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Biomedical subjects

J S Karp

Publications and source records attributed to J S Karp.

At least 37 records · Page 2Linked to original sources

Resting cerebral glucose metabolism in first-episode and previously treated patients with schizophrenia relates to clinical features.

BACKGROUND: Functional neuroimaging can elucidate brain dysfunction in schizophrenia. The frontal, temporolimbic, and diencephalic regions have been implicated. There is a lack of prospective samples of first-episode and previously treated patients followed up longitudinally. METHODS: Patients and controls (42 per group) were studied. Positron emission tomography with flurodeoxyglucose, cross-registered with magnetic resonance imaging, measured metabolism. Scales assessed clinical features, premorbid adjustment, and outcome. RESULTS: There were no differences between groups in whole-brain metabolism or regional ratios or in anterior-posterior gradients, but left midtemporal metabolism was relatively higher in patients. This was pronounced in the negative and Schneiderian and absent in the paranoid subtypes. Higher metabolism and lower relative left hemispheric values were associated with better premorbid adjustment and outcome. A higher subcortical-cortical gradient was noted in first-episode patients. CONCLUSIONS: There are no resting metabolic abnormalities in any brain region, but abnormal gradients are evident. These vary in subtypes, and laterality is associated with functioning. The results support the hypothesis of temporolimbic disturbance in schizophrenia that is all ready present at the onset of illness.

Adult↗

Singles transmission in volume-imaging PET with a 137Cs source.

The feasibility of a new method of attenuation correction in PET has been investigated, using a single-photon emitter for the transmission scan. The transmission scan is predicted to be more than a factor of ten faster with the singles method than the standard coincidence method, for comparable statistics. Thus, a transmission scan be completed in 1-2 min, rather than 10-20 min, as is common practice with the coincidence method. In addition, a potential advantage of using the single-photon source 137Cs, which has an energy of 662 keV, is that postinjection transmission studies can be performed using energy discrimination to separate the transmission from the emission data at 511 keV. In order to compensate for the energy difference of the attenuation coefficients at 662 keV compared to 511 keV, the transmission images are segmented into two compartments, tissue and lung, and known values (for 511 keV) of attenuation are inserted into these compartments. This technique also compensates for the higher amount of scatter present with the singles method, since it is not possible to use a position gate (based on collinearity of the source and two detector positions) as is commonly done with a positron-emitting source. We have demonstrated, with experimental phantom studies, that the singles transmission method combined with segmentation gives results equivalent both qualitatively and quantitatively to the coincidence method, but requires significantly less time.

Biophysical Phenomena↗

Long-term changes in bone mineral density following total knee replacement.

Bone density was measured using dual photon absorptiometry and dual xray absorptiometry below the tibial component under the medial and lateral plateaus, under the central peg, and distal to the central peg. Measurements of bone density were taken at 1 week, 6 weeks, 6 months, and 1 year after surgery in 31 patients. Seven of these patients also had measurements taken 8 years after surgery. The average age of the patients at surgery was 69 years old. One week after surgery, the mean bone density from all regions was 0.77 g/cm2 in women compared with 1.14 g/cm2 in men. Between 6 weeks and 6 months, the bone density below the tibial component declined inconsistently in most patients, but by 1 year the bone mineral density was statistically equal to the initial bone density at 1 week after surgery. Eight years after total knee arthroplasty, there was a 36.4% decrease in bone mineral density between men and women was not statistically significant. Medial plateau, lateral plateau, under the peg, and distal to the peg bone density changes tended to be the same. Maximum rates of bone resorption in patients with osteoporosis of the same age group have been reported to be between 1% and 2% per year. In this study, after an initial stable period, the bone density of the proximal tibia beneath the tibial component consistently decreased at a rate of 5% per year. Surgeons must consider this relatively large decrease in bone density if they are relying on bone for long-term stable fixation of the prosthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

A methodology for testing for statistically significant differences between fully 3D PET reconstruction algorithms.

