Dissertations / Theses on the topic 'Speech attenuation'

To effectively implement an occupational hearing conservation program, employers must know the amount of attenuation (noise reduction) provided by the hearing protective devices used by their employees. Currently standardized test methods, performed under laboratory conditions, cannot be easily implemented in industrial settings, and previously proposed field methods have depended upon the use of special headphones which are not typically available in the workplace. These problems have led many occupational hearing conservationists to use standard audiometric headphones to evaluate the attenuation provided to employees using insert-type hearing-protective devices. There has, however, been little research into the validity of using standard audiometric headphones to determine attenuation values. The purpose of this study was to describe a procedure for determining the attenuation of insert-type hearing-protective devices using standard audiometric earphones, typical industrial audiometric equipment, and other easily obtainable materials.

Speech intelligibility tests using three headset systems, two passive and one with active noise reduction technology, were conducted. Nine listeners, six males and three females, responded to 180 50-word Modified Rhyme Word Lists presented under two noise conditions, two conditions of bilateral phase reversal of the speech signal, and the three headset systems. These three independent variables were studied in a full factorial within-subjects design. The noise conditions were pink noise and recordings from the troop carrying compartment of a u.S. Army M-2 Bradley Fighting Vehicle (tank noise having substantial low frequency energy). Phase reversal of the speech signal was also tested for its effect on speech intelligibility. The three headset systems were the David Clark Noise Attenuating Aviation Headset, and the Bose Aviation Headset used in both its passive and active mode. Active noise reduction technology employs the physical principle of constructive and destructive interference by creating signals which are identical to the noise under the earmuff but out of phase by 180 degrees. This technology is most effective at frequencies below 1000 Hz. Results showed that the Bose headset in its active mode required a significantly higher speech-to-noise ratio in both noise environments than the two passive headset systems to achieve the 70% level of speech intelligibility, the dependent variable in this study. The mean speech level under the Bose headset in its active mode was 2.8 dB higher in tank noise and 3.5 dB higher in pink noise than under the David Clark headset. The Bose headset in the active mode, however, provided a greater degree of broadband attenuation especially in the lower frequency range, e.g. < 630 Hz. Phase reversal proved to be of no benefit to performance in either noise environment. The pink noise proved to be the harsher environment for speech intelligibility than did the tank noise, primarily due to the increased levels in the speech bandwidth. Articulation Index scores for the three headset systems evidenced that the differences in performance among the three headset systems were in part the result of better earphone response characteristics in the principal speech bandwidth (600 - 4000 Hz) in conjunction with the strong attenuation performance of the David Clark headset in that same range. It is suggested that, in the absence of better earphone response characteristics and a broader bandwidth of active noise reduction performance, speech intelligibility is no better under active noise reduction headsets than under quality passive headsets. Further, the levels of speech intelligibility attained by active noise reduction headsets are at a cost of increased signal strength and higher purchase price.
Ph. D.

The need for hearing protection in industry has evolved from the growing awareness of the detrimental effects of noise on hearing and recent legislation enacted to protect the hearing of noise-exposed employees through the use of hearing conservation programs. In lieu of expensive or impractical engineering and administrative controls, personal hearing protection devices (HPDs) are considered to be the most practical and effective means of protecting employees from the damaging effects of noise in industry today.

This work investigates the application of active noise control (ANC) to speech. ANC has had success reducing tonal noise. In this work, that success was extended to noise that is not completely tonal but has some tonal elements such as speech. Limitations such as causality were established on the active control of human speech. An optimal configuration for control actuators was developed for a sphere using a genetic algorithm. The optimal error sensor location was found from exploring the nulls associated with the magnitude of the radiated pressure with reference to the primary pressure field. Both numerically predicted and experimentally validated results for the attenuation of single frequency tones were shown. The differences between the numerically predicted results for attenuation with a sphere present in the pressure field and monopoles in the free-field are also discussed.The attenuation from ANC of both monotone and natural speech is shown and a discussion about the effect of causality on the results is given. The sentence “Joe took father’s shoe bench out” was used for both monotone and natural speech. Over this entire monotone speech sentence, the average attenuation was 8.6 dB with a peak attenuation of 10.6 dB for the syllable “Joe”. Natural speech attenuation was 1.1 dB for the sentence average with a peak attenuation on the syllable “bench” of 2.4 dB. In addition to the lower attenuation values for natural speech, the pressure level for the word “took” was increased by 2.3 dB. Also, the harmonic at 420 Hz in the word “father’s” of monotone speech was reduced globally up to 20 dB. Based on the results of the attenuation of monotone and natural speech, it was concluded that a reasonable amount of attenuation could be achieved on natural speech if its correlation could approach that of monotone speech.

[ES] Esta investigación tiene como objeto de estudio los mecanismos de atenuación empleados en la lengua oral china para contribuir con los estudios de lingüística conversacional china en un aspecto carente de estudios previos. Los objetivos principales del presente estudio son: 1) describir las características de los mecanismos de atenuación en chino. y 2) clasificar los mecanismos de atenuación que se utilizan en la lengua china oral. De ahí se desprenden cuatro objetivos específicos: 1) analizar de qué forma influye el contexto situacional y la cultura en el uso de las estrategias de atenuación en chino; 2) examinar las funciones de los mecanismos de atenuación; 3) explicar las características de los mecanismos de atenuación en los tipos de actos de habla y 4) identificar las características principales de los atenuantes en función de las variables género, edad y formación académica. Para cumplir con los objetivos planteados se ha elaborado un corpus formado por 14 conversaciones coloquiales que suman un total de 10 horas y 27 minutos de duración. Las relaciones que hay entre los interlocutores son de amistad y parentesco. La identificación de los mecanismos utilizados se realiza en base a la ficha metodológica de Albelda et al. (2014) A partir del análisis del corpus se han obtenido 21 tipos de mecanismos, cuyas características de uso evidencian el impacto cultural en ellas. Así mismo, se ha mostrado que la función por la que más se atenúa es la de prevención de amenazas a la imagen y, por la que menos, por la de reparación. Con respecto a los tipos de actos de habla, el asertivo es el que presenta un mayor número de uso de mecanismos de atenuación. Por último se ha mostrado que existen diferencias en el uso de los mecanismos de atenuación según las variables de género, edad y nivel de formación académica.
[CA] Aquesta tesi tracta d'investigar els mecanismes d'atenuació emprats en la llengua oral xinesa. Amb aquesta investigació es pretén contribuir en un camp que no té estudis d'aquests mecanismes en converses en llengua xinesa. Els objectius principals d'aquest estudi són: en primer lloc, classificar els mecanismes d'atenuació que s'utilitzen en la llengua xinesa oral, i en segon lloc, descriure les característiques d'aquests mecanismes d'atenuació. Es desprenen quatre objectius específics, que són: 1) analitzar si el context i la cultura influeixen en l'ús de les estratègies d'atenuació en xinès; 2) examinar les funcions dels mecanismes d'atenuació i la relació entre ells; 3) explicar les característiques dels mecanismes d'atenuació en els tipus d'actes de parla; i 4) identificar les característiques més freqüents lligades a les variables de gènere, edat i formació acadèmica. Per complir amb els objectius plantejats es va elaborar un corpus propi format per 14 converses col·loquials amb un total de 10 hores i 27 minuts de durada. Les relacions que hi ha entre els interlocutors són d'amistat o familiars. La identificació dels mecanismes utilitzats es realitza basant-se en la fitxa metodològica d'Albelda et al. (2014) A partir d'l'anàlisi s'han obtingut 21 tipus de mecanismes d'atenuació utilitzats en el corpus, les característiques de l'ús dels mecanismes van evidenciar l'impacte cultural en elles. així mateix, s'ha mostrat que la funció per la que més s'atenuen és la funció de prevenció d'amenaces a la imatge, i la que menys és la funció de reparació. Pel que fa als tipus d'acte de parla, en l'acte assertiu es presenta un major nombre de casos de mecanismes d'atenuació. Finalment s'ha mostrat que hi ha diferències en l'ús dels mecanismes d'atenuació segons el gènere, edat i nivell d'estudis.
[EN] This research addresses the issue of the usage of attenuation mechanism in oral Chinese. With this research we intend to contribute to fill in the gap of such studies in Chinese. The main objective of this research is to classify the attenuation mechanism used in oral Chinese language and to describe their characteristics. Four specific objectives include: 1) to analyze if the context and the culture influence the use of attenuation mechanism in Chinese; 2) to examine the functions of attenuation mechanism and the relationship between them; 3) to explain the characteristics of the attenuation mechanism in different types of speech act; and 4) to identify the significant differences between variables such as gender, age and educational level. In order to meet the objectives, we elaborated a corpus of 14 colloquial conversations with 10 hours and 27 minutes of audio recording. The relationships between the interlocutors are friends or family. The identification of the mechanisms used is carried out based on the methodological study of Albelda et al. (2014) 21 types of attenuation mechanism used in the corpus were obtained, the characteristics of the use of the mechanisms showed evidence of the cultural impact on them. Moreover, it revealed that the function of which is the most attenuated, is the function of preventing threats to the interlocutor's face, and the one that is least attenuated is the function of repair the damage caused by the face threating act. In all the types of speech act attenuated we found that in the assertive act there are a greater number of cases by using attenuation mechanism. At last, it has been shown that there are differences in the usage of attenuation mechanism according to gender, age and educational level.
Zhao, L. (2021). Estudio de la atenuación en conversaciones coloquiales chinas [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/164921
TESIS

