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Coronary computed tomography angiography (CTA) has a high negative predictive value for ruling out coronary artery disease with non-invasive evaluation of the coronary arteries. My work has attempted to provide metrics that could increase the positive predictive value of coronary CTA through the use of dual energy CTA imaging. After

Coronary computed tomography angiography (CTA) has a high negative predictive value for ruling out coronary artery disease with non-invasive evaluation of the coronary arteries. My work has attempted to provide metrics that could increase the positive predictive value of coronary CTA through the use of dual energy CTA imaging. After developing an algorithm for obtaining calcium scores from a CTA exam, a dual energy CTA exam was performed on patients at dose levels equivalent to levels for single energy CTA with a calcium scoring exam. Calcium Agatston scores obtained from the dual energy CTA exam were within ±11% of scores obtained with conventional calcium scoring exams. In the presence of highly attenuating coronary calcium plaques, the virtual non-calcium images obtained with dual energy CTA were able to successfully measure percent coronary stenosis within 5% of known stenosis values, which is not possible with single energy CTA images due to the presence of the calcium blooming artifact. After fabricating an anthropomorphic beating heart phantom with coronary plaques, characterization of soft plaque vulnerability to rupture or erosion was demonstrated with measurements of the distance from soft plaque to aortic ostium, percent stenosis, and percent lipid volume in soft plaque. A classification model was developed, with training data from the beating heart phantom and plaques, which utilized support vector machines to classify coronary soft plaque pixels as lipid or fibrous. Lipid versus fibrous classification with single energy CTA images exhibited a 17% error while dual energy CTA images in the classification model developed here only exhibited a 4% error. Combining the calcium blooming correction and the percent lipid volume methods developed in this work will provide physicians with metrics for increasing the positive predictive value of coronary CTA as well as expanding the use of coronary CTA to patients with highly attenuating calcium plaques.
ContributorsBoltz, Thomas (Author) / Frakes, David (Thesis advisor) / Towe, Bruce (Committee member) / Kodibagkar, Vikram (Committee member) / Pavlicek, William (Committee member) / Bouman, Charles (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Three dimensional (3-D) ultrasound is safe, inexpensive, and has been shown to drastically improve system ease-of-use, diagnostic efficiency, and patient throughput. However, its high computational complexity and resulting high power consumption has precluded its use in hand-held applications.

In this dissertation, algorithm-architecture co-design techniques that aim to make hand-held 3-D ultrasound

Three dimensional (3-D) ultrasound is safe, inexpensive, and has been shown to drastically improve system ease-of-use, diagnostic efficiency, and patient throughput. However, its high computational complexity and resulting high power consumption has precluded its use in hand-held applications.

In this dissertation, algorithm-architecture co-design techniques that aim to make hand-held 3-D ultrasound a reality are presented. First, image enhancement methods to improve signal-to-noise ratio (SNR) are proposed. These include virtual source firing techniques and a low overhead digital front-end architecture using orthogonal chirps and orthogonal Golay codes.

Second, algorithm-architecture co-design techniques to reduce the power consumption of 3-D SAU imaging systems is presented. These include (i) a subaperture multiplexing strategy and the corresponding apodization method to alleviate the signal bandwidth bottleneck, and (ii) a highly efficient iterative delay calculation method to eliminate complex operations such as multiplications, divisions and square-root in delay calculation during beamforming. These techniques were used to define Sonic Millip3De, a 3-D die stacked architecture for digital beamforming in SAU systems. Sonic Millip3De produces 3-D high resolution images at 2 frames per second with system power consumption of 15W in 45nm technology.

Third, a new beamforming method based on separable delay decomposition is proposed to reduce the computational complexity of the beamforming unit in an SAU system. The method is based on minimizing the root-mean-square error (RMSE) due to delay decomposition. It reduces the beamforming complexity of a SAU system by 19x while providing high image fidelity that is comparable to non-separable beamforming. The resulting modified Sonic Millip3De architecture supports a frame rate of 32 volumes per second while maintaining power consumption of 15W in 45nm technology.

