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Biomedical subjects

W R Brody

Publications and source records attributed to W R Brody.

At least 37 records · Page 2Linked to original sources

Low-dose, high-frame-rate versus regular-dose, low-frame-rate digital subtraction angiography.

Using intravenous digital subtraction angiography for carotid, cerebral, and renal arteries, a comparison was made between a single pulsed image and an integrated image composed of several pulsed images. The single image was generated with a conventional detected dose per frame while the frames composing the integrated image were generated at a lower dose per frame but at a higher frame rate. Comparisons were made for an equivalent detected dose per image. For relatively stationary arteries, the integrated images were equivalent or superior to the single images. When patient motion was present, or if pulsatile vessel motion was significant, the single image was better than the integrated image. A low-dose, high-frame-rate technique has the potential for furnishing physiologic data in addition to high-quality morphologic information.

Angiography↗

Evaluation of peripheral vascular disease using digital subtraction angiography.

Intravenous digital subtraction angiography (DSA) facilitates imaging of peripheral arteries and bypass grafts on an outpatient basis. Forty-five patients underwent intravenous peripheral angiography, 16 following placement of bypass grafts. Complex oblique and sagittal angulations optimize visualization of bifurcations and overlapping vascular structures. Reprocessing techniques using integrated masks and contrast images allow for diagnostic delineation of fine vascular detail. This is a practical, noninvasive, well tolerated method for both diagnostic screening and follow-up evaluation of patients with peripheral vascular disease.

Angiography↗

The application of matched filtering to contrast material dose reduction in digital subtraction angiography.

Temporal filtering methods were applied to a 50% reduction of contrast material dose in intravenous digital subtraction angiography (DSA). The performance of matched filtering was reviewed, indicating a 50% reduction of noise through the integration of an entire (greater than 10 sec) DSA image sequence spanning the contrast material bolus arrival and washout. Used in conjunction with 50% contrast material dose reduction, matched filtering could provide final iodine signal-to-noise ratios (SNR) comparable to those of conventional DSA. Half-contrast-material-dose (20 ml) filtered DSA runs were compared with full-contrast-material-dose (40 ml) unfiltered runs for 5 carotid, 2 cerebral, and 4 peripheral studies. In all but 2 studies, the half-contrast-material-dose runs were judged to be diagnostic. In all 4 peripheral studies and in some of the 7 carotid and cerebral studies the 20-ml results were judged to be equivalent to the 40-ml results. It is concluded that the half-contrast-material-dose temporally filtered approach is appropriate for peripheral runoff studies. Matched filtering was experimentally compared with simple integrated remasking. If the identical image sequence was used for each, the two had virtually identical performance for integration times less than 10 sec, consistent with theoretical predictions. Two other applications of matched filtering, SNR enhancement and x-ray exposure reduction, are discussed schematically.

Angiography↗

Work in progress: the application of temporal filtering techniques to hybrid subtraction in digital subtraction angiography.

Temporal filtering methods were applied to iodine signal-to-noise ratio (SNR) restoration in intravenous hybrid subtraction digital subtraction angiography (DSA). For equal detected exposure rates hybrid subtraction had approximately 35% of the SNR of temporal subtraction. When matched filtering was applied to a DSA run, the filtered result had approximately two times higher SNR than the peak contrast image in the run. Thus, when matched filtering techniques were applied to the hybrid image sequence, the resultant SNR increased to about 70% of that of temporal subtraction. With an additional factor-of-two increase in exposure rate for the hybrid run, SNR parity with temporal subtraction could be achieved. This compared with a factor-of-nine increase in exposure that would be required if no filtering were performed. Experimental hybrid matched filter results, generated with intravenous canine DSA studies, supported the predictions in SNR performance.

Angiography↗

Intravenous arteriography using digital subtraction techniques.

The application of digital computers to electronic x-ray imaging devices has rejuvenated interest in the field of intravenous arteriography. By utilizing computer image subtraction techniques, digital roentgenographic systems based on fluoroscopy or computed tomography (scanned projection radiography) provide significantly improved vascular imaging compared with conventional film subtraction methods. Digital subtraction angiography schemes isolate contrast media in the vessel by detecting differences in images obtained before and after the injection of contrast medium or changes in the relative attenuation of contrast media at different x-ray energies. Present applications include carotid and peripheral arteriography, thoracic and abdominal aortography, pulmonary arteriography, and ventriculography. Future applications may include intracerebral and coronary arteriography. These systems should provide low-risk outpatient screening arteriography.

