Transection of more than one sympathetic chain ganglion for hyperhidrosis increases the severity of compensatory hyperhidrosis and decreases patient satisfaction.

Sympathectomy (ETS) is an effective treatment for hyperhidrosis (HH), but compensatory hyperhidrosis (CH) is a common side effect. We reviewed our experience with 200 patients. Two hundred patients were retrospectively analyzed.

Image quality assurance in the prostate, lung, colorectal, and ovarian cancer screening trial network of the National Lung Screening Trial.

The National Lung Screening Trial is evaluating the effectiveness of low-dose spiral CT and conventional chest X-ray as screening tests for persons who are at high risk for developing lung cancer. This multicenter trial requires quality assurance (QA) for the image quality and technical parameters of the scans. The electronic system described here helps manage the QA process.

PACS workbench at Mallinckrodt Institute of Radiology (MIR). 1983.

Initial components of a Picture Archive and Communication System (PACS) workbench have been installed at the Mallinckrodt Institute of Radiology (MIR) providing a set of basic “utilities” which facilitate comprehensive design studies and experiments. Each of the primary areas of picture acquisition, transport, processing, archiving and viewing are addressed by the PACS workbench.

Prospects for quantitative computed tomography imaging in the presence of foreign metal bodies using statistical image reconstruction.

X-ray computed tomography (CT) images of patients bearing metal intracavitary applicators or other metal foreign objects exhibit severe artifacts including streaks and aliasing. We have systematically evaluated via computer simulations the impact of scattered radiation, the polyenergetic spectrum, and measurement noise on the performance of three reconstruction algorithms: conventional filtered backprojection (FBP), deterministic iterative deblurring, and a new iterative algorithm, alternating minimization (AM), based on a CT detector model that includes noise, scatter, and polyenergetic spectra. Contrary to the dominant view of the literature, FBP streaking artifacts are due mostly to mismatches between FBP's simplified model of CT detector response and the physical process of signal acquisition.

Enhanced interfaces for web-based enterprise-wide image distribution.

Modern Web browsers support image distribution with two shortcomings: (1) image grayscale presentation at client workstations is often sub-optimal and generally inconsistent with the presentation state on diagnostic workstations and (2) an Electronic Patient Record (EPR) application usually cannot directly access images with an integrated viewer. We have modified our EPR and our Web-based image-distribution system to allow access to images from within the EPR. In addition, at the client workstation, a grayscale transformation is performed that consists of two components: a client-display-specific component based on the characteristic display function of the class of display system, and a modality-specific transformation that is downloaded with every image.

Planning and implementing image delivery to outpatient specialty clinical practices in a large medical center.

Softcopy image viewing using web-based technologies has been deployed to 3 specialty outpatient practices - Lung Center, Neurosurgery, Orthopedic Surgery - where films remain available. Physicians and staff use Philips Easyweb (a web-based image browser) and BJC HealthCare ClinDesk (a Java-based electronic patient record) clients in patient examination rooms and physician workrooms to retrieve images from a Mitra image server. Practice-specific planning and training preceded deployment; on-site training and support came with deployment; on-site and telephone support are available as needed.

Observer study involving laser-digitized versus CCD-digitized images.

We compared laser- and CCD-digitized images for perceived image quality differences in a radiologist-observer study. Films of 50 two- and three-view studies (ankles, chests, c-spines, shoulders) were digitized on calibrated laser (Kodak Lumisys 75) and CCD (VIDAR SIERRA Plus) digitizers. Six radiologists independently compared digitized images on twin high-resolution monochrome monitors.

Perceived fidelity of compressed and reconstructed radiological images: a preliminary exploration of compression, luminance, and viewing distance.

The authors' goal was to explore the impact of image compression algorithm and ratio, image luminance, and viewing distance on radiologists' perception of reconstructed image fidelity. Five radiologists viewed 16 sets of four hard-copy chest radiographs prepared for secondary interpretation. Each set included one uncompressed, and three compressed and reconstructed images prepared using three different algorithms but the same compression ratio.

Soft-copy versus hard-copy cranial sonography: intraobserver agreement and workstation efficiency.

Objective: The objective of the study was to determine the intraobserver agreement, confidence level, and efficiency in interpretation of soft-copy (workstation) versus hard-copy (laser-printed film) sonograms of the cranium.

