Biomedical subjects

D B Plewes

Publications and source records attributed to D B Plewes.

At least 19 recordsLinked to original sources

PubMed1998

Magnetic resonance imaging of ultrasonic fields.

A nuclear magnetic resonance imaging (MRI) method is described that allows noninvasive, quantitative mapping of medical ultrasound (US) fields in tissue. Application of a resonant magnetic field gradient operating at the US frequency permits detection of nanometer motions associated with ultrasound, and allows direct measurement of absolute pressure, intensity, and speed of sound. By altering gradient timing, the propagation of US fields in time and space can be observed; this enables tracking of US scattering phenomena in a tissue-equivalent medium. An experimental apparatus was constructed that combined a 515-kHz focused US transducer configured with its focus in the center of a small-bore oscillating gradient. This provided an oscillating gradient with a peak gradient strength of 0.40 T/m over a useable imaging volume of 61 cm3. When used in conjunction with 1.5-T clinical MRI system, this apparatus allowed the clear visualization of the focused US field within this volume and its propagation with time. Current limits of sensitivity indicate a noise equivalent sensitivity of 3.8 nm in displacement amplitude, 19 kPa in pressure amplitude and 12 mW/cm2 in acoustic intensity. These studies indicate that MRI can provide a new, noninvasive method for US exposimetry and the basic study of ultrasound biophysics in tissue.

Agar↗

PubMed1997

In vivo validation of MR pulse pressure measurement in an aortic flow model: preliminary results.

MR imaging experiments were conducted to investigate the feasibility of estimating vascular pulse pressure waveforms from measurements of blood flow rates and vessel cross-sectional area. Blood flow waveforms were measured in the aorta's of three 25-30-kg pigs at multiple imaging sections using phase-contrast velocity imaging. Estimates of pulse pressure were derived from these data by evaluating a model characterizing the relationship between pressure, flow, and the cross-sectional area of a vessel segment. Comparisons between the MR-derived estimates of pressure and those obtained from a micromanometer pressure catheter indicate that accurate measurements (mean error +/- SD = 8.2 +/- 3.4, n = 6) can be obtained using conventional velocity imaging techniques. Optimization of the method will require the application of rapid imaging techniques and the development of strategies for obtaining a more localized measurement. With these improvements, our results suggest that MR-based measurement of pulse pressure and related elastic parameters is feasible.

Animals↗

PubMed1996

Analytical description of the high and low contrast behavior of a scan-rotate geometry for equalization mammography.

Many solutions have been proposed to overcome the problem of imaging the radiographically dense breast with high contrast mammographic film of limited dynamic range. In previous works, we have proposed utilizing a modulated fan-beam in a scan-rotate geometry RSER (Rotary Scanning Equalization Radiography), as an efficient method for producing exposure equalized mammograms. The image quality of RSER is similar to that attained with the inefficient single beam, raster scanning SER (Scanning Equalization Radiography) geometry. RSER has the potential to be a practical, efficient method for improving the detection of cancer in the dense breast. In this work, we present a theoretical analysis of the imaging properties of the RSER geometry in two regimes defined by the variation of x-ray transmission within the object. For low contrast objects, the imaging geometry was analyzed as a linear system, whereas the high contrast regime was studied by determining the contrast limit at which RSER requires nonphysical (negative) exposure modulation for a breast-like object. The low contrast transfer function of the RSER system is shown to be very similar to that of the SER geometry. We show that RSER enables the use of wide scanning beam of approximately 4 cm and thereby significantly reduces x-ray tube heat loading. Analysis of the high contrast behavior shows that a wide range of object contrasts and sizes can be equalized. For example, RSER can equalize a region of 100% glandular tissue within a 4.0 cm thick compressed breast composed of 100% adipose tissue. Thus, the RSER geometry produces images very similar to the more inefficient SER geometry, and is able to produce entrance exposure distributions appropriate for equalization of the range of contrast typically encountered in mammography.

Biometry↗

PubMed1996

Practical application of a scan-rotate equalization geometry to mammography.

