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A 3D reconstruction algorithm for EIT using a handheld probe for breast cancer detection.

A 3D reconstruction algorithm for electrical impedance tomography is presented for determining the distribution of electrical properties inside the body, given electrical measurements made on the surface. A linearized reconstruction algorithm using planar electrode arrays in a handheld probe geometry developed by Mueller et al (1999 IEEE Trans. Biomed. Eng. 46 1379-86) has been refined and extended in this paper. This algorithm is based on linearizing the conductivity about a constant value. We have extended the distance below the electrodes at which a target can be imaged by using a combination of two regularization schemes and a weighted mesh. An appropriate combination of Tikhonov and NOSER regularization produces satisfactory static images of a 2 cm cube placed 2 cm below the array, and difference images of a 1 cm cube 4 cm away from the array. The weighted mesh allows use of fixed regularization parameters for all depths of the target.

Breast Neoplasms↗

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↗

Effects of simulated microgravity on closed-loop cardiovascular regulation and orthostatic intolerance: analysis by means of system identification.

Microgravity-induced orthostatic intolerance (OI) continues to be a primary concern for the human space program. To test the hypothesis that exposure to simulated microgravity significantly alters autonomic nervous control and, thus, contributes to increased incidence of OI, we employed the cardiovascular system identification (CSI) technique to evaluate quantitatively parasympathetic and sympathetic regulation of heart rate (HR). The CSI method analyzes second-to-second fluctuations in noninvasively measured HR, arterial blood pressure, and instantaneous lung volume. The coupling mechanisms between these signals are characterized by using a closed-loop model. Parameters reflecting parasympathetic and sympathetic responsiveness with regard to HR regulation can be extracted from the identified coupling mechanisms. We analyzed data collected from 29 human subjects before and after 16 days of head-down-tilt bed rest (simulated microgravity). Statistical analyses showed that parasympathetic and sympathetic responsiveness was impaired by bed rest. A lower sympathetic responsiveness and a higher parasympathetic responsiveness measured before bed rest identified individuals at greater risk of OI before and after bed rest. We propose an algorithm to predict OI after bed rest from measures obtained before bed rest.

Adult↗

Quantification of brain phosphodiesterase 4 in rat with (R)-[11C]Rolipram-PET.

OBJECTIVE: Phosphodiesterase 4 (PDE4) catabolizes the second messenger 3', 5'-cyclic adenosine monophosphate and may play a critical role in brain diseases. Our aim was to quantify PDE4 in rats with positron emission tomography (PET). METHODS: High (n = 6) and low specific activity (SA) (n = 2) higher affinity ((R)-[(11)C]rolipram) and high SA lower affinity ((S)-[(11)C]rolipram) (n = 2) enantiomers were intravenously administered to Sprague-Dawley rats. Brain data were acquired using the ATLAS PET scanner and reconstructed using the 3D-ordered subset expectation maximization algorithm. Arterial samples were taken to measure unmetabolized [(11)C]rolipram. Total distribution volumes (V(T)') were calculated using a 1-tissue compartment (1C) and an unconstrained 2-tissue compartment (2C) model. RESULTS: High SA R experiments showed later and greater brain uptake, and slower washout than low SA R and S experiments. In all regions and in all experiments, the 2C model gave significantly better fitting than the 1C model. The poor fitting by the latter caused underestimation of V(T)' by 19-31%. The 2C model identified V(T)' reasonably well with coefficients of variation less than 10%. V(T)' values by this model were 16.4-29.2 mL/cm(3) in high SA R, 2.9-3.5 in low SA R, and 3.1-3.7 in S experiments. CONCLUSIONS: Specific binding of (R)-[(11)C]rolipram was accurately measured in living rats. In high SA R experiments, approximately 86% of V(T)' was specific binding. Distribution and changes of PDE4 in animal models can now be studied by measuring V(T)' of high SA (R)-[(11)C]rolipram.

3',5'-Cyclic-AMP Phosphodiesterases↗

Comparative analysis of algorithms for signal quantitation from oligonucleotide microarrays.

