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Biomedical subjects

P L Carson

Publications and source records attributed to P L Carson.

At least 55 records · Page 3Linked to original sources

Doppler ultrasound color flow imaging in the study of breast cancer: preliminary findings.

A prospective study of the Doppler color flow features of 55 proved breast cancers was performed. On a three-level scale of low to marked vascularity, visual assessment of the color flow images classified 82% of the cancers as moderately or markedly vascular (minimal: 14%, moderate: 29%, marked: 53%). Four percent of the cancers had no detectable flow. In 29 women, a volume of tissue comparable to the cancer was scanned in the contralateral normal breast. Sixty-nine percent of the normal breasts had moderate or marked vascularity (minimal: 28%, moderate: 41%, marked: 28%), and 3% were avascular. There was poor distinction between normal tissues and cancer which suggests that more sensitive Doppler methods than were employed in this study may be needed in order to detect the small vessel flow reported to be rather specific for malignancy. The high, 82%, detection rate of tumor vessels in this study suggests the potential use of color flow Doppler for directing more specific but lengthy Doppler procedures.

Adult↗

Quantitative tissue motion analysis of digitized M-mode images: gestational differences of fetal lung.

Quantitative analysis of transmitted cardiac motion in fetal lung is evaluated by applying correlation techniques to digitized M-mode images in 21 patients, subdivided into two subgroups by gestational age: (I) 25-30 weeks (11 patients), and (II) greater than or equal to 35 weeks (10 patients). The corresponding numbers of M-mode images analyzed for each group are 23 and 18, respectively. This partition is expected to reflect functionally "immature" and "mature" lungs. The estimated maximum mean radial deformation per unit epicardial excursion, (r), is calculated from the two-time, spatially averaged correlation function obtained between diastolic and systolic M-mode lines. The collective results for each subgroup are (r) I = 0.79 +/- 0.11 (sem) and (r) II = 0.62 +/- 0.13 (sem). The analysis presented, albeit in a limited population, is indicative of a trend in accordance with qualitative observations of Birnholz and Farrell (1985). M-mode analysis, as indicated by Adler et al. (1989) is a potentially useful technique to quantify such tissue motion.

Female↗

Ultrasound attenuation coefficient in the fetal liver as a function of gestational age.

An apparent increase in the ultrasound attenuation coefficient per unit frequency, alpha f, of fetal liver as a function of gestational age has been observed. Measurements were made in utero with a 25 megasample/sec RF digitizer and a real time ultrasound system with a 5 MHz scan head. A precise measurement of alpha f was employed in which the intercept was tied to 0 at a frequency of 0. In 178 examinations of normal pregnancies, the linear regression of the alpha f increased 26% between 26 and 40 weeks gestation. This statistically significant increase (p less than 0.0001) is consistent with several observations, those of Parker et al. of increased attenuation in liver when glycogen is added, the increasing glycogen storage in the liver before birth, and our own pre- and postnatal measurements reported elsewhere. A noninvasive assay for glycogen content would have important applications in medicine and biomedical science. However, an increase in measurement accuracy and precise correlation with glycogen content will be required to make meaningful predictions in individual cases, as opposed to the present statistical trends.

Embryonic and Fetal Development↗

ACR survey results: diagnostic imaging scientists and engineers.

The American College of Radiology's Committee on Physics Resources of the Commission on Human Resources conducted a survey of diagnostic imaging scientists and engineers to assess who is providing radiologic physics and related services in diagnostic imaging departments. The survey forms were distributed through the members of the American Healthcare Radiology Administrators. Survey results showed a predominance of M.S. and Ph.D. degrees in physics and medical/radiological physics. Nearly all respondents had their time split between numerous categories of work, such as clinical and research, and between different modalities such as diagnostic x-ray, nuclear medicine and radiation oncology. To enhance physics services in important areas such as CT, which currently receive little time, support is needed for work prioritization, for training, and for positions for physics and physics-support personnel.

Certification↗

Assessment of ultrasonic computed tomography in symptomatic breast patients by discriminant analysis.

From 95 subjects imaged with both speed of sound and attenuation ultrasonic computed tomography (UCT), quantitative analyses are presented on 40 cases where unequivocal correlating clinical diagnoses are available. Using four attenuation and speed of sound parameters from different regions of interest in the breast, a linear discriminator detects cancer with approximately 90% sensitivity and specificity. Increased confidence in the predictive power of this small study is given by a modern test of predictive power (jackknifing) and by the fact that diagnostic discrimination remains as high as 85% when only two parameters are employed--attenuation and speed of sound in the lesion minus those values in the remaining central mammary tissues. Speed of sound images appear particularly useful in older, fatty breasts where pulse echo ultrasound is particularly lacking. While UCT in the form studied here is not likely to receive wide clinical acceptance in the near future, a combined UCT/pulse echo system might find wide clinical utility if it can be sufficiently convenient and inexpensive.

