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L T Cook

Publications and source records attributed to L T Cook.

At least 19 recordsLinked to original sources

The transverse plane evolution of the most common adolescent idiopathic scoliosis deformities. A cross-sectional study of 181 patients.

STUDY DESIGN: The transverse plane evolution of the most common idiopathic deformities was studied using a cross-sectional database of 181 patients whose deformities were visualized by precise three-dimensional techniques. OBJECTIVE: The objective was to test the hypothesis that for all common idiopathic scoliosis deformities evolution occurs as a torsion, the apex vertebra translating away from the upper end vertebra and at the same time angulating in a clockwise arc for right apex deformities and a counterclockwise arc for left apex deformities. SUMMARY OF BACKGROUND DATA: Perdriolle and Vidal proposed this hypothesis in 1987, which explained observations we had made in 1983 and which was partially supported in thoracic curves in our 1992 study. METHODS: Deformities were characterized as single thoracic major, thoracic major and thoracolumbar or lumbar minor, double thoracic and thoracolumbar or lumbar major, and single thoracolumbar or lumbar major curves. The dependent variable studied was the coronal plane regional angular (Cobb) deformity. The independent variables studied were the lateral and anteroposterior translation of the apex vertebra in relation to the upper end vertebra, and the transverse plane translation and angulation of the apex vertebra in relation to the upper end vertebra. For the model or hypothesis to be true, the apex vertebra to upper end vertebra transverse plane translational distance and angular relationship should increase as the Cobb angle increases. RESULTS: In relation to the upper end vertebra, the apex vertebra always translated laterally, almost always was accompanied by transverse plane translation increase, and usually was accompanied by transverse plane angulation increase. Anteroposterior translation was minimal, but for thoracolumbar and lumbar curves it tended to be posterior. CONCLUSION: The theory that these deformities evolve as torsions, with the apex vertebra translating away from the upper end vertebra and at the same time following a clockwise angular pathway to the upper end vertebra of right apex curves and a counterclockwise angular pathway for left apex curves is supported. Compensatory thoracolumbar and lumbar curves evolve in the same manner as major curves.

Adolescent

Contrast-detail analysis of image degradation due to lossy compression.

A contrast-detail (CD) experiment was performed to study the effect of lossy compression on computed radiographic (CR) images. Digital CR images of a phantom were compressed by quantizing the full-frame discrete cosine transform and Huffman encoding the result. Since low-contrast detectability is directly linked to an important radiological task, namely, the detection of noncalcified pulmonary nodules in adult chest radiographs, the goal of the study was to quantify any loss in low-contrast detectability due to compression. Compression ratios varied significantly among compressed images, despite the use of fixed compression parameters; detectability could be specified by a single parameter of a CD curve; there was no significant reduction in detectability for an average compression ratio of 11:1; and, there was a statistically significant degradation in detectability for an average compression ratio of 125:1.

Humans

Comparison of the low-contrast detectability of a screen-film system and third generation computed radiography.

Contrast-detail (CD) analysis was used to compare the low-contrast detectability of computed radiography (CR) and screen-film (SF) as applied to the task of adult chest radiography. A phantom was constructed and imaged using the same exposure factors throughout all experiments. Within-observer variance, between-observer variance, and image sample variance were calculated and used to estimate the standard error for each experiment. The results of these CD experiments agreed with the predictions of the Rose model. Observers performed equally well for low-contrast target detection using CR and SF.

Adult

Enhancement of storage phosphor plate images: a C-language program.

A C-language software program has been developed for emulating the image enhancement processing of a storage phosphor plate system. This software has been implemented on a VAX 3400 computer. There are 2,100 lines of C-language code in the program. There are seven parameters used to specify the degree of enhancement. The software is being implemented on a single accelerator board.

Algorithms

Image calibration of laser digitizers, printers, and gray-scale displays.

Laser film digitizers, interactive gray-scale monitors, and laser film printers are necessary to transmit digital image information. These devices must be standardized so that hard- and soft-copy images are as similar as possible. Standardization of appropriate calibration procedures is necessary to attain this goal. Radiographs are converted into digital data representations by a laser film digitizer. These representations (and those obtained with other modalities) are transferred to a laser film printer or to an interactive monitor with gray-scale display. To obtain the best gray-level fidelity, printer output optical densities should be identical to those of the input film. Laser printers should be calibrated regularly to ensure uniform results. A gray-scale controller functions as an adjunct to the host computer and can automate the calibration process. Gray-scale controller functions may someday be incorporated into an accelerator or array-processor board.

