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At least 145 records · Page 8

Diagnostic value of stress thallium-201/rest technetium-99m-sestamibi sequential dual isotope high-speed myocardial perfusion imaging for the detection of haemodynamically relevant coronary artery stenosis

Background: The aim of this study was to determine the diagnostic accuracy of stress thallium-201/rest technetium-99m-sestamibi sequential dual-isotope high-speed myocardial perfusion imaging (DI-HS-MPI) against invasively determined fractional flow reserve (FFR). Methods: Fifty-four consecutive patients prospectively underwent DI-HS-MPI before invasive coronary angiography. Perfusion was scored visually by summed stress score on a patient and coronary territory basis. Significant coronary artery disease (CAD) was defined by the presence of ≥ 90% stenosis/occlusion or fractional flow reserve ≤ 0.80 for coronary stenosis ≥ 50%. Results: FFR was measured in 69 of 162 coronary vessels, with 1.28 ± 0.56 vessels assessed/patient. Sensitivity, specificity, and diagnostic accuracy of MPI for the detection of significant CAD were 92.8%, 69.2%, and 81.4%, on a patient basis, and 83.7%, 90.4%, and 88.8% by coronary territory. Conclusions: DI-HS-MPI accurately detects functionally significant CAD as defined by using FFR.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Collaborative Research: Unravelling the Physics Associated with the Production of Extremely Dense Plasma States of Microscale (Final Report) Nanosecond-pulsed Discharges

The aim of this project is to study and establish the physical mechanisms that contribute to the formation of anomalously dense plasmas in high-pressure nanosecond-pulsed discharges. These discharges have a broad range of applications such as plasma-assisted combustion, plasma flow actuators, biomedical sterilization and exotic materials synthesis. The structure and formation of these discharges, producing high plasma densities of ~10 14 -10 15 cm -3 , are well-studied and understood. Fast-pulsed microscale high-pressure discharges can be driven to even higher densities of > 10 19 cm -3 , approaching warm dense matter conditions. The mechanisms that generate these plasmas have not been understood. Analysis of the warm dense matter state under laboratory conditions is an expensive and non-trivial endeavor. For instance, dense plasmas can be generated by electrical explosions of metal foils and wires. Plasmas generated after the explosion have a short lifetime and often present difficult conditions for diagnostics. Generation of dense plasmas was also achieved during high-voltage nanosecond pulsed discharges when the so-called explosive electron emission is obtained. Unfortunately, this process is very difficult to control for the studies of warm dense matter. In our recent study, we have shown that additional heating of plasma by lasers can further increase the density of plasma and even lead to the fully ionized state. This method, potentially, allows better control of the plasma parameters. In this work, we studied a second stage laser-heated micro-discharge using a self-consistent one-dimensional particle-in-cell Monte Carlo-collision (1D PIC-MCC) model coupled with Maxwell’s equations. We predicted the generation of a fully ionized plasma on the picosecond time scale. However, this model considered the plasma as an ideal gas despite the high pressure and the nearly fully ionized state. The ideal plasma model assumes that the dilute gas approximation is valid, where the inter-particle interactions are negligible. For charged particles this assumption holds as long as the shielded Coulomb potential assumption is valid. For very high plasma densities, this concept breaks down since the Debye sphere surrounding each charged particle no longer contains enough electrons to statistically provide the shielding of the single particle Coulomb interaction potential. At such densities, the plasma can no longer be described as ideal and non-ideal coupling effects need to be considered. In this report, we elucidate our recent work of developing a PIC-MCC model with improvements for non-ideal plasma conditions due to Coulomb coupling at high densities. In particular, we study the interaction of green light radiation and a dense microplasma, and explore the non-ideal plasma effects in this interaction. In this computational model, we implement the two most important non-ideal effects: ionization potential depression (IPD) and enhanced collision cross sections. Our primary goal is to study the physics associated with electromagnetic (EM) wave heating, also called the second-stage wave-heating, and establish the role of plasma non-ideality in this phenomenon. Our secondary goal is to improve the chemistry mechanism of the 1D PIC-MCC model by including a more detailed excited species collision treatment. At high pressures, stepwise ionization from excited species might play an important role in the ionization process. Previously, this ionization mechanism was neglected due to the excitation collision cross section of xenon being smaller than that of ionization. However, a preliminary study showed that the excited species density in the initial microplasma was an order of magnitude higher than the electron density. Therefore, my aim is to determine the significance of this additional ionization pathway to the plasma generation.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗

