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S J Dwyer

Publications and source records attributed to S J Dwyer.

At least 19 recordsLinked to original sources
PubMed1992

Design of a high-speed, high-resolution teleradiology network.

A teleradiology system acquires radiographic images from one location and transmits them to one or more distant sites where they are displayed and/or converted to hard-copy film recordings. The long-term goal of teleradiology research is to show that teleradiology systems can provide diagnostically equivalent results when compared with conventional radiographic film interpretation. If this hypothesis is proven, provision of the following radiology services will be improved: (1) providing for primary interpretation of radiological images for patients in underserved areas as well as in other medical facilities; (2) integration of radiological services for multihospital/clinic health care provider consortiums; (3) improving emergency service and intensive care unit coverage; (4) offering consulting-at-a-distance with subspecialty radiologists; and (5) providing radiologists in the community or in rural areas with immediate access to large academic centers for help in the interpretation of difficult and problematic cases. We are designing a high-speed, high-resolution teleradiology network that will communicate between our level 3 medical center and several outlying medical centers within the metropolitan area. Computed tomography (CT), magnetic resonance (MR), and screen-film examinations will be digitized to 2,000 x 2,000 or 4,000 x 4,000 pixels at the remote sites, transmitted to the central referral facility, and sent to a laser film printer, replicating the original film. This film may then be used for primary diagnosis, overreading/consultative purposes, or for emergency department preparation. Inherently digital modality data (eg, MR and CT) can be sent without digitization of the multiformat film if desired.

Computer Communication Networks↗
PubMed1992

Image calibration of laser digitizers, printers, and gray-scale displays.

Laser film digitizers, interactive gray-scale monitors, and laser film printers are necessary to transmit digital image information. These devices must be standardized so that hard- and soft-copy images are as similar as possible. Standardization of appropriate calibration procedures is necessary to attain this goal. Radiographs are converted into digital data representations by a laser film digitizer. These representations (and those obtained with other modalities) are transferred to a laser film printer or to an interactive monitor with gray-scale display. To obtain the best gray-level fidelity, printer output optical densities should be identical to those of the input film. Laser printers should be calibrated regularly to ensure uniform results. A gray-scale controller functions as an adjunct to the host computer and can automate the calibration process. Gray-scale controller functions may someday be incorporated into an accelerator or array-processor board.

Calibration↗
PubMed1992

PACS mini refresher course. Wide area network strategies for teleradiology systems.

Teleradiology systems require the use of wide area networks (WANs). Design and implementation of a WAN depend on the number of images to be transmitted, desired digital image throughput (based on signaling rate), and cost of the communications link. Image transmission load must be estimated before the communications link can be selected. Communications links used in WANs include T-1 carrier point-to-point service, digital service (DS)-1 dial-up service, DS-3 point-to-point service, DS-0 dial-up service, digital microwave, fiberoptic local loop carriers, and metropolitan area networks (MANs). Depending on the distance between sites, T-1 service may be less costly than DS-1 service; however, for distances more than 200 miles, DS-1 service can be less expensive and more flexible. Both of these services and DS-0 service have lower signaling rates than DS-3 service, which is the fastest and most expensive link. Microwave and fiberoptic links are less expensive but have distance limitations of 14 and 30 miles, respectively. MANs are still being developed but hold the promise of higher signaling rates at lower costs.

Computer Communication Networks↗
PubMed1992

Performance characteristics and image fidelity of gray-scale monitors.

Gray-scale monitors are an essential element of electronic radiology, and their ability to provide images that are perceived to be identical to those available on conventional or laser-printed film is crucial to success of electronic radiology. Image fidelity is measured in physical characteristics (luminance, dynamic range, distortion, resolution, and noise) and with psychophysical techniques, including receiver operator characteristics analysis with clinical images and testing with contrast-detail patterns to determine threshold contrast. Currently, laser-printed images facilitate greater information transfer than does a gray-scale monitor because of their higher absolute luminance (500 ft-L vs 60 ft-L), greater perceived dynamic range, and better spatial resolution. In the near future, the developments of gray-scale monitors with 150-200 ft-L luminance, a display standard based on just noticeable differences, and algorithms to improve similarities between gray-scale display images and laser-printed images will help increase the acceptability of monitors as a means to make primary diagnoses.

Computer Peripherals↗
PubMed1992

Computed radiography in musculoskeletal imaging: state of the art.

