Comparison of a cathode-ray-tube and film for display of computed radiographic images.

The goal of the study was to compare a cathode-ray-tube (CRT) digital display with film by using task-dependent image quality assessment methods. Contrast-detail analysis was utilized. Human observers performed a simple detection task, specifically, detecting a pillbox target in a uniform Poisson field, using either film or a digital display that employed a CRT monitor. Observers performed equally well on both film and CRT when the window settings of the digital display were established subjectively by a radiologist. Changing the window settings of the digital display to match the average background luminance of a film-illuminator combination decreased the luminance contrast of the targets and observer performance was reduced, though these effects were probably not linked. The "gold standard" film had lower luminance contrast than the CRT displayed images, yet observer performance was never lower for film than for the CRT. Therefore we concluded that luminance contrast was not a limiting factor for observer performance in this study. The CRT monitor changed fairly rapidly after it was calibrated. During a period of six months the gamma of the display increased from 1.82 to 2.42 and the maximum luminance decreased from 319 to 228 cd/m2. Low luminance output demonstrated a larger percentage decrease (approximately equal to 85%) than high luminance output (approximately equal to 29%) over the same time period. These observations suggest that standard window settings should be reviewed from time to time to ensure that the display is used optimally. No special look-up table setup such as perceptual linearization was used.

Ovulatory delay alters postnatal growth, behavior, and brain structure in rats.

To investigate the effect of a delay in ovulation on postnatal growth and development in resultant rat offspring, a 1-day ovulatory delay was induced by sodium pentobarbital, animals mated, and the offspring monitored. There were no differences between control and 1-day delayed offspring in the number of live or dead births, number of males or females, nor in the ratio of sexes. Delayed pups had a slightly lower birth weight, but then recovered to weigh more than controls by day 12. In the first two weeks post-parturition, delayed pups displayed an earlier ability to reorient themselves in a negative geotaxis test, but no differences by the righting reflex and reflex suspension tests. At postnatal day (pnd) 28, delayed pups exhibited decreased activity in a continuous corridor test, but no alterations in gait. At this time, the brains of delayed animals revealed thickening of cortical layers V plus VI. There were significant correlations between various developmental endpoints (body weight, negative geotaxis, continuous corridor activity, and gait) and the cortical layer thicknesses. The results indicate that ovulatory delay produces changes in brain cortical thickness, with correlative changes in growth and behavior. Although the mechanisms by which ovulatory delay alters postnatal development and brain structure are unknown, ovulatory delay may alter the uterine environment during early pregnancy.

The effects of lossy compression on the detection of subtle pulmonary nodules.

We examined the ability of radiologists to detect pulmonary nodules in computed radiographic (CR) chest images subjected to lossy image compression. Low-contrast 1-cm diameter targets simulating noncalcified pulmonary nodules were introduced into clinical images and presented to ten radiologists in a series of two-alternative forced-choice (2AFC) observer experiments. The percentages of correct observer responses obtained while viewing noncompressed images (1:1) were compared with those obtained for the same images compressed 7:1, 16:1, 44:1, and 127:1. The images were compressed using a standard full-frame discrete cosine transform (DCT) technique. The degree of compression was determined by quantizing Fourier components in various frequency channels and then Huffman encoding the result. The data show a measurable decline in performance for each compression ratio. Through signal-to-noise ratio (SNR) analysis, we found that the reduction in performance was due primarily to the compression algorithm that increased image noise in the frequency channels of the signals to be detected.

Ultrasonic measurement of glomerular diameters in normal adult humans.

