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Biomedical subjects

H K Genant

Publications and source records attributed to H K Genant.

At least 487 records · Page 27Linked to original sources
PubMedDate not supplied

In vivo relationship between marrow T2* and trabecular bone density determined with a chemical shift-selective asymmetric spin-echo sequence.

Magnetic field inhomogeneities due to differences in susceptibility between trabecular bone and bone marrow result in a reduction in T2*. The authors previously quantified the relationship between the relaxation rate enhancement per unit change in bone density, delta R2*, using dried, excised vertebral bodies immersed in saline. In the present study, they investigated the precision and reproducibility of such measurements in vitro and found that the short-term precision ranges from 2% to 11%, while the long-term precision error, which may be governed by the placement of the region of interest, can vary up to 50%. A chemical shift-selective asymmetric spin-echo sequence was used to assess T2* changes in the saturated fat component of bone marrow in vivo. It was shown that the marrow fat relaxation rate increases as the surrounding trabecular bone density increases and that the delta R2* of the marrow fat component was 0.20 sec-1/mg/cm3. The results also indicate that the distribution of T2* varies with image resolution. Both in vitro and in vivo, characteristics of the relaxation time distribution such as the mean, standard deviation, and skewness decrease as image resolution decreases, the degree of variation depending on the density of the surrounding trabecular network.

Bone Density↗
PubMedDate not supplied

Quantitative MR relaxometry study of muscle composition and function in Duchenne muscular dystrophy.

Magnetic resonance imaging and maps of T1 and T2 values were used to study muscle composition in Duchenne muscular dystrophy (DMD). The mean T2 of anterior tibial muscle was 27 msec in healthy control subjects and 43 msec with increased fatty infiltration in DMD patients. In stronger DMD patients, the distribution of muscle T2 values was narrow, centered at 27 msec as in the controls, with a nonoverlapping fat peak centered at 49 msec. In weaker DMD patients, the width of the muscle T2 peak increased and the peak shifted toward the fat peak. Mean muscle T1 decreased from 1.7 to 0.6 second with increasing fatty infiltration. These results show that quantitative T1 and T2 maps may be used to assess muscle status and monitor DMD progression.

Adipose Tissue↗
PubMedDate not supplied

Investigation of MR decay rates in microphantom models of trabecular bone.

MR measurements of transverse relaxation time, T2*, in trabecular bone may provide both structural and density-related information for assessment of bone mineral status in osteoporosis. Using submillimeter scale glass phantoms as simplified models of trabecular bone, we have made a quantitative investigation of the dependence of T2* decay on modeled trabecular microstructure and MR image resolution. The experimental MR data are in excellent agreement with predictions from a computer simulation. Decreasing the modeled trabecular bone volume fraction, sigma, decreases the decay rate, as expected. However, if trabecular width and spacing are both increased without changing sigma, the decay rate is unchanged. The measured decay curves closely follow the predicted dependence on trabecular orientation. The decay rates are independent of image resolution, provided that the pixel dimensions are larger than the intertrabecular spacing. For smaller pixel sizes, the decay rate decreases with decreasing pixel size.

Bone Density↗
PubMedDate not supplied

[Three-dimensional computerized tomography of diseases of the bones and joints].

Three-dimensional CT (3-DCT) surface reconstructions were generated in 157 patients with various disorders of the musculoskeletal system. Whereas generating the 3-D display of ligaments, tendons, intervertebral discs and nerve roots was difficult and time-consuming, the comprehension of complex abnormalities of bony structures was easier than with two-dimensional CT. 3-DCT was particularly useful in the preoperative planning of hip and spine surgeries while it also simplified the intraoperative orientation. 3-DCT proved to be a useful diagnostic method supplementing axial computed tomography.

Bone Diseases↗
PubMedDate not supplied

Effect of film graininess and geometric unsharpness on image quality in fine-detail skeletal radiography.

Three direct x-ray films and three geometric conditions were used to study the effect of noise and sharpness on high resolution radiography of the hand. The Wiener spectrum of film graininess and the MTF of geometric unsharpness were measured. Radiographs of a wire mesh and a hand phantom, together with the Wiener spectra and MTFs, led to the following conclusions regarding fine-detail skeletal radiography, as currently employed: 1) bone structure detectable in vivo does not show minute structural detail; 2) the technique is primarily noise-limited; 3) the use of better geometry or finer grain film for improving resolution or noise is of limited practical value, whereas the use of poorer geometry or more noisy film results in appreciable degradation of skeletal images; and 4) the present standard technique for in vivo radiography of the hand, therefore, may be very nearly optimal for clinical applications.