Computed radiography is a 2K x 2K x 10 bit digital radiographic system that replaces the film-screen combination with a photo-stimulable phosphor plate. The advantages of this relatively new technology include linear detector response, improved detector efficiency, and digital processing capabilities. Musculoskeletal applications benefit significantly from these attributes, which result clinically in the ability to reduce both radiation dose and number of exposures. Studies of observers' performance have shown no statistically significant difference in diagnostic accuracy between film-screen and computed radiographic musculoskeletal images. Computed radiography is particularly useful in the evaluation of the musculoskeletal system in traumatized patients with portable radiographs, spine radiographs, scoliosis studies, and depiction of soft-tissue abnormalities. Limitations include change in image format and size, high cost, decreased spatial resolution, restricted throughput, increased perception of noise, and new artifacts that must be recognized. Spatial resolution limitations of computed radiography in identification of fine detail information can be improved by using magnification techniques. Radiation dose reduction with an exposure decrease of 25-50% can be achieved without loss of diagnostic accuracy, although this depends on the examination and the abnormality. An interactive workstation is important in the use of a computed radiographic system with capabilities to adjust display parameters to best depict images and disease. We conclude that computed radiography is an alternative to film-screen radiography without significant differences in diagnostic quality in the evaluation of musculoskeletal images.

Humans↗
PubMed1991

Image data compression using a new floating-point digital signal processor.

A new dual-ported, floating-point, digital signal processor has been evaluated for compressing 512 and 1,024 digital radiographic images using a full-frame, two-dimensional, discrete cosine transform (2D-DCT). The floating point digital signal processor operates at 49.5 million floating point instructions per second (MFLOPS). The level of compression can be changed by varying four parameters in the lossy compression algorithm. Throughput times were measured for both 2D-DCT compression and decompression. For a 1,024 x 1,024 x 10-bit image with a compression ratio of 316:1, the throughput was 75.73 seconds (compression plus decompression throughput). For a digital fluorography 1,024 x 1,024 x 8-bit image and a compression ratio of 26:1, the total throughput time was 63.23 seconds. For a computed tomography image of 512 x 512 x 12 bits and a compression ratio of 10:1 the throughput time was 19.65 seconds.

Algorithms↗
PubMed1991

Wide area networks for teleradiology.

Teleradiology networks transmit digital radiographic images from one location to another. These networks are wide area networks. Teleradiology networks are used for diagnostic purposes and preview tasks. Wide area networks for teleradiology use public service switching. The use of fiber optics networks provide reduced costs and increased flexibility. An example is presented that compares the cost of teleradiology networks.

Computer Communication Networks↗
PubMed1991

State-of-the-art digital radiography.

Technologic advances in digital radiography have improved the ways in which radiographic images are acquired, displayed, transmitted, recorded, and archived. With computed radiography, performed with storage phosphor plates and interactive high-resolution workstations, radiation dose is reduced and repeat exposures necessitated due to technical errors are eliminated. Digital fluorography allows reductions in dose, procedure time, and film costs. These digital imaging modalities have been well accepted clinically and are equal in diagnostic accuracy to conventional methods. Teleradiology has advanced with the development of laser film digitization, fiberoptic networks, and dial-up circuit switching technology. Laser film printers yield improved hard copies of transmitted images, but further work is needed to faithfully reproduce the images displayed on high-resolution work-stations. Although the capacity for archiving digital image data has increased (260,000 examinations or 23,500 Gbytes can be stored in a six-unit optical disc library), higher capacity storage media are needed. Further technologic advances in the speed of image transmission and storage capacity are anticipated.

Humans↗
PubMed1990

Information retrieval for teaching files: a preliminary study.

A computer algorithm for information retrieval from an electronic teaching file has been developed. This index enables the user to retrieve cases from a teaching file, based on the input of a combination of features. The algorithm is based on nearest neighbor analysis, and is programmed in the "C" language. A teaching file with this index is very easy to use as a reference resource for diagnosing unknown cases. A model was developed for a preliminary test of how likely a user would be to review a teaching file case that is the same diagnosis as an unknown case, thereby reducing uncertainty of diagnosis. The model used 110 cases of arthritis radiographs of hands scored by a skeletal radiologist. The result of the model suggests that the correct diagnosis would be reviewed 83% of the time. A standard method of reducing uncertainty of diagnosis (the maximum likelihood discriminant function) would have picked the correct diagnosis 78% of the time. The results indicate that a teaching file with the computer index is a practical tool for dealing with the uncertainty in diagnosis of unknown cases. The computer index could be included with videodisc-based teaching files (such as the American College of Radiology files). Using teaching files as a reference for interpreting unknown cases may reduce interobserver variability.

Algorithms↗
PubMed1990

Experience in the use of an image-processing workstation for a photostimulable phosphor radiographic system.

Photostimulable phosphor radiographic (computed radiographic) systems are being installed and evaluated by radiology departments. The use of interactive image-processing workstations are a major advantage for any computed radiography system. An interactive image-processing workstation enables rapid image retrieval, reduces the examination repeat rate, provides for image enhancement, and rapidly sets the desired display parameters for laser-printed images. The authors have conducted over 2,500 radiographic examinations using a computed radiographic system equipped with an interactive image-processing workstation. Their experience supports the necessity of such a workstation.

