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3D PET using a conventional multislice tomograph without septa.

A conventional multislice positron emission tomography scanner was modified to operate without interplane septa to evaluate its performance in collecting and reconstructing data in a three-dimensional (3D) format, thereby significantly increasing system sensitivity. A 3D filtered backprojection algorithm was implemented and tested, using both computer simulations and phantom measurements. No artifacts were apparent in the test images, although the algorithm was shown to lead to a 11% degradation in transaxial resolution in the outer planes. Following septa removal, sensitivity was found to increase by a factor of 7 with an increase in scatter fraction from 16 to 41%. Axial resolution degraded from 6.9 to 7.7 mm full width at half maximum at the center of the field of view. The maximum count rate without septa was 2.4 x 10(5) cps, at a concentration of 0.4 microCi/ml, compared with 1.3 x 10(5) cps at 1.5 microCi/ml with septa. Brain studies were performed with volunteers using 18F-fluorodeoxyglucose, 18F-fluorodopa, and H2 15O to compare noise-equivalent count rates and qualitatively assess image quality over a wide range of imaging conditions.

Algorithms

A noninvasive technique for detecting hypernasal speech using a nonlinear operator.

Speakers with a defective velopharyngeal mechanism produce speech with inappropriate nasal resonance (hypernasal speech). It is of clinical interest to detect hypernasality as it is indicative of an anatomical, neurological, or peripheral nervous system problem. There are various clinical techniques used to determine hypernasality. The current techniques are physically invasive or intrusive to some extent. A preferred approach for detecting hypernasality, would be noninvasive to maximize patient comfort and naturalness of speaking. In this study, a noninvasive technique based on the Teager Energy operator is proposed. Utilizing a property of the Teager Energy operator and a model for normal and nasalized speech, a significant difference between the Teager Energy profile for lowpass and bandpass filtered nasalized speech is shown. This difference is shown to be nonexistent for normal speech. A classification algorithm is formulated that detects the presence of hypernasality using a measure of the difference in the Teager Energy profiles. The classification algorithm was evaluated using a native English speaker population producing front (/i/) and mid (/A/) vowels. Results show that the presence of hypernasality in speech can be reliably detected using the proposed classification algorithm.

Algorithms

External ocular hyperemia: a quantifiable indicator of spacecraft air quality.

BACKGROUND: Eye irritation consistently ranks as a top astronaut complaint but is difficult to measure. Exposure to internal air pollution hypothetically disrupts the eye's tear film, thereby exposing the crewmembers' conjunctivae to the irritating effects of the recirculated, contaminant-laden atmosphere of the space vehicle. Causes elude engineers and toxicologists, who report that measured irritants remain below established Spacecraft Maximum Allowable Concentrations. Lack of objective ocular endpoints stymies efforts to identify etiologies. HYPOTHESIS: Computers offer a practical means of analyzing ocular hyperemia in space. METHODS: We use computer analysis to quantify redness and blood vessels of digitized images of bulbar conjunctivae in near real time. Custom software masks artifacts, lids and lashes for each photographic or telemedicine ocular image, Algorithms then generate semi-independent measurements of hyperemia. Computed difference scores between 34 pairs of images were compared with subjective difference scores as voted on by a panel of ophthalmology residents. RESULTS: Objective data were reliably extracted from ocular images and significantly correlated (r = 0.583, p < 0.05) with subjective scores. CONCLUSIONS: This ground-based methodology generates accurate and reliable ocular endpoint data without mass, volume, or power penalty. To assist in identifying and eliminating onboard ocular irritants, these objective data can be regressed against independent variables such as mission elapsed time, subjective astronaut complaints, levels of chemical and electromagnetic contaminants, nephthelometric and barothermal data. As missions lengthen, sensitive tools such as hyperemia quantification will become increasingly important for assessing and optimizing spacecraft environments.

Adult

Bayesian decision making based on measurements containing errors.

The paper presents a Bayesian approach to the construction of diagnostic and prognostic algorithms, based on the use of several diagnostic factors (tests) in combination. With this approach, the simultaneous use of dichotomous, discrete, categoric, and continuous factors is easy and the resulting algorithms are more efficient than those of other known methods. Moreover, each factor value that is available for use is assumed to represent an estimate (the result of an imperfect measurement) of some (unknown) true value. The proposed method of accounting for measurement errors is advantageous as regards efficiency for users of the algorithm (physicians) if the accuracy of the factor-measurement techniques at their disposal differs from that of the constructor of the algorithm (the scientist). The approach is illustrated by an example, and possible error models and methods of collecting statistical data are discussed.

Algorithms

A geometric algorithm for medical image correlations.

