| 1. |
- Eriksson, Thomas, et al.
(författare)
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Are low-dose CT scans a satisfactory substitute for stereoradiographs for migration studies? A preclinical test of low-dose CT scanning protocols and their application in a pilot patient.
- 2019
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Ingår i: Acta Radiologica. - : Sage Publications. - 0284-1851 .- 1600-0455.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Computed tomography (CT) has the potential to acquire the data needed for migration studies of orthopedic joint implants of patients who have had tantalum beads implanted at the time of joint replacement surgery. This can be accomplished with the same precision as radiostereometric analysis (RSA). Switching to CT would increase availability without the need for the specific facilities required for RSA. However, higher effective dose is a concern.PURPOSE: To investigate if migration measurements can be done with CT with an accuracy and effective dose comparable to that of conventional RSA.MATERIAL AND METHODS: Fourteen scanning protocols were tested in a hip phantom that incorporated tantalum beads and an uncemented femoral stem. The protocols were graded for clinical practice according to the three parameters of image quality, effective dose, and robustness of numerical data. After grading, the two protocols that graded best overall were applied to a pilot patient.RESULTS: All protocols produced scans in which the numerical data were sufficient for a migration analysis at least as precise as would be expected using RSA. A protocol with an effective dose of 0.70 mSv was shown to be applicable in a pilot patient.CONCLUSION: Low-dose CT scans with an effective dose comparable to a set of routine plain radiographs can be used for precise migration measurements.
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| 2. |
- Försth, Peter, 1966-, et al.
(författare)
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Motion Analysis in Lumbar Spinal Stenosis With Degenerative Spondylolisthesis : A Feasibility Study of the 3DCT Technique Comparing Laminectomy Versus Bilateral Laminotomy.
- 2018
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Ingår i: Clinical spine surgery. - : Wolters Kluwer. - 2380-0186 .- 2380-0194. ; 31:8, s. E397-E402
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: This was a randomized radiologic biomechanical pilot study in vivo. Objective: The objectives of this study was to evaluate if 3-dimensional computed tomography is a feasible tool in motion analyses of the lumbar spine and to study if preservation of segmental midline structures offers less postoperative instability compared with central decompression in patients with lumbar spinal stenosis with degenerative spondylolisthesis. Summary of Background Data: The role of segmental instability after decompression is controversial. Validated techniques for biomechanical evaluation of segmental motion in human live subjects are lacking. Methods: In total, 23 patients (mean age, 68 y) with typical symptoms and magnetic resonance imaging findings of spinal stenosis with degenerative spondylolisthesis (>3 mm) in 1 or 2 adjacent lumbar levels from L3 to L5 were included. They were randomized to either laminectomy (LE) or bilateral laminotomy (LT) (preservation of the midline structures). Documentation of segmental motion was made preoperatively and 6 months postoperatively with CT in provoked flexion and extension. Analyses of movements were performed with validated software. The accuracy for this method is 0.6 mm in translation and 1 degree in rotation. Patient-reported outcome measures were collected from the Swespine register preoperatively and 2-year postoperatively. Results: The mean preoperative values for 3D rotation and translation were 6.2 degrees and 1.8 mm. The mean increase in 3D rotation 6 months after surgery was 0.25 degrees after LT and 0.7 degrees after LE (P=0.79) while the mean increase in 3D translation was 0.15 mm after LT and 1.1 mm after LE (P=0.42). Both surgeries demonstrated significant improvement in patient-reported outcome measures 2 years postoperatively. Conclusions: The 3D computed tomography technique proved to be a feasible tool in the evaluation of segmental motion in this group of older patients. There was negligible increase in segmental motion after decompressive surgery. LE with removal of the midline structures did not create a greater instability compared with when these structures were preserved.
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| 3. |
- Goldvasser, Dov, et al.
