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J Beier

Publications and source records attributed to J Beier.

At least 37 records · Page 2Linked to original sources
PubMed1998

[2D and 3D parameter images for the analysis of contrast medium distribution in dynamic CT and MRI].

AIM: For dynamic contrast medium (CM) studies, parameter images exploit specific features of the time/intensity curve (TIC) of each pixel and represent these values in a new image. Existing concepts of two-dimensional CM analysis are extended for three-dimensional applications using adequate computer graphic visualization. METHODS: Imaging: intravenous CM injection; first-pass analysis using fast CT acquisition of a single slice; CM accumulation by 40 MR slices (6 sequences every 90 s = 240 images): Software: TIC of arbitrary 2D/3D regions; parameter images: (1) temporal maximum intensity projection (TMIP) of all voxels over time, (2) temporal CM gradients (TG) based on TIC amplitude, (3) TIC slope, (4) time of TIC peak, (5) correlation coefficient to reference TIC. The calculated 3D data of CM accumulation was visualized using multiplanar reformation, MIP, surface reconstruction, volume rendering, texture mapping and animation. RESULTS: In first-pass analyses, TMIP and TG allowed the simultaneous or separated presentation of different temporal phases of the CM bolus. Correlation images emphasized regions with similarities to given TIC patterns. Three-dimensional computer graphic techniques enabled (1) anatomical/functional mapping of original image and CM accumulation and (2) fused display of both spatial CM enhancement and color-encoded time of TIC peak in one common image. CONCLUSIONS: The quantification of presence, magnitude, and time-of-peak of CM accumulation in local image regions supports the assessment of vascularization and of ischemic or necrotic areas.

Breast Neoplasms↗
PubMed1998

[Morphologic image processing operators: reduction of partial volume effects for improved 3D visualization of CT data].

AIM: The quality of segmentation and three-dimensional reconstruction of anatomical structures in tomographic slices is often impaired by disturbances due to partial volume effects (PVE). The potential for artefact reduction by use of the morphological image processing operators (MO) erosion and dilation is investigated. DESIGN: The CT examinations of 31 patients with pathological alterations in lung or brain were segmented using automatic region growing and the MO were applied in a different number of iterations. The processed regions were 3D-reconstructed (shaded surface display, MIP, volume rendering) and the occurrence of PVE-related artefacts using the signal-to-background ratio (SBR) prior to and after MO application was compared. RESULTS: For all patients under review, the artefacts caused by PVE were significantly reduced by erosion (lung: mean SBRpre = 1.67, SBRpost = 4.83; brain: SBRpre = 1.06, SBRpost = 1.29) even with only a small number of iterations. Region dilation was applied to integrate further structures (e.g. at tumor borders) into a configurable neighbourhood for segmentation and quantitative analysis. CONCLUSIONS: The MO represent an efficient approach for the reduction of PVE artefacts in 3D-CT reconstructions and allow optimized visualization of individual objects.

Densitometry↗
PubMed1998

[Electron-beam computed tomography in heart surgery].

PURPOSE: Electron beam CT (EBCT) has been devised to improve the imaging of the heart and the great vessels. Therefore, this method is expected to facilitate the imaging workup of patients referred for cardiothoracic surgery. We set out to review the most important surgical issues that can be addressed with this method. METHODS: From June, 1997 until July, 1998, more than 300 patients were referred from cardiothoracic surgery. In a retrospective analysis, diagnostic results were reviewed and compared with surgical findings and the clinical course. RESULTS: Aortocoronary bypass graft occlusions were detected with a sensitivity of 100% and a specificity of 95%. Calcifications of the aorta, pericardium and intracardiac tumors were surgically confirmed in all instances. There was a significant association of the degree of coronary artery calcification and the progression of cardiac allograft vasculopathy in 50 heart transplant recipients. In EBCT of the aorta, a high degree of diagnostic confidence was found for aortic dissection, aortic wall hematoma or aortic perforation. CONCLUSIONS: We conclude that EBCT represents an important diagnostic tool both for surgical planning and postoperative surveillance in cardiothoracic surgery.

Adult↗
PubMed1998

[Diagnosis of the abdominal vascular system by means of electron-beam computed tomography (EBT)].

