Computer Assisted Radiology Computergesti.itzte Radiologie Proceedings of the International Symposium Vortrage des lnternationalen Symposiums

CAR '91 Computer Assisted Radiology

Edited by/Herausgegeben von H. U. Lemke, M. L. Rhodes, C. C. Jaffe, and R. Felix

Organizer/Organisator: H. U. Lemke

With 389 Figures/Mit 389 Abbildungen

Springer-Verlag Berlin Heidelberg GmbH

Prof. Heinz U. Lemke, Ph. D.

Technische Universitat Berlin lnstitut fUr Techn.lnformatik Berlin, Federal Republic of Germany

Michael L. Rhodes, Ph. D.

Toshiba, America MRI, Inc., San Francisco, USA

Prof. C.C.Jaffe, M.D.

Yale University, Dept. of Diagnostic Radiology New Haven, Conn., USA

Prof. Roland Felix, M.D.

Freie Universitat Berlin Universitatsklinikum Rudolf Virchow Berlin, Federal Republic of Germany

ISBN 978-3-662-00809-6 ISBN 978-3-662-00807-2 (eBook) DOI 10.1007/978-3-662-00807-2

This work is subjectto copyright. All rights are reserved, whether the whole or part ofthe material is concerned, specifically the rights of translation, reprinting, re-use of illustrations, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions ofthe German Copyright Law ofSeptember9, 1965, in its current version and a copyright fee must always be paid. Violations fall under the prosecution act of the German Copyright Law.

© Springer-Verlag Berlin Heidelberg 1991 Originally published by Springer-Verlag Berlin Heidelberg in 1991 Sofatcover reprint of the hardcover 1st edition 1991

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.

Typesetting: Camera ready by authors

68/3020 543210 - Printed on acid-free paper

Honorary Chairman: Auguste Wackenhetm, Centre Hosp1talier Regionale et Un1vers1ta1re Strasbourg, France

Symposium Committee

Heinz U Lemke Techn1sche Un1versitat Berlin, FRG

Mtchae/ L Rhodes lndustnal Adv1sory Board, San Franc1sco, USA

Roland Feltx Fre1e Un1versitat Berlin, FRG

Conrade C Jaffe Yale Un1versity, New Haven, USA

Symposium-Organizer

Prof Dr He1nz U Lemke c/o lnst1tut fOr Techn1sche lnformat1k Techn1sche Un1verS1tat Berlin Sekr CG/FR 3-3 Franklinstr 28 -29 D-1000 Berlin 10

Conference Officer Editorial Assistant

Bibiana R Moser CAR'91 c/o Univers1tatskl1n1kum Rudolf Vlrchow Wedd1ng, Alles Rtintgenhaus, Raum 1005 Augustenburger Platz 1 D-1000 Berlin 65 Tel +49 30 4505 2044 Fax +49 30 4505 2043

CAR.91 in cooperation with:

TU Techmsche Umvers1tat Berlin

FU Fre1e Umvers1tat Berl1n

acm AssociatiOn for Comput1ng Machlnery/SIGBIO

Deutsche Rontgengesellschaft

IAPR International AssociatiOn for Pattern Recogmt1on

EuroPACS European Soc1ety P1cture Arch1v1ng and Commumcat1on Systems

IEEE COMPUTER SOCIETY Computational Med1c1ne

S.I.R.M.N. Assoc1az1one ltal1ana d1 Rad1olog1a Med1ca e Med1c1na Nucleare

SPIE

Gl

ACR

NVvRd

BIR

The International Soc1ety for Optical Eng1neenng

Gesellschaft fur lnformat1k

Amencan College of Radiology

Nederlandse Veren1g1ng voor Rad10d1agnost1ek

The Bnt1sh Institute of Radiology

Deutsche Gesellschaft fur Blomed1z1n1sche Techn1k

JRS Japan Rad1olog1cal Soc1ety

RCR The Royal College of Rad1olog1sts

Soc1ete Franca1se de Rad1olog1e Med1cale

I MAC Image Management and Commumcat1on

Osterre1ch1sche Rontgengesellschaft

SGRNM

SCAR

WHO

Schwe1zensche Gesellschaft fur Rad1olog1e und Nuklearmed1z1n

Soc1ety for Computer Applications 1n Radiology

World Health Orgamsat1on

The Polish Medical Rad1olog1cal Soc1ety

DOCUMED lmag1ng and V1sual Documentation 1n Med1c1ne

IPMI Information Process1ng 1n Medical lmag1ng

Soc1ety for Computer Ass1sted Radiology, Peoples RepubliC of Ch1na

AMA Amencan Med1cal Assoc1at1on

The Bulganan Sc1ent1f1c Soc1ety of Roentgenology, Radiology and Rad1ob1ology

CSRS Czechoslovak Rad1olog1cal Soc1ety

Rad1olog1cal Soc1ety of the USSR

GMDS

E.S.P.R.

