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Biomedical subjects

K H Englmeier

Publications and source records attributed to K H Englmeier.

At least 73 records · Page 4Linked to original sources

[Sex-specific analysis of cartilage volume in the knee joint--a quantitative MRI-based study].

The objective of the present study was to determine differences in the normal knee joint cartilage volume of males and females, the analysis of the percentage distribution of the cartilage tissue onto the various joint surfaces, and the determination of the relationship between the cartilage volume, the body weight, and the tibial head diameter. We examined the knee joints of nine healthy men and nine women with a low level of physical activity. The cartilage volume was assessed with magnetic resonance imaging, applying a fat-suppressed gradient-echo sequence with a resolution of 2 x 0.31 x 0.31 mm3 and 3D image reconstruction. In the men, the absolute volumes of the femur and tibia, but not those of the patella, were significantly higher than in the women. The differences between the sexes were considerably lower after normalisation to the body weight and the tibial head diameter and were no more statistically significant. The interindividual variability was reduced after normalisation to these two parameters, the body weight being more effective. We did not observe sex-specific differences in the percentage of the total cartilage volume taken up by the various joint surfaces. Our results suggest that, in young individuals without cartilage lesions, there exist sex-specific differences of the cartilage volume in the knee joint. However, these can be explained in terms of general differences in body constitution (body weight and bone size), without further significant influences of the sex. The knowledge of the normal, sex-specific cartilage volume is relevant when attempting to estimate the amount of tissue loss at the time at which symptoms occur in a patient with degenerative joint disease.

Adult↗

[Principles and current possibilities of virtual scenarios for surgery planning].

This paper describes several new visualization and interaction techniques that enable the use of virtual environments for routine medical purposes. A new volume-rendering method supports shaded and transparent visualization of medical image sequences in real-time with an interactive threshold definition. Based on these rendering algorithms a segmentation approach offers intuitive assistance for a wide range of requirements in diagnosis and therapy planning. In addition, a hierarchical data representation for geometric surface descriptions guarantees optimal use of available hardware resources and prevents inaccurate visualization. Applications such as virtual endoscopy are described.

Computer Systems↗

Repeatability of patellar cartilage thickness patterns in the living, using a fat-suppressed magnetic resonance imaging sequence with short acquisition time and three-dimensional data processing.

A fast, reproducible, and noninvasive method is required for quantifying cartilage thickness clinically and for studying the deformation of articular cartilage during and after mechanical loading in vivo. The objective of the current investigation was to test the repeatability of regional distribution patterns of patellar cartilage thickness in the living on the basis of a fat-suppressed magnetic resonance imaging sequence with a short acquisition time and three-dimensional digital data processing. The knees of eight healthy volunteers were transversally imaged with a fat-suppressed FLASH-3D (fast low angle shot) sequence (acquisition time: 4 minutes and 10 seconds). In each case, the joint was newly positioned before each of the six replicate measurements was taken. The patellar cartilage was reconstructed three-dimensionally, and the distribution of cartilage thickness was determined with a three-dimensional minimal-distance algorithm. Whereas the cartilage volume ranged from 3,198 to 7,149 mm3, the mean coefficient of variation for the 6-fold volume measurement was 1.35%. On average, 75.1% (+/- 4.1%) of all test pixels could be attributed to the same cartilage thickness interval (0.5 mm) by image analysis; 14.8% (+/- 2.4%) deviated by one interval; 6.6% (+/- 1.5%), by two intervals; and 3.5% (+/- 1.8%), by more than two intervals. We conclude that, on the basis of a magnetic resonance imaging sequence with an acquisition time of less than 5 minutes, the quantitative distribution of cartilage thickness can be determined with high precision in vivo.

Adult↗

Spiral CT angiography and 3D reconstruction in patients with aortic coarctation.

