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PubMed2001

Realizations of fast 2-D/3-D image filtering and enhancement.

This paper proposes a novel algorithm for multidimensional image enhancement based on a fuzzy domain enhancement method, and an implementation of a recursive and separable low-pass filter. Considering a smoothed image as a fuzzy data set, each pixel in an image is processed independently, using fuzzy domain transformation and enhancement of both the dynamic range and the local gray level variations. The algorithm has the advantages of being fast and adaptive, so it can be used in real-time image processing applications and for multidimensional data with low computational cost. It also has the ability to reduce noise and unwanted background that may affect the visualization quality of two-dimensional (2-D)/three-dimensional (3-D) data. Examples for the applications of the algorithm are given for mammograms, ultrasound 3-D images, and photographic images.

Algorithms↗
PubMed1999

Information technology applications in biomedical functional imaging.

In parallel with rapid advances in computer technology, biomedical functional imaging is having an ever-increasing impact on healthcare. Functional imaging allows us to see dynamic processes quantitatively in the living human body. However, as we need to deal with four-dimensional time-varying images, space requirements and computational complexity are extremely high. This makes information management, processing, and communication difficult. Using the minimum amount of data to represent the required information, developing fast algorithms to process the data, organizing the data in such a way as to facilitate information management, and extracting the maximum amount of useful information from the recorded data have become important research tasks in biomedical information technology. For the last ten years, the Biomedical and Multimedia Information Technology (BMIT) Group and, recently, the Center for Multimedia Signal Processing have conducted systematic studies on these topics. Some of the results relating to functional imaging data acquisition, compression, storage, management, processing, modeling, and simulation are briefly reported in this paper.

Algorithms↗
PubMed2001

Optimal scheduling of tracing computations for real-time vascular landmark extraction from retinal fundus images.

Recently, this group published fast algorithms for automatic tracing (vectorization) of the vasculature in live retinal angiograms, and for the extraction of visual landmarks formed by vascular bifurcations and crossings. These landmarks are used for feature-based image matching for controlling a computer-assisted laser retinal surgery instrument currently under development. This paper describes methods to schedule the vascular tracing computations to maximize the rate of growth of quality of the partial tracing results within a frame cycle. There are two main advantages. First, progressive image matching from partially extracted landmark sets can be faster, and provide an earlier indication of matching failure. Second, the likelihood of successful image matching is greatly improved since the extracted landmarks are of the highest quality for the given computational budget. The scheduling method is based on quantitative measures for the computational work and the quality of landmarks. A coarse grid-based analysis of the image is used to generate seed points for the tracing computations, along with estimates of local edge strengths, orientations, and vessel thickness. These estimates are used to define criteria for real-time preemptive scheduling of the tracing computations. It is shown that the optimal schedule can only be achieved in perfect hindsight, and is thus unrealizable. This leads to scheduling heuristics that approximate the behavior of the optimal algorithm. One such approximation produced approximately 400% improvement in the quality of the partial results at a defined milestone, as compared to random scheduling. The resulting algorithm can be readily implemented on conventional and multiple-processor systems, and is being applied to computer-assisted laser retinal surgery.

Algorithms↗
PubMed2002

Shape recovery algorithms using level sets in 2-D/3-D medical imagery: a state-of-the-art review.

The class of geometric deformable models, also known as level sets, has brought tremendous impact to medical imagery due to its capability of topology preservation and fast shape recovery. In an effort to facilitate a clear and full understanding of these powerful state-of-the-art applied mathematical tools, this paper is an attempt to explore these geometric methods, their implementations and integration of regularizers to improve the robustness of these topologically independent propagating curves/surfaces. This paper first presents the origination of level sets, followed by the taxonomy of level sets. We then derive the fundamental equation of curve/surface evolution and zero-level curves/surfaces. The paper then focuses on the first core class of level sets, known as "level sets without regularizers." This class presents five prototypes: gradient, edge, area-minimization, curvature-dependent and application driven. The next section is devoted to second core class of level sets, known as "level sets with regularizers." In this class, we present four kinds: clustering-based, Bayesian bidirectional classifier-based, shape-based and coupled constrained-based. An entire section is dedicated to optimization and quantification techniques for shape recovery when used in the level set framework. Finally, the paper concludes with 22 general merits and four demerits on level sets and the future of level sets in medical image segmentation. We present applications of level sets to complex shapes like the human cortex acquired via MRI for neurological image analysis.

Algorithms↗
PubMed2004

Treatment effects of drotrecogin alfa (activated) in patients with severe sepsis with or without overt disseminated intravascular coagulation.