The average size of acoustic scatterers and the integrated backscatter coefficient of kidney cortex were measured in vivo from 2-4 MHz for a group of 50 normal adult volunteers. Our goal was to determine the sensitivity of the ultrasonic measurements under clinical conditions by identifying biologic sources of estimation uncertainty. Based on 10 measurements on each kidney of each volunteer, the average glomerular diameter for the group was found to be 216 +/- 27 microns (SD). Glomerular size was found to correlate with body surface area (r = 0.4), and the ratio of glomerular surface area to body surface area (GSA/BSA) was found to be constant throughout normal adult life with GSA/BSA = (8.24 +/- 1.35) x 10(-8) (SD). These results are consistent with histologic analyses found in the literature. Within an individual, 7% standard errors in GSA/BSA are typical. Biologic variability dominates the variance in scatterer size estimates in a group not matched for BSA, where it accounts for 47% of the variance. In a group of individuals matched for BSA, biologic variability accounts for only 21% of the variance; day-to-day variability accounts for 35% of the variance; and experimental parameters account for the remainder. If a deviation greater than 2 x SD is considered abnormal, then this technique can potentially detect changes in glomerular diameter as small as 30 microns within an individual. To detect abnormal GSA/BSA values for an individual, GSA/BSA would have to differ from the mean for that group by about 3.6 x 10(-8) or about 40%. Therefore, at this time scatterer size estimates appear most reliable for tracking the progression of disease and treatment for an individual over time.

Doppler US of helical flow in the portal vein.

In helical portal venous blood flow, the usual laminar flow in the portal vein is replaced by a spiral. This changes the color Doppler ultrasound (US) appearance to one of alternating or parallel red and blue bands. Duplex US may appear to show hepatopetal, hepatofugal, or simultaneous bidirectional flow depending on placement of the cursor within the helix. Helical portal venous flow is unusual in normal individuals (2.2% of 135 patients). Its presence should prompt further scrutiny for signs of liver disease, particularly portosystemic shunts, as in 20% of 41 patients who subsequently underwent liver transplantation. It is a normal finding immediately after liver transplantation (43% of 35 patients) and transjugular intrahepatic portosystemic shunt (TIPS) creation (28% of 36 patients). In both liver transplant and TIPS recipients, helical flow is usually transient. Its persistence long after transplantation in association with a prolonged increase in portal venous velocity is a useful sign of portal vein stenosis. Helical flow may also occur in cases of neoplastic invasion or displacement of the portal vein.

Contrast-detail analysis of image degradation due to lossy compression.

A contrast-detail (CD) experiment was performed to study the effect of lossy compression on computed radiographic (CR) images. Digital CR images of a phantom were compressed by quantizing the full-frame discrete cosine transform and Huffman encoding the result. Since low-contrast detectability is directly linked to an important radiological task, namely, the detection of noncalcified pulmonary nodules in adult chest radiographs, the goal of the study was to quantify any loss in low-contrast detectability due to compression. Compression ratios varied significantly among compressed images, despite the use of fixed compression parameters; detectability could be specified by a single parameter of a CD curve; there was no significant reduction in detectability for an average compression ratio of 11:1; and, there was a statistically significant degradation in detectability for an average compression ratio of 125:1.

Effects of endothelin-1 on renal microvasculature measured using quantitative ultrasound.

Renal vascular resistance is an important feature of kidney function and disease. To maintain adequate blood flow, renal vascular resistance varies in response to changes in systemic pressure. Vascular resistance is largely determined by arteriolar diameter, which is regulated by local and systemic factors. We used quantitative ultrasound techniques to follow renal vascular changes in anesthetized dogs during local intraarterial infusion of a potent vasoconstrictor, endothelin-1 (ET-1). Average arteriolar diameters were estimated by analyzing echo-signal spectra (5-15 MHz) obtained from renal cortex in vivo before, during, and after ET-1 infusion. At calculated arterial concentrations of 0.01 nM, 0.1 nM, and 1.0 nM, ET-1 reduced the average arteriolar diameter of 38 +/- 2 microns by 2%, 63%, and 91%, respectively, without producing a significant change in systemic blood pressure. Changes in scatterer size were consistent with the observed changes in renal hemodynamics detected using Doppler techniques. In addition, acoustic attenuation was found to increase with ET-1 concentration. These data suggest that quantitative ultrasound methods are sensitive to changes in renal arteriolar diameter, and may be a new noninvasive method for continuously monitoring changes in vascular resistance.

