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Automatic quantification of ejection fraction from gated myocardial perfusion SPECT.

UNLABELLED: We have developed a completely automatic algorithm to quantitatively measure left ventricular ejection fraction (LVEF) from gated 99mTc-sestamibi myocardial perfusion SPECT images. METHODS: The algorithm operates in the three-dimensional space and uses gated short-axis image volumes. It segments the left ventricle (LV), estimates and displays endocardial and epicardial surfaces for all gating intervals in the cardiac cycle, calculates the relative left ventricular cavity volumes and derives the global EF from the end-diastolic and end-systolic volume, all without operator interaction. The algorithm for measuring LVEF was tested in 65 clinical patients undergoing 16-interval and 8-interval rest-gated SPECT and validated against first-pass radionuclide ventriculography. RESULTS: Automatic segmentation and contouring of the LV was successful in 65/65 (100%) of the studies. Agreement between EFs measured from 8-interval gated SPECT and EFs calculated from first-pass data was high (y = 2.44 + 1.03x, r = 0.909, p < 0.001, s.e.e. = 6.87). Agreement between EF values measured from 16-interval and 8-interval gated SPECT was excellent (y = -2.7 + 0.97x, r = 0.988, p < 0.001, s.e.e. = 2.65), the latter being on average lower by 3.71 percentage points. CONCLUSION: Our automatic method is rapid and highly agrees with conventional radionuclide measurements of EF, thus providing clinically useful additional information to complement myocardial perfusion studies.

Algorithms↗

Automated volumetry at CT colonography: a phantom study.

RATIONALE AND OBJECTIVES: To assess the performance of a computer-aided detection (CAD) algorithm for measuring polyp-like structures on CT colonography (CTC) images of a phantom. MATERIALS AND METHODS: We constructed a Plexiglas phantom to which we affixed a series of idealized Plexiglas polyp-like objects, including spheres and hemispheres. We imaged the phantom in a four-channel detector CT scanner at a 1.3 mm slice thickness with a reconstruction interval of 0.6 mm, using combinations of 100 mAs, 30 mAs, horizontal and vertical orientation. For each set of CT images, the interior surface of the phantom was segmented. The CAD algorithm was applied to the resulting surface to identify the polypoid regions of interest and to calculate their volume and maximum linear dimension. Calculated values were then compared with actual values to yield percent error in each measurement. RESULTS: The mean error in volume for the subgroups of spheres and hemispheres was 3% and 5% respectively. Mean error in linear dimension was approximately 2% for both shape subgroups. All CAD-calculated values were closely correlated with their respective actual values. Parameter selection did not significantly affect the accuracy of the calculated measurements. CONCLUSIONS: Our CAD software accurately measured the greatest linear dimension and the volume of each of the polyp-like structures in our phantom. Results were largely independent of phantom orientation and the CT exposure factors.

Algorithms↗

Encoding of pitch in the human brainstem is sensitive to language experience.

Neural processes underlying pitch perception at the level of the cerebral cortex are influenced by language experience. We investigated whether early, pre-attentive stages of pitch processing at the level of the human brainstem may also be influenced by language experience. The human frequency following response (FFR), reflecting sustained phase-locked activity in a population of neural elements, was used to measure activity within the rostral brainstem. FFRs elicited by four Mandarin tones were recorded from native speakers of Mandarin Chinese and English. Pitch strength (reflecting robustness of neural phase-locking at the pitch periods) and accuracy of pitch tracking were extracted from the FFRs using autocorrelation algorithms. These measures revealed that the Chinese group exhibits stronger pitch representation and smoother pitch tracking than the English group. Consistent with the pitch data, FFR spectral data showed that the Chinese group exhibits stronger representation of the second harmonic relative to the English group across all four tones. These results cannot be explained by a temporal pitch encoding scheme which simply extracts the dominant interspike interval. Rather, these results support the possibility of neural plasticity at the brainstem level that is induced by language experience that may be enhancing or priming linguistically relevant features of the speech input.

Acoustic Stimulation↗

Novel approaches to the measurement of arterial blood flow from dynamic digital X-ray images.

