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At least 19 recordsLinked to original sources

Fast MR angiography of the aortoiliac arteries and arteries of the lower extremity: value of bolus-enhanced, whole-volume subtraction technique.

OBJECTIVE: MR angiography of the abdominal aorta and lower limb arteries has been hampered by the need to depict long segments of the arteries in short imaging times. To overcome these limitations, we combined fast acquisition of coronal sections with bolus-enhancement technique, subtraction, and whole-volume projection display. The purpose of this preliminary study was to determine the value of using this technique in patients with abdominal aortic lesions and atherosclerotic occlusive disease of the lower limbs. SUBJECTS AND METHODS: Ten healthy volunteers and 20 patients with abdominal aortic aneurysms (n = 15), vascular graft (n = 3), arteriovenous fistula (n = 1), and abdominal aortic dissection (n = 1) were examined by segmented K-space ultrafast gradient-echo sequences. Sequential 50-cm coronal sections were acquired before and after an IV bolus injection of gadolinium (0.1 mmol/kg). Subtraction images were created by subtracting precontrast from postcontrast images. In all MR images, signal intensity was measured in the aorta, the inferior vena cava, and the background tissues. The final MR angiogram was a summation image of each subtracted image and was compared with a preoperative conventional arteriogram. Data from each study were collected prospectively and analyzed in a blinded manner. The radiologist evaluated depiction of the following specific areas: the abdominal aorta, common iliac arteries on both sides, superficial femoral arteries and above-knee popliteal arteries, below-knee popliteal arteries, superior mesenteric artery, and renal arteries. The aneurysms were categorized as infrarenal or suprarenal and as involving or not involving the iliac arteries. The graft was considered patent if depicted at both its origin and its periphery. RESULTS: In the healthy volunteers, bolus-enhanced subtraction MR angiography depicted without in-plane saturation the aorta, iliac arteries, and arteries of the lower extremity in less than 2 min. Gadolinium significantly increased the aortic signal-to-noise ratio from 25 +/- 3 to 232 +/- 8 (p < .0001), whereas the signal intensity of the inferior vena cava, muscles, and fat remained relatively stable. Examinations were thought to be interpretable in all but two patients. Clear delineation of aneurysms, intimal flap and arteriovenous fistula, and graft patency (n = 3) or occlusion (n = 2) were similarly diagnosed by conventional and MR angiography. Superior mesenteric artery was depicted in all cases on postcontrast images before subtraction. The number of renal arteries (n = 29) was correctly identified in all 15 patients who had renal areas included in their aortograms on postcontrast images before subtraction. However, renal arteries throughout their full length were usually obscured by renal veins and bowel contrast enhancement on the final MR angiogram. Furthermore, bolus-enhanced subtraction MR angiography was able to depict all lower limb arteries. CONCLUSION: Although further evaluation and technical improvements are required, our preliminary results indicate that bolus-enhanced subtraction MR angiography is a promising new method for fast abdominal and peripheral vascular imaging.

Adult↗

Analysis of radioimmunodetection of tumors by the subtraction technique.

The subtraction method for radioimmunodetection (RID) of cancer is showing potential as a diagnostic tool. An objective assessment of this technique is needed in order to determine its clinical usefulness. A numerical analysis of the RID scintigrams was developed and applied to 21 RID studies on 20 patients for whom a final diagnosis had been established. The subtraction technique was shown to give rise to artifactual positive regions, which could be avoided by experienced clinicians. When artifact-producing regions were excluded, 97 regions were examined (80 nontumor, 17 tumor-containing). The "background" scintigrams were shown to be good models for nontumor regions of the antibody scintigrams, and tumor and nontumor regions were shown to form statistically distinct groups.

Antibodies↗

Left ventricular dual-energy digital subtraction angiography: a motion immune digital subtraction technique.

Digital subtraction angiography (DSA) allows quantitative analysis of ventricular function via densitometric and parametric imaging techniques. However, DSA is limited by the artifacts in temporal subtraction images that result from patient and cardiac motion. Dual-energy subtraction imaging is insensitive to motion. This study evaluated the initial application of dual-energy subtraction in cardiac patients. The image quality of dual-energy subtraction left ventriculograms obtained from a pulmonary artery injection of contrast was assessed in 13 patients, ranging in weight from 54 to 100 kg. The dual-energy images were compared with left ventricular images obtained using standard left ventricular injection cine angiography. End-systolic and end-diastolic ventricular volumes calculated from the cine (C) and dual-energy (DE) images using the Area-Length method were compared. The resulting regression line was DE = 0.98 C+ 7.0 ml, and the r value was 0.987. Dual-energy subtraction provided good left ventricular visualization, free from misregistration artifacts, even during patient motion.