Attenuation and scatter are limiting factors in image quality and quantitation of organ function by single photon emission computed tomography (SPECT). To correct brain images for attenuation an effective water/tissue attenuation coefficient of 0.12 cm$ sp{-1}$ (at 140 keV) or larger has been recommended in order to compensate for the additional bone (skull) attenuation.
It has been determined that the reconstructed images are overcorrected in the centre by 5%, and the optimum correction occurs for a reduced coefficient of 0.09 cm$ sp{-1}$. The overcorrection is due to increased attenuation at the edges of all projections where the path length through the bone is greater, although the bone also increases the scatter at the projection edges.
A correction scheme which uses effective bone and water coefficients was developed to compensate for the attenuation. Alternatively, prior to attenuation correction, a common scatter correction was found to be effective in explicitly removing the bone and water scatter.

A tomografia computadorizada por emissão de fóton único (SPECT) é uma das modalidades de diagnóstico na Medicina Nuclear em que se detecta a radiação emitida por um radiofármaco previamente administrado ao paciente. Visto que osfótons emitidos sofrem interações com o corpo do paciente, fazem-se necessárias as correções de atenuação e de espalhamento a fim de melhor representar a distribuição do radiofármaco, e assimresultar em imagens mais precisas. O objetivo deste trabalho é avaliar os parâmetros anotados como padrão para reconstruções de imagens tomográficas e as correções de atenuação e de espalhamento em imagens SPECT do Hospital de Clínicas da Faculdade de Medicina da Universidade de São Paulo, por meio de análises qualitativas e quantitativas das imagens reconstruída a partir das aquisições tomográficas. Sob um protocolo de SPECT-CT cerebral modificado para duas janelas de aquisição, foram adquiridas imagens SPECT e SPECT-CT (BrightView XCT, Philips) utilizando fantomaJaszczak e reconstruídas pelos métodos FBP, MLEM e OSEM. Os resultados mostram que o método FBP apresenta imagens de baixa precisão devido à baixa SNR. A avaliação sugere o uso dos métodos iterativos MLEM e OSEM com correção de atenuação como método padrão de reconstrução de imagens de perfusão cerebral. De acordo com a avaliação de imagens do fantomaJaszczak e análise do contraste entre esfera fria ebackground,propõe-se análise observacional e avaliação das imagens clínicas reconstruídas pelo método OSEM com os parâmetros 3 iterações, 16 subsets, filtro Butterworth com frequência de corte 0,34 e potencia 1, como novos parâmetros padrão de reconstrução de imagens.
Single Photon Emission Computed Tomography (SPECT) is one of the diagnostic modalities in nuclear medicine, it detects the radiation emitted by a radioisotope previously administered to the patient. Since the photons undergo interactions with the patient\'s body,attenuationand scatteringcorrections are necessary in order to best represent the distribution of the radiopharmaceutical, and thus result in more accurate images. The aim of this study is to evaluate the standard parameters for tomographic imagesreconstruction, and attenuation and scatter corrections ofSPECT images, from Hospital das Clínicas da Faculdade de Medicina de RibeirãoPreto, Universidade de São Paulo, through qualitativeand quantitative analysis of the reconstructed image obtained from SPECT aquisitions. Though a modified to two windows of acquisition protocol for cerebral SPECT-CT, we acquired SPECT and SPECT-CT images (BrightView XCT, Philips) using phantom Jaszczak and the ones were reconstructed by FBP, MLEM and OSEM methods. The results show that the FBP method has poor image precision due to low SNR. The review suggests the use of iterative methods MLEM and OSEM with attenuation correction as a standard method of image reconstruction of cerebral perfusion. According to the images the phantom Jaszczak and contrast analysis between cold sphere and background, we propose observational analysis and evaluations of clinical images reconstructed by OSEM method with parameters 3 iterations, 16 subsets, Butterworth filter with cutoff frequency 0.34 and order 1, as newstandard parameters for image reconstruction parameters.

The attenuation of photons within the body has been recognised as the major limiting factor hindering the ability of single photon emission computed tomography (SPECT) as a quantitative technique. This thesis investigates several aspects of an emission-transmission SPECT system using the Monte Carlo method and experimental techniques. The system was based on a rotating gamma camera fitted with a parallel hole collimator. The simulation of a transmission study was performed using a simple non-uniform mathematical phantom with two different external sources, a collimated line source and a flood source. The results showed that the attenuation maps were highly dependent on the geometry and photon energy of the source. The collimated line source produced improved image quality with lower statistical noise than the flood source. The results showed that, when high atomic number elements are present in the tissue composition, the attenuation coefficients at different energies are related through a second order polynomial transformation. If the object under study is formed of soft tissue equivalent materials, a linear transformation holds. The attenuation maps generated in the transmission study were used to correct for non-uniform attenuation compensation of an emission phantom. The results showed that non-uniform attenuation compensation improved image quality and reduced noise when compared to data without attenuation compensation. The presence of scattered photons in the emission data reduced the quality of the images and precluded accurate quantification. Absolute quantification was performed using the percent air sensitivity criterion. The largest difference between the theoretical and the Monte Carlo simulated images was approximately 8%. An emission-transmission myocardial perfusion study was simulated using an anthropomorphic phantom. Two photon energies of clinical interest were used, 75 keV and 140 keV, corresponding to the main photon emission energies of 201Tl and 99mTC. The results showed that 99mTc provided better image quality than 201Tl. Non-uniform attenuation compensation produced a very good agreement between the theoretical prediction and the simulation when scatter-free data were considered. The results presented in this thesis indicate that it is not possible to accomplish accurate attenuation compensation in general situations if scatter correction is not applied.