Predictive Modeling for Differential Diagnosis and Mortality Risk Assessment

The prevalence of electronic health record (EHR) systems has brought prodigious biomedical informatics opportunity. Automated machine learning methods can effectively utilize such data and have become common tools for healthcare predictive modeling. Researches in medical informatics have explored the potential of deep learning and classical models in emergent care scenarios. In particular, predicting differential diagnoses for admissions have proven useful in decreasing unnecessary lab tests and improving inpatient triage decision-making. Moreover, identification of high-risk patients for in-hospital mortality is vitally important to maximize allocation of medical resources.The Medical Information Mart for Intensive Care (MIMIC-III) database, containing de-identified critical care inpatient was used in our study. This data set captures hospital patient laboratory measurements, pharmacologic prescriptions, diagnostic data and procedure event recordings. When considering adult patients and discounting admissions with ICU length of stay less than 24 hours, there were 37,787 unique admissions and 30,414 total patients. We examined the top 25 most prevalent ICD-9 group-level disease specificities in MIMIC-III using a multi-label classification model. In-hospital mortality was modeled as binary classification with 4,155 (13%) adult patients that expired, of which 3,138 (75.5%) were in the ICU setting. The metrics AUC, F1 score, sensitivity and specificity values calculated for each disease label measured prediction performance.The usage of ICD-9 group codes reduced feature dimension from 14,567 to 942 and greatly improved distribution of patient diagnostic categories. Disease temporal patterns were captured by considering the most frequently sampled 6 vital signs and 13 laboratory values. Missing data were imputed at each time-stamp. Time-series raw hourly average values were converted into 5 summary features (mean, standard deviation, number of observations, min & max values). Patient demographic variables such as age, gender, marital status and ethnicity were also factored into the modeling. Choi et al showed that contextual embedding of medical data, diagnostic and procedural codes alone can predict future diagnoses with sensitivity as high as 0.79. We utilized an embedding technique called word2vec which allowed sparse representations of medical history to be transformed into dense word vectors. The mappings captured contextual information by treating each admission as a sentence and learning the most likely neighboring words in a sliding window fashion. Binary and multi-label classification was achieved via collapse models, which do not consider temporal information, as well as recurrent neural networks with regularization, Softmax output layer activation together with categorical cross-entropy as the loss function.

US Army collaboration↗

Technical Note: Method to correlate whole-specimen histopathology of radical prostatectomy with diagnostic MR imaging

Purpose: Validation of MRI-guided tumor boundary delineation for targeted prostate cancer therapy is achieved via correlation with gold-standard histopathology of radical prostatectomy specimens. Challenges to accurate correlation include matching the pathology sectioning plane with the in vivo imaging slice plane and correction for the deformation that occurs between in vivo imaging and histology. A methodology is presented for matching of the histological sectioning angle and position to the in vivo imaging slices. Methods: Patients (n = 4) with biochemical failure following external beam radiotherapy underwent diagnostic MRI to confirm localized recurrence of prostate cancer, followed by salvage radical prostatectomy. High-resolution 3-D MRI of the ex vivo specimens was acquired to determine the pathology sectioning angle that best matched the in vivo imaging slice plane, using matching anatomical features and implanted fiducials. A novel sectioning device was developed to guide sectioning at the correct angle, and to assist the insertion of reference dye marks to aid in histopathology reconstruction. Results: The percentage difference in the positioning of the urethra in the ex vivo pathology sections compared to the positioning in in vivo images was reduced from 34% to 7% through slicing at the best match angle. Reference dye marks were generated, which were visible in ex vivo imaging, in the tissue sections before and after processing, and in histology sections. Conclusions: The method achieved an almost fivefold reduction in the slice-matching error and is readily implementable in combination with standard MRI technology. The technique will be employed to generate datasets for correlation of whole-specimen prostate histopathology with in vivo diagnostic MRI using 3-D deformable registration, allowing assessment of the sensitivity and specificity of MRI parameters for prostate cancer. Although developed specifically for prostate, the method is readily adaptable to other types of whole tissue specimen, such as mastectomy or liver resection.

