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Biomedical subjects

W W Peppler

Publications and source records attributed to W W Peppler.

28 records · Page 2Linked to original sources

Videodensitometric quantitation of mean blood flow.

Standard angiography demonstrates the anatomy of arterial occlusive disease but does not define its physiological significance. However, measurement of flow in a compromised vessel at rest and following peripheral dilatation provides important physiological information. Using digital subtraction angiography, femoral arterial flows determined by the cross-correlation transit time technique were compared to measurements by electromagnetic flowmeter. Thirty-five femoral arterial flow measurements were obtained in nine dogs instrumented with an electromagnetic flow probe and balloon occluder. Renografin 76 (7 cc) was power-injected at 14 cc/sec into the distal abdominal aorta. Angiographic flow measurements correlated well with electromagnetic flowmeter measurements (r = 0.94, standard deviation of the difference (SDD) = 15 ml/min). Intravenous studies provided somewhat poorer correlation due to difficulties in defining dimensions (r = 0.72, SDD = 36). Paired contrast injections (2 injections in succession) in 11 studies increased flow from an average of 80 to 250 ml/min (a 210 +/- 100% increase), providing an estimate of a vessel's capacity to provide increased flow during peripheral dilatation. Thus, reliable angiographic flow determinations may be obtained by arterial and intravenous contrast injections, adding physiological information to anatomical definition.

Absorptiometry, Photon↗

Work in progress: hybrid temporal-energy subtraction in digital fluoroscopy.

Initial clinical results using a digital fluoroscopic implementation of the combined time-energy ("hybrid") subtraction technique are described, with emphasis on carotid and renal imaging. Where patient motion artifacts are due to soft-tissue motion alone, hybrid subtraction can remove them. Due to the need for a finite separation time between high- and low-energy pairs, however, the present implementation of the hybrid technique is not completely immune to soft-tissue motion. The intrinsic signal-to-noise ratio of hybrid imaging is less than that of conventional temporal subtraction. However, since the low-energy temporal subtraction images are included in the hybrid data set, the diagnostic quality of the examination is not compromised.

Analog-Digital Conversion↗

Total body bone mineral and lean body mass by dual-photon absorptiometry. I. Theory and measurement procedure.

A method was developed for measuring total body bone mineral (TBBM) and lean body mass in vivo using dual-photon absorptiometry. The entire body was scanned in a rectilinear raster (transverse speed of 1 cm/s and longitudinal steps of 2.5 cm) with a modified nuclear medicine scanner and conventional nuclear counting electronics. The source was 153Gd (1 Ci) with principal photopeaks at 44 and 100 keV. The scan time was about 70 min with an absorbed dose of under 1 mrem. The low dose allows measurements to be repeated at frequent intervals or used on children. Short-term (months) precision of TBBM was about 1.5% for isolated skeletons and about 2% on normal human subjects. Long-term (years) precision on skeletons was under 3%. The precision of percent fat was 0.9%, which would lead to an error of less than 1% in the TBBM. Geometry of measurements also had minimal (and correctable) influence on the accuracy of results. The accuracy (1 standard error of estimate) of TBBM on isolated skeletons (N = 5) was 36 g (equivalent to about 13 g of Ca) with a correlation coefficient of 0.99; this error amounts to about 1--1.5% in normal adults; 2% in older women, and 2.5% in osteoporotic females. The dual-photon absorptiometry method could be implemented in many nuclear medicine departments to follow skeletal changes during growth and aging or to follow the course of a disease or treatment.

Body Composition↗

Total body bone mineral and lean body mass by dual-photon absorptiometry. II. Comparison with total body calcium by neutron activation analysis.

Total body bone mineral (TBBM) was measured in vivo using dual-photon absorptiometry (DPA) in 10 subjects. The total body calcium (TBCa) was measured in the same subjects using neutron activation analysis. The correlation between the two methods was very high (r greater than 0.99) and the standard error of estimate was low. The TBCa relative to TBBM was about 39%. The two noninvasive methods provided nearly identical indications of skeletal mass, but the radiation exposure with DPA was 500 to 5000 times smaller (0.6 mrem vs 300 to 3000 mrem). The radius shaft bone mineral content was highly correlated with the TBBM (0.97) and the TBCa (0.98) and could be used to estimate the latter variables with errors (1 SEE) of 9% and 6%, respectively.

Body Composition↗

Total body bone mineral and lean body mass by dual-photon absorptiometry. III. Comparison with trunk calcium by neutron activation analysis.