Photon attenuation is believed to be one of the major causes of artefacts in cardiac SPECT studies and therefore should be corrected to improve the specificity of cardiac SPECT imaging for the detection of coronary artery disease. Today, many SPECT system manufacturers provide optional hardware (CT imaging) and software (OSEM reconstruction algorithm) technology attempting to produce attenuation corrected (artefacts-free) images and more accurate quantitative cardiac SPECT studies. However, this attenuation correction (AC) technique has not received widespread acceptance in routinely clinical practice due to the less-than-optimal validations of AC using realistic data and the potential for creating new artefacts. The purpose of this study is to validate whether AC can produce quantitatively accurate cardiac SPECT images and whether it creates more additional artefacts than it has cured. METHODS: Multiple experiments were carried out using cardiac SPECT data and the state-of-the-art AC technology available in Sheffield Teaching Hospitals (CT/SPECT hybrid system and OSEM algorithm). Cardiac SPECT data obtained from computer-simulated models, a physical phantom (anthropomorphic phantom with cardiac insert) and one patient data were used to validate and evaluate AC technique. Qualitative and quantitative analysis was performed to compare cardiac SPECT images without and with AC. RESULTS: The computer-simulated phantom showed that a realistic model can be generated and was used successfully for validation purposes. The simulation results showed that the attenuation artefacts were corrected significantly in both noiseless and noisy data. Using post-filtering with high number of iterations was found to be the reasonable criteria of stopping the reconstruction. The simulated data with 1 cm misregistration error between emission and transmission images produces a significant error in AC images. Attenuation artefacts were significantly corrected in all walls of cardiac insert in physical phantom with some non-uniformity in images reconstructed with low number of iterations. These images become more uniform with high number of iterations. Patient data demonstrated that AC appears to have worked well. CONCLUSION: OSEM algorithm was able to correct attenuation artefacts (without scatter modelling) of cardiac SPECT images using CT attenuation map with no evidence of generating additional artefacts. If such artefacts exist they must arise either from early stopping of the OSEM algorithm or other sources e. g. scatter and nusregistration. In conclusion, OSEM algorithm is recommended for AC in cardiac SPECT studies.

Positron emission tomography (PET) and single photon emission tomography (SPECT) are two nuclear emission-imaging modalities that rely on the detection of high-energy photons emitted from radiotracers administered to the subject. The majority of these photons are attenuated (absorbed or scattered) in the body, resulting in count losses or deviations from true detection, which in turn degrades the accuracy of images. In clinical emission tomography, sophisticated correction methods are often required employing additional x-ray CT or radionuclide transmission scans. Having proven their potential in both clinical and research areas, both PET and SPECT are being adapted for small animal imaging. However, despite the growing interest in small animal emission tomography, little scientific information exists about the accuracy of these correction methods on smaller size objects, and what level of correction is required. The purpose of this work is to determine the role of attenuation and scatter corrections as a function of object size through simulations. The simulations were performed using Interactive Data Language (IDL) and a Monte Carlo based package, Geant4 application for emission tomography (GATE). In IDL simulations, PET and SPECT data acquisition were modeled in the presence of attenuation. A mathematical emission and attenuation phantom approximating a thorax slice and slices from real PET/CT data were scaled to 5 different sizes (i.e., human, dog, rabbit, rat and mouse). The simulated emission data collected from these objects were reconstructed. The reconstructed images, with and without attenuation correction, were compared to the ideal (i.e., non-attenuated) reconstruction. Next, using GATE, scatter fraction values (the ratio of the scatter counts to the total counts) of PET and SPECT scanners were measured for various sizes of NEMA (cylindrical phantoms representing small animals and human), MOBY (realistic mouse/rat model) and XCAT (realistic human model) digital phantoms. In addition, PET projection files for different sizes of MOBY phantoms were reconstructed in 6 different conditions including attenuation and scatter corrections. Selected regions were analyzed for these different reconstruction conditions and object sizes. Finally, real mouse data from the real version of the same small animal PET scanner we modeled in our simulations were analyzed for similar reconstruction conditions. Both our IDL and GATE simulations showed that, for small animal PET and SPECT, even the smallest size objects (~2 cm diameter) showed ~15% error when both attenuation and scatter were not corrected. However, a simple attenuation correction using a uniform attenuation map and object boundary obtained from emission data significantly reduces this error (~1% for smallest size and ~6% for largest size, in non-lung regions). In addition, we did not observe any significant improvement between the uses of uniform or actual attenuation map (e.g., only ~0.5% for largest size in PET studies). The scatter correction was not significant for smaller size objects, but became increasingly important for larger sizes objects. These results suggest that for all mouse sizes and most rat sizes, uniform attenuation correction can be performed using emission data only. For smaller sizes up to ~ 4 cm, scatter correction is not required even in lung regions. For larger sizes if accurate quantization needed, additional transmission scan may be required to estimate an accurate attenuation map for both attenuation and scatter corrections.

In single photon emission computed tomography (SPECT) one is interested in reconstructing the activity distribution f of some radiopharmaceutical. The data gathered suffer from attenuation due to the tissue density µ. Each imaged slice incorporates noisy sample values of the nonlinear attenuated Radon transform (formular at this place in the original abstract) Traditional theory for SPECT reconstruction treats µ as a known parameter. In practical applications, however, µ is not known, but either crudely estimated, determined in costly additional measurements or plainly neglected. We demonstrate that an approximation of both f and µ from SPECT data alone is feasible, leading to quantitatively more accurate SPECT images. The result is based on nonlinear Tikhonov regularization techniques for parameter estimation problems in differential equations combined with Gauss-Newton-CG minimization.

Thesis (Ph. D.)--Ohio State University, 2002.
Title from first page of PDF file. Document formatted into pages; contains xvi, 162 p. Includes abstract and vita. Advisor: Lawrence L. Feth, Dept. of Speech and Hearing Science. Includes bibliographical references (p. 141-148).

