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Biomedical subjects

N J Mankovich

Publications and source records attributed to N J Mankovich.

At least 19 recordsLinked to original sources
PubMed1992

Stereolithographic models for surgical planning: preliminary report.

Recent application of computer graphics, using standardized cephalometric analyses, have allowed the surgeon to visualize the predicted surgical outcome on the computer video monitor. Stereolithographic models constructed from digital image data (computed tomography and magnetic resonance) will allow the surgeon to view the external and internal anatomy prior to surgery. This article describes the development of such technology and reports its use in one case.

Adult↗
PubMed1992

Three-dimensional CT scan reconstruction for the assessment of congenital aural atresia.

Major advances in medical computer graphics workstations have provided the capability to produce high quality three-dimensional image reconstructions from conventional thin-section computerized tomography (CT) scans with the ability to observe the imaged structure from any angle, with views and dimensions that are comparable to actual dissections. We have applied this technique to the temporal bone to assess congenital aural atresia in surgical planning for hearing reconstruction in six patients. The digital information produced by thin-section CT scanning allowed for the re-creation of multiplanar reformatted, shaded surface, and volumetric images. With this technique the surface landmarks of the temporal bone were readily visualized, the configuration of the atretic plate and middle ear in relation to the tegmen and glenoid fossa could be precisely assessed and the structure of the ossicular mass was easily analyzed. Most significantly, the facial nerve could be accurately and easily envisioned in its entire intratemporal course. Three-dimensional imaging is a highly desirable means for observing CT scan data to facilitate the surgical planning for correction of congenital aural atresia.

Adolescent↗
PubMed1991

Exposure rates in high-level-control fluoroscopy for image enhancement.

High-level fluoroscopic boost options that exceed conventional exposure limits are available as a means of reducing quantum mottle during angiography. Federal law does not specify exposure limits for such high-level controls but requires specific means of activation to safeguard against inadvertent use. The American Association of Physicists in Medicine recently recommended that high-level exposure rates not exceed 2.58 mC/kg/min (10R/min). At six institution surveyed, maximum exposure rates ranged from 5.42 to 24 mC/kg/min (21-93 R/min). Activation of high-level capability varied from a simple foot switch to a keyed interlock requiring a second operator to engage. There appears to be no industry coherence in high-level control exposure limits as yet, although the Center for Devices and Radiological Health recently initiated an investigatory program.

Environmental Exposure↗
PubMed1991

NMINT--introductory courseware for nuclear medicine: database design.

Computer-Aided Instruction (CAI) provides a dynamic and self-paced learning experience to the medical trainee. Microcomputer based hypermedia systems integrate text, graphics, and image information. We present the design of an introductory CAI course for nuclear medicine called NMINT and elaborate on the underlying relational database that contains clinically relevant information and links to local or remote image storage over high speed networks. The IBM PS/2 Windows system uses Toolbook software augmented by C language modules for image and image-overlay database access. The current implementation stores text, graphical lesson material, and image index information on microcomputer magnetic disk; image data are stored on the attached optical disk. The storage architecture is described in detail. We emphasize its multi-access methods and its expandability into department-wide image networks.

Computer Graphics↗
PubMed1990

The display of three-dimensional anatomy with stereolithographic models.

Stereolithography, a new technique of prototype fabrication developed for the aerospace industry, offers a unique way to display patient anatomy. Like current computer aided design (CAD) systems, it uses digital image data from computed tomography (CT) and magnetic resonance (MR) to produce a physical model. Unlike conventional CAD it does not require a cutting tool and, therefore, CAD toolpath limitations do not exist. The stereolithography apparatus uses an ultraviolet laser to selectively polymerize and solidify a polymeric liquid plastic solution under computer control. The device was used to produce a model of cranial bony anatomy from CT image data, providing full internal detail in the constructed model, including encased sinuses, foramen, and potentially complete internal anatomy within a closed skull. The advantages and disadvantages of this technology are reviewed with an emphasis on future development.

Computer Graphics↗
PubMed1990

Three-dimensional image display in medicine.

This article is a tutorial on the methods used to create three-dimensional (3-D) images for use in displaying patient anatomy. This new view into anatomy has developed over the last 10 years from the need of surgeons, radiation therapists, and radiologists to integrate the many images resulting from the recent growth in tomographic imaging including computed tomography (CT) and magnetic resonance imaging (MRI). CT and MRI studies result in 30 to 100 images. 3-D imaging processes and integrates this image data volume and extracts more meaningful, derivative images via multiplanar reconstruction (MPR), shaded surface processing, or volumetric processing. MPR reslices the image volume to produce novel views of patient anatomy while retaining the image voxel intensities. Realistic shaded surface display of 3-D objects can involve extensive processing of the images to create computer representations of objects rendered into a displayable 3-D scene. Volumetric imaging combines the voxel processing of MPR with the techniques of tissue classification and surface shading to produce novel projections of the image data volume that allow automated creation of 3-D scenes without recourse to the complexities of object delineation. As the ultimate 3-D display, recent advances in computer-aided design (CAD) and computer-aided manufacturing (CAM) allow the fabrication of physical models of anatomy using computer-controlled milling machines. New technology that actually builds the model layer by layer from a liquid plastic offers the possibility of complete models with intact internal anatomy. The growth in 3-D is certain as hardware and software costs decrease and medical professionals find further applications for this technology.

Humans↗
PubMed1988

Local area networks for radiology.

