Mirada Medical's Blog

New range of software and study at ASTRO 2011

Mirada will be showcasing a new range of software planning tools at ASTRO 2011 (Booth #1257) that incorporate its fusion technologies to support: dose warping, dose summation, atlas based auto-contouring, deformable fusion of multi-sequence MR, PET and SPECT and single click contour warping to support adaptive re-planning.

Dr. Mark Gooding, senior scientist at Mirada Medical, will present a study and poster on deformable CT-MR registration (#3262) at ASTRO. The study was chosen from a record breaking 2,437 abstracts submitted for review to be presented. ASTRO is the largest gathering of radiation oncology specialists in the world.

The study, titled “Assessing the quality of deformable CT-MR registration for the purpose of multi-modal radiotherapy planning,” examines the performance of Mirada’s multi-modal deformable registration algorithm for the fusion of head and neck, prostate and cervical diagnostic MR scans to CT planning volumes. Performance was assessed by experts in radiation oncology from four independent clinical institutions and quantitative errors were also measured using landmarks. In all cases, deformable registration significantly improved the alignment between MR and planning CT, approximately halving the registration error compared to conventional rigid alignment. The clinical experts’ assessment concluded that the results required minimal intervention prior to use in multi-modal contouring.

 

About the Author

Simona Nita is the Digital Marketing Manager at Mirada Medical Ltd. Simona has over 10 years of professional experience and a strong academic background in the field of Marketing.

About Mirada Medical

Mirada Medical is an internationally recognised brand in advanced medical imaging. The company develops high value clinical software applications, which are used across diagnostic radiology, nuclear medicine, radiation oncology, tumour board and elsewhere.

 

The opinions expressed in this blog represent the views of the author and not necessarily those of Mirada Medical Limited.

What are PET-CT scans?

A PET-CT scan uses acronyms for much longer terms: Positron Emission Tomography (PET) and Computerized Tomography (CT). They are both imaging tools that are used in hospitals throughout the world to help doctors locate cancerous cells and tumors in the body, in order toenable better and more accurate diagnosis. Each scan brings something to the process - the PET scan detects the metabolic signal of any growing cancer cells and the CT scan provides a very detailed image of the inside of the body which helps provide information about the location and quantity of any cancerous tumors. Used together these two scans are extremely powerful in terms of providing medical data and provide much information about the severity of any cancerous activity. This is the reason they are usually carried out at the same time. These scans use non-surgical processes and take very little time to carry out. They can be carried out on an outpatient basis and are completely painless tests

A PET scan is a type of nuclear medicine imaging and is carried out by exposing the body to some radioactive material. This is usually administered via an injection into the vein, a pill of some type or inhaled as a gas. The amount the body is exposed to is very small so there are no long term side effects. The radioactive material accumulates in the area of the body that is being investigated and by doing so, energy (gamma) rays are given off. These rays are picked up by a special probe and scanner. Working together, the probe and the scanner can detect how much of the radioactive material has been absorbed by the body and turn this into an image that provides intricate details of the structure and function of the organs, cells and tissue in that particular area.

Image fusion or co-registration refers to the practice of superimposing these images with the images produced by a computerized topography scan (CT scan) or even with a magnetic resonance image (MRI scan). By correlating images in this way even more accurate and more precise information can be gleaned which makes for better diagnosing of patients.

Whilst a PET scan is useful for measuring functions such as blood flow, oxygen use and a person’s glucose metabolism in order to see how particular organs are working, a CT scan is useful for providing internal images with anatomic information. When combined in the way described above doctors have access to a wealth of information that enables them to "see" exactly what is wrong with a person and how serious the condition is. When used together these two scans (or modalities) create synergy - they can provide much more detailed information and prove to be far more valuable than when used separately.

PET-CT scans are in particular used to detect cancer in the body. Not only can tumors be found but the rate of growth of cancerous cells and the extent to which they have spread can be seen. These types of scan can be given at regular intervals throughout the treatment of cancer to see how effective it has been and if the cancer is returning or being kept at bay. Aside from oncology, these scans are also useful for determining blood flow to the heart and assessing the damage after a heart attack to see what treatment or surgery would be appropriate. PET-CT scans are also useful for mapping brain function and detecting abnormalities such as tumors, disorders and problems with the nervous system.

The medical world benefits greatly from the use of pet-ct scans in their methods for diagnosis. Medical image processing is a powerful tool in the fight against many serious illnesses and disorders, but when used together in particular a PET scan and CT scan provide a wealth of information. It works particularly well with oncology software, enabling cancerous growth to be detected and monitored continuously.