We present a practical methodology for evaluating 3D PET reconstruction methods. It includes generation of random samples from a statistically described ensemble of 3D images resembling those to which PET would be applied in a medical situation, generation of corresponding projection data with noise and detector point spread function simulating those of a 3D PET scanner, assignment of figures of merit appropriate for the intended medical applications, optimization of the reconstruction algorithms on a training set of data, and statistical testing of the validity of hypotheses that say that two reconstruction algorithms perform equally well (from the point of view of a particular figure of merit) as compared to the alternative hypotheses that say that one of the algorithms outperforms the other. Although the methodology was developed with the 3D PET in mind, it can be used, with minor changes, for other 3D data collection methods, such as fully 3D cr or SPECT.

Algorithms↗

Figures of merit for comparing reconstruction algorithms with a volume-imaging PET scanner.

For volume-imaging PET scanners, no septa are used to maximize the sensitivity by collecting events oblique to the scanner axis. We answer two questions: (i) how does the performance of an image reconstruction algorithm for a volume-imaging PET scanner depend on its general dimensions? and (ii) at what point is a three-dimensional (3D) reconstruction algorithm needed for a volume-imaging scanner, as the axial extent is increased? A 3D reconstruction algorithm will accurately incorporate the oblique events in a reconstruction of the original source distribution. From simulations of an existing volume PET scanner with a maximum axial acceptance angle (+/-alpha) of alpha = 9 degrees, however, we show that the single-slice rebinning algorithm is a good compromise between sensitivity, speed, and accuracy when compared to standard two-dimensional reconstruction (alpha = 1 degrees), and a 3D reconstruction with alpha = 9 degrees. We also show with simulations that a new scanner with alpha = 27 degrees requires 3D reconstruction in order to achieve maximum sensitivity without unacceptable losses in accuracy. Measurements of scanner performance are based on a series of figures of merit that characterize image quality and quantitative accuracy measured from a set of simulated test phantoms.

Algorithms↗

Comparison of anatomically-defined versus physiologically-based regional localization: effects on PET-FDG quantitation.

The potential of anatomic imaging to improve the quantitative accuracy of functional brain imaging through refined regional definition is widely accepted. However, there are little data addressing the impact of approach to regional localization on quantitation of metabolic images in the absence of gross structural pathology. We compared MRI-based versus PET-based approaches to the analysis of PET 18F-fluorodeoxyglucose (FDG) images using a standard adjustable template based on simple geometric regions. For the MRI-based approach, templates and individual regions were adjusted to each individual's anatomy, whereas the PET-based definition involved only global proportional adjustment of the standard templates. Metabolic rates for glucose and volume-to-whole brain ratios were determined by two operators for 78 volumes of interest in five subjects. Pairwise correlations indicated high interoperator agreement for each approach and high intraoperator agreement for MRI-based versus PET-based metabolic values. The stability of the metabolic rates and ratios among operators and analysis approaches was supported by low coefficients of variation across measurements and small average differences in paired comparisons. Thus, within the current spatial resolution of PET imaging, quantitation of metabolic images is relatively robust to image analysis approach in the absence of gross structural abnormality. To take advantage of the greater quantitative accuracy promised by high-resolution anatomic and functional imaging, more refined delineation of anatomic images will be necessary.

Brain↗

Current and future technological trends in positron emission tomography.

Current trends in positron emission tomography (PET) instrumentation are examined, with an emphasis on providing information suitable to the prospective PET user. Basic principles underlying PET are explained and information on performance measurements, techniques, and quantitation are given in order to allow the user to compare and contrast different types of PET scanners. These scanner designs are described. Specific examples are given and the combination of PET with other modalities is discussed.

Equipment Design↗

Factors affecting accuracy and precision in PET volume imaging.

