Search PubMed⌕ Search

Biomedical subjects

T M Peters

Publications and source records attributed to T M Peters.

At least 37 records · Page 2Linked to original sources

Three-dimensional reconstruction of vascular trees: experimental evaluation.

This paper is the second of two that together present a novel approach to the problem of reconstructing vascular trees from a small number of projections. Previously, we described the reconstruction algorithm and how it effectively circumvents the matching or "correspondence problem" found in most photogrammetric or computer-vision-based approaches. The algorithm is fully automatic and assumes that the imaging geometry is known, the vascular tree is a connected structure, and that its center-lines have been identified in three or more images. It employs consistency and connectivity constraints and comprises three steps: The first generates a connected structure representing the multiplicity of solutions that are consistent with the first two views; the second assigns a measure of agreement to each branch in this structure based on one or more additional projections; and the third step employs this measure to distinguish between those branches comprising the vasculature and the accompanying artifacts. This paper addresses the issue of validation via simulations and experiments. In addition to a clinical case, we examine the performance of the algorithm when applied to simulated projections of two 3-D vascular models, both representative of the complexity faced in coronary and cerebral angiography. The results in each instance are impressive and demonstrate that adequate reconstructions may be obtained with as few as three distinct views.

Algorithms↗

Image-guided surgery of epilepsy.

Interactive image-guided techniques used in conjunction with three-dimensional images allow accurate planning and performance of a variety of neurosurgical procedures. The authors have used the frameless stereotactic Allegro Viewing Wand System to provide real-time correlation of the operating field and computerized images in over 200 neurosurgical operations carried out for intractable epilepsy. The authors experience shows that the viewing wand system is most helpful as an adjunctive navigational device in the microsurgical treatment of epilepsy.

Brain↗

Age-dependent penetrance of disease in a transgenic mouse model of familial amyotrophic lateral sclerosis.

The mutation gly93-->ala of Cu,Zn superoxide dismutase (SOD) is found in patients with familial amyotrophic lateral sclerosis and causes motor neuron disease when expressed in transgenic mice. The progression of clinical and pathological disease was studied in a line of mice designated G1H. Clinical disease started at 91 +/- 14 days of age with fine shaking of the limbs, followed by paralysis and death by 136 +/- 7 days of age. Pathological changes begin by 37 days of age with vacuoles derived from swollen mitochondria accumulating in motor neurons. At the onset of clinical disease (90 days), significant death of somatic motor neurons innervating limb muscles has occurred; mice at end-stage disease (136 days) show up to 50% loss of cervical and lumbar motor neurons. However, neither thoracic nor cranial motor neurons show appreciable loss despite vacuolar changes. Autonomic motor neurons also are not affected. Mice that express wild-type human Cu,Zn SOD remain free of disease, indicating that mutations cause neuron loss by a gain-of-function. Thus, the age-dependent penetrance of motor neuron disease in this transgenic model is due to the gradual accumulation of pathological damage in select populations of cholinergic neurons.

Aging↗

Effects of pulmonary fibrosis on the distribution of edema. Computed tomographic scanning and morphology.

The pulmonary interstitium acts as an important safety factor against alveolar flooding. To test the hypothesis that in advanced fibrosis, edema is redistributed away from a less compliant interstitium to flood alveoli, we induced severe left lung fibrosis in six dogs with radiation and intratracheal bleomycin. Twenty-four months later, edema was induced by infusing 20% body weight lactated Ringer's solution over 30 min, preceded and followed by computed tomography (CT) scanning. Lower lobes were frozen, and samples were taken for extravascular lung water measurements (Qwl/dQl), regional blood volume, and light microscopic grading of interstitial and alveolar edema. The total volumes of the control and fibrotic lungs were 800 +/- 63 and 45 +/- 10 ml (SE), respectively, indicative of severe fibrosis. Before edema, the fibrotic carinal and basal slices had CT densities 3.5 and 2.2 times greater than respective control slices. After edema, the densities of all control lung slices rose 2.5 times and that of fibrotic carinal and basal slices rose 1.5 times. Edema significantly accentuated the small gravity-dependent gradient in CT density of control lungs, but it had minimal effect on this gradient in fibrotic lungs. The Qwl/dQl for control and fibrotic lower lobes were 8.7 +/- 0.8 and 6.8 +/- 0.7 g H2O/g dry lung, respectively, but the amounts of water per lung volume were similar, and there was no gravity-dependent gradient in Qwl/dQl or in regional blood contents. By light microscopy, we found significantly less interstitial and more alveolar edema in the fibrotic lobes. We conclude that in severe pulmonary fibrosis, similar amounts of water accumulate per lung volume as in controls, and that there is predominant alveolar flooding over interstitial edema. We also conclude that the gravity-dependent gradients in CT densities postedema in the control lungs are not accounted for by edema fluid or congestion, but probably by atelectasis.