The presence of dense fibroglandular tissue within the breast is the most significant cause of failure to detect breast cancer with mammography. The dense tissue often produces a range of exposure which exceeds the useful dynamic range of film-screen mammography. It has been shown that equalization radiography overcomes the latitude limitations of film-screen imaging. Equalization compensates for regional variations in x-ray transmission within the patient through spatial modulation of the entrance exposure. We have proposed rotary scanning equalization radiography (RSER), a scan-rotate geometry for efficient equalization radiography. In RSER the image receptor is exposed by repeated scans of a source-modulated fan beam. The fan beam is rotated with respect to the patient between scans. Numerical simulations and theoretical analysis have shown that the superposition of exposure from appropriately modulated fan beams at a variety of angles is an entrance exposure that effectively equalizes the film exposure. The design and characteristics of a prototype RSER imaging system are described. Anthropomorphic breast phantom images are used to determine the improvement in image contrast obtained with RSER, the expected tube loading, and the presence of artifacts. RSER increases the fraction of the breast imaged with high contrast (at least 90% of peak gradient) from 46% (conventional mammography) to 80%. Subjective examination of the phantom images show that RSER achieves image quality very similar to that of much less efficient equalization geometries with only 2.7 times greater tube loading than conventional mammography. As predicted by theoretical analysis of exposure artifacts in RSER, the prototype RSER system is relatively immune to artifacts. Exposure artifacts were demonstrated for extreme variations in x-ray transmission within the patient. These results show that RSER is an efficient, practical means of overcoming the latitude limitations of film-screen mammography, and improving the detection of breast cancer.

Biophysical Phenomena↗

PubMed1996

Magnetic resonance imaging in potential postsurgical recurrence of breast cancer: pitfalls and limitations.

OBJECTIVE: To determine the sensitivity and specificity of magnetic resonance imaging (MRI) of the breast for detecting recurrent carcinoma. PATIENTS AND METHODS: Thirteen patients ranging in age from 47 to 77 years who had undergone lumpectomy 5 months to 8 years earlier and who had mammographic findings suggestive of recurrence underwent contrast-enhanced dynamic MRI. Histologic confirmation was obtained in all cases. RESULTS: Of the eight lesions (in seven patients) for which biopsy proved recurrence, MRI correctly identified six; there were two false negative results. Of the six benign lesions, four were correctly identified by MRI. The two false positive results involved fat necrosis and a foreign-body reaction respectively. CONCLUSION: These results confirm previous reports of the poor specificity of MRI of focal breast lesions. The authors therefore recommend caution in the use of breast MRI in the assessment and management of suspected recurrent carcinoma.

Aged↗

PubMed1995

Phase constrained encoding (PACE): a technique for MRI in large static field inhomogeneities.

In spin echo imaging, magnetization is assigned to a location defined by its frequency of rotation. In the presence of a static magnetic field inhomogeneity, however, this location does not correspond to the true location of the magnetization. This paper describes a magnetic resonance imaging technique called phase constrained encoding (PACE) that assigns magnetization to its true location through the use of a spin echo train and alternating readout gradients. Small artifactual side-bands occur in the point spread function but can be minimized or eliminated using higher gradient strengths, more echoes, and/or additional acquisitions. Implementation of a simple version of this technique confirms simulations.

Artifacts↗

PubMed1995

Role of equalisation mammography of dense breasts.

Parenchymal patterns characteristic of dense breasts are known to degrade the mammographic detection of small breast cancers and microcalcifications. This arises from large variations in exposure of the film, resulting in reduced image contrast over areas of suboptimal exposure. Based on sensitometric measurements of mammograms from a typical patient population, it is shown that over 60% of a typical mammogram in Wolfe's DY classification was found to be exposed suboptimally, suggesting a significant margin for improving mammography for these patients. In order to address this problem, a prototype mammographic version of scanning equalisation radiography (MSER) has been developed, which delivers a patient-specific spatially non-uniform distribution of breast exposure, adjusted to maintain optimal film exposure and contrast over the entire mammogram. Anthropomorphic phantom MSER images show a marked improvement in subjective image quality relative to conventional mammograms, while exhibiting a similar radiation risk. The detection of small microcalcifications and fibrils over clinically significant breast densities is found to be improved by factors eight and four, respectively. Such a system may be clinically practical through the use of multiple-beam equalisation methods with available X-ray tube technology.

