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Biomedical subjects

P F Sharp

Publications and source records attributed to P F Sharp.

At least 37 records · Page 2Linked to original sources
PubMed1997

Correlation between 99Tcm-HMPAO-SPECT brain image and a history of decompression illness or extent of diving experience in commercial divers.

OBJECTIVES: To explore the use of 99technetiumm-hexamethyl propylene amine oxime single photon computed tomography (HMPAO-SPECT) of the brain as a means of detecting nervous tissue damage in divers and to determine if there is any correlation between brain image and a diver's history of diving or decompression illness (DCI). METHODS: 28 commercial divers with a history of DCI, 26 divers with no history of DCI, and 19 non-diving controls were examined with brain HMPAO-SPECT. Results were classified by observer assessment as normal (I) or as a pattern variants (II-V). The brain images of a subgroup of these divers (n = 44) and the controls (n = 17) were further analysed with a first order texture analysis technique based on a grey level histogram. RESULTS: 15 of 54 commercial divers (28%) were visually assessed as having HMPAO-SPECT images outside normal limits compared with 15.8% in appropriately identified non-diver control subjects. 18% of divers with a history of DCI were classified as having a pattern different from the normal image compared with 38% with no history of DCI. No association was established between the presence of a pattern variant from the normal image and history of DCI, diving, or other previous possible neurological insult. On texture analysis of the brain images, divers had a significantly lower mean grey level (MGL) than non-divers. Divers with a history of DCI (n = 22) had a significantly lower MGL when compared with divers with no history of DCI (n = 22). Divers with > 14 years professional diving or > 100 decompression days a year had a significantly lower MGL value. CONCLUSIONS: Observer assessment of HMPAO-SPECT brain images can lead to disparity in results. Texture analysis of the brain images supplies both an objective and consistent method of measurement. A significant correlation was found between a low measure of MGL and a history of DCI. There was also an indication that diving itself had an effect on texture measurement, implying that it had caused subclinical nervous tissue damage.

Adult↗
PubMed1996

An image-processing strategy for the segmentation and quantification of microaneurysms in fluorescein angiograms of the ocular fundus.

Digital image-processing techniques can provide an objective and highly repeatable way of quantifying retinal pathology. This study describes an image-processing strategy which detects and quantifies microaneurysms present in digitized fluorescein angiograms. After preprocessing stages, a bilinear top-hat transformation and matched filtering are employed to provide an initial segmentation of the images. Thresholding this processed image results in a binary image containing candidate microaneurysms. A novel region-growing algorithm fully delineates each marked object and subsequent analysis of the size, shape, and energy characteristics of each candidate results in the final segmentation of microaneurysms. The technique is assessed by comparing the computer's results with microaneurysm counts carried out by five clinicians, using Receiver Operating Characteristic (ROC) curves. The performance of the automated technique matched that of the clinicians' analyses. This strategy is valuable in providing a way of accurately monitoring the progression of diabetic retinopathy.

Algorithms↗
PubMed1996

Decompression illness in sports divers detected with technetium-99m-HMPAO SPECT and texture analysis.

UNLABELLED: Diving for sport and recreation has increased in recent years, resulting in more incidences of diving illness. Therefore, we studied potential use of regional cerebral blood flow SPECT imaging with 99mTc-HMPAO in the management of divers who have experienced decompression illness (DCI). METHODS: A group of ten sports divers who had no experience of DCI were compared with ten sports divers who had experienced at least one episode of DCI. Transaxial SPECT images were first compared objectively using a first-order texture measure and then subjectively using a receiver operator characteristic (ROC) experiment. Experienced observers were asked to rate images subjectively in terms of the images' textural appearance. RESULTS: Both these techniques showed that there is a statistically significant difference between the two groups and the images produced by the DCI divers were generally more coarsely patchy when compared to the non DCI divers. The quantitative texture technique proved significantly better in identifying divers with DCI than the visual analysis by observers using ROC curves. CONCLUSION: Differences between the cerebral blood flow patterns of sports divers who have experienced DCI and sports divers who have no experience of DCI can be detected using 99mTc-HMPAO SPECT and a texture analysis technique.

Adult↗
PubMed1995

Quantitative image analysis of macular drusen from fundus photographs and scanning laser ophthalmoscope images.

Drusen are common features in the ageing macula and are associated with exudative age-related macular degeneration (ARMD). They appear as characteristic structures in indirect mode infrared scanning laser ophthalmoscope (SLO) images. Manual counting of drusen area in SLO images has shown no significant difference from that in standard fundus photographs in 6 eyes of 5 patients (p > 0.5). Computerised image processing techniques have been applied to digitised colour fundus photographs and indirect mode images to quantify the area of the macula affected by drusen in an automated fashion. Application of these methods may permit objective and repeatable assessment of the natural history of macular drusen. For a specificity of 90%, a sensitivity of 60% for colour fundus photographs and 35% for SLO images has been achieved, when compared with manual counting. The colour fundus photograph method also showed superior reproducibility compared with the SLO technique.

Aged↗
PubMed1995

Texture analysis of divers' brains using 99Tcm-HMPAO SPET.