We have developed two new algorithms for the measurement of blood flow from dynamic X-ray angiographic images. Both algorithms aim to improve on existing techniques. First, a model-based (MB) algorithm is used to constrain the concentration-distance curve matching approach. Second, a weighted optical flow algorithm (OP) is used to improve on point-based optical flow methods by averaging velocity estimates along a vessel with weighting based on the magnitude of the spatial derivative. The OP algorithm was validated using a computer simulation of pulsatile blood flow. Both the OP and the MB algorithms were validated using a physiological blood flow circuit. Dynamic biplane digital X-ray images were acquired following injection of iodine contrast medium into a variety of simulated arterial vessels. The image data were analyzed using our integrated angiographic analysis software SARA to give blood flow waveforms using the MB and OP algorithms. These waveforms were compared to flow measured using an electromagnetic flow meter (EMF). In total 4935 instantaneous measurements of flow were made and compared to the EMF recordings. It was found that the new algorithms showed low measurement bias and narrow limits of agreement and also out-performed the concentration-distance curve matching algorithm (ORG) and a modification of this algorithm (PA) in all studies.

Algorithms↗

Computer generation and quantitative morphometric analysis of virtual neurons.

An important goal in computational neuroanatomy is the complete and accurate simulation of neuronal morphology. We are developing computational tools to model three-dimensional dendritic structures based on sets of stochastic rules. This paper reports an extensive, quantitative anatomical characterization of simulated motoneurons and Purkinje cells. We used several local and global algorithms implemented in the L-Neuron and ArborVitae programs to generate sets of virtual neurons. Parameters statistics for all algorithms were measured from experimental data, thus providing a compact and consistent description of these morphological classes. We compared the emergent anatomical features of each group of virtual neurons with those of the experimental database in order to gain insights on the plausibility of the model assumptions, potential improvements to the algorithms, and non-trivial relations among morphological parameters. Algorithms mainly based on local constraints (e.g., branch diameter) were successful in reproducing many morphological properties of both motoneurons and Purkinje cells (e.g. total length, asymmetry, number of bifurcations). The addition of global constraints (e.g., trophic factors) improved the angle-dependent emergent characteristics (average Euclidean distance from the soma to the dendritic terminations, dendritic spread). Virtual neurons systematically displayed greater anatomical variability than real cells, suggesting the need for additional constraints in the models. For several emergent anatomical properties, a specific algorithm reproduced the experimental statistics better than the others did. However, relative performances were often reversed for different anatomical properties and/or morphological classes. Thus, combining the strengths of alternative generative models could lead to comprehensive algorithms for the complete and accurate simulation of dendritic morphology.

Algorithms↗

Do we need Monte Carlo treatment planning for linac based radiosurgery? A case study.

The accuracy of conventional empirical and semi-empirical dose calculation algorithms for radiation therapy treatment planning is limited. The main problem is that these algorithms fail to adequately consider the lateral transport of radiation. Most conventional algorithms use measured dose distribution data as input. These data induce an added inaccuracy to stereotactic radiosurgery dose calculations due to the difficulty of acquiring accurate dosimetric data for very small beams; however, since multiple arcs of large solid angles are usually used in stereotactic radiosurgery, the errors introduced by conventional dose algorithms are quite likely to be diluted. The use of Monte Carlo treatment planning for stereotactic radiosurgery has been investigated and described in the present paper. The OMEGA Monte Carlo code system is used as the dose engine in an in-house developed radiosurgery treatment planning system. The Monte Carlo treatment plans are done for two typical clinical cases. In one case, the collimator of 20 mm diameter is used and the lesion is located in the peripheral part of the brain. In the other case, the collimator diameter is 30 mm and the lesion is in the central part of the brain. The resultant dose distributions are compared with those calculated with a conventional dose algorithm which is based on the standard Tissue Maximum Ratio (TMR)/Off Axis Ratio (OAR) formalism. Without the inhomogeneity correction, the conventional algorithm yields accurate relative dose distributions for both cases compared with the Monte Carlo calculations. The absolute dose at the isocenter may be overestimated by the conventional algorithm by 1.5% for the first case and 2.6% for the second case; however, using the method of ratio of TMRs for inhomogeneity correction, the overestimation can be greatly reduced for both cases. The inclusion of the inhomogeneity correction into the conventional dose algorithm does not alter the relative dose distributions. Based on the clinical cases studied, it may be concluded that the conventional dose algorithm is sufficient for radiosurgery treatment planning and the Monte Carlo based radiosurgery treatment planning is unwarranted.

Aged↗

Application of information theory to the assessment of computed tomography.

