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Biomedical subjects

D J Vining

Publications and source records attributed to D J Vining.

10 recordsLinked to original sources
PubMed1998

Rectal imaging and cancer.

Rectal imaging has evolved substantially during the past 25 years and now offers surgeons exquisite anatomic detail and physiologic information. Dynamic cystoproctography, helical computed tomography, endoscopic ultrasonography, endorectal magnetic resonance imaging, and immunoscintigraphy have become standards for the diagnosis of rectal disease, staging of neoplasia, and survey of therapeutic results. The indications, limitations, and relative costs of current imaging methods are reviewed, and advances in imaging technology that promise future benefits to colorectal surgeons are introduced.

Cost-Benefit Analysis↗
PubMed1997

Virtual colonoscopy.

A new method for colon examination, virtual colonoscopy, has been created by combining spiral computed tomography and virtual reality computer technology. If virtual colonoscopy proves equal to or superior to traditional colonoscopy in sensitivity and specificity for cancer screening, it would yield significant clinical and public health benefits because of its potential for increased acceptance among patients as well as its considerably lower cost and risks.

Colon↗
PubMed1996

Virtual bronchoscopy. Relationships of virtual reality endobronchial simulations to actual bronchoscopic findings.

Advances in computer technology have permitted development of virtual reality images of the tracheobronchial tree using data sets derived from helical CT of the chest. To determine the relevance of these images to actual bronchoscopic findings, we compared "virtual bronchoscopy" images with videotaped bronchoscopy results in 20 patients who had undergone both helical chest CT and fiberoptic bronchoscopy during clinical evaluation of their thoracic problems. Suboptimal endobronchial simulations in ten patients identified important, readily-addressed technical requirements for this imaging procedure. In the ten patients with technically suitable renderings of the airway, virtual bronchoscopy simulations accurately demonstrated endobronchial obstructions by tumor in five, airway distortion and/or ectasia in four, and accessory bronchi in another. These preliminary observations suggest that virtual bronchoscopy simulations accurately represent major endobronchial anatomic findings. This technique may have a role in prebronchoscopy planning, endoscopy training, and/or endobronchial therapy, and merits further study.

Bronchial Diseases↗
PubMed1992

Receiver operating characteristic curves: a basic understanding.

Receiver operating characteristic (ROC) is one form of an objective measurement that can be used to compare newer imaging technologies against human observer performance (the ability of the expert radiologist). Use of ROC curves allows one to account for a continuum of radiologic interpretations when calculating sensitivity and specificity for an imaging modality and avoids the inaccuracies that arise from assuming that imaging findings are absolutely normal or abnormal. An ROC curve is generated by plotting sensitivity on the y axis as a function of [1-specificity] on the x axis for a continuum of diagnostic criteria. ROC curves allow visual analysis of the trade offs between the sensitivity and the specificity of a test with regard to the variable diagnostic criteria used by radiologists. Because ROC curve analysis is gaining wide acceptance in medical literature, an explanation of ROC methods with the use of simple examples is necessary to increase the knowledge and understanding of practicing radiologists.

Humans↗
PubMed1992

Childhood odontoid fractures evaluated with computerized tomography. Case report.

A case is presented that illustrates the use of computerized tomography for the evaluation of an odontoid fracture in a child. Such a "fracture" may actually represent a "synchondrotic slip" of the odontoid and C-2 vertebral body between the neural arches of C-2. Treatment should almost always be conservative. Complete healing of the injury is expected.

Child, Preschool↗
PubMedDate not supplied

Tracheobronchial tree: three-dimensional spiral CT with bronchoscopic perspective.

The purpose of this report is to describe an original 3D technique that permits bronchoscopic perspective simulations of the tracheobronchial tree on an affordable workstation. Software based on surface shading was developed to permit navigation through the central airways using spiral CT data. Multiplanar reformations are displayed simultaneously with the virtual bronchoscopy simulations to give information about tissues surrounding the airways. Two clinical examples are reported to illustrate the value of this advanced computer technique.

Bronchography↗
PubMedDate not supplied

Interpretation of abdominal CT: analysis of errors and their causes.

PURPOSE: Our goal was to analyze those factors contributing to the error rate in the interpretation of abdominal CT scans at an academic medical center. METHOD: From a total of 694 consecutive patients (329 male, 365 female), we evaluated the error rates of interpreting abdominal CT studies. The average patient age was 54 years. All abdominal CT studies were reviewed by three to five CT faculty radiologists on the morning after the studies were performed. The error rate was correlated with reader variability, the number of cases read per day, the presence of a resident, inpatient versus outpatient, organ systems, etc. The chi 2-test was used for statistical analysis. RESULTS: A total of 56 errors were found in the reports of 53 patients (overall error rate = 7.6%). Of these errors, 19 were judged to be clinically significant and 7 affected patient management. A statistically significant difference in error rates was noted among the five faculty radiologists (3.6-16.1%, p = 0.00062). No significant correlates between error rates and any of the other variables could be established. CONCLUSION: The primary determinant of error rates in body CT is the skill of the interpreting radiologist.

Abdomen↗
PubMedDate not supplied

Imaging of mediastinal lymph nodes: CT, MR, and FDG PET.

The evaluation of mediastinal lymph nodes is an important aspect of staging in patients with non-small cell lung cancer. Anatomic imaging of lymph nodes with computed tomography (CT) and magnetic resonance (MR) imaging has been limited by the relatively low sensitivity and specificity of these techniques. Advances in physiologic imaging of mediastinal lymph nodes with 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) have resulted in improved diagnostic accuracy in the determination of nodal status. Despite the limitations of CT, this technique still plays an important role by aiding in the selection of the most appropriate procedure for staging, by guiding biopsy, and by providing anatomic information for visual correlation with FDG PET images. At present, anatomic MR imaging of lymph nodes is primarily a problem-solving tool for cases with inconclusive CT results. Physiologic MR imaging with iron oxide is an exciting area of investigation, and the accuracy of this technique is being assessed in clinical trials. Anatomic and physiologic imaging techniques should be considered complementary rather than competitive imaging strategies.

Carcinoma, Non-Small-Cell Lung↗