Gesellschalt fur Med1z1n1sche Dokumentat1on, lnformat1k und Stat1st1k e V

European Soc1ety of Paed1atnc Radiology

Program Committee

M1tsuyuk1 Abe, MD Kyoto Untvers1ty, Japan

Paul R Algra, MD VU-AZH Amsterdam, NL

Ronald L Arenson, MD Hospital of the Un1v of PA, USA

Albert R Bakker, Ph D Le1den Un1vers1ty, NL

Roger A Bauman, MD Mass Gen Hasp , Boston, USA

Yves B1za1s, Ph D Nantes H6p1tal, France

Antomo Ch1esa, MD Spedal1 C1V1I1 Brescia, Italy

Claus D Claussen, MD Eberhard-Kari-Un1v Tub1ngen, FRG

Alan Colchester, M D Guy's Hosp1tal, London, UK

Bernard Crowe, B A , MPH Australian lnst of Health, AUS

Hans Dahlm, Ph D HELAX Uppsala, Sweden

Ludovico Dalla Palma, M D Osp d1 Catt1nara, Tneste, Italy

Adnan K D1xon, MD Addenbrooke's Hasp , Cambndge, UK

Samuel J Dwyer, Ill, Ph D Un1vers1ty of Kansas, USA

Uwe Faust, Ph D Un1vers1tat Stuttgart, FRG

Eckhard Fleck, M D Deutsches Herzzentrum, Berlin, FRG

Richard M Fnedenberg, M D Un1v of Cal , Med1cal Center, USA

Dav1d Gilday, MD , B E E Hasp S1ck Ch1ldren, Toronto, CON

Melvyn Greberman, MD, MPH Ctr Dev and Rad Health, USA

Chnst1an F C Gremacher, Ph D S1emens AG, Erlangen, FRG

Karl Hemz Hahne, Ph D UK Eppendorf, Hamburg, FRG

Herw1g Imhof, MD AKH W1en, Austna

Taman Inouye, MD Un1vers1ty of Tsukuba, Japan

Herbert J Kaufmann, MD Fre1e Un1vers1tat Berlin, FRG

Philipp Lang, MD Un1v of Cal , San Francisco, USA

Math1as Langer, MD Fre1e Un1vers1tat Berlin, FRG

Patnc1a Layze/1 General Electnc - MS. France

Martm J Lipton, MD Un1vers1ty of Chicago, USA

We1xue Lu, Ph D Zhe11ang Un1v , P R of Ch1na

Memhard Lunmg, MD Humboldt Untv- Chante, Berlin, FRG

Tomoho Maeda, MD Koehl Med1cal School, Japan

Roman Marcmiak, MD Med1cal Academy, Wroclaw, Poland

D1etnch Meyer-Ebrecht, Ph D RWTH Aachen, FRG

Seong K Mun, Ph D. Georgetown Un1v Hosp . USA

Stelios Orphanoudak1s, Ph D lnst of Camp Sc1ence, Greece

Michael Osteaux, MD Un1vers1ty Hasp of Brussels, Belg1um

Helmut Oswald, Ph D Deutsches Herzzentrum, Berlin, FRG

Stephen M P1zer, Ph D Un1vers1ty of North Carolina, U SA

Osman M Rat1b, M D , Ph D Umvers1ty Hosp1tal of Geneva, CH

Otto R1enhoff, M D Ph111pps-Un1vers1tat Marburg, FRG

D D Robertson, MD , Ph D J Hopk1ns Hasp , Baltimore, USA

Plimo Ross1, MD Un1vers1ta degl1 Stud1 d1 M1lano, Italy

Wolfgang Schlegel, Ph D DKFZ, He1delberg, FRG

Mohamed Hafez Shenf, M.D EI-Azhar Un1vers1ty, Ca1ro, Egypt

Jack Sk/ansky, Ph D Un1vers1ty of Cal1forn1a, lrv1ne, USA

H S1egfned Stiehl, Ph D Un1vers1tat Hamburg, FRG

E11ch1 Takenaka, MD. Nat Defence Med College, Japan

Klaus D Toenmes, Ph D Techmsche Un1v Berlin, FRG

Jayaram K Udupa, Ph D Un1vers1ty of Pennsylvania, USA

Michael W Vanmer, M.D Mall1nckrodt lnst of Rad , USA

Ench Voege/1, MD Kantonssp1tal Luzern, CH

Gabnele v Vo1gt, Ph D Techntsche Un1v Berlin, FRG

Thomas Wendler, Ph D Philips GmbH, Hamburg, FRG

Kari-Jurgen Wolf, MD Fre1e Un1vers1tat Berlin, FRG

/an Young, PhD GEC Research Labs , UK

Prelude

UN SIECLE DE RADIOLOGIE

Avar lJ'le date de naissanc:e predispose a une date de mat. Ne pas avoir de date de naissance, corrme Ia medecine en g{meral, predispose a l'etemite.

A.W .. in "Les radiologistes, imagers de Ia Mectecine·. *

La culture occidentale a toujours ete preoccupee d'images. Le deuxieme Concile de Nicee (787) et celui de Trente (1561) ont precise Ia valeur de l'image et redoutaient l'idoiAtrie. En anatomie l'image etait dessinee et multipliee pour les besoins pedagogiques. D'anciens ouvrages presentent des images souvent erronees , puis rectifiees au til des siecles. L'evolution des images est stagnante, relative au monde objectif des surfaces reflechies des objets, des plantes, des animaux et des personnes. Des images metaphysiques sont imaginees, porteuses d'angasse, de p9che, de notion de ciel et d'enfer .... • Les images sont plus ideopoi"lrtiques que les bruits, les saveurs et les odeurs· * . L'ere des cathedrales omees a l'exces par Ia statuaire et les vitraux se termine avec !'invention de l'imprimerie par Gutenberg. Le monde tridimensionnel est represente d'abord par Ia peinture et Ia gravure puis par Ia reproduction photographique .. La peinture reste toutefois classique. Elle evoque Ia metaphysique grAce a de nouvelles techniques qui ne sont pas de nouvelles technologies. La troisieme dimension est suggeree, mais reste cachee. Des tentatives de nouveau style sont Ia perspective, Ia vision stereoscopique (futur style de "face et profil" de Picasso), l'expressionnisme et l'impressionnisme avec le pointillisme (future digitalisation), le fauvisme, Ia caricature ... et surtout Ia peinture abstraite (future image traitee). Les nouvelles images ont envahi le monde et impose le style americano-europeen. Les cultures asiatiques, du moins le Japon, semblent accepter cette imagerie et participant a sa diffusion mondiale (image tridimensionnelle). Mais revenons-en a W.C.Roentgen eta l'image roentgenienne qui est !'absorption des RX par Ia matiere. C'est au cours des toutes premieres annees de ce siede que l'image roentgenienne s'est imposee au monde medical. Elle est a l'origine de Ia corporation des "radiologistes·, un groupe de specialistes des radiations. Tres rapidement ils vont

* Les radiologistes, imagiers de Ia mectecine. Axone, Mon1pellier, 2eme Edition, 1986

IX

se separer en ·radiodiagnosticiens· et en ·radiotherapeutes·. II faudra en fait distinguer les radiodagnosticiens et les radiophysiciens ou les racliocliniciens et les raclio­therapeutes Les racliocliniciens, dort je suis, s'orienteront vers Ia radiologie d'organes Tres rapiclement les radiologistes ne pourroot plus maitriser !'ensemble des techniques tant est grand le nombre des innovations durant cette deuxieme partie du vingtieme si6cle : tomographie, produits de contraste, seriographies, amplificateurs de brillance, scintigraphie, echographie, scanographie et resonance magnetique. On assiste a une grande diversification et a une instabilite des sources d'image qui deviennent multiples et m6me redondantes. Les radiologistes sont responsables du developpement de Ia semiologie radio-anatomique. Mais ce sont les inventeurs et les decouvreurs qui induisent les innovations. lis ne viennent pas de Ia radiologie: W.C. Roentgen est physician comme Pierre et Marie Curie, Bocage est officier, Ziedses des Plantes est d'abord ingenieur, Dos Santos est chirurgien, Egas Moniz et Oldendorf sont neurologues, Cormack est mathematician et Hounsfield est ingenieur.

Le ·concert d'image· entraine Ia dispersion des donnees elementaires avec chaque nouveau type d'image. "Le train radiologique circule a grande vitesse et il n'y a que peu de gares sur le reste de son trajet. II s'agira bientOt de changer de train sans oublier nos bagages .... : • • L'informatique nous attend. Elle est en train decreer les lettres de noblesse du specialiste de Ia nouvelle radiologie, le medecin specialiste appele CSMI ( computer specialist of medical imaging). Est-ce a dire qu'il annonce Ia fin de Ia "vieille radiologie", celle qui a une date de naissance, contrairement a Ia Medecine qli n'en a pas , ce qui Ia predispose a l'etemite ? . Ce nouveau specialiste est cartes un radiologiste mais prefigure ce qui sera le chef d'orchestre du concert des images. Dans l'equipe des imagiers strasbourgeois nous confions Ia fonction de CSMI au Docteur G Zoellner qui est medecin imagier ( radiologiste) et informaticien. II devra disposer d'une infrastructure modeme avec un laboratoire de recherche de Ia F aculte de Medecine (Systemes Ortevre et Oclile). II sera charge de Ia mise en place des systemes PACS, HIS et surtout d'un systeme RIS qui reste a perfectionner. En marge de cette ~ation il trouvera Ia solution de l'archivage des images et ouvrira Ia porte des domaines encore secrets des systemes experts de l'image et de !'intelligence artificielle. Les ·nouveaux radiologistes· sauront maitriser les nouveaux problemas que j'ai evoques : l'economie des images medicales et Ia redondance actuelle. Le foisonnement des images a ete evoque par notre ami, P.Castan • : "Ia radiologie modeme ... est devenue un carrefour interdisciplinaire .... Ce carrefour est dangereux, car beaucoup peuvent se faire ecraser·. Le nouveau specialiste (CSMI) saura regler Ia circulation dans ce carrefour.