Dual-photon absorptiometry using 153Gd (44 and 100 keV) was used to measure the bone mineral content (BMC) of the trunk and of the total body (TBBM) in 7 volunteers with no overt bone disease. These values were compared to those obtained with partial-body neutron activation of calcium (trunk Ca). The trunk Ca seemed to represent best a 60 x 30 cm area; the correlation coefficient with the corresponding BMC in that area was 0.97 (SEE congruent to 7%). Trunk Ca was also highly correlated with TBBM (r = 0.96; SEE = 8%) and with radius BMC (r = 0.92; SEE = 11%), but the correlations with the BMC of smaller subareas of the trunk were lower (r congruent to 0.9; SEE approximately 12%). The BMC of the lumbar spine was only moderately correlated with trunk Ca, radius BMC and TBBM (r approximately 0.82; SEE approximately 18%), and only slightly more associated with trunk BMC (r approximately 0.88; SEE approximately 14%). The BMC of the combined lumbar-thoracic spine showed higher correlations with trunk Ca, radius BMC and TBBM (r approximately 0.87; SEE approximately 13%), and trunk BMC (r = 0.93; SEE approximately 10%). An accurate and sensitive measure of spinal status requires a direct measurement of that area.

Adult↗

Digital subtraction bronchography with stable xenon.

An experimental animal study using digital subtraction fluoroscopy to image the bronchial tree with stable xenon shows that major bronchi can be imaged. A fast frame rate is necessary to minimize the effects of subject motion. Optimum contrast between air in lung and xenon in bronchi is obtained when the first two-thirds of a vital capacity breathhold consists of air or oxygen and the last one-third consists of 100% xenon.

Animals↗

Geometrical properties of a digital beam attenuator system.

A digital beam attenuator system has been developed to automatically generate patient-specific compensating filters for chest radiography. An initial low-dose test image is used to generate the attenuator, which is fabricated by overprinting multiple layers of a heavy-metal material onto a nonattenuating substrate. The attenuator is subsequently inserted into the x-ray beam for a final compensated radiograph. The effects of focal spot blurring and limited attenuator resolution result in the final compensated image containing only high-spatial frequency information. The frequency response of the process is not strictly describable by a modulation transfer function, but an approximation of the frequencies remaining in the compensated image is obtained for low-contrast conditions. It is found that a 4 X 4 blurring function on the original 64 X 64 test image is required for the attenuator to give appropriate compensated image appearance. A proposed attenuator printing scheme prints the attenuator in a 16 X 16 matrix, staggering successively printed layers to achieve the required 64 X 64 sampling with appropriate blurring. The resulting compensated image has good anatomical definition and contains a frequency response similar to that obtained by compensation techniques being investigated by Plewes and Sorenson.

Humans↗

A correlated noise reduction algorithm for dual-energy digital subtraction angiography.

It has long been recognized that the problems of motion artifacts in conventional time subtraction digital subtraction angiography (DSA) may be overcome using energy subtraction techniques. Of the variety of energy subtraction techniques investigated, non-k-edge dual-energy subtraction offers the best signal-to-noise ratio (SNR). However, this technique achieves only 55% of the temporal DSA SNR. Noise reduction techniques that average the noisier high-energy image produce various degrees of noise improvement while minimally affecting iodine contrast and resolution. A more significant improvement in dual-energy DSA iodine SNR, however, results when the correlated noise that exists in material specific images is appropriately cancelled. The correlated noise reduction (CNR) algorithm presented here follows directly from the dual-energy computed tomography work of Kalender who made explicit use of noise correlations in material specific images to reduce noise. The results are identical to those achieved using a linear version of the two-stage filtering process described by Macovski in which the selective image is filtered to reduce high-frequency noise and added to a weighted, high SNR, nonselective image which has been processed with a high-frequency bandpass filter. The dual-energy DSA CNR algorithm presented here combines selective tissue and iodine images to produce a significant increase in the iodine SNR while fully preserving iodine spatial resolution. Theoretical calculations predict a factor of 2-4 improvement in SNR compared to conventional dual-energy images. The improvement factor achieved is dependent upon the x-ray beam spectra and the size of blurring kernel used in the algorithm.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗

Coronary blood flow measurement using an angiographic first pass distribution technique: a feasibility study.

Due to the well-documented problems associated with visual interpretation of coronary angiograms, more physiologic means of assessing coronary artery stenosis are being investigated. One physiologic parameter that has been suggested is coronary flow reserve (CFR). A digital subtraction angiographic technique based on first pass distribution analysis (FPA) is proposed as a means of measuring CFR and absolute coronary flow. The theory of the FPA method is first outlined, and the implementation of a preliminary version of the FPA algorithm is described. Experiments verifying the utility of this algorithm for measuring absolute flow through a flow phantom, and through the canine circumflex artery are reported. It was determined that the preliminary FPA algorithm is capable of measuring canine coronary flow ratios (R) with accuracy and precision characteristics meeting or exceeding those reported for the parametric imaging technique (RFPA = 0.933.Rtrue, SEE = 0.16, r = 0.984). Accurate absolute flow (Q) measurements were obtained in all of the phantom experiments (QFPA = 1.054.Qtrue, r = 0.993), and in one of the three dogs that were studied (QFPA = 0.977.Qtrue, r = 0.935). The difficulty encountered in the other two dog experiments is attributed to the effects of system temporal lag, and would likely be corrected through the use of improved cameras. The feasibility of the general FPA method for measuring relative flow is established, and the potential for routine, absolute flow measurement is demonstrated.

Algorithms↗