Bone and Bones↗
PubMedDate not supplied

Optical versus radiographic magnification for fine-detail skeletal radiography.

Fine-detail radiographic techniques for peripheral skeletal imaging have gained wide clinical acceptance. In this study, the imaging properties and clinical applications of the optical magnification technique, which employs fine-grain industrial film and a large focal spot, are compared quantitatively and qualitatively with those of three slow screen-film techniques, namely, contact exposure with a large focal spot, 2 times radiographic magnification with a 0.3 mm focal spot, and 4 times radiographic magnification with a 50 mu focal spot. The modulation transfer functions (MTF's) of the recording systems and focal spots are obtained and film sensitometry performed. Clinical comparisons are made for patients with metabolic, arthritic, and neoplastic skeletal disorders. The results illustrate the superiority of the optical magnification technique over contact or 2 times magnification techniques using slow screen-film systems. If a microfocus tube is used, however, direct radiographic magnification may provide images comparable in resolution, noise and contrast to those made with the optical magnification technique, and at lower radiation exposure to the patient.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Comparison of non-screen techniques (medical vs. industrial film) for fine-detail skeletal radiography.

High resolution radiographic techniques for imaging the peripheral skeleton (hand and foot) have gained wide clinical acceptance. The two procedures receiving widest attention are non-screen techniques: one uses medical film (Kodak RP); and the other uses industrial film (Kodak Type M) combined with optical magnification. The imaging properties and clinical applications of these two techniques were examined. The modulation transfer functions (MTF's) of the recording systems, Wiener spectrum analyses of noise, and film sensitometry were obtained. Clinical comparisons were made from 200 consecutive patients radiographed with both techniques and the relative merits in metabolic, arthritic and traumatic afflictions were assessed. The results demonstrate the superiority of the industrial film compared to medical film technique in all parameters of image quality. However, the inconveniences of special processing and viewing necessitated by this technique, as well as the increased radiation exposure, limit its clinical application to small, selection groups of patients as determined from the clinical comparative study.

Arthritis↗
PubMedDate not supplied

Skeletal demineralization and growth retardation in inflammatory bowel disease.

Skeletal growth and mineralization in 54 adolescent and adult patients with inflammatory bowel disease have been analyzed comprehensively. Quantitative and qualitative radiologic techniques consisted of conventional roentgenography, photon absorptiometry, and radiographic morphometry. The data are correlated with the type, duration, and severity of disease, and with several modes of therapy. The results indicate the osteopenia and retardation of growth are common in patients with inflammatory bowel disease, particularly in adolescents, in whom the effects of corticosteroids on the skeleton are most deleterious.

Adolescent↗
PubMedDate not supplied

Quantitative bone mineral analysis using dual energy computed tomography.

This preliminary evaluation indicates that CT scanning permits measurement of cancellous, cortical or integral bone. With the single energy technique, precision is high and with mode, CT scanning may prove an important tool for assessing the axial skeleton is osteoporotic conditions.

Bone and Bones↗
PubMedDate not supplied

Heavy-ion radiography: density resolution and specimen radiography.

Heavy-ion radiography is performed by the passage of a beam of nuclei accelerated to energies of several hundred MeV/nucleon through an object. The technique of recording transmitted nuclei in a downstream stack of plastic sheets affords excellent resolution of density by recording the nuclei only at their stopping points. Imaging of a phantom--which stimulated tumors of low density contrast in a body part--by conventional radiography, computed tomographic scanning and the heavy-ion technique indicated superior density resolution for heavy-ion imaging at radiation dose. Superior imaging of tumors in pathologic specimens was demonstrated for heavy-ion imaging compared to conventional radiography. Values of stopping power for various tumors and normal tissues were determined by a computer-aided technique. Heavy-ion radiography shows promise for superior imaging of low contrast tumors at relatively low radiation low levels.

Achilles Tendon↗
PubMedDate not supplied

In vivo assessment of bone metabolism using the cortical striation index.