An automatic image correlation algorithm is discussed for the cranial region which is based on the geometric properties of the second moment tensor associated with a volume. The second moment tensor of two identical volumes represented in two different coordinate frames is evaluated to obtain the set of translations, rotations, and anisotropic scaling operators which relate the two coordinate frames. The theory is presented along with a discussion of quantitative error analysis to measure the usefulness of such an algorithm in the clinical setting.

Algorithms

Temperature field estimation using electrical impedance profiling methods. I. Reconstruction algorithm and simulated results.

Algorithmic methods for estimating complete temperature fields during hyperthermia treatments based on surface and internal electrical measurements are presented. The techniques utilized draw upon impedance imaging concepts, but rather than limit the measurements to positions on the body surface, internal impedance recording sites are allowed. Theoretical simulations show that this strategy improves the reconstructed image in the target region when either internal measurement locations are added to a given number of external recording sites or some external measurement locations are replaced by internal recording positions. The algorithms developed are tested on a set of problems with increasing levels of complexity. The culmination of these investigations is a complete simulation of a hyperthermia treatment and reconstruction of a thermal image for a body cross-section of an actual cancer patient. The results of this work suggest that the surface plus internal measurement approach holds some promise as a method for estimating temperature distributions during hyperthermia treatments. However, the simulations while promising are idealizations in that they are two-dimensional with modest levels of additive noise. In a companion paper, we explore the viability of this approach in several laboratory phantom experiments which include both static and heat-induced transient electrical property profiles.

Algorithms

Image analysis techniques for automatic evaluation of two-dimensional electrophoresis.

Techniques for automatic analysis of two-dimensional electrophoresis gels by computer-aided image analysis are described. Original gels or photographic films are scanned using a laser scanner and the files are transferred to a microcomputer. The program package first performs a compression and preevaluation of the files. Spot identification and quantification is performed by the chain code algorithm after appropriate zooming and cutting. Labeling facilitates spot identification and quantification in numerical and graphical (pseudocolor) representation on peripheral devices for camera ready output. Interpolation between measured basepoints is performed by cubic spline algorithms which are automatically switched on and off, depending on the need by the program. High speed analysis and graphic representation is achieved using fast Assembler language routines rather than high level languages. One-dimensional gels can be analyzed using the same software. Spot matching between parallel two-dimensional gels has not yet been implemented.

Electrophoresis, Gel, Two-Dimensional

Principles of morphometric grading.

Grading of the severity of lesions has increased in importance in histopathology. The simplest grading system has 2 grades. If there is variation in the measuring system, the grading will not be perfect, and there are also misgraded samples. We estimated the fraction of falsely graded cases by applying th NAG (Numerical Algorithm Group) Fortran Library. If all possible measurement values are equally probable the grades based on measurements within +/- 1 SD around the division line are false in 31.6% of cases. The corresponding figures for regions +/- 2 SD, +/- 3 SD, 1 to 2 SD, 1 to 3 SD, and 2 to 3 SD are 19.6, 13.3, 7.5, 4.2, and 0.8%, respectively. Detailed calculations were made which allowed accurate determination of the probability of a grade being false in different positions of the measurement scale. The results suggest that for diagnostic grading a borderline region should be defined (e.g. +/- 2 SD or +/- 3 SD around the division line).

Diagnostic Errors

Verification of the heart rate threshold.

Among the methods for determining anaerobic threshold (AT), the heart rate (HR) method seems to be the simplest. On the other hand, many conflicting results from comparing this method with others have been presented over the last 10 years. Therefore, the aim of this study was to compare the heart rate threshold (HRT) with the lactate turn point (LTP)-"second" break point of dependence of lactate (LA) to power output, ventilatory threshold (VT) and threshold determined by electromyography (EMGAT), all determined by the same exercise test and evaluated by the same computer algorithm. A group of 24 female students [mean age 20.5 (SD 1.6) years, maximal oxygen consumption 48.8 (SD 4.7) ml.kg-1.min-1] performed an incremental exercise test on a cycle ergometer (modified Conconi test) starting with an initial power output (PO) of 40 W with intensity increments of 10 W.min-1 until the subjects were exhausted. The HRT, LTP and EMGAT determination was done by computer-aided break-point regression analysis from dependence of functional measures on PO. The same computer algorithm was used for VT determination from the relationship between ventilation (V) and oxygen uptake (VO2) or carbon dioxide output (VCO2).(ABSTRACT TRUNCATED AT 250 WORDS)

Anaerobic Threshold

An inverse approach to determining myocardial material properties.

