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PubMed1991

Radiographic and electronic diagnostic systems.

Radiography forms the basis for determining the length of tooth in endodontic therapy. Radiographs can be manipulated by digital image processing, which can improve their diagnostic quality as well as enable the images to be stored electronically. Electronic apex locators, when used in conjunction with radiographs and electronic imaging systems, become useful adjuncts in endodontic treatment. They provide the clinician with the ability to accurately determine the length of tooth, thus making apex locators an important component in endodontic therapy.

Dental Pulp Cavity↗
PubMedDate not supplied

Thoracic lordosis in idiopathic scoliosis.

Lordosis, a significant aspect of thoracic scoliosis, is difficult to assess with routine clinical radiographs. Computerized analysis of 138 sets of standardized anteroposterior and lateral radiographs served to elicit the three-dimensional structure of scoliosis. Spinal curvatures in the usual anatomic planes and in the sagittal and frontal planes of the apical vertebrae were measured. Lordosis was present in 35% of curves greater than or equal to 40 degrees and in 50% of curves greater than 49 degrees. Lordosis may be a contraindication for brace treatment.

Anthropometry↗
PubMed1991

[Direct lymphography with special reference to peripheral lymphedema. Historical retrospect--technique--indications--alternative procedures--image documentation].

Indication for direct lymphography during the past forty years shows a downward tendency, mainly because of new alternative modern imaging methods. Nevertheless, in agreement with the actual literature it can be shown by own investigations with 8000 patients from 1964 to 1989 that one cannot give up lymphography totally. On principle lymphography is still carried out in case of testicular tumors, malignant lymphomas, unclear fever, lymphatic vessel injury and facultative in peripheric lymph edemas.

Humans↗
PubMed1991

New perspectives in CT and MR imaging.

Neuroimaging is a rapidly changing part of the care of children with central nervous system neoplasms. MR scanning, now a routine part of patient care, continues to advance, with new capabilities continuously developing. CT scanning, although often eclipsed by MRI, remains an essential imaging modality. The current state of the art, as well as new directions, are reviewed in this article.

Brain↗
PubMed1991

[Computer-assisted teleradiographic image interpretation in orthodontics].

The utilization of a computer supported cephalometric system using the analysis introduced by Hasund is demonstrated. In comparison to the traditional measurement by hand the advantages of a computerized analysis are: Time reduction, minimization of evaluation errors, the use of individualized norm values and the advantages in recording.

Cephalometry↗
PubMed1991

[Computerized cephalometric analysis in clinical use].

In making a computerized cephalometric analysis, first the film should be traced, and the landmarks pricked and manually digitalized into an X-Y coordinate system. The computer's analysis program registers for the landmarks, automatically calculates the angles and line distances, and then compares these values to the norms. The computer can also print out the measurements and draw a computer-produced graph on request. Such a procedure is convenient and yields more accurate results. The most common mistake, picking in the wrong sequence, can be controlled by carefully inspecting the computer-produced graph.

Cephalometry↗
PubMed1992

An introduction to model-based imaging.

The purpose of this paper is to clarify the distinction between the recognition of form, i.e. pattern recognition, and the interpretation of visual scenes, i.e. image understanding. Pattern recognition is part of image understanding, but the latter also includes cognitive tasks such as learning and inference. The key to developing image-understanding systems is to concentrate on the representation and use of models. This paper is a brief outline of the components of a model-based image-understanding system. First, the notions of iconic, categorical and symbolic knowledge are described. Although they appear to be disparate, the common notion is that the image understanding is based on recognizing concepts and not recognizing form. Next, the notion of a concept is defined, followed by representation techniques and control strategies for using concepts. Last, an example is given of an image-understanding system that learns to recognize concepts such as radiographic projections of teeth in panoramic radiographs.

Expert Systems↗
PubMedDate not supplied

Combining evidence from multiple imaging modalities: a feature-analysis method.