Breast Neoplasms↗

PubMed1995

An MR compatible flow simulator for intravascular pressure simulation.

An MR compatible flow simulator is described which generates physiologically realistic pressure and flow waveforms. The simulator is based on a servomotor-driven gear pump which produces pulsatile flow by modulation of the servomotor rotation rate. Operation of the simulator is under the control of a personal computer, which executes an iterative feedback loop to minimize errors between measured and desired pressure waveforms. The simulator is totally automatic, requiring only a few minutes of iteration to generate the desired pressure waveform. Accurate sinusoidal waveforms with frequencies up to 10 Hz have been generated using the simulator, with high-frequency contamination of the measured waveform at least 80 dB below the fundamental frequency. Aortic waveforms have been produced with realistic flow rates and pressure variations. The pump assembly is mechanically straightforward and can operate at an 8-m distance from the flow phantom to allow the device to be isolated from the MR magnet room.

Biophysical Phenomena↗

PubMed1995

A method for practical equalization mammography of the radiographically dense breast.

It has been shown that equalization radiography can overcome the well-known problem of limited film latitude encountered in mammography of the radiographically dense breast. Current equalization geometries based on single scanning beam (SER) or multiple-beam techniques approach the heat-loading limits of mammographic x-ray sources and require excessively long scan times. The authors have proposed an alternative geometry for equalization mammography, rotary scanning equalization radiography (RSER), which uses a slot beam in a translate-rotate geometry. RSER provides the simplicity of a single-beam geometry while offering improved tube efficiency over multiple-beam geometries. Numerical simulations and a prototype imaging system are used to show that equalized mammograms exhibiting high contrast throughout the breast can be obtained with a large scanning beam translated over the image at only four scanning angles. These results indicate that RSER is an efficient, simple, and practical means of imaging the dense breast.

Female↗

PubMed1994

Rotary scanning equalization radiography: an efficient geometry for equalization mammography.

The detection of cancer in the radiographically dense breast is problematic, since the breast will produce a range of exposure that exceeds the useful dynamic range of high contrast film-screen combinations. It has been shown previously that mammographic scanning equalization radiography (MSER) can be used to overcome the latitude limitations of film-screen mammography. However, the tube loading of MSER is orders of magnitude greater than conventional mammography. A new rotary geometry for equalization radiography is proposed, in which the image receptor is exposed by repeated scans of a modulated slot beam, oriented at a variety of scanning angles with respect to the object. The superposition of the exposure from appropriately modulated, rotated slot beams produces an entrance exposure that will effectively equalize the film exposure. The principle advantages of this geometry is its simplicity and reduced tube loading. To determine the effectiveness and feasibility of RSER the effect of conventional, MSER, and RSER have been numerically simulated on the appearance of clinical mammograms, the relative heat loading, and the fraction of the breast imaged with high contrast are calculated. It is found that RSER produces images that are free of artefacts, and exhibit a similar degree of equalization, as found in MSER images. RSER accomplishes this with only four scanning angles, and a beam that is approximately 4 cm wide. The resulting tube loading is only three times greater than that found in conventional imaging. Numerical simulations indicate that RSER is a simple, feasible means of overcoming the latitude limitations of film-screen mammography.

Computer Simulation↗

PubMed1994

The AAPM/RSNA physics tutorial for residents. Contrast mechanisms in spin-echo MR imaging.

