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Biomedical subjects

A E Todd-Pokropek

Publications and source records attributed to A E Todd-Pokropek.

8 recordsLinked to original sources

Functional imaging of the brain using single photon emission computerized tomography (SPECT).

The use of tracers is an important technique available for studying cerebral function. Changes in 'signal' are large, but as a result of its photon limited nature, the measurement of this signal is limited: spatially, temporally and in terms of accuracy. The most commonly used single photon (SPECT) system (as apposed to positron) is that with a rotating gamma camera, although multi-headed devices and special purpose rings are now also commonly available. The problems of obtaining good functional information are however identical. Firstly the devices need to be optimised in terms of resolution and sensitivity. Secondly several sources of error, notably those associated with scatter, attenuation and limited spatial resolution, need to be corrected, with the aim of obtaining quantitative estimates of radioactivity concentration. Finally such quantitative estimates need to be converted into meaningful estimates of physiological variables by use of an appropriate model. The general aim of many SPECT measurements is to estimate blood flow for example using Tc-99m labelled HMPAO as a tracer. Good results have been obtained in many clinical conditions: stroke, dementia, tumour and epilepsy, for example. Many other tracers are also available, for example to measure density of receptor sites. The use of SPECT in conjunction with other techniques after image registration is suggested as being an essential tool in extracting maximal clinical information.

Brain↗

The physical performances of a single slice positron tomographic system and preliminary results in a clinical environment.

Metabolic phenomena can be studied and measured non-invasively using positron emitting radionuclides and a suitably adapted tomographic system. The choice of a single slice ring camera is justified by its physical performance, which is presented here and discussed. A series of measurements with geometrical phantoms and analytical simulations have been performed to determine the critical characteristics of the system. This has permitted optimization of certain parameters enabling very interesting clinical results to be obtained at SHFJ, particularly in the area of cerebral physiopathology. In addition, the potential of obtaining absolute quantitative values of regional activity is presented. The calibration of the regional activity is presented. The calibration of the system, spatial non-stationarities, and attenuation correction, which represent the main sources of error, are considered in detail. A precision of the order of 10% should be obtainable. Such a quantitation method has been successfully applied to the in vivo study of the regional extraction of cerebral oxygen.

Brain↗

Improvement of scintigrams by computer processing.

Computer processing can improve the quality of scintigrams in several ways. It can increase the accuracy with which the image approximates the activity distribution by reversing degradation. It can selectively enhance normal or abnormal structures of interest. It can optimize the use of the display system presenting the image. The usefulness of computer processing must be determined by observer testing and clinical experience. The need to correct distortion in both intensity (nonuniformity) and space can be avoided by attention to calibration and to the setup of the imaging device employed and by use of the sliding energy window technique. Nonuniformity correction, especially for quantitative studies, should not be done using a flood field as this may actually decrease accuracy. Instead, any necessary correction should employ the sensitivity matrix, which measures the variation of sensitivity to a point source with the position of the source. Statistical fluctuations (noise) and degradation of resolution are commonly corrected using linear, stationary techniques [concepts which are defined and developed in the text], but nonstationary techniques appear to be frequently more successful at the expense of increased processing time. Techniques of choice for pure smoothing are nine-point binomial smoothing and variable shape averaging, and those for both sharpening and smoothing (preferred for most modern, high-count scintigrams) are unsharp masking, Metz or Wiener filtering, and bi-regional sharpening. Structures of interest can be enhanced by methods which detect and emphasize changes in local distributions of slope and curvature of intensity. High quality display devices are essential to reap any benefits from degradation correction. Those devices, which must have appropriately high sensitivity and must avoid display artifacts, have become available only recently. Use of the display should be matched to the processing done. Contrast enhancement, e.g. by histogram qualization, for optimal use for each image of the display intensity range, is often helpful. Most scintigram processing is done using computers with about 32K 16-bit words. Floating point hardware is often useful. Most processing methods require 1-30 seconds on such computers and usually under 15 seconds. Processing time tends to be negligible compared to time for user specification of the processing to be done, so the quality of command languages should be of concern. Careful observer studies using phantoms have shown processing to improve detectability of lesions when a single display is used for both processed and unprocessed images, but not when unprocessed images on standard analog displays are compared to processed images on common computer displays...

Computers↗