This study was designed to develop methods to improve radiologists' ability to detect and diagnose breast cancer. We evaluated the ability of a feature-analysis method to help radiologists merge judgements constructively from two rather disparate breast imaging tests. To accomplish these goals, we developed a list of perceptual features and quantitated the importance of each in the diagnosis of patients having both diaphanography (Test 1) and mammography (Test 2). Then, two decision aids were developed: One was a checklist of the critical diagnostic visual features from both tests that also assisted readers in rating these features numerically. The second was a computer-based classifier that assisted readers in merging the assessments of the two tests into one overall diagnostic probability. The value of these aids was assessed by comparing radiologists' accuracy in reading a set of proven cases in their standard fashion with their accuracy when reading in an enhanced mode, utilizing the checklist and computer classifier. When Test 1 was read adjunctively with Test 2, use of the decision aids led to a significant improvement in accuracy (p = .013) over the unenhanced, combined readings. For Test 1 alone, the aids led to a significant improvement over its low level of unenhanced reading (p = .046). For Test 2 alone, the enhancements provided little gain in accuracy over an already high level of performance on the full case set (p = .081), although significant gains were realized on the most difficult ones. We conclude that methods to aid standardization and merging of feature-based judgements can improve radiologists performance on complex diagnostic tasks.

Breast Neoplasms↗
PubMed1992

Image preprocessing for a picture archiving and communication system.

OBJECTIVES AND RATIONALE: In a picture archiving and communication system (PACS), images are acquired from multiple modalities and displayed on an electronic workstation. Each modality has different image characteristics. This variability must be addressed before the image is displayed. METHODS: The authors developed methods to automatically process magnetic resonance (MR), computed tomographic (CT), and computed radiography (CR) images before display and subjectively evaluated their effectiveness. RESULTS: Unwanted background successfully was automatically removed from 89.5% of 615 CR images. Of 803 chest, abdomen, and hand images 93% were automatically rotated to the correct orientation. CONCLUSIONS: Automated preprocessing of PACS images can be performed successfully, improving speed and convenience for the radiologist interpreting images at an electronic workstation.

Image Processing, Computer-Assisted↗
PubMed1992

Bending and fracture of the femoral component in cemented total hip replacement.

A computer method was used to make 41 measurements on the geometry of insertion of the femoral component in 200 Charnley total hip replacements. Surgery had been performed at least 12 years before, giving results which were classified as: success (90); fracture (56); or loose (54), according to rigid selection criteria. Fracture was associated with heavier patients in which there was poor proximal fixation of the femoral component but adequate distal fixation. Stems with a medial disposition proximally were more common in the fracture group than in the successful or loose groups. Sequential measurements of bending and subsequent fracture were made on the follow-up radiographs of 24 of the 200 cases (6 fracture and 18 successful). These measurements allowed bending to be detected at an earlier stage than by simple inspection of the radiographs.

Aged↗
PubMedDate not supplied

Retrospective fusion of radiographic and MR data for localization of subdural electrodes.

Prior to epilepsy surgery, subdural electrodes are often implanted and monitored for a few days to identify the focus of abnormal electrical activity. During the implantation and subsequent brain resection, there may be uncertainty about the exact location of the electrodes with respect to features of brain anatomy such as specific gyral convolutions or lesions. In experiments with a phantom and patients, implanted electrodes were imaged with multiplanar skull radiographs (or CT scans). After retrospective registration with preimplantation MR data, the electrodes were mapped from these studies onto an MR-derived three-dimensional brain model. The resulting multimodality displays showed the relationship of the electrodes to brain anatomy. In one patient the position of each electrode with respect to a metabolic lesion was also displayed by mapping preimplantation PET data onto the same brain model. This new display of electrode positions may strengthen the interpretation of subdural electrical recordings and thereby reduce uncertainty in planning the resection of epileptic tissue.

Adult↗
PubMed1991

Comparison of a PACS workstation with conventional film for interpretation of neonatal examinations: a paired comparison study.

