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Neuromonitoring of an experimental model of clip compression on the spinal nerve root to characterize acute nerve root injury.

OBJECTIVES: To evaluate the sensitivity of an electro-monitoring method in acute nerve root injury, and to determine a proposed criterion for irreversible electrophysiologic degradation. STUDY DESIGN: Acute nerve root injury was induced by a clip compression model in rabbits, mimicking nerve root injury by a transpedicular screw. A common neuromonitoring technique, spinal somatosensory-evoked potential, was used to study the electrophysiologic change during the procedure. SUMMARY OF BACKGROUND DATA: With the advent of the transpedicular screw system, increased risk of injury to the spinal root because of the passage of screws is not unexpected. Although both an experimental model and a clinical application in intraoperative neuromonitoring of spinal cord function have been established, the value of neuromonitoring of an acute spinal root injury remains obscure. Several neurophysiologic surveillance techniques have been used successfully to monitor the potential injury to the spinal cord during orthopedic procedures around the spinal cord and spinal column. Spinal somatosensory-evoked potential, which has the advantages of high amplitude and quick recording time, is used to detect nerve root impairment during the insertion of transpedicular screws. METHODS: Experimental acute nerve root injury was induced in rabbits by direct hemostatic clip compression on the nerve root (S1) during different time intervals. Spinal somatosensory-evoked potential elicited by stimulating the sciatic nerve and recorded from a needle electrode at the L6-L7 interspinous ligament was monitored immediately before and after compression. RESULTS: Spinal somatosensory-evoked potential is sensitive enough to detect the compromise of a single nerve root and that a decrease in the amplitude is the most reliable and sensitive sign. With this model, there was a statistically significant correlation between the compression time and reduction of amplitude and delay of latency. The criterion for irreversible electrophysiologic change was an amplitude loss of more than 20% and a delay in latency immediately after nerve root compression. CONCLUSIONS: It was concluded that spinal somatosensory-evoked potential can provide immediate feedback of nerve root injury and should be considered for use during the dynamic phase of transpedicular screw insertion.

Animals↗

Injuries in the adolescent porcine spine exposed to mechanical compression.

STUDY DESIGN: An experimental porcine study in which functional lumbar spinal units were tested in compression to failure. Biomechanical, radiographic, magnetic resonance imaging, and histological characteristics are described. OBJECTIVES: To explain the different patterns of injury seen in adults and adolescents resulting from traumatic injury to the vertebrae and to explain the mechanism behind traumatic displacement of the ring apophysis seen in athletes. SUMMARY OF BACKGROUND DATA: Recent investigations of the spine in adolescent who have sustained trauma have shown injuries to the growth zone, whereas studies of adults have shown injuries to the vertebral body. A higher frequency of abnormalities in the discs, the vertebral bodies, the endplates, and the ring apophyses has been demonstrated in athletes with high loads on the spine. There is controversy over the etiology of these changes. METHODS: Twelve functional lumbar spinal units (vertebra-disc-vertebra) obtained from six young male pigs were tested in compression to failure. All units were examined with plain radiography and magnetic resonance imaging before and after compression. After the compression, histologic samples were taken from the injury site. RESULTS: Identical traumatic changes were seen in all functional lumbar spinal units, i.e., fracture in the endplate through the growth zone posteriorly and displacement of the anulus fibrosus with a bony fragment at the point of insertion of the vertebra. The nucleus pulposus was ruptured and displaced through the fracture line in all cases. The injuries were not seen on radiographs but were detected on magnetic resonance images, as confirmed on microscopic and histologic examination. CONCLUSION: This study shows that the weakest part of the lumbar spine of the juvenile pig, when compressed, is the growth zone and the junction between the point of insertion of the anulus fibrosus and the vertebra. This location of weakness may explain the high frequency of disc degeneration and "persisting apophysis" seen in the spine of athletes.

Animals↗

Vertebral synovial osteochondromatosis with compressive myelopathy.

STUDY DESIGN: A case report of vertebral synovial osteochondromatosis with compressive myelopathy. OBJECTIVES: To describe the clinical, radiologic, and histopathologic features of vertebral facet synovial osteochondromatosis with compressive myelopathy. SUMMARY OF BACKGROUND DATA: There has been only one previously reported case of synovial osteochondromatosis affecting the vertebral facet joint and no previous report of associated compressive myelopathy. METHODS: The case history, radiology, surgical findings, and histopathology are reviewed. RESULTS: Vertebral facet synovial osteochondromatosis is a potential and readily manageable cause of spinal cord compression. CONCLUSIONS: Synovial osteochondromatosis of the vertebral facet joint should be considered as a cause of compressive myelopathy.

