore, this review focuses on our evolving understanding of …

Imaging How And Where We Breathe Oxygen: Another Big Short?, Dante P I Capaldi, Fumin Guo, Grace Parraga

Medical Biophysics Publications

The Big Short tells the story of a small group of skeptics who profited from the financial crisis in 2007 by betting against collateralized (mortgage) debt obligations (CDO). Importantly, the novel paints a clear picture of the eccentric nature of contrarians who think divergently and against the grain or bet against an accepted truth or “sure” thing. In a similar manner, Ishii and co-workers’ recent work describes their team’s development of a pulmonary imaging technology that provides divergent and disruptive in vivo lung measurements of oxygen partial pressure in the context of the prevailing and longstanding consensus around FEV1 as …

This Is What Copd Looks Like, Khadija Sheikh, Harvey O Coxson, Grace Parraga

Medical Biophysics Publications

Despite decades of research, and the growing healthcare and societal burden of chronic obstructive pulmonary disease (COPD), therapeutic COPD breakthroughs have not occurred. Sub-optimal COPD patient phenotyping, an incomplete understanding of COPD pathogenesis and a scarcity of sensitive tools that provide patient-relevant intermediate endpoints likely all play a role in the lack of new, efficacious COPD interventions. In other words, COPD patients are still diagnosed based on the presence of persistent airflow limitation measured using spirometry. Spirometry measurements reflect the global sum of all the different possible COPD pathologies and perhaps because of this, we lose sight of the different …

Pulmonary Imaging Biomarkers Of Gas Trapping And Emphysema In Copd: (3)He Mr Imaging And Ct Parametric Response Maps, Dante P I Capaldi, Nanxi Zha, Fumin Guo, Damien Pike, David G Mccormack, Miranda Kirby, Grace Parraga

Medical Biophysics Publications

PURPOSE: To directly compare magnetic resonance (MR) imaging and computed tomography (CT) parametric response map (PRM) measurements of gas trapping and emphysema in ex-smokers both with and without chronic obstructive pulmonary disease (COPD).

MATERIALS AND METHODS: Participants provided written informed consent to a protocol that was approved by a local research ethics board and Health Canada and was compliant with the HIPAA (Institutional Review Board Reg. #00000940). The prospectively planned study was performed from March 2014 to December 2014 and included 58 ex-smokers (mean age, 73 years ± 9) with (n = 32; mean age, 74 years ± 7) and …

Design And Evaluation Of An Mri-Compatible Linear Motion Stage., Mohammad Ali Tavallaei, Patricia M Johnson, Junmin Liu, Maria Drangova

Medical Biophysics Publications

PURPOSE: To develop and evaluate a tool for accurate, reproducible, and programmable motion control of imaging phantoms for use in motion sensitive magnetic resonance imaging (MRI) appli cations.

METHODS: In this paper, the authors introduce a compact linear motion stage that is made of nonmagnetic material and is actuated with an ultrasonic motor. The stage can be positioned at arbitrary positions and orientations inside the scanner bore to move, push, or pull arbitrary phantoms. Using optical trackers, measuring microscopes, and navigators, the accuracy of the stage in motion control was evaluated. Also, the effect of the stage on image signal-to-noise …

Cogstate Computerized Memory Tests In Patients With Brain Metastases: Secondary Endpoint Results Of Nrg Oncology Rtog 0933, Chip Caine, Snehal Deshmukh, Vinai Gondi, Minesh Mehta, Wolfgang Tomé, Benjamin W. Corn, Andrew Kanner, Howard Rowley, Vijayananda Kundapur, Albert Denittis, Jeffrey Noah Greenspoon, Andre A. Konski, Glenn S. Bauman, Adam Raben, Wenyin Shi, Merideth Wendland, Lisa Kachnic

Medical Biophysics Publications

Whole brain radiotherapy (WBRT) is associated with memory dysfunction. As part of NRG Oncology RTOG 0933, a phase II study of WBRT for brain metastases that conformally avoided the hippocampal stem cell compartment (HA-WBRT), memory was assessed pre-and post-HA-WBRT using both traditional and computerized memory tests. We examined whether the computerized tests yielded similar findings and might serve as possible alternatives for assessment of memory in multi-institution clinical trials. Adult patients with brain metastases received HA-WBRT to 30 Gy in ten fractions and completed Hopkins Verbal Learning Test-Revised (HVLT-R), CogState International Shopping List Test (ISLT) and One Card Learning Test …

Target Margins In Radiotherapy Of Prostate Cancer, Slav Yartsev, Glenn Bauman

Medical Biophysics Publications

We reviewed the literature on the use of margins in radiotherapy of patients with prostate cancer, focusing on different options for image guidance (IG) and technical issues. The search in PubMed database was limited to include studies that involved external beam radiotherapy of the intact prostate. Post-prostatectomy studies, brachytherapy and particle therapy were excluded. Each article was characterized according to the IG strategy used: positioning on external marks using room lasers, bone anatomy and soft tissue match, usage of fiducial markers, electromagnetic tracking and adapted delivery. A lack of uniformity in margin selection among institutions was evident from the review. …