Journal of X-Ray Science and Technology - Volume 28, issue 1

Authors: Wang, Yu | Wu, Bo | Zhang, Nan | Liu, Jiabao | Ren, Fei | Zhao, Liqin

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Since CAD (Computer Aided Diagnosis) system can make it easier and more efficient to interpret CT (Computer Tomography) images, it has gained much attention and developed rapidly in recent years. This article reviews recent CAD techniques for pulmonary nodule detection and diagnosis in CT Images. METHODS: CAD systems can be classified into computer-aided detection (CADe) and computer-aided diagnosis (CADx) systems. This review reports recent researches of both systems, including the database, technique, innovation and experimental results of each work. Multi-task CAD systems, which can handle segmentation, false positive reduction, malignancy prediction and other tasks at …the same time. The commercial CAD systems are also briefly introduced. RESULTS: We have found that deep learning based CAD is the mainstream of current research. The reported sensitivity of deep learning based CADe systems ranged between 80.06% and 94.1% with an average 4.3 false-positive (FP) per scan when using LIDC-IDRI dataset, and between 94.4% and 97.9% with an average 4 FP/scan when using LUNA16 dataset, respectively. The overall accuracy of deep learning based CADx systems ranged between 86.84% and 92.3% with an average AUC of 0.956 reported when using LIDC-IDRI dataset. CONCLUSIONS: We summarized the current tendency and limitations as well as future challenges in this field. The development of CAD needs to meet the rigid clinical requirements, such as high accuracy, strong robustness, high efficiency, fine-grained analysis and classification, and to provide practical clinical functions. This review provides helpful information for both engineering researchers and radiologists to learn the latest development of CAD systems. Show more

Keywords: Pulmonary nodules, computer-aided detection (CADe), computer-aided diagnosis (CADx), multi-task CAD

DOI: 10.3233/XST-190581

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 1-16, 2020

Authors: Wang, Zhiqiong | Xin, Junchang | Huang, Yukun | Xu, Ling | Ren, Jie | Zhang, Hao | Qian, Wei | Zhang, Xia | Liu, Jiren

Article Type: Research Article

Abstract: BACKGROUND: Breast cancer is one of the most important malignant tumors among women causing a serious impact on women’s lives and mammography is one the most important methods for breast examination. When diagnosing the breast disease, radiologists sometimes may consult some previous diagnosis cases as a reference. But there are many previous cases and it is important to find which cases are the similar cases, which is a big project costing lots of time. Medical image retrieval can provide objective reference information for doctors to diagnose disease. The method of fusing deep features can improve the retrieval accuracy, which solves …the “semantic gap” problem caused by only using content features and location features. METHODS: A similarity measure method combining deep feature for mammogram retrieval is proposed in this paper. First, the images are pre-processed to extract the low-level features, including content features and location features. Before extracting location features, registration with the standard image is performed. Then, the Convolutional Neural Network, the Stacked Auto-encoder Network, and the Deep Belief Network are built to extract the deep features, which are regarded as high-level features. Next, content similarity and deep similarity are calculated separately using the Euclidean distance between the query image and the dataset images. The location similarity is obtained by calculating the ratio of intersection to union of the mass regions. Finally, content similarity, location similarity, and deep similarity are fused to form the image fusion similarity. According to the similarity, the specified number of the most similar images can be returned. RESULTS: In the experiment, 740 MLO mammograms are used, which are from women in Northeast China. The content similarity, location similarity, and deep similarity are fused by different weight coefficients. When only considering low-level features, the results are better with fusing 60% content feature similarity and 40% lesion location feature similarity. On this basis, CNN deep similarity, DBN deep similarity, and SAE deep similarity are fused separately. The experiments show that when fusing 60% DBN deep feature similarity and 40% low-level feature similarity, the results have obvious advantages. At this time, the precision is 0.745, recall is 0.850, comprehensive evaluation index is 0.794. CONCLUSIONS: We propose a similarity measure method fusing deep feature, content feature, and location feature. The retrieval results show that the precision and recall of this method have obvious advantage, compared with the content-based image retrieval and location-based image retrieval. Show more

Keywords: Breast cancer, image retrieval, similarity measure, deep feature, mammograms

DOI: 10.3233/XST-190575

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 17-33, 2020

Authors: Wang, Qian | Ismail, Khalid N. | Breckon, Toby P.