61 RADIATION PROTECTION AND DOSIMETRY↗

Assessment of acute myocarditis by cardiac magnetic resonance imaging: Comparison of qualitative and quantitative analysis methods

Background: To compare cardiac magnetic resonance (CMR) qualitative and quantitative analysis methods for the noninvasive assessment of myocardial inflammation in patients with suspected acute myocarditis (AM). Methods: A total of 61 patients with suspected AM underwent coronary angiography and CMR. Qualitative analysis was performed applying Lake-Louise Criteria (LLC), followed by quantitative analysis based on the evaluation of edema ratio (ER) and global relative enhancement (RE). Diagnostic performance was assessed for each method by measuring the area under the curves (AUC) of the receiver operating characteristic analyses. The final diagnosis of AM was based on symptoms and signs suggestive of cardiac disease, evidence of myocardial injury as defined by electrocardiogram changes, elevated troponin I, exclusion of coronary artery disease by coronary angiography, and clinical and echocardiographic follow-up at 3 months after admission to the chest pain unit. Results: In all patients, coronary angiography did not show significant coronary artery stenosis. Troponin I levels and creatine kinase were higher in patients with AM compared to those without (both P < .001). There were no significant differences among LLC, T2-weighted short inversion time inversion recovery (STIR) sequences, early (EGE), and late (LGE) gadolinium-enhancement sequences for diagnosis of AM. The AUC for qualitative (T2-weighted STIR 0.92, EGE 0.87 and LGE 0.88) and quantitative (ER 0.89 and global RE 0.80) analyses were also similar. Conclusions: Qualitative and quantitative CMR analysis methods show similar diagnostic accuracy for the diagnosis of AM. These findings suggest that a simplified approach using a shortened CMR protocol including only T2-weighted STIR sequences might be useful to rule out AM in patients with acute coronary syndrome and normal coronary angiography.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Evolving Medical-Legal Issues in Breast Imaging

Because breast imaging practice is associated with a high number of medical malpractice lawsuits, understanding basic medical-legal parameters becomes even more important as new technology and conditions of practice evolve. Incorporating new supplementary breast screening in strategizing a response to the importance of breast density, recognizing the purpose and ramifications of issuing diagnostic imaging reports, understanding the role of expert witnesses in assisting standard of care determinations and employing reasonable applications for off-label use of medical devices exemplify the relevance of integrating defensible practice patterns in a changing medical environment. This article addresses these issues and provides a contextual discussion so that physicians and facilities are educated in their selection of a wide variety of approaches that can be applied to clinical use.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Miniature Time-of-Flight Mass Spectrometer

Major advances must occur to protect astronauts from prolonged periods in near-zero gravity and high radiation associated with extended space travel. The dangers of living in space must be thoroughly understood and methods developed to reverse those effects that cannot be avoided. Six of the seven research teams established by the National Space Biomedical Research Institute (NSBRI) are studying biomedical factors for prolonged space travel to deliver effective countermeasures. To develop effective countermeasures, each of these teams require identification of and quantitation of complex pharmacological, hormonal, and growth factor compounds (biomarkers) in humans and in experimental animals to develop an in-depth knowledge of the physiological changes associated with space travel. At present, identification of each biomarker requires a separate protocol. Many of these procedures are complicated and the identification of each biomarker requires a separate protocol and associated laboratory equipment. To carry all of this equipment and chemicals on a spacecraft would require a complex clinical laboratory; and it would occupy much of the astronauts time. What is needed is a small, efficient, broadband medical diagnostic instrument to rapidly identify important biomarkers for human space exploration. The Miniature Time-Of- Flight Mass Spectrometer Project in the Technology Development Team is developing a small, high resolution, time-of-flight mass spectrometer (TOFMS) to quantitatively measure biomarkers for human space exploration. Virtues of the JHU/APL TOFMS technologies reside in the promise for a small (less than one cubic ft), lightweight (less than 5 kg), low-power (less than 50 watts), rugged device that can be used continuously with advanced signal processing diagnostics. To date, the JHU/APL program has demonstrated mass capability from under 100 to beyond 10,000 atomic mass units (amu) in a very small, low power prototype for biological analysis. Further, the electronic nature of the TOFMS output makes it ideal for rapid telemetry to earth for in-depth analysis by ground support teams.

