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This paper presents the design, simulation, fabrication, and characterization of a novel large-scan-range electrothermal micromirror integrated with a pair of position sensors. Note that the micromirror and the sensors can be manufactured within a single MEMS process flow. Thanks to the precise control of the fabrication of the grid-based large-size Al/SiO2 bimorph actuators, the maximum piston displacement and optical scan angle of the micromirror reach 370 µm and 36° at only 6 Vdc, respectively. Furthermore, the working principle of the sensors is deeply investigated, where the motion of the micromirror is reflected by monitoring the temperature variation-induced resistance change of the thermistors on the substrate during the synchronous movement of the mirror plate and the heaters. The results show that the full-range motion of the micromirror can be recognized by the sensors with sensitivities of 0.3 mV/µm in the piston displacement sensing and 2.1 mV/° in the tip-tilt sensing, respectively. The demonstrated large-scan-range micromirror that can be monitored by position sensors has a promising prospect for the MEMS Fourier transform spectrometers (FTS) systems.

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PURPOSE: To identify technologist-controlled factors to decrease dose and improve image quality and evaluate their use during computed tomography (CT) kidney stone examinations. METHODS: Online scholarly databases were searched to acquire peer-reviewed, published articles involving methods of optimizing radiation dose during CT. These articles were reviewed, and the technologist-controlled factors identified were protocol selection, patient centering in the bore, and scan length. The author retrospectively reviewed CT kidney stone examinations performed at a free-standing emergency department to evaluate the use of these factors. RESULTS: Technologists consistently chose the correct scan protocol. Reviewed literature was used to determine the acceptable variance for positioning at isocenter and overscanning beyond anatomical landmarks. All patient positioning was off-center in the vertical direction, and in 3 of those examinations, patient positioning was off-center more than the 3 cm threshold. Horizontal off-center positioning was less frequent. All examinations had some amount of overscan, with 73.1% of patients being overscanned more than the determined threshold of 10% of total scan length. DISCUSSION: Accurate labeling of protocols at the console assist technologists in choosing protocols correctly. Technologists were inconsistent with patient centering and scan range. The amount of which images were off-center was consistent with previous research studies, while the amount of overscan was less than that found in previous studies. CONCLUSION: Technologists have an important role in optimizing patient radiation dose. Education and quality assurance could help technologists gain awareness of these factors and use them effectively.

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Multiphase CT scanning of the liver is performed for several clinical applications; however, radiation exposure from CT scanning poses a nontrivial cancer risk to the patients. The radiation dose may be reduced by determining the scan range of the subsequent scans by the location of the target of interest in the first scan phase. The purpose of this study is to present and assess an automatic method for determining the scan range for multiphase CT scans. Our strategy is to first apply a CNN-based method for detecting the liver in 2D slices, and to use a liver range search algorithm for detecting the liver range in the scout volume. The target liver scan range for subsequent scans can be obtained by adding safety margins achieved from Gaussian liver motion models to the scan range determined from the scout. Experiments were performed on 657 multiphase CT volumes obtained from multiple hospitals. The experiment shows that the proposed liver detection method can detect the liver in 223 out of a total of 224 3D volumes on average within one second, with mean intersection of union, wall distance and centroid distance of 85.5%, 5.7 mm and 9.7 mm, respectively. In addition, the performance of the proposed liver detection method is comparable to the best of the state-of-the-art 3D liver detectors in the liver detection accuracy while it requires less processing time. Furthermore, we apply the liver scan range generation method on the liver CT images acquired from radiofrequency ablation and Y-90 transarterial radioembolization (selective internal radiation therapy) interventions of 46 patients from two hospitals. The result shows that the automatic scan range generation can significantly reduce the effective radiation dose by an average of 14.5% (2.56 mSv) compared to manual performance by the radiographer from Y-90 transarterial radioembolization, while no statistically significant difference in performance was found with the CT images from intra RFA intervention (p = 0.81). Finally, three radiologists assess both the original and the range-reduced images for evaluating the effect of the range reduction method on their clinical decisions. We conclude that the automatic liver scan range generation method is able to reduce excess radiation compared to the manual performance with a high accuracy and without penalizing the clinical decision.