Article Type: Research Article

Abstract: BACKGROUND: The screening of baggage using X-ray scanners is now routine in aviation security with automatic threat detection approaches, based on 3D X-ray computed tomography (CT) images, known as Automatic Threat Recognition (ATR) within the aviation security industry. These current strategies use pre-defined threat material signatures in contrast to adaptability towards new and emerging threat signatures. To address this issue, the concept of adaptive automatic threat recognition (AATR) was proposed in previous work. OBJECTIVE: In this paper, we present a solution to AATR based on such X-ray CT baggage scan imagery. This aims to address the issues of …rapidly evolving threat signatures within the screening requirements. Ideally, the detection algorithms deployed within the security scanners should be readily adaptable to different situations with varying requirements of threat characteristics (e.g., threat material, physical properties of objects). METHODS: We tackle this issue using a novel adaptive machine learning methodology with our solution consisting of a multi-scale 3D CT image segmentation algorithm, a multi-class support vector machine (SVM) classifier for object material recognition and a strategy to enable the adaptability of our approach. Experiments are conducted on both open and sequestered 3D CT baggage image datasets specifically collected for the AATR study. RESULTS: Our proposed approach performs well on both recognition and adaptation. Overall our approach can achieve the probability of detection around 90% with a probability of false alarm below 20%. CONCLUSIONS: Our AATR shows the capabilities of adapting to varying types of materials, even the unknown materials which are not available in the training data, adapting to varying required probability of detection and adapting to varying scales of the threat object. Show more

Keywords: Adaptive automatic threat recognition, X-ray computed tomography, Image segmentation, Baggage security screening, Automatic threat detection

DOI: 10.3233/XST-190531

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 35-58, 2020

Authors: Gorji, Kourosh Ebrahimnejad | Sadat-Mirkazemi, Maryam | Banaei, Amin | Abedi-Firouzjah, Razzagh | Afkhami-Ardekani, Mahdieh | Ataei, Gholamreza

Article Type: Research Article

Abstract: BACKGROUND: Rectum and bladder are hallow structures and considered as critical organs in prostate cancer intensity modulated radiotherapy (IMRT). Therefore, dose received by these organ walls must be considered for prediction of radiobiological effects. Contouring the real organ walls is quite difficult and time consuming in CT/MRI images, so the easy contouring artificial walls with uniform thickness could be appropriated alternatives. OBJECTIVE: To compare reconstructed artificial walls with real walls of bladder and rectum in common prostate IMRT techniques based on dose volume-histograms (DVHs) derived from artificial and real walls. METHODS: Artificial walls were reconstructed with …2–10 mm and 2–8 mm thicknesses for bladder and rectum, respectively. Four common IMRT techniques were applied to each patient. Spearman correlation was used to find the relation between the DVHs of true walls with artificial walls and whole organs. Monte Carlo (MC) simulations of the IMRT techniques and dosimetric comparison were also performed on a standard patient data. RESULTS: The 2 mm thickness artificial walls showed the minimum differences with the true bladder and rectum walls based on absolute evaluations (the maximum difference < 10cc and standard deviation < 15cc). However, relative evaluations showed that all the artificial walls had high correlations with real walls for selecting dose volume parameters. There was also good agreement between the treatment planning system and MC simulations results. CONCLUSION: The DVH of whole organs was not a good surrogate of the true wall. The 2 mm artificial walls can be regarded as good alternatives for both of rectum and bladder. However, in relative dose evaluations all studied artificial walls were appropriate. Show more

Keywords: Prostate cancer, intensity modulated radiotherapy, bladder wall, rectum wall, Monte Carlo simulation

