Kirkman G. Baxter

Radionuclide Therapy of Intractable Bone Pain: Emphasis on Strontium-89

Management of bone pain in patients with multiple osseous metastases is a significant clinical problem. Phosphorus-32 has been used as systemic radioisotope therapy for the management of bone pain for over 40 years. However, significant hematological depression usually results and its use is limited. More recently, the bone-seeking radiopharmaceuticals strontium-89, samarium-153-ethylenediaminetetramethylene phosphonic acid, and rhenium-186-hydroxyethylidene diphosphonate have all been used as palliative treatment for patients with clinically significant bone pain. Excellent clinical responses with acceptable hematological toxicity have been observed. The clinical results rival those of external beam radiation therapy, with fewer systemic and hematological side effects. Systemic radionuclide therapy is indicated in the management of patients with painful metastatic prostate cancer in bone as soon as they escape primary hormonal management. This therapy also should play a role in the management of many patients with advanced breast cancer metastatic to bone. The role of radionuclidic therapy in osseous metastases from other malignancies is still being investigated. These compounds also hold promise as primary therapy for tumors of osseous origin. Systemic radionuclide therapy of painful bony metastases will become common in nuclear medicine practice in the next decade.

Teleradiology using switched dialup networks

A dialup wide-bandwidth digital teleradiology system is discussed. A laser film digitizer and a gray scale display system are used at Irwin and Munson Army Community Hospitals to digitize radiographic films and display digital images. A laser film printer at the University of Kansas Medical Center generates a film hardcopy of the transmitted digital data, and an interactive gray scale display is used to review the digital image data. The communication system consists of dialup switched multiple 56000 b/s digital channels, transmitting digital image data in parallel. Conventional radiographic films, multiformat camera films, and laser printed films from multimodality imaging systems have been successfully digitized, transmitted, and laser film recorded or gray scale displayed. It was found that the system provided clinically acceptable image quality reproductions. >

Wide area networks for teleradiology.

Teleradiology networks transmit digital radiographic images from one location to another. These networks are wide area networks. Teleradiology networks are used for diagnostic purposes and preview tasks. Wide area networks for teleradiology use public service switching. The use of fiber optics networks provide reduced costs and increased flexibility. An example is presented that compares the cost of teleradiology networks.

Image data compression using a new floating-point digital signal processor

A new dual-ported, floating-point, digital signal processor has been evaluated for compressing 512 and 1,024 digital radiographic images using a full-frame, two-dimensional, discrete cosine transform (2D-DCT). The floating point digital signal processor operates at 49.5 million floating point instructions per second (MFLOPS). The level of compression can be changed by varying four parameters in the lossy compression algorithm. Throughput times were measured for both 2D-DCT compression and decompression. For a 1,024×1,024×10-bit image with a compression ratio of 316∶1, the throughput was 75.73 seconds (compression plus decompression throughput). For a digital fluorography 1,024×1,024×8-bit image and a compression ratio of 26∶1, the total throughput time was 63.23 seconds. For a computed tomography image of 512×512×12 bits and a compression ratio of 10∶1 the throughput time was 19.65 seconds.

Radiology Image Management Networks

A radiology image management network connects together imaging equipment, display workstations, hardcopy units, electronic archiving systems, and department information management systems. The imaging equipment is connected to the network through image acquisition nodes. Image data is transmitted using a local area network. Images are displayed and manipulated on gray scale display workstations. Image data is stored at archiving nodes. Desired recordings of the image data are generated at hardcopy nodes. Patient data is acquired from the department or hospital information management system using gateways.