RESUMO
OBJECTIVE: The venous vascular anatomy of the caudate lobe is exceptional. The purpose of this study was to assess portal inflow and venous outflow volumes of the caudate lobe. METHODS: Extrahepatic (provided by the first-order branches) versus intrahepatic (provided by the second- to third-order branches) portal inflow, as well as direct (via Spieghel veins) versus indirect (via hepatic veins) venous drainage patterns were analyzed in virtual 3-D liver maps in 140 potential live liver donors. RESULTS: The caudate lobe has a greater intrahepatic than extrahepatic portal inflow volume (mean 55 ± 26 vs. 45 ± 26%: p = 0.0763), and a greater extrahepatic than intrahepatic venous drainage (mean 54-61 vs. 39-46%). Intrahepatic drainage based on mean estimated values showed the following distribution: middle > inferior (accessory) > right > left hepatic vein. CONCLUSIONS: Sacrifice of extrahepatic caudate portal branches can be compensated by the intrahepatic portal supply. The dominant outflow via Spieghel veins and the negligible role of left hepatic vein in caudate venous drainage may suggest reconstruction of caudate outflow via Spieghel veins in instances of extended left hemiliver live donation not inclusive of the middle hepatic vein. The anatomical data and the real implication for living donors must be further verified by clinical studies.
Assuntos
Veias Hepáticas/diagnóstico por imagem , Circulação Hepática , Fígado/irrigação sanguínea , Veia Porta/diagnóstico por imagem , Adolescente , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Veias Hepáticas/anatomia & histologia , Humanos , Masculino , Pessoa de Meia-Idade , Veia Porta/anatomia & histologia , Adulto JovemRESUMO
The passage through the hilar plate during right graft live donor liver transplantation (LDLT) can have dangerous consequences for both donors and recipients. The purpose of our study was to delineate hilar transection and biliary reconstruction strategies in right graft LDLT, with special consideration of central and peripheral hilar anatomical variants. A total of 71 consecutive donors underwent preoperative three-dimensional (3D) CT reconstructions and virtual 3D hepatectomies. A three-modal hilar passage strategy was applied, and its impact on operative strategy analyzed. In 68.4% of cases, type I and II anatomical configurations allowed for an en block hilar transection with simple anastomotic reconstructions. In 23.6% of cases, donors had "difficult" type II and types III/IV hilar bile duct anatomy that required stepwise hilar transections and complex graft biliary reconstructions. Morbidity rates for our early (A) and recent (B) experience periods were 67% and 39%, respectively. (1) Our two-level classification and 3D imaging technique allowed for donor-individualized transhilar passage. (2) A stepwise transhilar passage was favored in types III and IV inside the right-sided hilar corridor. (3) Reconstruction techniques showed no ameliorating effect on early/late biliary morbidity rates.
Assuntos
Transplante de Fígado , Fígado/anatomia & histologia , Fígado/cirurgia , Doadores Vivos , Adulto , Doença Hepática Terminal , Feminino , Hepatectomia , Humanos , Processamento de Imagem Assistida por Computador , Fígado/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To quantify the cooling effect of hepatic vessels on liver radiofrequency (RF) ablation ex situ. METHODS: Bipolar RF applicators (diameter = 1.8 mm, electrode length = 30 mm) were inserted parallel to perfused glass tubes (diameter = 5 and 10 mm; flow = 250-1,800 ml/min) at distances of 5 and 10 mm in porcine livers ex vivo. RF ablation was performed at 30 W/15 kJ. RF lesions were analyzed by measuring the maximum (r (max)) and minimum radius (r (min)) and the lesion area. RESULTS: Glass tubes without flow showed no influence on RF lesions, whereas perfused glass tubes had a significant cooling effect on lesions. r (min) was reduced to 50% at 5 mm applicator-to-vessel distance and the lesion area was reduced from 407 to 321 mm(2) (p < 0.001). There was no significant influence of glass tube diameter or flow volume on any of the analyzed parameters. CONCLUSIONS: Cooling effects of intrahepatic vessels could be simulated in an ex situ model. Cooling effects should be taken into account in RF ablation within 10 mm distance to major liver vessels regardless of blood flow volume or vessel diameter. Surgical RF ablation with temporary blood flow occlusion should be considered in such constellations.