Kathryn Dawson writes articles for Mirada Medical Limited, bringing you advanced software for fusing images from pet-ct scans. Their registration software aligns PET scan images as well as CT scan images. Mirada’s application for medical image processing offers comprehensive analysis for diagnosis, staging, treatment planning, assessment and response in oncology. Find out how XD3 is among the most advanced oncology software in use today.

Guide to diagnostic medical imaging

Medical imaging involves taking pictures of the inside of the body and looking out for abnormalities or in the case of x-rays for broken bones, amongst other problems. It is a very important aspect of making good diagnoses and more and more doctors rely upon scans to provide them with the data and information they need to help make an accurate diagnosis. If medical imaging didn't exist a host of illnesses could be left untreated such as cancer as they often don't display outward signs for a number of years. Internal bleeding after a trauma is another condition that makes medical imaging so important and life-saving.

There are several different types of diagnostic medical imaging. X-rays are one of the most common and well known, also known as radiologic technology. During an x-ray, the body is exposed to a small amount of radiation that passes through it. Some of the rays are absorbed as they travel, and they all travel at different speeds. Because of this they are able to be projected onto a special film which provides a picture of the inside of the body.

If anyone has seen an x-ray, you will see that the picture is not very detailed or clear which is why it is best for detecting fractures and breaks in the bones. These show up well in x-rays. Sometimes another shadow may be spotted. In this instance another scan may be required for the patient if the doctor thinks there may be something further to investigate other than a fractured bone. An x-ray is a completely painless experience and takes just a few minutes to obtain the pictures.

An ultrasound is another technology used for creating scans. These are most commonly used to show a baby in the womb. It provides a more in depth picture than an x-ray does, when looking at a baby it is possible to see the different parts of the body well. Although primarily used for this purpose it is also suitable for examining muscles, joints, tendons and all the internal organs in the body. Ultrasound is the safest imaging modality available today.

Yet clearer still, a CT scan or CAT scan as it is sometimes called provides an even greater insight into the body's interior. This is more advanced than either an x-ray or an ultrasound as is often used when a patient has been involved in a serious injury. It is often used to explore the brain - looking for signs of abnormality or swelling but it can be used to see the whole body. It works a little like an x-ray but a large number of images are taken at the same time. It is capable of assisting detection in all sorts of problems such as cancerous growths, tumors and blocked arteries and for that reason a scan is often the first port of call for a doctor wanting to make a diagnosis.

Last but not least, an MRI scan is a very accurate way of looking at the inside of the body. By sending radio waves through a magnetic field and interpreting the way energy is released from the atoms in the area being targeted, radiologists can determine a number of illnesses and diseases. Broken bones to tumors and internal bleeding can all be detected easily with an MRI scan.

Medical computer software such as that used for PACS imaging is crucial to its success and allows multiple physicians on a tumor board for example to examine the images produced. All of the scans are useful, each with its own set of advantages and disadvantages.


About the Author: Kathryn Dawson - Mirada Medical Limited, a developer of diagnostic medical imaging software for tumor board reviews.

What is magnetic resonance imaging for?

The term more commonly used in magnetic resonance imaging is an MRI scan. The multitude of television dramas set in hospitals mean that most people have at least heard of this procedure, although few could tell you how it works. Broadly speaking, an MRI scan is used for diagnosing abnormalities in the body. A radiologist will interpret the data which a doctor can then use to make a diagnosis of illness or disease affecting the body. It is one of the most common types of scan used in hospitals today as it is simple and very effective.

The way a magnetic image is taken is by first enveloping the part of the body being examined by a magnetic field. Through this intense field, radio waves that are being directed at the specific body part are sent. When the waves hit the body, the nuclei of the atoms within begin giving off an energy. This energy is detected by a computer which interprets the data into a picture format. The pictures and images displayed allow the radiologist to determine if there is anything wrong with the body as the energy patterns will be affected if there is and will be displayed in an unusual way. Often a functional MRI scan in particular will be used when carrying out this procedure. This works in exactly the same way as described above but the patient will be asked to carry out a few tasks while it is taking place. This won’t be complex puzzles but simple tasks such as talking or speaking. This allows the activity of the brain to be examined more thoroughly which helps greatly in the diagnosis of a multitude of illnesses.

An MRI scan is very effective at helping to detect health problems. Anything from broken bones to cancer can be sought out using this type of scan. If a doctor is looking to confirm a broken bone however they are more likely to use an X-Ray scan which is cheaper and easier to carry out. An MRI is more likely to be required in the event of a serious injury or head trauma. It is also common when looking to diagnose cancer as tumours can be spotted easily. Other conditions that an MRI is used for are to locate slipped discs and problems with the spine, abnormal tissue, blocked arteries and heart problems. They can also display internal bleeding and swelling in the brain. For this multitude of illnesses, all types of physician call upon the assistance of an MRI scan from time to time..cardiologists, neurosurgeons, doctors from all fields benefit from this form of scanning of their patients.