Adult↗

Improved detection of lung nodules by using a temporal subtraction technique.

PURPOSE: To evaluate the effect of a temporal subtraction technique for digital chest radiography with regard to the accuracy of detection of lung nodules. MATERIALS AND METHODS: Twenty solitary lung nodules smaller than 30 mm in diameter, including 10 lung cancers and 10 benign nodules, were used. The nodules were grouped subjectively according to their subtlety. For non-nodular cases, 20 nodules without perceptible interval changes were selected. All chest radiographs were obtained by using a computed radiographic system, and temporal subtraction images were produced by using a program developed at the University of Chicago. The effect of the temporal subtraction image was evaluated by using an observer performance study, with use of receiver operating characteristic analysis. RESULTS: Observer performance with temporal subtraction images was substantially improved (A(z) = 0.980 and 0.958), as compared with that without temporal subtraction images (A(z) = 0.920 and 0.825) for the certified radiologists and radiology residents, respectively. The temporal subtraction technique clearly improved diagnostic accuracy for detecting lung nodules, especially subtle cases. CONCLUSION: The temporal subtraction technique is useful for improving detection accuracy for peripheral lung nodules on digital chest radiographs.

Adult↗

[Lateral urethrocystography in digital subtraction technique].

The first application of the digital subtraction technique to lateral urethrocystography is described. This methodology facilitates gynecological-urological operations by providing reliable investigation results and an unambiguous image interpretation. Methods and first experiences with the digital subtraction technique in gynecological-urological diagnosis are reported.

Female↗

A subtraction technique in conventional angiography.

A subtraction technique is described for conventional angiography by which a superimposed vessel can be removed, allowing exact visualization of the area in question. The method is easy, requires only standard subtraction apparatus, and obviates the need for additional contrast material injections.

Angiography↗

Detection of lung nodules on digital chest radiographs: potential usefulness of a new contralateral subtraction technique.

PURPOSE: To evaluate the potential usefulness of a contralateral subtraction technique developed for radiologists' performance in the detection of subtle lung nodules on chest radiographs. MATERIALS AND METHODS: Fifty chest radiographs (25 normal and 25 abnormal with a subtle lung nodule) that were digitized with a 0.175-mm pixel size and 4,096 gray levels were used. Twelve radiologists (10 attending and two residents) participated in observer tests and read both original and contralateral subtraction images with a sequential testing method. Radiologists' performance was evaluated by means of receiver operating characteristic analysis with use of a continuous rating scale. The beneficial and detrimental effects of the contralateral subtraction technique on the radiologists' performance were also evaluated. RESULTS: The area under the receiver operating characteristic curve values obtained without and with contralateral subtraction images were 0.926 and 0.962, respectively. Results indicated that the contralateral subtraction images significantly (P <.05) improved diagnostic accuracy, particularly for radiologists with limited experience. CONCLUSION: The contralateral subtraction technique can assist radiologists in the correct identification of subtle lung nodules on chest radiographs.

Humans↗

The limitations of the dual radionuclide subtraction technique for the external detection of tumours by radioiodine-labelled antibodies.

A dual radionuclide subtraction technique for external detection of tumours has been evaluated to determine the viability of the method for use with radioisotope labelled antibodies. A number of external scintigraphic investigations have been carried out with 131I-labelled antibodies to carcinoembryonic antigen (CEA). The investigations were performed on patients with metastatic disease known to produce CEA. The dual radionuclide subtraction technique was used to account for the blood and tissue background. The 131I-labelled antibodies were found to localise in the metastatic lesions, but the subtraction technique using 99Tcm-labelled HSA and pertechnetate gave ambiguous results, which included the production of artefacts. The ambiguities noted in the clinical results were substantiated by experimental data, which highlight the unreliability of this technique.

Antibodies, Neoplasm↗

Effect of temporal subtraction technique on the diagnosis of primary lung cancer with chest radiography.

PURPOSE: The purpose of this study was to assess the diagnostic accuracy of the temporal subtraction technique in the detection of primary lung cancers by readers with different levels of experience. METHODS: Previous and current chest radiographs from 40 patients with histologically proven lung cancer and 40 controls were studied. Temporal subtraction images were produced using an automated digital subtraction technique. We evaluated the effect of temporal subtraction images in the diagnosis of lung cancer with chest radiographs via an observer performance study with the use of receiver operating characteristic analysis. Six experienced radiologists and six residents participated as observers. RESULTS: Observer performance for all observers was superior when temporal subtraction images were used (mean Az value increased from 0.764 to 0.836, p=0.0006). Although the average Az value for residents increased significantly, from 0.707 to 0.795 (p=0.0038), the average Az value for experienced radiologists increased only from 0.821 to 0.878 (n.s.). CONCLUSION: In conclusion, the temporal subtraction technique clearly improves diagnostic accuracy for the detection of primary lung cancer. The results indicated that the use of temporal subtraction images was more beneficial for the residents than for the experienced radiologists. This method would compensate to some extent for experience-dependent diagnostic accuracy in the detection of lung cancer.

