Norman L. Martin

Treatment of metastatic bone pain with strontium-89

We have utilized 89Sr as palliative treatment for bone pain secondary to metastatic cancer in the skeleton of over 200 patients. The best results have been in patients with carcinoma of the prostate (80% response rate) and breast (89%). Results in a small number of patients with a variety of other cell types were not nearly as encouraging. Strontium-89 provides excellent palliation in the management of bone pain secondary to prostate and breast carcinoma.

B-scan ultrasound evaluation of the pancreas. Advantages and accuracy compared to other diagnostic techniques.

Over 200 patients were examined by B-scan ultrasound for suspected pancreatic disease; in 94 cases a final diagnosis was proved. The diagnostic accuracy of ultrasound, upper gastrointestinal examination, isotope pancreatography, and arteriography is compared. The diagnostic ultrasound features of the various pancreatic disease processes are described. Pancreatic sonography provides the most accurate and least expensive method for evaluating the pancreas with no known patient morbidity. The upper gastrointestinal series and radionuclide study are complementary to sonography. Ultrasound should be the initial examination for the evaluation of patients with suspected pancreatic disease or epigastric mass.

Measurement accuracy of proximal femoral geometry using biplanar radiography.

Summary: Experimental testing indicates that the neck-shaft angle of the proximal femur can be reliably measured from biplanar radiographs, but torsion cannot. Calculated torsion varies significantly from true torsion as a function of the error created by femoral rotation, while the calculated neck-shaft angle is invariant with respect to rotation even though the calculated neck-shaft angle is mathematically dependent on calculated torsion. Theoretical considerations support this finding and demonstrate for the first time why it is true. This study demonstrates that clinical measurements of frontal plane hip deformities using existing biplanar radiography are quite accurate, but clinical measurements of torsional abnormalities are unreliable. These errors can be minimized if investigators specify the angle of the lateral X-ray beam on the anteroposterior film using methods described in this paper and if patient position is radiographically verified. The magnitude and types of errors inherent in biplanar radiography should be considered in planning preoperative strategies and in postoperative assessments of hip geometry.

The effects of lossy compression on the detection of subtle pulmonary nodules.

We examined the ability of radiologists to detect pulmonary nodules in computed radiographic (CR) chest images subjected to lossy image compression. Low-contrast 1-cm diameter targets simulating noncalcified pulmonary nodules were introduced into clinical images and presented to ten radiologists in a series of two-alternative forced-choice (2AFC) observer experiments. The percentages of correct observer responses obtained while viewing noncompressed images (1:1) were compared with those obtained for the same images compressed 7:1, 16:1, 44:1, and 127:1. The images were compressed using a standard full-frame discrete cosine transform (DCT) technique. The degree of compression was determined by quantizing Fourier components in various frequency channels and then Huffman encoding the result. The data show a measurable decline in performance for each compression ratio. Through signal-to-noise ratio (SNR) analysis, we found that the reduction in performance was due primarily to the compression algorithm that increased image noise in the frequency channels of the signals to be detected.

A case for 77-bromine labelled radiopharmaceuticals.

Abstract The use of radiobromine as a label for radiopharmaceuticals was demonstrated by the synthesis of 82 Br-2,4-dibromoesterone, using the procedure of Slaunwhite and Neely . Structure determination of the brominated steroid was accomplished by the use of melting point data, paper chromatoraphy and mass spectra analysis. Tissue distribution studies in animals demonstrated rapid blood clearance and excretion in the bile. Calculated radiation exposure dose for 77 Br-2,4-dibromoestrone is less than 131 I-Rose Bengal. A significant difference in tissue distribution was found when the data for 82 Br-2,4-dibromoesterone was compared to literature values for 82 Br-7,8-dibromoesterone. Comparison with 131 I-Rose Bengal and 99 m Tc-pyrodoxylideneglutamate suggest 77 Br-2,4-dibromoestrone would be a tracer of potential value for liver and gallbladder function studies.

Cost Of Managing Digital Diagnostic Images For A 614 Bed Hospital

The cost of recording and archiving digital diagnostic imaging data is presented for a Radiology Department serving a 614 bed University Hospital with a large outpatient population. Digital diagnostic imaging modalities include computed tomography, nuclear medicine, ultrasound, and digital radiography. The archiving media include multiformat video film recordings, magnetic tapes, and disc storage. The estimated cost per patient for the archiving of digital diagnostic imaging data is presented.

Film mammography: new low radiation technology.

A new mammographic technique with Kodak MIN-R film and a Kodak MIN-R screen in a vacuum package has been evaluated in 607 cases. Direct mammographic comparison is made with the Du Pont Lo-dose system in the first 101 patients. The system provides excellent diagnostic quality images with at least a two-fold reduction in patient exposure compared to other current mammographic techniques.

A method for radiographically measuring true femoral rotation.

Most current protocols for radiography of the hip do not require verification that the femur is in a rotationally neutral position. However, previous research indicates that any deviation in femoral rotation from a neutral position is transformed, degree for degree, to an error in calculated femoral tor~ i o n . ~ Ghelman4 suggested using a cross-table lateral view of the femoral condyles to verify femoral position, but the technique relied on superimposition of the femoral condyles only. If the condyles were not superimposed, the lower extremity was rotated until superimposition was achieved. This required either the use of fluoroscopy or multiple roentgenographic exposures to position the femur exact, thus increasing the radiation dosage to the patient and time involved in positioning the patient. Furthermore, the leg had to be immobilized once the neutral position was attained.

Salient Characteristics Of A Distributed Diagnostic Imaging Management System For A Radiology Department

The design and implementation of a distributed diagnostic imaging management system is new. The goal of these distributed systems is to integrate digital diagnostic imaging modalities through a local area network. This paper provides an estimate of the current utilization of digital diagnostic image data and provides the user logical functions required for each node of the distributed system.

Phosphor plate mammography: contrast studies and clinical experience

Mammography and accurate microcalcification detection require very good spatial resolution. We have compared the diagnostic capabilities of reduced-exposure, third-generation, 5 cycles/mm computed radiography (CR) phosphor plates with conventional screen-film in 67 patients. No difference in diagnostic accuracy was detected. The digital characteristics of storage phosphor plates erabled us to study the relationship between contrast and spatial resolution. We developed a computer program to identify a single 100 μm pixel in a digital image and assign various gray levels to that pixel. Using this model, we determined that, for our 5 cycles/mm CR system, the imaged contrast of a 100 μm object was 62% of the original contrast. Current 5 cycles/mm phosphor plate systems cannot adequately detect microcalcifications that approximate 100 μm or smaller unless a magnification technique is used.