DOI: 10.3233/XST-190592

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 59-70, 2020

Authors: Zhang, Mutian | Fan, Qiyong | Lei, Yu | Thapa, Bishnu | Padula, Gilbert

Article Type: Research Article

Abstract: BACKGROUND: Versa HD linear accelerators (linacs) are used for stereotactic radiosurgery treatment. However, the mechanical accuracy of such systems remains a concern. OBJECTIVE: The purpose of this study was to evaluate the accuracy of an Elekta Versa HD linac. METHODS: We performed measurements with a ball bearing phantom to calculate the rotational isocenter radii of the linac’s gantry, collimator, and table, and determine the relative locations of those isocenters. We evaluated the accuracy of the cone-beam computed tomography (CBCT) guidance with a film-embedding head phantom and circular cone-collimated radiation beams. We also performed dosimetric simulations to …study the effects of the linac mechanical uncertainties on non-coplanar cone arc delivery. RESULTS: The mechanical uncertainty of the linac gantry rotation was 0.78 mm in radius, whereas that of the collimator and the table was <0.1 mm and 0.33 mm, respectively. The axes of rotation of the collimator and the table were coinciding with and 0.13 mm away from the gantry isocenter, respectively. Experiments with test plans demonstrated the limited dosimetric consequences on the circular arc delivery given the aforementioned mechanical uncertainties. End-to-end measurements determined that the uncertainty of the CBCT guidance was≤1 mm in each direction with respect to the reference CT image. CONCLUSIONS: In arc delivery, the mechanical uncertainties associated with the gantry and the table do not require remarkable increases in geometric margins. If large enough, the residual setup errors following CBCT guidance will dominate the overall dosimetric consequence. Therefore, the Versa HD linac is a valid system for stereotactic radiosurgery using non-coplanar arc delivery. Show more

Keywords: Linear accelerator, stereotactic radiosurgery, mechanical uncertainty, cone-beam CT guidance

DOI: 10.3233/XST-190580

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 71-82, 2020

Authors: Zhao, Yuan | Shan, Tianqi | Chi, Zihui | Jiang, Huabei

Article Type: Research Article

Abstract: BACKGROUND: Microwave-induced thermoacoustic tomography (TAT) has potential for detecting germinal matrix hemorrhage (GMH). However, it has not been demonstrated in vivo . OBJECTIVE: To demonstrate the feasibility of TAT for in vivo detecting GMH by using neonatal mouse. METHODS: A cylindrical-scanning TAT system was developed with optimized microwave irradiation and ultrasound detection for neonatal mouse imaging. Neonatal mice were used to develop GMH model by injection of autologous blood into the periventricular region. After TAT experiments, the animals were sacrificed, frozen and excised to validate the TAT findings. The detailed comparative analyses of the TAT …images and corresponding photographs of the excised brain tissues were conducted. RESULTS: Satisfactory matches are identified between the TAT images and corresponding histological sections, in terms of the shape and size of the brain tissues. Some organs and tissues were also identified. Particularly, comparing to the corresponding histological sections, using TAT enables to more accurately detect the hematoma region at different depths in the neonatal mouse brain. CONCLUSIONS: This study demonstrates for the first time that TAT can detect GMH in neonatal mouse cerebrum in vivo . This represents the first important step towards the in vivo diagnosis and grading of hemorrhage in the infant human brain. Show more

Keywords: Thermoacoustic tomography, neonatal mouse, hemorrhage, germinal matrix hemorrhage, tissue dielectric properties

DOI: 10.3233/XST-190599

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 83-93, 2020

Authors: Yang, Tiejun | Song, Jikun | Li, Lei | Tang, Qi

Article Type: Research Article

Abstract: BACKGROUND Accurate segmentation of brain tumor depicting on magnetic resonance imaging (MRI) is an important step for doctors to determine optimal treatment plan of Gliomas, which are the common malignant brain tumors that seriously damage patients’ health and life. OBJECT This study aims to improve accuracy and efficiency of brain tumor segmentation on MRI using the advanced deep learning model. METHOD In this study, an improved model based on the U-net for accurate segmentation of brain tumor MRI images, called Deeper ResU-net, is proposed. First, a deep Deeper U-net is built, which has deeper network depth …compared with U-net, uses Squeeze Operator to control network parameters and attempts to enhance the feature extraction ability. Then, Deeper ResU-net is formed to eliminate degradation phenomenon of the deep network, in which residual unit is designed and integrated into the Deeper U-net to keep the number of parameters unchanged. RESULT Deeper ResU-net makes the deep network conduct stable training without degrading. Evaluation result shows that the Deeper ResU-net has achieved competitive result with average DSC metrics of 0.9, 0.82, 0.88 for Complete tumor region, Core tumor region and Enhanced tumor region, respectively. CONCLUSION By extending the U-net model to a deeper layer and adding the residual structure to ensure effective and stable training of the model, the experiment results demonstrate that applying the improved Deeper ResU-net can effectively eliminate the degradation phenomenon of deep network and improve segmentation performance. Show more