Adenocarcinoma↗

[A new method of evaluating helical artifact by image subtraction technique].

This paper proposes a new quantitative method of appraising the helical artifact generated by computed tomography (CT) images by helical scan. The quantities-appraisal method of the helical artifact uses as a sample image, the binarization image, which performs the threshold operation. Therefore, results may differ among observers and are lacking in objectivity. We devised a procedure (subtraction technique) that uses the subtraction process as a method of appraising the helical artifact that does not a perform a threshold operation, and evaluated this procedure. As compared with an area technique, a subtraction technique can divide a helical artifact into a plus CT value (Over Level) and a minus CT value (Under Level) and can evaluate them. This provides excellent repeatability and objectivity. Moreover, since CT value data are maintained, the quality of an artifact can also be evaluated, making this a very useful procedure. By using the subtraction technique, new information will be found by evaluating helical artifacts.

Artifacts↗

Visualization of mu1 opiate receptors in rat brain by using a computerized autoradiographic subtraction technique.

We have developed a quantitative computerized subtraction technique to demonstrate in rat brain the regional distribution of mu1 sites, a common very-high-affinity binding site for both morphine and the enkephalins. Low concentrations of [D-Ala2, D-Leu5]enkephalin selectively inhibit the mu1 binding of [3H]dihydromorphine, leaving mu2 sites, while low morphine concentrations eliminate the mu1 binding of [3H][D-Ala2, D-Leu5]enkephalin, leaving delta sites. Thus, quantitative differences between images of sections incubated in the presence and absence of these low concentrations of unlabeled opioid represent mu1 binding sites. The regional distributions of mu1 sites labeled with [3H]dihydromorphine were quite similar to those determined by using [3H][D-Ala2, D-Leu5]enkephalin. High levels of mu1 binding were observed in the periaqueductal gray, medial thalamus, and median raphe, consistent with the previously described role of mu1 sites in analgesia. Other regions with high levels of mu1 binding include the nucleus accumbens, the clusters and subcallosal streak of the striatum, hypothalamus, medial habenula, and the medial septum/diagonal band region. The proportion of total specific binding corresponding to mu1 sites varied among the regions, ranging from 14% to 75% for [3H][D-Ala2, D-Leu5]enkephalin and 20% to 52% for [3H]dihydromorphine.

Animals↗

Clinical application of single dual-energy subtraction technique with digital storage-phosphor radiography.

We used a single-exposure dual-energy subtraction technique with a storage-phosphor computed radiography (CR) system to evaluate various pulmonary diseases. Clinical applications of this method have been studies at our institution. In our experience, the dual-energy subtraction technique provided better visualization of pulmonary nodules, tracheobronchial abnormalities, pulmonary vascular diseases, calcification in a nodule, and rib lesions than conventional CR images did. Single-exposure dual-energy subtraction images were obtained with a sandwich technique using two storage-phosphor imaging plates with a 1-mm-thick copper filter interleaved between the two. The front plate obtains a lower kilovoltage image, whereas the back plate obtains a higher kilovoltage image. We can visualize soft tissue and bone images as well as unsubtracted digital images by the subtraction process.

Bronchial Diseases↗

Subtraction technique in intravenous aortography.

Excretory urography using the subtraction technique (100 ml of 60% urographic media injected in 10-12 seconds) demonstrated the aorta and its major branches well enough to prove useful clinically. The method is fast and graphic, and risk seems no greater than that associated with the standard urographic examination.

Aorta, Abdominal↗

Multi-slice CT for visualization of acute pulmonary embolism: single breath-hold subtraction technique.

