Medical Imaging Technology تكنولوجيا التصوير الطبي
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- ItemEvaluation of the Application of Orthopedic Metal Artifact Reduction and Iterative Reconstruction Algorithms in CT Imaging of Hip Prostheses(Al-Quds University, 2021-05-28) Omarah Naser Saed AbdAlqader; عماره ناصر سعيد عبد القادرThe CT imaging of metal hip prosthesis causes metal-related artifacts reducing the overall image quality and clinical value of CT. This study aims to an evaluation of using orthopedic metal artifact reduction (O-MAR) technique and iterative model-based reconstruction (IMR) in CT imaging of bilateral total hip prostheses in a pelvis phantom. The fabricated pelvis phantom has four major components, pelvis bones, muscle, fat, and vascular structures, and was made using different concentrations of respectively calcium sulfate, bee wax, agarose powder, and Iohexol. Two types of hip prosthesis were used total hip and Austen Moore prosthesis. Different types of algorithms, filtered back projection (FBP), iDose4, and IMR with different Kilo-Voltage peak (kVps) settings at 80, 100, 120, and 140, combined with O-MAR were applied on this phantom. The image quality criteria were CT number, noise, and signal to noise ratio (SNR) and were analyzed by five regions of interest (ROIs), while regions R1 and R5 were the primary focusing. The five RIOs representing the following anatomy (right common iliac artery, left common iliac artery, right gluteus medius muscle, fat, and urinary bladder) respectively from R1 – R5. Without the prosthesis, results showed that IMR resulted in lower CT number, noise values, and increased SNRs relative to FBP and iDose4 for regions R1-R5. With the prosthesis, O-MAR improved CT-number precision for region R1 by 49% and 83% for FBP and IMR (p<0.05), relative to iDose4 by 57% without any significant changes at (p<0.05). For region R5, O-MAR improved CT-number precision by 81%, 89%, and 92% towards baseline values for respectively FBP, iDose4, and IMR (p<0.05). Also, O-MAR was most efficient in minimizing noise when integrated with IMR with corrections in the noise in R5 with 79 %, 90 %, and 92 % for respectively FBP, iDose4, and IMR (p<0.05). . Additionally, O-MAR was most effective in correcting SNR deviations when integrated with IMR with absolute SNR corrections in region R5 with 29 ± 1 and 43 ± 4 for FBP and IMR (p<0.05), compared to iDose4 by 37 ± 7 without any significant changes (p>0.05). For region R1, O-MAR improves SNR corrections by 5 ± 1, 23 ± 5, and 42 ± 9 for respectively FBP, iDose4, and IMR (p<0.05). O-MAR paired with IMR revealed an HU correction for region R5 of 90%, 90%, 93%, and 93% for respectively 80, 100, 120, and 140-kVp results. Noise was corrected for with 92%, 91%, 92% and 92% for respectively 80, 100, 120 and 140-kVp results. SNR corrections were 37%, iv 38%, 46% and 52% for respectively 80, 100, 120 and 140-kVp results. For region R1, O-MAR combined with IMR showed an average HU correction of 90%, 68%, 81%, and 93% for respectively 80, 100, 120, and 140-kVp results. Noise was corrected with 89%, 88%, 90% and 89% for respectively 80, 100, 120 and 140-kVp results. SNR corrections were 55%, 42%, 38% and 34% for respectively 80, 100, 120 and 140-kVp results. In conclusion, O-MAR decreases the appearance of metal artifacts using iDose4 and is most efficient in severe artifacts when used in combination with 140-kVp and IMR. CT imaging of a bilateral total hip prosthesis phantom, using IMR together with O-MAR increases image quality by significantly minimizing metal artifacts, reducing noise, and enhancing CT number and SNR.
- ItemTreatment response assessment in lymphoma (Hodgkin's lymphoma and Non-Hodgkin's lymphoma) with FDG-PET in Palestinian health system(Al-Quds University, 2024-04-30) Salah Jamal Shehda Jaradat; صلاح جمال شحدة جراداتLymphoma is the most common type of malignant hematological cancer with more than 80 subtypes according to the latest classification of the World Health Organization. Lymphomas come in many forms. Primary subtypes include: Hodgkin's lymphoma (HL), and non-Hodgkin's lymphoma (NHL). Early and accurate diagnosis of these types of cancer helps determine the method of treatment. With the advent of Positron emission tomography/Computed tomography (PET/CT) technology, it helped us detect the location of cancer and determine its stage. In this study, FDG-PET/CT was used to evaluate the response of Hodgkin and non-Hodgkin lymphoma patients to treatment. PET/CT scans were taken for all lymphoma patients from the Patient's Friends Association Al-Ahli Hospital - Hebron, and the Patient's Friends Charitable Society (Al-Rahma Clinic) - Nablus. The study included 310 patients suffering from HL and NHL from Al-Ahli Hospital and Al-Rahma Clinic, where the number of HL patients was (196), number of NHL patients was (114), and the NHL were distributed as follows: (Follicular lymphoma 30, Diffuse large B cell lymphoma (DBCL) 71, T-lymphoblastic lymphoma 8 and Chronic lymphocytic leukemia 5). From the results we obtained, patients' responses to treatment were divided into four categories: stable metabolic response (SMR), partial metabolic response (PMR), complete metabolic response (CMR), and progressive metabolic disease (PMD). These types of responses were divided into Based on comparing patients' reports and monitoring their condition after receiving treatment.