PURPOSE: To evaluate the potential of electron-beam computed tomography (EBT) in the pre- and postinterventional assessment of vascular abdominal pathologies. MATERIAL AND METHODS: Forty patients with implanted transjugular portosystemic shunt (TIPS), 12 patients with peripheral arterial occlusive disease and 8 patients with infrarenal abdominal aortic aneurysm after endovascular implantation of bifurcation stents were prospectively examined with contrast-enhanced EBT during one year. The evaluation included analysis of time-density curves (TDC) and 3D reconstructions. Results were compared with Doppler sonography and/or DSA. RESULTS: In 30 of 40 TIPS patients, identical results were found with EBT, Doppler sonography and/or DSA. Reduced perfusions of the TIPS, which were subsequently confirmed by DSA, could not be shown with EBT in 3 patients. Nine of 12 patients with peripheral arterial occlusive disease and angiographically proven stenosis (> 75%) showed a reduced and delayed peak density of the time-density curves. The quantification of arterial stenosis, however, did not follow the angiographic values. In all patients with the implanted bifurcation stents, EBT could correctly exclude a leakage of the stent. CONCLUSION: EBT has certain advantages over conventional spiral CT in the evaluation of abdominal vascular pathologies due to the additional assessment of perfusion parameters. Clinical indications for the use of EBT are seen especially in the postinterventional follow-up of patients with implanted stents.

Abdomen↗
PubMed1998

Evaluation of segmentation algorithms for generation of patient models in radiofrequency hyperthermia.

Time-efficient and easy-to-use segmentation algorithms (contour generation) are a precondition for various applications in radiation oncology, especially for planning purposes in hyperthermia. We have developed the three following algorithms for contour generation and implemented them in an editor of the HyperPlan hyperthermia planning system. Firstly, a manual contour input with numerous correction and editing options. Secondly, a volume growing algorithm with adjustable threshold range and minimal region size. Thirdly, a watershed transformation in two and three dimensions. In addition, the region input function of the Helax commercial radiation therapy planning system was available for comparison. All four approaches were applied under routine conditions to two-dimensional computed tomographic slices of the superior thoracic aperture, mid-chest, upper abdomen, mid-abdomen, pelvis and thigh; they were also applied to a 3D CT sequence of 72 slices using the three-dimensional extension of the algorithms. Time to generate the contours and their quality with respect to a reference model were determined. Manual input for a complete patient model required approximately 5 to 6 h for 72 CT slices (4.5 min/slice). If slight irregularities at object boundaries are accepted, this time can be reduced to 3.5 min/slice using the volume growing algorithm. However, generating a tetrahedron mesh from such a contour sequence for hyperthermia planning (the basis for finite-element algorithms) requires a significant amount of postediting. With the watershed algorithm extended to three dimensions, processing time can be further reduced to 3 min/slice while achieving satisfactory contour quality. Therefore, this method is currently regarded as offering some potential for efficient automated model generation in hyperthermia. In summary, the 3D volume growing algorithm and watershed transformation are both suitable for segmentation of even low-contrast objects. However, they are not always superior to user-friendly manual programs for contour generation. When the volume growing algorithm is used, the contours have to be postprocessed with suitable filters. The watershed transformation has a large potential if appropriately developed to 3D sequences and 3D interaction features. After all, the practicality and feasibility of every segmentation method critically depend on various details of the user software as pointed out in this article.

Algorithms↗
PubMed1998

Differences in predominant enhancement mechanisms of superparamagnetic iron oxide and ultrasmall superparamagnetic iron oxide for contrast-enhanced portal magnetic resonance angiography. Preliminary results of an animal study original investigation.

RATIONALE AND OBJECTIVES: To determine the effect of particle size of superparamagnetic iron oxide (SPIO) contrast agents on magnetic resonance angiography of the portal venous system. METHODS: We studied eight beagle dogs by a T1-weighted 3D turbo-gradient echo magnetic resonance (MR) angiography sequence (TE 4 milliseconds, TR 11 milliseconds, flip angle 25 degrees, coronal imaging plane) before and after administration of either Resovist (SHU555A), a superparamagnetic iron oxide contrast agent with a mean particle size of 60 nm and a relaxivity ratio R2/R1 of approximately 7, or a new ultrasmall superparamagnetic iron oxide (USPIO) contrast agent with a mean particle size of approximately 20 nm and a R2/R1 ratio of approximately 2. Images were acquired on a 1.5-T MR body scanner. Both agents were injected as a peripheral bolus of 40 mumol Fe/kg body weight. Repeated scans were acquired before, immediately after, and 10, 20, 30, and 40 minutes after administration of the agent. RESULTS: After administration of Resovist, portal venous signal increased to 237% of control immediately after injection, while hepatic parenchymal signal intensity decreased to 86% of control. The maximal CNR increase to 177% was achieved immediately after injection of the agent. After USPIO, portal venous signal increased to 401% of the precontrast value immediately after injection, while hepatic parenchymal signal intensity also increased to 131% of control at this time. Hepatic signal then decreased progressively to 49% of control after 40 minutes. The maximal CNR increase to 326% was achieved 10 minutes after injection of the agent. CONCLUSIONS: It is concluded that superparamagnetic iron oxide particles of different sizes have different R2/R1 ratios and, consequently, different mechanisms of contrast improvement in T1-weighted portal MR angiograms.

