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Management and clinical utilization of computed tomography, magnetic resonance imaging, and angiography in Hokkaido University Hospital picture archiving and communication system.

We made a preliminary assessment of the Hokkaido University picture archiving and communication system (HU-PACS). Data access time from either imaging machines or data base to workstations was 1.5 minutes, which is great benefit for data communication in routine examinations. Image quality of the work station was estimated in terms of brain computed tomography (CT) and digitized cerebral angiograms. Cerebral infarction was definitely observed on the cathode-ray tube (CRT) monitor of the work station. Although the picture quality of CRT was acceptable, we had to manipulate window level and width for CRT diagnosis of cerebral angiography. Data compression was routinely used without significant degradation of those image quality. Nevertheless, further improvement of maneuverability of the workstation should be considered.

Angiography, Digital Subtraction

High pressure volumetric measurements in dipalmitoylphosphatidylcholine bilayers.

The one previously reported high pressure volumetric experiment on a phospholipid bilayer investigated a region of pressure between 0 and 25 MPa and obtained isothermal compressibility values for the liquid crystal and intermediate phases which differed by more than a factor of ten. We report new volumetric measurements around the main transition in dipalmitoylphosphatidylcholine (DPPC) from 0 to 100 MPa. The isothermal compressibility data for the two phases are of the same order of magnitude, and the experimentally determined coexistence curve, specific volume dependence, and volume discontinuity values are compared with the predictions of the phenomenological theory according to Sugar and Tarjan ((1982) Sov. Phys. Crystallogr. 27, 4-5). Significant discrepancies between this theory and experiment are found. Finally, the data indicate that steric interactions play a more dominant role in the main transition of phospholipid bilayers than in transitions in most thermotropic liquid crystals.

Atmospheric Pressure

A computer feedback system for clinical research.

This paper presents a computerized data base management and information retrieval system for a heroin addiction research clinic, which has potential application for any type of clinical research. It describes data input checking programs, file structures, and output programs. The system contains several interesting features: built-in feedback error detection and correction; patient month matrix formatting and data compression; and a virtual blocking system to reduce the size of the files.

Computers

Power spectral analysis of normal and pathological brainstem auditory evoked potentials.

The brainstem auditory evoked potential (BAEP) recording has become a powerful investigational tool in neurological diagnosis. The BAEPs of patients have different latencies and morphologies when compared to those of normals. In this paper the power spectra (PS) of BAEPs of 21 normals, 17 patients with multiple sclerosis (MS) and 12 patients with head injury (HI) computed by Blackman-Tukey (BT) and Maximum Entropy (ME) methods are examined for their frequency composition. Three major peaks appear at approximately 170 Hz, 520 Hz and 950 Hz in PS of normal BAEPs. The average power contained in the frequency bands spread around these frequency bands for BAEPs of patients differed significantly (P less than 0.05) from those of normal BAEPs. The peaks observed in ME spectra were found to match those computed using BT method. The model order for representing both normal and patient BAEPs is greater than 40 and data compression afforded by modelling the BAEPs is of the order of 5:1.

Adolescent

The CODATA/IUIS Hybridoma Data Bank: development of a hybrid system to handle complex data relationships.

System design for the Hybridoma Data Bank, a database of comprehensive information on immunoreagents for use by scientists in diverse disciplines, is described. Unique problems include: use of nomenclature from diverse fields that is neither static nor standard; the need for two representations of the database--textual for readability and numeric for complex search capabilities, analysis and data compression; and a method of translating between the two representations of the database.

Animals

Assessing the evolution of the evoked potential average: a new color display method.

A new method to control the averaging process and to check the stability of evoked potential (EP) components is described. The principle of the method is based on the display of the consecutive averages of the EP after each stimulus in a color-coded picture. In this way the evolution of the process is visualised instead of only the last average. The colors are assigned according to the amplitudes. The resulting picture initially consists of erratic colors. However, with increasing numbers of stimuli, tracks of one color soon emerge, indicating stable components. The number of stimuli necessary to generate a stable peak and the duration of stability can easily be quantified. Details with regard to the methods of extraction of essential data and data compression to record the picture are described. The color display method was evaluated with the analysis of 18 somatosensory evoked potentials and 17 visual evoked potentials of controls and 33 EPs of 18 patients. It is shown that this method preserves essential information about the averaging process: the stability of the EP components can be quantified and consequently the optimum number of stimuli to be applied. Furthermore, 14 of the 33 patient recordings showed artifacts, which could be traced with the average-evolution method, but not from the final average alone.

Color

Non-linear CT windows.