Assuntos
Ablação por Cateter , Temperatura Baixa , Fígado/irrigação sanguínea , Animais , Técnicas In Vitro , Estatísticas não Paramétricas , SuínosRESUMO
INTRODUCTION: Due to technical innovations in sectional diagram methods, whole-body imaging has increased in importance for clinical radiology, particularly for the diagnosis of systemic tumor disease. Large numbers of images have to be evaluated in increasingly shorter time periods. The aim was to create and evaluate a new software tool to assist and automate the process of diagnosing whole-body datasets. MATERIAL AND METHODS: Thirteen whole-body datasets were evaluated by 3 readers using the conventional system and the new software tool. The times for loading the datasets, examining 5 different regions (head, neck, thorax, abdomen and pelvis/skeletal system) and retrieving a relevant finding for demonstration were acquired. Additionally a Student T-Test was performed. For qualitative analysis the 3 readers used a scale from 0 - 4 (0 = bad, 4 = very good) to assess dataset loading convenience, lesion location assistance, and ease of use. Additionally a kappa value was calculated. RESULTS: The average loading time was 39.7 s (+/- 5.5) with the conventional system and 6.5 s (+/- 1.4) (p < 0.01) with the new software tool. For the different regions (conventional system/new software tool), the time reduction for readers 1, 2, and 3 were as follows: in the head region 35.9 % (p < 0.01)/49.9 % (p < 0.01)/54.3 % (p < 0,01), in the neck region 48.5 % (p < 0.01)/52.6 % (p < 0.01)/59.4 % (p < 0.05), in the thorax region 59.1 % (p < 0.01)/56.2 % (p < 0.05)/62.1 % (p < 0.05), in the abdominal region 61.9 % (p < 0.01)/62.7 % (p < 0.05)/47.9 % (p < 0.01) and in the pelvis region 73.1 % (p < 0.01)/63.7 % (p < 0.05)/55 % (p < 0.01), respectively. 148.2 s (+/- 94.8) compared to 2.5 s (+/- 0.5) were required to retrieve a previously described finding (p < 0.01). With and without the new software tool the same number of metastases was found (p < 0.01, k > 0.9). The qualitative analysis showed a significant advantage with respect to convenience (p < 0.01, k > 0.9). CONCLUSION: Use of the new software can achieve a significant time savings when working with whole-body datasets with a constant quality of findings and a significant advantage with respect to convenience. As a result, the problem of evaluating examinations with thousands of images can be approached systematically.
Assuntos
Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Metástase Neoplásica/diagnóstico , Software , Imagem Corporal Total/métodos , Eficiência , Humanos , Metástase Neoplásica/patologia , Estadiamento de Neoplasias , Variações Dependentes do Observador , Sensibilidade e EspecificidadeRESUMO
BACKGROUND AND PURPOSE: Quantitative markers of Alzheimer disease (AD), particularly in the early stages, are needed for clinical assessment and monitoring. We have evaluated a novel method to segment and visualize the ventricular system and obtain volumetric measures thereof. The temporal horn volume (THV) and index in patients with mild cognitive impairment (MCI) and in those with AD were evaluated. METHODS: High-resolution T1-weighted volume imaging was performed in 52 subjects (21 patients with MCI, 10 with AD, and 21 healthy control subjects). An interactive watershed transformation and semiautomated histogram analysis were implemented to produce segmented THV and temporal horn indices (THI) (ratio of THV to lateral ventricular volume). RESULTS: Cerebral ventricular and temporal horn size could be semiautomatically quantified from all 52 datasets. The method was fast and rater-independent. Qualitative ventricular inspections using surface rendering shading could uncover atrophic process with enlargement of the whole and especially temporal horn volume. Both THV and THI of patients with AD were significantly larger than those of patients with MCI or control subjects (P < .005). There was no significant difference in THV and THI between patients with MCI or control subjects (P > .05). There was a significant correlation between the neuropsychologic performance and both THI and THV across groups (P < .01). CONCLUSION: THV and THI could be used as markers of AD in the clinical environment and are expected to be helpful in monitoring therapeutic intervention.