The potential use of regional cerebral blood flow (rCBF) single photon emission tomography (SPET) imaging with 99Tcm-hexamethylpropyleneamine oxime (HMPAO) in the management of divers who have undergone a form of decompression sickness (DCS) was investigated using texture analysis. We imaged 50 divers, 10 of whom had only experienced DCS which had been categorized as Type 1, 20 of whom had a history of DCS classified as Type 2 and 20 of whom had not suffered an episode of DCS. A number of divers who had experienced Type 2 DCS had also had incidents of Type 1. The reconstructed SPET images were pre-processed and analysed using a first-order texture analysis technique based on a grey level histogram. The results showed that there was a significant textural difference between the divers who had only suffered episodes of DCS Type 1 and the diving controls and a difference between the divers with a history of Type 2 and the diving controls. No differences were found between the two groups of divers who had a history of DCS. This result suggests that DCS produces a detectable change in 99Tcm-HMPAO SPET brain images. However, the segmentation between the groups investigated was not complete and so the usefulness of this approach appears limited in individual cases but may provide useful information about the effects of different diving practices.

Adult↗
PubMed1995

Superimposition of PET images using 18F-fluorodeoxyglucose with magnetic resonance images in patients with pancreatic carcinoma.

Six patients with histologically proven adenocarcinoma of the pancreas were studied using 2-deoxy-2-[18F]-fluoro-D-glucose (18F-FDG) using positron emission tomography (PET), and magnetic resonance imaging (MRI). In all six cases there was avid accumulation of 18F-FDG within the pancreatic tumour and clear visualization of the tumour on the MRI images. Delineation of the tumours was aided by superimposition of the images from the two imaging methods, which was achieved by using a system of surface markers.

Adenocarcinoma↗
PubMed1995

Fundus imaging in patients with cataract: role for a variable wavelength scanning laser ophthalmoscope.

AIMS: An investigation was carried out to compare the image quality of the ocular fundus obtained clinically, photographically, and with the scanning laser ophthalmoscope (SLO) at visible and infrared wavelengths in patients with significant cataract. METHODS: Nineteen patients admitted for routine cataract extraction were examined clinically by two independent observers to ascertain cataract type and clarity of fundus view with an indirect ophthalmoscope. Fundus photography and both confocal and direct (non-confocal) SLO imaging at 590 nm, 670 nm, and 830 nm were carried out after pupillary dilatation. Images obtained were graded independently using a recognised grading system. RESULTS: Quality of SLO images appeared to be superior to indirect ophthalmoscopy (p < 0.01) and fundus photography (p < 0.001) when graded subjectively. Quantitative analysis of contrast of retinal vessels demonstrated significantly higher contrast for the SLO compared with digitised fundus photographs at all wavelengths tested (p < 0.001), with highest contrast at 590 nm. Use of a confocal aperture significantly improved vessel contrast but may reduce overall image intensity. CONCLUSIONS: Scanning laser ophthalmoscopy may offer a method to observe and record fine fundus detail in patients who have marked cataract.

Cataract↗
PubMed1995

Assessment of energy-weighted acquisition in SPECT using ROC analysis.

UNLABELLED: Energy-weighted acquisition is a technique for reducing Compton scatter effects in nuclear medicine images. The effect of energy-weighted acquisition on SPECT99mTc images was evaluated by comparing the energy-weighted acquisition images with those obtained using a 20% photopeak energy window. METHODS: SPECT images were compared using receiver operator characteristic (ROC) experiments testing the observer's ability to perform a pseudoclinical task. The tasks were detecting cold lesions within a uniform background and cold lesions within images created with a tomographic brain phantom. RESULTS: ROC analysis for each phantom produced different results. No significant difference was found between the two acquisition techniques in detecting cold lesions on uniform backgrounds. Energy-weighted acquisition improved cold lesion detection significantly within the brain phantom in comparison with 20% photopeak acquisition. CONCLUSION: Lesion detection in 99mTcSPECT images can be improved using energy-weighted acquisition. This improvement, however, is dependent on the nature of the object being imaged. Images with structure show improved detection, whereas uniform images do not.

Brain↗
PubMed1994

Performance measurements of an infrared digital scanning laser ophthalmoscope.

Direct digital acquisition of images using a scanning laser ophthalmoscope (SLO) offers several advantages over the conventional fundus camera; in particular, the ability to produce tomographic images using a confocal aperture. This note describes measurements of the performance of an SLO. Spatial resolution, measured by the modulation transfer function, MTF, was shown to be worse along the direction of scan. As expected, image uniformity was good, with a coefficient of variation of 1.9%. While the effect of using a 100 microns diameter confocal aperture instead of one with a 400 microns diameter was to reduce slice thickness from 2600 microns to 975 microns, image intensity was reduced by a factor of 30.

Humans↗
PubMed1994

The measurement of blood flow in humans using radioactive tracers.

Since the first description of the movement of blood around the body by William Harvey, the accurate measurement of blood velocity has provided a major challenge for medical science. This review looks at the contribution made by techniques using radioactive tracers. Initially consideration is given to the fundamental problem of how to measure the amount of radiotracer in an organ with sufficient accuracy, using both single-photon and positron-emitting tracers. The various models used to link tracer behaviour with blood flow are then discussed and the article closes with a detailed review of the clinical applications of blood flow measurements.