Angiography↗

Intracranial intravenous digital subtraction angiography.

Intravenous digital subtraction angiography (iDSA) promises to significantly alter the use of conventional cerebral angiography in the workup of neurological patients. Understanding its diagnostic potential and its limitations are important in incorporating this new examination into the diagnostic thought process of neuroradiologic tests. Different image processing techniques such as integration of mask and contrast images promise to improve image quality for neuroradiologic application. At present, iDSA is suitable for the diagnosis and follow-up of vascular lesions (atherosclerosis, aneurysms, arteriovenous malformations, venous sinus occlusion), and tumor (meningioma). Although limited, the spatial resolution of iDSA studies is capable of demonstrating diffuse vascular disease such as arteritis and vasospasm after subarachnoid hemorrhage. In some patients in conjunction with the CT scan, iDSA may prove sufficient as the primary and only diagnostic angiographic test necessary, supplanting conventional angiography.

Arteriosclerosis↗

Radiographic blood pool contrast agents for vascular and tumor imaging with projection radiography and computed tomography.

An emulsion of Ethiodol and Pluronic was evaluated as a vascular (blood pool) imaging agent with both the GE experimental scanned projection radiography system and conventional computed tomography (CT), 475 mg iodine/kg body weight of emulsion, was injected into 11 rabbits with thigh muscle V2 carcinomas. Both projection radiography scans and CT scans visualized aorta, vena cava, pulmonary, and femoral vessels, and distorted vessels around tumors for 20 min after infusion. This persistent vascular visualization allowed CT scanning at multiple contiguous levels, which could be followed by reformatting in the sagittal and coronal planes. Following diatrizoate in identical iodine/kg doses, vascular visualization persisted for only 1 min after infusion. Blood pool agents are ideal for projection radiography systems and CT reformatting of vascular anatomy.

Angiography↗

Contrast resolution of line-scanned digital radiography.

Contrast resolution of a prototype system for line-scanned digital radiography was evaluated using a phantom simulating low contrast tumors within the body. Simulated tumors having radiographic contrast as low as 0.5% were detectable in these studies. The results of these digital radiographic studies compare favorably to those of computed tomography in terms of both low contrast detectability and radiation dosage. Dual energy projection radiographic techniques show promise for eliminating obscuring shadows caused by overlying structures from digital radiographs, thus permitting clinical utilization of the excellent contrast resolution of the line scanned projection system.

Models, Structural↗

Renal imaging with dual energy projection radiography.

Applications of dual energy radiography to renal imaging were evaluated using an experimental system for line-scanned projection radiography. This system combines digital radiographs simultaneously obtained at two differing x-ray energies (85 and 135 kVp) to create images in which materials of a desired mean atomic number are selectively cancelled. A preliminary evaluation of the technique was performed for three renal imaging problems: detection and characterization of renal masses of low radiographic contrast, evaluation of renal artery stenosis and unilateral renal ischemia, and detection of renal calculi. In all three applications, the dual energy technique produced results indicating potential advantages over conventional radiographic studies.

Adenocarcinoma↗

Cancer imaging by scanned projection radiography.

We have evaluated scanned projection radiography (SPR) for the diagnosis of cancer. Four rabbits with V2 thigh carcinomas and nine patients with a variety of malignant neoplasms were studied with a GE CT/T 8800 scanner modified for SPR. Images were made before injection of intravenous contrast medium, and additional scans were taken after injection. Temporal subtraction was then performed on the digitized data. Rabbit thigh V2 carcinomas and human lung, liver, and extremity neoplasms were visualized. Contrast enhancement was phasic with early vessel demonstration and subsequent visualization of low density central areas of tumoral necrosis. Liver metastases appeared as poorly defined areas of low density. Because of the combination of high contrast sensitivity plus capability of imaging large tissue volumes on one scan, SPR may be valuable in cancer screening.

Adenocarcinoma↗

Intravenous carotid arteriography using line-scanned digital radiography.

Digital subtraction and an experimental system for line-scanned radiography were used to image the bifurcations of the carotid arteries. The subtracted images were obtained before and after injections of contrast media. The anatomy of the extracranial carotid arteries was demonstrated in most patients, and verified by selective catheter arteriograms. Unsuccessful studies were attributed to improper timing while obtaining the images, and to venous occlusion. Artifacts produced by motion limit the temporal subtraction method.

Angiography↗