Metacarpal cortical striations were evaluated in 350 patients using fine-detail radiography with optical magnification. Compared to the control population, mean striation-indices were elevated in growing children, primary and secondary hyperparathyroidism, osteomalacia and reflex sympathetic dystrophy syndrome. This technique may provide a useful quantitative assessment of bone metabolism, allowing differentiation of normal from hypermetabolic states. Serial assessment of cortical striation may be useful in monitoring response to therapy.

Acromegaly↗
PubMedDate not supplied

Quantitative computed tomography for spinal mineral assessment: current status.

Quantitative CT (QCT) is an established method for the noninvasive assessment of bone mineral content in the vertebral spongiosum and other anatomic locations. The potential strengths of QCT relative to dual photon absorptiometry (DPA) are its capability for precise three-dimensional anatomic localization providing a direct density measurement and its capability for spatial separation of highly responsive cancellous bone from less responsive cortical bone. The extraction of this quantitative information from the CT image, however, requires sophisticated calibration and positioning techniques and careful technical monitoring.

Adult↗
PubMedDate not supplied

Vertebral mineral determination by quantitative computed tomography (QCT): accuracy of single and dual energy measurements.

Quantitative CT (QCT) studies of trabecular vertebral bone tissue have been carried out in vitro on a GE CT/T 9800 scanner. Results of both single energy (SE) 80 kVp and dual energy (DE) 80/140 kVp QCT data are compared with chemical mineral analysis to determine accuracy. We examined 62 vertebral specimens, from 28 cadavers (19 male and 9 female with an age range of 19-93 years, mean = 60.4). Averaging the results of all vertebral bodies of the same individual for SEQCT versus ashweight, we found a correlation coefficient (r) of 0.94 (p less than 0.0001), a standard error of the estimate (SEE) of 12.2 mg/cm3 (calibrated to K2HPO4), with a coefficient of variation (CV) of 13.2% and an average underestimation of bone mineral content of 18.7 mg/cm3. The corresponding DEQCT results were r = 0.98 (p less than 0.0001), SEE = 7.4 mg/cm3, CV = 7.0%, and an average underestimation of 4.9 mg/cm3. The SE and DE results are correlated with r = 0.98 (p less than 0.0001), SEE = 8.0 mg/cm3, and CV = 8.7%. From our SEQCT data and the results of the chemical analysis of bone mineral and fat content we calculated a fat sensitivity of 7.7 mg/cm3 K2HPO4 per 100 mg/cm3 fat change for our scanner. Using an average fat variability of 87.5 mg/cm3, this leads to a fat-related uncertainty for the normative SEQCT data of 6.7 mg/cm3, which is far lower than the normal biological variation of 29.4 mg/cm3. Using tabulated normative data on fat content versus age and versus mineral content of 188 vertebral specimens from five collaborating centers, we derived a correction algorithm for QCT measurement that reduces our average underestimation to 0.88 mg/cm3 with an SEE of 12.1 mg/cm3. Hence, this correction procedure can be used to estimate the fat corrected absolute mineral density for research purposes or for scanners with high fat sensitivity. For the GE CT/T 9800 scanner, with a relatively low fat to mineral sensitivity at 80 kVp, the correction procedure is generally not recommended for clinical studies since it minimizes the average fat induced error but does not reduce the residual, partially fat related uncertainty. Finally, since the fat related uncertainty is small compared to biological variation, the correlation is high between SEQCT and DEQCT, and the radiation dose is lower and the precision higher for SEQCT, we suggest that most clinical diagnostic studies using the GE CT/T 9800 scanner for bone mineral determination employ SEQCT at 80 kVp.

Adult↗
PubMedDate not supplied

Three-dimensional CT and MR imaging in congenital dislocation of the hip: clinical and technical considerations.

Three-dimensional (3D) CT and 3D magnetic resonance (MR) imaging were performed in four patients with congenital dysplasia of the hip. Two patients were studied by 3D CT and two by 3D MR. Prior to volume segmentation, two-dimensional (2D) MR image preprocessing was used to correct for nonuniform signal intensity distribution from local variations in field strength and coil response. An unsharp mask of the original MR scan was computed by extreme blurring of the image to suppress the details of the object. The unsharp mask was divided into the image on a pixel-by-pixel basis. For improved object contrast first and second echo images were combined in a 1:2 ratio. To add an additional feature for volume segmentation, 2D MR image homogeneity was computed based on 3 X 3 pixel neighborhoods. Volume segmentation was performed using one feature for CT, i.e., attenuation range, and two features for MR, i.e., signal intensity and image homogeneity range. Three dimensional CT and 3D MR demonstrated the 3D relationships of femoral heads and acetabula. Three-dimensional CT was limited to patients who had ossified femoral heads, whereas 3D MR demonstrated the cartilaginous femoral head. The extent of acetabular coverage on which the mode of therapy is based was shown. Three-dimensional MR permitted imaging without gonadal irradiation. The 2D MR image preprocessing described here should provide even better results in objects with greater contrast, i.e., nonosseus structures, and those of larger size with relation to image degradation from partial volume effect.

