Myocardial scintigraphy and estimation of regional blood flow with xenon-133.
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Biomedical subjects
Publications and source records attributed to O Korhola.
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A computed radiography system (Digiscan, Siemens) connected to an image workstation (Siemens) has been used for 1 1/2 years in our department. The image quality is good and it has been possible to reduce radiation dose by about 30% without any appreciable loss of image quality. The image workstation has been used in cases where image postprocessing is considered to be useful. For routine reporting of X-ray images the workstation is too slow although the image quality is comparable to that of the computed radiography film.
Computed radiography (CR) with storage phosphors offers a wide dynamic range and improved sensitivity compared to film-screen technology. CR was combined in this study with a prototype multiple pencil-beam (MPB) imaging device which has been shown to be very effective in scatter reduction. The combination was analyzed and compared to the standard technique of grid screening in two ways: a free-response ROC (FROC) analysis was first performed followed by a blinded test arrangement for visual analysis of image quality in a series of computed radiography of the lumbar spine by both the MPB and grid modalities. The results of the FROC study showed a statistically significant (P less than or equal to 0.01) improvement in signal detection. The MPB-CR images of the lumbar spine had more contrast but also a slightly mottled or grainy appearance. Image quality was found good but contrast processing was criticized because it seemed to result in a too steep display of contrast in MPB imaging. This should be avoidable by changing the image processing parameters.
Some scatter studies have previously been conducted using film as a detector. The serious limitations caused by the narrow latitude, the non-linear density response, and the required optical densitometric measurements of film can be avoided by computed radiography (CR) which provides linear numeric data over a wide dynamic range. The imaging plate is used as a large-area detector and the data is analyzed from the computer memory. Variation in the scatter-to-primary ratio within an image caused by absorption differences was simulated in a water-aluminum phantom. The measurement technique showed repeatable results, being comparable to the values expected on the basis of previous studies. A multiple pencil-beam (MPB) imaging device was also compared to a standard 1:12 grid by this technique. The maximal scatter-to-primary ratio in our model was up to 7.9 with no scatter reduction, 1.5 with grid, and 0.4 with the MPB device. The variation caused by the absorption of primary radiation was much less in the MPB modality, and the MPB system was also less sensitive to an increase in the used tube voltage from 60 to 120 kVp. The benefits of multiple pencil-beam imaging in scatter reduction are briefly discussed.
We conducted a prospective study in order to compare ultrasonography, computed tomography and magnetic resonance imaging in the detection of liver foci in patients with acute leukaemia and clinical suspicion of hepatic candidiasis. 28 adult patients fulfilling set entry criteria after recovery from neutropenia were studied. Lesions in the liver were detected by at least one imaging modality in 21 patients: by ultrasonography in 7 (33% of detected cases), computed tomography in 12 (57%) and by magnetic resonance imaging in 20 patients (95%). Magnetic resonance imaging was significantly more sensitive than ultrasonography (p<0.001) and computed tomography (p<0.02). The difference between computed tomography and ultrasonography was not statistically significant (p=0.1). Invasive procedures performed in 10 patients provided definite proof of candidiasis in 5 patients, and nodes on the liver surface, compatible with yeast infection, were seen during laparoscopy in 3 other patients without proof of fungal infection. We confirm that magnetic resonance imaging is superior to ultrasonography and computed tomography in imaging liver foci in leukaemic patients recovering from neutropenia with persistent non-specific signs of infection or hepatic involvement.
To evaluate the use of ultra low-field (0.02 T) magnetic resonance (MR) imaging in the diagnosis of musculoskeletal infection, MR examinations with T2 weighted sequences were performed in 61 patients thought to be suffering from one of four major diagnostic categories: Soft-tissue abscesses (n = 22), osteomyelitis (n = 21), septic arthritis (n = 9) and spondylitis (n = 9). Infection was confirmed for 37 of these 61 patients. The verified abscesses, arthritis, spondylitis and acute osteomyelitis could be detected by 0.02 T MR. The sensitivity was poor in cases of chronic osteomyelitis. There was one false positive finding in a patient with a possible soft tissue infection. The 0.02 T MR examination failed four times. Two patients were too heavy and another 2 patients had magnetic material in or near the scanning field. Compared with computed tomography and isotope scanning, 0.02 T MR proved a little more informative, but without any statistical significance.