O objetivo deste trabalho foi avaliar a influência das correções de atenuação e espalhamento na reconstrução quantitativa em SPECT. O estudo foi baseado em diversas simulações de Monte Carlo, com ênfase especial no modelo torso-cardíaco matemático (MCAT). Para a reconstrução, foi utilizado o algoritmo iterativo ML-EM com projetor-retroprojetor modificado pelo mapa de atenuação. Para avaliar a correção de espalhamento, foram simulados os espectros energéticos, com múltiplas ordens de espalhamento Compton. O método da dupla janela de energia (Jaszczak) foi aplicado, devido a sua simplicidade, e as imagens corrigidas foram comparadas com as de fótons primários. Foram analisadas as escolhas das janelas do fotopico e espalhamento, além da dependência do fator de espalhamento k com a distribuição de atividades do objeto. Duas abordagens foram adotadas para a obtenção dos mapas de atenuação: a estimativa do mapa uniforme diretamente dos dados de emissão, sem o uso de imagens de transmissão; e o borramento de mapas não-uniformes, reconstruídos a partir das projeções por transmissão. A estimativa do mapa de atenuação diretamente dos sinogramas de emissão baseou-se nas condições de consistência da transformada de Radon atenuada. Neste caso, foram estudados os efeitos de diferentes contagens e vários coeficientes de atenuação iniciais sobre as imagens corrigidas. Os mapas de atenuação não-uniformes foram borrados com um \"kernei\" gaussiano, aplicados nas correções e os efeitos na quantificação foram analisados. Os espectros energéticos emitidos pelo modelo MCAT mostraram que os fótons espalhados não poderiam ser excluídos a contento, mesmo que fossem utilizadas janelas de aquisição estreitas sobre o fotopico. Em relação a correção de Jaszczak, verificou-se que a escolha das janelas de fotopico e espalhamento é crucial e confirmou-se que o valor de k é altamente dependente do objeto examinado. Dada uma estimativa inicial do mapa de atenuação, o uso das condições de consistência para estimar o mapa de atenuação uniforme, consistente com os dados de emissão do modelo MCAT simulado, resultou sempre em uma mesma forma, para quaisquer valores iniciais do conjunto de parâmetros. Apesar do erro diminuir com o aumento da contagem, o melhor coeficiente de atenuação não pôde ser obtido, mesmo em altas contagens. Isto se deve a presença dos fótons espalhados, que alteraram a solução das condições de consistência, reduzindo as dimensões do mapa. Os resultados indicaram que a correção de espalhamento é o fator mais importante na reconstrução quantitativa em SPECT. Com referência aos efeitos quantitativos da correção de atenuação, não foram observadas diferenças significativas com a utilização dos mapas borrados, enquanto que a correção com mapas uniformes mostrou-se menos eficaz.
The goal of this work is to evaluate the influence of scatter and attenuation correction methods in quantitative SPECT reconstruction. The study was based on several Monte Carlo simulations, with special emphasis on the mathematical cardiac-torso phantom (MCAT). Iterative ML-EM reconstruction with modified projector-backprojector was used. To evaluate the scatter correction, energy spectra were simulated for SPECT imaging including multiple order Compton scattered photons. The dual energy window method proposed by Jaszczak was applied and scatter corrected images were compared with primary photons images. The choice of the scattering and photopeak windows and the dependence of the scatter factor k with the activity distribution were also analysed. Two approaches were adopted for obtaining the maps for attenuation correction: the estimation of the attenuation maps directly from the emission data, without transmission imaging, and the blurring of non-uniform attenuation maps, reconstructed from transmission data. The estimation of attenuation maps directly from the emission sinograms was based on the consistency conditions of attenuated Radon transform. In this case, the effects of different counting rates and various initial attenuation coefficients on the corrected images were studied. The non-uniform attenuation maps were blurred with a gaussian kernel with different variances, applied in further corrections and their effects on quantitation were examined. Analysis of energy spectra emitted from the MCAT phantom showed that scattered photons cannot be totally excluded, even when narrow acquisition windows were used. As far as the Jaszczak correction is concerned, results showed that the choice of photopeak and secondary windows is crucial and that the value of k is highly dependent on the imaged object. Given an initial estimation of the attenuation map with a constant coefficient, the use of consistency conditions to estimate the uniform map, consistent with the emission data of simulated MCAT phantom, resulted in the same shape for any set of initial parameters. In spite of the fact that the error falls with increasing counting rate, higher counts are not able to determine the best attenuation coefficient. This is due to scattered photons, which alter the solution of consistency conditions, reducing the size of estimated maps. Results indicated that the scatter correction is the most important factor inquantitative SPECT reconstruction. Furthermore, no significant differences were observed in the quantitation, when using the blurred non- uniform attenuation maps in attenuation correction, while corrections with uniform maps proved to be less efficient

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Ocean Engineering, 1985.
MICROFICHE COPY AVAILABLE IN ARCHIVES AND ENGINEERING.
Includes bibliographies.
by Subramaniam D. Rajan.
Ph.D.

Nous proposons dans le cadre de cette thèse une nouvelle approche permettant de s'affranchir de l'atténuation mammaire en tomographie par émission monophotonique (TEMP) de perfusion myocardique. Elle est constituée de deux parties : - la première consiste à rendre les projections acquises consistantes. - la deuxième consiste à pondérer ces même les projections corrigées durant la reconstruction. Nous avons effectué l'étude de validité de nos méthodes sur quelques exemples de simulation TEMP de perfusion myocardique simulant l'atténuation mammaire et sur quelques exemples d'études patients réelles notamment : des cas d'atténuation mammaire, d'infarctus inférieure, d'infarctus apical, d'infarctus antérieur, d'ischémie antérieure et inférieure. Les résultats semblent encourageants. Il s'agit dans le proche avenir de mener une étude de validation chez les patients versus un gold standard (coronarographie, coroscanner)
We propose in this thesis a new approach to correct the breast attenuation in SPECT myocardial perfusion imaging. It consists of two parts: -The first is to make the acquired projections consistent with each other. - The second is to weight the corrected attenuated projection during the reconstruction. We conducted a validation of our methods on some examples of myocardial perfusion SPECT imaging simulating the breast attenuation and some examples of real patient studies including: breast attenuation, anterior myocardial infarction, inferior myocardial infarction, anterior myocardial ischemia and inferior myocardial ischemia. The obtained results are encouraging. At this step, it is interesting in the near future to conduct a validation study in patients versus a gold standard (angiography, coroscan).Key words: SPECT, tomographic reconstruction, breast attenuation, Iterative reconstruction, attenuation correction, myocardial perfusion imaging, nuclear medicine

This thesis aims to investigate the acoustic properties of ultrasound contrast agents (UCAs) at high ultrasound frequencies. In recent years, there has been increasing development in the use of high frequency ultrasound in the fields of preclinical, intravascular, ophthalmology and superficial tissue imaging. Although research studying the acoustic response of UCAs at low diagnostic ultrasonic frequencies has been well documented, quantitative information on the acoustical properties of UCAs at high ultrasonic frequencies is limited. In this thesis, acoustical characterisation of three UCAs was performed using a preclinical ultrasound scanner (Vevo 770, VisualSonics Inc., Canada). Initially the acoustical characterisation of five high frequency transducers was measured using a membrane hydrophone with an active element of 0.2 mm in diameter to quantify the transmitting frequencies, pressures and spatial beam profiles of each of the transducers. Using these transducers and development of appropriate software, high frequency acoustical characterisation (speed and attenuation) of an agar-based tissue mimicking material (TMM) was performed using a broadband substitution technique. The results from this study showed that the acoustical attenuation of TMM varied nonlinearly with frequency and the speed of sound was approximately constant 1548m·s-1 in the frequency range 12-47MHz. The acoustical properties of three commercially available lipid encapsulated UCAs including two clinical UCAs Definity (Lantheus Medical Imaging, USA) and SonoVue (Bracco, Italy) and one preclinical UCAs MicroMarker (untargeted) (VisualSonics, Canada) were studied using the software and techniques developed for TMM characterisation. Attenuation, contrast-to-tissue ratio (CTR) and subharmonic to fundamental ratio were measured at low acoustic pressures. The results showed that large off-resonance and resonant MBs predominantly contributed to the fundamental response and MBs which resonated at half of the driven frequency predominantly contributed to subharmonic response. The effect of needle gauge, temperature and injection rate on the size distribution and acoustic properties of Definity and SonoVue was measured and was found to have significant impacts. Acoustic characterisations of both TMM and UCAs in this thesis extend our understanding from low frequency to high frequency ultrasound and will enable the further development of ultrasound imaging techniques and UCAs design specifically for high frequency ultrasound applications.

Die Option Mechanism Dynamics (MDO) von Creo Parametric ist ein Tool aus dem Bereich Starrkörperdynamik. Im Kern des Vortrags steht jedoch die MDO-Funktion 3D-Kontakt, die einzigartig mit elastischen Körpern arbeitet. Im Vortrag wird die Vorgehensweise bei der dynamischen Simulation eines Rutschreifens auf GFK-Wasserrutschen erläutert, abschließend werden Animationsbeispiele präsentiert.