The imaging process has two fundamental stages: detection and display. The detection stage can be quantified rigourously using Shannon's information theory. This requires the contrast scale (CS), modulation transfer function (MTF), and noise power spectrum [N(f)] to be combined into a signal-to-noise ratio (SNR). This results in two fundamental summary figures of merit: the density of noise equivalent quanta (NEQ) in the image and the information bandwidth integral (IBWI). These algorithm-independent measures are used to quantify the recording stage. The display stage is less well understood since it couples to an external observer. Several types of decision makers are treated. Examples are drawn from first and second generation CT, demonstrating that thye are nearly quantum limited for large signals, indicating how their algorithms are matched or mismatched to the geometry, and calculating the contrast-detail diagrams for those decision makers.

Data Display↗

A Monte Carlo simulation of range for an invasive impedance respiration monitor.

One method of rate responsive pacing utilizes an analog of minute ventilation as the input to the rate control algorithm. A measure of the intravenous impedance along the pacing catheter is a convenient means of determining minute ventilation. Design of the impedance converter requires a knowledge of the range of DC and AC impedance signals. During normal and deep breathing, 116 AC measurements were taken from 34 Electrophysiology (EP) patients and 31 DC measurements were taken from 13 EP patients. The patient data produced skewed distributions with a normal AC mean of 0.45 +/- 0.40 ohms p-p, a deep AC mean of 2.0 +/- 1.6 ohms and a DC mean of 44 +/- 13 ohms. An eight variable static model was derived from prior work. Five of the physiological variables were chosen from established clinical ranges, one geometrical variable was chosen from prior work and two were selected by matching the statistics of a Monte Carlo analysis of the model with the statistics of the patient data. The blood resistivity was obtained from prior work. A simulation of 1000 measurements produced a normal breathing range of 0 to 2.24 ohms, a deep breathing range of 0 to 9.6 ohms and a DC range of 19 to 100 ohms.

Algorithms↗

Freeze-drying process design by manometric temperature measurement: design of a smart freeze-dryer.

PURPOSE: To develop a procedure based on manometric temperature measurement (MTM) and an expert system for good practices in freeze drying that will allow development of an optimized freeze-drying process during a single laboratory freeze-drying experiment. METHODS: Freeze drying was performed with a FTS Dura-Stop/Dura-Top freeze dryer with the manometric temperature measurement software installed. Five percent solutions of glycine, sucrose, or mannitol with 2 ml to 4 ml fill in 5 ml vials were used, with all vials loaded on one shelf. Details of freezing, optimization of chamber pressure, target product temperature, and some aspects of secondary drying are determined by the expert system algorithms. MTM measurements were used to select the optimum shelf temperature, to determine drying end points, and to evaluate residual moisture content in real-time. MTM measurements were made at 1 hour or half-hour intervals during primary drying and secondary drying, with a data collection frequency of 4 points per second. The improved MTM equations were fit to pressure-time data generated by the MTM procedure using Microcal Origin software to obtain product temperature and dry layer resistance. Using heat and mass transfer theory, the MTM results were used to evaluate mass and heat transfer rates and to estimate the shelf temperature required to maintain the target product temperature. RESULTS: MTM product dry layer resistance is accurate until about two-thirds of total primary drying time is over, and the MTM product temperature is normally accurate almost to the end of primary drying provided that effective thermal shielding is used in the freeze-drying process. The primary drying times can be accurately estimated from mass transfer rates calculated very early in the run, and we find the target product temperature can be achieved and maintained with only a few adjustments of shelf temperature. The freeze-dryer overload conditions can be estimated by calculation of heat/mass flow at the target product temperature. It was found that the MTM results serve as an excellent indicator of the end point of primary drying. Further, we find that the rate of water desorption during secondary drying may be accurately measured by a variation of the basic MTM procedure. Thus, both the end point of secondary drying and real-time residual moisture may be obtained during secondary drying. CONCLUSIONS: Manometric temperature measurement and the expert system for good practices in freeze drying does allow development of an optimized freeze-drying process during a single laboratory freeze-drying experiment.

Freeze Drying↗

Automatic segmentation and quantification of electron micrographs: extracellular components.