Assuntos
Processamento de Imagem Assistida por Computador/métodos , Ventrículos Laterais/patologia , Imageamento por Ressonância Magnética/métodos , Lobo Temporal/patologia , Idoso , Doença de Alzheimer/patologia , Atrofia , Ventrículos Cerebrais/patologia , Cognição/fisiologia , Transtornos Cognitivos/patologia , Hipocampo/patologia , Humanos , Aumento da Imagem/métodos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Giro Para-Hipocampal/patologiaRESUMO
BACKGROUND: The venous drainage of the liver plays an essential role in securing viability of both graft and remnant in live donor liver transplantation (LDLT). There is still controversy on whether the middle hepatic vein (MHV) should be routinely included as part of the graft or retained with the remnant liver. The purpose of this study was to analyze hepatic venous drainage patterns based on information obtained by 3-dimensional CT-imaging reconstructions. METHODOLOGY: Fifty five potential live liver donors were evaluated between January 2003 and May 2004 at our Institution. We analyzed two anatomical definitions of liver dominance: total liver dominance (TLD) and hemiliver dominance (HLD). The following concepts were addressed: 1) Hepatic vein territories, 2) Hepatic vein dominance relationship, 3) Territorial belonging- patterns of the MHV to the right and left hemilivers, additionally an analysis of venous outflow in the central liver sectors was performed. RESULTS: Our results showed that: 1) The definitions of dominance: TLD vs. HLD overlap, displaying the MHV belonging, by taking into account the individual right hepatic vein (RHV) variability; 2) A dominant RHV for the whole liver indicates that the RHV is also dominant in the right hemiliver; 3) The MHV belongs predominantly to the left hemiliver (LHL); 4) The left hepatic vein (LHV) is dominant in the LHL. CONCLUSION: Both dominance definitions provide independent mappings of the liver and offer helpful insight into venous dominance relationship.
Assuntos
Veias Hepáticas/anatomia & histologia , Processamento de Imagem Assistida por Computador , Transplante de Fígado , Fígado/anatomia & histologia , Doadores Vivos , Tomografia Computadorizada por Raios X , Adulto , Feminino , Humanos , Imageamento Tridimensional , Masculino , Complicações Pós-Operatórias , Coleta de Tecidos e ÓrgãosRESUMO
BACKGROUND: Diffusion tensor imaging and related fibre tracking techniques have the potential to identify major white matter tracts afflicted by an individual pathology or tracts at risk for a given surgical approach. However, the reliability of these techniques is known to be limited by image distortions, image noise, low spatial resolution, and the problem of identifying crossing fibres. This paper intends to bridge the gap between the requirements of neurosurgical applications and basic research on fibre tracking uncertainty. METHOD: We acquired echo planar diffusion tensor data from both 1.5 T and 3.0 T scanners. For fibre tracking, an extended deflection-based algorithm is employed with enhanced robustness to impaired fibre integrity such as caused by diffuse or infiltrating pathological processes. Moreover, we present a method to assess and visualize the uncertainty of fibre reconstructions based on variational complex Gaussian noise, which provides an alternative to the bootstrap method. We compare fibre tracking results with and without variational noise as well as with artificially decreased image resolution and signal-to-noise. FINDINGS: Using our fibre tracking technique, we found a high robustness to decreased image resolution and signal-to-noise. Still, the effects of image quality on the tracking result will depend on the employed fibre tracking algorithm and must be handled with care, especially when being used for neurosurgical planning or resection guidance. An advantage of the variational noise approach over the bootstrap technique is that it is applicable to any given set of diffusion tensor images. CONCLUSIONS: We conclude that the presented approach allows for investigating the uncertainty of diffusion tensor imaging based fibre tracking and might offer a perspective to overcome the problem of size underestimation observed by existing techniques.