In this thesis, shows a current issue for free space optics, limiting their use in practice with regard to the availability and reliability. They conducted measurements on wireless optical links and the observed values is calculated by the availability of the connection. Subsequently, measurements are performed on alternate versions of wireless and copper connections. Observed values were compared with a wireless optical link. It is made of optical design of wireless connections at home.

This Master’s thesis analizes technologies suitable for metropolitan area networks. In this thesis there are mentioned technologies used for wireless transfer with speeds above 1 Gbps. There are described basic features and parameters of microwave radio relay links in 70/80GHz range and free space optic links. These technologies are compared with classic optical networks. Practical part of thesis was focused on development of application which calculates signal attenuation caused by the passage of the atmosphere for both technologies. Results gained from this application are mentioned in this Master’s thesis.

Le développement de plusieurs méthodes de reconstruction quantitatives dédiées à la Tomographie par Emission Mono Photonique du petit animal a été au cœur de cette thèse. Dans cette optique, une modélisation rigoureuse par simulation Monte Carlo du processus d’acquisition du système disponible, a été mise en place et validée. La modélisation matricielle combinée à l’algorithme de reconstruction itératif OS-EM, a permis la caractérisation des performances du système. Les valeurs de sensibilité et de résolution spatiale tomographique sont respectivement de 0,027% au centre du champ de vue et de 0,87 mm. Les limitations majeures des méthodes Monte Carlo nous ont conduit à développer une génération matricielle efficace et simplifiée des effets physiques occurrents dans le sujet. Mon approche, basée sur une décomposition de la matrice système, associée à une base de données pré-calculées, a démontré un temps acceptable pour un suivi quotidien (1h), conduisant à une reconstruction d’images personnalisée. Les approximations inhérentes à l’approche mise en place ont un impact modéré sur les valeurs des coefficients de recouvrement, une correction d’environ 10% ayant été obtenue
My thesis focuses on the development of several quantitative reconstruction methods dedicated to small animal Single Photon Emission Computed Tomography. The latter is based on modeling the acquisition process of a 4-heads pinhole SPECT system using Monte Carlo simulations.The system matrix approach, combined with the OS-EM iterative reconstruction algorithm, enabled to characterize the system performances and to compare it to the state of the art. Sensitivity of about 0,027% in the center of the field of view combined with a tomographic spatial resolution of 0,87 mm were obtained.The major drawbacks of Monte Carlo methods led us to develop an efficient and simplified modeling of the physical effects occurring in the subject. My approach based on a system matrix decomposition, associated to a scatter pre-calculated database method, demonstrated an acceptable time for a daily imaging subject follow-up (1h), leading to a personalized imaging approach. The inherent approximations of the scatter pre-calculated approach have a moderate impact on the recovery coefficients results, nevertheless a correction of about 10% was achieved

Detailed information about the oceanic environment is essential for many applications in the field of marine geology, marine biology, coastal engineering, and marine operations. Especially, knowledge of the properties of the sediment body is often required. Acoustic remote sensing techniques have become highly attractive for classifying the sea bottom and for mapping the sediment properties, due to their high coverage capabilities and low costs compared to common sampling methods. In the last decades, a number of different acoustic devices and related techniques for analyzing their signals have evolved. Each sensor has its specific application due to limitations in the frequency range and resolution. In practice, often a single acoustic tool is chosen based on the current application, supported by other non-acoustic data where required. However, different acoustic remote sensing techniques can supplement each other, as shown in this thesis. Even more, a combination of complementary approaches can contribute to the proper understanding of sound propagation, which is essential when using sound for environmental classification purposes. This includes the knowledge of the relation between acoustics and sediment properties, the focus of this thesis. Providing a detailed three dimensional picture of the sea bottom sediments that allows for gaining maximum insight into this relation is aimed at.

Chapters 4 and 5 are adapted from published work, with permission:

DOI:10.1121/1.3569718 (link: http://asadl.org/jasa/resource/1/jasman/v129/i5/p2878_s1) and

DOI:10.1109/JOE.2010.2066711 (link: http://ieeexplore.ieee.org/xpl/articleDetails.jsp?tp=&arnumber=5618582&queryText%3Dsiemes)

In reference to IEEE copyrighted material which is used with permission in this thesis, the IEEE does not endorse any of the Université libre de Bruxelles' products or services.

Doctorat en Sciences de l'ingénieur
info:eu-repo/semantics/nonPublished

Le dihydrogène, communément appelé hydrogène, est un gaz dangereux qui devient explosif au-dessus d'une concentration de 4% dans l'air. Par conséquent, de nombreuses applications pour lesquelles l'hydrogène est utilisé ou produit nécessitent des capteurs d'hydrogène pour s'assurer que cette limite n'est jamais atteinte. Ces applications comprennent la surveillance des déchets radioactifs, la production d'énergie propre ou plus généralement la surveillance des gaz industriels. La plupart des dispositifs de détection existants actuellement sur le marché sont basés sur l'utilisation d'un composé chimique ou d'une couche sensible spécifiquement conçue, qui dans la plupart des cas n'est pas stable dans le temps, généralement au bout quelques mois il y a une dégradation des propriétés de la couche ou du composé chimique. Cela a conduit au développement de méthodes qui reposent sur des mécanismes de détection physiques plutôt que chimiques pour la détection de l'hydrogène : ces méthodes ont l'avantage d'être stables sur des périodes beaucoup plus longues. Dans le contexte de la surveillance des déchets radioactifs, des travaux antérieurs avaient montré que les micropoutres non revêtue de couche sensible étaient capables de détecter l'hydrogène gazeux jusqu'à 0,01% en mesurant leur changement de fréquence de résonance. Les travaux de cette thèse prolongent cette étude en y ajoutant la capacité de distinguer l'hydrogène des autres gaz potentiellement interférents. Dans le cas des micropoutres, la discrimination des gaz est réalisée en mesurant non seulement la masse volumique du gaz mais aussi sa viscosité grâce à la mesure simultanée de la fréquence de résonance et du facteur de qualité. Des transducteurs ultrasoniques micro-usinés capacitifs (CMUT) ont également été utilisés comme alternative aux micropoutres. Avec les CMUT, la vitesse du son et l'atténuation acoustique ont également été mesurées à l’aide d’un montage de type mesure de temps de vol au lieu des mesures du spectre du dispositif à la résonance. Dans le cas de la mesure de l'atténuation, une méthode permettant d'obtenir une bonne sélectivité de la détection d'hydrogène vis-à-vis de gaz interférents tels que le dioxyde de carbone et le méthane a été développée
Hydrogen is a hazardous gas that becomes explosive above a concentration of 4% in air. As a result, many applications where hydrogen is either used or produced require hydrogen sensors to ensure that this limit is never reached. These applications include radioactive waste monitoring, clean energy production or more generally industrial gas monitoring. Most existing sensing devices currently on the market are based on the use of a specifically engineered chemical component or film, which in most cases is not stable over time, lasting usually a few months. This has led to the development of methods that rely on physical sensing mechanisms rather than on chemical ones for the detection of hydrogen: these methods have the advantage of being stable over much longer periods of time. In the context of radioactive waste monitoring, previous work has shown that uncoated (no chemical film) microcantilevers are capable of detecting hydrogen gas up to 0.01% by measuring their change in resonant frequency. This work extends this study by adding the ability to distinguish hydrogen from potential interfering gases. In the case of microcantilevers, gas discrimination is achieved by measuring not only the density of the gas but also its viscosity with the measurement of both the resonant frequency and the quality factor. Capacitive micromachined ultrasonic transducers (CMUTs) have also been used as an alternative to microcantilevers. With the CMUTs, both sound velocity and acoustic attenuation have been measured by a time of flight setup instead of device measurements at resonance. In the case of attenuation measurement, a method for obtaining good selectivity of hydrogen measurement against interfering gases such as carbon dioxide and methane has been developed