Calibration

Computed radiography in musculoskeletal imaging: state of the art.

Computed radiography is a 2K x 2K x 10 bit digital radiographic system that replaces the film-screen combination with a photo-stimulable phosphor plate. The advantages of this relatively new technology include linear detector response, improved detector efficiency, and digital processing capabilities. Musculoskeletal applications benefit significantly from these attributes, which result clinically in the ability to reduce both radiation dose and number of exposures. Studies of observers' performance have shown no statistically significant difference in diagnostic accuracy between film-screen and computed radiographic musculoskeletal images. Computed radiography is particularly useful in the evaluation of the musculoskeletal system in traumatized patients with portable radiographs, spine radiographs, scoliosis studies, and depiction of soft-tissue abnormalities. Limitations include change in image format and size, high cost, decreased spatial resolution, restricted throughput, increased perception of noise, and new artifacts that must be recognized. Spatial resolution limitations of computed radiography in identification of fine detail information can be improved by using magnification techniques. Radiation dose reduction with an exposure decrease of 25-50% can be achieved without loss of diagnostic accuracy, although this depends on the examination and the abnormality. An interactive workstation is important in the use of a computed radiographic system with capabilities to adjust display parameters to best depict images and disease. We conclude that computed radiography is an alternative to film-screen radiography without significant differences in diagnostic quality in the evaluation of musculoskeletal images.

Humans

Conventional screen/film vs reduced exposure photostimulable phosphor plate imaging in lower extremity venography: an ROC analysis.

Half-exposure phosphor plates used in venography substantially reduce the total X-ray exposure to a patient while increasing the chance that all images will be of excellent diagnostic quality. Simultaneous half-exposure phosphor plate and full-exposure conventional screen/film venograms were obtained of 35 patients and compared by using receiver operating characteristic (ROC) analysis. The area under the ROC curve ranged from 0.67 to 0.78 for conventional films and 0.68 to 0.91 for phosphor plates. Group performances on conventional films vs phosphor plates were not statistically different. No statistically significant difference in individual performance with the two techniques was seen in seven of the eight interpreters at the 95% confidence level. The eighth interpreter performed significantly better with phosphor plates than with conventional films. Interpreters with and without specific experience in phosphor plate venography were grouped separately, and performance of the two groups was compared in each technique. No difference in performance was found between the groups when interpreting conventional venograms, but, when interpreting phosphor plate venograms, the group with specific experience performed significantly better than they had with conventional venograms, and significantly better than the other group did at interpreting either conventional or phosphor plate venograms. We conclude that phosphor plate venograms made at a 50% reduction in X-ray exposure are equal to, and may surpass, conventional screen/film venograms for diagnosing acute venous thrombosis of the calf and thigh. We recommend expanding the indications for phosphor plate radiography to include contrast venography of the lower extremities.

Adult

Nondisplaced fractures: spatial resolution requirements for detection with digital skeletal imaging.

Fifty-six radiographs of nondisplaced or minimally displaced fractures of the extremities and an equal number of studies with normal findings were selected and digitized to produce spatial resolution varying from 5.75 to 0.72 line pairs per millimeter (1p/mm), corresponding to pixel sizes ranging from 0.08 to 0.64 mm. The conventional and digitized images were evaluated by 10 radiologists, who gave their decision confidence on a graded scale. Receiver operating characteristic analyses were performed from these data to compare the digital images with the conventional radiographs. There was a progressive improvement in observer performance as the pixel size decreased. A pixel size greater than 0.16 mm (2.88 1p/mm) resulted in a significant loss of diagnostic accuracy in comparison with conventional radiographs. Specific fractures in which a larger pixel size adversely affected the evaluation included torus injuries, corner fractures in child abuse, minimal avulsion injuries, and fractures that demonstrated only trabecular disruption.

Adult

Chest radiography: comparison of high-resolution digital displays with conventional and digital film.

This study was performed to compare the performances of observers using three display formats for chest radiography. The display formats were conventional radiographs, digitized radiographs (2,048 X 2,048 X 12 bits) printed on laser film, and digitized radiographs (2,048 X 2,048 X 12 bits) displayed on a high-resolution (2,560 X 2,048 X 12-bit) gray-scale display. The test set for the study consisted of 163 cases. Sixty-four of the cases were normal, whereas the 99 remaining cases demonstrated one or more common radiographic abnormalities. Nine abnormalities were selected for analysis: costophrenic angle blunting, interstitial disease, atelectasis, pneumothorax, parenchymal mass, consolidation, obstructive disease, hilar/mediastinal mass, and apical scarring. Six experienced general radiologists participated in the evaluation. Receiver operating characteristic curves were generated for each abnormality and display format. The results indicate that, while the three display formats are equivalent for the detection of some abnormalities, detectable differences in observer performance may be seen even at 2,048 X 2,048 X 12 bits for the detection of obstructive disease, pneumothorax, interstitial disease, and parenchymal masses.

