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Biomedical subjects

K R Hoffmann

Publications and source records attributed to K R Hoffmann.

At least 19 recordsLinked to original sources

A system for determination of 3D vessel tree centerlines from biplane images.

With the increasing number and complexity of therapeutic coronary interventions, there is an increasing need for accurate quantitative measurements. These interventions and measurements may be facilitated by accurate and reproducible magnifications and orientations of the vessel structures, specifically by accurate 3D vascular tree centerlines. A number of methods have been proposed to calculate 3D vascular tree centerlines from biplane images. In general, the calculated magnifications and orientations are accurate to within approximately 1-3% and 2-5 degrees, respectively. Here, we present a complete system for determination of the 3D vessel centerlines from biplane angiograms without the use of a calibration object. Subsequent to indication of the vessel centerlines, the imaging geometry and 3D centerlines are calculated automatically and within approximately 2 min. The system was evaluated in terms of the intra- and inter-user variations of the various calculated quantities. The reproducibilities obtained with this system are comparable to or better than the accuracies and reproducibilities quoted for other proposed methods. Based on these results and those reported in earlier studies, we believe that this system will provide accurate and reproducible vascular tree centerlines from biplane images while the patient is still on the table, and thereby will facilitate interventions and associated quantitative analyses of the vasculature.

Coronary Angiography↗

Volume rendering quantification algorithm for reconstruction of CT volume-rendered structures: Part I. Cerebral arteriovenous malformations.

Volume rendering is a visualization technique that has important applications in diagnostic radiology and in radiotherapy but has not achieved widespread use due, in part, to the lack of volumetric analysis tools for comparison of volume rendering to conventional visualization techniques. The volume rendering quantification algorithm (VRQA), a technique for three-dimensional (3-D) reconstruction of a structure identified on six principal volume-rendered views, is introduced and described. VRQA involves three major steps: 1) preprocessing of the partial surfaces constructed from each of six volume-rendered images; 2) merging these processed partial surfaces to define the boundaries of a volume; and 3) computation of the volume of the structure from this boundary information. After testing on phantoms, VRQA was applied to CT data of patients with cerebral arteriovenous malformations (AVM's). Because volumetric visualization of the cerebral AVM is relatively insensitive to operator dependencies, such as the choice of opacity transfer function, and because precise volumetric definition of the AVM is necessary for radiosurgical treatment planning, it is representative of a class of structures that is ideal for testing and calibration of VRQA. AVM volumes obtained using VRQA are intermediate to those obtained using axial contouring and those obtained using CT-correlated biplanar angiography (two routinely used visualization techniques for treatment planning for AVM's). Applications and potential expansions of VRQA are discussed.

Algorithms↗

Automated calculation of the centerline of the human colon on CT images.

RATIONALE AND OBJECTIVES: This article presents an evaluation of an automated technique for determining the colon centerline with computed tomographic (CT) data sets. MATERIALS AND METHODS: The technique proceeds as follows. After indication of a voxel in the rectum, voxels corresponding to air were segmented. Points along the colon centerline were estimated on the basis of centers of mass of grown voxels. A second segmentation and centerline calculation was initiated at the cecum. These two centerlines were then averaged. The resulting average was refined by using lumen data obtained perpendicular to the average centerline. The accuracy of the technique was investigated with simulation phantoms. The technique was also evaluated for 40 clinical colon cases. Calculated centerline points were compared with those indicated by radiologists for a randomly selected clinical case. RESULTS: In the simulation studies, the calculated centerline points were, on average, within 2.5 mm of the true centerlines but differed by up to 4 mm in regions of deep folds or sharp turns. In the clinical colon study, 40% of the centerlines were computed with a single seed point and 25% with two seed points. Average centerlines were computed in 1 minute. The root mean square difference between the computed centerline points and those indicated by the radiologists was 4-5 mm (comparable to interobserver variations). CONCLUSION: Accurate centerlines can be determined from colon CT data with this automated technique.

Colon↗

Biplane X-ray angiograms, intravascular ultrasound, and 3D visualization of coronary vessels.