Chondromatosis, Synovial↗

Sciatica caused by cervical and thoracic spinal cord compression.

STUDY DESIGN: Two case reports of sciatica that was considered to be caused by cervical and thoracic spinal cord compression. OBJECTIVES: To point out that sciatica can be an initial major symptom in patients with cervical or thoracic spinal cord lesions. SUMMARY OF BACKGROUND DATA: Usually, tract pain caused by cord compression is considered to be diffuse and does not resemble sciatica. METHODS: Medical history, physical findings, and the results of imaging studies were reviewed in one case of cervical cord tumor and one case of thoracic kyphosis. RESULTS: In both cases, sciatica was the initial and major symptom. Imaging studies showed no lesion in the lumbar spine. In one patient, a cervical dumbbell tumor was found to compress the cervical cord, and in the other the spinal cord was severely compressed at the thoracic kyphosis. The sciatica disappeared immediately after decompression surgery in both cases. CONCLUSIONS: Leg pain resembling sciatica can be caused by cord compression at the cervical and thoracic level. Thoracic kyphosis may be a causative factor in sciatica, in addition to spinal cord tumor and disc herniation, which have been reported previously.

Adult↗

Segmental stability and compressive strength of posterior lumbar interbody fusion implants.

STUDY DESIGN: Human cadaveric study on initial segmental stability and compressive strength of posterior lumbar interbody fusion implants. OBJECTIVES: To compare the initial segmental stability and compressive strength of a posterior lumbar interbody fusion construct using a new cortical bone spacer machined from allograft to that of titanium threaded and nonthreaded posterior lumbar interbody fusion cages, tested as stand-alone and with supplemental pedicle screw fixation. SUMMARY OF BACKGROUND DATA: Cages were introduced to overcome the limitations of conventional allografts. Radiodense cage materials impede radiographic assessment of the fusion, however, and may cause stress shielding of the graft. METHODS: Multisegmental specimens were tested intact, with posterior lumbar interbody fusion implants inserted into the L4/L5 interbody space and with supplemental pedicle screw fixation. Three posterior lumbar interbody fusion implant constructs (Ray Threaded Fusion Cage, Contact Fusion Cage, and PLIF Allograft Spacer) were tested nondestructively in axial rotation, flexion-extension, and lateral bending. The implant-specimen constructs then were isolated and compressed to failure. Changes in the neutral zone, range of motion, yield strength, and ultimate compressive strength were analyzed. RESULTS: None of the stand-alone implant constructs reduced the neutral zone. Supplemental pedicle screw fixation decreased the neutral zone in flexion-extension and lateral bending. Stand-alone implant constructs decreased the range of motion in flexion and lateral bending. Differences in the range of motion between stand-alone cage constructs were found in flexion and extension (marginally significant). Supplemental posterior fixation further decreased the range of motion in all loading directions with no differences between implant constructs. The Contact Fusion Cage and PLIF Allograft Spacer constructs had a higher ultimate compressive strength than the Ray Threaded Fusion Cage. CONCLUSIONS: The biomechanical data did not suggest any implant construct to behave superiorly either as a stand-alone or with supplemental posterior fixation. The PLIF Allograph Spacer is biomechanically equivalent to titanium cages but is devoid of the deficiencies associated with other cage technologies. Therefore, the PLIF Allograft Spacer is a valid alternative to conventional cages.

Bone Screws↗

Spinal radiation before surgical decompression adversely affects outcomes of surgery for symptomatic metastatic spinal cord compression.

STUDY DESIGN: A retrospective chart review was performed. OBJECTIVE: To determine whether preoperative spinal radiation increases the number of major wound complications in patients with cancer who have symptomatic spinal cord compression. SUMMARY OF BACKGROUND DATA: Many factors have increased the number of patients hospitalized with symptomatic spinal cord compression after spinal irradiation. The surgical management of metastatic spinal cord compression may be complicated by preoperative radiation. METHODS: A retrospective review of 123 patients admitted with symptomatic metastatic spinal cord compression from 1970 through 1996 was conducted. The final study population of 85 patients was separated into three treatment groups: 1) radiation only, 2) radiation followed by surgery, and 3) de novo surgery followed by radiation. RESULTS: The major wound complication rate for patients who had radiation before surgical decompression and stabilization was 32%, or threefold, higher than the 12% observed in patients who had de novo surgery (P < 0.05). No other clinical factor or condition predicted the development of a major wound complication. Patients treated initially with surgery had superior functional outcomes in an analysis stratified by Frankel grade (P < 0.05). Of the ambulatory patients who underwent de novo surgery, 75% remained ambulatory and continent 30 days after treatment, whereas only 50% of those treated with radiation before surgery had similar outcomes. CONCLUSIONS: Spinal radiation before surgical decompression for metastatic spinal cord compression is associated with a significantly higher major wound complication rate. In addition, preoperative spinal irradiation might adversely affect the surgical outcome.

