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Biomedical subjects

S Napel

Publications and source records attributed to S Napel.

At least 19 recordsLinked to original sources
PubMed1997

Virtual endoscopy of the paranasal sinuses using perspective volume rendered helical sinus computed tomography.

Our goal was to use three-dimensional information obtained from helical computed tomographic (CT) data to explore and evaluate the nasal cavity, nasopharynx, and paranasal sinuses by simulated virtual endoscopy (VE). This was done by utilizing a new image reconstruction method known as perspective volume rendering (PVR). Thin-section helical CT of the nasal cavity, nasopharynx, and paranasal sinuses was performed on a conventional CT scanner. The data were transferred to a workstation to create views similar to those seen with endoscopy. Additional views not normally accessible by conventional endoscopy were generated. Key perspectives were selected, and a video "flight" model was choreographed and synthesized through the nasal cavity and sinuses based on the CT data. VE allows evaluation of the nasal cavity, nasopharynx, and paranasal sinuses with appreciation of the relationships of these spatially complex structures. In addition, this technique allows structural visualization with unconventional angles, perspectives, and locations not conventionally accessible. Although biopsies, cultures, and lavages routinely done with endoscopy cannot be performed with VE, this technique holds promise for improving the diagnostic evaluation of the nasal cavity, the nasopharynx, and the paranasal sinuses. The unconventional visual perspectives and very low morbidity may complement many applications of simple diagnostic endoscopy.

Endoscopy↗
PubMed1997

Accuracy of detection and measurement of renal calculi: in vitro comparison of three-dimensional spiral CT, radiography, and nephrotomography.

PURPOSE: To compare accuracy of three-dimensional (3D) spiral computed tomography (CT) performed without administration of contrast material with that of radiography and linear nephrotomography in detection and measurement of renal calculi. MATERIALS AND METHODS: Fifty renal calculi within an abdominal phantom were imaged with 3D spiral CT, radiography, and linear nephrotomography. Spiral CT data were analyzed with workstation-based 3D imaging software, with a thresholding procedure based on the maximally attenuating voxel within each calculus during measurement. Measurement accuracy and detection rates were compared according to modality. Conventional and magnification-corrected measurements from radiography and linear nephrotomography were included. RESULTS: Spiral CT depicted calculi and allowed determination of the collective two-dimensional and 3D linear measurements statistically significantly more accurately than the other techniques; the mean linear measurement errors along individual axes did not exceed 3.6%. With 3D spiral CT, calculus volumes were determined with a mean error of -4.8%. CONCLUSION: 3D spiral CT enabled highly accurate determination of the volumes and all three linear dimensions of renal calculi. In addition, 3D spiral CT depicted calculi more sensitively than traditional techniques and provided new information and improved accuracy in the evaluation of nephrolithiasis.

Bias↗
PubMed1996

Perspective volume rendering of CT and MR images: applications for endoscopic imaging.

PURPOSE: To use perspective volume rendering (PVR) of computed tomographic (CT) and magnetic resonance (MR) imaging data sets to simulate endoscopic views of human organ systems. MATERIALS AND METHODS: Perspective views of helical CT and MR images were reconstructed from the data, and tissues were classified by assigning color and opacity based on their CT attenuation or MR signal intensity. "Flight paths" were constructed through anatomic regions by defining key views along a spline path. Twelve movies of the thoracic aorta (n=3), tracheobronchial tree (n=4), colon (n=3), paranasal sinuses (n=1), and shoulder joint (n=1) were generated to display images along the flight path. All abnormal results were confirmed at surgery. RESULTS: PVR fly-through enabled evaluation of the full range of tissue densities, signal intensities, and their three-dimensional spatial relationships. CONCLUSION: PVR is a novel way to present volumetric data and may enable noninvasive diagnostic endoscopy and provide an alternate method to analyze volumetric imaging data for primary diagnosis.

Aorta, Thoracic↗
PubMed1995

A versatile system for multimodality image fusion.