The technology for determination of the 3D vascular tree and quantitative characterization of the vessel lumen and vessel wall has become available. With this technology, cardiologists will no longer rely primarily on visual inspection of coronary angiograms but use sophisticated modeling techniques combining images from various modalities for the evaluation of coronary artery disease and the effects of treatment. Techniques have been developed which allow the calculation of the imaging geometry and the 3D position of the vessel centerlines of the vascular tree from biplane views without a calibration object, i.e., from the images themselves, removing the awkwardness of moving the patient to obtain 3D information. With the geometry and positional information, techniques for reconstructing the vessel lumen can now be applied that provide more accurate estimates of the area and shape of the vessel lumen. In conjunction with these developments, techniques have been developed for combining information from intravascular ultrasound images with the information obtained from angiography. The combination of these technologies will yield a more comprehensive characterization and understanding of coronary artery disease and should lead to improved and perhaps less invasive patient care.

Coronary Angiography↗

Quantitative evaluation of vessel tracking techniques on coronary angiograms.

Accurate, automated determination of vessel center lines is essential for two- and three-dimensional analysis of the coronary vascular tree. Therefore, we have been developing techniques for vessel tracking and for evaluating their accuracy and precision in clinical images. After points in vessels are manually indicated, the vessels are tracked automatically by means of a modified sector-search approach. The perimeters of sectors centered on previous tracking points are searched for the pixels with the maximum contrast. The sector size and radius are automatically adjusted based on local vessel tortuosity. The performance of the tracking technique in regions of high-intensity background is improved by application of a nonlinear adaptive filtering technique in which the vessel signal is effectively removed prior to background estimation. The tracking results were evaluated visually and by calculation of distances between the tracked and user-indicated centerlines, which were used as the "truth." Two hundred and fifty-six coronary vessels were tracked in 32 angiograms. Vessels as small as 0.6 mm in diameter were tracked accurately. This technique correctly tracked 255/256 (>99%) vessels based on an average of 2-3 indicated points per vessel. The one incorrect tracking result was due to a low signal-to-noise ratio (SNR<2). The distance between the tracked and the "true" centerlines ranged from 0.4 to 1.8 pixels, with an average of 0.8 pixels. These results indicate that this technique can provide a reliable basis for 2D and 3D vascular analysis.

Coronary Angiography↗

Computer-aided diagnosis of pulmonary nodules: results of a large-scale observer test.

PURPOSE: To determine the effect of computer-aided diagnosis (CAD) on the accuracy of pulmonary nodule detection. MATERIALS AND METHODS: Twenty abnormal chest radiographs, each with a single nodule, and 20 normal radiographs were digitized with a laser scanner. These images were analyzed by using a computer program that indicates areas that may represent pulmonary nodules. The radiographs were displayed on computer workstations in randomized order, and an observer test was performed. One hundred forty-six observers participated, including 23 chest radiologists, 54 other radiologists, 27 radiology residents, and 42 nonradiologists. Cases were interpreted first without and then with the use of CAD. The observers' responses were recorded on a continuous confidence rating scale. Detection accuracy both with and without CAD was evaluated with receiver operating characteristic analysis. RESULTS: The detection accuracy was significantly higher for all categories of observers when CAD was used (chest radiologists, P = 8 x 10(-6); other radiologists, P = 2 x 10(-16); radiology residents, P = 6 x 10(-7); and nonradiologists, P = 8 x 10(-9)). CONCLUSION: CAD has the potential to improve diagnostic accuracy in the detection of lung nodules on digital radiographs.

Diagnosis, Computer-Assisted↗

Evaluation of imaging geometries calculated from biplane images.