The objective of this study was to assess the reliability of spiral CT angiography (CTA) and 3D reconstruction in patients with aortic coarctation (CoA). Eighteen patients with suspected or surgically proven coarctation were examined by spiral CT. In addition to the axial slices, 3D reconstructions, such as shaded surface display (SSD) and maximum intensity projection (MIP), were used to determine the diameters of the CoA and the pre- and poststenotic aorta and to visualise the collateral vessels. Diameters derived from cardiac catheterization were compared with those from CTA in 8 patients. The degree of aortic stenosis was correlated with blood pressure gradients (BPG) in 12 patients. The difference between the diameters of the CoA and the pre- and poststenotic aorta derived from MIP and angiography was not statistically significant (p = 0.69). With SSD the internal thoracic artery was detected in 16 and the posterior intercostal artery in 13 cases. The degree of aortic stenosis correlated poorly with the BPG (r = 0.51, r2 = 0.26). CTA with 3D reconstruction represents a reliable noninvasive technique for the assessment of the degree of CoA and the visualisation of collateral vessels. It may serve as a follow-up investigation after intervention or surgical treatment.

Adolescent↗

A non-invasive technique for 3-dimensional assessment of articular cartilage thickness based on MRI. Part 2: Validation using CT arthrography.

Established methods for the measurement of articular cartilage thickness are invasive and cannot be sequentially applied in living subjects. In the present study, the distribution of cartilage thickness throughout entire joint surfaces was determined from MR images obtained with a fat-suppressed gradient-echo sequence at a resolution of 0.31 x 0.31 x 2.00 mm3, and compared to that derived from CT arthrography. A minimal distance algorithm was employed to produce 3D cartilage thickness maps of seven cadaveric human knee joints. The mean amount of deviation of the cartilage volumes was 5.6% (+/- 4.6), statistical analysis showing that there was high agreement between the two methods (r = 0.995, slope = 1.037, y-intercept = -90.5 mm3). The 3D thickness maps yielded a striking agreement between the two methods, the maximum values generally yielding a deviation of none or one thickness interval of 0.5 mm. This investigation shows that accurate 3D assessment of articular cartilage thickness can be performed with MRI, this technique having the advantage that it is suitable for investigating living subjects.

Adult↗

A non-invasive technique for 3-dimensional assessment of articular cartilage thickness based on MRI. Part 1: Development of a computational method.

Articular cartilage thickness is of relevance in various fields in diagnostics and biomedical research. In view of recent improvements of MR cartilage imaging a computational method has been developed for three-dimensional determination of cartilage thickness from tomographic datasets. A correction algorithm that compensates for the error implied in the voxel based distance measurements is implemented. Four different thickness definitions have been applied to two numerical test structures in order to judge their usability in the medical realm. The results for each of the thickness measurement methods are shown as color-coded thickness maps wrapped round the test objects. An algorithm determining at each point the minimal distance from the articular surface to the bone-cartilage interface is suggested to give the most suitable demonstration of articular cartilage. This algorithm is successfully applied to a 3-dimensional data set of human knee joint cartilage obtained with a fat-suppressed gradient-echo sequence from a healthy volunteer. A non-invasive method for determining cartilage thickness could become a very valuable tool in diagnostic radiology, orthopaedic practice and biomechanics.

Adult↗

[Three-dimensional thickness and volume measurements of the knee joint cartilage using MRI: validation in an anatomical specimen by CT arthrography].

PURPOSE: In the present study we intended to validate knee joint cartilage volume and thickness measurements with MRI. METHODS: Ten fresh cadaver knees (age 29 to 64 yrs.) were sagittally imaged, using a fat-suppressed FLASH-3D sequence with a resolution of 2 x 0.31 x 0.31 mm3. Then, a contrast agent was injected and the specimens submitted to CT arthrography. From both modalities the patellar, femoral, and tibial cartilages were segmented semiautomatically and reconstructed three-dimensionally. The cartilage thickness was determined independently of the sectional plane, based on a "minimal distance algorithm". RESULTS: The volumes and the regional distribution patterns yielded a very high degree of similarity on direct comparison of both imaging modalities. The average volume error between MRI and CT was 3.8% (+/- 3.0%), the correlation 0.998, the slope of the regression line 1.04 and the gamma-intercept -80 mm3. The analysis yielded no significant differences between the two methods (Wilcoxon signed rank test, 5% level) in the patella, femur, medial, and lateral tibia. CONCLUSION: The results suggest that, based on a fat-suppressed FLASH sequence with high resolution and three-dimensional concepts of digital image analysis, the cartilage volume and thickness can be analysed non-invasively and with high accuracy by MRI.

