Biomedical subjects

K H Englmeier

Publications and source records attributed to K H Englmeier.

At least 55 records · Page 3Linked to original sources

PubMed1999

Interobserver reproducibility of quantitative cartilage measurements: comparison of B-spline snakes and manual segmentation.

The objective of this work was to develop a segmentation technique for thickness measurements of the articular cartilage in MR images and to assess the interobserver reproducibility of the method in comparison with manual segmentation. The algorithm is based on a B-spline snakes approach and is able to delineate the cartilage boundaries in real time and with minimal user interaction. The interobserver reproducibility of the method, ranging from 3.3 to 13.6% for various section orientations and joint surfaces, proved to be significantly superior to manual segmentation.

Cartilage, Articular↗

PubMed1999

Low-cost ISDN videoconferencing equipment for orthopaedic second opinions.

We validated the application of low-cost ISDN videoconferencing equipment for telemedicine. A telemedicine benchmark was designed and four different office videoconferencing systems were evaluated, all using basic-rate ISDN connections (128 kbit/s). All the low-cost systems showed generally good or acceptable performance for clinical use. We also investigated the feasibility of videoconferencing for an orthopaedic second-opinion service. Eight point-to-point conferences were conducted to discuss real clinical cases by use of interactive sharing of medical images. The average duration of each session was 35 min. Encouraging results were obtained.

Costs and Cost Analysis↗

PubMed1999

Guidelines for multipoint videoconferencing using low-cost, PC-based equipment.

We have compiled a set of guidelines for effective multipoint videoconferencing carried out with low-cost, PC-based systems. The guidelines are based on experience gained during multipoint videoconferences in epidemiology and orthopaedics/radiology. Joint data inspection and manipulation were carried out by application sharing between the PCs. The guidelines are categorized by the time of their application and also by their content. For effective multipoint videoconferences, preparation of the agenda and of digital documents is mandatory. The prevention of echo effects and half-duplex audio connections are of special importance. A protocol to optimize the order of speakers increases the efficient use of conference time. The guidelines worked well when used in a multisite research project and addressed the most important weak points of multipoint videoconferences using low-cost equipment.

Costs and Cost Analysis↗

PubMed1999

Three-dimensional analysis of the width of the subacromial space in healthy subjects and patients with impingement syndrome.

OBJECTIVE: The aim of this study was to per form a three-dimensional analysis of the width of the subacromial space during passive and active arm abduction in healthy volunteers and patients with impingement syndrome. SUBJECTS AND METHODS: The shoulders of 10 healthy subjects and 10 patients with impingement syndrome were imaged with an open MR system during abduction, with and without activation of the shoulder muscles. An apparatus was designed for applying an adduction force of 10 N to the distal humerus during image acquisition, and the minimal acromiohumeral distance was measured after three-dimensional reconstruction. RESULTS: In the 10 healthy volunteers, muscle activity led to a significant decrease (-32%; p < .05) of the acromiohumeral distance at 60 degrees of abduction, whereas at 120 degrees of abduction the distance was significantly increased (+44%; p < .05). In these volunteers, muscle activation caused no significant effect at 90 degrees of abduction. However, in the 10 patients with impingement syndrome, muscle activity led to a significant decrease in the width of the subacromial space compared with that of the healthy contralateral side (-68%; p < .05). CONCLUSION: Muscle activity and arm position were found to cause systematic changes in the width of the subacromial space. However, functional deficits of the supraspinous muscle in patients with early-stage impingement syndrome were not apparent during muscle relaxation.

Acromion↗

PubMed1999

A new hybrid renderer for virtual bronchoscopy.