A technique is developed that will calculate accurate and reliable imaging geometries and three-dimensional (3D) positions from biplane images of a calibration phantom. The calculated data provided by our technique will facilitate accurate 3D analysis in various clinical applications. Biplane images of a Lucite cube containing lead beads 1 mm in diameter were acquired. After identifying corresponding beads in both images and calculating their image positions, the 3D positions of the beads relative to each focal spot were determined. From these data, the transformation relating the 3D configurations were calculated to give the imaging geometry relating the biplane views. The 3D positions of objects were determined from the biplane images along with the corresponding imaging geometries. In addition, methods are developed to evaluate the quality of the calculated results on a case-by-case basis in the clinical setting. Methods are presented for evaluating the reproducibility of the calculated geometries and 3D positions, the accuracy of calculated object sizes, and the effects of errors due to time jitter, variation in user-indication, centering, and distortions on the calculated geometries and 3D reconstructions. The precision of the translation vectors and rotation matrices of the calculated geometries were within 1% and 1 degree, respectively, in phantom studies, with estimated accuracies of approximately 0.5% and 0.4 degree, respectively, in simulation studies. The precisions of the absolute 3D positions and orientations of the calculated 3D reconstructions were approximately 2 mm and 0.5 degree, respectively, in phantom studies, with estimated accuracies of approximately 1.5 mm and 0.4 degree, respectively, in simulation studies. This technique will provide accurate and precise imaging geometries as well as 3D positions from biplane images, thereby facilitating 3D analysis in various clinical applications. We believe that the study presented here is unique in that it represents the first steps toward understanding and evaluating the reliability of these 3D calculations in the clinical situation.

Biophysical Phenomena↗

CT colonography with three-dimensional problem solving for detection of colonic polyps.

OBJECTIVE: We performed CT colonography in patients referred for conventional colonoscopy, interpreted the axial images, and used commercially available software to reconstruct endoluminal perspective views to differentiate polyps from folds. SUBJECTS AND METHODS: We prospectively examined 44 patients (27 men and 17 women; mean age, 58 years old) with CT colonography by interpreting the axial images and using three-dimensional rendering for problem solving only. The CT scans were interpreted by two radiologists who were unaware of patients' histories as revealed by colonoscopic findings. The findings on colonography were compared with those of conventional colonoscopy to determine sensitivity, specificity, time spent on interpretation, and confidence of interpretation. RESULTS: Colonoscopy showed normal findings in 28 patients and 22 polyps in the remaining 16 patients. Six polyps were 8 mm or larger, three were 5-7 mm, and 13 were 5 mm or smaller. The findings of the two observers revealed an overall sensitivity of 50% and 38%, respectively, and a specificity of 93% and 86%, respectively. Sensitivity for polyps larger than 8 mm was 83% and specificity was 100% for both observers. The average amount of time spent on interpretation was 28 min 30 sec (range, 14-65 min). Both observers used the endoluminal view for differentiating folds from polyps in 23 (52%) of 44 patients, which had only minimal impact on interpretation time. CONCLUSION: CT colonography can be performed and the images interpreted using currently available hardware and software by initially using the axial images to search for polyps of significant size. Endoluminal views should be used only when necessary to help distinguish normal folds from fixed raised lesions that are suggestive of polyps.

Colonic Polyps↗

Determination of three-dimensional positions of known sparse objects from a single projection.

A new technique is developed for accurate determination of the three-dimensional position and orientation of known sparse objects, e.g., a configuration of points, from a single-perspective projection. In this technique, a computer model of the known object is translated and rotated so as to align it optimally in a least-squares sense with the projection lines connecting the image points with the focal spot by using a modification of the projection-Procrustes technique. The translational and rotational adjustments are repeated iteratively until the angular change between iterations is less than 0.25 degree. Simulations indicate that, for rms input image errors of 0.03 cm, the three-dimensional positions and orientations can be determined to within approximately 0.2 cm and 0.3 degree for a wide range of initially guessed positions and orientations, and positions can be determined with an accuracy of approximately 0.3 cm for objects having as few as four points. In phantom experiments, three-dimensional positions and orientations of a cube phantom were reproducibly determined to within 0.23 cm and 0.13 degree. The entire calculation requires only 10 s on a VAX 3500 to converge to the solution. The accuracy, precision, and speed of the technique indicate that it will be a useful tool for determination of three-dimensional positions and orientations of known sparse objects.

Computer Simulation↗

Determination of 3D positions of pacemaker leads from biplane angiographic sequences.