Animals↗

Three-dimensional display of cortical anatomy and vasculature: magnetic resonance angiography versus multimodality integration.

We present two methods for acquiring and viewing integrated three-dimensional (3D) images of cerebral vasculature and cortical anatomy. The aim of each technique is to provide the neurosurgeon or radiologist with a 3D image containing information which cannot ordinarily be obtained from a single imaging modality. The first approach employs recent developments in MR which is now capable of imaging flowing blood as well as static tissue. Here, true 3D data are acquired and displayed using volume or surface rendering techniques. The second approach is based on the integration of x-ray projection angiograms and tomographic image data, allowing a composite image of anatomy and vasculature to be viewed in 3D. This is accomplished by superimposing an angiographic stereo-pair onto volume rendered images of either CT or MR data created with matched viewing geometries. The two approaches are outlined and compared. Results are presented for each technique and potential clinical applications discussed.

Brain↗

From radio-astronomy to medical imaging.

A common thread in much of the medical imaging that has developed over the past 20 years has been the Fourier transform. It was Richard Bates' interest in radio-interferometry, as well as his fascination with problems of medical imaging that prompted an initial interest in applying Fourier techniques to medical imaging in general and to Computed Tomography in particular. This resulted 20 years ago in one of the earliest technical papers advocating Fourier techniques for reconstructing cross-sections from radiographic projections (Bates and Peters, NZ J Science 14:883-896, 1971). Since those early days, medical imaging has explored into a multi-billion dollar industry. The CT scanner has become the workhorse imaging modality in the radiology department, while its more recent relative, the MR scanner, is rapidly gaining ground as a technique of even greater importance. Richard Bates, with his team of "Medical Imagers" was a very significant force in the development of the field of Medical Imaging as we know it today. This paper attempts to chronicle the genesis of this process from the personal perspective of the author.

Diagnostic Imaging↗

Integration of stereoscopic DSA with three-dimensional image reconstruction for stereotactic planning.

Following 4 years of experience using a microcomputer-based system for the planning of stereotactic neurosurgery, we have now developed a workstation with the capability of displaying and analyzing three-dimensional images for this purpose. In addition to viewing volumetrically rendered three-dimensional computer tomograms and magnetic resonance images, we may directly view and analyze stereoscopic digital angiograms. In addition to each set of images being viewed in isolation, we may also combine the three-dimensional anatomical images with the stereoscopic angiograms. This new system is based on a computer equipped with a light polarization switched screen capable of displaying stereoscopic images directly to the observer, thus permitting him to interact with the three-dimensional volume directly, determining coordinates and positioning probe trajectories.

Angiography, Digital Subtraction↗

Three-dimensional isodose distributions in stereotactic radiosurgery.

A personal computer based three-dimensional treatment planning system, which may be used for planning any linear accelerator (Linac) based radiosurgical technique, is presented. The system is used to calculate dose distributions for most of the Linac-based techniques currently in use as well as the theoretically optimum 4 pi geometry. The maximum and minimum dose falloffs are used to compare the various Linac-based radiosurgical techniques. The dynamic rotation technique developed at McGill University is shown to produce distributions with dose falloffs similar to the multiple converging arc techniques used elsewhere and those obtained for the Gamma Unit. Also considered are the effects of beam energy, in the range of 4-25 MV, and beam profiles on the dose distribution.