Not everyone is suitable for an MRI. Anyone with metallic plates or pins in their bodies may not be able to have the scan carried out, and those who have undergone chemotherapy may also be unsuitable. Artificial joints such as hips or knees may affect the results so this could pose a problem too. Most people however are able to have it. Although some don’t like the feeling of enclosure that is involved in an MRI, it is a completely pain free experience. There are no side effects either and it can be carried out on an outpatient basis.

Because the picture provided by magnetic resonance imaging (or MRI) is extremely clear it is a very useful tool for doctors wanting to diagnose patients. Clinical oncology, the study and treatment of cancer, is particularly reliant on these types of scan to make accurate diagnoses. Without medical imaging systems, doctors would have a much harder time diagnosing illnesses or indeed spotting serious problems such as internal bleeding following a major trauma. A scan (in one form or another) is often one of the first measures taken when a patient is admitted to hospital following a serious accident.

Kathryn Dawson writes articles for Mirada Medical Limited, a developer of state-of-the-art software for viewing scans from magnetic resonance imaging as well as other medical imaging systems. Their software products offer the benefit of combining serial analysis of scans acquired over time with very powerful image registration technologies. Imaging software solutions for clinical oncology are now enhanced using Mirada’s exportable casebook information pack for better communication.

CASEBOOK – 5 easy steps to creating great medical presentations

Casebook by Mirada Medical is freely downloadable

1. Installing

Download your free copy of Casebook from www.mirada-casebook.com and follow the simple installation steps.

2. Loading the data

Once the Casebook software has been installed, open PowerPoint to create a presentation. There will be a Mirada Medical tab (PowerPoint 2007) or toolbar (PowerPoint 2003). The Mirada Medical addin contains three buttons, Add Casebook, Import Data and Edit Casebook. Select Add Casebook, and the Import Data screen appears. Select Import Single File or Import Directory to browse for the file or directory you wish to add as the base image data (for example, CT) and again for the Overlay Image Data (for example, PET). You may also select, if you wish, a single series of DICOM data as the base image layer. When files or directories have been selected, click OK. The files will be loaded into Casebook and placed on the slide. By default, the data is resampled to be aligned to the patient axis. The data can be loaded in its original orientation by unchecking the Axis-align data to patient box at import. This may reduce the memory required by Casebook for non-axis aligned data.

3. Editing Casebook

Select Edit Casebook to view the imported images. Several features are available to adjust the display. The view layout may be changed via the layout button in the upper right corner of the screen. This is defaulted to All Views, but will change to indicate the currently viewed layout. You may triangulate by moving the cross-hair position.

The left mouse button is, by default, set to adjust the window and level. By selecting the appropriate tools from the toolbar, its behaviour can be modified:

 
  
The middle mouse button can be used adjust the pan, the scroll wheel adjusts the currently viewed slice and the right mouse button adjusts the zoom. When the Casebook slide is displayed during a slide show, image manipulation tools are available to the presenter. Adjustments made during an editing session will be shown when the slideshow is run, but are not saved when the file is saved.

4. Using bookmarks

The view state (cross-hair position, slice, view layout, window & level, transparency etc) can be saved in the form of bookmarks during editing mode. These bookmarks are saved when the PowerPoint presentation is saved, allowing you to quickly jump back to key locations in the data when presenting your slideshow. To add a bookmark, navigate to the point of interest and adjust the visualisation as desired, then click Add. A dialog will appear to let you edit the bookmark title. Having entered the bookmark title, click OK to add the bookmark. Bookmarks can only be created in the Casebook editor.

If you no longer want a bookmark, select that bookmark and click Delete to remove it. Move Up and Move Down can be used to rearrange the order of the bookmarks in the bookmark list. These functions are only available in the Casebook editor.

5. Saving your presentation

Click the Microsoft Office Button and then click Save As (PowerPoint 2007) or File à Save As in the toolbar (PowerPoint 2003), name the file, and select Presentation as file type. Click Save. Casebook data are saved within the PowerPoint file in a lossy compressed format.

And finally, run your professional, accurate presentation and engage your audience!

 

Mirada's world first fully functioning fusion case presentation tool is now available for free download from www.mirada-medical.com. Casebook by Mirada Medical is the world’s first easy to use, fully interactive, completely free and professionally developed medical image and fusion image viewer designed to be used with Microsoft PowerPoint presentations. Casebook features include interactive windowing, zoom, transparency and slice navigation, triangulated MPR views, bookmarks and any modality combination fused views.