This paper presents a versatile system for registering and visualizing computed tomography and magnetic resonance images. The system utilizes a semi-automatic, surface-based registration strategy which has proven useful for registering a number of different anatomical structures. A triangular mesh approximates surfaces in one image set while a set of surface points is used as a surface approximation in the other set. A non-linear optimization procedure determines the transformation that minimizes the total sum-squared perpendicular distance between triangles of the mesh and surface points. This system has been used without modification to successfully register images of the brain, spine and calcaneus.

Brain↗
PubMed1995

Method for correcting magnetic resonance image distortion for frame-based stereotactic surgery, with preliminary results.

We previously described a technique for correcting patient-specific magnetic field inhomogeneity spatial distortion in magnetic resonance images (MRI), which was not applicable to patients fitted with MRI-compatible stereotactic fiducial frames. Here we describe an improvement to the technique that permits application for these patients. Measurements with a cadaver head show that this method achieves MRI stereotactic localization accuracy of 1 mm.

Head↗
PubMed1995

MR geometric distortion correction for improved frame-based stereotaxic target localization accuracy.

We present a method to correct the geometric distortion caused by field inhomogeneity in MR images of patients wearing MR-compatible stereotaxic frames. Our previously published distortion correction method derives patient-dependent error maps by computing the phase-difference of 3D images acquired at different TEs. The time difference (delta TE = 4.9 ms at 1.5 T) is chosen such that the water and fat signals are in phase. However, delta TE is long enough to permit phase wraps in the difference images for frequency offsets greater than 205 Hz. Phase unwrapping techniques resolve these only for connected structures; therefore, the phase difference for fiducial rods may be off by multiples of 2 pi relative to the head. We remove this uncertainty by using an additional single 2D phase-different image with delta TE = 1 ms (during which time no phase-wraps are typically expected) to determine the correct multiple of 2 pi for each rod. We tested our method in a cadaver and in a patient using CT as the gold standard. Targets in the frame coordinates were chosen from CT and compared with their locations in MR. Localizing errors using MR compared with CT were as large as 3.7 mm before correction and were reduced to less than 1.11 mm after correction.

Artifacts↗
PubMed1995

Registration error quantification of a surface-based multimodality image fusion system.

This paper presents a new reference data set and associated quantification methodology to assess the accuracy of registration of computerized tomography (CT) and magnetic-resonance (MR) images. Also described is a new semiautomatic surface-based system for registering and visualizing CT and MR images. The registration error of the system was determined using a reference data set that was obtained from a cadaver in which rigid fiducial tubes were inserted prior to imaging. Registration error was measured as the distance between an analytic expression for each fiducial tube in one image set and transformed samples of the corresponding tube obtained from the other. Registration was accomplished by first identifying surfaces of similar anatomic structures in each image set. A transformation that best registered these structures was determined using a nonlinear optimization procedure. Even though the root-mean-square (rms) distance at the registered surfaces was similar to that reported by other groups, it was found that rms distances for the tubes were significantly larger than the final rms distances between the registered surfaces. It was also found that minimizing rms distance at the surface did not minimize rms distance for the tubes.

Biophysical Phenomena↗
PubMed1995

Detection of ureteral calculi in patients with suspected renal colic: value of reformatted noncontrast helical CT.

OBJECTIVE: The purpose of this study was to determine the value of reformatted noncontrast helical CT in patients with suspected renal colic. We hoped to determine whether this technique might create images acceptable to both radiologists and clinicians and replace our current protocol of sonography and abdominal plain film. SUBJECTS AND METHODS: Thirty-four consecutive patients with signs and symptoms of renal colic were imaged with both noncontrast helical CT and a combination of plain film of the abdomen and renal sonography. Reformatting of the helical CT data was performed on a workstation to create a variety of reformatted displays. The correlative studies were interpreted by separate blinded observers. Clinical data, including the presence of hematuria and the documentation of stone passage or removal, were recorded. RESULTS: Findings on 18 CT examinations were interpreted as positive for the presence of ureteral calculi; 16 of these cases were determined to be true positives on the basis of later-documented passage of a calculus. Thirteen of the 16 cases proved to be positive were interpreted as positive for renal calculi using the combination of abdominal plain film and renal sonography. The most useful CT reformatting technique was curved planar reformatting of the ureters to determine whether a ureteral calculus was present. CONCLUSION: In this study, noncontrast helical CT was a rapid and accurate method for determining the presence of ureteral calculi causing renal colic. The reformatted views produced images similar in appearance to excretory urograms, aiding greatly in communicating with clinicians. Limitations on the technique include the time and equipment necessary for reformatting and the suboptimal quality of reformatted images when little retroperitoneal fat is present.