PURPOSE: To improve the diagnosis of pathologic modified airways, a new hybrid visualization system has been developed and tested based on digital image analysis and synthesis of spiral CT as well as the visual simulation of bronchoscopy. METHOD/MATERIALS: 20 patients with pathologic modifications of the airways (tumors, lung transplantation) were examined with Spiral-CT. The shape of the airways and the lung tissue is defined by an automatic volume growing method and a following geometric reconstruction by the computation of geometric primitives. This is the basis of a multidimensional display system which visualizes volumes, surfaces and computation results simultaneously. The enable the intuitive and immersive inspection of the airways a virtual reality system, consisting of two graphic engines, a head mounted display system, data gloves and specialized software was integrated. RESULTS: In 20 cases the extension of the pathologic modification of the airways could be visualized with the virtual bronchoscopy. The user interacts with and manipulates the 3D model of the airways in an intuitive and immersive way. In contrast to previously proposed virtual bronchoscopy systems the described method permits truly interactive navigation, detailed quantitation of anatomic structures and a "see through" the bronchial wall. The system enables a user oriented and fast inspection of the volumetric image data. CONCLUSIONS: To support radiological diagnosis with additional information a virtual bronchoscopy was developed. It enables the immersive and intuitive interaction with 3D Spiral CTs by truly 3D navigation in the airways. The system was tested with 20 Spiral-CTs of bronchial tumors and obstructions and is well suited for the inspection of structures beyond the bronchialtree.

Algorithms↗

PubMed1998

Hybrid rendering and virtual endoscopy of the auditory and vestibular system.

A hybrid rendering method (color-coded 3D shaded-surface and volume display) with the possibility of virtual endoscopy using image data sets from HR-SCT was developed. To show the possible advantages and benefits of the improved rendering algorithm we have specifically highlighted the use in relation to the auditory and vestibular system. Postprocessing image visualization offers improved morphological analysis, and will benefit radiological diagnostics, medical education, surgical planning, surgical training and postoperative assessment.

Adult↗

PubMed1998

An MR-based technique for quantifying the deformation of articular cartilage during mechanical loading in an intact cadaver joint.

The objective of this study was to develop an MR-based technique for quantifying the deformation of articular cartilage during mechanical loading in an intact cadaver joint at high spatial and temporal resolution. A nonmetallic pressure device was constructed for applying loads of >1000 N to a femoro-patellar articulation within an extremity coil of a clinical 1.5 T MRI scanner. Digital image processing methods were used to determine the location- and time-dependent cartilage deformation in consecutive 2D fat-suppressed FLASH images. Additionally, three-dimensional reconstruction of the cartilage was performed from 3D fat-suppressed FLASH image data. During the first 10 min of static compression, thickness changes between 10 and 30% were observed. Thickness changes greater than 50% and volume changes of 20% were recorded after 3 h. The technique permits analysis of the load and time-dependent mechanical behavior of articular cartilage in its natural environment.

Adult↗

PubMed1998

A technique for determining the spatial relationship between the rotator cuff and the subacromial space in arm abduction using MRI and 3D image processing.

An MR imaging-based technique for three-dimensional determination of subacromial space width in relation to the rotator cuff in arm abduction is presented. Five volunteers were examined in an open MRI in seven arm positions, and coronal images were obtained with a gradient-echo sequence. 3D reconstruction of the bones and the supraspinatus was performed, and the minimal spatial distances between acromion, clavicle, and humerus were calculated. The closest contact between the supraspinatus and the anterior inferior part of the acromion occurred at 90 degrees abduction in internal rotation. The technique presented allows investigation of the morphological basis of the impingement syndrome.

Acromion↗

PubMed1998

[Computer-assisted diagnosis based on computer-based image interpretation and 3D-visualization].

PURPOSE: To survey methods for 3D data visualization and image analysis which can be used for computer based diagnostics. MATERIAL AND METHODS: The methods available are explained in short terms and links to the literature are presented. Methods which allow basic manipulation of 3D data are windowing, rotation and clipping. More complex methods for visualization of 3D data are multiplanar reformation, volume projections (MIP, semi-transparent projections) and surface projections. Methods for image analysis comprise local data transformation (e.g. filtering) and definition and application of complex models (e.g. deformable models). RESULTS: Volume projections produce an impression of the 3D data set without reducing the data amount. This supports the interpretation of the 3D data set and saves time in comparison to any investigation which requires examination of all slice images. More advanced techniques for visualization, e.g. surface projections and hybrid rendering visualize anatomical information to a very detailed extent, but both techniques require the segmentation of the structures of interest. Image analysis methods can be used to extract these structures (e.g. an organ) from the image data. DISCUSSION: At the present time volume projections are robust and fast enough to be used routinely. Surface projections can be used to visualize complex and presegmented anatomical features.

Diagnosis, Computer-Assisted↗

PubMed1998

[Virtual and three-dimensional bronchoscopy with spiral and electron beam computed tomography].