Assuntos
Corpo Caloso/anatomia & histologia , Imagem de Difusão por Ressonância Magnética , Imagem Ecoplanar , Processamento de Imagem Assistida por Computador/métodos , Tratos Piramidais/patologia , Adulto , Idoso , Algoritmos , Neoplasias Encefálicas/patologia , Feminino , Glioma/patologia , Humanos , Masculino , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Proper outflow reconstruction is essential in LDLT. Preoperative planning requires meticulous attention to hepatic vein dominance patterns. The purpose of our study was to provide a combined anatomical-physiological classification of hepatic vein dominance useful for surgical decision-making in both donors and recipients. METHODOLOGY: We analyzed 3-dimensional CT-imaging reconstructions of 55 potential live liver donors evaluated at our Institution between January 2003 and May 2004. RESULTS: Our data revealed that: 1) The middle hepatic vein (MHV) and left hepatic vein (LHV) show a relative lack of anatomical diversity, whereas the right hepatic vein (RHV) exhibits multiple variants, 2) 45% donors had inferior hepatic veins (IHV) with anatomically and physiologically relevant venous drainage territories, 3) The RHV is usually dominant when present as a single vein without anatomical IHV (type 1A), or when considered as a complex with IHV (type 1Bx) (80% vs. 88%), 4) Only 55% of dominant type 1Bx RHV/IHV-complex automatically included a dominant type 1By RHV by itself, 5) A single RHV out of anatomical complex with IHV (type 1By) was dominant in only 48% of our donor candidates, 6) The MHV types 2A and 2By are strongly dominant accounting for up to 57% of total liver volume (TLV). CONCLUSIONS: We propose a new classification based on both anatomical and physiological hepatic venous configurations. Our model also provides a new nomenclature that can be universally applied to preoperative planning in LDLT.
Assuntos
Veias Hepáticas/anatomia & histologia , Veias Hepáticas/cirurgia , Transplante de Fígado , Fígado/irrigação sanguínea , Fígado/cirurgia , Adolescente , Adulto , Tomada de Decisões , Feminino , Veias Hepáticas/fisiologia , Humanos , Imageamento Tridimensional , Fígado/diagnóstico por imagem , Circulação Hepática , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: For living donor liver transplantation (LDLT) accurate diagnostic workup is essential. Multiple imaging approaches are currently used. Problems arise in the assessment of vascular and bile duct anatomy, liver graft volume, and vascular territories involved. A 3D visualization system that improves anatomic assessment, allows interactive surgery planning, and acts as an intraoperative guide with enhanced precision is required. Refinements in computed tomography (CT) technology with the introduction of multidetector-row CT scanners and implementation of mathematical methods on computerized digital data has enabled CT-based 3D visualizations. MATERIALS AND METHODS: Sixteen LDLT candidates and three LDLT recipients were assessed by multislice CT examination. Image processing of the digital raw data for 3D visualization included segmentation and calculation of center lines. A hierarchical mathematical model representing the vascular and biliary tree was created. This allowed calculation of individual vascular territories. RESULTS: 3D CT-based visualization in LDLT facilitates diagnostic workup with high accuracy for analyses of vascular and bile duct variants, volumetry, and assessment of the optimal surgical splitting line of the living donor liver. Resultant areas of either arterial devascularization or venous congestion can be displayed and quantified preoperatively. The diagnostic method is of major impact on patient selection and directly influences intraoperative surgical guidance. The currently practiced "multiple imaging approach" approach, especially with regard to invasive diagnostics, can be avoided in the future.
Assuntos
Processamento de Imagem Assistida por Computador/métodos , Transplante de Fígado/métodos , Fígado/anatomia & histologia , Fígado/diagnóstico por imagem , Doadores Vivos , Monitorização Intraoperatória/métodos , Tomografia Computadorizada por Raios X , Família , Humanos , Lactente , Tamanho do ÓrgãoRESUMO
A method is described for the automated detection of microcalcifications in digitized mammograms. The method is based on the Laplacian scale-space representation of the mammogram only. First, possible locations of microcalcifications are identified as local maxima in the filtered image on a range of scales. For each finding, the size and local contrast is estimated, based on the Laplacian response denoted as the scale-space signature. A finding is marked as a microcalcification if the estimated contrast is larger than a predefined threshold which depends on the size of the finding. It is shown that the signature has a characteristic peak, revealing the corresponding image features. This peak can be robustly determined. The basic method is significantly improved by consideration of the statistical variation of the estimated contrast, which is the result of the complex noise characteristic of the mammograms. The method is evaluated with the Nijmegen database and compared to other methods using these mammograms. Results are presented as the free-response receiver operating characteristic (FROC) performance. At a rate of one false positive cluster per image the method reaches a sensitivity of 0.84, which is comparable to the best results achieved so far.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Mamografia/métodos , Intensificação de Imagem Radiográfica/métodos , Algoritmos , Artefatos , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Curva ROC , Sensibilidade e EspecificidadeRESUMO
A new method is introduced to project the sulcal pattern of the brain surface onto a 2D plane. Twin brains are compared against each other using the planar representation. We obtained T1-weighted Flash-3D MRI volumes from 14 male twins (seven monozygotic, seven dizygotic) with 3 mm-thick coronal slices. The projection is based on potential theory: A virtual electrostatic field is calculated between the area of the segmented brain and a surrounding spherical electrode. Field lines starting from each border point of the segmented brain follow the gradient towards the sphere, leading to field line concentrations due to the underlying sulci. The unwrapped sphere surface with the number of field lines per area unit is used as the 2D representation of the sulcal pattern. The resulting brain projections show a distinctive pattern, and a visual assignment of the twin pairs from the unsorted set is possible because of a high similarity of the patterns between twin pairs. Global correlation coefficients for each pair of maps yield significantly higher values for matching monozygotic twin pairs (mean = 20.2, range 12.3-25.6) than for unmatched pairs (mean = 13.0, range 1.1-28.5). As a conclusion, our method allows us to map the location and depth of the sulci on a 2D plane. The resulting maps allow quantitative inter-individual comparisons on the entire brain or parts of the brain surface.
