Stephen W. Hughes

Voxel‐based localization in frame‐based and frameless stereotaxy and its accuracy

The problem of accurate stereotactic localization and registration of targets in computed tomography (CT) data sets is addressed, in particular the effect of using a single transformation matrix to map voxel coordinates onto stereotactic coordinates. An algebraic approach to the calculation of stereotactic target coordinates in tomographic data acquired with conventional stereotactic localizers is presented. The volume transformation matrix (VTM) is discussed, which is useful for the registration of volumetric data sets, and also corresponds to the rigid body transformation matrix used in many so-called frameless registration methods. The VTM can lead to accuracy degradation, in particular due to patient movement during scanning. Simulations were performed and CT data sets acquired with patients fitted with the CRW or the GTC stereotactic localizer were analyzed. Comparison of STM- and VTM-derived stereotactic coordinates shows an average overall registration error of 0.1 mm for anesthetized patients and in the range 0.6-1.4 mm for nonanesthetized patient. Accuracy maps are described that enable the user to visualize the registration error in relation to the data. It is shown that the effect of fiducial point localization error and patient movement for VTM-based localization is minimized when all available fiducials in the region of interest are used. The significance of these results is discussed, and methods are proposed to minimize these effects for frame-based and frameless registration methods.

Estimation of fetal lung volume using enhanced 3-dimensional ultrasound: a new method and first result

Objective To measure fetal lung volume using a computer based, enhanced, 3‐dimensional ultrasound imaging system.

3-D reconstruction of an ancient Egyptian mummy using X-ray computer tomography.

Computer tomography has been used to image and reconstruct in 3-D an Egyptian mummy from the collection of the British Museum. This study of Tjentmutengebtiu, a priestess from the 22nd dynasty (945-715 BC) revealed invaluable information of a scientific, Egyptological and palaeopathological nature without mutilation and destruction of the painted cartonnage case or linen wrappings. Precise details on the removal of the brain through the nasal cavity and the viscera from the abdominal cavity were obtained. The nature and composition of the false eyes were investigated. The detailed analysis of the teeth provided a much closer approximation of age at death. The identification of materials used for the various amulets including that of the figures placed in the viscera was graphically demonstrated using this technique.

A technique for measuring the surface area of articular cartilage in acetabular fractures

The aim of this study was to develop a reliable technique for measuring the area of a curved surface from an axial computed tomography (CT) scan and to apply this clinically in the measurement of articular cartilage surface area in acetabular fractures. The method used was a triangulation algorithm. In order to determine the accuracy of the technique, areas of hemispheres of known size were measured to give the percentage error in area measurement. Seven such hemispheres were machined into a Perspex block and their area measured geometrically, and also from CT scans by means of the triangulation algorithm. Scans of 1, 2 and 4 mm slice thickness and separation were used. The error varied with slice thickness and hemisphere diameter. It was shown that the 2 mm slice thickness provides the most accurate area measurement, while 1 mm cuts overestimate and 4 mm cuts underestimate the area. For a hemisphere diameter of 5 cm, which is of similar size to the acetabulum, the error was -11.2% for 4 mm cuts, +4.2% for 2 mm cuts and +5.1% for 1 mm cuts. As expected, area measurement was more accurate for larger hemispheres. This method can be applied clinically to quantify acetabular fractures by measuring the percentage area of intact articular cartilage. In the case of both column fractures, the percentage area of secondary congruence can be determined. This technique of quantifying acetabular fractures has a potential clinical application as a prognostic factor and an indication for surgery in the long term.

Survival following interstitial brachytherapy for recurrent malignant glioma.

SummaryThe treatment of recurrent malignant glioma is difficult and at present largely disappointing. Furthermore the results of any treatment modality need to be interpreted with knowledge regarding patient selection and timing of treatment. The results of interstitial brachytherapy using iodine-125 in 23 patients are presented. There were no operative complications. Median survival time from tumour recurrence and implantation was 36 and 25 weeks respectively. Karnofsky Performance Status (KPS) was significantly associated with survival, though patient age, original tumour histology, prior chemotherapy, and time to recurrence were not. Treatment does confer modest survival benefit as compared to controls, but our results are not as impressive as others. Reasons for this finding are discussed.