Disseminated intravascular coagulation (DIC) is a serious condition associated with sepsis. Clinical management of DIC is hampered by lack of clear diagnostic criteria. The International Society on Thrombosis and Haemostasis (ISTH) has proposed a diagnostic scoring algorithm for overt DIC based on routine laboratory tests. The objective was to assess a modified version of the ISTH scoring system and determine the effect of drotrecogin alfa (activated) (DrotAA, recombinant human activated protein C) on patients with DIC. The large database from the PROWESS clinical trial in severe sepsis was retrospectively used to assess a modified ISTH scoring system. Baseline characteristics and treatment effects of DrotAA were evaluated. At baseline, 29% (454/1568) of patients had overt DIC. Overt DIC was a strong predictor of mortality, independent of APACHE II score and age. Placebo-treated patients with overt DIC had higher mortality than patients without (43 vs. 27%). DrotAA-treated patients with overt DIC had a trend towards greater relative risk reduction in mortality than patients without (29 vs. 18%, P = 0.261) but both groups had greater relative risk reduction than placebo-treated patients. Serious bleeding rates during DrotAA infusion in patients with and without overt DIC were slightly increased (P = 0.498), compared with placebo, while clinically overt thrombotic events during the 28-day period were slightly reduced (P = 0.144). Modified ISTH overt DIC scoring may be useful as an independent assessment for identifying severe sepsis patients at high risk of death with a favorable risk/benefit profile for DrotAA treatment. Patients without overt DIC also received significant treatment benefit.

Adult↗
PubMed2006

Treatment effects of high-dose antithrombin without concomitant heparin in patients with severe sepsis with or without disseminated intravascular coagulation.

BACKGROUND: Disseminated intravascular coagulation (DIC) is a serious complication of sepsis that is associated with a high mortality. OBJECTIVES: Using the adapted International Society on Thrombosis and Haemostasis (ISTH) diagnostic scoring algorithm for DIC, we evaluated the treatment effects of high-dose antithrombin (AT) in patients with severe sepsis with or without DIC. PATIENTS AND METHODS: From the phase III clinical trial in severe sepsis (KyberSept), 563 patients were identified (placebo, 277; AT, 286) who did not receive concomitant heparin and had sufficient data for DIC determination. RESULTS: At baseline, 40.7% of patients (229 of 563) had DIC. DIC in the placebo-treated patients was associated with an excess risk of mortality (28-day mortality: 40.0% vs. 22.2%, P < 0.01). AT-treated patients with DIC had an absolute reduction in 28-day mortality of 14.6% compared with placebo (P = 0.02) whereas in patients without DIC no effect on 28-day mortality was seen (0.1% reduction in mortality; P = 1.0). Bleeding complications in AT-treated patients with and without DIC were higher compared with placebo (major bleeding rates: 7.0% vs. 5.2% for patients with DIC, P = 0.6; 9.8% vs. 3.1% for patients without DIC, P = 0.02). CONCLUSIONS: High-dose AT without concomitant heparin in septic patients with DIC may result in a significant mortality reduction. The adapted ISTH DIC score may identify patients with severe sepsis who potentially benefit from high-dose AT treatment.

Aged↗
PubMedDate not supplied

A geometric algorithm for medical image correlations.

An automatic image correlation algorithm is discussed for the cranial region which is based on the geometric properties of the second moment tensor associated with a volume. The second moment tensor of two identical volumes represented in two different coordinate frames is evaluated to obtain the set of translations, rotations, and anisotropic scaling operators which relate the two coordinate frames. The theory is presented along with a discussion of quantitative error analysis to measure the usefulness of such an algorithm in the clinical setting.

Algorithms↗
PubMed1994

A spatial-frequency dependent quantum accounting diagram and detective quantum efficiency model of signal and noise propagation in cascaded imaging systems.

