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Biomedical subjects

A H Rowberg

Publications and source records attributed to A H Rowberg.

At least 19 recordsLinked to original sources

Use of data in a radiology information system for labeling computed radiographs: an interface to connect the two systems.

Computers have greatly facilitated the processing and storage of radiologic information. Manufacturers of radiology information systems (RISs) are gradually incorporating options for interfacing their products with other computers (e.g., hospital information systems). However, a growing need exists to also interface RISs with digital radiologic equipment so that images (e.g., computed radiographs of the chest and skeleton) are automatically labeled with identification data. Such connectivity would eliminate redundant work by technologists, decrease errors in the labeling of images, and increase the consistency of patients' data within a radiology department. Unfortunately, the rapid advances in digital technology, combined with the lack of a well-defined standard for the transfer of demographic information between dissimilar systems, have delayed development of these interfaces. We have developed a widely applicable method to automatically transfer patients' demographic data from an RIS to a commercially available computed radiography system. A personal computer is configured with inexpensive programmable telecommunications software to create an interactive gateway, which eliminates the need for redundant data entry (compared with entering data once on the RIS and again on the stand-alone computed radiography system), and thus also decreases errors in the labeling of images.

Local Area Networks

Future opportunities using technical advantages in picture processing and data transfer.

In recent years there have been many significant developments in the ability to process radiographic pictures and transfer the images from one location to another, and we can now examine the application of computers in the radiographic evaluation of rheumatoid arthritis. Image management and communication systems can assist in providing better health care while lowering costs. Although this work is still in its infancy, the rapid growth in both hardware capability and software techniques will soon make these techniques available to physicians everywhere. The expanding capability in the commercial world is being embraced by the radiology department, and will soon allow rheumatologists to access images at greater distances, and do more with the images which become available.

Arthritis, Rheumatoid

Displaying radiologic images on personal computers: image processing and analysis.

This is the fourth article of our series for radiologists and imaging scientists on displaying, manipulating, and analyzing radiologic images on personal computers. Classic image processing is divided into point, area, frame, and geometric processes. Point processes change image pixel values based on the value of the pixel of interest. Histogram equalization adjusts the pixel values in the image based on the distribution of pixel values. Area processes change the pixel of interest based on the values of the surrounding pixels, known as the neighborhood. Area processes using a convolution kernel are often used as image filters. Common convolution kernels include low-frequency, high-frequency, and edge-enhancement filters. Edge enhancement can be performed with convolution kernels such as shift and difference, gradient-directional and Laplacian filters, or with nonlinear methods such as Sobel's algorithm. Frame processes mathematically combine two or more images, often for noise reduction and background subtraction. Geometric processes alter the location of pixels within the image, but usually not the pixel values. Common radiologic applications of image processing include window width and window level adjustments (point process), adaptive histogram equalization (area process), unsharp masking (area process), computed radiography image processing (combined area and point processes), digital subtraction angiography (frame and geometric processes), region of interest analysis (area process), and image rotation (geometric process). As digital imaging becomes more widespread, radiologists need to understand the image processing that is fundamental to these modalities.

Algorithms

Displaying radiologic images on personal computers: image storage and compression--Part 2.

This is part 2 of our article on image storage and compression, the third article of our series for radiologists and imaging scientists on displaying, manipulating, and analyzing radiologic images on personal computers. Image compression is classified as lossless (nondestructive) or lossy (destructive). Common lossless compression algorithms include variable-length bit codes (Huffman codes and variants), dictionary-based compression (Lempel-Ziv variants), and arithmetic coding. Huffman codes and the Lempel-Ziv-Welch (LZW) algorithm are commonly used for image compression. All of these compression methods are enhanced if the image has been transformed into a differential image based on a differential pulse-code modulation (DPCM) algorithm. The LZW compression after the DPCM image transformation performed the best on our example images, and performed almost as well as the best of the three commercial compression programs tested. Lossy compression techniques are capable of much higher data compression, but reduced image quality and compression artifacts may be noticeable. Lossy compression is comprised of three steps: transformation, quantization, and coding. Two commonly used transformation methods are the discrete cosine transformation and discrete wavelet transformation. In both methods, most of the image information is contained in a relatively few of the transformation coefficients. The quantization step reduces many of the lower order coefficients to 0, which greatly improves the efficiency of the coding (compression) step. In fractal-based image compression, image patterns are stored as equations that can be reconstructed at different levels of resolution.

Algorithms

Dual lookup table algorithm: an enhanced method of displaying 16-bit gray-scale images on 8-bit RGB graphic systems.