Extracellular glycosaminoglycans when precipitated by tannic acid, appear in electron micrographs as amorphous reticulate masses or fragments sometimes finely beaded and often associated with collagen fibrils. An algorithm for automatic classification, segmentation, and quantification of the amount of tannic acid-precipitable material (TAPM) and collagen in electron microscopic images is presented. Small patches of a region are initially located and the patch boundaries are traced using a binary contour tracing algorithm. The patches are then grown out and merged together to form one large area. This area is classified using a two-dimensional feature vector into one of two classes: a region with TAPM and collagen, or one with cell bodies and/or processes. Once these areas are classified and segmented, the distribution of TAPM is measured. The algorithm was tested on several TAPM images displaying varying amounts and configurations of TAPM with good results. It may also be adapted to process other electron microscopic images containing elements of interest which have complex or amorphous form.

Animals↗

Behavior of the copper band of cytochrome c oxidase in rat brain during FC-43-for-blood substitution.

FC-43-for-blood substitution experiments were conducted in anesthetized rats to evaluate NIR spectroscopic responses by living brain to exchange transfusion at very low hematocrits. The NIR responses to the exchange process also assess the ability of multiwavelength algorithms to measure independent changes in the relative amounts of Hb, tHbO2 and oxidized cytochrome a,a3 in the tissue. These data indicate that FC-43 circulation at high FIO2 (1.00) delivers sufficient O2 to the rat brain to maintain the oxidation state of the mitochondrial oxidase near pre-exchange values. The results also confirm the ability of four wavelength algorithms to distinguish changes in the oxidized copper band of cytochrome a,a3 from changes in absorption by Hb and HbO2.

Animals↗

Three-dimensional fluorescence lifetime tomography.

Near-infrared fluorescence tomography using molecularly targeted lifetime-sensitive, fluorescent contrast agents have applications for early-stage cancer diagnostics. Yet, although the measurement of fluorescent lifetime imaging microscopy (FLIM) is extensively used in microscopy and spectroscopy applications, demonstration of fluorescence lifetime tomography for medical imaging is limited to two-dimensional studies. Herein, the feasibility of three-dimensional fluorescence-lifetime tomography on clinically relevant phantom volumes is established, using (i) a gainmodulated intensified charge coupled device (CCD) and modulated laser diode imaging system, (ii) two fluorescent contrast agents, e.g., Indocyanine green and 3-3'-Diethylthiatricarbocyanine iodide differing in their fluorescence lifetime by 0.62 ns, and (iii) a two stage approximate extended Kalman filter reconstruction algorithm. Fluorescence measurements of phase and amplitude were acquired on the phantom surface under different target to background fluorescence absorption (70:1, 100:1) and fluorescence lifetime (1:1, 2.1:1) contrasts at target depths of 1.4-2 cm. The Bayesian tomography algorithm was employed to obtain three-dimensional images of lifetime and absorption owing to the fluorophores.

Algorithms↗

Digital filters for firing rate estimation.

When a rate histogram is used to represent the firing pattern of a neuron there is the potential for serious error due to aliasing, and because of this the rate histogram is a very poor way to represent neural activity. It is theoretically possible to encode a signal in a spike train and decode it without error by filtering and sampling. There is no natural optimal filter design for this problem, but it is possible to specify the characteristics of a good rate estimating filter heuristically and design a filter with these characteristics. Two rate estimating filters are described here. Their performance has been tested, and compared to the rate histogram and the French-Holden rate estimating algorithm, by measuring their ability to recover signals encoded as impulse sequences by Integral Pulse Frequency Modulation (IPFM). These filters are simple to implement and perform well. They should be used in preference to the rate histogram.

Action Potentials↗

Computerized measurement of the three-dimensional distribution of optic disc pallor.

PURPOSE: To describe a method which provides quantitative measurements of the surface area of pallor in each quadrant of the three-dimensional optic cup, using photogrammetric measurements from simultaneous stereophotographs and computerized image analysis. METHODS: Simultaneous stereophotographs of one normal subject and two subjects with primary open angle glaucoma were digitized and analyzed for depth measurements. The boundaries of the optic disc, optic cup and region of pallor were identified. Pallor/disc and pallor/cup ratios were subsequently calculated for the superior, temporal, inferior and nasal walls. RESULTS: A digitized photograph and a Laplacian-filtered image were obtained for each eye to be studied. After processing each stereo pair through a similarity sequential detection-based algorithm, depth measurements are represented as a grey scale image, a contour plot, and a wire mesh, with the boundaries of the optic disc, optic cup and pallor superimposed. Ratios are given of the surface area of pallor to the surface area of the disc and the surface area of pallor to the surface area of the cup, by quadrant. CONCLUSIONS: Determination of surface area of pallor to cup may be useful in detecting early visual field loss in glaucoma and neurological disease.