Adult↗

Lumbar spine mechanical response to axial compression load in vivo.

STUDY DESIGN: Lumbar spine kinematic response to a 1.0 body weight compressive load was measured in vivo by comparison of relaxed and loaded magnetic resonance image sets in the sagittal plane. OBJECTIVES: To identify and measure acute response mechanisms of the lumbar spine during compression loading. SUMMARY OF BACKGROUND DATA: The isolated ligamentous spine buckles under small loads (88 N); yet, the spine supports >10 times that load in daily activities. Mechanical function of the lumbar spine in vivo is not well understood, and only a few studies examined the spine during in vivo loading. METHODS: Magnetic resonance imaging scans of subjects were taken while subjects were relaxed and while supporting a 1.0 body weight compressive load. Vertebral bodies and disc perimeters were digitized, and relative centroid positions were measured and compared between conditions. Lumbar rotation, bending, compression, and disc translation were determined. Two parameter ensembles were analyzed to describe mechanisms of "spine shrinkage" (decrease of projected spine length) and lumbosacral response. RESULTS: All subjects underwent spine shrinkage (-3.9 +/- 1.2 mm) dominated by cumulative bending, except in three subjects where the rotation component dominated. Levels L2-L4 extended, while L5 flexed, and dL2 through dL4 translated anterior, while dL5 translated posterior. Significant segmental deformations were as follows: L3 extension (-3.3 +/- 3.1 degrees ), dL5 disc translation (-1.4 +/- 1.4 mm), and posterior sacral rotation (3.2 +/- 4.7 degrees ). CONCLUSIONS: Spine shrinkage occurred mainly from spine bending and rotation, with only small contribution from spine compression (shortening along the spine curvature). Response pattern groupings indicated at least two unique subgroups, but the cause remains to be determined.

Adult↗

Mechanical evidence of cervical facet capsule injury during whiplash: a cadaveric study using combined shear, compression, and extension loading.

STUDY DESIGN: A comparison of cervical facet capsule strain fields in cadaveric motion segments exposed to whiplash-like loads and failure loads. OBJECTIVES: To compare the maximum principal strain in the facet capsular ligament under combined shear, bending, and compressive loads with those required to injure the ligament. SUMMARY OF BACKGROUND DATA: The cervical facet capsular ligament is thought to be an anatomic site for whiplash injury, although the mechanism of its injury remains unclear. METHODS: Motion segments from seven female donors were exposed to quasi-static flexibility tests using posterior shear loads of 135 N applied to the superior vertebra under four compressive axial preloads up to 325 N. The right facet joint was then isolated and failed in posterior shear loading. The Lagrangian strain field in the right facet capsular ligament was calculated from capsular displacements determined by stereophotogrammetry. Statistical analyses examined the effect of axial compression on motion segment flexibility, and compared maximum principal capsular strain between the flexibility and failure tests. RESULTS: Capsular strain increased with applied shear load but did not vary with axial compressive load. The maximum principal strain reached during the flexibility tests was 61% +/- 33% of that observed in subcatastrophic failures of the isolated joints. Two specimens reached strains in their flexibility tests that were larger than their corresponding strains at subcatastrophic failure in the failure tests. CONCLUSIONS: The cervical facet capsular ligaments may be injured under whiplash-like loads of combined shear, bending, and compression. The results provide a mechanical basis for injury caused by whiplash loading.

Cadaver↗

Pathomechanisms of nerve root injury caused by disc herniation: an experimental study of mechanical compression and chemical irritation.