Comparison of the low-contrast detectability of a screen-film system and third generation computed radiography.

Contrast-detail (CD) analysis was used to compare the low-contrast detectability of computed radiography (CR) and screen-film (SF) as applied to the task of adult chest radiography. A phantom was constructed and imaged using the same exposure factors throughout all experiments. Within-observer variance, between-observer variance, and image sample variance were calculated and used to estimate the standard error for each experiment. The results of these CD experiments agreed with the predictions of the Rose model. Observers performed equally well for low-contrast target detection using CR and SF.

Mn[III] uroporphyrin I: a novel metalloporphyrin contrast agent for magnetic resonance imaging.

We have used an intracranial 9L rat brain tumor model to determine whether a novel metalloporphyrin, Mn[III] uroporphyrin I (MnUROP-I), could function as an intravenous MRI contrast agent for brain tumors. In several experiments, 24 male Fischer 344 rats were inoculated intracranially with 9L brain tumor cells. On day 15 postinoculation, animals were anesthetized and the femoral vein exposed. Prior to the intravenous injection of the contrast agent, a precontrast scan (1 Tesla in a standard head coil) was performed. Thirty min after injection of the contrast agent, a postcontrast scan was performed. Although there was only a suggestion of abnormality on the precontrast scans, the presence of tumor was visibility enhanced in the postcontrast scans. In 3 animals scanned at 24 hr postinjection, persistent tumor enhancement was demonstrated. Measured tumor sizes on the MRI scans were consistent with sizes measured at autopsy and histologically. These results demonstrate that MnUROP-I is an effective MRI contrast agent for the detection of an intracranial brain tumor in the rat model.

Teleradiology: an assessment.

A teleradiology system acquires radiographic images at one location and transmits them to one or more remote sites, where they are displayed and/or converted to hard copy. These systems often employ wide area networks. Their goal is to provide improved radiologic services at all sites on the network. Experience in the use of teleradiology systems has demonstrated the need for a laser film digitizer, an optical disk, and a high-quality display and/or laser film printer at each site. Single-site hardware purchase costs average $196,000, plus an additional 20% for yearly network services. Hardware purchased for a consultation or central referral facility approximates $344,000.

Chest radiography: comparison of high-resolution digital displays with conventional and digital film.

This study was performed to compare the performances of observers using three display formats for chest radiography. The display formats were conventional radiographs, digitized radiographs (2,048 X 2,048 X 12 bits) printed on laser film, and digitized radiographs (2,048 X 2,048 X 12 bits) displayed on a high-resolution (2,560 X 2,048 X 12-bit) gray-scale display. The test set for the study consisted of 163 cases. Sixty-four of the cases were normal, whereas the 99 remaining cases demonstrated one or more common radiographic abnormalities. Nine abnormalities were selected for analysis: costophrenic angle blunting, interstitial disease, atelectasis, pneumothorax, parenchymal mass, consolidation, obstructive disease, hilar/mediastinal mass, and apical scarring. Six experienced general radiologists participated in the evaluation. Receiver operating characteristic curves were generated for each abnormality and display format. The results indicate that, while the three display formats are equivalent for the detection of some abnormalities, detectable differences in observer performance may be seen even at 2,048 X 2,048 X 12 bits for the detection of obstructive disease, pneumothorax, interstitial disease, and parenchymal masses.

Digital fluoroscopy and radiography system: technical description and clinical examples.

We conducted a preliminary evaluation of a digital fluoroscopy system for general applications, including gastrointestinal imaging, venography, myelography, and genitourinary fluoroscopy. We describe the system, present examples of images obtained in a variety of applications, and assess the performance of the system.

Pitfalls and differential diagnosis in biliary sonography.