PURPOSE: The purpose of our preliminary animal study was to evaluate the feasibility of a new subtraction technique for visualization of perfusion defects within the lung parenchyma in segmental and subsegmental pulmonary embolism (PE). MATERIALS AND METHODS: In three healthy pigs, PE were artificially induced by fresh human clot material. Within a single breath-hold, CT angiography (CTA) was performed on a 16-slice multi-slice CT scanner (SOMATOM Sensation 16; Siemens, Forchheim, Germany) before and after intravenous application of 80 mL of contrast-medium, followed by a saline chaser. Scan parameters were 120 kV and 100 mAs (eff.), using a collimation of 16 x 1.5 mm and a table speed/rot. of 36 mm (pitch: 1.5; rotation time: 0.5 s). A new 3D subtraction technique was developed, which is based on automated segmentation, non-linear spatial filtering and non-rigid registration. Data were analysed using a color-encoded "compound view" of parenchymal enhancement and CTA information displayed in axial, coronal and sagittal orientation. RESULTS: Subtraction was technically feasible in all three data sets. The mean scan time for each series was 4.7 s, interscan delay was 14.7 s, respectively. Therefore, an average breath-hold of approximately 24 s was required for the overall scanning procedure. Downstream of occluded segmental and subsegmental arteries, perfusion defects were clearly assessable, showing lower or missing enhancement compared to normally perfused lung parenchyma. In all pigs, additional peripheral areas with triangular shaped perfusion defects were delineated, considered typical for PE. CONCLUSIONS: Our initial results from the animal model studied show that perfusion imaging of PE is feasible within a single breath-hold. It allows a comprehensive assessment of perfusion deficits as the direct proof of a pulmonary embolus, can be combined with an indirect visual quantification of the density changes in the adjacent lung tissue.

Acute Disease↗

Digital subtraction technique for evaluation of peri-implant bone change in digital dental imaging.

The purpose of this study was to investigate digital subtraction technique in digital dental imaging for implant performance, used to quantitatively evaluate bone change around dental implants. For longitudinal assessment of peri-implant bone change, we applied subtraction technique to digital peri-apical radiographs using a digital dental imaging system in two cases at the upper canine and premolar regions. In both cases, we found two peaks of bone change at the crestal region; we also quantitatively demonstrated a marked change over the first one-month period and approximately three-month period spanning the fourth month to the end of the sixth month following implantation. Digital peri-apical radiography accommodating the digital subtraction program should be re-acknowledged as a reliable modality for assessing amount of bone change at local implantation sites.

Alveolar Bone Loss↗

Nuclide imaging of vascular graft-platelet interactions: comparison of indium excess and technetium subtraction techniques.

Indium-111-labeled platelet adherence to ePTFE thoracoabdominal vascular prostheses in a canine model (n = 10) was quantitated by (1) an indium-111 excess technique, contrasting graft radioactivity to that in a reference region, and (2) a technetium-99m subtraction technique, with radioactivity of circulating platelets eliminated by discounting background blood activity. Variation in graft thrombogenicity was provided by seeding six prostheses with enzymatically derived autologous endothelial cells, and implanting four prostheses without seeding. Grafts were imaged at 1, 4, and 6 weeks postimplantation, with platelet labeling using indium-111-oxine and red blood cell labeling using technetium-99m. At 7 weeks grafts were excised and gamma activity was measured in proximal, middle, and distal segments. Luminal generation of TxB2 and 6-keto-PGF1 alpha from midportions of grafts was assayed. Indium-111 excess ratios at 6 weeks correlated with actual gamma activity of excised grafts (proximal r = 0.80, P less than 0.01; middle r = 0.73, P less than 0.05; distal r = 0.48, ns) but such a correlation did not exist for the technetium-99m subtraction technique (r = -0.05, -0.25, and 0.16, in the three segments, respectively, all ns). The ratio of graft to aortic TxB2 production revealed a positive correlation with graft gamma activity (r = 0.87, P less than 0.01), and the ratio of graft 6-keto-PGF1 alpha to TxB2 production also correlated with gamma counts (r = -0.64, P = 0.05). In this experimental setting technetium-99m subtraction analysis was an imprecise method of detecting graft platelet accumulation, whereas indium-111 excess ratios proved to be a more accurate method of quantitating vascular prosthetic thrombogenicity.

Animals↗

Enhanced magnetic resonance imaging and subtraction techniques in postoperative evaluation of craniofacial resection for sinonasal malignancy.

The use of magnetic resonance imaging (MRI) enhanced with gadolinium. and diethylenetriamine pentaacetic acid (DTPA) in the preoperative evaluation of sinonasal malignancy is well established and has an accuracy of over 98%. Since 1979, 208 patients have undergone craniofacial resection at London's Institute of Laryngology & Otology, primarily for sinonasal neoplasia affecting the anterior skull base. Thirty-five "high-risk" patients had MRI at follow-up. The MRI scans were assessed before the patients were examined under anesthesia. MRI was assessed before examination under anesthesia and the results compared with histologic findings demonstrating a reasonable degree of positive correlation but one which is inferior to that found preoperatively (80%). An extension of this technique using the subtraction of T1-weighted MRI with Gd-DTPA highlights areas of increased vascularity, which significantly improves the ability to predict recurrence at the skull base and above the surgical repair in the anterior cranial fossa (94%).

Adult↗