Child↗
PubMedDate not supplied

Precise determination of paraspinous musculature by quantitative CT.

The ability to quantify muscular size has important implications in monitoring the effects of muscle disorders, in assessing the efficacy of interventions aimed at abbreviating muscle atrophy, and in examining the association between muscle and bone as a correlate of osteoporosis. We have developed an autocontouring technique for the precise determination of paraspinous musculature that can be implemented as an adjunct to our current CT method of spinal trabecular densitometry without additional scanning time or radiation exposure. Using two distinct patient groups, we evaluated the validity of this technique by assessing intra- and interobserver variability. Using the average coefficient of variation (CV) as an estimate of precision, we found intraobserver variability to be essentially equivalent whether evaluated in young, healthy men (0.69%) or in older, mildly osteoporotic women (0.74%). When the muscle evaluations of two observers were compared, the variability was somewhat higher, 1.81 and 1.83% in older and younger subjects, respectively. We scanned an additional 10 subjects twice, with intermediate repositioning, and found the reproducibility (CV) of determining paraspinous muscle area to be 0.97%. Given this estimated high level of precision, we derived the approximate magnitude of change in muscle size that could be observed using two-point measurements in time. Small average changes, on the order of 1-2%, could be detected using small groups of subjects (10-20/group). Moreover, we found that, even in the individual patient, relatively small changes (3-6%) could be detected given our low imprecision estimate. We believe this quantitative approach holds promise for monitoring muscle changes in vivo as well as for rigorously exploring the relationship between muscle and bone.

Adult↗
PubMedDate not supplied

Quantification of knee joint fluid volume by MR imaging and CT using three-dimensional data processing.

A noninvasive, quantitative technique to estimate joint fluid volume using three-dimensional (3D) processing of magnetic resonance (MR) imaging and CT data was evaluated. The mean accuracy error of this 3D approach with MR imaging, performed on five fresh cadaver knees, was -2.4 +/- 5.1% SD when volume estimates were based on heavily T2-weighted transverse images. A considerably higher mean accuracy error of -12.5 +/- 16.9% SD was found when the 3D approach with CT was used (four fresh cadaver knees), probably because of the small attenuation differences between articular soft-tissue structures and joint fluid. A mean precision error of 4.9 +/- 2.3% SD was found when two radiologists independently evaluated in vivo MR imaging studies of 12 knees with joint effusion. Because of the low CT accuracy, no in vivo studies were performed using CT. Thus, this preliminary study shows that quantification of joint fluid volume with 3D data processing offers more accuracy with MR imaging than with CT. The 3D approach with MR imaging provides a potential tool for clinical studies.

Humans↗
PubMedDate not supplied

Electrically-stimulated muscle hypertrophy in paraplegia: assessment by quantitative CT.

To identify the magnitude of muscle hypertrophy following electrically stimulated exercise in paraplegic subjects, we used quantitative CT (QCT) of the midthigh prior to and following 6 weeks of bicycle ergometry. Three patients who had suffered acute spinal cord injury were examined in this pilot investigation. Average absolute changes in muscle cross-sectional area by QCT were determined to be 10.6 cm2 (p = 0.042) at a distal site located 100 mm above the tibial plateau and 18.8 cm2 (p = 0.019) at a more proximal site (175 mm). Expressed as a percentage increase, these changes were likewise found to be significant. When the total thigh musculature was segmented into anterior and posterior regions, significant increases were observed only among the anterior muscle groups at both the distal and the proximal sites. Muscle hypertrophy as determined by standard anthropometric techniques at 200 mm above the patella was not found to be significant. We conclude that QCT is a valuable technique for discerning changes in muscle size during fitness training and that, in our population, it was capable of differentiating specific muscle compartment hypertrophy secondary to electrical stimulation.

Adult↗