Computer Systems↗
PubMed1990

Nondisplaced fractures: spatial resolution requirements for detection with digital skeletal imaging.

Fifty-six radiographs of nondisplaced or minimally displaced fractures of the extremities and an equal number of studies with normal findings were selected and digitized to produce spatial resolution varying from 5.75 to 0.72 line pairs per millimeter (1p/mm), corresponding to pixel sizes ranging from 0.08 to 0.64 mm. The conventional and digitized images were evaluated by 10 radiologists, who gave their decision confidence on a graded scale. Receiver operating characteristic analyses were performed from these data to compare the digital images with the conventional radiographs. There was a progressive improvement in observer performance as the pixel size decreased. A pixel size greater than 0.16 mm (2.88 1p/mm) resulted in a significant loss of diagnostic accuracy in comparison with conventional radiographs. Specific fractures in which a larger pixel size adversely affected the evaluation included torus injuries, corner fractures in child abuse, minimal avulsion injuries, and fractures that demonstrated only trabecular disruption.

Adult↗
PubMed1990

Chest radiography: comparison of high-resolution digital displays with conventional and digital film.

This study was performed to compare the performances of observers using three display formats for chest radiography. The display formats were conventional radiographs, digitized radiographs (2,048 X 2,048 X 12 bits) printed on laser film, and digitized radiographs (2,048 X 2,048 X 12 bits) displayed on a high-resolution (2,560 X 2,048 X 12-bit) gray-scale display. The test set for the study consisted of 163 cases. Sixty-four of the cases were normal, whereas the 99 remaining cases demonstrated one or more common radiographic abnormalities. Nine abnormalities were selected for analysis: costophrenic angle blunting, interstitial disease, atelectasis, pneumothorax, parenchymal mass, consolidation, obstructive disease, hilar/mediastinal mass, and apical scarring. Six experienced general radiologists participated in the evaluation. Receiver operating characteristic curves were generated for each abnormality and display format. The results indicate that, while the three display formats are equivalent for the detection of some abnormalities, detectable differences in observer performance may be seen even at 2,048 X 2,048 X 12 bits for the detection of obstructive disease, pneumothorax, interstitial disease, and parenchymal masses.

Humans↗
PubMed1990

Teleradiology: an assessment.

A teleradiology system acquires radiographic images at one location and transmits them to one or more remote sites, where they are displayed and/or converted to hard copy. These systems often employ wide area networks. Their goal is to provide improved radiologic services at all sites on the network. Experience in the use of teleradiology systems has demonstrated the need for a laser film digitizer, an optical disk, and a high-quality display and/or laser film printer at each site. Single-site hardware purchase costs average $196,000, plus an additional 20% for yearly network services. Hardware purchased for a consultation or central referral facility approximates $344,000.

Computer Communication Networks↗
PubMed1989

Digital imaging of the chest.

During the past several years, image acquisition in nuclear medicine, computed tomography, ultrasonography, subtraction angiography, and magnetic resonance has been by digitization. Despite these advances, research in the development of digital imaging in conventional radiography has lagged behind. Although studies with a variety of digital techniques have been carried out on several fronts, we still do not possess a method that has captured the imagination of the majority of radiologists and other physicians to a point where it could replace conventional screen-film imaging. This article reviews the current status and general principles of the technology, focusing on the four digital radiographic techniques that have shown the greatest promise - film digitization, an image intensifier - based system, photostimulable phosphor plates, and a scanned projection system. The physical aspects of each of the four systems and the clinical results that have been reported to date, as well as the advantages and disadvantages of each system, are presented.

Humans↗
PubMed1989

Digital venography of the lower extremity.

A digital 33-cm fluoroscopic system equipped with conventional spot-film and digital or video hard-copy capabilities was evaluated for its usefulness in diagnosing deep venous thrombosis of the lower extremities. The impact of different fluoroscopic field sizes, spatial resolution, and contrast variance was measured by using phantoms. The results indicate that the physical characteristics of the digital system are acceptable for lower-extremity venography. Digital fluoroscopic hard copy was compared with conventional spot films in 22 examinations. The digital examinations were as accurate as the conventional examinations. Procedure time, exposure to radiation, film costs, and repeated injections of contrast medium because of errors in exposure were reduced with the digital method. The need for extra technologists was eliminated. The advantages of digital radiographic displays, postprocessing, storage, and transmission were maximized. Digital fluoroscopic examinations were as accurate as conventional spot films and were found to have many advantages.

Fluoroscopy↗