Next a 3-D plane-wave imaging system that utilizes both separable beamforming and coherent compounding is presented. The resulting system has computational complexity comparable to that of a non-separable non-compounding baseline system while significantly improving contrast-to-noise ratio and SNR. The modified Sonic Millip3De architecture is now capable of generating high resolution images at 1000 volumes per second with 9-fire-angle compounding.
ContributorsYang, Ming (Author) / Chakrabarti, Chaitali (Thesis advisor) / Papandreou-Suppappola, Antonia (Committee member) / Karam, Lina (Committee member) / Frakes, David (Committee member) / Ogras, Umit Y. (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Rapid intraoperative diagnosis of brain tumors is of great importance for planning treatment and guiding the surgeon about the extent of resection. Currently, the standard for the preliminary intraoperative tissue analysis is frozen section biopsy that has major limitations such as tissue freezing and cutting artifacts, sampling errors, lack of

Rapid intraoperative diagnosis of brain tumors is of great importance for planning treatment and guiding the surgeon about the extent of resection. Currently, the standard for the preliminary intraoperative tissue analysis is frozen section biopsy that has major limitations such as tissue freezing and cutting artifacts, sampling errors, lack of immediate interaction between the pathologist and the surgeon, and time consuming.

Handheld, portable confocal laser endomicroscopy (CLE) is being explored in neurosurgery for its ability to image histopathological features of tissue at cellular resolution in real time during brain tumor surgery. Over the course of examination of the surgical tumor resection, hundreds to thousands of images may be collected. The high number of images requires significant time and storage load for subsequent reviewing, which motivated several research groups to employ deep convolutional neural networks (DCNNs) to improve its utility during surgery. DCNNs have proven to be useful in natural and medical image analysis tasks such as classification, object detection, and image segmentation.

This thesis proposes using DCNNs for analyzing CLE images of brain tumors. Particularly, it explores the practicality of DCNNs in three main tasks. First, off-the shelf DCNNs were used to classify images into diagnostic and non-diagnostic. Further experiments showed that both ensemble modeling and transfer learning improved the classifier’s accuracy in evaluating the diagnostic quality of new images at test stage. Second, a weakly-supervised learning pipeline was developed for localizing key features of diagnostic CLE images from gliomas. Third, image style transfer was used to improve the diagnostic quality of CLE images from glioma tumors by transforming the histology patterns in CLE images of fluorescein sodium-stained tissue into the ones in conventional hematoxylin and eosin-stained tissue slides.

These studies suggest that DCNNs are opted for analysis of CLE images. They may assist surgeons in sorting out the non-diagnostic images, highlighting the key regions and enhancing their appearance through pattern transformation in real time. With recent advances in deep learning such as generative adversarial networks and semi-supervised learning, new research directions need to be followed to discover more promises of DCNNs in CLE image analysis.
ContributorsIzady Yazdanabadi, Mohammadhassan (Author) / Preul, Mark (Thesis advisor) / Yang, Yezhou (Thesis advisor) / Nakaji, Peter (Committee member) / Vernon, Brent (Committee member) / Arizona State University (Publisher)
Created2019
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Description
This report provides information concerning qualities of methylcellulose and how those properties affect further experimentation within the biomedical world. Utilizing the compound’s biocompatibility many issues, ranging from surgical to cosmetic, can be solved. As of recent, studies indicate, methylcellulose has been used as a physically cross-linked gel, which

This report provides information concerning qualities of methylcellulose and how those properties affect further experimentation within the biomedical world. Utilizing the compound’s biocompatibility many issues, ranging from surgical to cosmetic, can be solved. As of recent, studies indicate, methylcellulose has been used as a physically cross-linked gel, which cannot sustain a solid form within the body. Therefore, this report will ultimately explore the means of creating a non-degradable, injectable, chemically cross-linking methylcellulose- based hydrogel. Methylcellulose will be evaluated and altered in experiments conducted within this report and a chemical cross-linker, developed from Jeffamine ED 2003 (O,O′-Bis(2-aminopropyl) polypropylene glycol-block-polyethylene glycol-block-polypropylene glycol), will be created. Experimentation with these elements is outlined here, and will ultimately prompt future revisions and analysis.
ContributorsBundalo, Zoran Luka (Author) / Vernon, Brent (Thesis director) / LaBelle, Jeffrey (Committee member) / Overstreet, Derek (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2013-05
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Description
The advent of medical imaging has enabled significant advances in pre-procedural planning, allowing cardiovascular anatomy to be visualized noninvasively before a procedure. However, absolute scale and tactile information are not conveyed in traditional pre-procedural planning based on images alone. This information deficit fails to completely prepare clinicians for complex heart

The advent of medical imaging has enabled significant advances in pre-procedural planning, allowing cardiovascular anatomy to be visualized noninvasively before a procedure. However, absolute scale and tactile information are not conveyed in traditional pre-procedural planning based on images alone. This information deficit fails to completely prepare clinicians for complex heart repair, where surgeons must consider the varied presentations of cardiac morphology and malformations. Three-dimensional (3D) visualization and 3D printing provide a mechanism to construct patient-specific, scale models of cardiovascular anatomy that surgeons and interventionalists can examine prior to a procedure. In addition, the same patient-specific models provide a valuable resource for educating future medical professionals. Instead of looking at idealized images on a computer screen or pages from medical textbooks, medical students can review a life-like model of patient anatomy.