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(1) Background: To evaluate the diagnostic performance of a simulated ultra-low-dose (ULD), high-pitch computed tomography pulmonary angiography (CTPA) protocol with low tube current (mAs) and reduced scan range for detection of pulmonary embolisms (PE). (2) Methods: We retrospectively included 130 consecutive patients (64 ± 16 years, 69 female) who underwent clinically indicated high-pitch CTPA examination for suspected acute PE on a 3rd generation dual-source CT scanner (SOMATOM FORCE, Siemens Healthineers, Forchheim, Germany). ULD datasets with a realistic simulation of 25% mAs, reduced scan range (aortic arch-basal pericardium), and Advanced Modeled Iterative Reconstruction (ADMIRE®, Siemens Healthineers, Forchheim, Germany) strength 5 were created. The effective radiation dose (ED) of both datasets (standard and ULD) was estimated using a dedicated dosimetry software solution. Subjective image quality and diagnostic confidence were evaluated independently by three reviewers using a 5-point Likert scale. Objective image quality was compared using noise measurements. For assessment of diagnostic accuracy, patients and pulmonary vessels were reviewed binarily for affection by PE, using standard CTPA protocol datasets as the reference standard. Percentual affection of pulmonary vessels by PE was computed for disease severity (modified Qanadli score). (3) Results: Mean ED in ULD protocol was 0.7 ± 0.3 mSv (16% of standard protocol: 4.3 ± 1.7 mSv, p < 0.001, r > 0.5). Comparing ULD to standard protocol, subjective image quality and diagnostic confidence were comparably good (p = 0.486, r > 0.5) and image noise was significantly lower in ULD (p < 0.001, r > 0.5). A total of 42 patients (32.2%) were affected by PE. ULD protocol had a segment-based false-negative rate of only 0.1%. Sensitivity for detection of any PE was 98.9% (95% CI, 97.2-99.7%), specificity was 100% (95% CI, 99.8-100%), and overall accuracy was 99.9% (95% CI, 98.6-100%). Diagnoses correlated strongly between ULD and standard protocol (Chi-square (1) = 42, p < 0.001) with a decrease in disease severity of only 0.48% (T = 1.667, p = 0.103). (4) Conclusions: Compared to a standard CTPA protocol, the proposed ULD protocol proved reliable in detecting and ruling out acute PE with good levels of image quality and diagnostic confidence, as well as significantly lower image noise, at 0.7 ± 0.3 mSv (84% dose reduction).

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INTRODUCTION: Non-contrast CT KUB scans performed to assess renal colic should be limited to scanning between the upper pole of the highest kidney and the pubic symphysis to minimise unnecessary irradiation. This audit aimed to assess the amount of overscanning in CT KUBs outside this range. METHODS: CT KUB scans taken over a 10-day period were assessed. Unnecessary overscan above the highest kidney was measured as a percentage of the total scan range. A target of less than 10% overscanning was set. The vertebral position of the upper pole of the highest kidney was also measured and compared to the actual level of the scan. RESULTS: 88 patients were assessed. 89.8% (79/88) of scans didn't meet the target of less than 10% overscanning above the highest kidney, and were associated with a higher radiation dose to the patient. The average overscanning above the highest pole of the kidney was 16.4% of the whole scan. The average overscan below the pubic symphysis was 1.54%. We also found that 100% of scanned kidneys lied below the upper border of the T11 vertebra, in spite of scans starting as high as T7. CONCLUSION: A large proportion of scans included unnecessary overscanning above the highest kidney. We have identified the upper border of the T11 vertebral body as a potential location from which to begin the upper margin of a CT KUB scan. IMPLICATIONS FOR PRACTICE: By starting CT KUB scans at the upper border of the T11 vertebral body, we can allow the whole kidney to be imaged while minimising unnecessary overscanning above the kidney, thus lowering excess patient irradiation while still producing high quality scans.