Most digital radiologic images have an extended contrast range of 9 to 13 bits, and are stored in memory and disk as 16-bit integers. Consequently, it is difficult to view such images on computers with 8-bit red-green-blue (RGB) graphic systems. Two approaches have traditionally been used: (1) perform a one-time conversion of the 16-bit image data to 8-bit gray-scale data, and then adjust the brightness and contrast of the image by manipulating the color palette (palette animation); and (2) use a software lookup table to interactively convert the 16-bit image data to 8-bit gray-scale values with different window width and window level parameters. The first method can adjust image appearance in real time, but some image features may not be visible because of the lack of access to the full contrast range of the image and any region of interest measurements may be inaccurate. The second method allows "windowing" and "leveling" through the full contrast range of the image, but there is a delay after each adjustment that some users may find objectionable. We describe a method that combines palette animation and the software lookup table conversion method that optimizes the changes in image contrast and brightness on computers with standard 8-bit RGB graphic hardware--the dual lookup table algorithm. This algorithm links changes in the window/level control to changes in image contrast and brightness via palette animation.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms

Displaying radiologic images on personal computers: practical applications and uses.

This is the fifth and final article in our series for radiologists and imaging scientists on displaying, manipulating, and analyzing radiologic images on personal computers (PCs). There are many methods of transferring radiologic images into a PC, including transfer over a network, transfer from an imaging modality storage archive, using a frame grabber in the image display console, and digitizing a radiograph or 35-mm slide. Depending on the transfer method, the image file may be an extended gray-scale contrast, 16-bit raster file or an 8-bit PC graphics file. On the PC, the image can be viewed, analyzed, enhanced, and annotated. Some specific uses and applications include making 35-mm slides, printing images for publication, making posters and handouts, facsimile (fax) transmission to referring clinicians, converting radiologic images into medical illustrations, creating a digital teaching file, and using a network to disseminate teaching material. We are distributing a 16-bit image display and analysis program for Macintosh computers, Dr Razz, that illustrates many of the principles discussed in this review series. The program is available for no charge by anonymous file transfer protocol (ftp).

Audiovisual Aids

Evaluation of a combined two- and three-dimensional compression method using human visual characteristics to yield high-quality 10:1 compression of cranial computed tomography scans.

RATIONALE AND OBJECTIVES: The compression of cranial computed tomography scans was improved by using independent intra- and interframe compression techniques. METHODS: For intraframe compression, an image was decomposed into four subimages, one subimage was chosen as a reference subimage, and three of the subimages were predicted from the reference subimage. The prediction error was encoded with a classified vector quantizer (CVQ) based on human visual perception characteristics. Interframe redundancy is exploited by a displacement estimated interslice (DEI) algorithm that encodes the differences between reference subimages from adjacent slices. This combined DEI/CVQ method was subjectively evaluated by 13 radiologists under a blinded protocol, and was compared to the CVQ method alone, the DEI method alone, the original images, and to a standard intraframe discrete cosine transform (DCT) compression method. RESULTS: Only the combined DEI/CVQ method at 10:1 compression was not scored significantly different from the original images. At 15:1 compression, the DEI/CVQ method was scored significantly better than the 10:1 DCT and any other 15:1 compression methods. CONCLUSIONS: Compressed image quality is enhanced by exploiting inter- and intraframe redundancy, and by modeling some characteristics of human visual perception. The DEI/CVQ method is well-suited for progressive transmission, and thus, holds potential in teleradiology as well as picture archiving and communications systems.

Analysis of Variance

Dr. Browse, a digital image file format Browser.

The emerging widespread adoption of the Digital Imaging Communications in Medicine (DICOM) standard will increase the demand for radiologic image transfer between radiologic image acquisition, archive, display and printing devices. Unfortunately, there are and will continue to be many devices that do not and will not support this standard, especially older radiologic equipment and devices from nonradiologic vendors. Determining the image file format characteristics of images from such equipment is often difficult, and done on an ad hoc basis. We have developed a software tool that assists users in determining the image file format parameters of unknown radiologic images.

Analog-Digital Conversion

Displaying radiologic images on personal computers.

This is the second article of our series for radiologists and imaging scientists on displaying, manipulating, and analyzing radiologic images on personal computers (PCs). The first article discussed the digital image data file, standard PC graphic file formats, and various methods for importing radiologic images into the PC. This article discusses the hardware, software, and user interface issues related to displaying gray scale images on PCs. In particular, this segment focuses on the process of converting the digital image into gray shades on a color monitor. A method for displaying and interactively setting the window width and window level parameters of 16-bit radiologic images on PCs with standard red green blue graphic hardware is illustrated in a sample application.

Computer Graphics

Displaying radiologic images on personal computers: image storage and compression: Part 1.