In cases where surgical repair is insufficient to return the heart to normal function, a patient may proceed to advanced heart failure, and a heart transplant may be required. Unfortunately, a finite number of available donor hearts are available. A mechanical circulatory support (MCS) device can be used to bridge the time between heart failure and reception of a donor heart. These MCS devices are typically constructed for the adult population. Accordingly, the size associated to the device is a limiting factor for small adults or pediatric patients who often have smaller thoracic measurements. While current eligibility criteria are based on correlative measurements, the aforementioned 3D visualization capabilities can be leveraged to accomplish patient-specific fit analysis.

The main objectives of the work presented in this dissertation were 1) to develop and evaluate an optimized process for 3D printing cardiovascular anatomy for surgical planning and medical education and 2) to develop and evaluate computational tools to assess MCS device fit in specific patients. The evaluations for objectives 1 and 2 were completed with a collection of qualitative and quantitative validations. These validations include case studies to illustrate meaningful, qualitative results as well as quantitative results from surgical outcomes. The latter results present the first quantitative supporting evidence, beyond anecdotal case studies, regarding the efficacy of 3D printing for pre-procedural planning; this data is suitable as pilot data for clinical trials. The products of this work were used to plan 200 cardiovascular procedures (including 79 cardiothoracic surgeries at Phoenix Children's Hospital), via 3D printed heart models and assess MCS device fit in 29 patients across 6 countries.
ContributorsRyan, Justin Robert (Author) / Frakes, David (Thesis advisor) / Collins, Daniel (Committee member) / LaBelle, Jeffrey (Committee member) / Pizziconi, Vincent (Committee member) / Pophal, Stephen (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Dynamic susceptibility contrast MRI (DSC-MRI) is a powerful tool used to quantitatively measure parameters related to blood flow and volume in the brain. The technique is known as a “bolus-tracking” method and relies upon very fast scanning to accurately measure the flow of contrast agent into and out of a

Dynamic susceptibility contrast MRI (DSC-MRI) is a powerful tool used to quantitatively measure parameters related to blood flow and volume in the brain. The technique is known as a “bolus-tracking” method and relies upon very fast scanning to accurately measure the flow of contrast agent into and out of a region of interest. The need for high temporal resolution to measure contrast agent dynamics limits the spatial coverage of perfusion parameter maps which limits the utility of DSC-perfusion studies in pathologies involving the entire brain. Typical clinical DSC-perfusion studies are capable of acquiring 10-15 slices, generally centered on a known lesion or pathology.

The methods developed in this work improve the spatial coverage of whole-brain DSC-MRI by combining a highly efficient 3D spiral k-space trajectory with Generalized Autocalibrating Partial Parallel Acquisition (GRAPPA) parallel imaging without increasing temporal resolution. The proposed method is capable of acquiring 30 slices with a temporal resolution of under 1 second, covering the entire cerebrum with isotropic spatial resolution of 3 mm. Additionally, the acquisition method allows for correction of T1-enhancing leakage effects by virtue of collecting two echoes, which confound DSC perfusion measurements. The proposed DSC-perfusion method results in high quality perfusion parameter maps across a larger volume than is currently available with current clinical standards, improving diagnostic utility of perfusion MRI methods, which ultimately improves patient care.
ContributorsTurley, Dallas C (Author) / Pipe, James G (Thesis advisor) / Kodibagkar, Vikram (Thesis advisor) / Frakes, David (Committee member) / Sadleir, Rosalind (Committee member) / Schmainda, Kathleen (Committee member) / Arizona State University (Publisher)
Created2017
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Description
Intraoperative diagnosis in neurosurgery has traditionally relied on frozen and formalin-fixed, paraffin-embedded section analysis of biopsied tissue samples. Although this technique is considered to be the “gold standard” for establishing a histopathologic diagnosis, it entails a number of significant limitations such as invasiveness and the time required for processing and

Intraoperative diagnosis in neurosurgery has traditionally relied on frozen and formalin-fixed, paraffin-embedded section analysis of biopsied tissue samples. Although this technique is considered to be the “gold standard” for establishing a histopathologic diagnosis, it entails a number of significant limitations such as invasiveness and the time required for processing and interpreting the tissue. Rapid intraoperative diagnosis has become possible with a handheld confocal laser endomicroscopy (CLE) system. Combined with appropriate fluorescent stains or labels, CLE provides an imaging technique for real-time intraoperative visualization of histopathologic features of the suspected tumor and healthy tissues.