(författare)
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In vivo and ex vivo measurement of polyethylene wear in total hip arthroplasty
- 2014
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 85:3, s. 271-275
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Tidskriftsartikel (refereegranskat)abstract
- Background - Determination of the amount of wear in a polyethylene liner following total hip arthroplasty (THA) is important for both the clinical care of individual patients and the development of new types of liners. Patients and methods - We measured in vivo wear of the polyethylene liner using computed tomography (CT) (obtained in the course of regular clinical care) and compared it to coordinate-measuring machine (CMM) readings. Also, changes in liner thickness of the same retrieved polyethylene liner were measured using a micrometer, and were compared to CT and CMM measurements. The distance between the centers of the acetabular cup and femoral head component was measured in 3D CT, using a semi-automatic analysis method. CMM readings were performed on each acetabular liner and data were analyzed using 3D computer-aided design software. Micrometer readings compared the thickest and thinnest regions of the liner. We analyzed 10 THA CTs and retrievals that met minimal requirements for CT slice thickness and explanted cup condition. Results - For the 10 cups, the mean difference between the CT readings and the CMM readings was -0.09 (-0.38 to 0.20) mm. This difference was not statistically significant (p = 0.6). Between CT and micrometer, the mean difference was 0.11 (-0.33 to 0.55) mm. This difference was not statistically significant (p = 0.6). Interpretation - Our results show that CT imaging is ready to be used as a tool in clinical wear measurement of polyethylene liners used in THA.
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| 4. |
- Hatherly, Robert, et al.
(författare)
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Technical Requirements for Na18F PET Bone Imaging of Patients Being Treated Using a Taylor Spatial Frame.
- 2014
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Ingår i: Journal of nuclear medicine technology. - : Society of Nuclear Medicine. - 1535-5675 .- 0091-4916.
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Tidskriftsartikel (refereegranskat)abstract
- Diagnosis of new bone growth in patients with compound tibia fractures or deformities treated using a Taylor spatial frame is difficult with conventional radiography because the frame obstructs the images and creates artifacts. The use of Na(18)F PET studies may help to eliminate this difficulty.METHODS: Patients were positioned on the pallet of a clinical PET/CT scanner and made as comfortable as possible with their legs immobilized. One bed position covering the site of the fracture, including the Taylor spatial frame, was chosen for the study. A topogram was performed, as well as diagnostic and attenuation correction CT. The patients were given 2 MBq of Na(18)F per kilogram of body weight. A 45-min list-mode acquisition was performed starting at the time of injection, followed by a 5-min static acquisition 60 min after injection. The patients were examined 6 wk after the Taylor spatial frame had been applied and again at 3 mo to assess new bone growth.RESULTS: A list-mode reconstruction sequence of 1 × 1,800 and 1 × 2,700 s, as well as the 5-min static scan, allowed visualization of regional bone turnover.CONCLUSION: With Na(18)F PET/CT, it was possible to confirm regional bone turnover as a means of visualizing bone remodeling without the interference of artifacts from the Taylor spatial frame. Furthermore, dynamic list-mode acquisition allowed different sequences to be performed, enabling, for example, visualization of tracer transport from blood to the fracture site.
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| 5. |
- Weidenhielm, Lars, et al.
(författare)
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Prosthetic liner wear in total hip replacement : a longitudinal 13-year study with computed tomography.
- 2018
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Ingår i: Skeletal Radiology. - : Springer. - 0364-2348 .- 1432-2161. ; 47:6, s. 883-887
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Tidskriftsartikel (refereegranskat)abstract
- This case report follows a woman who had a total hip replacement in 1992 when she was 45 years old. Six serial computed tomography (CT) examinations over a period of 13 years provided information that allowed her revision surgery to be limited to liner replacement as opposed to replacement of the entire prosthesis. Additionally, they provided data that ruled out the presence of osteolysis and indeed none was found at surgery. In 2004, when the first CT was performed, the 3D distance the femoral head had penetrated into the cup was determined to be 2.6 mm. By 2017, femoral head penetration had progressed to 5.0 mm. The extracted liner showed wear at the thinnest part to be 5.5 mm, as measured with a micrometer. The use of modern CT techniques can identify problems, while still correctable without major surgery. Furthermore, the ability of CT to assess the direction of wear revealed that the liner wear changed from the cranial to dorsal direction.
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| 6. |
- West, Jay B., et al.