Algorithms↗

[Three-dimensional thickness and volume measurements of the knee joint cartilage by MR tomography: reproducibility in volunteers].

OBJECTIVE: To determine the reproducibility of three-dimensional volume and thickness measurements of the knee joint cartilage with MRI in volunteers. METHODS: The knees of 7 healthy individuals (ages 23 to 58 yrs.) were sagittally imaged with a resolution of 2 x 0.31 x 0.31 mm3, using a fat-suppressed FLASH-3 D sequence. The knee was repositioned in between replicate acquisitions, 6 data sets being obtained in each case. After semiautomatic segmentation and three-dimensional reconstruction of the cartilage, the thickness was determined independent of the original section orientation. The coefficient of variation for repeated volume measurements and the deviations of the maximal cartilage thickness values were calculated subsequently. RESULTS: The mean variation of the cartilage volumes of the replicate measurements was 1.4% (+/- 0.8%) in the patella, 1.7% (+/- 1.5%) in the femur, 3.0% (+/- 1.2%) in the medial tibial plateau and 3.5% (+/- 2.0%) in the lateral tibial plateau. The comparison of the distribution patterns of cartilage thickness yielded a high degree of agreement. Only in rare cases deviations of more than 0.5 mm were observed. CONCLUSIONS: The results show that the presented method for determining the quantitative distribution of articular cartilage yields a high degree of precision. It offers new possibilities in screening risk groups, monitoring the course of degenerative joint disease and the investigation of functional adaptation of the cartilage to mechanical loading.

Adult↗

Virtual reality in medicine-computer graphics and interaction techniques.

This paper describes several new visualization and interaction techniques that enable the use of virtual environments for routine medical purposes. A new volume-rendering method supports shaded and transparent visualization of medical image sequences in real-time with an interactive threshold definition. Based on these rendering algorithms two complementary segmentation approaches offer an intuitive assistance for a wide range of requirements in diagnosis and therapy planning. In addition, a hierarchical data representation for geometric surface descriptions guarantees an optimal use of available hardware resources and prevents inaccurate visualization. The combination of the presented techniques empowers the improved human-machine interface of virtual reality to support every interactive task in medical three-dimensional (3-D) image processing, from visualization of unsegmented data volumes up to the simulation of surgical procedures.

Algorithms↗

Hybrid rendering of multidimensional image data.

The most important rendering methods applied in medical imaging are surface and volume rendering techniques. Each approach has its own advantages and limitations: Fast surface-oriented methods are able to support real-time interaction and manipulation. The underlying representation, however, is dependent on intensive image processing to extract the object surfaces. In contrast, volume visualization is not necessarily based on extensive image processing and interpretation. No data reduction to geometric primitives, such as polygons, is required. Therefore, the process of volume rendering is currently not operating in real time. In order to provide the radiological diagnosis with additional information as well as to enable simulation and preoperative treatment planning we developed a new hybrid rendering method which combines the advantages of surface and volume presentation, and minimizes the limitations of these approaches. We developed a common data representation method for both techniques. A preprocessing module enables the construction of a data volume by interpolation as well as the calculation of object surfaces by semiautomatic image interpretation and surface construction. The hybrid rendering system is based on transparency and texture mapping features. It is embedded in a user-friendly open system which enables the support of new application fields such as virtual reality and stereolithography. The efficiency of our new method is described for 3-D subtraction angiography and the visualization of morpho-functional relationships.