X

La nouvelle radiologie, cella qui va entrer dans le XXI . siecle se presentera avec

l'habillage de l'informatique et de l'ecologie. H.U. Lemke est le promoteur des

methodologies exposees au Congres Monclal du CAR 91.

L'image reste l'une des preoccupations de Ia medecine, elle illustre toute Ia pedagogie

modeme et se prAte au traitement informatique. Je suis sOr que le Professeur H U.Lemke *

fera de CAR 91 un episode fondamental de I' evolution de l'imagerie. Je le connais bien et je

sais qu'il posslkte les armes pour creer le trepied futur de l'image , celui qui comprend

"m8clecine , informatique et ecologie •. Je souhaite qu'il reussisse.

Professeur A Wad<enheim

Faculte de Mec:tecine

Universite Louis Pasteur Strasbourg (France)

** H.U. LEMKE etColl. Computer assisted Radiology. CAR 1989. SpringerVertag.

Preface

With each CAR meeting in Berlin, it is tempting to take account of the development

since the first symposium, in 1985.

CAR can now claim to be the primary meeting place among professionals from the

medical and physical sciences who deal with advanced computer and

communications technology and its integration into clinical practice. The focus is on

the image of the patient. In particular, how the images can be enhanced and made

available to improve the health care for the patient.

Traditionally, the topics of CAR which cover the development towards this global

concern for health care are:

Digital Image Generation

CT,MR,DSA,US,SPECT,PET,DR

Image Management and Commmunication (IMAC)

Picture Archiving and Communication Systems (PACS),

Digital Optical Recording and Communication, Local Area Networks,

Distributed Radiology and Teleconferencing, ISDN,

Multi-Media Data Base Management and Communication,

PACS/Radiologicallnformation System (RIS)

Interface, Standards, System Planning, Implementation and Evaluation

Medical Work Stations

Computer Vision, Computer Graphics,

Modelling and Human Computer Interaction

Application Systems for

Computer Assisted Radiological Diagnosis,

Computer Assisted Orthopaedics,

Computer Assisted Radiation Therapy and

Computer Assisted Surgical Planning.

These topics have been integrated also into the CAR'91 Program. In recognition of

important topical problems, CAR'91, however, is augmented by a number of special

sessions.

XII

The first of these deals with the social aspects of CAR with all of its far-reaching

prospects. Discussion themes are the effects of CAR on doctor and patient, the

influence of CAR on medical training and expert systems as well as the social and

economic influence of CAR on the health service. Here in particular, the future

infrastructure of radiology will be dealt with.

The second special session is dedicated to a special group of patients: children. For

the first time, within the framework of CAR, an attempt will be made to show how

these new technological diagnostic procedures can support radiology for children,

and how, when necessary, decisive support can be given for the newborn, infants,

children, and adolescents.

Teleradiology, which will be covered in the third special session, has been derived

from the general field of telemedicine. Teleradiology attempts to deal with the

specific problems arising from medical image transfer within the broad spectrum of

communication systems available.

Specifically, it deals with the exchange of images between medical personnel by

overcoming physical distance. Modern systems allow for multi-media communication

supporting conferencing modes using speech, text, images and graphics. With these

systems, new types of radiological services are made possible.

The attentive observer of the CAR series of meetings has noticed the dramatic

increase of institutions and organizations in support of CAR since its inception.

Internationally, many established radiological and technical societies, as well as

newly founded societies, such as SCAR and EuroPACS, recognize computer and

communication in radiology as worthy for special attention.

CAR has also profited from the political ease allowing Eastern European radiological

societies to join the meeting. Specifically, the Polish Medical Radiological Society,

the Bulgarian Scientific Society of Roentgenology, Radiology and Radiobiology, the

Czechoslovak Radiological Society and the Radiological Society of the USSR can

now be welcomed into the CAR community.

Hopefully, CAR meetings will promote and integrate the world-wide activity in this

field. Future meetings are therefore planned to alternate between the United States

and Europe, perhaps in the not too distant future, Asia and specifically Japan, will

join this endeavour.

Acknowledgement

The honorary chairman of CAR'91, Auguste Wackenheim, who I have been fortunate to know for many years, has been concerned during his professional life as regards the essence of radiology and imaging.

Apart of addressing fundamental problems in modern radiology, he recognized that

the digital image will be the basis of a profound reformation of methods in radiology.

Many of his recent books include propositions in this direction and can be used as a general philosophy, also for a computer assisted radiology.

The international radiological community was shaken, when a heavy illness at the

beginning of 1990 seemed to take A. Wackenheim away from further professional

work. Fortunately, however, in recent months, he has regenerated enough strength

to be active again on issues related to imaging and informatics. A. Wackenheim's prelude to these proceedings documents his preoccupation with the future of

radiology.

As the organizer of the CAR meetings, I must protect myself against taking for

granted the help of the many individuals who have supported CAR and shaped it into

what it is now.

Another year of intensive preparatory work towards CAR has been completed by

Bibiana Moser, with strong assistance from Franziska Schweikert and Olga Deutsch. Fullfilling targets under the pressure of time has been accomplished with great motivation and energy. Also the timely publication of these proceedings is due to the hard work of this team in conjunction with the Springer-Verlag.

Similarly to previous CARs, financial backing came from the Senate of Berlin, due to

the continuing efforts of Joachim Rudolf and Lutz Reinke, against many odds arising from the new political situation in Berlin. Additional financial flexibility was provided

by Ogle Burian of Schering AG, particularly for inviting individuals to fullfil specific

work tasks for CAR.

XIV

It is also comforting to experience the extensive support for CAR from the symposium and program committee. I am very grateful for this, particularly to

Roland Felix and Dietrich Meyer-Ebrecht for their efforts towards the poster session

and work-in-progress exhibition, respectively.

My wife Jean has accepted that CAR can also be at times a way of life. The last 6

months before a CAR, our topic of conversation is mostly focusing on this event. I

thank her for listening, encouraging and giving me strength.