Brain Neoplasms↗

Within-herd variation in energy utilization for maintenance and gain in beef cows.

Fourteen mature, nonpregnant, nonlactating Angus cows (498 kg) were individually fed through two consecutive phases (maintenance [M], 80 d and ad libitum [A], 70 to 79 d) to estimate within-herd variation in individual cow ME requirements for maintenance (MEm) and to identify factors contributing to this variation. Body composition was determined at initiation of phase M, at termination of phase M (also initiation of phase A) and at the end of phase A by a two-pool D2O dilution technique. Daily MEm averaged 156.7 kcal/kg BW.75 (SD = 18.4 kcal/kg BW.75) and efficiency of ME use for tissue gain or loss averaged 76% (SD = 30%). Estimates of ME intake to maintain 1 kg of protein or 1 kg of fat were 192.9 (SE = 24.8) or 20.7 (SE = 21.5) kcal. These data indicate that among cows of similar fat masses, those with larger protein masses had higher energy requirements for maintenance. Daily MEm was positively correlated (P less than .16) with liver weight (r = .40) and relative proportions of liver (r = .44; P less than .16) and heart (r = .48; P less than .10) in the empty body. Also, daily MEm was correlated negatively (P less than .05) with weight (r = -.71) and relative proportion of omental and mesenteric fat (r = -.78). Estimates of ME required for deposition of 1 kcal of protein or fat were 5.56 (SE = 1.01) or 1.26 (SE = .09) kcal. Weight of liver and the sum of liver, spleen, kidney and heart weights increased 1.58 (R2 = .47) and 1.95 kg (R2 = .52) per kilogram of daily weight gain during phase A. These results indicate that increased performance caused increased organ mass (liver).

Animal Feed↗

Clinical applications of integrated 3-D stereoscopic imaging in neurosurgery.

Stereotactic neurosurgery planning, an intrinsically three-dimensional procedure, is generally performed on the basis of two-dimensional tomographic or projection images. We present extensions to these conventional approaches that use stereoscopic digital subtraction angiography, three-dimensional volume rendered computed tomography or magnetic resonance images, or a combination of these modalities. The stereoscopic DSA images are analysed interactively on a 3-D workstation. This system employs a liquid-crystal polarizing shutter to display alternate left- and right-eye views to a user wearing polarized glasses. Quantitative planning operations may be performed on the basis of the angiograms alone, or in conjunction with tomographic images of the anatomy. We also describe the procedures used to produce volume-rendered three-dimensional images from MR and CT data-sets, as well as the methodology for combining the stereoscopic angiograms with the volumetric anatomical images.

Algorithms↗

Stereotactic neurosurgery planning on a personal-computer-based work station.

Stereotactic surgery requires knowledge of cerebral structures derived from more than one image source. We have developed a PC-AT-based workstation that accepts patient images, made with the stereotactic frame in place, from CT, MRI, and DSA modalities. Reference markers on the frame are identified in the images to establish the coordinate geometry for each modality. Target points may be identified on each image type and trajectories of probe paths to these points defined. Targets identified on one set of images may be transferred automatically to other images of the same patient in order to guarantee a vessel-free path of approach to a target point deep within the brain. To date several hundred patients have had stereotactic surgery performed on the basis of plans using this system. Procedures included biopsy and aspiration of lesions, implantation of electrodes for the recording of deep EEG signals, and radiosurgical techniques. We present clinical examples of the use of this system in typical stereotactic neurosurgery procedures, address stereoscopic applications, and discuss the results of intermodality tests to establish the accuracy of the technique.

Angiography, Digital Subtraction↗

Anatomical interpretation of MR scans of the brain.