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PURPOSE: To evaluate the in vivo feasibility of a multibolus contrast agent (CA) injection protocol with a reduced CA volume for thoraco-abdominal CT angiography (CTA) and to compare it to a single-bolus CA injection protocol. METHOD: 63 patients who underwent CTA with the multibolus protocol (60 ml CA) were divided in two groups either without (group 1, n = 48) or with (group 2, n = 15) aortic dissection. The aortic contrast enhancement was measured in group 1 using manual ROI analysis (10 segments), as well as semi-automated linear attenuation profiles. A subgroup (n = 18) of group 1, who also underwent imaging with the single-bolus protocol (94 ml CA), was used to compare both protocols. In group 2, differences in attenuation of the true and the false lumen for both the single- and the multibolus protocol were assessed with ROI attenuation measurements in both lumina. Comparisons were made using Wilcoxon test. RESULTS: Average attenuation was above 200 HU for 98 % of cases using the multibolus protocol. There was superior contrast homogeneity for the multibolus protocol with a lower standard deviation of attenuation values along the length of the scan (p = 0.003), while average attenuation was higher for the single-bolus protocol (p = 0.002). Prolonged enhancement plateau lead to a more uniform opacification of the true and the false lumen in patients with aortic dissection using the multibolus protocol (p = 0.012). CONCLUSIONS: The multibolus protocol in thoraco-abdominal CTA is feasible in patients. It shows consistently high arterial enhancement with superior contrast homogeneity compared to a single-bolus protocol in patients with and without aortic dissection.

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This paper describes an input shaping method based on an experimental transfer function to effectively obtain a desired scan output for an electrostatic microscanner driven in a quasistatic mode. This method features possible driving extended to a higher frequency, whereas the conventional control needs dynamic modeling and is still ineffective in mitigating harmonics, sub-resonances, and/or higher modes. The performance of the input shaping was experimentally evaluated in terms of the usable scan range (USR), and its application limits were examined with respect to the optical scan angle and frequency. The experimental results showed that the usable scan range is as wide as 96% for a total optical scan angle (total OSA) of up to 9° when the criterion for scan line error is 1.5%. The usable scan ranges were degraded for larger total optical scan angles because of the nonlinear electrostatic torque with respect to the driving voltage. The usable scan range was 90% or higher for most frequencies up to 160 Hz and was drastically decreased for the higher driving frequency because fewer harmonics are included in the input shaping process. Conclusively, the proposed method was experimentally confirmed to show good performance in view of its simplicity and its operable range, quantitatively compared with that of the conventional control.

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BACKGROUND: To evaluate a reduced range CT protocol in patients with suspected acute appendicitis as compared to standard abdominal CT regarding diagnostic performance, effective radiation dose and organ doses. METHODS: In this study, we retrospectively included 90 patients (43 female, mean age 56.7 ± 17 years) with suspected acute appendicitis who underwent CT of abdomen and pelvis. From those CTs, we reconstructed images with a reduced scan range from L1 to the the pubic symphysis. Full range and reduced range datasets were assessed by two radiologists for i) coverage of the Appendix, ii) presence/absence of appendicitis and iii) presence of differential diagnoses. Furthermore, effective radiation doses as well as organ doses were calculated using a commercially available dose management platform (Radimetrics, Bayer HealthCare). RESULTS: The Appendix was covered by the reduced range CT in all cases. In 66 patients CT confirmed the presence of appendicitis. In 14 patients, other relevant differential diagnoses were identified by CT, whereas in 10 patients no relevant findings were detected. Both readers identified all patients with appendicitis on both full and reduced range CT. For reduced range CT, total effective dose was 39% lower than for full range CT (reduced range: 4.5 [1.9-11.2] vs. full range: 7.4 [3.3-18.8] mSv; p ≤ 0.001). Notably, a remarkable reduction of organ dose in the female breasts by 97% (0.1 [0.1-0.6] vs. 3.8 [0.5-18.8] mSv; p ≤ 0.001) and in the testicles in males by 81% (3.4 [0.7-32.7] vs. 17.6 [5.4-52.9] mSv; p ≤ 0.001) was observed for reduced range CT compared to full range CT. CONCLUSIONS: In patients with suspected acute appendicitis, reduced range abdominopelvic CT results in a comparable diagnostic performance with a remarkable reduction of total effective radiation dose and organ doses (especially breast dose in female and testicle dose in male patients) as compared to full range CT.