碩士
國立清華大學
原子科學系
88
In PET or SPECT system, the photon transited from the midst of the body passes through more materials than those from the edge of the body does. Therefore, the center of the projection will be attenuated more than the edge of the projection. As a result, in the reconstructed image, the activity in the center section will be less than actual situation, and the activity of the edge section is on the contrary. It’s called attenuation effect. In order to correct this effect, we must compensate the attenuation in the projection data. Currently, there are two major methods for attenuation correction. First, use a radiation source (ex. Co-60 ) to rotate round the patient body. Second, using Chang’s method, it assume that total attenuation coefficient in the body is constant, which is usually equal to water. Accordingly, we just correct the error from the distance. If the attenuation coefficient is not uniform, the error might be large. So, we focus on the attenuation coefficient in the body and search for new method. How do we know the inner attenuation coefficient distribution? We can calculate unknown inner structure from known standard CT slice, using standard-axis distortion interpolation method. Then, obtaining the body’s attenuation coefficient distribution information, we can repeat Chang’s calculation with adding attenuation coefficient information. In this way, it could increase precision of nuclear medicine image, and also the patients may avoid receiving additional radiation dose.

The propagation of acoustic waves through water-saturated granular sediments has been widely studied, yet existing propagation models can not adequately predict the speed and attenuation of sound across the range of frequencies of interest in underwater acoustics, especially in loosely packed sediments that have been recently disturbed by storms or wave action. Advances in modeling are currently dependent on experimental validation of various components of existing models. To begin to address these deficiencies, three well-controlled laboratory experiments were performed in gravity-settled glass beads and reconstituted sand sediments. Sound speed and attenuation measurements in the 0.5 kHz to 10 kHz range are scarce in the literature, so a resonator method was used to investigate a reconstituted sand sediment in this range. The literature contains laboratory and in situ measurements of sound speed and attenuation at higher frequencies, but existing models can not predict both the speed of sound and attenuation simultaneously in some sediments. A time-of-flight technique was used to determine the speed of sound and attenuation in monodisperse water-saturated glass beads, binary glass bead mixtures, and reconstituted sediment samples in the frequency range 200 kHz to 900 kHz to investigate the effect of sediment inhomogeneity. The effect of porosity, independent of changes in other sediment physical properties, has not been demonstrated in the experimental literature. Therefore, a fluidized bed technique was used to independently vary the porosity of monodisperse glass bead samples from 0.37 to 0.43 and a Fourier phase technique was used to determine the speed and attenuation of sound. Collecting these results together, measured sound speeds showed positive dispersion below 50 kHz while negative dispersion was observed above 200 kHz for some samples. Attenuation measurements showed an approximately f⁰̇⁵ dependence in the low frequency regime and an approximately f³̇⁵ dependence for large-grained samples in the high frequency regime. The laboratory experiments presented in this work demonstrate that both sound speed and attenuation in idealized loosely packed water-saturated sediments can not be simultaneously predicted by existing models within the uncertainties of the model input parameters, but the independent effect of porosity on sound speed can be predicted.
text

The Medical Internal Radiation Dose (MIRD) protocol has provided a solid foundation over the years for calculating the internal absorbed dose but as for providing an assessment that is specific to the individual patient's organ/tumor anatomy, it falls short. Various methods have been proposed to overcome the shortcomings of the MIRD protocol, but each has its own limitations. Quantitative SPECT proves to be the most desirable option for determining dose estimates, yet the prolonged scan times prevent SPECT from becoming a clinical protocol in dosimetry. Given the time constraints of clinical SPECT, planar quantitative imaging has proved a popular choice for dosimetry studies, but the resulting dose overestimates may prevent maximum therapy from being achieved. Proposed here is a protocol that contends to be clinically feasible, patient-specific, and promising in its results. This protocol combines the benefits of both quantitative planar and SPECT imaging. By maintaining the majority of scans as planar yet incorporating the benefits of attenuation corrected SPECT scans, a more accurate, yet attainable clinical protocol can be achieved. The 2 or more SPECT scans suggested make use of a Gadolinium-153 transmission source so that a simultaneous emission/transmission scan provide a patient-specific, attenuation corrected SPECT image. The SPECT data is then used to constrain the planar data, resulting in a more accurate dose estimate than would arise from planar alone. Phantom experiments demonstrate that the errors in absorbed dose estimates have improved from an average of 159% for planar methods alone to 14% by the addition of a SPECT constraint.

No
Clinkers of high alumina cements are separated into three granular formulations with particle sizes in the range 0.6-0.71 mm, 0.71-1.18 mm and greater than 1.18 mm. These are used to manufacture consolidated samples of porous concrete in an autoclave. The acoustic and microscopic properties of loose and consolidated porous samples of concrete are investigated using both experimental methods and mathematical modelling. Values of porosity, flow resistivity, tortuosity and parameters of the pore size distribution are determined and used to predict closely the sound speed, acoustic attenuation and normal incidence absorption coefficient of these materials. It is shown that high alumina cements do not require additional binders for consolidation and that the structural bonds in these cements are developed quickly between individual clinkers in the presence of water. The hydration product build-up during the consolidation process is insignificant which ensures good acoustic performance of the consolidated samples resulting from a sufficient proportion of the open pores. The value of porosity in the consolidated samples was found to be around 40%, which is close to that measured in some commercial acoustic absorbers. This work provides a foundation for the development of acoustically efficient and structurally robust materials, which can be integrated in environmentally sustainable concrete and masonry structures.

This thesis consists of five chapters. Chapter 1 presents the basic ideas of SPECT imaging. This chapter also explains the phenomenon of attenuation and shows how the attenuation effect affects SPECT imaging. Chapter 2 reviews various attenuation estimation methods and attenuation compensation methods. The advantages and disadvantages of these methods are discussed in this chapter. Moreover, this chapter discusses three artifacts such as missing counts, truncation and cross-talk effect, and their corrections. Additionally, this chapter presents three map reconstruction methods: FBP, OSEM and OSTGS. OSTGS has been tested by using computer simulations described in Chapter 3. Chapter 3 presents transmission simulations performed analytically. The analytical transmission simulations can be used to simulate simultaneous transmission /emission data acquisition by combining Monte Carlo SLMSET emission simulations. Different reconstruction methods have been tested in this computer simulation and the thorax phantom experiment described in Chapter 4. The results of these tests indicate that the cross-talk correction performance achieved by using OSTGS is better than that achieved by using conventional subtraction cross-talk correction. Finally, a summary is presented in Chapter 5 in which three topics for future work are being discussed.

碩士
國立成功大學
土木工程學系碩博士班
96
Both high-speed rail (HSR) and Southern Taiwan Science Industrial Park (STSIP) are major key-points of balancing the development in southern and northern Taiwan. Vibrations induced by passing HSR are a serious care by STSIP. Although vibration measurements for various selected points have been done by STSIP, there are still lacks of enough in-site measurement data related to the attenuation of vibration in STSIP. The main purpose of this study is to perform the in-situ the attenuation measurements of vibration induced by HSR. The attenuation characteristics in STSIP are also discussed in this study. Two models, which are Bornitz and Nakano Aritomo attenuation model, are used to analyze the measuring data under several conditions to obtain the attenuation coefficient. The results obtained from these two models are also compared in this study. A simple empirical equation for attenuation coefficient is reduced. The results show that negative attenuation coefficients are observed when using Bornitz and Nakano Aritomo attenuation model only. However, this situation can be improved by using this two models with Edwards and Northwood attenuation model.