STUDY DESIGN: An electrophysiologic and histologic study on nerve roots after mechanical compression and/or local application of nucleus pulposus (NP) was performed. OBJECTIVE: To assess the effects of mechanical compression and/or chemical irritation caused by NP. SUMMARY OF BACKGROUND DATA: It has been shown that application of NP to nerve roots without compression induces histologic and functional changes in nerve roots and the dorsal root ganglia. In clinical situations, however, mechanical compression has also been considered an important factor in disc herniation. METHODS: Eighteen dogs (9-15 kg) were used in this study. Four groups were used to assess the effect of each factor: 1) sham group (n = 3); 2) NP group (NP applied under the S1 lamina) (n = 5); 3) comp group (a plastic balloon placed under the S1 lamina) (n = 5); and 4) comp+NP group (a balloon and NP placed under the S1 lamina) (n = 5). Ascending cauda equina action potentials (CEAPs) and cauda equina-sensory nerve conduction velocity (SCV) were recorded before, immediately after, and 1 week after treatment. Histologic changes were also assessed by light microscopy. RESULTS: There were no significant differences in CEAP and SCV among the four groups immediately after the treatment. However, 1 week after treatment, the amplitudes in the NP group, comp group, and comp+NP group were statistically significantly lower compared with those in the sham group. The comp+NP group showed significantly lower amplitude than did the NP group and comp group. Immediately after treatment, SCV in the NP group and comp group did not show significant differences compared with that in the sham group. However, 1 week after treatment, SCV in the comp+NP group was significantly lower compared with that in the sham group. Histologic changes such as intraneural edema, Schwann cell edema, and nerve fiber injury seemed to be more pronounced in the comp+NP group than in the other groups. CONCLUSIONS: It was shown that each of the assessed factors induces nerve dysfunction. However, the combination of mechanical compression (mass effect of herniated NP) and chemical irritation (inflammation around nerve root) may induce more nerve root injury than each factor per se.

Animals↗

Cervical cord compression in an elderly patient with Hurler's syndrome: a case report.

STUDY DESIGN: A case of cervical cord compression in an elderly lady with Hurler's syndrome is reported. OBJECTIVE: To report the occurrence of cervical cord compression in a 56-year-old patient of Hurler's syndrome, making her the oldest patient with Hurler's. The case report also highlights the appropriate management that could be given to this group of difficult patients. SUMMARY OF BACKGROUND DATA: The literature on Hurler's syndrome is reviewed in terms of long-term survival and surgical management of spinal compression. No report in the literature describes cervical spine decompression in Hurler's syndrome in a patient this old. METHOD: Clinical and radiologic features of Hurler's induced cervical cord compression are described. Pathologic changes of Hurler's myleopathy are also reported. RESULTS: The patient underwent cervical spine decompression and tolerated the procedure well. The patient was able to mobilize free of the wheel chair and showed significant neurologic recovery. CONCLUSION: The case report highlights the success of surgery in Hurler's induced cervical cord compression. It also adds to the literature the oldest patient of Hurler's syndrome to undergo any form of spinal surgery.We present here a 59-year-old lady with Hurler's syndrome, who underwent a successful cervical spine decompression and stabilization for cervical myelopathy. At 59 years of age, she was the oldest case of Hurler's to undergo spinal surgery. The case highlights the importance of undertaking major spinal surgeries in these difficult inherited disorders with reasonable success, as against common belief.

Cervical Vertebrae↗

Primary and secondary osteoporosis' incidence of subsequent vertebral compression fractures after kyphoplasty.

STUDY DESIGN: Retrospective review of prospective database. OBJECTIVES: Define the incidence of adjacent and remote fractures after kyphoplasty vertebral augmentation, and identify vulnerable subpopulations at increased risks. SUMMARY OF BACKGROUND DATA: Painful osteoporotic compression fractures can be effectively treated with methyl methacrylate vertebral augmentation, but the effect of intervention on the generation of future remote and adjacent fractures has not been identified. No paper has analyzed the association of long-term steroid use to subsequent compression fractures. METHODS: A total of 175 patients were treated for compression fractures, from October 1999 to November 2001, 60 patients were excluded due to insufficient follow-up (less than 3 months) or malignancy related fracture. The remaining 115 patients' charts and radiographs were then individually analyzed. New fractures were identified based on changes from baseline imaging studies (). Demographic information, vertebral levels treated, adjacent fractures, and remote fractures underwent statistical analyzed (P < 0.05). RESULTS: A total of 225 vertebral bodies were treated in 115 patients using the kyphoplasty technique; of those, 26 patients developed 34 subsequent compression fractures. The mean follow-up was 11 months (range, 3-33 months). The incidence of subsequent fracture per procedure per kyphoplasty was 15.1% (34 of 225), overall incidence per patient was 22.6% (26 of 115). There were 80 patients with primary osteoporosis and 35 patients with secondary steroid-induced osteoporosis. These populations were similar in terms of demographics, single or multiple sites, along with two or three adjacent levels treated. Seventeen of the 26 (65%) patients with subsequent fracture had secondary steroid-induced osteoporosis, while only 9 of the 26 (35%) patients had primary osteoporosis. Therefore, the incidence of post-kyphoplasty VCF in the primary osteoporotic patient was 11.25% (9 of 80) and the incidence in the steroid-induced osteoporotic patient was 48.6% (17 of 35). This increased fracture rate in the steroid-dependent patients was significant (P < 0.0001), along with adjacent fractures (12 of 19 on steroids, P = 0.0009), and remote fractures (7 of 9 on steroids, P = 0.027). CONCLUSIONS: Steroid-induced compression fractures appear to have an increased incidence of subsequent fractures after the kyphoplasty procedure. The kyphoplasty protocol with concurrent medical osteoporotic regimen does not appear to increase, and may serve to reduce, the incidence of remote and adjacent fractures for primary osteoporotic fractures.