Computer Graphics↗

Determination of knee joint cartilage thickness using three-dimensional magnetic resonance chondro-crassometry (3D MR-CCM).

The objective of this article was to analyze the accuracy and precision with which the quantitative distribution of articular cartilage can be determined in the knee joint using MRI. A three-dimensional (3D) technique that accounts for the out-of-plane deviation of the interface normal in strongly curved joint surfaces (3D MR-CCM) has been developed for cartilage thickness measurements. Eight cadaveric knee-joint specimens and six volunteers were imaged using a fat-suppressed gradient-echo sequence at a resolution of 2 x 0.31 x 0.31 mm3. Cartilage volumes and topographical thickness maps were obtained and compared with those derived from anatomical sections by image analysis. The deviation of the MR volumes from those of the sections was 1-12%, the coefficient of variation after repositioning ranged from 2.9% (patella) to 8.2% (lateral tibial plateau). Between 60% and 80% of all image points could be attributed to identical thickness intervals, less than 20% deviating by more than 0.5 mm. The intraobserver and interobserver reproducibilities were very high in both the specimens and the volunteers. In the knee joint, 3D reconstructions of the cartilages, and measurements that take into account the out-of-plane deviation of the interface normals (3D MR-CCM), are required.

Adult↗

[A method of computer-assisted, 3-dimensional subtraction angiography using spiral roentgen computerized tomography].

The objective of this study was to develop a method for 3D subtraction CT angiography and to optimize the visualization after semi-automatic segmentation. Ten patients with aneurysms of the abdominal aorta were examined using spiral CT. To reconstruct the vessels, as well as adjacent organs such as the liver and kidneys, one image data volume was acquired before and after injection of the contrast agent. The CT scans were obtained with a Siemens Somatom Plus 4. To improve the results of automatic segmentation, as well as visualization by maximum intensity projection (i.e. removal of bony structures), subtraction of both image volumes is necessary. However, small translation shifts disturb the subtraction process and produce artificial contours. To calculate the disparities along the three coordinate axes of two corresponding image volumes, a cepstrum filter is applied to a pair of image volumes. After detection of the disparities, which manifest as bright spots, the real shift of the two subsignals can be calculated. Translation of the corresponding image volume pairs to their correct positions improves the subtraction process. In all cases the size of the aneurysm and the abdominal organs could be better segmented and visualized. Application of the cepstrum filter and subtraction of the image volumes before and after contrast medium injection completely removes the bony structures in the image data and results in superior visualization results.

Angiography, Digital Subtraction↗

A method for the estimation of the hemoglobin distribution in gastroscopic images.

The assessment of blood flow in the gastrointestinal mucosa could be a useful indicator for the diagnosis and treatment of several diseases, such as ulcers, gastritis, colitis or early cancer. The quantity of blood flow is roughly estimated by computing the spatial hemoglobin distribution in the mucosa. The method presented here enables a practical realization by calculating approximately the hemoglobin concentration based on a spectrophotometric analysis of endoscopic true-color images, which are recorded during routine examinations. A system model based on the reflectance spectroscopic law of Kubelka-Munk is derived, which enables an estimation of the hemoglobin concentration by means of the color values of the images. Additionally, a transformation of the color values is developed, in order to improve the luminance independence. Applying this transformation and estimating the hemoglobin concentration for each pixel of interest, the hemoglobin distribution can be computed. The results obtained are mostly independent of luminance. An initial validation of the method is made by a quantitative estimation of the reproducibility.

Algorithms↗

Displacement correction and surface reconstruction of the retina using scanning laser ophthalmoscopic images.