Assuntos
Mapeamento Encefálico/métodos , Córtex Cerebral/anatomia & histologia , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética , Adulto , Anatomia Transversal/métodos , Biometria/métodos , Humanos , Masculino , Análise por Pareamento , Modelos Neurológicos , Gêmeos Dizigóticos , Gêmeos MonozigóticosRESUMO
Combining the measurement of bone mineral density (BMD) and the classification of the trabecular structure in cancellous bone improves the estimation of the degree of osteoporosis. A fractal method for the automatic quantitative classification of the trabecular structure in midvertebral slices of lumbar vertebrae is introduced. This method is based on the computation of the fractal dimension (box counting method) for varying binarization thresholds. Radiographic images from 30 lumbar vertebrae and CT images from an additional 16 lumbar vertebrae were analysed by calculating the dimension D in dependency of the threshold value T. The function D(T) was normalized by the average image grey value, eliminating the bone mineral density from the computations. The results show that the images of the lumbar vertebrae have fractal properties, and the function D(T) has a typical behaviour that allows the discrimination of the degree of osteoporosis. With two parameters extracted from the function D(T) the correlation coefficients with BMD were both -79% for the radiographic images, and -93% and -91% for the CT data, respectively.
Assuntos
Densidade Óssea , Fractais , Osteoporose/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiopatologia , Osteoporose/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
The box counting dimension is a frequently applied tool for the classification of trabecular bone structure. The algorithm requires a binarization of the gray value data, for example that acquired by high resolution CT (HRCT). We recently proposed a method to eliminate bone mineral density (BMD) by applying a linear normalization scheme. Further consideration has shown that full BMD independence has not been achieved, and the structural parameter proposed was therefore difficult to interpret. In this study we present an alternative approach to obtain a structural parameter that is independent of BMD. HRCT volume data was acquired on 21 lumbar vertebrae from five cadavers. In the segmented spongiosa, thresholding was based on different quantiles of the gray value histogram, yielding invariance over linear and non-linear transformations. Thresholding at high gray value levels (80% quantile) shows the highest level of significance when discriminating between osteoporotic and non-osteoporotic cases. As an addition to the measurement of BMD alone, the determination of structural properties allows an improvement of the assessment of the individual fracture risk.
Assuntos
Algoritmos , Fractais , Vértebras Lombares/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Densidade Óssea , Cadáver , Computação MatemáticaRESUMO
The structural classification of trabecular bone is of considerable clinical importance for the diagnosis of osteoporosis. Assessment of the cortical bone mineral density (BMD) and analysis of cortical structure is necessary because the cortex is also affected by osteoporosis. We describe a method for the automatic classification of the cortex from its structure on high resolution (HR) CT images. The method is based on the distribution of areas with low BMD in the cortex. Two different approaches are presented; one uses the grey scale profile of the cortical ridge, and the other one evaluates the distribution of connected regions (clusters) of low BMD. i.e. areas that lie below a certain threshold value. In HRCT images from 22 lumbar vertebrae, the number of intersections of the cortical intensity profile with a horizontal line was determined at various positions of this threshold line. At a certain position, there was a local maximum in the number of intersections which was 38% higher in the osteoporotic cases. The maximum shows a moderate correlation with the cortical BMD of rni = -0.72 (p < 0.0001). The number nc of connected regions (clusters) with pixel values below a certain threshold value was determined in relation to the threshold value T. The resulting function nc(T) shows a relative maximum slightly below the average grey scale value of the respective image. The curve depends on the degree of osteoporosis: the height of the maximum (i.e. the maximal number of clusters ncmax) allows distinction to be made between different degrees of osteoporosis, and ncmax shows a correlation with the cortical BMD of rnc = -0.84 (p < 0.0001).