Volume imaging positron emission tomographic (PET) scanners with no septa and a large axial acceptance angle offer several advantages over multiring PET scanners. A volume imaging scanner combines high sensitivity with fine axial sampling and spatial resolution. The fine axial sampling minimizes the partial volume effect, which affects the measured concentration of an object. Even if the size of an object is large compared to the slice spacing in a multiring scanner, significant variation in the concentration is measured as a function of the axial position of the object. With a volume imaging scanner, it is necessary to use a three-dimensional reconstruction algorithm in order to avoid variations in the axial resolution as a function of the distance from the center of the scanner. In addition, good energy resolution is needed in order to use a high energy threshold to reduce the coincident scattered radiation.

Algorithms↗

Performance standards in positron emission tomography.

A standard set of performance measurements is proposed for use with positron emission tomographs. This set of measurements has been developed jointly by the Computer and Instrumentation Council of the Society of Nuclear Medicine and the National Electrical Manufacturers Association. The measurements include tests of spatial resolution, scatter fraction, sensitivity, count rate losses and randoms, uniformity, scatter correction, attenuation correction, and count rate linearity correction.

Humans↗

Standards for performance measurements of PET scanners: evaluation with the UGM PENN-PET 240H scanner.

A standard set of performance measurements is proposed for use with positron emission tomographs. This set of measurements has been developed by the Computer and Instrumentation Council of the Society of Nuclear Medicine and the National Electrical Manufacturers Associations. These measurements are discussed and compared to the set of standard measurements being proposed by the Instrumentation Task Group of the European Economic Community Concerted Action of Cellular Regeneration and Degeneration. The performance of the PENN-PET 240H scanner from UGM Medical Systems is tested with this set of measurements. The PENN-PET scanner consists of six continuous position-sensitive NaI(T1) detectors, which results in a 50 cm transverse field-of-view and a 12.8 cm axial field-of-view. The fine spatial sampling in the axial direction allows the data to be sorted into as many as 64 transverse planes, each 2 mm thick. A large axial acceptance angle, without inter-plane septa, results in a high sensitivity, with a low scatter and randoms fraction, due to the use of a narrow photopeak energy window. This paper emphasizes those performance measurements which illustrate the special characteristics of a volume imaging scanner, compared to a more traditional multi-ring scanner.

Equipment Design↗

Continuous-slice PENN-PET: a positron tomograph with volume imaging capability.

The PENN-PET scanner consists of six hexagonally arranged position-sensitive Nal(TI) detectors. This design offers high spatial resolution in all three dimensions, high sampling density along all three axes without scanner motion, a large axial acceptance angle, good energy resolution, and good timing resolution. This results in three-dimensional imaging capability with high sensitivity and low scatter and random backgrounds. The spatial resolution is 5.5 mm (FWHM) in all directions near the center. The true sensitivity, for a brain-sized object, is a maximum of 85 kcps/microCi/ml and the scatter fraction is a minimum of 10%, both depending on the lower level energy threshold. The scanner can handle up to 5 mCi in the field of view, at which point the randoms equal the true coincidences and the detectors reach their count rate limit. We have so far acquired [18F]FDG brain studies and cardiac studies, which show the applicability of our scanner for both brain and whole-body imaging. With the results to date, we feel that this design results in a simple yet high performance scanner which is applicable to many types of static and dynamic clinical studies.

Equipment Design↗

The high count rate performance of a two-dimensionally position-sensitive detector for positron emission tomography.

In positron tomographs using a small number of position-sensitive detectors, each detector must operate at high singles event rates, especially during dynamic studies. To enable the PENN-PET tomography to perform studies involving high data rates, the high count rate behaviour of the position-sensitive scintillation detector used in the tomograph was investigated at singles rates in excess of 2 million counts per second (MCPS). Detector dead-time, minimised through the use of pulse clipping (clipping time, 120 ns), is a maximum of 20% at the highest data rates. At 2 MCPS and 240 ns pulse integration time, the full width at half maximum of the point spread function (PSF) worsens by approximately 20% over its low count rate value of 5.2 mm. Furthermore, at high count rates, pulse pile-up produces long tails in the PSF along the detector's long axis. These tails were reduced or eliminated through the use of a shortened pulse integration time (160 ns instead of 240 ns), an upper level energy discriminator and a local centroid event positioning algorithm. Detector performance was characterised for different combinations of these event processing techniques, and the mechanisms by which pulse pile-up distorts the high count rate PSF were investigated using computer simulations. With the incorporation of the high count rate event processing techniques, the detector's count rate capability enables the PENN-PET tomograph to handle most current imaging protocols.