PURPOSE: To compare spiral computed tomography (CT) and electron-beam CT (EBT) for 3D and virtual CT-bronchoscopy. MATERIALS AND METHODS: 17 patients with various disorders of the tracheobronchial system were examined using fiberoptic bronchoscopy, spiral CT and EBT. 3D images were reconstructed from CT data sets using automated segmentation based on volume-growing methods. Surface-rendered, volume-rendered, and hybrid reconstructions were visualized in real time using a data helmet. RESULTS: All data sets could be processed to high-quality three-dimensional (3D) and virtual reconstructions. The reduction of motion artifacts due to shorter scan times made EBT data sets better suited for automated segmentation and less susceptible to motion artifacts. 3D and virtual reconstructions did not increase the diagnostic sensitivity of CT compared to axial reconstructions alone. CONCLUSIONS: Shorter scan times of CT imaging yield higher-quality 3D and virtual reconstructions. Modern reconstruction techniques are valuable visualization tools for select indications and are the prerequisite for future developments in computer-aided medicine.

Bronchial Neoplasms↗

PubMed1998

Quantitative relationships of normal cartilage volumes of the human knee joint--assessment by magnetic resonance imaging.

The objective of this study was to assess the normal range of cartilage volumes in the knee joints of healthy adults, the ratio between the patellar, femoral, and tibial cartilages, and the correlation of the volumes with age, body weight, height, body mass index (obesity), patellar bone size, and the diameter of the tibial head. We examined the knee joints of nine healthy volunteers and eleven normal post-mortem specimens with an age range of 24 to 82 years. The cartilage volumes of the patella, femur, medial tibia and the lateral tibia were quantified, using a fat-suppressed FLASH-3D sequence (resolution 2x0.31x0.31 mm3) and digital postprocessing, involving three-dimensional reconstruction. The mean total volume of the knee joint cartilage was 23,245 mm3, the relative standard deviation (CV%) 19%, and the range 16,341 to 33,988 mm3. In the patella, femur and tibia, the CV% amounted to between 22 and 25%. These joint surfaces occupied a relatively variable proportion of the total knee joint volume, the percentage of the patella being 11 to 22%, that of the femur 54 to 69%, that of the medial tibia 7 to 12%, and that of lateral tibia 11 to 16%. The volumes of the lateral tibia were systematically higher than those of the medial tibia (P<0.001). There was no significant correlation of the knee joint cartilage volume with age (r=+0.05), body weight (r=+0.38), height (r=+0.39) or body mass index (r=+0.29), but a relatively high correlation with the diameter of the tibial head (r=+0.78, P<0.001). After normalising the volumes to this diameter, the CV% of the total knee joint cartilage volume was reduced to 13%, its variation being 12 to 21% in the patella, femur and tibia. MRI is available for measuring cartilage volume during growth, functional adaptation, and tissue loss in degenerative joint disease. The study shows that a wide variation of cartilage volumes exists in the knee joints of normal adults. To reduce the variability between individuals, the cartilage volumes may be normalised to the head of the tibial diameter.

Adult↗

PubMed1998

VR interaction techniques for medical imaging applications.

Methods of virtual reality (VR) offer new ways of human-computer interaction. Medicine is predestined to benefit from this new technology in many ways. Virtual environments can support physicians in their work, alleviate communication between specialists from different fields or be established in educational and training applications. For the field of visualization and analysis of three-dimensional anatomical images (e.g. CT or MRI scans), an application is introduced which expedites recognition of spatial coherencies and the exploration and manipulation of the 3D data. To avoid long periods of learning and accustoming and to facilitate work in such an environment, a powerful human-oriented interface is required allowing interactions similar to the real world and utilization of our natural experiences. This paper shows the use of eye tracking parameters for a level-of-detail algorithm and the integration of a glove-based hand gesture recognition into the virtual environment as an essential component of the human-machine interface. Furthermore, virtual bronchoscopy and virtual angioscopy are presented as examples for the use of the virtual environment.

Diagnosis, Computer-Assisted↗

PubMed1998

A method for quantifying time dependent changes in MR signal intensity of articular cartilage as a function of tissue deformation in intact joints.