This thesis scrutinizes CLE technology for its ability to provide real-time intraoperative in vivo and ex vivo visualization of histopathological features of the normal and tumor brain tissues. First, the optimal settings for CLE imaging are studied in an animal model along with a generational comparison of CLE performance. Second, the ability of CLE to discriminate uninjured normal brain, injured normal brain and tumor tissues is demonstrated. Third, CLE was used to investigate cerebral microvasculature and blood flow in normal and pathological conditions. Fourth, the feasibility of CLE for providing optical biopsies of brain tumors was established during the fluorescence-guided neurosurgical procedures. This study established the optimal workflow and confirmed the high specificity of the CLE optical biopsies. Fifth, the feasibility of CLE was established for endoscopic endonasal approaches and interrogation of pituitary tumor tissue. Finally, improved and prolonged near wide-field fluorescent visualization of brain tumor margins was demonstrated with a scanning fiber endoscopy and 5-aminolevulinic acid.

These studies suggested a novel paradigm for neurosurgery-pathology workflow when the noninvasive intraoperative optical biopsies are used to interrogate the tissue and augment intraoperative decision making. Such optical biopsies could shorten the time for obtaining preliminary information on the histological composition of the tissue of interest and may lead to improved diagnostics and tumor resection. This work establishes a basis for future in vivo optical biopsy use in neurosurgery and planning of patient-related outcome studies. Future studies would lead to refinement and development of new confocal scanning technologies making noninvasive optical biopsy faster, convenient and more accurate.
ContributorsBelykh, Evgenii (Author) / Preul, Mark C (Thesis advisor) / Vernon, Brent (Thesis advisor) / Nakaji, Peter (Committee member) / Stabenfeldt, Sarah E (Committee member) / Arizona State University (Publisher)
Created2020
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Description
This thesis describes the development, characterization, and application of new biomedical technologies developed around the photoacoustic effect. The photoacoustic effect is defined as optical absorption-based generation of ultrasound and provides the foundation for a unique method of imaging and molecular detection. The range of applications of the photoacoustic effect have

This thesis describes the development, characterization, and application of new biomedical technologies developed around the photoacoustic effect. The photoacoustic effect is defined as optical absorption-based generation of ultrasound and provides the foundation for a unique method of imaging and molecular detection. The range of applications of the photoacoustic effect have not yet been fully explored. Photoacoustic endoscopy (PAE) has emerged as a minimally invasive tool for imaging internal organs and tissues. One of the main themes of this dissertation involves the first reported dual-intrauterine photoacoustic and ultrasound deep-tissue imaging endoscope. This device was designed to enable physicians at the point-of-care to better elucidate overall gynecological health, by imaging the lining of the human uterus. Intrauterine photoacoustic endoscopy is made possible due to the small diameter of the endoscope (3mm), which allows for complete, 360-degree organ analysis from within the uterine cavity. In certain biomedical applications, however, further minimization is necessary. Sufficiently small diameter endoscopes may allow for the possibility of applying PAE in new areas. To further miniaturize the diameter of our endoscopes, alternative imaging probe designs were investigated. The proposed PAE architecture utilizes a hollow optical waveguide to allow for concentric guiding of both light and sound. This enables imaging depths of up to several millimeters into animal tissue while maintaining an outer diameter of roughly 1mm. In the final focus of this dissertation, these waveguides are further investigated for use in micropipette electrodes, common in the field of single cell electrophysiology. Pulsed light is coupled with these electrodes providing real-time photoacoustic feedback, useful in navigation towards intended targets. Lastly, fluorescence can be generated and collected at the micropipette aperture by utilizing an intra-electrode tapered optical fiber. This allows for a targeted robotic approach to labeled neurons that is independent of microscopy.
ContributorsMiranda, Christopher (Author) / Smith, Barbara S. (Thesis advisor) / Kodibagkar, Vikram (Committee member) / LaBaer, Joshua (Committee member) / Frakes, David (Committee member) / Barkley, Joel (Committee member) / Arizona State University (Publisher)
Created2021