Potember, Richard S.↗

Improved diagnostic accuracy of thallium-201 myocardial perfusion single-photon emission computed tomography with CT attenuation correction

Background: The benefits of attenuation correction (AC) in technetium-99m myocardial perfusion imaging (MPI) have been well established. However, the value of thallium (Tl-201) AC and routine computed tomography AC (CTAC) were less well established. The aims of this study were to evaluate the diagnostic performance of thallium (Tl-201) MPI with additional CTAC and to determine which participants would benefit most. Methods and Results: A total of 108 consecutive patients who underwent Tl-201 MPI and received coronary angiography within 3 months were enrolled. Diagnostic performance was determined by sensitivity, specificity, and receiver operating characteristic curve analysis. Subgroup analyses were performed using gender and obesity. CTAC improved the area under the curve (0.84 vs. 0.77, P = 0.037 at patient level), primarily due to a significant improvement in specificity (0.78 vs. 0.57, P = 0.013) and no significant difference in sensitivity (0.79 vs. 0.82, P = 0.75). In subgroup analysis, CTAC was most helpful in obese subjects, men, and especially right coronary artery lesions. Conclusions: CTAC significantly improved diagnostic performance primarily by increasing the specificity, and the improvements were significantly greater in obese patients and male patients. These findings suggest that CTAC should be applied to Tl-201 MPI as routine clinical practice.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

BI-RADS 3: Current and Future Use of Probably Benign

Purpose of Review: Probably benign (BI-RADS 3) causes confusion for interpreting physicians and referring physicians and can induce significant patient anxiety. The best uses and evidence for using this assessment category in mammography, breast ultrasound, and breast MRI will be reviewed; the reader will have a better understanding of how and when to use BI-RADS 3. Recent Findings: Interobserver variability in the use of BI-RADS 3 has been documented. The 5th edition of the BI-RADS atlas details the appropriate use of BI-RADS 3 for diagnostic mammography, ultrasound, and MRI, and discourages its use in screening mammography. Data mining, elastography, and diffusion weighted MRI have been evaluated to maximize the accuracy of BI-RADS 3. Summary: BI-RADS 3 is an evolving assessment category. When used properly, it reduces the number of benign biopsies while allowing the breast imager to maintain a high sensitivity for the detection of early stage breast cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

An Evaluation of Image Acquisition Techniques, Radiographic Practice, and Technical Quality in Neonatal Chest Radiography

Neonatal chest radiography is a frequently performed diagnostic examination, particularly in preterm infants where anatomical and/or biochemical immaturity impacts on respiratory function. However, the quality of neonatal radiographic images has been criticized internationally and a prevailing concern has been that radiographers (radiologic technologists) fail to appreciate the unique nature of neonatal and infant anatomical proportions. The aim of this study was to undertake a retrospective evaluation of neonatal chest radiography image acquisition techniques against key technical criteria.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Theranostic Radiopnictogens: 71 As, 72 As, and 119 Sb (Final Technical Report)

This project has developed new methods for the cyclotron production of medically relevant radionuclides 71 As and 119 Sb. Arsenic and antimony are chemically homologous elements (group 5A, also known as the pnictogens) that have radionuclides that are of considerable interest within nuclear medicine. Such radiopnictogens include the potentially therapeutic radionuclides 119 Sb (t 1/2 = 38 h) that decays with the emission of 24.5 low energy, high potency electrons per decay with little concomitant photon radiation and 77 As (t 1/2 = 39 h) that decays with average beta energy of 230 keV and diagnostic nuclides 71 As (t 1/2 = 65 h, 28% β+) and 72 As (t 1/2 = 26 h, 80% β+) for positron emission tomography (PET). This work has had major success developing new methods for the cyclotron production and radiochemical isolation of 71 As, supporting parallel developments for 119 Sb, and assessing the chemical similarities between these two homologous radionuclides. This project brought into collaboration two universities with complimentary skill sets, proficiencies, expertise, and facilities: the University of Wisconsin (UWisc) and the University of Missouri (Mizzou). Professors Ellison and Engle have experience in the small cyclotron production and radiochemical isolation of radionuclides, including 72 As and 119 Sb. Their recently developed metallurgic methods for fabricating cyclotron targets have great potential to expand and allow for the biomedical cyclotron production of long- lived, lower positron energy 71 As. Professors Hennkens and Jurisson have significant experience in the reactor production, radiochemical isolation, and biological functionalization of radioarsenic. Recent development of trithiol-based chelator molecules for functionalizing radioarsenic provide a platform for the investigation of the fundamental challenges of the promising low-energy-electron emitter, 119 Sb. Through their positions within their respective University’s graduate schools, the PIs and Co-Is effectively trained of graduate students and postdoctoral researchers in nuclear and radiochemistry, sub-specialties specifically identified in the Department of Energy (DOE) Office of Science Isotope Program long-range plan. Annual laboratory research visits for students between UWisc and Mizzou provided essential broad-field experience and scientific networking that is critical for maintaining their path along the training pipeline to productive careers in isotope production. This research collaboration has provided significant benefits to the DOE University Isotope Network and radionuclide-using researchers around the country.