Photon attenuation and scatter in myocardial perfusion SPECT are major sources of diagnostic uncertainty because they affect both the qualitative and quantitive characteristics of patient images. Recent studies have demonstrated improved performance in the diagnostic accuracy of Sestamibi myocardial perfusion SPECT images when using attenuation corrected images [1]. One technique for correcting for attenuation uses a short (65 cm) focal length fan beam collimator and a line Methods for correcting images for scatter using adjacent energy windows have also been proposed. Though methods for correcting for these problems exist, implementation in a clinical setting has been difficult. We have developed a clinical protocol for performing attenuation and scatter correction. The system uses a fan-beam collimator and a line source of activity on a PRISM 3000, triple head camera system for acquiring transmission data. For acquiring emission data, parallel hole collimators are placed on the two other camera heads to determine: (1) the photo-peak image, (2) the scatter contribution to the photo-peak image, and (3) a large scatter window for estimating the body outline. The body outline is used as a spatially varying gamma prior for correcting the transmission image for the effects of object truncation. Presented herein is also a method of automatically selecting a spatially varying Gibbs prior to control the noise in the iterative reconstruction. The method of Ordered Subsets-Expectation Maximization is also used to accelerate the reconstruction of the images [2]. We observed in phantom studies that correcting images for attenuation and scatter will reduce the effects of these artifacts but may emphasize other effects, i.e. detector response, patient motion, etc. Improvements in uniformity of myocardial images were observed for Sestamibi phantom studies using a breast attenuator which partially obscured the heart. However, less significant improvements were observed using 201Tl where the heart was completely obscured by the breast attenuator. This protocol demonstrated that clinical implementation of attenuation and scatter correction is possible without significant adjustment of clinical routine. However, because of the residual artifacts present in the corrected images, it is necessary to obtain simultaneously data for reconstructing images using traditional FBP protocols. in conjunction with correction protocols.

yes
Background Disruptions to the progress of the centre-of-pressure trajectory beneath prosthetic feet have been reported previously. These disruptions reflect how body weight is transferred over the prosthetic limb and are governed by the compliance of the prosthetic foot device and its ability to simulate ankle function. This study investigated whether using an articulating hydraulic ankle attachment attenuates centre-of-pressure trajectory fluctuations under the prosthetic foot compared to a fixed attachment. Methods Twenty active unilateral trans-tibial amputees completed walking trials at their freely-selected, comfortable walking speed using both their habitual foot with either a rigid or elastic articulating attachment and a foot with a hydraulic ankle attachment. Centre-of-pressure displacement and velocity fluctuations beneath the prosthetic foot, prosthetic shank angular velocity during stance, and walking speed were compared between foot conditions. Findings Use of the hydraulic device eliminated or reduced the magnitude of posteriorly directed centre-of-pressure displacements, reduced centre-of-pressure velocity variability across single-support, increased mean forward angular velocity of the shank during early stance, and increased freely chosen comfortable walking speed (P ≤ 0.002). Interpretation The attenuation of centre-of-pressure trajectory fluctuations when using the hydraulic device indicated bodyweight was transferred onto the prosthetic limb in a smoother, less faltering manner which allowed the centre of mass to translate more quickly over the foot.

碩士
中臺科技大學
醫學影像暨放射科學系暨研究所
104
The sensitivity of polymer gel dosimeter is high in radiation detection, which will be polymerized or cross-linked under the radiation exposure. The new NIPAM polymer gel dosimeter changes in the ultrasonic echo signals at different radiation dose. Set ultrasonic measurement system device, for tuning and system integration, to find out the optimum operating frequency and parameters, calculation and correction of NIPAM polymer gel dosimeter attenuation coefficient.The storage modulus of DMA was 2.24X10-3 MPa in 0Gy, 3.22X10-3 MPa in 5Gy, 4.01X10-3 MPa in 10Gy, 5.86X10-3 MPa in 15Gy. The ultrasonic attenuation of UCT was 0.76dB in 0Gy,1.31 dB in 5Gy, 2.22 dB in 10Gy,3.4 dB in 15Gy. The ultrasonic speeds of gel dosimeters in UCT were 1786 m/s in 0Gy, 1754 m/s in 5Gy, 1717 m/s in 10Gy, 1675 m/s in 15Gy.