Adult↗
PubMed1994

Quantifying MRI geometric distortion in tissue.

We present a method to quantify the MR field inhomogeneity geometric distortion to subpixel accuracy without using objects of known dimensions and without using an external standard such as CT. Our method may be used to quantify the geometric accuracy of MR images of anatomical structures of unknown geometry and also to test any geometry correction scheme. We have quantified the distortion in a tissue phantom and found the largest error to be approximately 2.8 pixels (1.8 mm) for Bo = 1.5 T, G = 3.13 mT/m and FOV = 160 x 160 x 70.7 mm3. We also found that our previously published correction technique reduced the largest error to 0.3 pixels (mu = 0.02 and sigma = 0.07 pixels).

Image Processing, Computer-Assisted↗
PubMed1994

Single breath-hold pulmonary magnetic resonance angiography. Optimization and comparison of three imaging strategies.

RATIONALE AND OBJECTIVES: Ultrafast gradient-recalled-echo techniques for obtaining high-quality pulmonary magnetic resonance angiograms within a single breath-hold were optimized. METHODS: Fourteen subjects were imaged with both the body coil and a phased-array surface coil, using three gradient-recalled-echo pulse sequences: 1) two-dimensional sequential; 2) two-dimensional interleaved; and 3) volumetric acquisitions. Image quality was assessed with varied flip angle, receiver bandwidth, slice thickness/number, and matrix size. Cardiac compensation diminished ghost artifacts in the interleaved sequence. Individual sagittal sections and maximum intensity projections were reviewed. RESULTS: Pulmonary magnetic resonance angiograms acquired with volumetric and two-dimensional interleaved gradient-recalled-echo pulse sequences benefit greatest from intravenous gadolinium and result in greater pulmonary arterial visualization than traditional time-of-flight techniques. Phased-array coils result in improved vessel detection. CONCLUSIONS: High-quality breath-held pulmonary magnetic resonance angiography can be obtained with an intravenous contrast-enhanced gradient-recalled-echo acquisition; however, image quality is dependent on the pulse sequence.

Adult↗
PubMed1994

Spiral CT of renal artery stenosis: comparison of three-dimensional rendering techniques.

PURPOSE: To evaluate the accuracy of computed tomographic (CT) angiography in the detection of renal artery stenosis (RAS). MATERIALS AND METHODS: CT angiography was performed in 31 patients undergoing conventional renal arteriography. CT angiographic data were reconstructed with shaded surface display (SSD) and maximum-intensity projection (MIP). Stenosis was graded with a four-point scale (grades 0-3). The presence of mural calcification, poststenotic dilatation, and nephrographic abnormalities was also noted. RESULTS: CT angiography depicted all main (n = 62) and accessory (n = 11) renal arteries that were seen at conventional arteriography. MIP CT angiography was 92% sensitive and 83% specific for the detection of grade 2-3 stenoses (> or = 70% stenosis). SSD CT angiography was 59% sensitive and 82% specific for the detection of grade 2-3 stenoses. The accuracy of stenosis grading was 80% with MIP and 55% with SSD CT angiography. Poststenotic dilatation and the presence of an abnormal nephrogram were 85% and 98% specific, respectively. CONCLUSION: CT angiography shows promise in the diagnosis of RAS. The accuracy of CT angiography varies with the three-dimensional rendering technique employed.

Adult↗
PubMed1994

Characterization of spatial distortion in magnetic resonance imaging and its implications for stereotactic surgery.

The different sources of spatial distortion in magnetic resonance images are reviewed from the point of view of stereotactic target localization. The extents of the two most complex sources of spatial distortion, gradient field nonlinearities and magnetic field inhomogeneities, are discussed both qualitatively and quantitatively. Several ways by which the spatial distortion resulting from these sources can be minimized are discussed. The clinical relevance of the spatial distortion along with some strategies to minimize the localization errors in magnetic resonance-guided stereotaxy are presented.