(författare)
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Comparison and evaluation of retrospective intermodality image registration techniques
- 1997
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Ingår i: SPIE - The International Society for Optical Engineering. - : SPIE - International Society for Optical Engineering. ; , s. 332-347
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Konferensbidrag (refereegranskat)abstract
- All retrospective image registration methods have attached to them some intrinsic estimate of registration error. However, this estimate of accuracy may not always be a good indicator of the distance between actual and estimated positions of targets within the cranial cavity. This paper describes a project whose principal goal is to use a prospective method based on fiducial markers as a ’gold standard’ to perform an objective, blinded evaluation of the accuracy of several retrospective image-to-image registration techniques. Image volumes of three modalities – CT, MR, and PET – were taken of patients undergoing neurosurgery at Vanderbilt University Medical Center. These volumes had all traces of the fiducial markers removed, and were provided to project collaborators outside Vanderbilt, who then performed retrospective registrations on the volumes, calculating transformations from CT to MR and/or from PET to MR, and communicated their transformations to Vanderbilt where the accuracy of each registration was evaluated. In this evaluation the accuracy is measured at multiple ’regions of interest,’ i.e. areas in the brain which would commonly be areas of neurological interest. A region is defined in the MR image and its centroid C is determined. Then the prospective registration is used to obtain the corresponding point C’ in CT or PET. To this point the retrospective registration is then applied, producing C’ in MR. Statistics are gathered on the target registration error (TRE), which is the disparity between the original point C and its corresponding point C’. A second goal of the project is to evaluate the importance of correcting geometrical distortion in MR images, by comparing the retrospective TRE in the rectified images, i.e., those which have had the distortion correction applied, with that of the same images before rectification. This paper presents preliminary results of this study along with a brief description of each registration technique and an estimate of both preparation and execution time needed to perform the registration.
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| 7. |
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| 8. |
- Aguilar, Antonio, et al.
(författare)
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Positive Patient Identification using RFID and Wireless Networks
- 2006
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Ingår i: Proceedings of the HISI 11th Annual Conference and Scientific Symposium, Dublin, Ireland. - Dublin, Ireland.
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Konferensbidrag (refereegranskat)abstract
- The increased focus on patient safety in hospitals has yielded a flood of new technologies and tools seeking to improve the quality of patient care at the point-of-care. Hospitals are complex institutions by nature, and are constantly challenged to improve the quality of healthcare delivered to patients while trying to reduce the rate of medical errors and improve patient safety. Here a simple mistake such as patient misidentification, specimen misidentification, wrong medication, or wrong blood transfusion can cause the loss of a patient's life. The focus of this paper is the implementation and evaluation of a handheld-based patient identification system that uses radio frequency identification (RFID) and 802.11b wireless networks to identify patients. In this approach, each patient is given a RFID wristband which contains demographic information (patient ID number, patient summary, hospital code) of the patient. A handheld device equipped with 802.11b wireless connectivity and a RFID reader is then used by the medical staff to read the patient's wristband and identify the patient. This work was carried out at the Department of Medical Physics and Bioengineering at the University College Hospital Galway, Ireland and in co-operation with the National University of Ireland, Galway.
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| 9. |
- Ahlin, Lars, et al.
(författare)
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Automous Tactical Communications Possibilities and Problems
- 1997
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Ingår i: MILCOM 97 Proceedings. - 0780342496 ; , s. 393-397
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Konferensbidrag (refereegranskat)abstract
- In the battlefield of the future, more and more information will be available for making decisions on a tactical level, provided that this information can be dispersed rapidly and accurately. As a consequence, advanced tactical decision support that now is limited to advanced platforms (e.g. combat aircrafts) will become available at a much lower level, ranging from different kinds of vehicles, down to the individual soldier by means of ultra-light weight ``wearable'' equipment. Establishing reliable wireless communications in such a large group of users with unprecidented bandwidth demands and requirements on survivability constitutes a considerable enginerring challenge. In the paper we will, after a short review of some existing approaches, investigate the specific engineering challenges and the fundamental limitations of such low level, autonomous communication systems. Further we give an example of a system architecture, harmonized with a proposed structure for third generation commercial wireless systems (e.g. UMTS). Our conclusions show that mainly distributed computing complexity, device power consumption and available bandwidth constitute the fundamental problems.
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| 10. |
- Aitken, Candice L., et al.
(författare)
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Comparison of three methods used for fusion of SPECT-CT images of liver matastases
- 1998
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Ingår i: Fusion98, International Conference on Multisource-Mulltisensor Information Fusion. - : CSREA Press. - 1892512009 ; , s. 435-442
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Konferensbidrag (refereegranskat)abstract
- We compare three methods for fusing SPECT-CT images: ImageMatch - an automatic three-dimensional/two-dimensional method developed by Focus Imaging; IBM Visualization Data Explorer - a three-diemensional interactive method developed by Internation Business Machines, Inc.; and qsh - an interactive three-dimensional/two-dimensional method developed at New York University. While many fusion methods have proved successful for registering brain images, most methods have been less successful for thoracic and abdominal images. We use images of liver metastases obtained with a radiolabeled breast tumor-directed antibody to illustrate the strengths and weakness of the methods reviewed. The images used are typical clinical images from eigth patients. We conclude that an optimal image fusion program should combine the strengths of each of the methods reviewed.
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