Assuntos
Densidade Óssea , Processamento de Imagem Assistida por Computador/métodos , Vértebras Lombares/diagnóstico por imagem , Osteoporose/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Avaliação como Assunto , Feminino , Humanos , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Osteoporose/fisiopatologiaRESUMO
Traditionally the intrahepatic vascular anatomy is correlated to the segment anatomy of the liver for which--following Couinaud [1]-the portal vein has been accepted as a guiding structure. This paper proposes a new method for the extraction and 3D-visualization of the portal vein based on Spiral CT data. Starting from a seed voxel, the algorithm expands stepwise within the structure of interest. Bifurcations are recognized and a symbolic tree is generated simultaneously which allows for interactive identification of sub-branches, their selection and specific colouring. The method is able to extract at least three generations of branches of the portal vein. A volume renderer is used to visualize the reconstructed portal vein superimposed to a transparent view of liver tissue and focal lesions. This provides a new tool for the planning of segment-oriented liver surgery (e.g. localization of lesions relative to the portal vein). But the method promises also to be useful for other applications, e.g. comparative studies of liver anatomy and pathology, or portosystemic shunt operations--TIPS (transjugular intrahepatic portosystemic shunts).
Assuntos
Algoritmos , Processamento de Imagem Assistida por Computador , Veia Porta/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Humanos , Veia Porta/anatomia & histologiaRESUMO
PURPOSE: In a clinical study, the feasibility of using a mammography workstation for the display and interpretation of digital mammography images was evaluated and the results were compared with the corresponding laser film hard copies. MATERIALS AND METHODS: Digital phosphorous plate radiographs of the entire breast were obtained in 30 patients using a direct magnification mammography system. The images were displayed for interpretation on the computer monitor of a dedicated mammography workstation and also presented as laser film hard copies on a film view box for comparison. The images were evaluated with respect to the image handling, the image quality and the visualization of relevant structures by 3 readers. RESULTS: Handling and contrast of the monitor displayed images were found to be superior compared with the film hard copies. Image noise was found in some cases but did not compromise the interpretation of the monitor images. The visualization of relevant structures was equal with both modalities. Altogether, image interpretation with the mammography workstation was considered to be easy, quick and confident. CONCLUSIONS: Computer-assisted visualization and interpretation of digital mammography images using a dedicated workstation can be performed with sufficiently high diagnostic accuracy.
Assuntos
Processamento de Imagem Assistida por Computador , Mamografia/métodos , Idoso , Neoplasias da Mama/prevenção & controle , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Mamografia/normas , Pessoa de Meia-IdadeRESUMO
PURPOSE: A retrospective clinical-histological study to determine the diagnostic accuracy of mammography using conventional screen-film cassettes (hard copy), high-resolution digital phosphor storage plates (hard copy) and monitor display (soft copy) for microcalcifications and focal lesions (BI-RADS (TM) category 4 or 5). MATERIALS AND METHODS: From April to November 2001, 76 patients underwent conventional film-screen mammography and, after diagnosis and preoperative wire localization, digital mammography with the same exposure parameters. Five investigators retrospectively determined the diagnosis after the operation from randomly distributed mediolateral views (hard-copy reading) and from the monitor display (soft-copy reading). These results were correlated with the final histology. RESULTS: The accuracy of conventional screen-film mammography, digital mammography and monitor-displayed mammography was 67%, 65% and 68% for all findings, (n = 76), 59%, 59% and 68% for microcalcifications (n = 44) and 75%, 72% and 63% for focal lesions (n = 32). The overall results showed no difference. CONCLUSION: Our findings indicate equivalence of conventional screen-film mammography, high-resolution digital phosphor storage plate mammography and monitor-displayed mammography.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mamografia/métodos , Intensificação de Imagem Radiográfica , Adenocarcinoma/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Mamárias/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Lobular/diagnóstico por imagem , Carcinoma Medular/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Fibroadenoma/diagnóstico por imagem , Fibrose/diagnóstico por imagem , Humanos , Lipoma/diagnóstico por imagem , Pessoa de Meia-Idade , Papiloma/diagnóstico por imagem , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
The research project "VICORA - Virtual Institute for Computer-Assisted Radiology", funded by the German Federal Ministry of Education and Research, was initiated in the year 2000. Its virtual organization brings together physical science, engineering, information technology, clinical radiology and the medical technology industry. In the German radiology research domain VICORA serves as a model for interdisciplinary collaboration for the changing radiology paradigm illustrated by a "radiologycube". The project does not only aim at scientific goals but also considers the infrastructure, components and human resource management within a virtual organization. The common rapid prototyping platform ILAB 4 ensures user-friendly and time-efficient software that assists with the routine radiology work-flow including full DICOM functionality. By offering a new work environment and collaborative culture based on telematics and knowledge exchange in radiology research, VICORA overcomes limitations of traditional research organization.