Adenofibroma↗

Fetal depth and ultrasound path lengths through overlying tissues.

Measurements of minimum thicknesses, in a four-layer, overlying tissue model, on 22 pregnancies between 15 and 20 weeks gestation, yielded a global minimum and a mean of the minimum total thickness per patient of 1.7 and 2.9 cm, respectively, and a minimum and mean subcutaneous fat thickness of 0.7 and 1.4 cm. Conservative calculations of the minimum attenuation per patient, at 3.5 MHz indicated that less than 2.5% of 15 to 20 week pregnancies should fall below the lower 95% prediction line of: Attenuation (dB) = 0.10 X Maternal Weight (kg) - 3.0. The smallest calculated attenuation for any of the 21 subjects was 0.8 dB MHz-1 indicating just under a factor of two protection at 3.5 MHz of proximal fetal tissues compared with ultrasound intensities measured in water. This value is lower than those generally used in the past. The knowledge of distributions of transducer-to-fetal distances and thicknesses of overlying tissues is also important for improvement of image quality. Measurement of minimum depth of the anterior fetal thorax in 57 examinations of 25 to 40 week fetuses yielded minimum and mean values of 2.5 and 4.1 cm, respectively.

Female↗

Anisotropic ultrasonic backscatter from the renal cortex.

We have demonstrated a significant, directionally dependent, anisotropic, echogenicity from the cortices of two sheep kidneys and a normal human cadaver kidney. The anisotropy corresponds to the relationship of the sound field to the medullary rays and interlobular arteries. At 7.5 MHz, the backscatter from specimens of cortex of a sheep kidney was 4.7 +/- .7 dB (mean +/- SEM) greater in parts of the cortex where the field was perpendicular to these structures as opposed to where it was parallel to them. In addition, we measured the angular distribution of this anisotropy and compared it to the 5 dB inclusion angle of the 5 MHz linear array that was used in measurements on the whole kidney specimens. The transducer inclusion angle was 10 degrees +/- 2 degrees, while the angular distribution was 34 degrees +/- 22 degrees and 23 degrees +/- 11 degrees (mean +/- SD) for the intact sheep and human kidney, respectively, demonstrating some variation of the medullary rays from perfect specular reflectors. This anisotropy should be visible in standard diagnostic scanning, and its recognition could increase ultrasound's sensitivity for the detection of renal disease.

Animals↗

Lesion detectability in ultrasonic computed tomography of symptomatic breast patients.

From 95 subjects imaged with both speed of sound and attenuation ultrasonic computed tomography (UCT), analyses were performed on 40 cases for which unequivocal clinical diagnoses were available for correlation. This paper describes the UCT image characteristics and addresses the hypothesis that carcinomas and other lesions can be detected and localized by means of simple visual criteria or lesion characteristics that are quantitative relative to those of other breast tissues in the same patient. The most useful within-patient criterion was selection of the solid mass with the highest speed of sound in either breast (12 of 12 carcinomas). Architectural asymmetry between breasts in the three types of images was a significant contributing factor in visual image interpretation in seven of the eight cancer patients in whom there were comparable images of both breasts. Solid masses were discriminated by attenuation coefficient and pulse echo criteria. Our results did not substantiate the hypothesis that the average speed of sound throughout the cancer containing breast would be higher than in the contralateral breast. These results are better than might be expected from pulse echo imaging alone on this population. However, clinical implementation probably should be deferred until the technique is made more convenient and less expensive, or more accurate with a greater promise for diagnosis of minimal cancers.

Breast↗

Visualization of tumor vascularity in a rabbit VX2 carcinoma by Doppler flow mapping.

Using an ultrasonic dynamic flow imager that displays both soft tissues and color-coded flow in the same two-dimensional slice, we were able to display neovascularity in a rabbit VX2 carcinoma. Intravenous infusion of epinephrine altered the flow dynamics in two arteries, one within the tumor and one at the periphery. Further, we were also able to visualize areas of multidirectional flow presumably due to complex arterial patterns and arteriovenous shunts. It is concluded that the color-coded Doppler instrument may overcome some of the methodological problems associated with tumor diagnosis via flow characteristics in the human breast. The literature indicates that the vascular response to the vasoactive drugs or thermal stress may increase differentiation of malignant breast lesions. This experiment suggests that Doppler images and measurements may be made efficiently with color-coded Doppler images, particularly with the addition of more quantitative features to the imager.