A stereotactic method of brain localization is applied to magnetic resonance imaging for the interpretation of brain structures. This proportional grid system developed by Talairach is based on two intracerebral structures, the anterior and posterior commissures. It takes into account individual variations in brain size and shape. In an experimental study on cadavers we demonstrated that his system permitted accurate identification of cortical structures on CT scan. In this paper, we describe its application to MR. It provides, on a routine basis, a simple reliable method of anatomical interpretation. The use of this grid system is made easier by the fact that both commissures are seen on midsagittal MR scans.

Brain↗

[Integration of digital angiography, magnetic resonance, x-ray computed tomography and positron emission tomography in stereotaxy].

Consecutively to drastic changes which occurred in cerebral imagery techniques, we have developed a stereotactic apparatus and system based on the integration of several new techniques allowing visualisation of the brain: tomodensitometry (TDM), digital subtraction angiography (DSA), magnetic resonance (MR) and positron emission tomography (PET). TDM, DSA and MR can be performed in stereotactic conditions with the apparatus in situ. They give the computer the anatomic references necessary for all calculations. MR and PET images obtained without stereotactic apparatus can also be integrated into the stereotactic study at the condition that DSA was formerly performed in stereotactic conditions, i.e. with the apparatus in situ. The visualisation of the corpus callosum makes this integration possible. An optimal definition of cerebral tumors or target-structures for intracerebral electrode recording is thus obtained.

Brain Diseases↗

Stereotactic surgical planning with magnetic resonance imaging, digital subtraction angiography and computed tomography.

Over the past 2 years at the Montreal Neurological Institute and Hospital, we have evolved an integrated environment for the planning of stereotactic procedures, based on images from magnetic resonance imaging, digital subtraction angiography and computed tomography modalities. These procedures rely on fiducial marker sets which are attached to our 'OBT' stereotactic frame, and which may be recognized in the images. The software package is modular and operates in both minicomputer (PDP-11 and VAX) and IBM personal computer environments. In addition to routine tasks for stereotactic planning, the package also supports dosimetry planning for stereotactic radiosurgery.

Brain↗

Stereotactic external beam calculations for radiosurgical treatment of brain lesions.

Radiosurgical techniques are becoming increasingly popular for the selective destruction of brain lesions. To ensure precision in the procedure, set-up and treatment of lesions in this manner, we have adopted standard stereotactic methods to allow one to calculate accurately the absorbed dose and also to preserve accuracy in locating the target site in three dimensions. At McGill University, radiosurgery is performed using the dynamic technique, which utilizes the concurrent rotation of both the 10-MV photon beam linear accelerator (from 30 to 330 degrees) and the patient couch (from 75 to -75 degrees) about a common point centered on the target within the lesion. A three-dimensional treatment planning system for the calculation of dose distributions implemented in conjunction with CT, MRI and DSA stereotactic image analysis systems is presented.

Brain Neoplasms↗

Integrated stereotaxic imaging with CT, MR imaging, and digital subtraction angiography.

A stereotaxic frame, compatible with digital subtraction angiography, computed tomography, and magnetic resonance imaging, is described along with a set of software programs that run in an independent imaging computer system, as well as in the computers associated with each modality. Plexiglas plates fastened to the sides of the frame contain fiducial markers that can be recognized in the images and from which the section position and in-plane coordinates of any point in the image relative to the frame may be determined. Coordinate measurements of isolated point targets may be made to an accuracy of better than +/- 1 mm within a 15-cm field of view in the plane of the section or projection on all modalities. The stereotaxic system is of sufficiently high accuracy to be used on a routine clinical basis with one or more of the above modalities.

Cerebral Angiography↗

C.T. aided stereotaxy for depth electrode implantation and biopsy.

We describe a computer program which facilitates the analysis of a series of C.T. scans made while a stereotaxic frame is fixed to the patient. The program has 2 modes of operation: a) The operator may select a region and determine the three-dimensional frame coordinate. b) The operator may select a set of frame coordinates and have the computer program display these at the appropriate sites on the C.T. scans. It these sites are the positions of depth electrodes, then a recording of the epileptic spike activity may be displayed at the appropriate sites on the scans.

Adult↗