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Biomedical subjects

F Kelcz

Publications and source records attributed to F Kelcz.

32 records · Page 2Linked to original sources

K-edge digital subtraction arthrography of the painful hip prosthesis: a feasibility study.

K-edge energy subtraction radiography is a method for detecting the presence of iodinated contrast material by subtracting two digital radiographs produced by X-ray beams with energies above and below the iodine K edge. We performed a feasibility study on the application of K-edge energy digital subtraction arthrography (KEDSA) to painful hip prostheses. During arthrography, loosening of the prosthesis is implied if contrast material is seen dissecting around the prosthesis, an often difficult detection task because of adjacent prosthesis metal or cement. In conventional arthrography a preliminary mask image is thus used from which films obtained after injection of iodinated contrast material are subtracted. Movement by the patient during this process may preclude subsequent subtraction. With KEDSA, since multiple image pairs may be obtained after the injection of contrast material, the problem of patient motion is virtually eliminated. A conventional X-ray tube operating between 55 and 65 kVp was alternately filtered by iodine and cerium filters to produce the KEDSA images. The apparatus was capable of producing a subtracted image within 3 sec. The technique was applied to phantoms and to six patients immediately after hip arthrography that had been positive for prosthesis loosening. Although of lower spatial resolution, the KEDSA images were, in all cases, positive for loosening in a pattern consistent with the conventional arthrographic images. KEDSA was shown to be successful in detecting extraarticular contrast material. During a single study, subtraction in various imaging planes as well as postexercise subtraction imaging can be accomplished-techniques not heretofore possible in routine subtraction arthrography.

Aged↗

Extraneous factors affecting resistive index.

Recently, numerous studies have referred to the resistive index as an accurate indicator of acute renal transplant rejection. We encountered several factors other than rejection that resulted in an elevation of the resistive index in both clinical and experimental situations. Any compressive effect on the kidney will elevate the resistive index. This compression may arise from an adjacent mass such as a fluid collection, most commonly hematoma, or even from excessive pressure transmitted via the transducer by a heavy-handed technician. Resistive index elevation also has been demonstrated in experimentally induced hypotension. Technically inaccurate scanning can yield a falsely low resistive index, but these previously mentioned entities can falsely elevate it, leading to an incorrect diagnosis of acute rejection.

Animals↗

Mammographic evaluation of the postsurgical and irradiated breast.

Mammography is important in women who elect lumpectomy and radiation therapy for breast carcinoma: to record the preoperative state, to assess the completeness of resection, and to detect recurrences and second primaries. Mammography of these patients, however, is difficult since surgery and irradiation may cause changes simulating carcinoma. This article describes the findings in the postsurgical and irradiated breast and the difficulty of differentiating the changes from recurrent carcinoma. It also illustrates the findings in recurrences and second primaries.

Breast↗

Clinical and experimental investigation of a smoothed CT reconstruction algorithm.

The usefulness of a smoothed reconstruction CT algorithm was studied using raw data from the EMI Mark I head scanner. The reconstruction algorithm operated on an off-line computer, independent of the EMI algorithm. This technique greatly reduces image noise and improves the visibility of very low-contrast structures, but at the cost of reduced spatial resolution. Phantom tests with contrasts as low as 0.14% demonstrated the validity of the images. Clinical results showed greatly improved visualization of gray and white matter with no increase in dose. It was necessary to expand the CT density scale so that the range from air to water was divided into 2,000 parts.

Brain↗

Computed tomographic measurement of the xenon brain-blood partition coefficient and implications for regional cerebral blood flow: a preliminary report.

The calculation of regional cerebral blood flow requires, in addition to the measurement of the clearance, a knowledge of the regional brain-blood partition coefficient. The usual 133Xe washout techniques do not measure this latter parameter but use published values for normal brain tissue. This may lead to large errors in pathological tissue because the partition coefficient changes significantly in brain tumors. Investigations have begun into the use of CT and stable xenon to produce a cross sectional view of the brain in terms of its brain-blood partition coefficients. Results of experiments using an iodine phantom and xenon inhalation in animals are presented.

Animals↗

Pulsed magnetization transfer contrast for MR imaging with application to breast.

The relative populations and transverse relaxation times of the solid-like hydrogen pool (PB and T2B) and the magnetization transfer (MT) rates between the solid-like and liquid-like hydrogen pools (kappa) have been determined for three different agar gel concentrations (2%, 4%, and 8% by weight) as well as excised fibroglandular breast tissue specimens. PB was determined to be .003(.001), .01(.002), .02(.01), and .06(.01); T2B was determined to be 13.0(.2), 14.0(.1), 14.5(.1) and 15.2(1.3) microseconds; and kappa was determined to be 0.78(.01), 1.15(.02), 2.00(.02), and 3.55(1.5) sec-1 for the 2%, 4%, and 8% agar gels and the fibroglandular tissue, respectively. The image signal intensities of a pulsed MTC-prepared gradient-echo imaging technique are predicted using these MT parameters and are shown to agree well with experimental data obtained from a clinical MR imaging system. This technique is shown to suppress signal intensity of fibroglandular breast tissue by 40%-50% without exceeding SAR limits (< or = 8 W/kg) and is helpful for visualizing lesions and silicone implants.

Breast↗

MR hysterosalpingography in a rabbit model.