A method for a three-dimensional surface reconstruction of the retina in the area of the papilla is presented. The surface reconstruction is based on a sequence of discrete gray-level images of the retina recorded by a scanning laser ophthalmoscope (SLO). The underlying assumption of the surface reconstruction algorithm developed here is that the depth information is also encoded in the brightness values of the single pixels in addition to the ordinary spatial 2D information. The brightness of an image position depends on the degree of reflection of a confocal laser beam. Only those surface structures located directly in the focus plane of the confocal laser beam produce a high response to the laser light. The displacements between the single images of a sequence are considered to be approximately linear and are corrected by applying the cepstrum technique. The depth is estimated from the volumetric representation of the image sequence by searching for the maximal value of the brightness within a computed depth profile, at every image position. In the resulting images, disturbances occurring during the recording cause incorrect local estimations of the depth. These local disturbances are corrected by applying specially developed surface improvement processes. The work is concluded with a comparison of several different approaches to reduce the noise and disturbances in SLO image data.

Algorithms↗

Estimation of blood flow in the upper gastrointestinal tract by analysis of endoscopic true color images.

A method is presented that estimates the local blood flow in the mucosa of the organs of the upper gastrointestinal tract; the method is based on the analysis of endoscopic true-color images. The quantity of blood flow is approximated by the estimation of the hemoglobin concentration in the mucosa. The first step of our algorithm consists of a neural segmentation, which excludes artifacts of the images that interfere with further computation. Next, a transformation of the image data is performed within the RGB-color space in order to obtain an estimation of the blood distribution, which is independent of the local brightness in the images. Finally the quantity of blood flow is estimated on the basis of physical laws of reflectance spectroscopy. Our method is characterized by the following features: 1) It computes an estimation of the blood flow for a whole endoscopic image; as such it is more powerful than local measuring methods; 2) Our method does not need any modifications of the endoscopic equipment; and 3) The use of our method does not put any additional strain on the patient.

Color↗

Image analysis and synthesis of multimodal images in medicine.

Radiologic and clinical practice can be enhanced by improved access to multimodal image information. Analysis, visualization, method characteristic image processing and image synthesis is needed not only for the interpretation of the images but also for performing effective consultations with clinical colleagues and computer supported therapy planning and control strategies. A method is presented which enables the fast display, three-dimensional visualization and the modality oriented analysis of multimodal image information. Based on a unique image format, modality specific procedures and two- or three-dimensional processing tools of image analysis produce the input data for therapy planning programs. The easy use of this multimedia visualization tool enables radiologists and clinicians to deal with their image data. The description of methods and procedures, as well as typical examples of radiologic practice will demonstrate the efficiency of the presented system.

Algorithms↗

[Visualized three-dimensional reconstruction and image analysis in orthopedics and trauma surgery].

Computer tomography is a commonly used technique for detecting pathological alterations in soft tissue and the skeleton. The remote access to image informations as well as the allocation of display and processing tools via networks enables improved diagnostic and therapeutic practice in orthopaedic and traumatologic surgery. The realization of a user friendly image analysis system displays and processes the acquired images in a modality oriented manner. Our method is based on a unique file format and specific evaluation procedures to produce the input data for three-dimensional display and algorithms for the individual design of implants. Our image analysis system can process the data of conventional computer tomographies with three or more mm distance. In contrast to the available systems there is a low significance of radiation effects.

Computer Graphics↗

Visualization of multimodal image information in medicine.

Radiological and clinical practice can be enhanced by improved access to multimodal image informations. Analysis, visualization, method characteristic image processing and image synthesis is needed not only for the interpretation of the images but also for performing effective consultations with clinical colleagues and computer supported therapy planning and control strategies. The distributed system RADVIS (radiological visualization) is presented which enables the fast display, three dimensional visualization and the modality oriented analysis of multimodal image informations. Based on a unique image format, modality specific evaluation procedures and two- or three dimensional processing tools of image analysis produce the input data for therapy planning programs. The easy use of this multimedia visualisation tool enables radiologists and clinicians to deal with their image data. The description of methods and procedures of the prototype, as well as typical examples of radiologic practice will demonstrate the efficiency of the presented system.

Humans↗