Η διερεύνηση της διαγνωστικής και προγνωστικής αξία της διόρθωσης φωτονιακής εξασθένησης με χάρτες μέσω CT χαμηλής δόσης και ευκρίνειας στη στεφανιαία νόσο. ΠΕΙΡΑΜΑΤΙΚΟ ΣΚΕΛΟΣ Υλικό και Μέθοδος: Σε ομοίωμα Data Spectrum πραγματοποιήθηκαν SPECT/CT απεικονίσεις με 201Tl & 99mTc αφενός χωρίς ελλείμματα στο καρδιακό ένθεμα όπου μετρήθηκε ομοιογένεια εικόνας και κρούσεις και αφετέρου με την τοποθέτηση ελλειμμάτων, «διατοιχωματικών» & «υπενδοκαρδίων» όπου υπολογίστηκαν το μέγεθος (FWHM) και η αντίθεση του ελλείμματος. Κατόπιν οι AC & NAC απεικονίσεις συνεκρίθησαν κατά ζεύγη ως προς τις προαναφερθείσες παραμέτρους. Αποτελέσματα: Στις μετρήσεις χωρίς έλλειμμα ευνοήθηκε η μέθοδος με διόρθωση (AC) αυξάνοντας την ομοιογένεια της φυσιολογικής εικόνας και εξομαλύνοντας το λόγο κρούσεων κατωτέρου/προσθίου τοιχώματος. Στις απεικονίσεις με έλλειμμα η AC μέθοδος εμφάνισε καλύτερο FWHM ενώ η τεχνική χωρίς διόρθωση εξασθένησης (NAC) αποδείχθηκε ανώτερη ως προς την αντίθεση του ελλείμματος. ΔΙΑΓΝΩΣΤΙΚΟ ΣΚΕΛΟΣ Υλικό και Μέθοδος: Διερευνήθηκαν αναδρομικώς 120 εξεταζόμενοι χαμηλού pre-test κινδύνου ΣΝ με αρνητικούς κλινικούς δείκτες και 120 πρώϊμα στεφανιογραφηθέντες (<60 ημέρες μετά MPI με 201Tl + CT-AC). Οι AC & NAC εικόνες εκτιμήθηκαν τυφλά τόσο ποιοτικά όσο και ημιποσοτικά (Summed Stress Score - SSS, Summed Difference Score - SDS). Κατόπιν, υπολογίστηκε το normalcy στον πληθυσμό χαμηλού κινδύνου ενώ στους στεφανιογραφηθέντες με gold standard τα αγγειογραφικά δεδομένα υπολογίστηκαν ευαισθησίες, ειδικότητες και διαγνωστικές ακρίβειες στο γενικό πληθυσμό και κατά φύλο στην επικράτεια του LAD και του συνδυασμού RCA/LCx οι οποίες συνεκρίθησαν με τη McNemar δοκιμασία. Τέλος, σχεδιάστηκαν ROC καμπύλες και έγινε σύγκριση μεταξύ τους κατά ζεύγη. Αποτελέσματα: Στον πληθυσμό χαμηλού κινδύνου η AC τεχνική υπερίσχυσε στο normalcy, ενώ στους στεφανιογραφηθέντες στατιστική σημαντικότητα παρατηρήθηκε στην περιοχή κατανομής της RCA/LCx στο γενικό πληθυσμό και στους άνδρες, όπου η NAC μέθοδος ήταν πιο ευαίσθητη και η AC πιο ειδική, χωρίς να προκύψουν στατιστικώς σημαντικά αποτελέσματα κατά τις συγκρίσεις ως προς τη διαγνωστική ακρίβεια και στις κατά ζεύγη συγκρίσεις των AUC στις ROC καμπύλες. ΠΡΟΓΝΩΣΤΙΚΟ ΣΚΕΛΟΣ Υλικό και Μέθοδος: Πρόκειται για προοπτική μελέτη με 637 συμμετέχοντες στους οποίους πραγματοποιήθηκε SPECT/CT απεικόνιση ρουτίνας και εκτιμήθηκαν ημιποσοτικά οι AC & NAC εικόνες (SSS – τυφλή ανάλυση). Μετά από κλινική παρακολούθηση κατεγράφησαν οι θάνατοι (πρωτεύον καταληκτικό σημείο), καθώς και οι συνδυασμοί θανάτων/ΟΕΜ και θανάτων/ΟΕΜ/οψίμων επαναγγειώσεων (δευτερεύοντα καταληκτικά σημεία). Κατόπιν, ορίστηκαν διαχωριστικές SSS τιμές του πληθυσμού βάσει της συχνότητας συμβαμάτων, και σχεδιάστηκαν Kaplan-Meier καμπύλες επιβίωσης στο γενικό πληθυσμό και στις SSS υποομάδες (AC & NAC) οι οποίες συνεκρίθησαν μεταξύ τους με την LogRank μέθοδο. Τέλος, οι κλινικές και απεικονιστικές παράμετροι αξιολογήθηκαν με την Cox μέθοδο, τόσο στο μονοπαραγοντικό (univariate) μοντέλο όσο και στην πολυπαραγοντική ανάλυση παλινδρόμησης (multivariate regression analysis). Αποτελέσματα: Κατά τη διάρκεια της κλινικής παρακολούθησης (ѱSD = 42.3±12.8 μήνες) σημειώθηκαν 24 θάνατοι (7 καρδιογενείς), 13 ΟΕΜ και 28 επαναγγειώσεις. Από την κατηγοριοποίηση του πληθυσμού προέκυψαν τρεις SSS υποομάδες για κάθε μέθοδο: 0-4, 5-13 και >13 (NAC) και 0-2, 3-9 και >9 (AC). Στην Kaplan-Meier ανάλυση η NAC παρήγαγε στατιστικώς σημαντικά αποτελέσματα μεταξύ των ομάδων 5-13 και >13 ως προς θανάτους και μεταξύ όλων των SSS υποπληθυσμών για αμφότερα τα δευτερεύοντα καταληκτικά σημεία, ενώ η AC κατάφερε να διαχωρίσει μεταξύ 0-2 & >9 ως προς θανάτους/ΟΕΜ και 0-2 & 3-9 ως προς συνολικά συμβάματα. Στο μονοπαραγοντικό Cox μοντέλο η NAC απεικόνιση κατάφερε στατιστική σημαντικότητα τόσο για SSS>4 όσο και >13 ως προς όλα τα καταληκτικά σημεία με την AC να παρουσιάζει ανάλογα αποτελέσματα για SSS>2 ως προς μείζονα και συνολικά συμβάματα και για SSS>9 ως προς το σύνολο των συμβαμάτων. Τέλος, στην πολυπαραγοντική ανάλυση παλινδρόμησης, η NAC αποδείχθηκε ανεξάρτητη προβλεπτική παράμετρος για θανάτους/ΟΕΜ και σύνολο συμβαμάτων, ενώ στην AC δεν παρατηρήθηκαν στατιστικώς σημαντικά αποτελέσματα. Συμπέρασμα: Η διόρθωση φωτονιακής εξασθένησης μέσω χαρτών εξασθένησης με CT δεν φαίνεται να προσαυξάνει τη διαγνωστική ακρίβεια ή την προγνωστική ισχύ του SPECT αιματώσεως μυοκαρδίου και η ανεπίλεκτη χρησιμοποίησή της στην κλινική πράξη μπορεί να οδηγήσει σε υποεκτίμηση της στεφανιαίας νόσου και του κινδύνου καρδιακών συμβαμάτων που αυτή συνεπάγεται.
To investigate the diagnostic and prognostic value of photon attenuation correction through maps derived from low-dose/low-resolution CT in coronary artery disease. EXPERIMENTAL PART Materials and Methods: SPECT/CT 201Tl and 99mTc imaging was performed on a Data Spectrum torso phantom, firstly without “myocardial” defects (assessment of overall and regional image uniformity and counts) and afterwards with the insertion of “subendocardial” and “transmural” defects (measurement of defect FWHM and contrast); subsequently, attenuation corrected (AC) & non-corrected (NAC) images were compared pairwise as regards the aforementioned parameters. Results: AC was favoured in the measurements without defects by increasing image uniformity and optimizing inferior-to-anterior wall count ratio. When defects were imaged, AC was superior at the assessment of FWHM whereas NAC achieved better defect contrast. DIAGNOSTIC PART Materials and Methods: One-hundred and twenty patients with negative clinical markers for CAD as well as 120 patients (90 males, 30 females) who were subjected to coronary angiography within 60 days post-MPI (201Tl SPECT/CT) were retrospectively reviewed. AC & NAC images were evaluated blindly both qualitatively and semi-quantitavely (Overall Summed Stress Score – SSS & Summed Difference Score – SDS as well as corresponding scores for LAD and RCA/LCx vascular domains). In the low-risk population, AC & NAC normalcy rate was assessed and in the population with angiographic reference sensitivity, specificity and diagnostic accuracy were calculated for both AC & NAC MPI which were compared with the McNemar test. Finally, ROC curves were created and the AUC were compared. Results: In the low-risk population AC increased normalcy rate while in the patients with angiographic correlation statistically significant results were obtained in the general and male population in the RCA/LCx territory, where NAC was more sensitive and AC displayed higher specificity without any significant results as regards diagnostic accuracy or ROC AUC comparisons. PROGNOSTIC PART Materials and Methods: 637 unselected patients underwent 201Tl MPI with CT-AC. AC & NAC images were interpreted blindly and summed stress scores (SSS) were calculated. Study endpoints were all-cause mortality and the composites of death/non-fatal acute myocardial infarction (AMI) and death/AMI/late revascularization. On the basis of the event rate distribution across SSS values SSS subgroups were created, Kaplan-Meier curves were drawn and compared by the use of the LogRank test and finally clinical and scintigraphic parameters were entered into the univariete and multivariate Cox regression model. Results: During a follow-up of 42.3±12.8 months 24 deaths, 13 AMIs and 28 revascularizations were recorded. Prognostic SSS groups formed were: 0-4,5-13,>13 for NAC and 0-2,3-9,>9 for AC. Kaplan-Meier functions were statistically significant between NAC SSS groups for all study endpoints. AC discriminated only between SSS 0-2 and >9 for death/AMI and between 0-2 and 3-9 for death/AMI/revascularization. In the univariate Cox regression, abnormal NAC achieved statistical significance for all endpoints whereas AC managed to do so only for SSS >2 & >9 regarding major and all events and for SSS>9 as regards all events. In the multivariate model, abnormal AC yielded no significance for either endpoint whereas abnormal NAC proved independent from other covariates for the composite endpoints. CONCLUSION: Photon attenuation correction with the use of CT-derived attenuation maps does not seem to increase the diagnostic accuracy or prognostic value of myocardial perfusion SPECT and its non-selective utilization in clinical practice may lead to underestimation of coronary artery disease and the subsequent risk of cardiac events.