Adult↗

Multi-conformational peptide dynamics derived from NMR data: a new search algorithm and its application to antamanide.

A search algorithm, called MEDUSA, is presented which allows the determination of multiple conformations of biomolecules in solution with exchange rate constants typically between 10(3) and 10(7) s-1 on the basis of experimental high-resolution NMR data. Multiples of structures are generated which are consistent as ensembles with NMR cross-relaxation rates (NOESY, ROESY), scalar J-coupling constants, and T1 rho measurements. The algorithm is applied to the cyclic decapeptide antamanide dissolved in chloroform. The characteristic radio-frequency field dependence of the T1 rho relaxation rates found for the NH protons of Val1 and Phe6 can be explained by a dynamical exchange between two structures.

Algorithms↗

[Determination algorithms in oscillometric blood pressure measurement].

This paper discusses the method of oscillometric blood pressure determination. A new criterion for systolic pressure and diastolic pressure determination has been proposed, which is based on ratio changes of the oscillation amplitude under a wide normalized range. Primary experiment results show the new criterion is effective.

Algorithms↗

Detection and management of an implantable cardioverter defibrillator lead failure: incidence and clinical implications.

OBJECTIVES: This study evaluated the long-term reliability of an implantable cardioverter defibrillator (ICD) lead to determine the incidence, clinical presentation, and management of lead failure. BACKGROUND: Despite recent advances in ICD technology, the long-term reliability of ICD leads remains a significant problem. METHODS: Concern about long-term reliability of coaxial polyurethane ICD leads caused us to systematically study all patients implanted with Medtronic (Minneapolis, Minnesota) 6936 lead at our institution. We performed follow-up of 74 patients with 76 ICD leads that were implanted from February 28, 1995 to September 8, 1997. Thirty-seven patients underwent routine clinical ICD follow-up testing and ventricular fibrillation induction to determine the status of their ICD lead after a mean follow-up of 68.6 +/- 8.2 months. RESULTS: The lead survival analysis shows a cumulative failure probability of 37% (confidence interval, 24% to 54%) at 68.6 months. Six patients demonstrated a previously undescribed mode of ICD lead failure: prolonged oversensing immediately after shock therapy. The use of short interval counters to monitor nonphysiologic R-R intervals and the measurement of ring-to-coil impedance detected early lead failures in five patients. CONCLUSIONS: This analysis shows: 1) problems with ICD leads may not become apparent until late during follow-up and may become a significant late problem, 2) a "signature" mode of lead failure for the 6936 consisting of oversensing of electrical noise following shocks, 3) early detection of lead failure with a short interval counter algorithm or measurement of ring-to-coil impedance may be clinically useful.

Aged↗

Postmortem radiology of fatal hemorrhage: measurements of cross-sectional areas of major blood vessels and volumes of aorta and spleen on MDCT and volumes of heart chambers on MRI.

OBJECTIVE: Autopsy determination of fatal hemorrhage as the cause of death is often a difficult diagnosis in forensic medicine. No quantitative system for accurately measuring the blood volume in a corpse has been developed. MATERIALS AND METHODS: This article describes the measurement and evaluation of the cross-sectional areas of major blood vessels, of the diameter of the right pulmonary artery, of the volumes of thoracic aorta and spleen on MDCT, and of the volumes of heart chambers on MRI in 65 autopsy-verified cases of fatal hemorrhage or no fatal hemorrhage. RESULTS: Most cases with a cause of death of "fatal hemorrhage" had collapsed vessels. The finding of a collapsed superior vena cava, main pulmonary artery, or right pulmonary artery was 100% specific for fatal hemorrhage. The mean volumes of the thoracic aorta and of each of the heart chambers and the mean cross-sectional areas of all vessels except the inferior vena cava and abdominal aorta were significantly smaller in fatal hemorrhage than in no fatal hemorrhage. CONCLUSION: For the quantitative differentiation of fatal hemorrhage from other causes of death, we propose a three-step algorithm with measurements of the diameter of the right pulmonary artery, the cross-sectional area of the main pulmonary artery, and the volume of the right atrium (specificity, 100%; sensitivity, 95%). However, this algorithm must be corroborated in a prospective study, which would eliminate the limitations of this study. Quantitative postmortem cross-sectional imaging might become a reliable objective method to assess the question of fatal hemorrhage in forensic medicine.

Adolescent↗