Heinz U. Lemke

Berlin, July 1991

Contents

DIGITAL IMAGE GENERATION

Magnetic Resonance Imaging - MRI

Digital Imaging and its Impact on Radiology in Japan (a new Concept of Image Save and Carry System: ISAC)

Shozo Hashimoto (J), Keynote Speaker • • . • • . • . . . . . . . . • • . • • . . • • • • . • • . . • 3

MR-Imaging of Stenotic Flow Phenomena - Experimental Studies

B. Krug, H. Kugel, G. Friedmann, R. Schmitt, H.J. Hirche (FRG) . . . . . . . . . . . . . . . . . . 9

Digital Subtraction Cisternography (DSC), CT Cisternography and MR Imaging in Spinal and Paraspinal Cystic Lesions

A.K. Wakhloo, M. Schumacher, V. Van Velthoven, J. Hennig (FRG) . . . . . . . . . . . . . . . . 15

MR Receptor Imaging of the Liver

P. Reimer, R. Weissleder, A.S. Lee, J. Wittenberg, T.J. Brady (USA) . . . . . . . . . . . . . . . 22

Considerations for the Unbiased In-Vivo Determination of the Volume and Surface Area of Structures of Clinical Interest Using Magnetic Resonance Imaging

N. Roberts, V. Howard, M. W. Bourne, J: Salisbury, G. H. Whitehouse, R.H. T. Edwards (UK) . . . 29

Hematopoietic Bone Marrow Hyperplasia of the Knee: Use of Out-of-Phase Gradient-Echo MR Imaging

Ph. Lang, R. Fritz, S. Majumdar, H.K. Genant (USA) . . . . . . . . . . . . . . . . . . . . . . . . 36

Computer-Assisted Integration and Display of Diagnostic Features in MR Spin Echo Multi Echo Sequences

S. Cagnoni, D. Caramel/a, E. Marin, G. Valli (I) . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Phase Image Correction for Magnetic Resonance Chemical Shift Imaging

E.A. Castren, J.A. Pohjonen (SF). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

Digital Subtraction Angiography - DSA

3D Reconstruction of Vascular Structures from few X-Ray Projections

E. Klotz, P. Haaker, R. Koppe, R. Linde (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Digital Peripheral Angiography with Subtraction and Automated Stepping: Comparison with other Techniques

T. Hilbertz, U. Fink, H. Berger, R. Beck, U. Eberwein (FRG) . . . . . . . . . . . . . . . . . . . . 62

Three-Dimensional Computerized Angiography

Y. Trousset, C. Picard, D. Saint-Felix, A. Rougee (F) . . . . . . . . . . . . . . . . . . . . . . . . 68

Experimental Validation of a Model for Blood Flow Measurement from DSA Images

R. Le Goff, P. Gerlot-Chiron, Y. Bizais (F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

XVI

Digital Radiography

Digital Luminescence Radiography in the Daily Routine

E. Voegeli (CH), G. Stumpf (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Clinical Requirements for Computed Radiography Imagery Analysis

M. W. Hedgcock Jr., T.S. Levitt, V.M. Shadle (USA) . . . . . . . . . . . . . . . . . . . . . . . . . 88

Digital and Conventional Chest Radiographs: A Comparative Study on the Diagnosis of Interstitial Lung Disease

W. f)(Jiken, A.E. Horwitz, Th. Krahe, P. Landwehr, K. Lackner (FRG) . . . . . . . . . . . . . . . 96

Examination of Swallowing Disorders using Digital Cine-Radiography (DCA)

K.F.R. Neufang, P. Siemens, B. Krug, W. Gross-Fengels, J. Gubitz, K. Ewen (FRG) . ...... 102

Optimized Image Processing for Routine Digital Radiography

I. Maack, U. Neitzel (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 09

Radiography of the Chest- A Comparative Study of Analog and Digital Techniques

K.J. Lehmann, H.P. Busch, M.C. Freund, w. Jaschke, M. Georgi, K. Richter (FRG) ....... 115

Artefacts in Digital Storage Phosphor Radiography

J. W. Oestmann (NL), M. Prokop, C.M. Schaefer, M. Galanski (FRG) . . . . . . . . . . . . . . . 122

Digital Radiology Applied to the Study of the Oral Cavity by Orthopantomography

P. Burci, A. Pastremoli, C. Malagola, R. Stamati, M. Miceli, S. Sartoni Galloni, G. Guidarelli (I) . 127

Abdominal X-Ray Examinations - Conventional and Digital Techniques

B. Krug, K.F.R. Neufang, G. Friedmann, Th. Kupper(FRG) .................... 131

Observer Performance as a Function of Hardcopy Size

C.M. Schaefer, M. Prokop, J. W. Oestmann. S. Reichelt. B. Haubitz, W. Wiesmann, H.S. Stender, M. Galanski (FRG) . .................................. 138

Digital Storage Phosphor Radiography in Gastrointestinal Disease

C.M. Schaefer, M. Prokop, P. Reimer, M. Galanski (FRG), R. Greene, D. Hall (USA). . . . . . . 143

Optimal Parameters for Unsharp Mask Filtering of Digital Chest Radiographs

M. Prokop, C.M. Schaefer, J.W. Oestmann, A. Meschede, S. Reichelt, M. Galanski (FRG) ... 149

Ultrasound • US

Digital Interface for Selective Capture of Ultrasound Images

0. Ratib, A. Rosset, G. Trayser, R. Rivolet, J.F. Vurlod (CH) . ................... 157

Ultrasonic Tissue Characterization of Myocardium using Texture Analysis of Echocardiographic Images

E. Lieback, R. Meyer, M. Nawrocki, R. Hetzer (FRG) . . . . . . . . . . . . . . . . . . . . . . . . 162

Sonographic Volume Processing of Malignant Prostatic Lesions

D. Caramel/a, G. Braccini, L. Battolla, C. Bartolozzi, F. Cartei, 0. Salvetti (I) . . . . . . . . . . . 166

XVII

Computer Tomography • CT

The Weighted Tchebycheff Norm Method for Multicriterion Image Reconstruction

Lu Weixue, Wang Yuanmei (PR China) . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 173

Quantitative Dynamic CT of Malignant Liver Tumors

C. Zwicker, M. Langer, R. Langer, K Rosenkranz, R. Felix (FRG) . . . . . . . . . . . . . . ... 177

Quantitative Volumetric Assessment of Orbital Soft Tissue

F. W. Zonneveld, L. Koornneef, D. Witteboi-Post (NL) . . . . . . . . . . . . . . . . . . . . . . . . 181

Colour-Coded 3D-Reconstruction of Abdominal Organs and Vessels

A.P. Wunderlich, M. Strotzer, J. Gmeinwieser, P. Gerhardt (FRG) . . . . . . . . . . . . . . . . . 187

A new Method for Assessing the Anchorage of Custom-Made Hip Endoprostheses with CT

R. Sokiranski, E. Klotz, S. Klotz, D. Felsenberg, S. Exner (FRG) . . . . . . . . . . . . . . . . . . 194

A Non-Stationary Markovian Modeling for the Lung Nodule Detection in CT

F. Preteux (F) ....•........................................ 199

Computed Tomography and 3-D-Surface Reconstructions of the Spine in Patients with Lower Back Pain

A. Kern, T. Waggershauser, R. Felix (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205

Degenerative Disc Disease and Volume Raytracing: A new Sophisticated Way to High Accuracy Computed Tomography in Patients with Low Back Pain

