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Biomedical subjects

Kenneth D Hopper

Publications and source records attributed to Kenneth D Hopper.

5 recordsLinked to original sources

Computerized tomographic colonography: performance evaluation in a retrospective multicenter setting.

BACKGROUND & AIMS: No multicenter study has been reported evaluating the performance and interobserver variability of computerized tomographic colonography. The aim of this study was to assess the accuracy of computerized tomographic colonography for detecting clinically important colorectal neoplasia (polyps >or=10 mm in diameter) in a multi-institutional study. METHODS: A retrospective study was developed from 341 patients who had computerized tomographic colonography and colonoscopy among 8 medical centers. Colonoscopy and pathology reports provided the standard. A random sample of 117 patients, stratified by criterion standard, was requested. Ninety-three patients were included (47% with polyps >or=10 mm; mean age, 62 years; 56% men; 84% white; 40% reported colorectal symptoms; 74% at increased risk for colorectal cancer). Eighteen radiologists blinded to the criterion standard interpreted computerized tomography colonography examinations, each using 2 of 3 different software display platforms. RESULTS: The average area under the receiver operating characteristic curve for identifying patients with at least 1 lesion >or=10 mm was 0.80 (95% lower confidence bound, 0.74). The average sensitivity and specificity were 75% (95% lower confidence bound, 68%) and 73% (95% lower confidence bound, 66%), respectively. Per-polyp sensitivity was 75%. A trend was observed for better performance with more observer experience. There was no difference in performance across software display platforms. CONCLUSIONS: Computerized tomographic colonography performance compared favorably with reported performance of fecal occult blood testing, flexible sigmoidoscopy, and barium enema. A prospective study evaluating the performance of computerized tomography colonography in a screening population is indicated.

Colonic Neoplasms↗

Erdheim-Chester disease.

BACKGROUND: Erdheim-Chester disease is a rare non-Langerhans' cell histiocytosis. OBJECTIVE: This case report is presented to familiarize clinicians with Erdheim-Chester disease and its differential diagnosis. RESULTS AND CONCLUSION: Erdheim-Chester disease presents with unique clinical and pathologic findings. Its xanthoma-like lesions can cause significant morbidity and mortality.

Adult↗

Orbital, thyroid, and breast superficial radiation shielding for patients undergoing diagnostic CT.

Computed tomography (CT) now provides over 30% of all radiation received from medical imaging. Superficial radiosensitive organs, such as the thyroid, eyes, and breasts receive a greater proportion of this radiation because of increase scatter and the lack of overlying other tissues to partially absorb some of the dose. This article describes the use of bismuth radioprotective garments to shield these radiosensitive areas while preserving the overall quality of the diagnostic image.

Breast↗

Correlation between presumed sinusitis-induced pain and paranasal sinus computed tomographic findings.

BACKGROUND: The correlation between facial and/or head pain in patients clinically suspected of having sinusitis and actual localized findings on sinus computed tomographic (CT) imaging are poorly understood. OBJECTIVE: To prospectively evaluate the relationship of paranasal sinus pain symptoms with CT imaging. METHODS: Two hundred consecutive patients referred by otolaryngologists and internists for CT of the paranasal sinuses participated by completing a questionnaire immediately before undergoing CT. Three radiologists blinded to the patients' responses scored the degree of air/fluid level, mucosal thickening, bony reaction, and mucus retention cysts using a graded scale of severity (0 to 3 points). The osteomeatal complexes and nasolacrimal ducts were also evaluated for patency. Bivariate analysis was performed to evaluate the relationship between patients' localized symptoms and CT findings in the respective sinus. RESULTS: One hundred sixty-three patients (82%) reported having some form of facial pain or headache. The right temple/forehead was the most frequently reported region of maximal pain. On CT imaging the maxillary sinus was the most frequently involved sinus. Bivariate analysis failed to show any relationship between patient symptoms and findings on CT. Patients with a normal CT reported a mean 5.88 sites of facial or head pain versus 5.45 sites for patients with an abnormal CT. CONCLUSIONS: Patient-based responses of sinonasal pain symptoms fail to correlate with findings in the respective sinuses. CT should therefore be reserved for delineating the anatomy and degree of sinus disease before surgical intervention.

Facial Pain↗

Comparison of electron-beam and ungated helical CT in detecting coronary arterial calcification by using a working heart phantom and artificial coronary arteries.

PURPOSE: To determine the sensitivity and specificity of cardiac gated electron-beam computed tomography (CT) and ungated helical CT in detecting and quantifying coronary arterial calcification (CAC) by using a working heart phantom and artificial coronary arteries. MATERIALS AND METHODS: A working heart phantom simulating normal cardiac motion and providing attenuation equal to that of an adult thorax was used. Thirty tubes with a 3-mm inner diameter were internally coated with pulverized human cortical bone mixed with epoxy glue to simulate minimal (n = 10), mild (n = 10), or severe (n = 10) calcified plaques. Ten additional tubes were not coated and served as normal controls. The tubes were attached to the same location on the phantom heart and scanned with electron-beam CT and helical CT in horizontal and vertical planes. Actual plaque calcium content was subsequently quantified with atopic spectroscopy. Two blinded experienced radiologic imaging teams, one for each CT system, separately measured calcium content in the model vessels by using a Hounsfield unit threshold of 130 or greater. RESULTS: The sensitivity and specificity of electron-beam CT in detecting CAC were 66.1% and 80.0%, respectively. The sensitivity and specificity of helical CT were 96.4% and 95.0%, respectively. Electron-beam CT was less reliable when vessels were oriented vertically (sensitivity and specificity, 71.4% and 70%; 95% CI: 39.0%, 75.0%) versus horizontally (sensitivity and specificity, 60.7% and 90.0%; 95% CI: 48.0%, 82.0%). When a correction factor was applied, the volume of calcified plaque was statistically better quantified with helical CT than with electron-beam CT (P =.004). CONCLUSION: Ungated helical CT depicts coronary arterial calcium better than does gated electron-beam CT. When appropriate correction factors are applied, helical CT is superior to electron-beam CT in quantifying coronary arterial calcium. Although further work must be done to optimize helical CT grading systems and scanning protocols, the data of this study demonstrated helical CT's inherent advantage over currently commercially available electron-beam CT systems in CAC detection and quantification.

Arterial Occlusive Diseases↗