A method is proposed to determine accurately the signal intensity changes of the articular cartilage from sectional MR images and its related cartilage deformation under compression in an intact joint. Image processing methods are developed to delineate and register the cartilage boundaries in consecutive MR images in order to track corresponding tissue sectors during the loading experiment. Regions of interest can then be defined and traced during the compression, making a spatial and temporal analysis of signal intensity changes possible. In addition, the cartilage deformation is calculated in the respective tissue sectors and is related to the MR signal changes. Using a fat-suppressed FLASH 3D sequence, the preliminary results showed location-dependent slight changes of the signal intensity varying from individual to individual. The quantitative analysis of the signal intensity changes as a function of cartilage deformation with magnetic resonance imaging (MRI) aims to characterize microstructural properties of the articular cartilage that may lead to a better understanding of degenerative joint disease.

Adult↗

PubMed1998

Effect of physical exercise on cartilage volume and thickness in vivo: MR imaging study.

PURPOSE: To quantify, with magnetic resonance (MR) imaging, the in vivo changes in cartilage volume and thickness after physical exercise. MATERIALS AND METHODS: The patellae of eight volunteers were imaged six times at physical test by using a spoiled fat-suppressed gradient-echo sequence with an acquisition time of 4.10 minutes. The volunteers then performed 50 knee bends, and two more data sets were acquired 3-7 minutes and 8-12 minutes after exercise. The patellar cartilage volume was determined after three-dimensional reconstruction, and the thickness was assessed with a three-dimensional minimal-distance algorithm. RESULTS: Whereas repositioning had a small effect on the measurements (mean coefficient of variation, 1.4%), a statistically significant decrease in cartilage volume was observed 3-7 minutes (mean decrease, 6.0%; P < .05) and 8-12 minutes (mean decrease, 5.2%; P < .05) after exercise. The deformation was homogeneous throughout the joint surface. In one asymptomatic volunteer, a cartilage lesion became more pronounced after exercise. CONCLUSIONS: MR imaging can be used to investigate the response of articular cartilage to physical exercise in vivo. Patients or volunteers should be allowed a sufficient period of physical rest if quantitative measurements of cartilage volume and thickness are to be undertaken in longitudinal studies.

Adult↗

PubMed1998

[Relevance of susceptibility-induced geometrical distortion for validity of MRI-based cartilage volume and density measurements of the knee joint].

The aim of the present study was to analyze the relevance of susceptibility-induced geometrical distortion to the accuracy of MR-based cartilage volume and thickness measurement in the human knee joint. Nine cadaveric knee joints were imaged in the sagittal plane with MRI at a resolution of 2 x 0.31 x 0.31 mm3, using a fat-suppressed gradient echo sequence, with a normal gradient orientation and also with the frequency- and phase-encoding directions changed. CT arthrographic data sets were then obtained. On the basis of 3-D constructions, we determined the cartilage volume and, with a 3-D minimal distance algorithm, the thickness distribution, of the patella, femur and tibia. Irrespective of the gradient orientation, good agreement was observed between MRI and CT arthrography in terms of cartilage volumes and maximum cartilage thickness. With a normal gradient orientation the volume was overestimated by 2.5% in MRI, and 2.3% when the gradients were changed. The maximum cartilage thickness was underestimated by 0.24 intervals (interval = 0.5 mm) with a normal gradient orientation, and by 0.22 intervals when the gradient orientation was changed. In none of the joint surfaces was a relevant difference between the two methods observed. It can be shown that, using high-resolution, fat-suppressed gradient-echo sequences--susceptibility-induced geometrical distortion has no significant effect on the accuracy of MR-based cartilage volume and thickness measurements. MRI would therefore appear suitable for the design of patient-specific finite element models with the aim of analysing load transmission in diarthrodial joints and planning surgical interventions.

Adult↗

PubMed1998

In vivo reproducibility of three-dimensional cartilage volume and thickness measurements with MR imaging.