07 ISOTOPE AND RADIATION SOURCES↗

Dual-Energy CT Pulmonary Angiography: Quantification of Disease Burden and Impact on Management

Purpose of Review: Computed tomography pulmonary angiography (CTPA) has become the imaging modality of choice for patients with suspected pulmonary embolism (PE). Post-processing techniques currently available for dual-energy CT pulmonary angiography (DE-CTPA) enhance image quality and provide additional value in the diagnosis of PE. The objective of this article is to summarize these recent developments and discuss the appropriate use of DE-CTPA post-processing applications. Recent Findings: DE-CTPA post-processing applications enable reconstruction of virtual monoenergetic images (VMI) and color-coded iodine-perfusion maps to increase contrast conditions and visualize lung perfusion defects in case of embolic occlusion of pulmonary arteries. Both techniques revealed a superior diagnostic performance for the detection of pulmonary emboli and assessment of the pulmonary perfusion compared to the standard image reconstructions. Summary: DE-CTPA is a well-established method for excluding or diagnosing PE. Continued developments in DE-CTPA post-processing techniques improve patient management and allow for a quantification of disease burden.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Children, medical radiation and the environment: An important dialogue

There are unique considerations in the medical care of children, which includes the use of medical imaging. Medical imaging is frequently necessary and is essential in diagnosis and management of children with illness and injury. Much of medical imaging requires ionizing radiation. While virtually all diagnostic imaging radiation is considered low-dose level, there is still a broad misperception about what modalities use ionizing radiation and how much radiation risk exists in the medical environment. A discussion of radiation exposure is especially relevant in children due to their increased vulnerability, including to radiation-induced cancer. Ionizing radiation is both naturally occurring and man-made, including medical sources that have been increasing over the past few decades and can vary in radiation dose both between different modalities and for similar examinations. Perspectives vary regarding cancer risk and levels of radiation resulting from diagnostic imaging, however most medical and scientific organization support the perspective that the risk of cancer at these levels is uncertain. It is important to have balanced and informed resources for the use of ionizing radiation in the care of children, and it is equally important to assure that the delivery of this content is appropriate to the audience to which it is intended. For these reasons, it is valuable to review the issues related to use of ionizing radiation in medical imaging in children.

54 ENVIRONMENTAL SCIENCES↗

SU-F-J-183: Interior Region-Of-Interest Tomography by Using Inverse Geometry System

Purpose: The inverse geometry computed tomography (IGCT) composed of multiple source and small size detector has several merits such as reduction of scatter effect and large volumetric imaging within one rotation without cone-beam artifact, compared to conventional cone-beam computed tomography (CBCT). By using this multi-source characteristics, we intend to present a selective and multiple interior region-of-interest (ROI) imaging method by using a designed source on-off sequence of IGCT. Methods: All of the IGCT sources are operated one by one sequentially, and each projection in the shape of narrow cone-beam covers its own partial volume of full field of view (FOV) determined from system geometry. Thus, through controlling multi source operation, limited irradiation within ROI is possible and selective radon space data for ROI imaging can be acquired without additional X-ray filtration. With this feature, we designed a source on-off sequence for multi ROI-IGCT imaging, and projections of ROI-IGCT were generated by using the on-off sequence. Multi ROI-IGCT images were reconstructed by using filtered back-projection algorithm. All these imaging process of our study has been performed by utilizing digital phantom and patient CT data. ROI-IGCT images of the phantom were compared to CBCT image and the phantom data for the image quality evaluation. Results: Image quality of ROI-IGCT was comparable to that of CBCT. However, the distal axial-plane from the FOV center, large cone-angle region, ROI-IGCT showed uniform image quality without significant cone-beam artifact contrary to CBCT. Conclusion: ROI-IGCT showed comparable image quality and has the capability to provide multi ROI image within a rotation. Projection of ROI-IGCT is performed by selective irradiation, hence unnecessary imaging dose to non-interest region can be reduced. In this regard, it seems to be useful for diagnostic or image guidance purpose in radiotherapy such as low dose target localization and patient alignment. This research was supported by the Mid-career Researcher Program through NRF funded by the Ministry of Science, ICT & Future Planning of Korea (NRF-2014R1A2A1A10050270) and by the Radiation Technology R&D program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (No. 2013M2A2A7038291)