MOTIVATION: Recent years' exponential increase in DNA microarrays experiments has motivated the development of many signal quantitation (SQ) algorithms. These algorithms perform various transformations on the actual measurements aimed to enable researchers to compare readings of different genes quantitatively within one experiment and across separate experiments. However, it is relatively unclear whether there is a 'best' algorithm to quantitate microarray data. The ability to compare and assess such algorithms is crucial for any downstream analysis. In this work, we suggest a methodology for comparing different signal quantitation algorithms for gene expression data. Our aim is to enable researchers to compare the effect of different SQ algorithms on the specific dataset they are dealing with. We combine two kinds of tests to assess the effect of an SQ algorithm in terms of signal to noise ratio. To assess noise, we exploit redundancy within the experimental dataset to test the variability of a given SQ algorithm output. For the effect of the SQ on the signal we evaluate the overabundance of differentially expressed genes using various statistical significance tests. RESULTS: We demonstrate our analysis approach with three SQ algorithms for oligonucleotide microarrays. We compare the results of using the dChip software and the RMAExpress software to the ones obtained by using the standard Affymetrix MAS5 on a dataset containing pairs of repeated hybridizations. Our analysis suggests that dChip is more robust and stable than the MAS5 tools for about 60% of the genes while RMAExpress is able to achieve an even greater improvement in terms of signal to noise, for more than 95% of the genes.

Algorithms↗

Case-based distance measurements for the selection of controls in case-matched studies: application in coronary interventions.

In case-based studies, controls are retrospectively assigned to patients in order to permit a statistical evaluation of the study results through a comparison of the main outcome measures for the patient and retrieved control groups. Inappropriate selection of the controls by using false retrieval parameters or a false algorithm might lead to an incorrect data analysis and a false interpretation of the results. The main hypothesis of the presented study was that, if the matching baseline parameters were at least nearly perfectly selected, then the outcomes of the matched pairs should be similar, or no significant differences in study outcome should be observed between the patients and the matched controls. In the present study, the case-based domain was created from 1566 patients who had undergone intracoronary stent implantation. Uni- and multivariate logistic regression analysis determined nine significant predictors (matching variables) for the occurrence of major adverse cardiac events. An additional 425 consecutive patients undergoing intracoronary stent implantation were then matched with all the potential controls from the database by calculating the individual distance between the patient and the matched control on the basis of the elaborated retrieval algorithm. To test the matching hypothesis, different distance measurements, and an altered outcome and retrieval process were examined. With "flexible" distance measurements, the mean distance between the patients and the first matched controls was 1.31. The major adverse cardiac events were compared in the patient and matched control groups. The best sensitivity and specificity values of the matching system could be achieved in matched pairs with the distance < or =3.00 (95.1% of all patients). On the further stepwise exclusion of the matched pairs exhibiting a distance greater than 2 and 1, then the number of "matchable" controls and the specificity of our matching concept decreased considerably. When the short- or mid-term outcome was compared by using the long-term follow-up matching parameters, no correlation could be found between the treated subjects and controls, indicating that for the other study, main measures of other appropriate parameters must be selected, and demonstrating the importance of the outcome-oriented selection of the retrieval parameters. Furthermore, the outcome measures of the patients and randomly (non-systematically) selected controls did not correlate, revealing the impossibility of drawing correct study conclusions from a non-matched, randomly assigned pairs. In conclusion, the sensitivity and specificity of the matching program, and the study conclusions depend on the appropriately predefined matching parameters and retrieval algorithm.

Algorithms↗

A statistical measure of tissue heterogeneity with application to 3D PET sarcoma data.

In vivo measurement of local tissue characteristics by modern bioimaging techniques such as positron emission tomography (PET) provides the opportunity to analyze quantitatively the role that tissue heterogeneity may play in understanding biological function. This paper develops a statistical measure of the heterogeneity of a tissue characteristic that is based on the deviation of the distribution of the tissue characteristic from a unimodal elliptically contoured spatial pattern. An efficient algorithm is developed for computation of the measure based on volumetric region of interest data. The technique is illustrated by application to data from PET imaging studies of fluorodeoxyglucose utilization in human sarcomas. A set of 74 sarcoma patients (with five-year follow-up survival information) were evaluated for heterogeneity as well as a number of other potential prognostic indicators of survival. A Cox proportional hazards analysis of these data shows that the degree of heterogeneity of the sarcoma is the major risk factor associated with patient death. Some theory is developed to analyze the asymptotic statistical behavior of the heterogeneity estimator. In the context of data arising from Poisson deconvolution (PET being the prime example), the heterogeneity estimator, which is a non-linear functional of the PET image data, is consistent and converges at a rate that is parametric in the injected dose.

Algorithms↗

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↗

Pruning and model-selecting algorithms in the RBF frameworks constructed by support vector learning.