OBJECTIVE: Previous studies suggest that MR imaging is capable of providing accurate data on knee joint cartilage volume and thickness in vitro, but the reproducibility of these data in living subjects has not been analyzed rigorously. Our aim was therefore to determine the in vivo reproducibility of volume and thickness measurements from replicated data sets, applying three-dimensional (3D) postprocessing methods. SUBJECTS AND METHODS: Eight healthy volunteers were imaged six times at a resolution of 2 x 0.31 x 0.31 mm with a fat-suppressed fast low-angle shot 3D sequence, the knee being repositioned in between replicated examinations. Three-dimensional reconstructions of the articular cartilage surfaces were obtained from sagittal data sets, and the cartilage volumes were calculated. The thickness distribution was analyzed throughout the joint surfaces independent of the section orientation, using a previously validated 3D minimal-distance algorithm. RESULTS: In the volunteers, the coefficient of variation for replicated volume measurements ranged from 1.3% (patella) to 3.4% (lateral tibia), and the standard deviation of the individual cartilage volumes ranged from +/- 16% (lateral tibia) to +/- 22% (femur). The intraclass correlation coefficient ranged from .959 (lateral tibia) to .995 (patella). The interobserver evaluation was similar to the interscan reproducibility. The mean interscan deviation of the maximal cartilage thickness interval ranged from 0.1 to 0.3 cartilage thickness intervals (of 0.5 mm); only in rare cases did we record deviations greater than one thickness interval. CONCLUSION: MR imaging can be used to determine cartilage volume and thickness in the knee joints of living subjects with high precision, provided that a fat-suppressed gradient-echo sequence with adequate resolution and 3D digital image processing are used.

Adult↗

PubMed1998

Accuracy of cartilage volume and thickness measurements with magnetic resonance imaging.

A noninvasive imaging technique for quantifying articular cartilage is needed for diagnosis, monitoring, and therapy control in osteoarthritis. In this study the accuracy of three-dimensional cartilage volume and thickness measurements in the knee with magnetic resonance imaging was analyzed. Eight cadaveric specimens had sagittal imaging with a fat suppressed gradient echo sequence. After a contrast agent was injected, two sagittal computed tomography data sets were obtained, with the knees being repositioned between the examinations. The cartilage thickness was determined, after three-dimensional reconstruction, using a minimal distance algorithm. The mean absolute volume deviation between magnetic resonance imaging and computed tomography arthrography was 3.3% and that between the two computed tomography data sets was 3.6%. The absolute error in determining the maximal cartilage thickness with magnetic resonance imaging was on average 0.6 intervals (of 0.5-mm thickness) and that between the computed tomography examinations was 0.5 intervals. In a patient with anterior knee pain, a focal cartilage defect was seen with magnetic resonance imaging, and this was verified by arthroscopic examination. Using three-dimensional image processing, magnetic resonance imaging can provide accurate data on cartilage volume and thickness in the human knee joint surfaces. This imaging technique potentially may be valuable in the treatment of patients with joint disease.

Adult↗

PubMed1998

[Noninvasive analysis of cartilage volume and cartilage thickness in the human elbow joint using MRI].

The aim of the study was to non-invasively analyse the cartilage volume and thickness in the human elbow joint with magnetic resonance imaging. 12 fresh frozen specimens (ages 20 to 69 yrs.) were investigated using a 1.5 T magnet, and a water-excitation FLASH-3D sequence at a resolution of 1 x 0.25 x 0.25 mm3. After linear interpolation to 0.125 x 0.125 mm2 in the image plane, the cartilages were segmented interactively with a Snake algorithm. Following three-dimensional reconstruction, the cartilage volumes were determined, and the mean and maximal cartilage thickness computed by Euclidean distance transformation. The total cartilage volume of the human elbow joint amounted to between 3.90 and 7.17 ml (mean 5.5 ml +/- 20%). The humerus occupied 49 to 60%, the radius 15 to 27% and the ulna 20 to 29% of the total volume. The mean cartilage thickness ranged from an average of 0.9 (proximal part of the ulna) to 1.4 mm (capitulum humeri), and the maximal thickness from 2.3 mm (proximal part of the ulna) to 2.9 mm (distal part of the ulna). The ulnar cartilage showed a more inhomogeneous distribution than that of the humerus and radius. The interindividual variability of the cartilage thickness was less than that of the volume. There was no significant relationship of the volume with age (r = 0.11) or body weight (r = 0.51). However, based on the joint size (r = 0.71-medio-lateral extension of the articular surfaces) about 50% of the variability of the total cartilage volume could be predicted. The technique presented is suitable for designing computer models to investigate the load transmission and functional adaptation of diarthrodial joints, and for diagnosing and monitoring joint disease.

Adult↗