A. Kern, W. KrOger, R. Felix (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207

Accuracy of Images and Measurements in 3D Bone Imaging

A. Pommert, W.-J. Hoeltje, N. Holzknecht, U. Tiede, KH. HfJhne (FRG). . . . . . . . . . .... 209

Colour Mapping of Tissue Perfusion Data Derived from Dynamic Computed Tomography

KA. Miles, M.P. Hayba/1, A.K Dixon (U.K) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216

Assessment of Bone Structure by Quantitative Computed Tomography

C.-C. GIOer, K.G. Faulkner, S. Grampp, P. Steiger. H.K Genant (USA) .............. 220

Multlmodallty Imaging • MMI

3D Matching of Structural (CT, MR) and Functional (PET) Brain Image Data

Y. Huang, H. Steinmetz, U. Kno", H. Herzog (FRG) . . . . . . . . . . . . . . . . . . . . . . . . 229

Functional Diagnosis by Combining Biomagnetic Source Localization and Digital Images

J. Uebler, K. Abraham-Fuchs, M. Gebhardt, G. RfJhrlein, S. Schneider (FRG) . . . . . . . . . . 234

Fusion of Electromagnetic Source Data and Tomographic Image Data

P.A. van den Elsen, M.A. Viergever (NL). . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240

XVIII

APPLICATION SYSTEMS

Computer Assisted Radiation Therapy- CART

Impact of Computer and Communication Technology on Radiology and Related Disciplines

W. R. Hendee (USA), Keynote Speaker . • . . . . . . . . . . . . . . . . . . . ...... 249

Proposal of a Medical Knowledge System for Biological Radiotherapy Planning

G. Becker, M. Bamberg, W. Schlegel (FRG) . ............... . see Appendix page .... 915

Automated Data Entry and Localisation of Interstitial Seed Implants in Brachytherapy

E. Claridge, E. Claridge (UK) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256

3D Therapy Planning for Interstitial Microwave Hyperthermia of Brain Tumors

M. Seebass, W. Schlegel, W.J. Lorenz (FRG) . . . . . . . . . . . . . . . . . . . . . . . . 263

A Survey of Algorithms for 3-Dimensional Electromagnetic Problems in Hyperthermia

P. Wust, J. Nadobny, R. Felix, M. Doh/us (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . 269

Computer Assisted Radiological Diagnosis - CARD

Knowledge Based Interpretation of Cranial MR Images

I. C. Carlsen, M. lmme, M.H. Kuhn, W. Menhardt, K. Ottenberg, K.-H. Schmidt (FRG) ...... 277

Interpretation of Cranial MR-Images using a Digital Atlas of the Human Head

H.H. Zachmann (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283

A Multilayered Neural Network for the Recognition of Lung Nodules on Digital Chest Radiographs

M.G. Penedo, D. Cabello, S. Barra, A. Mosquera, M.J. Carreira (E) ....... .

Characterisation of Benign Clustered Microcalcifications with a New Image Analysis Method

. . 289

R. Gilles, F. Bouvet-Lefebvre, J. Masse/at, E. Kahn (F) . . . . . . . . . . . . . . . . . . . . . . . 295

Extraction and Measurement of Lesion Edge Blur in Mammograms by Computer Image Analysis

J.H. Richter, E. Claridge (UK) . .................................... 301

Automatic Identification of Probable Abnormal Scans in Magnetic Resonance Imaging of the Head

N. Saeed, I.R. Young (UK) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308

NEURES, a Generizable Approach to Computer Assisted Diagnosis of CTimages with a Mixed Analytic and Connectivistic Model

G. Zollner, A. Wackenheim, J.F. Rapp, L. Steib, B. Kastler (F) . . . . . . see Appendix page .... 891

Expert System Advice as a By-Product of Image Acquisition and Reporting: Obstacles to be Overcome

P.G. Mutalik, P.R. Fisher, G.G. We/tin, H.A. Swett (USA) . ..................... 315

XIX

Computer Assisted Orthopaedics - CAO

3-D Surface Detection and Pattern Recognition for Surgical Planning in Orthopaedics

A. Wallin (CH) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323

Volume Based Object Manipulation for Simulation of Hip Joint Motion

B. Pflesser, U. Tiede, K.H. H6hne (FRG). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329

Measuring the Accuracy of CT Bone Geometry for Orthopedic Implants

N.J. Mankovich, D. D. Robertson (USA), J. Essinger (CH) . . . . . . . . . . . . . . . . . . . . . 336

Computer Assisted Surgical Planning - CASP

Volumetric CT-Based Model Milling in Rehearsing Surgery

F. W. Zonneveld, M.F. Noorman van der Dussen, P.F.G.M. van Waes (NL), U. Kliegis (FRG) . . 347

Transparent Liver Rendering Showing Metastases and Their Relation to Liver Veins for Optimizing Hepatic Surgery

L. K6hler, N. Rilinger, A. Hewett, H. Niemann, P. Jensch (FRG) . . . . . . . . . . . . . . . . . . 354

Indications for CAS (Computer Assisted Surgery) Systems as Navigation Aid in ENT-Surgery

L. Klimek, R. M6sges, M. Bartsch (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358

Navigation Support for Surgery by Means of Optical Position Detection

W. Krybus, A. Knepper, L. Adams, R. Ruger, D. Meyer-Ebrecht (FRG) . . . . . . . . . . . . . . 362

Diagnostic Imaging of Craniosynostosis

M. W. Vannier, B.S. Brunsden, J.L. Marsh (USA) . . . . . . . . . . . . . . . . . . . . . . . . . . 367

The Integrated Display of CT, Angiograms and Intracranial EEG for Stereotactic Surgery Planning in Epilepsy

L. Lemieux, S. Lester, D. Rsch (UK) ................................. 374

IMAGE MANAGEMENT AND COMMUNICATION

Picture Archiving & Communication Systems- PACS

PACS in Japan

Kiyonari lnamura (J), Invited Speaker • • • . • . . • . . . . . . . . . • . . . . . . . . . . . . . .. 383

Geneva PACS Project: A Hospital-wide Integrated System

0. Ratib, Y. Ligier, M. Funk, D. Hochstrasser, J.R. Scherrer (CH) . . . . . . . . . . . . . . . . . 391

PACS - Experiences and Future Developments

F. Astinet, M. Langer, A. Kem, W. Zendel, 0. Guckelberger, R. Felix (FRG) . . . . . . . . . . . 398

Introduction of Digital Imaging Archiving System at John Hunter Hospital, Newcastle, Australia

B.L. Crowe, A. Perrignon (AUS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... 407

First Results of a Small PACS-Unit

U. Rnk, B. Mayr, Th. Hilbertz, S. NissenMeyer, J. Weber, Ch. Glirtner, A. Will (FRG) . . . . . . 414

XX

Two Years Experience with a PACS-Entry-Levei-System as a Basis for a Modular IMACS in Freiburg

B. Kohlberger, Ph. Vinee (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419

Film and PACS: Friends or Foes

G. Claeys, V. Wanchoo (B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425

TMS ™, the Integrated Network Solution for Better Cancer Treatment

H. Dahlin, P. Ekstrom, B. Hagstrom (S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 432

The Vienna SMZO-PACS-Project: The Totally Digital Hospital

w. Hruby, H. Mosser, M. Urban (A), W. Ruger (FRG) . . . . . . . . . . . . . . . . . . . . . . . . 436

A New Task in Radiology: The Radiology Information and Communication Coordinator

H. Mosser, M. Urban, W. Hruby (A) . ................................. 442

Clinical Problems Associated with the Introduction of PACS

R. Friedenberg (USA), Invited Speaker •...•.••..•.....•............... 447 D. Katz, M. Joyce Pais (USA)

Are Hospital-wide PACS Implementations Possible now (soon)?

