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Biomedical subjects

G H Roberson

Publications and source records attributed to G H Roberson.

At least 19 recordsLinked to original sources

Integrated radiology information system, picture archiving and communications system, and teleradiology--workflow-driven and future-proof.

The proliferation of integrated radiology information system/picture archiving and communication system (RIS/PACS) and teleradiology has been slow because of two concerns: usability and economic return. A major dissatisfaction on the usability issue is that contemporary systems are not intelligent enough to support the logical workflow of radiologists. We propose to better understand the algorithms underlying the radiologists' reading process, and then embed this intelligence into the software program so that radiologists can interact with the system with less conscious effort. Regarding economic return issues, people are looking for insurance against obsolescence in order to protect their investments. We propose to future-proof a system by sticking to the following principles: compliance to industry standards, commercial off-the-shelf (COTS) components, and modularity. An integrated RIS/PACS and teleradiology system designed to be workflow-driven and future-proof is being developed at Texas Tech University Health Sciences Center.

Algorithms↗

Radiology information systems, picture archiving and communication systems, teleradiology--overview and design criteria.

Information technology (IT), long taken for granted in commercial settings, is now being utilized for health-care applications. Medical imaging has lagged comparatively due to the extremely vast data content of each frame; thus, the requirement for expensive high-end components. Further, IT in radiology has evolved from two distinctly separate camps--information systems, known as RIS (radiology information systems) and PACS (picture archiving and communications systems). Both RIS and PACS applications have migrated to the PC environment, enabling cost-effective implementation, but from two backgrounds: RIS from vendors using conventional information systems platforms and products, and PACS from radiographic film and modality vendors. The radiology department at Texas Tech University has assembled a seamlessly integrated, enterprise-wide RIS/PACS/teleradiology intranet. The design criteria include user-friendliness, flexibility to respond to changing needs, and open modular architecture to assure interoperability, cost-effectiveness, and future-proofing of investment. Since no single venor could provide an integrated system meeting our specifications, we decided to assume the burden of constructing our own system. As the system integrator, we embrace open architecture, thus enabling the incorporation of industry-standard-compliant, COTS (commercially off the shelf) products as modules. Microsoft Windows NT operating system, Visual C++ programming language, TCP/IP (transmission control protocol/internetworking protocol), relational SQL (structured query language) database, ODBC (open database connectivity), HL-7 (health level seven) and DICOM (digital imaging and communications in medicine) interfaces are utilized. The usage of COTS components reduces the cost to very affordable levels. With this approach, any module in our system can be replaced when outmoded, without affecting other modules in our system, making it truly future-proof. Construction and evolution of our system (TECHRAD) is reviewed.

Computer Systems↗

Secondary syringomyelia due to intramedullary spinal cord metastasis. Case report and review of literature.

Intramedullary spinal cord metastasis is relatively rare. We describe a patient having intramedullary spinal cord metastasis associated with syringomyelia, confirmed by magnetic resonance imaging, in a patient who had poorly differentiated carcinoma of the lung. The patient responded to treatment with steroids and radiotherapy, with complete resolution of neurologic symptoms and syringomyelia.

Adult↗

Radiological aspects of inverted papilloma.

Of 115 proved cases of inverted papilloma, 81 were studied radiographically. The tumor was seen in both early and late stages. Many cases presented as recurrent tumor after multiple surgical procedures. A common radiologic presentation was a unilateral mass in the nasal fossa with opacification of the contiguous maxillary sinus in a moderately advanced tumor stage. However, other radiologic patterns were encountered and it was therefore impossible to categorize any of these findings as specific for inverted papilloma.

Adolescent↗

Angiography and embolization of the internal maxillary artery for posterior epistaxis.

Epistaxis that originates from the posterior aspect of the nasal cavity is most often due to hemorrhage from one of the branches of the internal maxillary artery. There are multiple methods of treatment of this problem that vary in effectiveness, complexity, and stress on the patient. Most cases are controlled with either packing or surgical arterial ligation, but occasionally patients either cannot tolerate this therapy or continue to hemorrhage. We describe ten patients who were referred to the Neuroradiology Section of the Massachusetts General Hospital from the Massachusetts Eye and Ear Infirmary for angiography and embolization of the internal maxillary artery for epistaxis.