Passive myocardial material properties have been measured previously by subjecting test samples of myocardium to in vitro load-deformation analysis or, in the intact heart, by pressure-volume relationships. A new method for determining passive material properties, described in this paper, couples a p-version finite element model of the heart, a nonlinear optimization algorithm and a dense set of transmural measured strains that could be obtained in the intact heart by magnetic resonance imaging (MRI) radiofrequency tissue tagging. Unknown material parameters for a nonlinear, nonhomogeneous material law are determined by solving an inverse boundary value problem. An objective function relating the least-squares difference of model-predicted and measured strains is minimized with respect to the unknown material parameters using a novel optimization algorithm that utilizes forward finite element solutions to calculate derivatives of model-predicted strains with respect to the material parameters. Test cases incorporating several salient features of the inverse material identification problem for the heart are formulated to test the performance of the inverse algorithm in typical experimental conditions. Known true material parameters can be determined to within a small tolerance and random noise is shown not to affect the stability of the inverse solution appreciably. On the basis of these validation experiments, we conclude that the inverse material identification problem for the heart can be extended to solve for unknown material parameters that describe in vivo myocardial material behavior.

Algorithms

Performance evaluation of implantable artificial organs by sound spectrum analysis.

In this paper, a sound spectrum analyzing method was proposed to pre detect malfunctions of implantable artificial organs, such as an electromechanical total artificial heart (TAH) or prosthetic valves, without any percutaneous invasion. For this purpose, a sound detecting device was developed using a high sensitivity condenser microphone with a frequency range of more than 13 kHz. Output signals of this device are sampled at 100 kHz maximally, and sampled data are stored in an IBM PC (SamBo, Korea). To remove environmental noises in the measured sound, an adaptive least-mean square algorithm was employed. Using the squared value of the sound signal, the best position where only sounds from mechanical components can be measured was found. The sound spectrum was obtained by the periodogram spectral estimating method. Experiments were performed with this system, and the results indicated that: 1) by using an adaptive noise cancelling algorithm, a more noise-free signal can be obtained; 2) the harmonics from the mechanical components of a pendulum type electromechanical TAH were approximately 1.3 KHz; 3) a spectral change was observed when we compared the power spectral densities of a normal and failed TAH; 4) the spectral shift to higher harmonics occurred with an increase in heart rate; and 5) the sound propagation properties of tissue were investigated with animal experiments. The method proposed was found to be applicable in the detection of implantable artificial organ mechanical failure by sound spectrum analysis without the need for percutaneous invasion.

Acoustics

Jitter correction: a computer algorithm for reduction of the velocity recovery function artifact.

The measurement of neuromuscular jitter in single fiber electromyography may be artifactually raised by a component of interdischarge interval (IDI)-dependent jitter caused by the velocity recovery function (VRF) in muscle fibers. We have developed a computer algorithm for on-line mathematical correction for this artifact, thus improving the reliability of neuromuscular jitter estimates. The method, based on a modeling technique, was validated using intramuscular stimulation in order to either exclude an IDI-dependent component (using regular stimulation) or to include an IDI-dependent component (using pseudorandom stimulation). In 10 normal subjects the distribution of 106 corrected jitter values obtained using voluntary activity showed no difference from the measured values. This finding implies that previously published values for normal jitter are not likely to have been influenced by the VRF effect.

Action Potentials

A new algorithm for the identification of multiple input Wiener systems.

Multiple-input Wiener systems consist of two or more linear dynamic elements, whose outputs are transformed by a multiple-input static non-linearity. Korenberg (1985) demonstrated that the linear elements of these systems can be estimated using either a first order input-output cross-covariance or a slice of the second, or higher, order input-output cross-covariance function. Korenberg's work used a multiple input LNL structure, in which the output of the static nonlinearity was then filtered by a linear dynamic system. In this paper we show that by restricting our study to the slightly simpler Wiener structure, it is possible to improve the linear subsystem estimates obtained from the measured cross-covariance functions. Three algorithms, which taken together can identify any multiple-input Wiener system, have been developed. We present the theory underlying these algorithms and detail their implementation. Simulation results are then presented which demonstrate that the algorithms are robust in the presence of output noise, and provide good estimates of the system dynamics under a wide set of conditions.

Algorithms

EIT image reconstruction using sensitivity weighted filtered backprojection.

A set of specifications thought useful to advance the utility of electrical impedance tomography as a clinical imaging modality is proposed, together with an approach to image reconstruction designed to fulfil these specifications. Computer simulations are used to investigate the performance of this reconstruction approach on simple, known, impedance distributions and to develop the method to the stage of a complete reconstruction algorithm. The algorithm is then tested on data sets produced by measurements on a physical phantom, and on a set of measurements made on a volunteer human subject.

Algorithms

Real-time tracking of parameters of lung mechanics: emphasis on algorithm tuning.