60 APPLIED LIFE SCIENCES↗

Physiological adaptation to space flight

In space, adaptive physiological changes have been observed in virtually all body systems, but how far these changes progress with time is not known. Their time course demonstrates variable patterns; some systems show evidence of gradual and progressive change. Biomedical postflight data have shown that a compensatory period of readaptation to one gravity is required after space flight, with longer intervals required for longer missions. Consistent readaptation trends include orthostatic intolerance and neurovestibular difficulties. For the long-duration missions of the exploration era, it is critical to determine the extent to which deleterious changes (e.g., bone loss and possible immunological changes) can be reversed upon return to earth. Radiation protection is another critical enabling element for missions beyond low earth orbit. Radiation exposure guidelines have not been established for exploration missions. Currently our experience is insufficient to prescribe countermeasures for the stay times associated with a lunar base or a mission to Mars. Artificial gravity may provide a solution, but the level and duration of exposure necessary to prevent deconditioning must be determined. Central issues for medical care in remote settings are preventive, diagnostic, and therapeutic care and the minimization of risk.

Nicogossian, Arnauld E.↗

Compact Microscope Imaging System Developed

The Compact Microscope Imaging System (CMIS) is a diagnostic tool with intelligent controls for use in space, industrial, medical, and security applications. The CMIS can be used in situ with a minimum amount of user intervention. This system, which was developed at the NASA Glenn Research Center, can scan, find areas of interest, focus, and acquire images automatically. Large numbers of multiple cell experiments require microscopy for in situ observations; this is only feasible with compact microscope systems. CMIS is a miniature machine vision system that combines intelligent image processing with remote control capabilities. The software also has a user-friendly interface that can be used independently of the hardware for post-experiment analysis. CMIS has potential commercial uses in the automated online inspection of precision parts, medical imaging, security industry (examination of currency in automated teller machines and fingerprint identification in secure entry locks), environmental industry (automated examination of soil/water samples), biomedical field (automated blood/cell analysis), and microscopy community. CMIS will improve research in several ways: It will expand the capabilities of MSD experiments utilizing microscope technology. It may be used in lunar and Martian experiments (Rover Robot). Because of its reduced size, it will enable experiments that were not feasible previously. It may be incorporated into existing shuttle orbiter and space station experiments, including glove-box-sized experiments as well as ground-based experiments.

McDowell, Mark↗

Breast Imaging of Transgender Individuals: A Review

Purpose: This review will inform radiologists about the evidence base regarding radiographic imaging for transgender individuals and considerations for providing culturally sensitive care for this population. Findings: Transgender individuals are increasingly referred for both screening and diagnostic breast imaging. It is important that the clinic environment is welcoming, the medical staff utilize accepted terminology and patients are able to designate their gender and personal history to ensure appropriate care. Hormone and surgical treatments used for transition by many transgender women and men may change the approach to imaging. Summary: Although not yet evidence-based, screening mammography is currently suggested for transgender women with risk factors, including those receiving hormone treatment over 5 years. The risk for breast cancer in transgender individuals is still being defined.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

WE-G-209-00: Identifying Image Artifacts, Their Causes, and How to Fix Them

Digital radiography, CT, PET, and MR are complicated imaging modalities which are composed of many hardware and software components. These components work together in a highly coordinated chain of events with the intent to produce high quality images. Acquisition, processing and reconstruction of data must occur in a precise way for optimum image quality to be achieved. Any error or unexpected event in the entire process can produce unwanted pixel intensities in the final images which may contribute to visible image artifacts. The diagnostic imaging physicist is uniquely qualified to investigate and contribute to resolution of image artifacts. This course will teach the participant to identify common artifacts found clinically in digital radiography, CT, PET, and MR, to determine the causes of artifacts, and to make recommendations for how to resolve artifacts. Learning Objectives: Identify common artifacts found clinically in digital radiography, CT, PET and MR. Determine causes of various clinical artifacts from digital radiography, CT, PET and MR. Describe how to resolve various clinical artifacts from digital radiography, CT, PET and MR.

60 APPLIED LIFE SCIENCES↗