Arch W. Templeton

Solitary Pulmonary Lesions: Computer-Aided Differential Diagnosis and Evaluation of Mathematical Methods

The Roentgenographic differential diagnosis of solitary lung nodules is a difficult problem (3). In a significant group of patients the roentgen findings are virtually nonspecific, while in other cases the radiologist feels confident in making a specific diagnosis. Thus, the radiologist faces a twofold dilemma. Not only must he decide what disease process is most likely responsible for the roentgenographic findings, but he must also determine how confident he can be about his diagnosis in each case. To resolve the type of diagnostic problem discussed above, Ledley and Lusted (4) proposed a mathematical approach based on Bayes theorem of prior probabilities. With the aid of the digital computer, this method has been applied to the differential diagnosis of many disease groups, including congenital heart lesions (9), primary bone tumors (6), thyroid dysfunctions (2), and gastric ulcers (10). All of these studies have employed not only Bayes theorem but also the assumption that the signs and symptoms used ...

The Computer Analysis and Diagnosis of Gastric Ulcers

THE VALUE of roentgenographic examination of the stomach in patients with upper gastrointestinal symptoms is well established (10, 12), and the accuracy of the roentgenologist in detecting all stomach abnormalities has been variously cited to be between 85 and 95 per cent (1, 3, 4, 7, 10). Even so, one of the most controversial differential diagnoses confronting a radiologist is that of whether a gastric ulcer is benign or malignant (15). Many roentgen signs have been described which are thought to be of value in making this differentiation, but the statistical significance of the various clinical findings and roentgenographic signs has never been established. The use of computers in analyzing data relating to medical disease entities is widely accepted. Computer diagnosis has exceeded the diagnostic accuracy of the trained radiologist in selected bone tumors (8). Radiographic manifestations of carcinoma of the lung have also been evaluated by computer technics (9). The statistical evaluation of 70 radiog...

The computer evaluation and diagnosis of congenital heart disease, using roentgenographic findings.

Many roentgenographic signs have been described (2,4,8, 9, 11, 13, 18) which are considered characteristic of specific congenital heart abnormalities, but no single study has examined the frequencies with which each of these signs is distributed over a broad spectrum of congenital defects. This study evaluates the occurrence of 20 roentgenographic parameters as found in 9 uncomplicated congenital heart lesions. The 9 lesions include secundum type of interatrial septal defect (IASD), primum type of interatrial septal defect, interventricular septal defect (IVSD), patent ductus arteriosus (PDA), tertralogy of Fallot, coarctation of the aorta, pulmonary valve stenosis, aortic valve stenosis, and complete transposition of the great vessels. These defects comprise about 87 per cent of all congenital heart deformities (10). An accurate evaluation of the 20 roentgenographic parameters and their occurrence in different congenital heart lesions required a rapid and uniformly consistent method of handling data. The...

RADIATE: A New Concept for Computer Coding, Transmitting, Storing, and Retrieving Radiological Data

The rapid transcription and transmission of the radiologists opinion into the written report on the ward is a goal constantly sought but rarely achieved. Storage of vast quantities of radiologic (and all medical) information is an acute and expanding problem. The expeditious retrieval of accurately stored information is nearly impossible. Electronic digital computers which process, transmit, store, and retrieve large amounts of data at speeds which approach that of light are the tools most capable of efficiently performing these functions for the radiologist. Computers are being used for the diagnosis and grading of certain bone tumors (3). Various criteria for diagnosing benign and malignant gastric ulcers (9), carcinoma of the lung (4), and thyroid disease (1) are being continually evaluated and modified by computer-compiled frequency distribution and probability significance tables. Computer retrieval and analysis of electronically scanned roentgenograms are under investigation (7). Dosimetry calculat...

Combined superior vena cavography and azygography in patients with suspected lung carcinoma.

Intraosseous costal or spinous process azygography has occasionally been used for visualization of the thoracic venous system in the preoperative assessment of carcinoma of the lung (2, 7). Obstruction of the superior vena cava or extrinsic compression or invasion of its lumen is a relatively frequent finding in the natural history of pulmonary carcinoma, especially when the lesion originates in the right lung (3). In 85 per cent of 33 cases coming to autopsy in one series, cancer was the etio-logic agent producing superior vena caval obstruction (1). To our knowledge, the combined use of superior vena cavography and azygography as part of the preoperative assessment of pulmonary carcinoma has not been previously reported. Our experience with 63 consecutive patients who have been evaluated for suspected primary lung carcinoma by the use of superior vena cavography and azygography forms the basis of this report. The roentgenographic patterns of abnormality are evaluated and presented. The importance of pro...