Our objective was to evaluate the efficacy of MR imaging as compared with conventional hysterosalpingography (HSG) for the detection of fallopian tube patency after uterine injection of contrast material. Rabbit uterine horns (n= 18) were catheterized transvaginally. Five fallopian tubes were ligated and 11 were left unaltered. T1-weighted gradient-echo MR images were obtained before, during, and after injection of 1.0-3.0 mL of a dilute gadolinium-containing contrast agent. Corresponding conventional studies were performed with an equivalent volume of iohexol. Images were evaluated by two blinded readers. Observers agreed in all cases on the presence (n = 11) or absence (n = 5) of peritoneal spill with conventional HSG. Interpretation of MR HSG concurred with conventional HSG in 14 of 16 cases for each observer (P > .05). Reasons for misdiagnosis included small amounts of spill (n = 2), artifact (n = 1), and subtle spill between bowel loops (n = 1). Sensitivity and specificity for MR HSG were 95.5% and 70%, respectively, for the diagnosis of tubal patency/occlusions. No statistical difference was found between MR HSG and conventional HSG for the diagnosis of fallopian tube patency/obstruction. Potential advantages of MR HSG include no ionizing radiation, potentially diminished local contrast toxicity, superior visualization of uterine fibroids and endometriosis, and visualization of ovaries. We conclude that this technique warrants further study, including the use of a primate model to better simulate human anatomy.

Animals↗

Application of a quantitative model to differentiate benign from malignant breast lesions detected by dynamic, gadolinium-enhanced MRI.

Both benign and malignant breast lesions may exhibit intense contrast enhancement when imaged using gadolinium-enhanced MRI. We propose a quantitative approach for fitting dynamic signal intensity (SI) data that may distinguish benign from malignant lesions. We studied 78 lesions in 75 women (18 malignancies, 16 fibroadenomas, and 44 other benign breast lesions) to determine the potential of this model for decreasing false-positive MR results. Twenty-eight lesions showed no enhancement; all were benign. One lesion showed a complex pattern not amenable to region-of-interest analysis and was considered a false positive. SI versus time data for the remaining 49 lesions were fit to the proposed model. We found that one parameter, M, the normalized slope of the SI enhancement profile evaluated at half the maximal signal intensity, seemed to be highly correlated with malignancy and offered improved discrimination between malignant and benign lesions compared to a previously published two-point slope method.

Breast Diseases↗

Limitations of the keyhole technique for quantitative dynamic contrast-enhanced breast MRI.

The effect of keyhole data acquisition on quantitative analysis of dynamic MRI was examined. Experiments were performed retrospectively on raw data obtained from clinical dynamic contrast-enhanced breast imaging procedures. The effects of keyhole phase-encoding acquisition and type of reconstruction algorithm on the accuracy of derived quantitative parameters was assessed. Results indicate that the minimum keyhole size used should be restricted by the approximate minimum size of the expected lesions. Furthermore, reconstruction algorithms that offer improved image resolution do not circumvent this restriction.

Algorithms↗

Absorption-edge fluoroscopy using a three-spectrum technique.

We have recently reported on a 1-kVp, two-filter image subtraction method for visualizing low concentrations of elements like iodine which have K-shell absorption edges in the diagnostic x-ray energy range. However, in the application of this technique to human thyroid imaging, superimposed images due to variations in tissue and bone thickness presented serious difficulties. In this paper, a technique is described for implementing a 3-kVp, three-filter approach. Using carefully chosen spectra and logarithmic image processing, images are produced which are compatible with our previously described two-stage storage-tube subtraction device. Proper manipulation of the resulting difference images results in a final absorption-edge image in which only the element of interest is visualized, with unwanted background images suppressed. Computer calculations are presented to illustrate the relative sizes of difference signals arising from the element of interest and from tissue and bone backgrounds. Phantom studies using iodine concentrations as small as 1 mg/cm2, with variations of 10 cm of tissue and 2 g/cm2 of bone, suggest that the theory is sound and that, with straightforward apparatus modifications, images of good quality should be possible.

Fluoroscopy↗

Spectral considerations for absorption-edge fluoroscopy.

In our previous reports on absorption-edge fluoroscopy, it was not possible to relate fully the subtleties involved in the selection of spectral parameters. This paper is intended as an overview of this important aspect of the technique. It is shown that, by using the 1-kVp, 2-filter technique, it is possible to image certain elements (e.g., iodine and xenon) in the presence of tissue variations of +/-2 cm about the thickness at which perfect tissue cancellation takes place. Use of logarithmic signal processing extends this range, but bone thickness variations may not be accomodated because only two x-ray energies are involved in the imaging process. Use of a 3-kVp, 3-filter technique with logarithmic signal processing is shown to solve this problem. Computer simulations show that 1-mg/cm2 iodine may be imaged in the presence of 10 cm or more tissue variations and 2000-mg/cm2 bone variations.

Bone and Bones↗

Noise considerations in dual energy CT scanning.

Dual energy CT scanning (tomochemistry) has been proposed as a method for determining various parameters relating to the elemental composition of the tissues. In this paper, our aim is to study the relative noise inherent in two proposed techniques for dual energy scanning; a "two crystal" technique and a "two kV" technique. In the two crystal technique, a split crystal detector is used to simultaneously obtain the high and low energy data during one scan at high kV. The two kV technique requires two scans taken with widely different kV settings. We first review three commonly used approaches for utilizing the scan data to compute the relevant parameters. A theoretical formalism is constructed which aids in understanding these methods. Then this formalism is used to study the influence of CT image noise on measurement precision in the case where the unknown parameters are densities. It is shown that, (1) the unavoidable overlap in the spectral data obtained by the two crystal technique results in a much lower signal-to-noise ratio than can be obtained by using the two kV technique, (2) the necessity for hard filtration of the high energy beam in the two kV technique has not heretofore been appreciated, and (3) the dose for a given x-ray tube heat load is also lower with the two kV technique.

Body Composition↗