Ultrasonography has a primary role in the imaging of biliary disease. Most cases are straightforward, but the authors emphasize unusual manifestations, uncommon diseases, and artifacts that may present diagnostic challenges. Issues in differential diagnosis are discussed for the following findings: internal gallbladder echoes (calculi vs tumefactive sludge, air, hematobilia, parasitic infestation, cholecystosis, neoplasia, and artifacts), gallbladder wall thickening (acute cholecystitis vs acalculous cholecystitis, artifacts, ascites, hypoalbuminemia, hepatitis, and sclerosing cholangitis), pericholecystic fluid (cholecystitis vs ascites, perforated ulcer, and trauma), bile duct dilatation (biliary obstruction vs sclerosing cholangitis, biliary air, anomalous portal system, biliary atresia, Caroli disease, and cholangiocarcinoma), perinatal and neonatal biliary disease, and sclerosing cholangitis.

Experience in the use of an image-processing workstation for a photostimulable phosphor radiographic system.

Photostimulable phosphor radiographic (computed radiographic) systems are being installed and evaluated by radiology departments. The use of interactive image-processing workstations are a major advantage for any computed radiography system. An interactive image-processing workstation enables rapid image retrieval, reduces the examination repeat rate, provides for image enhancement, and rapidly sets the desired display parameters for laser-printed images. The authors have conducted over 2,500 radiographic examinations using a computed radiographic system equipped with an interactive image-processing workstation. Their experience supports the necessity of such a workstation.

Digital venography of the lower extremity.

A digital 33-cm fluoroscopic system equipped with conventional spot-film and digital or video hard-copy capabilities was evaluated for its usefulness in diagnosing deep venous thrombosis of the lower extremities. The impact of different fluoroscopic field sizes, spatial resolution, and contrast variance was measured by using phantoms. The results indicate that the physical characteristics of the digital system are acceptable for lower-extremity venography. Digital fluoroscopic hard copy was compared with conventional spot films in 22 examinations. The digital examinations were as accurate as the conventional examinations. Procedure time, exposure to radiation, film costs, and repeated injections of contrast medium because of errors in exposure were reduced with the digital method. The need for extra technologists was eliminated. The advantages of digital radiographic displays, postprocessing, storage, and transmission were maximized. Digital fluoroscopic examinations were as accurate as conventional spot films and were found to have many advantages.

Digital imaging of the chest.

During the past several years, image acquisition in nuclear medicine, computed tomography, ultrasonography, subtraction angiography, and magnetic resonance has been by digitization. Despite these advances, research in the development of digital imaging in conventional radiography has lagged behind. Although studies with a variety of digital techniques have been carried out on several fronts, we still do not possess a method that has captured the imagination of the majority of radiologists and other physicians to a point where it could replace conventional screen-film imaging. This article reviews the current status and general principles of the technology, focusing on the four digital radiographic techniques that have shown the greatest promise - film digitization, an image intensifier - based system, photostimulable phosphor plates, and a scanned projection system. The physical aspects of each of the four systems and the clinical results that have been reported to date, as well as the advantages and disadvantages of each system, are presented.

Local area networks for radiology.

This article is a tutorial on local area networks (LAN) for radiology applications. LANs are being implemented in radiology departments for the management of text and images, replacing the inflexible point-to-point wiring between two devices (computer-to-terminal). These networks enable the sharing of computers and computer devices, reduce equipment costs, and provide improved reliability. Any LAN must include items from the following four categories: transmission medium, topology, data transmission mode, and access protocol. Media for local area networks are twisted pair, coaxial, and optical fiber cables. The topology of these networks include the star, ring, bus, tree, and circuit-switching. Data transmission modes are either analog signals or digital signals. Access protocol methods include the broadcast bus system and the ring system. A performance measurement for a LAN is the throughput rate as a function of the number of active computer nodes. Standards for LANs help to ensure that products purchased from multiple manufacturers will operate successfully.