Keywords: Brain tumor MRI, image segmentation, U-net, residual units, CNN

DOI: 10.3233/XST-190552

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 95-110, 2020

Authors: Chen, Jenny Ling-Yu | Wang, Miao-Ci | Huang, Yu-Sen | Huang, Chao-Yuan | Pan, Chun-Kai | Hsu, Che-Yu | Lan, Keng-Hsueh | Kuo, Sung-Hsin

Article Type: Research Article

Abstract: BACKGROUND: Extended-field (EF) bone marrow-sparing (BMS) radiotherapy is attracting interest for cervical cancer patients with para-aortic lymphadenopathy. OBJECTIVE: To compare dosimetric quality of volumetric-modulated arc therapy (VMAT) vs. helical tomotherapy (HT) during EF BMS radiotherapy. METHODS: HT dose-volume histogram parameters including (1) coverage, homogeneity, and conformity of target volumes, (2) sparing of organs-at-risk, (3) monitor units, and (4) estimated treatment time were compared with those of VMAT in 20 cervical cancer patients who underwent EF BMS radiotherapy. The pelvic and para-aortic regions received 45-Gy dose (25 fractions), with simultaneous integrated boost of 55 Gy (25 fractions) for …pelvic and para-aortic lymphadenopathy, followed by a parametrial boost of 9 Gy (5 fractions). RESULTS: The HT-based and VMAT techniques achieved adequate and similar target volume coverage with good dose homogeneity and conformity, while sparing all organs-at-risk, including the rectum, bladder, bowel, bone marrow, femoral head, kidney, and spinal cord. The HT treatment plan had significantly higher monitor units (p  < 0.001) and longer estimated treatment times (p  < 0.001). CONCLUSIONS: VMAT and HT plans are suitable for EF BMS radiotherapy, which can achieve adequate target volume coverage while sufficiently sparing normal tissue. In addition, VMAT, compared to HT planning, yielded shorter estimated treatment times. Show more

Keywords: Cervical cancer, extended-field bone marrow sparing, volumetric-modulated arc therapy, helical tomotherapy

DOI: 10.3233/XST-190593

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 111-124, 2020

Authors: Zhang, Zejian | Wang, Xisheng | Chen, Dong | Peng, Naixiong | Chen, Jicheng | Wang, Qinjun | Yang, Minlong | Zhang, Yuanyuan

Article Type: Research Article

Abstract: PURPOSE To evaluate therapeutic efficacy of two minimally invasive surgical methods in managing acute ureteral obstruction and severe infection caused by upper urinary tract calculi (UUTC). PATIENTS AND METHODS Data of 47 patients diagnosed with acute upper urinary tract obstruction and severe infection caused by ureteral calculus using X-ray CT between September 2014 and January 2019 were retrospectively analyzed. All patients were treated with immediate renal drainage and, after infection and ureteral obstruction were relieved, UUTC removal. Renal drainage was performed by ultrasound-guided percutaneous nephrostomy and retrograde ureteral catheterization was performed using cystoscopy. Kidney and ureteral stones were …removed; renal function and the urinary tract were examined by X-ray during follow-up. RESULTS Percutaneous nephrostomy was performed in 29 patients in a critical condition including intolerance to surgery, high-grade hydronephrosis, or failure of retrograde ureteric stent placement. In other 18 patients diagnosed with small stones (≤10 mm) and low-grade hydronephrosis, indwelling double-J ureteral stents were temporally installed by a cystoscope. Acute infection and ureteral obstruction were relieved; white blood cell counts returned to normal values within 3 to 7 days after drainage in all patients. In the second-stage treatment, percutaneous nephrolithotomy (PCNL), ureteroscopic lithotripsy, extracorporeal shock wave lithotripsy and nephrectomy were performed in 24, 10, 8 and 5 patients, respectively. No patients developed severe complication after stone removal surgery. All patients were followed up for 3 months to 4.5 years. Renal function was significantly recovered; 17/29 (59%) patients with elevated serum creatinine returned to normal and serum creatinine in 12/29 (41%) patients improved significantly after drainage, with a pre-operation level of 285±169μ M vs 203±91μ M post-operation (P  = 0.014). Five patients were lost during follow-up. CONCLUSION This study demonstrated an optimal approach for relieving upper urinary tract obstruction and acute infection in which percutaneous nephrostomy drainage is preferred for patients with severe pyonephrosis, large stones (>10 mm) with high-grade hydronephrosis, steinstrasse, or failure in retrograde ureteric stent placement, while retrograde ureteral catheterization using cystoscopy is suitable for patients diagnosed with small stones (≤10 mm) and low-grade hydronephrosis. Show more