This paper presents the pruning and model-selecting algorithms to the support vector learning for sample classification and function regression. When constructing RBF network by support vector learning we occasionally obtain redundant support vectors which do not significantly affect the final classification and function approximation results. The pruning algorithms primarily based on the sensitivity measure and the penalty term. The kernel function parameters and the position of each support vector are updated in order to have minimal increase in error, and this makes the structure of SVM network more flexible. We illustrate this approach with synthetic data simulation and face detection problem in order to demonstrate the pruning effectiveness.

Algorithms↗

Spectral signal-to-noise ratio and resolution assessment of 3D reconstructions.

Measuring the quality of three-dimensional (3D) reconstructed biological macromolecules by transmission electron microscopy is still an open problem. In this article, we extend the applicability of the spectral signal-to-noise ratio (SSNR) to the evaluation of 3D volumes reconstructed with any reconstruction algorithm. The basis of the method is to measure the consistency between the data and a corresponding set of reprojections computed for the reconstructed 3D map. The idiosyncrasies of the reconstruction algorithm are taken explicitly into account by performing a noise-only reconstruction. This results in the definition of a 3D SSNR which provides an objective indicator of the quality of the 3D reconstruction. Furthermore, the information to build the SSNR can be used to produce a volumetric SSNR (VSSNR). Our method overcomes the need to divide the data set in two. It also provides a direct measure of the performance of the reconstruction algorithm itself; this latter information is typically not available with the standard resolution methods which are primarily focused on reproducibility alone.

Algorithms↗

Investigating the TEPC radiation quality factor response for low energy accelerator based clinical applications.

The use of a tissue equivalent proportional counter (TEPC) filled with propane based tissue equivalent gas simulating a 2 microm diameter tissue sphere has been investigated to estimate the radiation quality factor of the neutron fields used in in vivo neutron activation measurements at the McMaster University 3 MV Van de Graaff accelerator. The counter response to estimate the effective quality factor based on the definitions of Q(L) provided in ICRP 26 and 60 as a function of neutron energy has been examined experimentally using monoenergetic and continuous neutron spectra in the energy range of 35 to 600 keV. In agreement with other studies, the counter failed to provide a flat R(Q) response and showed a sharp drop below 200 keV neutron energy. Development of an algorithm to evaluate the quality factors using measured dose-mean lineal energy, yD, and comparison of the algorithm with other reported algorithms and analytical methods developed for the improvement in TEPC dose equivalent response has been reported.

Algorithms↗

A novel algorithm to remove electrical cross-talk between surface EMG recordings and its application to the measurement of short-term synchronisation in humans.

Pairs of discharges of single motor units recorded in the same or different muscles often show synchronisation above chance levels. If large numbers of units are synchronous within and between muscles then the synchrony will be measurable in population recordings such as surface EMG. Measuring synchrony between surface EMG recordings has a number of practical and scientific advantages compared with single motor units recorded from intramuscular electrodes. However, the measurement of such synchrony in the time domain between surface EMGs is complicated because the recordings are contaminated by electrical cross-talk. In this study we recorded surface EMG simultaneously from five hand and forearm muscles during a precision grip task. Using a novel 'blind signal separation' algorithm, we were able to remove electrical cross-talk. The cross-talk-corrected EMGs could then be used to assess task-dependent modulation in both oscillatory (15-30 Hz) and non-oscillatory synchrony (all other frequencies). In agreement with previous studies, the oscillatory component was maximal during steady holding but abolished during movement. By contrast, the non-oscillatory component of the EMG synchrony appeared remarkably constant throughout all phases of the task. We conclude that surface EMG recordings can be of considerable use in the assessment of population synchrony changes, providing that electrical cross-talk between nearby channels is removed using a statistical signal processing technique. Our results show a striking difference in the task-dependent modulation of oscillatory and non-oscillatory synchrony between muscles during a dynamic precision grip task.

Adult↗

Velocity fluctuation reduction in vector Doppler ultrasound using a hybrid single/dual-beam algorithm.

In order to reduce the fluctuations in the velocity magnitude estimate, we propose a modification to the standard algorithm for reconstructing the (two component) vector velocity from the measured Doppler shifts in two directions. This uses the standard dual-beam algorithm, combined with temporal smoothing, to find only the velocity angle, then uses the single-beam algorithm to estimate the velocity magnitude. We present initial data showing the significant reduction in velocity estimate fluctuation that this hybrid method achieves compared to the standard algorithm.