The diagnostic value of neonatal examinations using picture archiving and communication systems (PACS) was compared with that of conventional radiographs. A total of 202 consecutive chest or abdominal radiographs from the newborn intensive care unit were digitized for display on a commercially available PACS console. Experimental design was a paired comparison study. Plain films and PACS images were reviewed alternately in unbiased fashion. After the examination was evaluated using the second modality, any change in diagnosis or confidence in diagnosis was noted. Overall evaluation showed slight preference for the PACS modality. Change of diagnosis or in confidence of diagnosis was more than twice as likely to occur with evaluation of PACS (35%) after hardcopy than with evaluation of conventional radiographs (14%) after PACS. Of the variety of image processing features available on PACS, only window and leveling were judged to be of significant value. These results indicate that PACS and conventional radiographs of the neonatal chest and abdomen are of similar diagnostic value.

Humans↗
PubMedDate not supplied

Image processing in digital chest radiography: effect on diagnostic efficacy.

The usefulness of digital image processing of chest radiographs was evaluated in a clinical study. In 54 patients, chest radiographs in the posteroanterior projection were obtained by both 14 inch digital image intensifier equipment and the conventional screen-film technique. The digital radiographs (512 x 512 image format) viewed on a 625 line monitor were processed in three different ways: (1) standard display; (2) digital edge enhancement for the standard display; and (3) inverse intensity display. The radiographs were interpreted independently by three radiologists. The diagnoses were confirmed by CT, follow-up radiographs and clinical records. Chest abnormalities of the films analyzed included 21 primary lung tumors, 44 pulmonary nodules, 16 cases with mediastinal disease and 17 cases with pneumonia/atelectasis. Interstitial lung disease, pleural plaques, and pulmonary emphysema were found in 30, 18 and 19 cases, respectively. The sensitivity of conventional radiography when averaged overall findings was better than that of the digital techniques (P less than 0.001). The differences in diagnostic accuracy measured by sensitivity and specificity between the three digital display modes were small. Standard image display showed better sensitivity for pulmonary nodules (0.74 vs 0.66; P less than 0.05) but poorer specificity for pulmonary emphysema (0.85 vs. 0.93; P less than 0.05) compared with inverse intensity display. We conclude that when using 512 x 512 image format, the routine use of digital edge enhancement and tone reversal at digital chest radiographs is not warranted.

Adolescent↗
PubMed1991

Carpal orientation from computed reference axes.

Carpal instability is usually diagnosed by abnormal two-plane radiographic angles. These angles are often unreliable. A method that eliminates interpretation of overlapping shadows and uses all of the carpal geometry should improve clinical diagnoses. The digital data from computed tomography scans can be manipulated to describe the carpal orientation in the normal wrist. The digital data from the computed tomography scans of twenty-two normal wrists were used to compute distances with and without directions between the volumetric centroids of the carpal bones. An expansion technique also extracted from the computed tomography data an orthogonal set of vectors, the principal axes. The first principal axis describes the longest dimension of each bone. The average angle produced by the first principal axes of the scaphoid and lunate was 23.6 degrees, scaphoid and capitate was 73.2 degrees, and the capitate and the lunate was 93.5 degrees. These computations represent new carpal axes and intercarpal angles that are not related to the commonly measured two-plane radiographic angles. They should prove helpful in the study of kinematics and pathomechanics in the wrist joint.

Carpal Bones↗
PubMed1991

Computer-aided interpretation and quantification of angular periodontal bone defects on dental radiographs.

Capabilities of human observers to detect and describe small bone defects objectively are limited. Digital image processing can provide a useful contribution to the diagnostic process. This paper describes the evaluation of a computer-aided procedure for the interpretation and quantification of angular periodontal bone defects on dental radiographs. The computer-aided procedure was able to rank series of artificial periodontal bone lesions as accurate as experienced clinicians. Comparison of data from clinical inspection of lesions during surgery and quantitative results of the digitized procedure shows that the latter produced reliable information on the lesions size. Reproducibility is satisfactory. It was concluded that computer-aided detection and description of periodontal bone defects decreases the interobserver variability in general and the time-dependent variability in repeated assessments of a single observer.

Alveolar Bone Loss↗