Keywords: Urolithiasis, upper urinary tract calculi (UUTC), pyonephrosis, percutaneous treatment

DOI: 10.3233/XST-190576

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 125-135, 2020

Authors: Zheng, Zhu | Jiang, Yunchao | Huang, Lin | Zhao, Yuan | Jiang, Huabei

Article Type: Research Article

Abstract: Noninvasive extraction of tissue conductivity distribution is important in brain imaging and cancer detection. Here we present an improved method that can accurately image tissue conductivity using tomographically measured microwave-induced thermoacoustic data. Our reconstruction algorithm is first tested using simulations, and then validated using tissue phantom experiments where saline-containing tubes are used as target(s) with various target sizes, positions and conductivities. The average error of reconstruction for the simulations is reduced from 4.87% to 1.38% compared with the previous algorithm. The experimental results obtained suggest that accurate quantitative thermoacoustic imaging would provide a potential tool for precision medicine.

Keywords: Thermoacoustic imaging, conductivity distribution, quantitative thermoacoustic tomography method

DOI: 10.3233/XST-190577

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 137-145, 2020

Authors: Jiang, Chuanjie | Yang, Yongjun | Zhou, Jiping | Yang, Kai | Yao, Shuqiang | Jiang, Zewei | Wu, Rui

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate the accuracy of a novel guidance method of pedicle screw implantation determined by spinal stress. METHODS: We retrospectively analyzed patients underwent pedicle screw internal fixation between January 2015 and August 2018 in our hospital. Patients were divided into two groups according to the methods of pedicle screw implantation namely, the conventional nail placement and novel guidance method of pedicle screw implantation determined by spinal stress. Accuracy of spinal pedicle screw placements was evaluated using intraoperative and postoperative X-ray computed tomography (CT) examination and intraoperative touch of nerve root dissection pedicle bone. The success rate of …intraoperative one-time screw placement was calculated according to Heary classification I. RESULTS: A total of 785 patients underwent pedicle screw internal fixation were retrospectively analyzed. Among them 384 patients were treated using conventional nail placement (Group A) and 401 patients were treated using the technique according to analysis of spinal stress (Group B). There was no significant difference in terms of the characteristics between two groups. There were significant differences in terms of the success rate of total of screw placement (88.7% vs. 96.2%, P  < 0.001) including thoracic screw placement (87.8% vs. 94.5%, P  = 0.003) and lumbar screw placement (88.8% vs. 96.5%, P  = 0.001) for Group A and Group B, respectively. CONCLUSIONS: Using the novel guidance method of pedicle screw implantation determined by spinal stress might improve the accuracy of pedicle screw implantation. Show more

Keywords: Pedicle screw implantation, free-hand, stress conduction, thoracolumbar spine

DOI: 10.3233/XST-190566

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 147-155, 2020

Authors: Zhou, Wei-Ping | Zan, Xing-You | Hu, Xiao-Yun | Liu, Xiao | Sudarshan, Sanjeev Kumar Pitla | Yang, Shu-Dong | Guo, Yu-Jiang | Fang, Xiang-Ming