Assuntos
Diagnóstico por Computador/métodos , Processamento de Imagem Assistida por Computador/métodos , Radiologia/métodos , Interface Usuário-Computador , Humanos , Radiologia/tendênciasRESUMO
PURPOSE: To implement a software platform (DynaVision) dedicated to analyze data from functional imaging of tumors with different mathematical approaches, and to test the software platform in pancreatic carcinoma xenografts in mice with severe combined immunodeficiency disease (SCID). MATERIALS AND METHODS: A software program was developed for extraction and visualization of tissue perfusion parameters from dynamic contrast-enhanced images. This includes regional parameter calculation from enhancement curves, parametric images (e. g., blood flow), animation, 3D visualization, two-compartment modeling, a mode for comparing different datasets (e. g., therapy monitoring), and motion correction. We analyzed xenograft tumors from two pancreatic carcinoma cell lines (BxPC3 and ASPC1) implanted in 14 SCID mice after injection of Gd-DTPA into the tail vein. These data were correlated with histopathological findings. RESULTS: Image analysis was completed in approximately 15 minutes per data set. The possibility of drawing and editing ROIs within the whole data set makes it easy to obtain quantitative data from the intensity-time curves. In one animal, motion artifacts reduced the image quality to a greater extent but data analysis was still possible after motion correction. Dynamic MRI of mice tumor models revealed a highly heterogeneous distribution of the contrast-enhancement curves and derived parameters, which correlated with differences in histopathology. ASPC1 tumors showed a more hypervascular type of curves with faster and higher signal enhancement rate (wash-in) and a faster signal decrease (wash-out). BXPC3 tumors showed a more hypovascular type with slower wash-in and wash-out. This correlated with the biological properties of the tumors. CONCLUSION: With the described software, it was possible to analyze tissue perfusion parameters in small xenograft tumor models in mice. Our data correlated with histopathological data, and the qualitative and quantitative perfusion parameters could distinguish two tumor entities with different growth characteristics.
Assuntos
Imageamento Tridimensional , Imageamento por Ressonância Magnética , Neoplasias Pancreáticas/diagnóstico , Software , Animais , Artefatos , Linhagem Celular Tumoral , Meios de Contraste , Modelos Animais de Doenças , Gadolínio DTPA , Técnicas Histológicas , Aumento da Imagem , Camundongos , Camundongos SCID , Modelos Teóricos , Neoplasias Pancreáticas/irrigação sanguínea , Neoplasias Pancreáticas/patologia , Perfusão , Transplante HeterólogoRESUMO
Run-length coding has attracted much attention in wavelet-based image compression because of its simplicity and potentially low complexity. The main drawback is the inferior RD-performance compared to the state-of-the-art-coder SPIHT. In this paper, we concentrate on the embedded progressive run-length code of Tian and Wells (1996, 1998). We consider significance sequences drawn from the scan in the dominant pass. It turns out that self-similar curves for scanning the dominant pass increase the compression efficiency significantly. This is a consequence of the correlation of direct neighbors in the wavelet domain. This dependence can be better exploited by using groups of coefficients, similar to the SPIHT algorithm. This results in a new and very fast coding algorithm, which shows performance similar to the state-of-the-art coder SPIHT, but with lower complexity and small and fixed memory overhead.