The majority of sequences used in routine clinical magnetic resonance imaging rely on the concepts involving the spin echo. Spin-echo sequences require long acquisition times (1-10 minutes), but compared with faster gradient-recalled echo methods, spin-echo methods are relatively immune to signal loss and distortions from field inhomogeneity and tissue-induced susceptibility variations. Through modifications of intersequence repetition time (TR), echo formation interval (echo time [TE]), and various gradient moments, image contrast can be altered to emphasize tissue relaxation times T1, T2, or proton density. The TR and TE values control the amount of T1 weighting and T2 weighting, respectively. At long TR intervals (approximately 10 x tissue T1 values) and minimum TE values, the difference in signal intensity arising from relaxation vanishes, and contrast arises solely from the differences in proton density between the two tissues. Images formed with short TR intervals and long TE values exhibit very low signal-to-noise ratio and negligible contrast and should be avoided. Recently, fast spin-echo sequences have partially overcome the limitation of long acquisition times, with up to 16-fold reduction, by acquiring multiple lines in k space with multiecho sequences.

Artifacts↗

PubMed1994

Detection of pituitary microadenomas: comparison of dynamic keyhole fast spin-echo, unenhanced, and conventional contrast-enhanced MR imaging.

OBJECTIVE: Pituitary microadenomas may not be detected on conventional MR images. We supplemented conventional unenhanced and contrast-enhanced MR imaging with a dynamic keyhole fast spin-echo (kFSE) method in order to compare how frequently a microadenoma could be detected with the three different methods. SUBJECTS AND METHODS: Eighteen consecutive patients with clinical and laboratory evidence of pituitary microadenomas had unenhanced, dynamic kFSE, and conventional contrast-enhanced MR imaging of the pituitary gland. A control group of 13 subjects without pituitary disease also had dynamic kFSE MR imaging. Hard copies of all the studies were obtained in an identical fashion, and then the MR images of the patients and control subjects were randomly mixed. The studies were reviewed by a neuroradiologist who had no knowledge of the clinical status of the subjects. The presence or absence of any pituitary focal hypointensity consistent with the appearance of a microadenoma was noted. RESULTS: A pituitary lesion consistent in appearance with a microadenoma was detected on dynamic kFSE images in 13 of the 18 patients, on unenhanced images in nine patients, and on conventional contrast-enhanced images in 10 patients. In four patients, a microadenoma was detected on dynamic kFSE images only. Dynamic kFSE images showed a lesion in four of the 13 control subjects. CONCLUSION: Dynamic kFSE MR imaging is a useful supplemental sequence in patients undergoing MR imaging because of pituitary endocrinopathy. It may show lesions that would otherwise escape detection.

Adenoma↗

PubMed1991

Improved imaging of bone with scan equalization radiography.

Use of scan equalization radiography (SER) for imaging bone in the head, face, neck, and shoulder was evaluated in a clinical comparison study with conventional radiographs of randomly selected patients. Two hundred nine pairs of normal and abnormal SER images and conventional radiographs were compared by four radiologists in a side-by-side viewing situation. The radiologists compared the visibility of specific anatomic features and rated the SER images as better than, equal to, or worse than the conventional radiographs. In the evaluation of the images of the cervical spine, the radiologists much preferred the SER images 63% of the time because of slight improvement in bone detail and marked improvement in detail of the soft tissues. In the evaluation of the images of the shoulder, the radiologists preferred the SER image 58% of the time and preferred the conventional radiograph only 5% of the time (p less than .05). In the evaluation of the images of the skull, face, and mandible, the radiologists preferred the SER images 62% of the time and the conventional images 4% of the time (p less than .05). The superior image quality with the SER technique was recognized by all radiologists in the study and was the overwhelmingly preferred way of imaging the shoulder, neck, head, and face.

Adult↗

PubMed1989

Hybrid methods of chemical-shift imaging.

We propose a family of hybrid chemical-shift sequences which combines two physical principles for water/lipid separation to minimize artifacts introduced by B0 and B1 inhomogeneities. Hybrid sequences provide improved species discrimination over earlier methods without resorting to postprocessing while maintaining a multislice/multiecho capability.

Abdomen↗

PubMed1989

Comparison of scanning equalization and conventional chest radiography.