Article Type: Research Article

Abstract: OBJECTIVE: To investigate the characterization of breast lesions using diffusion kurtosis model-based imaging. METHODS: This prospective study included 120 consecutive patients underwent preoperative DCE-MRI examinations and multi-b-value diffusion-weighted imaging (DWI). Among them, 88 malignant lesions and 44 benign lesions were detected, 56 normal fibroglandular breast tissue were selected as normal control. Conventional apparent diffusion coefficient (ADC), DKI-based parameters mean kurtosis (MK) and mean diffusivity (MD) were analyzed by lesions types and histological subtypes using one-way ANOVA and receiver operating characteristic (ROC) curve. RESULTS: (1) The malignant group showed significantly lower ADC and MD (1.07±0.32×10-3 mm2 …/s and 1.30±0.40×10-3 mm2 /s, respectively) and higher MK (0.87±0.18) than those in the benign group (1.29±0.26×10-3 mm2 /s, 1.62±0.31×10-3 mm2 /s and 0.67±0.18) and control group (1.67±0.33×10-3 mm2 /s, 2.24±0.28×10-3 mm2 /s and 0.52±0.08) with all P  < 0.001. (2) Areas under ROC curve (AUC) for diagnosing malignant lesions were 0.936 for MD, 0.911 for MK and 0.897 for ADC, respectively. AUC for MD was significantly higher than that for ADC (P  = 0.015). The optimal cut-off value, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were as follow: ADC = 1.18×10-3 mm2 /s, 78.3%, 93.2%, 81.2%, 81.6%, 81.4%; MD = 1.48×10-3 mm2 /s, 82.2%, 98.3%, 84.4%, 87.8%, 86.2%; MK = 0.78, 91.5%, 85.3%, 89.0%, 85.8%, 87.2%. (3) Invasive ductal carcinoma (IDC), ductal carcinoma in situ (DCIS) and mucinous adenocarcinoma also showed significant differences among ADC, MD and MK (with P  < 0.05). CONCLUSIONS: MR-DKI parameters enable to improve breast lesion characterization and have diagnostic potential applying to different pathological subtypes of breast cancers. Show more

Keywords: Diffusion weighted imaging, diffusion kurtosis imaging, breast lesions, pathological subtypes

DOI: 10.3233/XST-190590

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 157-169, 2020

Authors: Li, Shuo | Mi, Shijun | Guo, Ruijun | Ma, Xiuqing | Han, Mei

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate application of a computed tomography (CT)-ultrasound fusion imaging technique to unilateral percutaneous vertebroplasty (PVP) for treating patients with osteoporotic thoracolumbar compression fracture. METHODS: Fourteen patients with osteoporotic thoracolumbar compression fractures were included, randomly divided into CT-ultrasound fusion imaging (n  = 7) and traditional X-ray fluoroscopy groups (n  = 7). Patients in the first group underwent unilateral PVP using real-time CT-ultrasound fusion imaging. A body surface locator was placed on the side contralateral to the scheduled puncture site (2–3 cm from the spinous process). Patient CT image information was recorded in the ultrasound system for registration during real-time ultrasound …and CT fusion imaging, and one-click automatic registration was then performed. The puncture point and target point at which the puncture needle arrived were determined on CT images, with the puncture being performed under ultrasound guidance. Patients in the second group underwent X-ray fluoroscopy-guided PVP. Bone cement injection was injected under monitoring using a C-arm X-ray system. Patients’ X-ray exposure and puncture times were recorded and compared between the two groups. RESULTS: The average puncture times in the CT-ultrasound fusion imaging and traditional X-ray fluoroscopy groups were 2.50±0.31 min (without exposing patients and operators to radiation) and 5.00±0.65 min (with the same duration of radiation exposure), respectively. The average times for bone cement injection were 3.29±0.81 min and 3.50±0.86 min, respectively. The mean visual analog scale (VAS) scores were 2.10±0.11 and 2.20±0.21, respectively. The bone cement was evenly distributed without cement leakage in patients in the CT-ultrasound fusion imaging group, but a poor distribution of bone cement and bone cement leakage were found in one patient in the traditional X-ray fluoroscopy group. CONCLUSIONS: Real-time CT-ultrasound fusion imaging is easy to perform, and provides precise localization of the puncture point, path, and target point. The selected puncture path was reasonable, and the needle had reached the target point accurately, which increased the success rate of puncture without radiation exposure. Show more

Keywords: Ultrasound fusion imaging technique, unilateral percutaneous vertebroplasty, osteoporotic thoracolumbar compression fracture

DOI: 10.3233/XST-190563

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 171-183, 2020

Authors: Khan, Sajid Ullah | Ullah, Imran | Ahmed, Imran | Imran, Ali | Ullah, Najeeb

Article Type: Correction

DOI: 10.3233/XST-200001

Citation: Journal of X-Ray Science and Technology, vol. 28, no. 1, pp. 185-185, 2020