The display of computerized tomographic (CT) data requires data compression because of the limited shades of grey which the eye can differentiate. This may lead to information loss which can be minimized by a more efficient utilization of the available levels of grey than that afforded by conventional linear windows. Automated histogram equalization for grey level assignment has not been satisfactory because of the underlying assumption that the information content at any given CT level is proportional to the number of pixels at that level. For four different anatomic regions; the lumber spine, abdomen, brain and chest, an empiric graph of the clinical information content vs CT levels was integrated to yield the shape of a graph assigning shades of grey vs CT level i.e. a non-linear window. This non-linear window curve was utilized in the same manner as the linear window, namely the window center and width were under the direct control of the observer through the window center and width knobs. Each non-linear window was implemented on images of its anatomic region and interactively optimized on the screen till a maximal display of information was obtained. These optimal non-linear windows compared favorably with linear windows in most cases. This method provides the means to display more information on a CT image with no extra processing time, additional equipment or special training.

Brain

Image manipulation: digital versus analog.

A conceptual difference between "analog" and "digital" digitizing is reviewed. Analog and digital type image filing systems are discussed from a comparative point of view: The analog type is advantageous in the number of recordable images, the recording and reproducing speed, and the ability to record a moving picture, while the digital type, in which images are digitized when recorded, is capable of reproducing a higher quality image that does not deteriorate when copied repeatedly. It has the advantage that it easily interfaces with computer systems. As technology developed to compensate for the drawbacks of the digital type systems, image data compression was introduced. Finally, the possibility for recording a moving picture in a digital type system is discussed.

Image Processing, Computer-Assisted

High-resolution facial feature saliency mapping.

For recognition of a target there must be some form of comparison process between the image of that target and a stored representation of that target. In the case of faces there must be a very large number of such stored representations, yet human beings seem able to perform comparisons at phenomenal speed. It is possible that faces are memorized by fitting unusual features or combinations of features onto a bland prototypical face, and such a data-compression technique would help to explain our computational speed. If humans do indeed function in this fashion, it is necessary to ask just what are the features that distinguish one face from another, and also, what are the features that form the basic set of the prototypical face. The distributed apertures technique was further developed in an attempt to answer both questions. Four target faces, stored in an image-processing computer, were each divided up into 162 contiguous squares that could be displayed in their correct positions in any combination of 24 or fewer squares. Each observer was required to judge which of the four target faces was displayed during a 1 s presentation, and the proportion of correct responses for each individual square was computed. The resultant response distributions, displayed as brightness maps, give a vivid impression of the relative saliency of each feature square, both for the individual targets and for all of them combined. The results, while broadly confirming previous work, contain some very interesting and surprising details about the differences between the target faces.

Adult

Evaluation of routine telephone transmission of nuclear medicine studies.

Rapid and reliable transmission of nuclear medicine studies using conventional telephone lines and commercially available modems and computer systems has been accomplished through use of software developed within the authors' hospital. Original digital images of all-night and weekend studies, acquired on any of the acquisition computers from different manufacturers, are now routinely sent for remote reading at the physician's home. Data, software, and letters are routinely exchanged using modems and standard telephone lines with a sister institution in Haifa, Israel. The software has been designed to achieve no loss data compression and minimal turnaround time loss. Thus, an average lung perfusion image or gallbladder study requires about 1-3 minutes of transmission time. Full analysis and display software is available on the remote computer.

Computer Communication Networks

Radiological image compression: full-frame bit-allocation technique.

A full-frame bit-allocation technique has been developed for radiological image compression based on encoding the cosine transform of the image. Six different types of diagnostic images were used to examine this technique, and the results have been encouraging. Reconstructed images from compressed-image data with compression ratios of 4:1, 8:1, 12:1, and 16:1 did not have excessive visual degradation. It is concluded that this technique is suitable for diagnostic image compression.

Computers

Foot strike and the properties of the human heel pad.

Many force-plate records of human locomotion show an impulse (the foot strike) shortly after ground contact. The authors' hypothesis is that this results from the rapid deceleration of a mass (the 'effective foot') under forces which compress the heel pad. The quantitative implications are investigated through an illustrative calculation. The observations used are (a) the peak force reached in foot strike (b) the vertical velocity of the foot immediately before ground contact and (c) the properties of the heel pad in compression. Data for (a) and (b) are available in the literature; measurements for (c) are presented here. The deductions are: (a) the time taken to reach peak force is about 5.4 ms, which agrees with published measurements; (b) the mass of the effective foot is about 3.6 kg. The effective foot thus includes a substantial portion of the leg: this seems reasonable. The models used for the calculations clarify the relationship between the foot strike and the shock wave, which it generates.

Biomechanical Phenomena

Background of the demonstrated IMAGIS activities and future expectations.