F.P. Ottes, A.R. Bakker, J.M.L. Kouwenberg (NL) . . . . . . . . . . . . . . . . . . . . . . . . . . 450

Strategies for the Progressive Introduction of PACS

A. F. Naylor (USA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Servima: An Open PACS with a Distributed Image Data-Base and Display Server. Integrating a Mixed Workstation Environment by Software Standards

. ... 456

G. Zollner, A. Wackenheim, J.F. Rapp, J.L. Dietemann (F) . . . . . . . . see Appendix page .... 911

Prefetching Offers Prospects for a Quick Responding PACS

B.M. van Poppe/, H. Ladder, P.H. Elsakkers, N.L. Koens, A.R. Bakker (NL) . . . . . . . . . . . . 464

A General Image File Format

D.A.G. Wicks, G.J. Barker, D.L. Plummer (UK) ...... 471

Discrete X-Ray Transform Application in Compression of Digital Images

S.G. Zougbi (West Banks) ...................................... 477

lmNeV2 Transmits Images at 140 MbiVs

A. Keizers, D. Meyer-Ebrecht, F. VossebOrger (FRG), W.J.J. Stut (NL) . . . . . . . . . . . . . . 482

Expanding the Dimension of PACS

M. Herforth, W. Beier, B. Luetke (FRG) . . . . . . . . . . . . . . . . . . see Appendix page .... 905

Radiologlcallnfonnatlon System - RIS

HeaHh Level Seven for Radiology Applications

S. W. Smith, M.E. Ebert (USA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 491

Modem RIS Design from a Radiologist's View

Ch. Glirtner, J. Weber, S. Nissen-Meyer, Th. Hilbertz, U. Fink (FRG) . . . . . . . . . . . . . . . 496

XXI

HCI in Breast Cancer Screening

A.G. Gale (UK) . ............................................ 499

Data Bases - DB

PACS Integration with Hospital Information Structures: Requirements, Problems and Possible Solutions

F. Prampolini (/) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 507

A Geometric Indexing Scheme for an Image Library

H.D. Tagare, G.R. Gindi, J.S. Duncan, C.C. Jaffe (USA) ...................... 513

Graphical Tools and Retrieval Strategies for Medical Image Databases

P. Kofakis, S. Orphanoudakis (GR). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 519

Digital Image Management and Standards - ST

Standard Activities of Radiology in Japan

Takahiro Kozuka MD (J), Invited Speaker. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 527

Open System Characteristics

R. Hinde/ PhD (USA), Invited Speaker . . . . . . . . . . . . . . . . . . . see Appendix page .... 897

MEDICAL WORKSTATIONS

Computer Graphics and Computer Vision - CG/CV

Formation of Image Objects in Human Vision

S.M. Pizer PhD (USA), lnv~ed Speaker . . . . . . . . . . . . . . . . . . . . J. M. Coggins, C.A. Burbeck (USA)

Automated 3D MR Image Analysis with a Rule-Based Segmentation System

. ..... 535

H.-H. Ehricke (FRG) . ......................................... 543

Three-Dimensional Imaging of the Wrist

L. Brunie, P. Cinquin, S. Miguet (F). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 549

Estimating Partial Volume Induced Local Blurring of Organ Contours in Computed Tomograms

G. Gabrielides, H. Neumann, H.S. Stiehl (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . 556

Mathematical Morphology and Active Contour Model: A Cooperative Approach for Segmentation of Lung Contours in CT

F. Preteux (F), Y. Hei-Or (IL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563

Symbolic Description of Complex 3D Objects from Medical Volume Data

X. Cheng, G. Gerig (CH) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 569

Multimodality Imaging with PET, MRI and CT

R. Acharya (USA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 575

XXII

Computer Characterisation of Clustered Microcalcifications in Mammograms

F. Lefebvre, R. Gilles, J. Masselot, E. Kahn (F) . . . . . . . . . . . . . . . . . . . . . . . . . . . 582

Characterization of Vasculature in 3D Medical Images

K.P. Andriole, S.C. Orphanoudakis (GR). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 588

A Neural Network Approach to MR and CT Image Understanding

R. Poli, D. Caramel/a, M. Rucci, G. Valli (I) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 594

Segmentation and Recognition of MR Pathological Images

S. Dellepiane, G. Venturi, G. Vemazza (I) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600

Segmentation of Dual-Echo MR Head Data

G. Gerig, 0. KObler (CH), J. Martin, R. Kikinis (USA) . . . . . . . . . . . . . . . . . . . . . . . . 606

Segmentation System for Medical Images

0. Huttunen, 0. Lipponen, T. Vehkomaki, T. Katila, X. Yu, J. Yla-Jaaski (SF) . .......... 612

A Knowledge-Based System for the Automatic Interpretation of X-Ray CT Scans

K. Natarajan, M.G. Cawley, J.A. Newell (UK) ............................ 618

Digital Image Processing of X-Ray and MR Breast Images

S.L. Free, K. Straughan, R.I. Kitney, A. W. Goode, M.J. Turner, C. Panah (UK) . . . . . . . . . . 624

Man Computer Interaction - MCI

A Rule-Based Model of Diagnostic Information Requirements for the Design of Adaptive Image Workstations

Th. Wendler, B. Wein (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 629

Scrolling Radiologic Images: Requirements, Designs, and Analyses

D. V. Beard, P. Brown, B.M. Hemminger, R. Misra (USA) . . . . . . . . . . . . . . . . . . . . . . 636

Interactive User Interface for Visualizing Digital Medical Images

M. Funk, Y. Ligier, 0. Ratib, R. Perrier, C. Girard (CH) . . . . . . . . . . . . . . . . . . . . . . . 642

Modelling • MOD

Automatic Generation of a Dynamic Anatomical Model for Use in Subsequent Radiological Image Interpretation

M.G. Cawley, K. Natarajan, J.A. Newell (UK) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651

Modelling 3D Geometric Objects in the Extended Cell Enumeration Representation

U. Tronnier, F. Hasenbrink, A. WitUch (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 657

A 3D C 1 Stereotactic Deformation Model to Merge Multimodality Images and Atlas Data

D. Lemoine, C. Barillot, B. Gibaud, E. Pasqualini (F) . . . . . . . . . . . . . . . . . . . . . . . . 663

3-D Reconstruction, Modelling and Viewing of Coronary Vessels

A. Wahle, H. Oswald, G.-A. Schulze, J. Beier, E. Fleck (FRG) . . . . . . . . . . . . . . . . . . . 669

3D Modelling of Medical Imagery

K.D. Toennies (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 677

XXIII

Design and Applications- DA

3-D Visualization and Analysis of Biomedical Images Using ANALYZE

R.A. Robb PhD (USA), Invited Speaker . • . . . . • . . . • . . . . . . . . . . . . . . . . . . . . . 685