Animals↗

Motion artifacts in quantitative magnetic resonance imaging.

Several investigators have emphasized the potential value of quantitative relaxation times in the assessment of diseases. In performing such measurements using the spin-echo technique, we have encountered several anomalous results, whereby the intensity of the organ parenchyma on second-echo images is greater than on first echo images. This is most likely a result of respiratory motion, and it occurs only rarely. Several volunteers were studied before and after exercise to see if respiratory motion could reproduce the anomalous intensity reverse; a reversal of intensities in renal parenchyma was observed in two of five individuals. We conclude that respiratory motion artifacts will seriously limit quantitative magnetic resonance imaging of the upper abdomen if respiratory gating during imaging is not used.

Humans↗

Tissue characterization of the testes using ultrasonic CT. Work in progress.

Ultrasonic computed tomography (UCT) can aid in characterizing tissue for the detection and diagnosis of leukemic infiltration of the testes. Preliminary studies in 6 healthy adults and 26 patients (3-20 years old) with leukemia or non-Hodgkin lymphoma suggest that elevated speed of sound in the testis may be an indicator of leukemic infiltration. UCT may become an important screening method for detecting testicular involvement. In long-term follow-up, UCT can be performed more frequently and easily than biopsy, which is the current screening method.

Adult↗

Boundary effects from opposed magnetization artifact in IR images.

A cancellation of signal intensity at the interface separating selected tissue-equivalent materials is observed in inversion recovery proton MR images. The absence of signal intensity at the interface is always one pixel wide and appears only when the tissue-equivalent materials forming the interface differ substantially in their longitudinal relaxation times (T1). Images were obtained of various two-layer combinations of tissue-equivalent materials consisting of vegetable oil, animal fat, saline, aqueous Mn+2, or 2% agar doped with Mn+2. This type of boundary is compared with chemical shift artifacts, which at 0.15 T and 0.35 T produce a similar effect. A clinical example of the opposed magnetization artifact is also shown. Since tissues with substantially different T1s are found in vivo, it is expected that this effect could lead to an instrument-dependent artifact that could easily be misinterpreted.

Electron Spin Resonance Spectroscopy↗

Interlaboratory comparison of ultrasonic attenuation and speed measurements.

A set of test samples, all containing ultrasonically equivalent tissue-mimicking material, was produced and measurements of ultrasonic speed and ultrasonic attenuation coefficients were made at seven laboratories using various techniques. The ultrasonic speed values agree well with one another, having a spread of about 0.3 per cent; thus, speed values for tissue parenchyma appearing in the literature are likely to be accurate. Values of ultrasonic attenuation coefficients agree fairly well with one another, with differences between individual values and the group mean of generally less than 20 per cent of the group mean.

Humans↗

Ultrasonic computed tomography of the breast. Improvement of image quality by use of cross-correlation time-of-flight and phase-insensitive attenuation measurements.

The authors present two methods of reducing refraction artifacts in ultrasonic computed tomography of the breast. Measuring the time of flight of sonic pulses by cross-correlation instead of leading-edge detection significantly reduces distortion and improves resolution in speed-of-sound images. Phase-insensitive reception of pulse energy across a large aperture array is shown to be superior to a conventional single-element transducer for attenuation imaging.

Breast Diseases↗

Sonographic evaluation of the cartilage of the knee.

Real-time ultrasound was assessed as a means of evaluating osteoarthritis of the knee. The knee was maintained in complete flexion so as to expose the weight-bearing portion of the femoral condylar cartilage. After establishing the validity of the method in an excised bovine knee, 7 asymptomatic individuals, 10 arthritic patients, and several patients with other conditions were examined. The results indicated that sonography can be used to measure the thickness of the articular cartilage in man, as well as to detect changes in its surface and internal characteristics. Early changes of arthritis may be revealed in this manner.

Adolescent↗

Estimation of ultrasonic attenuation and mean backscatterer size via digital signal processing.

The backscattered rf signals from the lungs of fetal sheep during their last trimester of development were digitized and processed in an attempt to correlate ultrasonic parameters with measured functional parameters related to lung maturation. The broadband, post- TGC , rf signal of a commercial B-mode ultrasonic scanner was digitized at a sampling rate of 25 MHz. Sorting excluded data from regions of rib shadowing and other nonlung structures from analysis. The sorted data were used to estimate the slope of the ultrasonic attenuation coefficient with respect to frequency via linear regression on the average difference of the logarithm of power spectra from separated data segments. The power spectra were also corrected for attenuation, averaged and used to compute the power cepstrum of the backscattered signal which can be related to mean backscatterer radius. Results are presented for eight fetal sheep.

Animals↗