This article is a tutorial on local area networks (LAN) for radiology applications. LANs are being implemented in radiology departments for the management of text and images, replacing the inflexible point-to-point wiring between two devices (computer-to-terminal). These networks enable the sharing of computers and computer devices, reduce equipment costs, and provide improved reliability. Any LAN must include items from the following four categories: transmission medium, topology, data transmission mode, and access protocol. Media for local area networks are twisted pair, coaxial, and optical fiber cables. The topology of these networks include the star, ring, bus, tree, and circuit-switching. Data transmission modes are either analog signals or digital signals. Access protocol methods include the broadcast bus system and the ring system. A performance measurement for a LAN is the throughput rate as a function of the number of active computer nodes. Standards for LANs help to ensure that products purchased from multiple manufacturers will operate successfully.

Humans↗
PubMed1988

Operational radiologic image archive on digital optical disks.

A digital optical disk archive for storage of computed radiographic, computed tomographic, magnetic resonance, ultrasonographic, and digitized film radiographic images was installed. In the system, digital images enter a minicomputer, are temporarily stored on magnetic disks, and are archived onto write-once read-many optical disks at their full resolution. A pictorial index of minified images is maintained for each patient. After 8 months of operation, 49,400 megabytes of images had been retained on 19 optical disks stored, after January 1987, in a mechanical jukebox-style optical disk library. The success rate for archival capture of images during the initial period was 96.6%. The failures were due to overfilling of the magnetic disk, a problem addressed through the addition of a second magnetic disk unit. There were no medium-related image errors during the early period. Problems resulting from the slow speed of optical disk systems were addressed operationally by initiating recall of a patient's archived images from the optical to the faster magnetic disk as soon as the system received a request to acquire a new image. Also, optical disk retrieval times are expected to improve with technologic development.

Electronic Data Processing↗
PubMed1988

Quantitative coronary arteriography: design and validation.

The authors assessed the performance of an automatic and rapid coronary quantification method by evaluating its accuracy in a stenosis phantom. Measurements were obtained with a lucite phantom with 2-, 3-, and 4-mm vessel diameters and concentric stenoses of 33%, 50%, 67%, and 75%. Direct digital angiographic images as well as 10 X 10 spot films and 35-mm cine angiography films were acquired with and without structural noise and mask subtraction. The films were digitized with magnification factors of one and two. An interactive analysis program was used to automatically determine the vessel edges with a Gaussian fit to the cross-sectional density profiles perpendicular to the center line of the vessel. Relative changes of the densitometric cross-sectional area along the vessel were used to assess the percentage of stenosis. Densitometric measurements were comparable in both digital and cine angiograms (r = .99 and r = .98, respectively); however, diameter measurements showed a higher variability and were dependent on the amount of magnification applied to the images.

Absorptiometry, Photon↗
PubMed1988

Picture archiving and communication systems (PACS) for radiological images: state of the art.

Implementation of a Picture Archiving and Communication System (PACS) is a system integration task and requires the knowledge of multidisciplinary fields. This paper reviews current PACS development with emphasis on radiological images. The following topics are covered: methods of image acquisition, image compression, storage, display, communication, and image database structure. Methods of implementation of PACS in a clinical environment as well as current operational PACS in hospitals are reviewed. A survey of private industry participating in PACS research and development are also given.

Hospital Information Systems↗
PubMed1987

Influence of geometric distortion and exposure parameters on sensitivity of digital subtraction radiography.

In the course of digital subtraction radiography (DSR), variation in the alignment of the x-ray source object and image receptor is an undesirable but frequent problem. The influence of angulation changes between the x-ray source and object on the quality of the subtracted image was measured with the visualization of a thin chip of bone (thickness less than or equal to 0.85 mm). Twenty radiographic image pairs that differed by known geometric distortions ranging from 0 to 9 degrees horizontal and vertical were subtracted. The ability to detect a thickness change varied strongly with angular distortion. Under optimal conditions (no distortion), DSR was able to detect a change in thickness of cortical bone of 0.12 mm. Under approximately clinical circumstances (3 degree misalignment), a thickness change of 0.35 mm was detected with 50% accuracy (three of six cases), while a thickness change of 0.42 mm was detected with 100% accuracy (six of six cases). In addition, the influence of exposure parameters on DSR was investigated. Twenty-one radiographic film pairs were subtracted with differing densities and contrasts. Images made at 70 kVp with an optical density of 0.61 in the dentin produced the best subtracted images. However, even images made with one fourth the conventional exposure produced diagnostic information when analyzed with DSR; this was not seen with conventional analysis of the normally exposed radiographic films.

Densitometry↗
PubMed1986

Digital subtraction angiography: a comparison of 512(2) and 1024(2) imaging.

A commercial DSA unit was modified by the manufacturer to permit 1024 X 1024 8-bit imaging. System upgrade includes a high-resolution 1049-line TV camera that operates with variable aperture to minimize x-ray exposure during 1024(2) imaging. To compare the change in resolution and radiation exposure between 512(2) and 1024(2) imaging with this system, a two-phase phantom study was performed using a high-contrast converging lead line phantom and a specially designed high-resolution low-contrast Lucite phantom. The two-phase phantom study tested general system resolution performance and resolution under simulated and actual clinical conditions for each field size (15, 25, and 36 cm). The 512(2) imaging was performed with the aperture reduced to the 512 setting; 1024(2) imaging was performed with the aperture at the 512 and 1024 values. The 1024(2) imaging resulted in only modest improvement in resolution compared to 512(2). While Nyquist limits were approached with 512(2) imaging, this was not the case with 1024(2) imaging. This suggests other factors such as system noise are playing a significant role in 1024(2) image degradation.

Angiography↗