We consider the problem of tracking rapid changes in the viscous and elastic properties of the respiratory system by using mouth flow and transpulmonary pressure data measured during mechanical ventilation. A recursive least-squares algorithm with adjustable compensator is used for online estimation of an R-C model of the breathing mechanics. Specific simulation experiments are presented to provide guidelines to select suitable values for the key variable, which controls the compromise between tracking ability and noise sensitivity. The results obtained confirm the critical role of the optimum tuning in relation to the noise level. Experimental results obtained from data measured on mechanically-ventilated dogs, in which respiratory distress syndrome was intravenously induced by oleic acid, demonstrate that the tuned algorithm is able to track appropriately both the viscous and elastic properties of lung mechanics. Parameter estimates are consistent with those obtained by standard and robust offline algorithms and their time course is in qualitative agreement with known physiopathological behaviour.

Airway Resistance

A fast spot segmentation algorithm for two-dimensional gel electrophoresis analysis.

An important issue in the automation of two-dimensional gel electrophoresis image analysis is the detection and quantification of protein spots. A spot segmentation algorithm must detect, define the extent of, and measure the integrated density of spots under a wide variety of actual gel image conditions. Besides these functions, the algorithm must be memory efficient to be able to process very large gel images and do this in a reasonable amount of computation time on low-cost computers, such as workstations and personal computers. We have developed a fast spot segmentation algorithm, extending the GELLAB-II segmenter, which extracts spots in a single raster scanning pass through the gel image. The performance analysis of the algorithm will be given in the paper as well as a discussion of the algorithm.

Algorithms

Closed-loop control of airway occlusion pressure at 0.1 second (P0.1) applied to pressure-support ventilation: algorithm and application in intubated patients.

OBJECTIVE: Airway occlusion pressure at 0.1 sec (P0.1) is an index of respiratory center output. During pressure-support ventilation, P0.1 correlates with the mechanical output of the inspiratory muscles and has an inverse relationship with the amount of pressure-support ventilation. Based on these observations, we designed a closed-loop control which, by automatically adjusting pressure-support ventilation, stabilizes P0.1, and hence patient inspiratory activity, at a desired target. The purpose of the study was to demonstrate the feasibility of the method, rather than its efficacy or even its influence on patient outcome. DESIGN: Prospective, randomized trial. SETTING: A general intensive care unit of a university hospital in Italy. PATIENTS: Eight stable patients intubated and ventilated with pressure-support ventilation for acute respiratory failure. INTERVENTIONS: Patients were transiently connected to a computer-controlled ventilator on which the algorithm for closed-loop control was implemented. The closed-loop control was based on breath by breath measurement of P0.1, and on comparison with a target set by the user. When actual P0.1 proved to be higher than the target value, the P0.1 controller automatically increased pressure-support ventilation, and decreased it when P0.1 proved to be lower than the target value. For safety, a volume controller was also implemented. Four P0.1 targets (1.5, 2.5, 3.5, and 4.5 cm H2O) were applied at random for 15 mins each. MEASUREMENTS AND MAIN RESULTS: The closed-loop algorithm was able to control P0.1, with a difference from the set targets of 0.59 +/- 0.27 (SD) cm H2O. CONCLUSIONS: The study shows that P0.1 can be automatically controlled by pressure-support ventilation adjustments with a computer. Inspiratory activity can thus be stabilized at a level prescribed by the physician.

Acute Disease

Variceal hemorrhage.

Figure 2 is the algorithm followed in our institution for management of acute variceal hemorrhage. A small percentage of patients who present with active variceal hemorrhage will stop bleeding after gastric lavage alone. However, most patients require an intravenous vasopressin infusion at a dose of 0.4 units per minute, preferably combined with intravenous administration of nitroglycerin. Although glypressin and somatostatin may be associated with fewer side effects than vasopressin, the superiority of these drugs remains to be determined. Whether pharmacologic therapy succeeds or fails, most patients then proceed to endoscopic sclerotherapy. Sclerotherapy may be used as a temporizing measure in preparation for elective surgery or as a long-term, definitive treatment for prevention of recurrent hemorrhage. Balloon tamponade is reserved for patients who are bleeding too rapidly for effective sclerotherapy and for sclerotherapy failures in preparation for emergency surgery. Because recurrent hemorrhage frequently occurs after balloon deflation, a more definitive treatment (surgery or endoscopic sclerotherapy) should be planned for all patients who undergo balloon tamponade. Because operative risk is unacceptably high for patients with hepatic functional decompensation secondary to variceal hemorrhage, we believe that a policy of routine emergency surgery is unwise. Rather, emergency surgical intervention is reserved for the relatively small number of patients (15 to 25 per cent) who continue to bleed after nonoperative options have failed. Shunt surgery should be considered early in the course of patients with bleeding secondary to gastric varices and portal hypertensive gastropathy, both of which respond poorly to nonoperative measures.

Algorithms