Animals↗
PubMed1994

Clinical investigation of an infrared digital scanning laser ophthalmoscope.

An infrared scanning laser ophthalmoscope (SLO) has been custom built in order to investigate the application of confocal and indirect mode SLO imaging to patients with fundus disease. Infrared light is reflected from the fundus to a greater extent than visible light permitting lower illumination power and, as it penetrates the retinal pigment epithelium, choroidal structures can be readily imaged. Furthermore, as conventional infrared illumination and detection systems are not well suited to ophthalmoscopy, this area is underdeveloped as a potential source of useful clinical data. Confocal, direct and indirect imaging modes have been used to image fundi of normal volunteers and patients with fundus disease. In comparison with conventional fundus photography confocal infrared SLO imaging improves visualisation of choroidal vasculature, retinal pigment epithelial abnormalities, laser photocoagulation scars, and optic disc pores in the lamina cribrosa. Direct infrared SLO imaging enables fundus visualisation through nuclear lens opacities. Furthermore, indirect mode imaging enhances significantly the appearance of macular drusen. The potential clinical benefit of these observations is discussed.

Adult↗
PubMed1993

Digital fundus imaging using a scanning laser ophthalmoscope.

While many systemic diseases have ophthalmic manifestations with visible pathological features affecting the fundus, diabetic eye disease is of particular interest. There are many advantages in using digital image analysis to quantify the extent of retinal pathology in diabetes particularly to monitor its progression. However, the usual method of imaging involves photographing the retina using a fundus camera. Not only does this require that the photographs be digitized prior to analysis, but the resulting illumination across the image is non-uniform and this creates problems in digital image analysis. This paper describes the construction of a scanning laser ophthalmoscope interfaced to a computer, which has a number of significant advantages for digital retinal imaging. Firstly, it has better uniformity of illumination than the fundus camera and operates at much lower light levels. Secondly, it permits imaging at various wavelengths with no consequent degradation in image quality; in particular, the value of imaging at infrared wavelengths to give greater tissue penetration is demonstrated. Finally, by introducing the capability for confocal imaging, tomographic images can be taken, improving the perceptibility of features situated deep in the retina. Typical images are shown to demonstrate the potential of this instrument.

Diabetic Retinopathy↗
PubMed1992

Automated detection and quantification of microaneurysms in fluorescein angiograms.

Fluorescein angiograms from diabetics were digitised for analysis using digital image-processing techniques. Computer algorithms were written to detect and count microaneurysms present in the images. The accuracy, speed and reproducibility of the technique were assessed and compared with those of manual counts made by clinicians from both digitised and analogue images. Free-response ROC (receiver operating characteristic) curves were used to assess the performance of both the clinicians and the computer by comparing the results with "gold standards" compiled from prints of the original fluorescein angiograms. The computer performed as well as the clinicians when the latter were analysing the digitised images (512 x 512 pixel resolution), but only when one image was acquired at 4 times this resolution did the computer's performance match that of the clinicians analysing the analogue image. The automated technique was more reproducible than the manual method.

Algorithms↗
PubMed1991

Detection and quantification of hyperfluorescent leakage by computer analysis of fundus fluorescein angiograms.

Digital imaging systems can be used for direct acquisition of images of the ocular fundus or for their indirect acquisition from fundus photographs or transparencies. Computerised image processing techniques can then be used to manipulate and quantify features of interest. We describe a method for the detection and quantification of macular leakage in fluorescein angiograms. The rate of change in fluorescence over time is examined on a pixel-by-pixel basis and used to provide a gradient threshold that discriminates pixels displaying leakage from normal pixels. A region-growing technique is then used to enhance the detection of leakage missed by gradient thresholding alone. This report discusses the potential applications of the technique and highlights the methodology required to obtain reproducible results.

Fluorescein↗
PubMed1991

Quantification of diabetic maculopathy by digital imaging of the fundus.

Measurement of the extent of diabetic retinopathy is an essential part of assessing the efficacy of local or systemic treatment regimens. Current clinical studies use empirical grading of retinopathy which is performed by a trained observer using standard photographs. This method is relatively arbitrary, as well as time consuming and vulnerable to observer error. We have developed a digital fundus imaging system and image processing programs which provide objective, quantitative measures of macular oedema, retinal exudates, and microaneurysms in diabetic retinopathy. Using fluorescein angiograms, the degree of macular oedema is quantified both in terms of area of fundus involved and severity of oedema by analysis of the temporal changes in intensity of fluorescence. Fluorescein angiograms are also used for the detection and counting of microaneurysms, by a combination of shade correction, matched filtering, and shape algorithms. For detection and measurement of retinal exudates, a colour transparency projected through a red free filter is analysed using a combination of shade correction and thresholding techniques. The system described is in clinical use, and has potential for a wide variety of applications. With further development, digital analysis of fundus images should supercede the currently used manual semi-quantitative methods, providing faster, more accurate, objective quantitative results.

Aneurysm↗