Radiologists Start Designing their Digital Workplace: Prototyping with a Digital Image Workstation in the Radiology

M. Dahm, K Glaser, H. Jansen-Dittmer, A. Keizers, P. KrOger, D. MeyerEbrecht, K MOnkerKaupp, H. Rudolf, C. Schilling, R. Sieslack, W. Winkler, B. Wein, R. GOnther (FRG) . 699

The MGI Workstation: An Interactive System for 3D Medical Graphics Applications

A.C. Tan, S.R. Richards, A.D. Linney (UK) . ............................. 705

Match Vox -A Workstation for Computer Assisted Neuroimaging 1

T. Schatz, H. Vogt, M. Gerke, H.J. Kretsch mann (FRG). . . . . . . . . . . . . . . . . . . . ... 711

3D Surface Display of Blood Vessels by Postprocessing of MR Angiographic Data

F. Trtlber, B. Ostertun, A. Steudel, B. Siewert, W.A. Kaiser, M. Reiser (FRG) P. van Dijk, J. Gieseke (NL). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 716

Accuracy of Measurement in Quantitative Coronary Angiography (QCA)

J. Beier, H. Oswald, U. Sauer, E. Fleck (FRG). . . . . . . . . . . . . . . . . . . . . . . . . . . . 721

The Effect of Image Magnification and Context Reduction on Diagnostic Performance with a Digital Workstation

K Glaser, B. Wein, B. Fasel (FRG). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 727

PACS Versus Hard Copy for Image Analysis-Evaluation of Time Effects and Diagnostic Accuracy (This object is included in "PACS- Experiences and Future Developments")

F. Astinet, M. Langer, A. Kern, W. Zendel, 0. Guckelberger, R. Felix (FRG) . . . . . . . . . . . 733

SPECIAL SESSION ON SOCIAL ASPECTS

Social Implications

Medico/Legal Consequences of Digital Radiological Imaging

J.O.M.C. Craig MD (UK) Keynote Speaker ••..••..•..................... 737

Computer-Aided Diagnosis in Radiology

H.A. Swett MD (USA), Invited Speaker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 738

Clinical Experience with a PACS Serving the Medical Intensive Care Unit at the University of Pennsylvania

H.L. Kundel, S.B. Seshadri, R.L. Arenson (USA) .......................... 744

Aspects of Clinical Organization and Operation Forms for 3D Treatment Planning

G. Gademann, J. Romahn, G. Becker, W. Schlegel, G. van Kaick, M. Wannenmacher (FRG) . ......•............................... 749

IMACS: Use in Clinical Case Demonstration and Teaching

E. List-He/twig, R. Rechid, A. Ullrich, KJ. Klose (FRG) . . . . . . . . . . . . . . . . . . . . . . . 755

XXIV

SPECIAL SESSION ON PEDIATRIC RADIOLOGY

Computer Assistance In Pediatric Radiology

Computer Assisted Radiology for Infants and Children

Mutsuhisa Fujioka (J), Invited Speaker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 763

The Role of Computer Assisted Imaging in Paediatric Nuclear Medicine

D.L. Gilday (CON), Invited Speaker . . . . . . . . . . . . . . . . . . . . ........ 771

Computation of Tumor Burden in the Pediatric Patient

I.R. Greenshields, F. DiMario, G. Ramsby (USA) . . . . . . . . . . . . . . . . . . . . . . . . . . 776

Digital Radiography (DR) in the Detection of Pediatric Hip Disorders

T. Hilbertz, U. Rnk, T. Pfeifer, H. Schedel (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . 782

Comparison of Digital with Film Screen Radiography in a Pediatric Emergency Room Setting

B. Shuckett, K. Mascola, P. Babyn, D. Manson, A Daneman (CON). . . . . . . . . . . . . . . . 787

SPECIAL SESSION ON TELERADIOLOGY RACEITELEMED

Full-Scale Replacement of a Visiting Radiologist Service with Teleradiology

T. Sund, E. Rinde, J. Sttrmer (N) . . . . . . . . . . . . . . . . . . . . . . . .

Technical Suppositions Using Videoconference Systems in Medicine for Large Audience

.... 793

W. Zendel, B. Erdmann, M. Langer, F. Astinet, R. Felix, U. Lemke (FRG) . . . . . . . . . . . . . 799

Videoconferencing in Medicine - Evaluation of Image Quality and Diagnostic Accuracy

F. Astinet, M. Langer, C. Zwicker, 0. Guckelberger, R. Felix (FRG) . . . . . . . . . . . . . . . . 803

Nuclear Medicine Image Distribution and Telecommunication through Public Broadband VBN

F. Bitter, R. Ochsenkiihn, W.E. Adam, R. Knopp, H.-J. Biersack, P. Hieber, P. Muller (FRG) . .. 804

Functional Requirements on Teleradiology Systems

E. List-Hellwig, K.J. Klose, 0. Rienhoff (FRG) ............................ 811

POSTER SESSION

DIGITAL IMAGE GENERATION Magnetic Resonance Imaging

3D Projection Reconstruction: Implementation and Application to NMR Imaging

XXV

M. Staemmler, R. Brill, K. Gersonde (FRG) ............................. 819

An Image Analysis Study on Brain Magnetic Resonance Imaging for Hepatic Encephalopathy

H.J. Syh, J.R. McConnell (USA) ................................... 820

Fast MR Imaging of the Cervical Spine

P. Schubeus, B. Sander, W. Schomer, U. Tosch, R. Felix (FRG) . ................. 821

Fast MR Imaging with Modified T2-Weighted Spin Echo Sequences

P. Schubeus, B. Sander, W. SchOmer, M. Deimling, R. Felix (FRG) . . ...... 822

MR Imaging of the Wrist: 3-DFT Volume Acquisition with Multiplanar Reformatting

Ph. Lang, S. Grampp, M. Vahlensieck, S. Majumdar, H.K. Genant (USA) . . . . . . . . 823

PINT: Pseudo-Inversion Null T2 Images to Enhance Contrast

R.J. Kurland, W. W. Woodruff Jr., G.R. Funkhouser, A. 0. Jones (USA) . see Appendix page .... 919

Nuclear Medicine

Applications of Deconvolution Algorithms and Smoothing Techniques to Renal Functional Images

I. Karagoz, E. Akata (TR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 824

Radionuclide Cisternography, using SPECT and 3D Rendering

H. Henkes, G. Huber, J. Hierholzer, C. Kujat, T. Scherb, W. Becker, U. Piepgras (FRG) . . . . . 825

Computer Tomography

Intraarterial Dynamic CT as a Control of Tumor-Perfusion before Regional Chemotherapy in Lung, Breast and Liver Cancers

A. Rieber, H.-J. Brambs, J. Gerich, G.W. Kauffmann (FRG) .....

A Comparative CT Study using 2 Different Invasive Application Routes of Contrast Material in the Detection of Liver Metastases before Surgery