Algorithms↗

An algorithm for automatic needle localization in ultrasound-guided breast biopsies.

An algorithm was developed in order to reduce operator dependence in ultrasound-guided breast biopsy, by automatically locating the needle in the ultrasound image, and displaying its location on the image for the user. Ultrasound images of a typical breast biopsy needle inserted in a tissue-mimicking agar were obtained to test the algorithm. The resulting images were examined by a group of observers who recorded the values of the angle, intercept and tip coordinates of the needle in the image, and inter- and intra-observer variability studies were performed on the results. The results of the algorithm segmentation were compared to the values recorded by the observers, and physical measurements recorded at the time the images were acquired. The algorithm segmentation was precise enough to successfully (when considering angle and tip segmentation) target 90% of tumors of 4.5 mm in diameter situated at the center of the image.

Algorithms↗

[Diagnosis and treatment of closed injury of liver].

The experience of surgical treatment of closed injury of liver (CIL) in 101 patients is summarized. The complex scheme of therapeutic and diagnostical measures in patients with CIL was elaborated. This included diagnostic algorithm that allows to diagnose the injury in time, intra-operation tactical measures, directing of post-operation period. Application of this scheme in 26 patients with CIL permitted to decrease post-operative complications rate by 5.9%, mortality--by 10.1%.

Humans↗

Interpersonal ambivalence, perceived relationship adjustment, and conjugal loss.

Ambivalence is widely assumed to prolong grief. To examine this hypothesis, the authors developed a measure of ambivalence based on an algorithmic combination of separate positive and negative evaluations of one's spouse. Preliminary construct validity was evidenced in relation to emotional difficulties and to facial expressions of emotion. Bereaved participants, relative to a nonbereaved comparison sample, recollected their relationships as better adjusted but were more ambivalent. Ambivalence about spouses was generally associated with increased distress and poorer perceived health but did not predict long-term grief outcome once initial outcome was controlled. In contrast, initial grief and distress predicted increased ambivalence and decreased Dyadic Adjustment Scale scores at 14 months postloss, regardless of initial scores on these measures. Limitations and implications of the findings are discussed.

Adult↗

Rasch model estimation: further topics.

Building on Wright and Masters (1982), several Rasch estimation methods are briefly described, including Marginal Maximum Likelihood Estimation (MMLE) and minimum chi-square methods. General attributes of Rasch estimation algorithms are discussed, including the handling of missing data, precision and accuracy, estimate consistency, bias and symmetry. Reasons for, and the implications of, measure misestimation are explained, including the effect of loose convergence criteria, and failure of Newton-Raphson iteration to converge. Alternative parameterizations of rating scales broaden the scope of Rasch measurement methodology.

Algorithms↗

In vivo dosimetry during pelvic treatment.

High precision in vivo entrance and exit dose measurements have been performed with p-type diodes on patients during 8 MV X-ray irradiation of the pelvis, to investigate the accuracy of dose calculations in this region. Based on phantom measurements the accuracy of the p-type diode measuring system itself, i.e. the agreement with ionisation chamber dose measurements, was shown to be better than 0.7% while the reproducibility in the dose determination was 1.1%, 1.5% and 1.6% (1 S.D.) at the entrance point, isocentre and exit point, respectively, for the wedged lateral fields. Patient movement and the uncertainty in the diode position increased these values to 1.7%, 1.5% and 3.1% (1 S.D.) for dose determinations on patients. From the entrance and exit in vivo dose values the dose actually delivered to the isocentre was determined. For the anterior-posterior beams a good correspondence for most patients was observed at the entrance and exit point and at the isocentre between the in vivo and calculated dose values. For the wedged lateral beams a systematic deviation of about 3% was observed. In addition to the in vivo dose measurements phantom dose measurements have been performed to quantify the accuracy of the dose calculation algorithms including the computation of the number of monitor units. These measurements also served to quantify the effects of the actual patient on the dose delivery. The measurements showed that accurate calculation of the dose requires a separation of the head and phantom scatter contribution of the output of the treatment machine. The dependence of the wedge factor on field size, depth and source-skin-distance has also to be considered for accurate dose calculations. The effect of the patient on the dose calculation is mainly related to the actual electron densities of fat and bone structures compared to water: neglecting these densities in the dose computation could yield deviations up to 8.5% for the exit point in wedged beams. Based on these results, improvements in the dose calculation algorithms and monitor unit calculation including the use of the actual electron densities will be implemented in the treatment planning procedure.

Algorithms↗