PubMed Health⌕ Search

Biomedical subjects

D R Ney

Publications and source records attributed to D R Ney.

At least 19 recordsLinked to original sources

The current state of the art in three dimensional oncologic imaging: an overview.

PURPOSE: To provide an overview of the methods and clinical applications of three dimensional (3D) medical imaging in the oncologic patient. METHODS AND MATERIALS: We briefly outline the techniques currently used to create 3D medical images with an emphasis on their strengths and shortcomings as they relate to oncologic imaging and radiation therapy planning. We then discuss some of the most important and promising oncologic applications of 3D imaging and suggest likely future directions in this rapidly developing field. RESULTS: Since the first application of 3D techniques to medical data over a decade ago, 3D medical images have evolved from relatively crude representations of musculoskeletal abnormalities to detailed and accurate representations of a variety of soft tissue, vascular, and oncologic pathology. The rapid development of both computer hardware and software coupled with the application of 3D techniques to a variety of imaging modalities have expanded the clinical applications of this technology dramatically. CONCLUSIONS: 3D medical images are clinically practical tools for oncologic evaluation and effective radiation therapy planning.

Humans↗

Digital video applications in radiologic education: theory, technique, and applications.

Computer-assisted instruction (CAI) has great potential in medical education. The recent explosion of multimedia platforms provides an environment for the seemless integration of text, images, and sound into a single program. This article discusses the role of digital video in the current educational environment as well as its future potential. An indepth review of the technical decisions of this new technology is also presented.

Computer-Assisted Instruction↗

Two-dimensional and three-dimensional imaging of the in vivo lung: combining spiral computed tomography with multiplanar and volumetric rendering techniques.

We applied multiplanar techniques and a modified version of our volumetric rendering program for three-dimensional imaging to single-breath hold spiral computed tomography (CT) datasets to generate two- and three-dimensional (2-D and 3-D) images of the in vivo lung. We report details of the combined 2-D/3-D spiral CT technique along with three representative cases from our initial experience.

Adult↗

Spiral computed tomography arterial portography with three-dimensional volumetric rendering for oncologic surgery planning. A retrospective analysis.

RATIONALE AND OBJECTIVES: Surgical resection of metastatic neoplasms of the liver can prolong survival of patients. The decision to resect a tumor depends to a great extent on the location of lesions relative to hepatic vasculature. Spiral computed tomography arterial portography (SCTAP) is an excellent technique for preoperative localization of tumors. The addition of three-dimensional rendering of image data sets should enhance the efficiency and accuracy of the interpretation of these data by the surgeon. METHODS: Fourteen patients with surgically and pathologically proven solitary and multiple metastatic hepatic neoplasms underwent SCTAP: Volume data sets thus derived were used to produce life-like three-dimensional animated images through a process known as volumetric rendering. These images were presented to the surgeon, who evaluated them based on several criteria. RESULTS: Accurate and clinically useful images were produced routinely in 13 of 14 patients. CONCLUSIONS: Clinical utility of three-dimensional rendering of SCTAP data sets for preoperative localization of hepatic lesions has been shown retrospectively. A larger, prospective study is suggested to demonstrate the accuracy and efficacy of the technique.

Adult↗

Effect of image display on the quality of multiplanar reconstruction of computed tomography data.

RATIONALE AND OBJECTIVES: The objective of this study is to determine whether the use of edge-enhancement post-processing filters was useful in the computed tomographic (CT) multiplanar evaluation of skeletal trauma. METHODS: The group consisted of a series of 10 cases of skeletal trauma (3 cases of acetabular fractures, 3 cases of tibial plateau fractures, and 4 cases of ankle fractures). All patients had a CT scan using a scan protocol of 4-mm collimation and 3-mm interscan interval. All transaxial images were reconstructed with both a standard algorithm and with an edge-enhancement filter. The images from each group were then reconstructed into coronal and sagittal planes. Three individuals independently reviewed each case and compared image pairs to determine whether images using an edge-enhancement filter were of better or worse quality than standard images. RESULTS: The reviewers found the images with edge-enhancement to be equal to or superior to images reconstructed with a standard algorithm, regardless of the image plane chosen. This bias was especially true in cases of hip and ankle trauma. CONCLUSIONS: When CT supplemented by multiplanar imaging is used in patients with skeletal trauma, image data reconstruction should be done with an edge-enhancement filter to optimize image detail.

Acetabulum↗

Advanced computer applications in radiology: clinical applications.

Computers play a major role in bridging the gap between image generation and patient care by providing enhanced images that better meet the needs of referring physicians. Spiral computed tomography allows generation of three-dimensional images that are not affected by motion artifact. Volume rendering, a three-dimensional reconstruction algorithm, yields images free of computer-generated artifacts and superior in quality. Currently, technologic computer advances play an important role in three clinical areas: orthopedic applications, oncologic applications, and prosthetic design. Three-dimensional imaging is especially valuable in fracture assessment because it allows exploration of image data to define the location of fracture fragments, the integrity of the joint space, and any possible displacement. With three-dimensional imaging, the extent of tumor spread into adjacent soft tissue or involvement of blood vessels can be determined, even in difficult anatomic areas. Volume rendering and increased computer speed allow greatly improved treatment planning for radiation therapy and custom design of orthopedic prostheses. Through the mutual understanding of goals between physicians and computer scientists, the computer can reach its full potential in medicine, resulting in improved patient care.

Diagnostic Imaging↗

Three-dimensional display of hepatic venous anatomy generated from spiral computed tomography data: preliminary results.

