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Biomedical subjects

R K Taira

Publications and source records attributed to R K Taira.

At least 37 records · Page 2Linked to original sources

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↗

Magnetic resonance imaging of iron overload in children treated with peritoneal dialysis.

The ability of magnetic resonance imaging (MRI) to detect iron overload in children with end-stage renal disease (ESRD) was studied in 18 multiply transfused patients, aged 15.5 +/- 4.8 years, and 5 nontransfused children without evidence of renal disease. In the transfused patients, the serum ferritin (SF) level was compared to (a) a subjective rating of signal intensity of MRI images (scale of 0-10), (b) mean T1 values of liver and spleen, and (c) computer-assisted measurements of spin echo intensity (SEI) of liver, spleen, muscle and fat tissue. On subjective evaluation, the mean signal intensity was significantly lower in transfused patients than in controls and a significant correlation with the SF levels was observed for ratings of both liver and spleen. Mean T1 values of liver and spleen did not correlate with the SF levels. On computer analysis, the ratios of SEI of fat/liver, fat/spleen, muscle/liver and muscle/spleen were significantly correlated with the SF levels as well as the subjective evaluation sources. These data indicate that MRI is a suitable technique of documenting the presence and degree of iron overload in multiply transfused children with ESRD.

Adolescent↗

MR evaluation of early myelination patterns in normal and developmentally delayed infants.

This study demonstrates the ability of MR imaging to show progression of myelination in 64 infants and young children (ages 4 days to 36 months). T2-weighted spin-echo pulse sequences, frequently used for routine screening of intracranial disease, were used. Gray-white matter differentiation was seen in all patients, and changes occurring with age were documented. Three distinct patterns were seen, and age ranges were established for each pattern in developmentally normal children: (1) infantile (birth-6 months); (2) isointense (8-12 months); and (3) early adult (10 months onward). There was a statistically significant difference between the age ranges of the normal and developmentally delayed children showing all three patterns. These data should be helpful for identifying and following sequentially both infants with clinically suspected developmental delay and those with dysmyelinating or demyelinating disease.

Brain↗

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↗

A picture archiving and communication system module for radiology.

This paper presents the design and implementation of a clinical picture archiving and communication system (PACS) module within the radiology department of a 700-bed teaching hospital. The system is composed of an integrated network of digital devices used to electronically acquire, store, manage, and display radiological text and image information. Operationally the system behaves as a large queueing network allowing processes to operate concurrently in a coordinated and prioritized fashion. Secondary reviews (radiology conferences and fast case reviews by clinicians) are being conducted from a 512 X 512 CRT viewing station. Preliminary evaluation based on formal survey and usage statistics shows that the system is rapidly being accepted by radiologists and clinicians for the review and processing of digital radiographic images.

Hospital Bed Capacity, 500 and over↗

Performance characteristics of a laser scanner and laser printer system for radiological imaging.

This paper describes the performance characteristics of a laser scanner and laser printer system for radiological imaging. The laser scanner can digitize a 14'' X 17'' X-ray film to 2000 X 2400 X 10 bit in about 100 s. The laser printer can format 16 images on a 8'' X 10'' or 14'' X 17'' film with up to 2300 X 3050 X 8 bit resolution in about 50 s. Our experiments show that the laser scanner and the laser printer have a spatial resolution of 3 cycles/mm with excellent spatial linearity and flat field response. This system is a major component of a picture archiving and communication system in a digital-based radiology department. As a stand-alone system, it has certain clinical applications such as a contrast enhancement of radiographs and potential dose reduction to the patient.

Animals↗

Radiological laser film scanner sampling artifact.

Artifacts seen on laser digitized radiographs are analyzed and mathematically explained based on the concept of image contrast. Our investigation considered the following determinants: (a) laser spot size, (b) signal processing components, (c) image characteristics, and (d) observer performance. A functional relationship between the sampling interval, laser spot size, and the contrast of the artifact seen on the digitized image is derived. This relationship is verified experimentally using a variable spot size laser source and sampling at interval of 175.0 microns. The problem of digitizing artifact seen on film images obtained with anti-scatter grids is discussed.

Analog-Digital Conversion↗

PACS database architecture and design.

PACS (Picture Archiving and Communication Systems) database design requires careful understanding of the data and processing needs of radiologists, referring physicians, radiology staff, administrators, and researchers. Due to access requirements, the physical implementation for the management of small text data sets differs from the implementation strategy for large image data sets (centralized vs. distributed storage strategies). In this paper we discuss the database structure, storage architecture, file placement strategies, and administration considerations of the UCLA PACS.

Database Management Systems↗

Systems integration for PACS.

A successful PACS (Picture Archiving and Communications System) implementation requires an eclectic integration of a number of key technologies. Among these are equipment interfaces, communications, storage, and display. Coincident with this, the software architecture must support a distributed system of heterogeneous structures, provide for protocol and format conversions to a unified system standard, be scalable to accommodate expansion, and provide a measure of fault tolerance. In this paper we survey the current state of the UCLA PACS components and architecture.

Computer Systems↗

Implementation of a large-scale picture archiving and communication system.