Scintillation Counting↗

Quantitative computed tomography reflects vertebral fracture morbidity in osteopenic patients.

We studied the relationship between spontaneous vertebral compression fractures and lumbar vertebral trabecular bone density in 69 consecutive patients with suspected osteopenia. Seven had biopsy-confirmed osteomalacia. The remaining 62 were divided into three groups: group 1--asymptomatic patients suspected of having osteopenia on plain films, but with no vertebral compression fractures (N = 24); group II--those with one to five vertebral compression fractures (N = 16); and group III--those with six or more vertebral compression fractures (N = 22). A quantitative computed tomographic (QCT) scan of the lumbar spine was performed on all patients. Patients in group I had QCT values of 94 +/- 23 mg/cm3 (mean +/- SE); those in group II had QCT values of 66 +/- 28 mg/cm3; and those in group III had values of 34 +/- 28 mg/cm3. There were significant differences among all groups (P less than .001), although there was considerable overlap of individuals among the groups. There was no significant difference between the mean QCT value of patients with one compression fracture and the value of those with between two and five compression fractures. Patients with biopsy-proven osteomalacia had higher vertebral trabecular bone density than patients with osteoporosis and compression fractures. Our study provides evidence suggesting a strong inverse relationship between QCT-measured vertebral bone density and the presence of vertebral compression fractures in a group of osteopenic patients.

Absorptiometry, Photon↗

Positron emission tomography imaging--technical considerations.

Positron imaging instrumentation has improved rapidly in the last few years. Scanners currently under development are beginning to approach fundamental limits set by positron range and noncolinearity effects. This report reviews the latest developments in positron emission tomography (PET) instrumentation, emphasizing the development of coding schemes that reduce the complexity and cost of high-resolution scanners. The relative benefits of using time-of-flight (TOF) information is discussed as well.

Biophysical Phenomena↗

A positron camera using position-sensitive detectors: PENN-PET.

A single-slice positron camera has been developed with good spatial resolution and high count rate capability. The camera uses a hexagonal arrangement of six position-sensitive NaI(Tl) detectors. The count rate capability of NaI(Tl) was extended to 800k cps through the use of pulse shortening. In order to keep the detectors stationary, an iterative reconstruction algorithm was modified which ignores the missing data in the gaps between the six detectors and gives artifact-free images. The spatial resolution, as determined from the image of point sources in air, is 6.5 mm full width at half maximum. We have also imaged a brain phantom and dog hearts.

Animals↗

Performance of a position-sensitive scintillation detector.

The spatial resolution of a NaI(T1), 25 mm thick bar detector designed for use in positron emission tomography has been studied. The position along the 500 mm long detector is determined from the centroid of the light distribution in the crystal as measured by a linear array of photomultiplier tubes. A Monte Carlo computer simulation was performed to investigate the factors limiting the spatial resolution. The program allowed us to study the effect of various phototube configurations and crystal surfaces. Since the resolution is affected by the width of the light distribution, we studied the effect of sharpening the distribution by modifying the front crystal surface with grooves cut perpendicular to the long axis of the crystal and by using non-linear preamplifiers. The simulation predicts a spatial resolution (FWHM) of 3 mm with this crystal. Experimental measurements of spatial resolution were performed concurrently with the simulations. In particular, a modified grooved crystal was measured to have 4.0 mm spatial resolution, an improvement over the original crystal without grooves. With delay line pulse shortening, which increases the count rate capability of the detector, the grooved crystal was measured to have 5.5 mm spatial resolution.

Animals↗