This is the third article of our series for radiologists and imaging scientists on displaying, manipulating, and analyzing radiologic images on personal computers. Part 1 of this article discusses image storage and reviews the basic concepts of information theory and image compression; part 2 will discuss specific methods of image compression. There are a wide variety of removable storage devices available to users who need to archive radiologic images on their personal computers. Tape drives have potentially very large storage capacity but slow performance. Removable SyQuest (SyQuest Technology, Femont, CA) and Bernoulli disks have near hard disk performance and can store from 100 to 150 Mbytes. Magneto-optical drives can store nearly 1 Gb on a 5.25" disk, with somewhat slower performance. Selecting the most appropriate storage solution requires a careful balance of the user's requirements, including performance, storage needs, cost and compatibility with other users. Despite the advances in low cost high capacity storage technology, image compression remains a crucial technology for modern diagnostic radiology because digital images require such large amounts of storage. Image compression is possible because radiologic images have relatively low entropy (high information content) compared with random noise. Image compression is classified as lossless (nondestructive) or lossy (destructive). Lossless image compression commonly achieve compression ratios of 1.5:1 to 3:1 (33% to 67%), whereas lossy compression can compresses images from 3:1 to 30:1 (67% to 97%).(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Storage Devices

A new method for computed tomography image compression using adjacent slice data.

RATIONALE AND OBJECTIVES: The authors developed and subjectively evaluated an interslice compression algorithm that explores the redundancy among adjacent slices of an x-ray computed tomography (CT) scan. This algorithm has been compared to an intraslice compression algorithm based on the two-dimensional discrete cosine transform. METHODS: Nine x-ray CT head images from three patients were compressed with this interslice method at compression ratios of 5:1, 10:1, and 15:1. The same images were also compressed with the intraslice method at the same ratios. Six radiologists judged quality of randomly selected compressed and decompressed images compared to that of the originals. The evaluation data were analyzed statistically with the analysis of variance and Tukey's multiple comparison. Kappa-like statistics (Williams index and O'Connell and Dobson indexes) were also calculated to measure the agreement among readers beyond the amount expected by chance. RESULTS: The interslice coding algorithm showed significantly better quality than the intraslice method at significance level 0.05, even though there was no difference in the objective distortion measure (signal-to-noise ratio). Also, the quality of 10:1 compressed images with the interslice coding algorithm was not significantly different from that of the originals at level 0.05. While large variations in agreement occurred among readers, the overall agreement was statistically significant. CONCLUSIONS: By using adjacent slice information in compressing x-ray CT images, significantly better quality in compressed and decompressed images was achieved. While 10:1 compressed images with the interslice algorithm were not significantly different from the originals in quality at level 0.05, effect on diagnostic accuracy remains to be investigated.

Algorithms

Authentication and management of radiologic reports: value of a computer workstation integrated with a radiology information system.

An increasing number of radiology departments are using computers to facilitate management of radiologic information. Transcription, storage, and printing of radiologic reports are among the primary functions of a radiology information system. Consequently, manual signature of radiologic reports is being replaced by on-line electronic authentication. However, the utilities provided on most radiology information systems to review, edit, and otherwise manipulate radiologic reports are relatively crude compared with commercial word-processing and data-base management software available for personal computers. We have developed a personal computer software system that is integrated with our existing radiology information system; expedites the radiologist's task of reviewing, editing, and authenticating (i.e., signing) radiologic reports; provides a teaching file data base on the workstation into which radiologic reports and patients' demographics can be instantly transferred; and provides a similar data base to facilitate follow-up on those examinations deemed appropriate for quality-assurance procedures. These features improve the radiologist's efficiency and increase his or her willingness to more fully exploit the intended purposes of a radiology information system.

Humans

The need and user requirements for integrating images with radiology reports.

Radiology reports are likely to be more useful if they contain appropriate graphic material. Diagnostic conclusions and recommendations become more convincing and useful when the clinician personally can review the image on which these are based. Modern desk-top publishing techniques make it possible to incorporate radiographic images, appropriately selected and annotated, as part of the radiology report. It is believed that such illustrated reports would be preferred by referring physicians, notwithstanding a significant loss of image detail. A survey of these referring physicians was carried out to determine whether this hypothesis was correct.

Computer Peripherals

Preliminary experience with portable digital imaging for intensive care radiography.

A digital radiography system based on reusable, photostimulable phosphor technology was evaluated in approximately 3,500 portable chest radiographs of patients in an intensive care unit. The system functioned well in this application. No major problems were encountered in the visualization of tubes or catheters or in the detection of pneumothoraces. Assessment of fluid volume status or the presence of small pleural effusions, especially when these were bilateral, was initially somewhat difficult but became easier as investigators became familiar with the system. Radiologists were quicker than nonradiologists to accept the minimized two-on-one display format. Critical evaluation of the overall performance of digital systems such as this one is needed for a better definition of the system's strengths and weaknesses. Specifically, statistical analyses of the ability to detect disease states such as pneumothoraces, interstitial lung disease, lung nodules, and pleural abnormalities need to be performed.

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