In vitro and in vivo analyses of stress on pacemaker leads and their components during the heart cycle have become especially important because of incidences of failure of some of these mechanical components. For stress analyses, the three-dimensional (3D) position, shape, and motion of the pacemaker leads must be known accurately at each time point during the cardiac cycle. We have developed a method for determination of the in vivo 3D positions of pacemaker leads during the entire heart cycle. Sequences of biplane images of patients with pacemakers were obtained at 30 frames/s for each projection. The sequences usually included at least two heart cycles. After patient imaging, biplane images of a calibration object were obtained from which the biplane imaging geometry was determined. The centerlines of the leads and unique, identifiable points on the attached electrodes were indicated manually for all acquired images. Temporal interpolation of the lead and electrode data was performed so that the temporal nonsynchronicity of the image acquisition was overcome. Epipolar lines, generated from the calculated geometry, were employed to identify corresponding points along the leads in the pairs of biplane images for each time point. The 3D positions of the lead and electrodes were calculated from the known geometry and from the identified corresponding points in the images. Using multiple image sets obtained with the calibration object at various orientations, the precision of the calculated rotation matrix and of the translation vector defining the imaging geometry was found to be approximately 0.7 degree and 1%, respectively. The 3D positions were reproducible to within 2 mm, with the error lying primarily along the axis between the focal spot and the imaging plane. Using data obtained by temporally downsampling to 15 frames/s, the interpolated data were found to lie within approximately 2 mm of the true position for most of the heart cycle. These results indicate that, with this technique, one can reliably determine pacemaker lead positions throughout the heart cycle, and thereby it will provide the basis for stress analysis on pacemaker leads.

Calibration↗

Small simulated polyps in pig colon: sensitivity of CT virtual colography.

PURPOSE: The authors evaluated computed tomographic (CT) virtual colography for the detection of simulated polyps under ideal conditions, as well as the effects on lesion conspicuity of (a) collimation, (b) table pitch, and (c) orientation of the colon lumen with respect to the gantry. MATERIALS AND METHODS: Pig colon was resected and cleansed, and polyps with diameters of 3, 7, and 10 mm were created. Each specimen was scanned with collimation of 5 and 7 mm and table pitch of 1.0, 1.6, and 2.0 at angles of 0 degrees, 45 degrees, and 90 degrees to the gantry. The initial two-dimensional (2D) images were reconstructed at 1-mm intervals (2D reconstructions), from which three-dimensional (3D) virtual colography images were generated. Polyp conspicuity on the initial and reconstructed 2D images and the 3D reconstructions was evaluated on a three-point scale: 0 = polyp not depicted, 1 = polyp faintly depicted, and 2 = polyp clearly depicted. RESULTS: The 10-mm-diameter polyp was clearly depicted (grade 2 conspicuity) on every initial and reconstructed 2D image and 3D reconstruction without regard to collimation, table pitch, or angle to the gantry. The 7-mm-diameter polyp was clearly depicted (grade 2 conspicuity) on every initial and reconstructed 2D image, but conspicuity on 3D reconstructions varied as the imaging parameters varied. The 3-mm-diameter polyp was faintly depicted (grade 1 conspicuity) on the initial and reconstructed 2D images and 3D reconstructions, but conspicuity varied on the 3D reconstructions as the imaging parameters varied. CONCLUSION: CT virtual colography helped detection of small mucosal polyps regardless of the angle of the colon lumen to the gantry at which they were obtained.

Animals↗

Determination of 3D imaging geometry and object configurations from two biplane views: an enhancement of the Metz-Fencil technique.

We present a new technique based on the method developed by Metz and Fencil for estimation of the 3D imaging geometry and 3D object configurations from biplane angiographic acquisitions. The new method employs the 3D configuration of points calculated by the Metz-Fencil technique as an initial estimate. A 3D Procrustes algorithm is employed to translate, rotate, and scale the configuration until it aligns optimally with the set of lines that connects a focal spot with the corresponding set of image points. This alignment procedure is applied independently for each view. The rotation and translation that relate the two aligned data sets are then determined by an additional 3D Procrustes calculation. These steps are applied iteratively. Evaluations were based on Monte Carlo simulation and phantom studies. With this new technique, the mean absolute errors in magnification, in the relative position of the points, and in the angles defining the rotation and translation matrices were approximately 3.0%, 1.5 mm, and 5 degrees and 3 degrees, respectively, for rms input errors in the image data up to 2.0 pixels (0.7 mm). Errors in the results can be as small as 0.5%, 0.16 mm, 0.6 degrees, and 0.3 degrees, respectively, if input image-data error is 0.035 mm. The improvement of the Metz-Fencil technique described here may provide a basis for precise estimation of the biplane imaging geometry and the 3D positions of vessel bifurcation points.