A clinical comparison study of scanning equalization radiography (SER) and conventional chest radiography was performed with the latest prototype SER system. Conventional chest radiography was performed at 120 kVp with Lanex regular screens (Eastman Kodak, Rochester, NY) and Kodak Ortho-G or Ortho-C film (Eastman Kodak). The 253 volunteer patients were examined with both techniques. The chest radiographs were interpreted by four radiologists. The study group was composed of 58 normal and 195 abnormal posteroanterior and lateral chest radiographs. In 31 cases there were two major radiologic diagnoses. The number of correct interpretations increased when the SER images were examined, compared with the conventional Ortho-G (chi 2 = 4.17, P less than .05) and conventional Ortho-C (chi 2 = 16.9, P less than .001) radiographs. The overall accuracy of disease detection improved for all radiologists with the SER system. There was no disease category in which the accuracy of interpretation decreased when the SER system was used. The SER system is a clinically reliable method of improving image quality and increasing diagnostic accuracy.

Humans↗

PubMed1989

Lung weight in vivo measured with computed tomography and rebreathing of soluble gases.

In nine anesthetized dogs, accuracy of noninvasive measurements of lung weight (W) and gas volume in vivo was determined from volume and density determined by computed tomography (CT) and by rebreathing helium and the soluble gases dimethyl ether (WDME) and acetylene (WC2H2). Reference standards were obtained from the postmortem scale weight of the frozen lungs (Wscale) and compared with the CT lung weights measured in the living dog (WCT-38) and the frozen carcass (WCT-cold). WCT-cold did not significantly differ from Wscale [-2 +/- 9% (SD), P = 0.7]. WCT-cold was 10% greater than WCT-38 (0.10 greater than P greater than 0.05), suggesting an increase in lung weight despite immediately commencing freezing after death. WDME measured 64 +/- 6% and WC2H2 56 +/- 12% of WCT-38. Serial multiple measurements in three dogs over 14 wk showed a coefficient of variation (CV) of 10 +/- 2% for WDME, 18 +/- 2% for WC2H2, 4.1 +/- 0.9% for WCT, 2.6 +/- 0.8% for CT density, and 3.5 +/- 1.6% for functional residual capacity (FRC) by CT. FRC calculated from CT consistently underestimated FRC measured by rebreathing helium by 18 +/- 8% (P less than 0.005). This error, despite good agreement between WCT and Wscale, was explained by underestimation of CT total lung volume and overestimation of lung density by factors known to affect CT readings, such as partial volume effects, beam hardening, and limited number of input signals. These data show that CT scanning can provide serial measurement of the mass, density, and volume of the lungs with a CV in the order of 5%, but the rebreathing of soluble gases gives more than double this variability. Measurements of WDME performed on the same day had a CV of 3 +/- 1%, so that WDME provides a precise noninvasive means to measure lung weight in acute studies.

Acetylene↗

PubMed1988

Fat suppression in the time domain in fast MR imaging.

Two gradient-recalled lipid suppression sequences are proposed. A two-excitation sequence cycles the TE interval between excitations to alter the lipid phase which is followed by complex subtraction. A four-excitation variant which improves the extent of lipid suppression by partially compensating for errors resulting from spin-spin relaxation and B0 inhomogeneities is outlined.

Humans↗

PubMed1988

Improved pulmonary nodule detection with scanning equalization radiography.

The potential for improved pulmonary nodule detection with scanning equalization radiography (SER) was evaluated by means of observer performance testing during the interpretation of posteroanterior conventional radiographs and SER images of an anthropomorphic chest phantom with simulated nodules. A test set of 200 conventional and 200 SER radiographs of phantoms containing either one nodule or none was interpreted by four radiologists attempting to detect a nodule and indicate a confidence value. Their ability to detect nodules positioned over the lung was slightly improved with SER compared with conventional radiography (sensitivity, .56 vs .70); for nodules over the mediastinum or diaphragmatic areas, it was much improved (sensitivity, .29 vs .64). The results were also analyzed with receiver-operating characteristic methods, which revealed a significant improvement in lesion detect-ability over the thicker body parts with SER images. The capability of equalized chest radiographs to provide improved lesion detectability suggests that SER may set a new standard for film-based chest radiography and have a large clinical application.

Humans↗