Materials And Methods: Cranial sonograms of 100 premature infants were randomly reviewed twice on both soft-copy and hard-copy images by three observers and were graded for hemorrhage using a five-level scale. The kappa statistic was calculated to measure intraobserver agreement.

Networks for electronic radiology.

Next-generation health care systems must successfully integrate hospital information, laboratory automation, and medical-image management to provide a seamless view of the complete medical record to the primary care physician across a distributed medical enterprise. Broadband networks are an important component of the systems required to achieve this goal. This article provides a brief tutorial on relevant network principles and products, a perspective on the evolution of the field, and a simple view of the network requirements posed by electronic radiology.

Glycosphingolipid composition of murine neuroblastoma cells: O-acetylesterase gene downregulates the expression of O-acetylated GD3.

We have studied the glycosphingolipid composition in an F-11 neuroblastoma cell line originated from hybridization of a mouse neuroblastoma cell line (N18TG-2) with rat dorsal root ganglion cells. The total lipid-bound glucose of F-11 cells was estimated to be 0.28 micrograms/mg of protein and the total lipid-bound sialic acid was 0.

Quality monitoring of soft-copy displays for medical radiography.

As presentation of medical radiographic images on soft-copy displays (cathode ray tubes) becomes increasingly prevalent in electronic radiography, methods of quality assurance must be developed to ensure that radiologists can effectively transfer film-based reading skills. Luminance measurements provide the basis for evaluating the state of soft-copy displays. An integrated approach has been implemented at Mallinckrodt Institute of Radiology (MIR, Washington University, St Louis, MO) that facilitates measurement of geographically distributed soft-copy displays with centralized data logging, performance tracking, and calibration.

Teleradiology via narrow-band integrated services digital network (N-ISDN) and Joint Photographic Experts Group (JPEG) image compression.

The importance of remote access to both radiological images and medical information has stimulated many demonstration projects that use a variety of telecommunications providers' offerings. Teleradiology, through modest cost channels, can achieve adequate response times using a combination of narrow-band integrated services digital network (N-ISDN) and data compression. A demonstration project, developed in collaboration with Southwestern Bell Technology Resources, Inc, uses the aggregate bandwidth of two B channels (achieving a rate of 120 kilobits per second) and a block-oriented discrete cosine transform compression/decompression implementation based on the Joint Photographic Experts Group Standard for Still Image Compression.

Performance characteristics and image fidelity of gray-scale monitors.

Gray-scale monitors are an essential element of electronic radiology, and their ability to provide images that are perceived to be identical to those available on conventional or laser-printed film is crucial to success of electronic radiology. Image fidelity is measured in physical characteristics (luminance, dynamic range, distortion, resolution, and noise) and with psychophysical techniques, including receiver operator characteristics analysis with clinical images and testing with contrast-detail patterns to determine threshold contrast. Currently, laser-printed images facilitate greater information transfer than does a gray-scale monitor because of their higher absolute luminance (500 ft-L vs 60 ft-L), greater perceived dynamic range, and better spatial resolution.

A distributed approach to integrated inquiry and display for radiology.

Picture archive and communications (PACS) systems should be flexible and modular in design so that new advances in storage, computation, and display technology can be introduced into the system without a significant redesign of existing software. The acquisition, storage, and management of radiologic images must be carefully integrated with a radiology information system. Our architecture is based on a four-level data model: (1) patient information, (2) examination information and reports, (3) image information, and (4) instances of images.

A prototype of a high-resolution computerized radiology teaching file.

Computers provide an excellent tool for handling the task of organizing a radiology teaching file. Currently available computerized teaching files are either film-based, slide-based, or use laser-disc video technology for image display. There are obvious advantages to having the management of radiologic images under the control of a computer, and the need for a higher resolution alternative to video laser-disc technology becomes apparent when one tries to computerize a chest radiology teaching file.

Hospital-wide distribution of nuclear medicine studies through a broadband digital network.

Nuclear medicine provides a good environment for the evaluation of picture archiving and communication systems (PACS) because of the relatively small quantity of digital data that are generated, leading to reduced requirements for storage, display, and transmission compared with those found in radiology. The PACS in nuclear medicine is characterized by use of a single computer as a central storage, display, and analysis node. Images are acquired with use of small, low-cost computers attached to each camera.