Aged↗

Matrix remodeling expression in anulus cells subjected to increased compressive load.

STUDY DESIGN: Mechanobiology study of gene expression changes as a result of compressive overload of anular fibrochondrocytes. OBJECTIVE: To test hypotheses regarding phenotype shift in genes coding for representative extracellular matrix (ECM) proteins and matrix modulators. SUMMARY OF THE BACKGROUND DATA: In degenerative disc disease, the transfer of compressive load through the disc shifts largely from the nucleus onto the anulus. In vivo models simulating this condition have shown derangement of the collagenous ultrastructure in the anulus. In vitro models of cultured anulus cells subjected to static compressive stress generally suggest a down-regulation of synthesis. This study evaluated the expression of specific isomers of genes responsible for mechanical viability and metabolism of the disc under cyclic compressive loads. METHODS: Fibrochondrocytes were digested from the anuli of 3, 2-week-old pigs, embedded in 1.5% alginate gel, and hydrostatically compressed at 0.5 Hz for 3 hours to amplitudes of 10 and 30 atm. These levels represented nominal load transfer through the healthy disc and high load transfer through the degenerative disc. Ribonucleic acid was isolated, reverse transcribed, and evaluated by real-time polymerase chain reaction for expression of type I (C-I) and type II (C-II) collagen, aggrecan, the matrix metalloproteinase (MMP-1), and the transforming growth factor beta (TGFbeta-1). Results were expressed at percentages of uncompressed controls. RESULTS: The lower pressure of 10 atm resulted in up-regulation of all ECM protein genes. C-I and C-II both averaged 141%, and aggrecan 121% of controls (P < 0.05). MMP-1 and TGFbeta-1 were essentially unchanged. With the pressure increased to 30 atm, C-II remained approximately at the level expressed under lower pressure, but C-I was reduced to 42% of controls (P < 0.05), indicating a phenotype shift. MMP-1 and TGFbeta-1 also were down-regulated to 71% and 54% of controls, respectively (P < 0.05). CONCLUSIONS: The up-regulation of the ECM genes with nominal pressure highlights the mechanobiological importance of common activity in fibrocartilage homeostasis. Differential regulation of the 2 primary collagen types with high pressure indicates a capacity of the anulus to remodel according to pathomechanical conditions.

Aggrecans↗

System for deep venous thrombosis detection using objective compression measures.

A system for objective vessel compression assessment for deep venous thrombosis characterization using ultrasound image data and a sensorized ultrasound probe is presented. Two new objective measures calculated from applied force and transverse vessel area are also presented and used to describe vessel compressibility. A modified star-Kalman algorithm is used for feature detection in acquired ultrasound images, and objective measures of vessel compressibility are calculated from the detected features and acquired force and location data from the sensorized probe. A three-dimensional shape model of the examined vessel that includes compressibility measures mapped as colors to its surface is presented on the user interface, as well as a virtual representation of the image plane. The compressibility measures were validated using expert segmentation of healthy and diseased vessels and compared using paired t-tests, which showed a significant difference between healthy and diseased cases for both measures. 100% sensitivity and specificity were obtained for both measures. The system was implemented in real-time (16 Hz) and evaluated using a tissue phantom and on healthy human subjects. Sensitivity was 100% and 60%, while specificity was 97% for both measures when implemented. The initial results for the system and its components are promising.

Algorithms↗

On the use of standards for microarray lossless image compression.