This paper describes the implementation of a large-scale picture archiving and communication system (PACS) in a clinical environment. The system consists of a PACS infrastructure, composed of a PACS controller, a database management system, communication networks, and optical disk archive. It connects to three MR units, four CT scanners, three computed radiography systems, and two laser film digitizers. Seven display stations are on line 24 h/day, 7 days/wk in genitourinary radiology (2K), pediatric radiology in-patient (1K and 2K) and outpatient (2K), neuroradiology (2K), pediatric ICU (1K), coronary care unit (1K), and one laser film printing station. The PACS is integrated with the hospital information system and the radiology information system. The system has been in operation since February 1992. We have integrated this PACS as a clinical component in daily radiology practice. It archives an average of 2.0-gigabyte image data per workday. A 3-mo system performance of various components are tabulated. The deployment of this large-scale PACS signifies a milestone in our PACS research and development effort. Radiologists, fellows, residents, and clinicians use it for case review, conferences, and occasionally for primary diagnosis. With this large-scale PACS in place, it will allow us to investigate the two critical issues raised when PACS research first started 10 yrs ago: system performance and cost effectiveness between a digital-based and a film-based system.

Computer Communication Networks↗

Integration of a voice processor machine in a PACS.

The final stage of development of a clinical picture archiving and communication system (PACS) at the University of California at Los Angeles (UCLA) department of radiological sciences consists of building a documentation package of a complete radiological consultation. In this paper, we present the technological aspect of the integration of a digital voice server in our PACS environment. This component improves the timely delivery of the diagnostic report with the images. The interface of this voice system is integrated into the PACS display station. It offers the user the capability to easily dictate and/or listen to radiological reports, while viewing and/or performing image processing operations at the display station.

Computer Communication Networks↗

A unified timeline model and user interface for multimedia medical databases.

A multimedia medical database model and prototype is described for supporting a timeline-based presentation of information. The database links image and text data in a way that permits users to look at medical information in a single unified view. Various visualization programs permit the user to view data in various ways, including full image views, graphs, and tables. Our technology is applied for proof-of-concept to two areas: thoracic oncology and thermal tumor ablation therapy of the brain. This effort is part of the multidisciplinary KMeD project in collaboration with medical research and clinical treatment projects at UCLA.

Data Display↗

Hyperad: augmenting and visualizing free text radiology reports.

Hyperad is an automated computer system designed to extract key concepts from thoracic radiology reports and give physicians access to a large database containing the reports and key concepts. The concepts are extracted from textual documents with natural language processing techniques, then stored with the original documents in the database, which can be queried in terms of findings or associated attributes from an intuitive and easily accessible interface. The extracted concepts are represented both textually in a coded hypertext format and graphically on a coronal cross-sectional anatomy atlas, an idealized graphical model of human anatomy. To facilitate implementation, the communication protocols and standards of the World Wide Web (Web) were adopted. The reports and associated forms are encoded in standard hypertext markup language, which makes it possible to use hypermedia links to navigate the Hyperad database with any graphical Web browser. In the future, Hyperad may prove useful for other applications.

Computer Systems↗

Teleradiology as a foundation for an enterprise-wide health care delivery system.

An effective, integrated telemedicine system has been developed that allows (a) teleconsultation between local primary health care providers (primary care physicians and general radiologists) and remote imaging subspecialists and (b) active patient participation related to his or her medical condition and patient education. The initial stage of system development was a traditional teleradiology consultation service between general radiologists and specialists; this established system was expanded to include primary care physicians and patients. The system was developed by using a well-defined process model, resulting in three integrated modules: a patient module, a primary health care provider module, and a specialist module. A middle agent layer enables tailoring and customization of the modules for each specific user type. Implementation by using Java and the Common Object Request Broker Architecture standard facilitates platform independence and interoperability. The system supports (a) teleconsultation between a local primary health care provider and an imaging subspecialist regardless of geographic location and (b) patient education and online scheduling. The developed system can potentially form a foundation for an enterprise-wide health care delivery system. In such a system, the role of radiologist specialists is enhanced from that of a diagnostician to the management of a patient's process of care.

Appointments and Schedules↗

Automatic structuring of radiology free-text reports.

A natural language processor was developed that automatically structures the important medical information (eg, the existence, properties, location, and diagnostic interpretation of findings) contained in a radiology free-text document as a formal information model that can be interpreted by a computer program. The input to the system is a free-text report from a radiologic study. The system requires no reporting style changes on the part of the radiologist. Statistical and machine learning methods are used extensively throughout the system. A graphical user interface has been developed that allows the creation of hand-tagged training examples. Various aspects of the difficult problem of implementing an automated structured reporting system have been addressed, and the relevant technology is progressing well. Extensible Markup Language is emerging as the preferred syntactic standard for representing and distributing these structured reports within a clinical environment. Early successes hold out hope that similar statistically based models of language will allow deep understanding of textual reports. The success of these statistical methods will depend on the availability of large numbers of high-quality training examples for each radiologic subdomain. The acceptability of automated structured reporting systems will ultimately depend on the results of comprehensive evaluations.

Humans↗

Image content extraction: application to MR images of the brain.

A system for automatically extracting image content features was developed that combines registration to a labeled atlas with natural language processing of free-text radiology reports. The system was then tested with T1-weighted, spoiled gradient-echo magnetic resonance (MR) imaging studies of the brain performed in nine patients. The locations of 599 structures were visually assessed by an experienced radiologist and compared with the locations indicated by automated output. The in-plane accuracy of the contours was subjectively evaluated as either good, moderate, or poor. The criterion for classifying a structure as correctly located was that 90% or more of all the images containing the structure had to be correctly identified. For 98% of the structures, the images identified by the automated algorithm agreed with those identified by the radiologist, and in 83% of cases, image contours showed a good in-plane overlap. The results of this validation study demonstrate that this combination of registration and natural language processing is accurate in identifying relevant images from brain MR imaging studies. However, the range of applicability of this technique has yet to be determined by applying the technique to a large number of studies.

Algorithms↗