The detective quantum efficiency (DQE) is a system parameter that can be used to accurately describe image noise transfer characteristics through many imaging systems. A simpler approach used by some investigators, particularly when evaluating new ideas and system designs, is to describe the system as a series of cascaded stages. Each stage may correspond to either an increase in the number of quanta (e.g., conversion from x-ray to optical quanta in a radiographic screen), or a loss (a detection or coupling probability). The number of secondary quanta at each stage per incident primary quantum is given by the product of all preceding gains, and can be displayed graphically for convenient interpretation. The stage with the fewest quanta is called the "quantum sink," limiting the pixel signal-to-noise ratio to less than the square root of the number of quanta per pixel. This conventional zero-spatial-frequency "quantum accounting diagram" (QAD), however, neglects the spatial spreading of secondary quanta and can seriously underestimate image noise. It is shown that this problem is avoided with the introduction of a spatial-frequency dependent QAD, expressed as the product of the gains and squared modulation-transfer functions (MTF) of each stage. A generalized expression is developed for the DQE of a cascaded imaging system that is dependent only on the gain, gain Poisson excess (related to the variance), and MTF, of each stage. A direct relationship is then shown to exist between the DQE and values in the QAD. The QAD of a hypothetical system consisting of a charge-coupled device camera and a scintillating screen is evaluated as an illustrative example. The conventional zero-frequency analysis suggests two quantum sinks occur with approximately equal importance: one in the number of x rays, and one in the number of optical quanta. The spatial-frequency dependent analysis, however, shows the optical quantum sink becomes severe and dominates at nonzero frequencies. The necessary increase in gain or optical numerical aperture required to prevent the optical quantum sink for spatial frequencies of interest is determined from the QAD analysis. The visual impact of this nonzero spatial-frequency quantum sink is shown in images generated using a Monte Carlo simulation of the cascading process.

Algorithms↗
PubMed1991

Predicting human immunodeficiency virus type 1-positive sera by using two enzyme immunoassay kits in a parallel testing format.

Two algorithms for screening sera for antibody to human immunodeficiency virus type 1 were compared for their efficiency in identifying a true-positive sample in a population with heterogeneous risk factors, using the criteria of specificity and positive predictive value (PPV). In the first algorithm, all sera were screened by using a single enzyme immunoassay (EIA) kit, and a specificity of 98.6% and a PPV of 69.3% was calculated for true-positive sera. The second algorithm employed two different EIA kits in parallel to screen each sample. In the first instance, a specificity and a PPV of 100% was calculated if a positive sample was defined as reactive by both EIA kits; in the second, a specificity of 99.97% and a PPV of 99.4% was obtained if this criterion was extended to include a combination of one reactive and one equivocal result obtained with the two EIA kits.

Algorithms↗
PubMed1985

Pediatric liver transplantation. Part II. Diagnostic imaging in postoperative management.

The postoperative diagnostic imaging examinations of 44 children who underwent 59 orthotopic liver transplantations were reviewed. The imaging modalities used for the evaluation of suspected complications include plain roentgenography, ultrasonography (US), computed tomography (CT), nuclear scintigraphy, arteriography, percutaneous and operative cholangiography, and endoscopic retrograde cholangiopancreatography. The main postoperative complications included ischemia, thrombosis (hepatic artery and portal vein), infarction, obstruction or leakage of the biliary anastomosis, hepatic and perihepatic infection, and allograft rejection. US, the most frequently used abdominal imaging modality, was best suited for detection of biliary duct dilatation, fluid collections in or around the transplanted liver, and hepatic arterial, inferior vena caval, and portal vein thrombosis. CT was especially helpful in corroborating findings of infection and in locating abscesses. Technetium 99m sulfur colloid (early- and late-phase imaging) provided a sensitive, although nonspecific, means of assessing allograft vascularization and morphology. Angiography showed vascularity most clearly, and cholangiography was the most useful in the assessment of bile duct patency. A diagnostic imaging algorithm is proposed for evaluation of suspected complications.

Adolescent↗
PubMed2005

[Recurrent urinary tract infections].

Recurrent urinary tract infections (RUTI) are a frequent clinical problem in sexually active young women, pregnant or postmenopausal women and in patients with underlying urological abnormalities. The present chapter reviews RUTI based on their classification: relapses, which usually occur early (< 1 month), are caused by the same microorganism and are associated with underlying urological abnormalities, and reinfections, which usually occur later and are caused by a new distinct microorganism (or by the same microorganism usually located in the rectum or uroepithelial cells). The pathogenesis of RUTI is reviewed and the risk factors associated with RUTI in premenopausal women (usually related to sexual activity), postmenopausal women (in whom estrogen deficiency has a significant effect on the vaginal Lactobacillus flora), and in pregnant women are discussed. Likewise, an extensive review of the distinct therapeutic strategies to prevent RUTI is provided: self-treatment of cystitis, continuous antibiotic prophylaxis, postcoital antibiotic prophylaxis, topical vaginal estrogens, Lactobacillus, cranberry juice, intravesical administration of non-virulent E. coli strains and vaccines, among others. Several diagnostic-therapeutic algorithms are included. These algorithms are based on the type of urinary infection (relapse-reinfection), on the type of patient (young, postmenopausal, or pregnant women) and on the number of episodes of RUTI.

Adolescent↗