Artifacts↗
PubMed1993

Diagnosis of carotid artery disease: preliminary experience with maximum-intensity-projection spiral CT angiography.

OBJECTIVE: Spiral CT allows continuous data to be acquired rapidly, and if a correctly timed IV bolus of contrast material is given, spiral CT angiography can be performed. This study was designed to evaluate spiral CT angiography with maximum-intensity-projection reconstructions for assessing the degree of carotid artery stenosis. SUBJECTS AND METHODS: Spiral CT angiography (of 28 carotid bifurcations in 14 patients) was compared in a blinded fashion with conventional angiography (of 28 bifurcations) and with two-dimensional time-of-flight MR angiography (of 12 bifurcations) to assess degree of stenosis. A nonblinded comparison of the contour of the lumen at the site of stenosis was then made between conventional angiography, spiral CT angiography, and MR angiography. The degree of stenosis was measured in each internal carotid artery and categorized as mild (< 30%), moderate (30-69%), or severe (70-99%) stenosis or as occlusion. Maximum-intensity-projection images were used for the evaluations; however, if calcification was circumferential and the lumen of the carotid artery could not be analyzed in the area of the calcification, the axial source images were used. RESULTS: The results of CT angiography and conventional angiography agreed overall in 25 (89%) of 28 cases (r = .921, p = .05, Spearman rank correlation). The presence of severe stenosis or occlusion was correctly identified in seven of seven cases. In the moderate and mild stenosis categories, 18 (86%) of 21 were correctly identified (r = .802, p = .122). Three internal carotid arteries (11%) had circumferential calcification that necessitated evaluation of the axial source images, and the measurements obtained from the axial images agreed well with angiographic findings. MR angiography correlated well with the various categories of stenosis. However, when we compared MR angiography directly with CT angiography and conventional angiography, we found that the degree of stenosis was overestimated when MR angiography was used. CONCLUSION: Our results show that spiral CT angiography shows normal and abnormal carotid anatomy well when compared with conventional angiography. The short examination time and clear depiction of arterial caliber in areas of stenosis are significant advantages of spiral CT angiography compared with MR angiography.

Aged↗
PubMed1993

Three-dimensional spiral computed tomographic angiography: an alternative imaging modality for the abdominal aorta and its branches.

PURPOSE: We sought to apply a new technique of computed tomographic angiography (CTA) to the preoperative and postoperative assessment of the abdominal aorta and its branches. METHODS: After a peripheral intravenous contrast injection, the patient is continuously advanced through a spiral CT scanner, while maintaining a 30-second breath-hold. Thirty-five patients with abdominal aortic, renal, and visceral arterial disease have undergone CTA. RESULTS: Diagnostic three-dimensional images were obtained in patients with aortic aneurysms (n = 9), aortic dissections (n = 4), and mesenteric artery stenoses (n = 4). The technique has also been used to assess vessels after operative reconstruction or endovascular intervention in 18 patients. These preliminary studies have correlated well with conventional arteriographic findings. In aneurysmal disease both the lumen and mural thrombus and associated renal artery stenoses are visualized. The true and false channels of aortic dissections and the perfusion source of the visceral vessels are clearly shown; patency of visceral and renal reconstruction or stent placement are confirmed. CTA is relatively noninvasive and can be completed in less time than conventional angiography with less radiation exposure. CONCLUSIONS: This initial experience suggests that CTA may be a valuable alternative to conventional arteriography in the evaluation of the aorta and its branches.

Adult↗
PubMed1992

CT angiography with spiral CT and maximum intensity projection.

The authors describe a technique for obtaining angiographic images by means of spiral computed tomography (CT), preprocessing of reconstructed three-dimensional sections to suppress bone, and maximum intensity projection. The technique has some limitations, but preliminary results in 48 patients have shown excellent anatomic correlation with conventional angiography in studies of the abdomen, the circle of Willis in the brain, and the extracranial carotid arteries. With continued development and evaluation, CT angiography may prove useful as a screening tool or replacement for conventional angiography in some patients.

Abdomen↗