A new method is presented for generating three-dimensional images of the hepatic venous anatomy from helical computed tomography (CT) scans using volumetric rendering. The helical CT scans were obtained using peripheral injection of intravenous contrast via a power injector. Five patients with suspected liver tumors were studied from which one sample case was selected for illustration. Surgical planning of hepatic resection from three-dimensional images will soon become a practical part of patient care.

Adult↗

Examination of the pathologic anatomy of ankle fractures.

A prospective study of the translational and rotational displacement of the lateral malleolus in ankle fractures was carried out utilizing roentgenographic techniques. Twenty-six ankle fractures in 25 patients were studied using both routine plain films and CT scanning with two- and three-dimensional multiplanar reconstruction. Eighty-one percent were Lauge-Hansen supination-external rotation type injuries. Overall, 21 fractures did not involve the medial malleolus. Initial talar shift was less than or equal to 2 mm in 15 fractures. Although all patients exhibited external rotation deformities of the lateral malleolus on plain films, only one fracture was found to possess any degree of external rotation relative to the talus. The proximal fibula was seen on CT scans to have increased internal rotation with respect to the tibia in 19 cases. One patient had a slightly externally rotated proximal fibula; the remainder appeared normally aligned. The displacements measured by the CT scans at the talofibular articulation were compared with the standard plain film measurements. The displacements at the distal lateral malleolus were consistently overestimated by the plain roentgenograms, presumably because the capsular and ligamentous attachments to the distal fibula limit malleolar displacement. The talocrural angle, determined on both plain films and CT scans, was also not found to be a sensitive measure of fibular shortening nor of the severity of the fracture. The results of this study suggest that, in an isolated lateral malleolar ankle fracture, the apparent external rotation of the fracture fragment is relative only to the proximal fibula and is not associated with derangement of the talofibular articulation. Based on these mechanical considerations, surgical intervention for such fractures may not be necessary. This hypothesis is consistent with previous long-term clinical studies.

Adolescent↗

Comparison of helical and serial CT with regard to three-dimensional imaging of musculoskeletal anatomy.

To test the hypothesis that helical computed tomographic (CT) scans provide three-dimensional images as good as or better than those provided by serial CT, two objects were used to study the effects of helical CT: an angled cylindrical bone phantom and a human cadaveric femur specimen with a simulated fracture 1 mm wide. Both objects were immersed in a water bath, and a series of helical and serial CT scans were obtained with various parameters. Volumetric rendering was applied to the resultant data sets to create three-dimensional images, which three radiologists reviewed in a blinded manner to rate their fidelity, accuracy, and diagnostic usefulness. As expected, the images obtained with thin collimation and small intersection spacing or slow table movement were considered superior. Helical and serial CT data acquired with similar parameters were similar in quality, but helical CT is approximately five times faster than serial CT; hence, it is possible to use thinner collimation and obtain more sectional data with helical CT.

Femur↗

Spiral CT of the pancreas with multiplanar display.

This essay illustrates the findings obtained with spiral CT imaging in pancreatic disease. Features of spiral CT--fast scanning, dynamic injection of contrast material allowing optimal vessel opacification, and supplemental multiplanar imaging--promise to provide increased accuracy in the diagnosis and staging of pancreatic disease. With further development of continuous (spiral/helical) scanning technology, this technology should expand to cover a wider range of applications.

Adolescent↗

Computer-based radiological teaching programs: the challenge and trauma of development and implementation.

Computers are becoming an invaluable part of the radiologist's environment whether they are used as a source of the patient's clinical or laboratory information, to store x-ray or pathologic reports or as a viewing station for films. The use of computers in the educational environment is but a natural extension of the increased computerization of the radiologic department. This article reviews the use of personal computers in a teaching environment via the construction of the computed tomography teaching program entitled "CT: The Game." The decisions that must be made in terms of hardware and software prior to program development as well as the actual development are discussed. The potential of computers in terms of continuing education as well as in residency training programs is discussed with the potential for the future addressed.

Computer Systems↗

The use of graphic design in an interactive computer teaching program.

The widespread diffusion of affordable computers into the scientific and educational community has provided the opportunity to design medical and scientific teaching programs illustrated either by hand or by utilizing commercially available software and manipulating existing computer generated images. The medical illustrator can provide the ideal aesthetic link between text format information and the visual representation of such knowledge in a concise presentation format. The availability of interactive multimedia programs has given the medical illustrator an environment to create and enhance Hypermedia designed specifically for the purpose of medical education. This paper will focus on the incorporation of illustration and screen design into "CT The Game," an experimental medical teaching program currently being developed in the Johns Hopkins Body CT Imaging Laboratory. The program is designed to provide an enjoyable approach to learning Computed Tomography (CT), and is directed toward an audience of medical students, residents, and fellows.

Computer Graphics↗

Data base management in radiology: a simplified approach.

The increasing availability of personal and departmental computers in radiology departments has led to increasing interest in data management. Data base management software must be system compatible, simple, and flexible to insure its acceptance and constant use. Once in place, such a system streamlines the daily documentation of interesting cases for conference, follow-up, research, and quality assurance. The authors have developed such a data base program for tracking computed body tomography cases in their department, which can be run as a portable computer to maximize ease of access and therefore usage.

Database Management Systems↗

Sacral foramina: view at CT.

Conventional transaxial computed tomography (CT) is superior to plain radiography in depicting the sacrum. Because of the shape and orientation of the sacrum, CT provides oblique views of the structures of interest. With easily reproducible landmarks and standard transaxial CT data, orthogonal image sets can be produced that provide a true en face orientation matching the obliquity of the sacrum. This allows optimal visualization of the paired foramina and of the sacroiliac joints for better assessment of trauma, tumor, or inflammatory disease.

Humans↗