Humans

Image data compression in magnification hand radiographs.

A study was conducted on the use of an irreversible compression technique, Fourier quantization, to reduce the amount of digital data needed for an image. The effect of image compression was studied in radiographs obtained to diagnose subperiosteal bone resorption. Magnification radiographs of 44 hands were digitized to an array size of 4,096 X 4,096 X 12 bits. Selected subregions containing a single middle phalanx were compressed and reconstructed. A subset of the resultant 12-bit uncompressed and 8-, 7-, and 6-bit compressed images were read by four radiologists whose responses were analyzed with receiver operating characteristic (ROC) techniques. There were 81 images used in the ROC analysis, of which 48 were normal and 33 showed subperiosteal resorption. No statistically significant loss of diagnostic quality was detected for 8- or 7-bit compressed images, with average compression ratios of 16:1 and 28:1, respectively. Diagnostic quality was lost with 6-bit images, with an average compression ratio of 107:1.

Arthritis

Estimating digital information throughput rates for radiology networks. A model.

The design and implementation of a digital radiology image management system requires the definition, evaluation, and comparison of appropriate measures of system performance. The mean throughput rate is an important measure of the actual performance of a finished system. The mean throughput rate identifies the transmission of digital information either in bits/second or tasks/second. It is dependent on software, database management, equipment interface designs, number of users and display stations, and communications media. The mean throughput rate can document resource allocation bottlenecks within a given system. A model for estimating the mean throughput rate and its application in helping us design our radiology digital image networks is described.

Electronic Data Processing

Liver cysts in autosomal-dominant polycystic kidney disease: clinical and computed tomographic study.

Hepatic CT findings were analyzed in 44 patients with autosomal-dominant polycystic kidney disease and were correlated with liver and renal function tests and liver, splenic, and renal CT volume measurements. CT showed many large liver cysts in 31.8% of patients, small liver cysts in 25%, and no liver cysts in 43.2%. Patients with many large cysts often showed increased liver volumes. Splenic volumes did not differ significantly in patients with and without liver cysts, suggesting that portal hypertension is rarely associated with cystic liver disease. There was no correlation between severity of liver involvement and extent of renal cystic disease as determined from urea nitrogen and creatinine levels and renal volumes. Liver function tests were normal except in two patients, one with a cholangiocarcinoma, which may have arisen from a cyst, and the other with an infected liver cyst and chronic active hepatitis. Accordingly, if liver function tests are abnormal, an attempt should be made to identify complications of polycystic liver disease such as tumor, cyst infection, and biliary obstruction. Such complications are rare but may be seen in patients whose lives are prolonged by dialysis and renal transplantation. CT is a useful method for detecting liver cysts and identifying patients at risk for these complications.

Adult

Computer graphics for digitally formatted images.

The increasing use of digitally formatted imaging systems requires high-quality interactive gray-scale computer raster graphics systems for the management, display, and analog film recording of digital image and alphanumeric information. These systems are a combination of computer hardware and software and implement a set of graphics protocols. This paper describes a set of interactive graphics protocols that has been developed for clinical use.

Computers

The top view for analysis of scoliosis progression.

Using computerized spinal analysis, a new top view was developed that displays the spine as if the observer were above and looking down on the patient. Serial top views were obtained of 12 patients with idiopathic scoliosis. In five patients with clinically stable curves, the top views showed no change. One patient with an enlarging rib hump was seen on the top view to have progressive kyphosis but stable scoliosis. Six patients with progressive scoliosis all demonstrated collapse of the thoracic curve in the anteroposterior direction. Five of these six patients had associated lumbar curves. Three lumbar curves demonstrated collapse in the anteroposterior direction similar to the collapse of the thoracic curves, and the other two curves appeared elongated in the anteroposterior direction.

Adolescent

The cost of managing digital diagnostic images.

A study of the cost of recording and archiving digitally formatted diagnostic images is presented for an academic radiology department serving a 614-bed university hospital and a large outpatient population. The radiological examinations include computed tomography, nuclear medicine, ultrasound, and digital radiography. The archiving management strategies studied include the combined use of computer magnetic tapes, computer disc storage, and multiformat video film recordings. The estimated cost per patient for the archiving of digital diagnostic images is presented.

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