Adult↗

Mechanisms of acute carotid stroke.

In a three-year study, the clinical course and results of intracranial angiography were compared in patients having an acute stroke in the carotid artery territory combined with angiographic abnormalities indicating severe extracranial carotid stenosis or occlusion. Two major mechanisms of stroke were delineated. In one group, the angiographic intracranial abnormalities strongly suggested the presence of embolism in the cerebral vessels supplied by the stenotic or occluded carotid artery; many of these patients had no obvious transient ischemic attacks prior to their stroke and experienced a moderate to severe clinical deficit. In the other group, evidence of embolism was absent; many showed a widespread delay in cerebral arterial perfusion, experienced a greater frequency of transient ischemic attacks before their stroke, and had a milder stroke than did those with embolism.

Carotid Artery Diseases↗

Computed tomography of masses in the lacrimal gland region.

Twenty patients with mass lesions in the lacrimal gland region were evaluated with computed tomography (CT). The extent of the mass and its relationship to the globe, optic nerve, and extraocular muscles were clearly seen. The CT appearance on plain scan and the presence or absence of contrast enhancement, bone involvement, and cystic components often suggested the specific pathological diagnosis. Although orbital ultrasonography and CT were frequently complementary, ultrasonography was more definitive in inflammatory diseases, while CT demonstrated better extraorbital extension.

Adenocarcinoma↗

Evaluation of mucoceles of the paranasal sinuses with computed tomography.

Eighteen patients with mucoceles of the paranasal sinuses were studied by plain radiography, pluridirectional tomography, and computed tomography (CT). Sixteen of the lesions had a homogeneous appearance on CT but demonstrated variable absorption characteristics, with acutely infected mucoceles showing rim enhancement. Plain radiography and pluridirectional tomography were usually sufficient for making a diagnosis and defining the extent of the lesion, but CT more accurately demonstrated orbital and intracranial extension. Both transverse and coronal CT are essential for adequate evaluation.

Adolescent↗

Therapeutic embolization of juvenile angiofibroma.

Therapeutic embolization of juvenile angiofibromas was performed in 15 boys, aged 12--18 years, 11 of whom subsequently underwent surgery. Intraoperative blood loss was reduced from an average of 2,400 ml in nonembolized patients to 800 ml after embolization. Angiography is of value to confirm the diagnosis prior to excision and to delineate the extent of the tumor. Embolization may be performed at the same sitting as a presurgical adjunct or possibly as a definitive or palliative therapeutic method. The embolization procedure is discussed in detail, emphasizing techniques and potential hazards of such procedures.

Adolescent↗

Computed tomography in primary malignant lymphoma of the brain.

Primary malignant lymphoma of the brain is a rare lesion characterized clinically by varied nonspecific neurologic deficits and usually a rapid fulminant deterioration and death. This course may be altered by radiotherapy, and early diagnosis assumes major importance. Laboratory tests, EEG, radionuclide scans, angiography, and pneumoencephalography may not show definite abnormality in the early stages. This report concerns four cases in which good correlation between the location of the brain lesion and the abnormality on computed tomography scan was demonstrated.

Adult↗

Computed tomography of the paranasal sinuses and face: part I. Normal anatomy.

With the ability to image both bone and soft tissue structures, computed tomography (CT) is capable of visualizing many normal anatomical structures of the paranasal sinuses and face not seen with other radiological techniques. The superficial and deep fat planes, all of the muscles of mastication, and many of the facial muscles are readily identified. The extraocular muscles, optic nerves, and globes are clearly seen. The purpose of this report is to review the normal anatomy of the paranasal sinuses and face imaged by CT in both the transverse and coronal planes.

Face↗

Computed tomography of the paranasal sinuses and face: part II. Pathological anatomy.

Computed tomography (CT) has added an important new dimension to the radiological evaluation of diseases of the paranasal sinuses and face. Using transverse and coronal scans, accurate assessment of the character and extent of mass lesions in this region can be achieved. Erosion of thin bony lamine and involvement of soft tissue structures of the face can be seen. Most important, CT is capable of precisely defining the extension of lesions into the pterygopalatine fossa, orbit, and cranial cavity, information that is essential for therapeutic planning.

Adult↗