Virtual reconstruction and morphological analysis of the cranium of an ancient Egyptian mummy

A mummy of an Egyptian priestess dating from the 22nd dynasty (c. 770 BC), completely enclosed in an anthropoid (human shaped) coffin, was scanned on a CT scanner. An accurate reconstruction of the cranium was generated from 115 × 2 mm CT images using AVS/Express on a SGI computer. Linear measurements were obtained from six orthogonal cranial views and used in a morphometric analysis software package (CRANID). The analyses carried out were both linear and nearest neighbour discriminant analysis. The results show that there is a 52.9% probability that the mummy is an Egyptian female, with a 24.5% probability that the mummy is an African female. Thus the technique confirms that the coffin contains an Egyptian female, which is consistent with the inscription on the coffin and the shape of the pelvic bones as revealed by plain X-rays. These results show that this technique has potential for analysing forensic cases where the bones are obscured by soft tissue and clothing. This technique may have an application in virtual autopsies.

Ultrasound Assessment of Articular Cartilage: Analysis of the Frequency Profile of Reflected Signals from Naturally and Artificially Degraded Samples

This article investigates in vitro the hypothesis that the frequency profile of ultrasound reflections may be used to characterize degradation and osteoarthritic progression in articular cartilage, irrespective of the effects of transducer orientation. To this end, ultrasound echoes were taken in the time domain from the articular surface and osteochondral junction of normal, collagen meshwork-disrupted, proteoglycan-depleted, and osteoarthritic samples, converted to the frequency domain by fast Fourier transform and analyzed. Our results show the significant effects of specific enzymatic degradation programs on the ultrasound frequency profile of reflections from the cartilage surface and osteochondral junction, and their manifestation in the tissue surrounding a focal osteoarthritic defect. Collagen meshwork disruption was most apparent in the profile of reflections from the articular surface, while proteoglycan depletion was most clearly observed in the reflections from the osteochondral junction. The reflected signals from the osteochondral junction may further contain information about the subchondral bone. From these results we proposed that the analysis of specific frequencies of reflected ultrasound signals has the potential to differentiate normal from degraded articular cartilage-on-bone, when the angle of incidence can be controlled within a ±1.2° limit. This encourages further research into the effects of progressive artificial degradation of the cartilage matrix and subchondral bone on the spectral profile to quantify the relationship between the frequency profile and the level of specific degradation in naturally degraded joints.

Medical Ultrasound Imaging.

Ultrasound is used extensively in the field of medical imaging. In this paper, the basic principles of ultrasound are explained using ‘everyday’ physics. Topics include the generation of ultrasound, basic interactions with material and the measurement of blood flow using the Doppler effect.

A practical example of a siphon at?work

In this article, some classroom experiments are described for correcting the common misconception that the operation of a siphon depends on atmospheric pressure. One experiment makes use of a chain model of a siphon and another demonstrates that flow rate is dependent on the height difference between the inflow and outflow of a siphon and not atmospheric pressure. A real-life example of the use of a siphon to refill a lake in South Australia is described, demonstrating that the siphon is not only of academic interest but has practical applications.

A technique for fast and accurate measurement of hand volumes using Archimedes' principle

A new technique for measuring hand volumes using Archimedes principle is described. The technique involves the immersion of a hand in a water container placed on an electronic balance. The volume is given by the change in weight divided by the density of water. This technique was compared with the more conventional technique of immersing an object in a container with an overflow spout and collecting and weighing the volume of overflow water. The hand volume of two subjects was measured. Hand volumes were 494±6 ml and 312±7 ml for the immersion method and 476±14 ml and 302±8 ml for the overflow method for the two subjects respectively. Using plastic test objects, the mean difference between the actual and measured volume was -0.3% and 2.0% for the immersion and overflow techniques respectively. This study shows that hand volumes can be obtained more quickly than the overflow method. The technique could find an application in clinics where frequent hand volumes are required.