The interest in methods that are able to efficiently compress microarray images is relatively new. This is not surprising, since the appearance and fast growth of the technology responsible for producing these images is also quite recent. In this paper, we present a set of compression results obtained with 49 publicly available images, using three image coding standards: lossless JPEG2000, JBIG, and JPEG-LS. We concluded that the compression technology behind JBIG seems to be the one that offers the best combination of compression efficiency and flexibility for microarray image compression.

Data Compression↗

Light field compression using disparity-compensated lifting and shape adaptation.

We propose disparity-compensated lifting for wavelet compression of light fields. With this approach, we obtain the benefits of wavelet coding, such as scalability in all dimensions, as well as superior compression performance. Additionally, the proposed approach solves the irreversibility limitations of previous light field wavelet coding approaches, using the lifting structure. Our scheme incorporates disparity compensation into the lifting structure for the transform across the views in the light field data set. Another transform is performed to exploit the coherence among neighboring pixels, followed by a modified SPIHT coder and rate-distortion optimized bitstream assembly. A view-sequencing algorithm is developed to organize the views for encoding. For light fields of an object, we propose to use shape adaptation to improve the compression efficiency and visual quality of the images. The necessary shape information is efficiently coded based on prediction from the existing geometry model. Experimental results show that the proposed scheme exhibits superior compression performance over existing light field compression techniques.

Algorithms↗

JPEG compression history estimation for color images.

We routinely encounter digital color images that were previously compressed using the Joint Photographic Experts Group (JPEG) standard. En route to the image's current representation, the previous JPEG compression's various settings-termed its JPEG compression history (CH)-are often discarded after the JPEG decompression step. Given a JPEG-decompressed color image, this paper aims to estimate its lost JPEG CH. We observe that the previous JPEG compression's quantization step introduces a lattice structure in the discrete cosine transform (DCT) domain. This paper proposes two approaches that exploit this structure to solve the JPEG Compression History Estimation (CHEst) problem. First, we design a statistical dictionary-based CHEst algorithm that tests the various CHs in a dictionary and selects the maximum a posteriori estimate. Second, for cases where the DCT coefficients closely conform to a 3-D parallelepiped lattice, we design a blind lattice-based CHEst algorithm. The blind algorithm exploits the fact that the JPEG CH is encoded in the nearly orthogonal bases for the 3-D lattice and employs novel lattice algorithms and recent results on nearly orthogonal lattice bases to estimate the CH. Both algorithms provide robust JPEG CHEst performance in practice. Simulations demonstrate that JPEG CHEst can be useful in JPEG recompression; the estimated CH allows us to recompress a JPEG-decompressed image with minimal distortion (large signal-to-noise-ratio) and simultaneously achieve a small file-size.

Algorithms↗

Dynamic image data compression in the spatial and temporal domains: clinical issues and assessment.

In our previous work, we developed a novel approach to dynamic image data compression, and demonstrated that very high compression ratios can be achieved while preserving relevant kinetic information. However, the technique has not yet been assessed with clinical data. Many issues need to be addressed to tailor the method for clinical use. In this paper, we apply the compression technique to dynamic [18F] 2-fluoro-deoxy-glucose (FDG) brain positron emission tomography (PET) data, using a five-parameter model to include cerebral blood volume (CBV) and partial volume (PV) effects. Functional images generated from the compressed data are compared with those from the original uncompressed data. We show that the storage requirements for a typical clinical dynamic PET image data set can be reduced by more than 95%, without degradation of image quality. Furthermore, the technique greatly reduces the computational complexity of further clinical image postprocessing such as smoothing and generation of functional images. It is expected that the compression technique will be of benefit in image data management and telemedicine.

Algorithms↗

Perceptually tuned JPEG coder for echocardiac image compression.

In this work, we propose an efficient framework for compressing and displaying medical images. Image compression for medical applications, due to available Digital Imaging and Communications in Medicine requirements, is limited to the standard discrete cosine transform-based joint picture expert group. The objective of this work is to develop a set of quantization tables (Q tables) for compression of a specific class of medical image sequences, namely echocardiac. The main issue of concern is to achieve a Q table that matches the specific application and can linearly change the compression rate by adjusting the gain factor. This goal is achieved by considering the region of interest, optimum bit allocation, human visual system constraint, and optimum coding technique. These parameters are jointly optimized to design a Q table that works robustly for a category of medical images. Application of this approach to echocardiac images shows high subjective and quantitative performance. The proposed approach exhibits objectively a 2.16-dB improvement in the peak signal-to-noise ratio and subjectively 25% improvement over the most useable compression techniques.

Algorithms↗