Robert J. Telepak

Preliminary assessment of computed tomography and satellite teleradiology from operation desert storm

Computed tomography at military transportable hospitals was used for the first time during the recent Operation Desert Storm in the Saudi Arabian desert. Scan quality was excellent and the scans proved clinically important in patient management. A teleradiology link via satellite to the U.S. mainland was also successfully employed. The objectives of the teleradiology link were to validate the concept distant interpretation of images obtained on the battlefield and to provide specialty radiology consultation. This technology shows great promise for future applications, both for combat casualty care and for civilian disaster medical support operations.

Radionuclide imaging in the assessment of lung injury

Nuclear medicine imaging techniques are being more widely applied to study a variety of lung injuries. Ventilation and perfusion imaging is often superior to other roentgenographic techniques for establishing the diagnosis and demonstrating the extent of such injuries. At several large burn centers, the Xe-133 washout technique has become the cornerstone for diagnosing early inhalation injury. The overall accuracy of this procedure is 92%. Regional decreases in ventilation and perfusion can reliably localize aspirated radiolucent foreign bodies. Disproportionate perfusion changes are often the earliest indicator of radiation pneumonitis and other forms of vascular injury. Other types of injury, such as gastropulmonary aspiration, blunt trauma, and near-drowning, require further evaluation before the ultimate role of nuclear imaging is defined. An imaging technique to assess capillary permeability in the adult respiratory distress syndrome would be of great clinical benefits.

Fourier phase analysis in non-cyclic dynamic studies.

Single harmonic Fourier amplitude and phase (FA/P) analyses of 129 radionuclide angiographic (RNA) studies were found to reflect accurately the sequence and quantity of perfusion determined in the independently interpreted RNA studies. In addition, the anatomic detailing in peripheral studies (hands, feet, etc.) was considered superior to that obtained in RNA studies.

Chest radionuclide angiography in the evaluation of pulmonary masses

A retrospective analysis of 104 chest radionuclude angiography (CRNA) studies establishes the utility of this procedure in the evaluation of pulmonary malignancies and benign masses. Remarkable abnormalities in the perfusion of the lungs were identified in 36 (58%) of 62 cases that were not predictably normal or predictably abnormal form the clinical setting. While 60 of these 62 cases involved malignancy being evaluated for metastases, only 21 (34%) had metastases Identified by radionuclide bone or liver-spleen scintigraphy. In addition to diagnosis of superior vena cava obstruction, the CRNA may have a more frequent application as an adjunct to routine scintigraphic studies directed to the identification of metastatic disease.

Computer edge displays for cardiac wall motion evaluation.

Several computer display techniques in both black and white and color are described. Use of such techniques improves the qualitative evaluation of ECG-gated cardiac blood pool studies, especially by less experienced observers. Detection of wall motion at the interface between the myocardial wall and the labeled blood within the cardiac chambers is greatly enhanced. No additional equipment nor computer processing time is required to use these display schemes.