In The Netherlands a national PACS development programme has been started, supported by the Dutch Society of Radiology and funded by the Dutch Department of Health because of the national character of the project. Three main partners are cooperating in this development: the Utrecht University Hospital (AZU), BAZIS and Philips International (Product Division Medical Systems), with the Delft University of Technology as the main BAZIS subcontractor. The non-profit foundation BAZIS, developing and supporting the ZIS Hospital Information System (in use in some 30 Dutch hospitals, over 15,000 acute beds), initiated its current IMAGe Information System (IMAGIS) projects in 1984. The activities were later integrated into the Dutch PACS project started in 1986. The final goal of the project is to achieve a PACS which is fully integrated with already existing hospital information systems (HIS). The development and operation of a HIS-PACS include many aspects of technical and clinical. The current efforts of BAZIS are concentrated on three main issues: diagnostic image quality evaluation (e.g. effects of data compression); modelling, software simulation and technology assessment of a prototype PACS (both general and detailed aspects); and coupling and integration of PACS and HIS (e.g. the BAZIS ZIS). Philips, Hamburg, is supplying equipment, particularly prototype components. A systematic clinical evaluation will take place at the Utrecht University Hospital.2+ We outline the background of the intermediate results as demonstrated during the 6th EuroPACS Conference:the psychophysical software package for Feature Evaluation And System Inspection By Logged Experiments (FEASIBLE); the modelling and simulation software package for Medical Image Representation, Archiving and Communication, Learned by Extensive Simulation (MIRACLES); and first results of the coupling experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks

[Thyroid carcinoma as cystic nodule. The diagnostic role of cytology by needle aspiration].

195 patients affected by a cystic thyroid lesion were studied by a Fine Needle Aspiration biopsy (FNAb). 42 patients were operated on account of clinical data, compressive phenomena or cytologic results suggesting a neoplasia. Out of the operated patients, 3 were affected by a carcinoma in the cystic lesion (one "pure" cystic nodule and two "mixed" ones), while three more patients with multinodular goiters showed a carcinomatous lesion in a nodule different from the cystic one. Macroscopic characteristics of the aspirated fluid (quantity and quality) didn't affect the cytologic diagnosis. Cytology was useful in the preoperative diagnosis of benign thyroid nodules (only two false positives out of 42 patients) and was diagnostic in all the three patients affected by a carcinoma in the cystic nodule.

Adolescent

Digital imaging and picture archiving and communication systems.

Great progress has been made in digital imaging of the chest. Most studies are dealing with computed radiography. Chest radiography in the intensive care unit may, in most cases, be performed using computed radiography. However, subtle pulmonary interstitial disease can be demonstrated less confidently using computed radiography. Significantly better detection of calcified lung nodules can be obtained by using simplified single-exposure dual-energy technique that uses storage phosphor. The wide latitude of computed radiography permits images of high quality in areas other than chest radiography. Encouraging results are presented especially in the diagnostic evaluation of scoliosis and other musculoskeletal abnormalities. An important technical innovation in digital radiography is an improved method for single-exposure dual-energy digital imaging using prefiltration with gadolinium, a cassette consisting of four photostimulable phosphor plates, spatially dependent scatter and beam hardening corrections, and noise reduction algorithm. Other groups tested algorithms for enhancement of digital images that allowed significant data compression. The implementation of picture archiving and communication systems (PACS) is inevitable; the question concerning PACS implementation is not why, but when. A comparison of the cost-effectiveness of PACS with conventional film archiving and communication systems shows that PACS should provide indirect savings when regarding the hidden costs of conventional systems. Much more experience will be needed before there is general agreement on the best design for the radiologist's workstation. Teleradiology should contribute to radiologic consultation for remote locations, because it improves the efficacy of management of patients in such locations.

Child

Shape description in osteology using automatic Fourier analysis. Example of the human atlas.

An image analysing procedure for the shape characterisation in osteology is described. We used expansion in Fourier series of an equiangular polar representation of the contour. Fourier analysis is an information preserving technique, and it is therefore possible to reconstruct the original contour from the shape descriptors (Fourier coefficients and descriptors). The properties of the truncated expansion of the Fourier series can be used for smoothing effect and noise reduction, for interpolated reconstruction, and for data compression. Fourier analysis also allows a quantitative description of the shape. The first components describe the gross feature, the following ones the fine details.

Cervical Atlas

[Diagnostic limitations of isolated axiography interpretation].

Axiographic images of eccentric condylar paths can be more reliably interpreted by considering the clinical function data, compression test results and the MPI. In the case presented the abnormal position of the right condyle would have gone unnoticed without such a combined approach to the problem.

Cephalometry

Towards a digital model for an electron-microscope image.

An image model is defined based on the boundaries between image regions with different textures and series of descriptions of those textures. Six models of texture are studied under the categories of pixel-based and region-based models. Several techniques for the determination of the unit-cell of textures are presented. The model is applied to the consideration of (a) image correction, (b) the classification of image texture, (c) image enhancement including averaging of detail in periodic specimens, and (d) image data compression. A floating point format, which provides a significant simplification for the Huffman code, is also introduced.

Algorithms