Algorithms↗

Development of a digital duplication system for portable chest radiographs.

To provide high-quality duplicate chest images for the intensive care units, we have developed a digital duplication system in which film digitization is performed in conjunction with nonlinear density correction, contrast adjustment, and unsharp mask filtering. This system provides consistent image densities over a wide exposure range and enhancement of structures in the mediastinum and upper abdominal areas, improving visibility of catheters and tubes. The image quality is often superior to that of the original radiograph and is more consistent from day to day. Repeat rates for portable chest radiographs have been reduced by more than a factor of two since implementation of digitization in December 1991, and the number of repeat examinations caused by exposure errors have been substantially reduced.

Computer Systems↗

Cardiac function. Quantification with magnetic resonance and computed tomography.

An integral part of cardiac imaging is the evaluation of cardiac function. The parameters measured are essential elements of cardiac diagnosis, patient management, and the estimation of prognosis. Both computed tomography and magnetic resonance can measure cardiac indices with an accuracy and reproducibility unrivaled by present clinical imaging methods; however, analysis times to calculate these variables are, at present, prohibitively lengthy, and automated methods are sorely needed. In this article, the authors review the progress being made to automate analysis and the functional parameters that can be measured by computed tomography and magnetic resonance; they conclude that both techniques can provide excellent information for cardiac diagnosis.

Echocardiography↗

Evaluation of an enhanced digital film-duplication system by receiver operating characteristic analysis.

RATIONALE AND OBJECTIVES: Over- or underexposure often results in poor quality radiographs. Using receiver operating characteristic analysis, the authors investigated the potential utility of a system that corrects densities in such images to improve the accuracy of lung nodule detection. METHODS: Chest radiographs were digitized by a laser film digitizer. Simulated nodules were superimposed on 36 improperly exposed chest radiographs. All images, with and without nodules, were then processed by a nonlinear density-correction technique. Hard-copy images were produced by a laser film printer. Eight radiologists evaluated the corrected and uncorrected images for the presence or absence of lung nodules using a continuous (0-100) confidence-rating scale. RESULT: The detectability of lung nodules improved significantly in the retrocardiac/retrodiaphragmatic regions of underexposed images and in the peripheral lung region of overexposed images. CONCLUSIONS: This system may increase diagnostic accuracy in detection of lung nodules in improperly exposed images.

Confidence Intervals↗

Clinical experience with an advanced laser digitizer for cost-effective digital radiography.

Film digitization has not been widely pursued in clinical settings mainly because of perceived limitations involving film latitude and image quality. However, a high-quality laser digitizer can be combined with wide-latitude film and specially developed digital processing techniques to achieve image quality comparable or superior to that of storage phosphor computed radiography (SPR) over a wide range of exposure. This film digitization system provides the operational advantages of digital radiography, such as consistent image density, high-quality inexpensive duplicates, and digital storage and retrieval capability. The reliability and monetary costs of the system also compare favorably with those of SPR. In the long term, technologies that employ reusable plates and do not require chemical processing to produce diagnostic images may well replace screen-film systems. Presently, however, film digitization remains a practical and cost-effective approach to digital radiography.

Cost-Benefit Analysis↗

An "intelligent" workstation for computer-aided diagnosis.

Computer-aided diagnosis (CAD) involves a computerized analysis of radiographs that is used as a "second opinion" by the radiologist. The approach presented incorporates computer vision and artificial intelligence techniques and includes schemes for the analysis of lung nodules, interstitial infiltrates, and cardiomegaly seen on chest radiographs; masses and clustered microcalcifications on mammograms; and stenoses and blood flow on angiograms. The demonstration of various CAD schemes in chest radiography and mammography on a six-monitor workstation simulates one possible clinical implementation of CAD in radiology. Whether soft- or hard-copy display media are used, the radiologist can refer to the CAD results and still use the original radiograph for the final diagnosis. Although initial impressions of this simulated "intelligent" workstation are encouraging, CAD is still in a preliminary stage of development. Various methods for effectively and efficiently integrating CAD into a clinical radiology department are being investigated.

Angiography↗