Animals↗
PubMed1998

MRI-assisted specification/localization of target volumes. Aspects of quality control.

The transportation of MRI information on tumor extension into CT-based radiation therapy planning is desirable for several reasons. MRI's better contrast resolution is usually considered the most important, as it leads to a more exact definition of target volumes. Unlike diagnostic imaging, where a certain margin of error in depiction of tumor extension seems acceptable, radiation therapy planning makes it absolutely necessary, that the contents of every MR pixel (or voxel) correspond exactly to the corresponding area in the patient examined. This exact correspondence may be disturbed by a variety of influencing factors. Objects like various implants may lead to the most severe image distortions and--even worse--contrast alterations, some of which are not easily visible on the slices which are used for target volume definition. Additionally, MR images may have intrinsic faults which are able to change the correspondence between the voxel and the part of the patient's body it represents. Quality control has therefore to ensure that parameters like slice thickness are correct and kept constant by the imager. Image fusion may then be used to transfer MR information on tumor extension into the CT data. Electron density distribution provided by CT then allows for treatment planning. Implanted markers may then be used to ensure exact correspondence between the examined parts of the patient's body and the representing pixel or voxel. Care should be taken that landmarks themselves do not influence this relationship.

Brain Neoplasms↗
PubMed1998

[Expanded palliative indications for transtracheal oxygen administration].

Transtracheal oxygen therapy (TTOT) is applied particularly to patients with chronic obstructive pulmonary disease. We treated four patients in a preterminal stage of their disease, the primary diagnoses being pulmonary fibrosis and bronchoalveolic carcinoma. Oxygen administered by nasal delivery devices had been inefficient in all patients. TTOT reduced dyspnoea, improved exercise tolerance and reduced hospital stay. We conclude that TTOT has a potential for being medically beneficial in a preterminal stage of pulmonary fibrosis and carcinoma.

Aged↗
PubMed1997

[Multi-media presentation of radiologic image data with the Internet].

AIM: Recent developments of the Internet (World Wide Web) allow the integration of audio, video, digital film sequences, and three-dimensional data. The applicability of these innovations for medical documentation is demonstrated. METHODS: Our existing software for medical image processing and 3D reconstruction was extended to provide images, film sequences, and complex 3D models in an Internet-compatible data format. RESULTS: The multimedia results of the image processing were integrated into Internet documents. Specialized programs are no longer necessary for visualization. The Internet software allows for user-friendly handling and interactive presentation of the 2D and 3D data. CONCLUSIONS: The Internet offers public-domain software for display of images, audio/video, and 3D data. Thus, the tools of the Internet represent an ideal basis for local hospital information systems, computer-aided medical education, and teleconferencing.

Computer Communication Networks↗
PubMed1997

Registered image subtraction for CT-, MR- and coronary angiography.

Conventional post-processing of digital subtraction angiography (DSA) by 3D spiral CT, 3D MRI and 2D DSA is often hampered by extended artefacts due to patient movements during examination. In this paper an image registration procedure prior to the digital subtraction is introduced allowing an enhanced visualization of the contrast agent. The object displacement is detected by analysis of image deformations in small local regions. The motion pattern is used to compute a new synthetic mask of maximum congruence with the contrast medium image. This new mask image is then used in the subsequent subtraction. The algorithm works fully automatically and does not need any interactive placement of landmarks. Results obtained from subtraction of uncorrected and corrected sequences were compared with each other. The registration procedure provided good results in the suppression of subtraction artefacts and in the enhancement of vascular structures. Results are presented from subtraction of 2D and 3D data from CTA, MR mammography and coronary angiography.

Artifacts↗
PubMed1997

[Fractal surface analysis of intrapulmonary space-occupying lesions from high-resolution CT studies].

PURPOSE: The visual assessment of shape and surface structures of pulmonary nodules (PN) (smooth edges vs. spiculae) serves as a qualitative, subjective criterion in differential diagnosis. These properties must be quantified by computer-assisted evaluation, an adequate mathematical model, and new quantitative shape parameters. METHODS: 12 patients were investigated by high resolution CT. Based on 3D reconstructions with increasing thresholds, the PN surface S, volume V, fractal dimension (FD = In(S)/ In(square root of V)), and fractal index (F1 = square root of S/ square root of V) were calculated. RESULTS: The relations between the reconstruction threshold and the calculated tumour surface, respective volume, are of a fractal nature: S = c1 x thres1/d, V = c2 x thres1/D (c1, c2, d, D: real constants). Whereas the absolute values of surface and volume strongly depend on the chosen threshold (mean volume differences of 249%), the derived parameter of the fractal dimension for a specific PN is nearly constant for all thresholds under review (r = 0.998, SD = 0.05). CONCLUSIONS: FD and FI are new diagnostic features for the assessment of PN surface structure and morphology. Thus, the assessment of pulmonary nodules can be supported by new quantitative parameters representing surface irregularity due to invasive tumour growth into adjacent tissue.