- ItemStudy of the effects of posture on the volume of abdominal and pelvic organs using Ultrasonography(Al-Quds University, 2024-05-16) Jessica Salim Jeries Badawi; جيسيكا سليم جريس بدويStudy of the human body organs sizes and their clinical positions is of particular importance in different clinical applications including diagnostics and therapeutical. This kind of studies is important in the investigation of anthropometrical characteristics of populations as well. This thesis deals with the determination of dimensions and volumes of organs of healthy adult people in the abdominal and pelvic regions using Ultrasonography (USG) in supine and sitting postures and investigate the change in organ volume between the two postures. Twenty healthy participants (subjects) were investigated in the study 11 females and 9 males. The age of all subjects ranged from 30 and 70 years with different body mass indexes. The average body mass index of females was 25.56 ± 1.49 kg/m2 and of males was 26.32 ± 1.55 kg/m2. Prior to the measurement of organs sizes by USG, a pilot study was conducted on two subjects; female and male to check the consistency of USG modality with Magnetic resonance imaging technique (MRI) which is considered the golden standard for evaluation of body organ dimensions. Both the organs span and volume of the two subjects involved in the pilot study were determined by the MRI and USG techniques in supine and sitting positions according to standard protocols. The organs investigated were; liver, spleen, right and left kidneys, ovaries, prostate, urinary bladder, gall bladder and testicles all in supine position. Statistical analysis of results of all organs measurements of the two subjects including graphical presentations, normal probability plots of the difference between the two techniques, Bland-Altman analysis confirmed a strong correlation between MRI and USG in the determination of organs dimensions (spans and volumes). As example correlation coefficient between MRI and USG in measuring female abdominal and pelvic organs spans in supine was 0.99. Mean difference (bias) was about 0.0012, the lower CI at 95% confidence level was – 0.33, upper CI at 95% confidence level was 0.33. compatible results were also obtained for the male in pilot study. Volumes of organs were calculated from the measured dimensions (AP, Length and Transverse) assuming ellipsoidal shape of the organs. Calculated volumes for the pilot study subjects were compatible with the values published in literature. Comparison between liver volume calculated in the pilot study and by using Child’s equation considered the most accurate for estimating liver volume using 2D Ultrasound was in very good agreement (difference of about 0.6%). All measurements in sitting position were conducted by USG only on a folding chair specially constructed for the purpose of this study. Mean splenic span for all females in supine position was 10.18 ±0.95 cm, in sitting position 10 ± 0.7 cm; for males 12.34 ± 1.71 cm in supine position and 11.72 ± 1.69 cm in sitting position. The average decrease in organs span varies between organs from about 7% for spleen to about 16% for left ovary. There was statistically significant difference between the span of organs measured in supine and sitting positions. Two tailed t-tests were used to analyze the difference in the spans of organs between supine and sitting positions at 95% confidence level. For all organs, in no case, the volume of any organ in sitting position was equal or greater than that in supine position and the average decrease in volume between supine and sitting positions for all investigated organs was about 28%. To analyze the differences in organ volume between supine and sitting positions, paired t-tests (two-tailed) as well as Wilcoxon Signed rank were used for different organs separately for males and females and also for main organs together for both genders (for liver, spleen, right kidney and left kidney). For individual organs as well as for the main four organs also Wilcoxon Signed rank (the non-parametric version of the paired t-test) tests were used. The two tests gave similar results. For female right kidney volume difference, the two tailed p-value was 0.00001, for males liver volume the p-value was 0.0008. For female spleen volume differences analysis between supine and sitting positions p-value was 1.3x10-5. For differences analysis in volumes including four main organs mentioned above (n=80 all the 4 organ volumes of all participants) a paired two tailed t-test and Wilcoxon signed rank test both gave a p-value < 0.00001. Both tests indicate a strong statistically significant difference in volumes 95% confidence level. The differences in organ spans and volumes between supine and sitting positions are statistically significant and therefore can be detected by Ultrasonography.