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Untargeted metabolomics aims at obtaining quantitative information on the highest possible number of low-molecular biomolecules present in a biological sample. Rather small changes in mass spectrometric spectrum acquisition parameters may have a significant influence on the detectabilities of metabolites in untargeted global-scale studies by means of high-performance liquid chromatography-mass spectrometry (HPLC-MS). Employing whole cell lysates of human renal proximal tubule cells, we present a systematic global-scale study of the influence of mass spectrometric scan parameters and post-acquisition data treatment on the number and intensity of metabolites detectable in whole cell lysates. Ion transmission and ion collection efficiencies in an Orbitrap-based mass spectrometer basically depend on the m/z range scanned, which, ideally, requires different instrument settings for the respective mass ranges investigated. Therefore, we split a full scan range of m/z 50-1000 relevant for metabolites into two separate segments (m/z 50-200 and m/z 200-1,000), allowing an independent tuning of the ion transmission parameters for both mass ranges. Three different implementations, involving either scanning from m/z 50-1000 in a single scan, or scanning from m/z 50-200 and from m/z 200-1000 in two alternating scans, or performing two separate HPLC-MS runs with m/z 50-200 and m/z 200-1000 scan ranges were critically assessed. The detected features were subjected to rigorous background filtering and quality control in order to obtain reliable metabolite features for subsequent differential quantification. The most efficient approach in terms of feature number, which forms the basis for statistical analysis, identification, and for generating biological hypotheses, was the separate analysis of two different mass ranges. This lead to an increase in the number of detectable metabolite features, especially in the higher mass range (m/z greater than 400), by 2.5 (negative mode) to 6-fold (positive mode) as compared to analysis involving a single scan range. The total number of features confidently detectable was 560 in positive ion mode, and 436 in negative ion mode.

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PURPOSE: The aim of this study was to develop an efficient CT scan range estimation method that is based on the analysis of image data itself instead of metadata analysis. This makes it possible to quantitatively compare the scan range of two studies. METHODS: In our study, 3D stacks are first projected to 2D coronal images via a ray casting-like process. Trained 2D body part classifiers are then used to recognize different body parts in the projected image. The detected candidate regions go into a structure grouping process to eliminate false-positive detections. Finally, the scale and position of the patient relative to the projected figure are estimated based on the detected body parts via a structural voting. The start and end lines of the CT scan are projected to a standard human figure. The position readout is normalized so that the bottom of the feet represents 0.0, and the top of the head is 1.0. RESULTS: Classifiers for 18 body parts were trained using 184 CT scans. The final application was tested on 136 randomly selected heterogeneous CT scans. Ground truth was generated by asking two human observers to mark the start and end positions of each scan on the standard human figure. When compared with the human observers, the mean absolute error of the proposed method is 1.2% (max: 3.5%) and 1.6% (max: 5.4%) for the start and end positions, respectively. CONCLUSION: We proposed a scan range estimation method using multiple body parts detection and relative structure position analysis. In our preliminary tests, the proposed method delivered promising results.

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A fiber-optic 3D confocal scanning microendoscope employing MEMS scanners for both lateral and axial scan was designed and constructed. The MEMS 3D scan engine achieved a lateral scan range of over ± 26° with a 2D MEMS scanning micromirror and a depth scan of over 400 µm with a 1D MEMS tunable microlens. The lateral resolution and axial resolution of this system were experimentally measured as 1.0 µm and 7.0 µm, respectively. 2D and 3D confocal reflectance images of micro-patterns, micro-particles, onion skins and acute rat brain tissue were obtained by this MEMS-based 3D confocal scanning microendoscope.