Aged↗
PubMed1996

Accuracy and precision of angiographic volumetry methods for left and right ventricle.

We imaged and quantified 60 ventricle casts (30 LV, 30 RV) to evaluate the accuracy and reliability of angiographic ventricle volumetry. We analyzed the seven biplane methods most frequently used in clinical routine: Arcilla, Arvidsson, Dodge, Ferlinz, Simpson (LV + RV) and Wynne. The ventricle contours were defined by (1) manual drawing on the computer screen, (2) manual drawing using a graphical tablet and (3) automatic contour detection. A high inter-class variation in volume accuracy between the different methods was observed (S.D. = 12.7 ml). The volume methods for the LV (mean differences MDLV: [-2.2, +8.5] ml, average MDLV = 1.8 ml) are more accurate than for the RV (MDRV: [-11.4, +33.1] ml, average MDRV = 12.1 ml). The intrinsic error is about the same for all approaches and is very high: average S.D. = 20 ml, RMS = 185 ml. Manual contour definition results in a volume over-estimation (average MDman = +32.8 ml, r = 0.731) compared with automatic contour detection (average MDauto = +6.2 ml, r = 0.810). LV hypertrophy results in a volume under-estimation of the LV (MDLV = -7 ml) and an over-estimation of the RV (MDRV = +6 ml). RV hypertrophy leads to the opposite effect. It was shown that ventricle volumetry and the calculation of derived parameters (ejection fraction) is extremely case dependent and can only be an estimate of the actual value.

Angiography↗
PubMed1996

[3-D visualization of thoracic tumors from MR images].

AIM: In cooperation with the thoracic surgery department 3-D visualizations of tumors were generated to support the surgeons in preoperative planning. As opposed to 3-D reconstructions of CT data, those representations based on MRI images remain an exception. In this paper different methods of three dimensional visualization of lung tumors are presented and compared to each other. DESIGN: These methods are 1. contour based surface models, 2. threshold based surface models and 3. rendered scenes of segmented volume data with transparent, color-coded display. RESULTS: Combinations of all three methods in one single image are possible as well with the software we developed. Furthermore, cut planes through the original data can be integrated into the 3-D scene. The segmentation of anatomical objects is performed either manually or automatically with various procedures. CONCLUSIONS: Adequate possibilities of manipulation and archiving allow a fast handling and processing even of large data sets. The calculated volumes of the anatomical objects can be used for quantitative studies. Arbitrary views of the three dimensional reconstructions can be generated within a few seconds. Even animation can easily be calculated and displayed with 30 frames/second.

Adult↗
PubMed1996

Randomized, placebo controlled trial of withdrawal of slow-acting antirheumatic drugs and of observer bias in rheumatoid arthritis.

Patients with rheumatoid arthritis, in stable treatment with methotrexate, penicillamine, or sulfasalazine, were randomized in a double-blind fashion either to continuation of their usual treatment or to placebo. 112 patients were included; 52 patients who refused participation had no more severe disease than the others. The patients felt worse on placebo than on active drug (p = 0.002). The mean differences in number of tender, painful and swollen joints after one month were 2.4 (p = 0.08), 3.0 (p = 0.12) and 2.2 (p = 0.03), respectively. Treatment failure occurred for 42 patients of whom 33 received placebo (p = 0.000,001). There was no difference in the severity of side effects (p = 0.91). The patients guessed their treatment correctly more often than expected (p = 0.02) because of the perceived effect. None of the two observers guessed better than chance, and there were no differences between the observers' evaluations of the joints. The effect of slow-acting antirheumatic drugs was unequivocal and no observer bias occurred.

Aged↗
PubMed1996

[clinical application of multiplanar and 3D reconstruction of spiral CT in diagnosis of acetabulum fractures].

This review describes recent visualizations of computed tomography for the diagnosis of acetabular fractures. The techniques of conventional and helical-CT for the imaging of the acetabulum are compared. Furthermore, the different methods of multiplaner and three-dimensional reconstructions e.g. shaded surface display, maximum intensity projection, and volume rendering are presented. Figures of each method are demonstrated and the diagnostic potential of multiplanar and three-dimensional imaging for fractures of the pelvis is discussed.

Acetabulum↗
PubMed1996

[3-dimensional post-myelographic CT reconstruction in diagnosis and therapy planning of spinal dysraphism].

Dysrhaphia is often associated with severe osseous aberrations of the spine such as, for example scoliosis, hemivertebra, and synostosis. With the advanced possibilities of the post-processing of CT-data (segmentation, three-dimensional reconstruction), post-myelo-CT is an excellent method for the evaluation of osseous structures and the myelon in preoperative planning.

Adolescent↗