- ItemCriteria for dental implant selection in Palestine(Al-Quds University, 2024-06-10) Bara'a abd alhakeem jobran rojoub; براءة عبد الحكيم جبران رجوبDental implants are alloplastic materials that are placed in order to assist repair or replace damaged orofacial components. The outcome is dependent on how well the implant's substance integrates with the surrounding tissue. However, this integration is influenced by several factors, such as implant material, bone quantity and quality, and implant loading status. Accurately detecting anatomical features in relation to implant size increases the success rate of implant surgery and reduces the risk of surgical damage. This can only be accomplished by a comprehensive and suitable radiological examination. In order to help the dentist, determine the best kind of implant for the patient, the study focuses at the characteristics of the implant and the medical imaging modalities Cone Beam Computed Tomography (CBCT) and panoramic that the dentist performs. A cross-sectional descriptive study about the functions of medical imaging in dental implants and the factors that influence selecting the type of implant among Palestine's dentists who perform dental implant. An online survey including inquiries about preferred dental implants, the status of patient’s economy, and other important factors that influenced their choice of implant type. The statistical analysis conducted using IBM SPSS v27 to investigate the relationships and differences between various variables, Cronbach's alpha, chi-square test, Spearman's rank correlation, Kruskal Wallis and Mann-Whitney U test were used to examine relationship between the study’s variables. Throughout the analysis, we consider statistically significant of a P-value of less than 0.05, indicating that observed effects were unlikely to be due to chance. 94.6% of participants stated that CBCT is their primary medical imaging modality. Additionally, the study's findings indicate that the following factors influenced the dentist's decision regarding the type of implant: (a) the time required for the procedure, which was 69.8% P-Value ˂0.001; (b) the patient's age, which was 60.4% P-Value ˂0.001; (c) the implant's cost, which was 62.8% P-Value ˂0.001; and (d) the patient's required number of implants, which was 59.7% P-Value ˖0.001. Surgical implants were selected primarily in comparison to basal and compressive implants based on characteristics such as implant stability, success and continuity, surrounding bone growth, and the expected medical benefit overall. The majority of Palestinian dentists use CBCT to identify the type of implant. Additionally, the outcomes demonstrated that while basal implants produce equivalent results more quickly, dentists did not initially favor them. When choosing an implant type, dentists considered the patient's age, the duration of the surgery, and the implant's cost into account.
- ItemMedical Wastes Management and Recycling: The Case of Bethlehem Governorate(Al-Quds University, 2024-07-21) Rayyan Marwan Mohammed AbuZayyad; ريّان مروان محمد أبوزيّادBackground: Medical waste management is a crucial issue in healthcare due to its potential health risks. Rapid population growth increases the demand for disposable medical equipment and supplies, leading to more medical waste. Purpose: The main purpose of the study is to investigate the current medical wastes management process in Bethlehem governorate. Then addressing the required steps needed in order to implement recycling program, and highlight its impact on health and economy. It assesses current medical waste management practices, the feasibility of recycling, and the effects of medical waste on health and the environment. Methods and Data Collection: The study was conducted in Bethlehem governorate, targeting healthcare facilities. Data was collected through structured interviews with healthcare management and site visits, along with secondary data from annual reports by the Joint Services Council (JSC). The study focused on facilities, which generates significant medical wastes, such as Beit Jala governmental hospital that consists of several specialized departments, that indicates the large volume of service provided, which in turn provided us with supplies and used items list that was helpful to identify and classify wastes materials to be recycled. Results: The study found a direct correlation between medical waste volume and healthcare services provided. The Arab Society for Rehabilitation and Beit Jala Governmental Hospital produced the most waste in 2021 and 2022, with plastic waste making up 66% of the total. This presents both environmental challenges and opportunities for economic benefits through recycling. However, the Palestinian plastic recycling market is constrained by insufficient investment. Medical sharp wastes, representing 14% of waste, pose safety risks but can be recycled with proper treatment. Other materials which represent 20% of medical wastes, that mainly consist of bed sheets, surgical gowns and fabrics, offer economic value when recycled (140-199 $ per ton). The annual high cost of medical waste management (242,000 – 292,000 $) highlights the potential economic benefits of recycling, which can reduce costs, extend landfill lifespan, conserve energy, and protect public health. The study showed that establishing a medical waste recycling facility in Bethlehem is not only feasible but also beneficial. It promises to reduce the environmental impact of medical waste, provide economic gains through revenue generation, and support the principles of a circular economy. This initiative can serve as a model for other regions, demonstrating the transformative potential of effective medical waste recycling practices. Conclusion: Medical waste recycling positively impacts health, the environment, and the economy. Investing in recycling infrastructure and technology is essential to realize these benefits and reduce the costs associated with inadequate waste management practices.