. ........... 826

N. Rilinger, H. Niemann, H.J. 11/iger, H.J. Halbfass (FRG). . . . . . . . . . . . . . . . . . . . . . 827

Assessment of Acetabular Cup Orientation in Computed Tomography - A New Concept of Measuring Angles After Total Hip Replacement

D. Radtke, R. Sokiranski, S. Exner, M. Seidel, A. Radtke, R. Rahmanzadeh (FRG). . . . . . . . 828

Three-Dimensional Imaging of Liver Masses

J. Gmeinwieser, A. Wunderlich, M. Strotzer, W. Bautz, P. Gerhardt (FRG) . . . . . . . . . . . . 829

Three-Dimensional Reconstruction of Bone Structures

S. Delageniere, P. Grangeat (F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830

Volume Determination for Soft Tissue Organs or Lesions from CT Images

H. Rchte, W. A. Kalender (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 831

XXVI

Lateral Dual X-Ray Absorptiometry of the Spine: Comparison to AP-DXA and OCT

Ph. Lang, P. Steiger, S. Schmitz, H.K. Genant (USA) . . . . . . . . . . . . . . . . . . . . . . . . 832

A Spatial Limited Angle Model for Computerized Tomography

P.M. Salzberg (Puerto Rico) . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 833

Geometry-Induced Errors in CT-Imaging

S. Alliney (I) . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 834

Ultrasound

Evaluation of Ultrasonic Statistical Parameters, Speckle Parameters and Attenuation in the Discrimination of Diffuse Liver Diseases

A.-B.M. Youssef, A.A.R. Sharawi, A.H. Sayed (ET) . . . . . . . . . . . . . . . . . . . . . . . . . 835

A Practical Approach in Modelling Ultrasound Linear-Array Image Generation

A.-B.M. Youssef, Y.M. Kadah (ET) . ................................. 836

Techniques for 3D Volume Imaging with Ultrasound

J.E. Gardener, W.R. Lees, A. Gillams, A.D. Linney, R. Richards, A. C. Tan (UK) ......... 837

A Neural Network for Ultrasound Image Lesion Recognition

X. Magnisalis, M.G. Strintzis (GR) . . . . . . . . . . . . . . . . . . . . . see Appendix page .... 920

Digital Substraction Angiography

3-D Reconstruction of Coronary Network from Two and Three Projections: Results on Real Data

M. Garreau, C. Venaille, C. Chardenon, J.L. Coatrieux, R. Col/orec (F) . . . . . . . . . . . . . . 838

Non-Invasive Coronary Angiography with the System NIKOS II W.-R. Dix, K. Engelke, W. Graeff, C. Hamm, J. Heuer, B. Kaempf, W. Kupper, M. Lohmann, B. Reime, R. Reumann (FRG). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 839

Digital Radiography

Digital Radiography with Stimulable Phosphors; Clinical Use

F. Dhaenens, J.A. Verschaekelen, L. Van Fraeyhoven, G. Marchal, A.L. Baert (B) . . . . . . . . 840

Computed Radiography (CR) System in the Remote X-Ray Department

E. Asai, H. Kato, M. Takano (J) . ................................... 841

Radiation Dose Requirements in Digital Image Intensifier Radiography (DIIR)

K.J. Lehmann, H.P. Busch, M. Georgi (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 842

Computer Assisted Arthrography after Hip Joint Replacement

B.K. Rnk, U. Fink, M. Hansen, M. Pfahler, C.M. Kirsch (FRG) . . . . . . . . . . . . . . . . . . . 843

Recognition of Densities in Digital X-Ray Images

G. Braccini, D. Caramel/a, L. Battolla, R. Cioni, L. Berte/lotti, 0. Salvetti(/) . • . . . . . . . . .. 844

Methods of Automatic Feature Extraction and Diagnostic Classification of the Heart in Digital Chest Radiographs

XXVII

H. Gerst, K. Richter, H. Cobet (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 845

A New Method for X-Ray Dose Reduction in Fluoroscopy

R. Freyer, K. Sliva, M. Weissig (FRG) ................. 846

MuHimodallty Imaging

Primary-Information as Starting-Point for Digital and/or Analogous Processing by Imaging in Oncology

W. Konig, H. Griiner (FRG) ...................................... 847

APPLICATION SYSTEM Computer Assisted Radiation Therapy

Value of CT and MRI for Assessment of Tumor Volume and Technical Demands in Radiation Therapy

S. Sehlen, D. Matthaei, M. Busch, E. Duhmke (FRG) . . . . . . . . . . . . . . . . . . . . . . . . 848

Measurement Techniques in Photodynamic Therapy

R.H. Jindra (A) . ............................................ 849

A New Source Model for Linear Accelerators

E. Ihnen, J.M. Jensen (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 850

CT and MR Based 3D Therapy Simulation

U. Tronnier, F. Hasenbrink, A. Wittich (FRG) ............... 851

Computer Assisted Radiological Diagnosis

An Approach to Computer Aided Diagnosis in Breast Cancer Screening

A. G. Gale, G.E. Walker (UK) ....................... .

Double-Contrast Examination of Gastrointestinal Tract: Application of Digital Processing

V. Cavallo, A. Fanucci, F. Giovagnorio (I)

Computer Assisted Orthopaedics

Realistic 3-D Views of Articular Surfaces and Soft Tissue

S. Stephenson, Fang Tsai (USA) . . . . . . . . . . . . . . . . . . . .

The Significance of Tc99m-Bone-Scintigraphy in Cementless Total Hip Arthroplasty and the Value in the Detection of Loosening

. ... 852

.... 853

.... 854

B. Grunert, L. Eckart, M. Gericke, H. Thierfelder, J. Pannhorst, R. Felix (FRG) . . . . . . . . . . 855

3-Phase-Scintigraphy with 99mTc-Labelled Nanocolloids in the Diagnosis of Postoperative Infections

B. Grunert, L. Eckart, M. Gericke, H. Thierfelder, J. Pannhorst, R. Felix (FRG) . . . . . . . . . . 856

XXVIII

Computer Assisted cardiology

A Comparison between Digital Cardiac Imaging Measured Cardiac Output and the Fick Method of Cardiac Output Estimation for Patients with Coronary Artery Disease

W. Benzer, W. Metzler, P. Reinisch (A), A. Bakker (NL). . . . . . . . . . . . . . . . . . . . . . . 857

Epipolar Relation to 3D Reconstruction of Coronary Arteries from Biplane X-Ray Angiograms

Y. Bao, H. Oswald, A. Wahle, E. Fleck (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 858

Cardiovascular Angiography on a Macintosh llci

E. Gronenschild, R. Groothedde, J. Janssen (NL) . . . . . . . . . . . . . . . . . . . . . . . . . . 859

Computer Assisted Neurology

3D Reconstruction of Neurofunctional Systems of the Human Brain

H. Vogt, T. Schutz, M. Gerke, P. Beigel, C. Buhmann, A. Riedel, M. WahlerLUck, H. -J. Kretsch mann (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 860

Computer Assisted Surgical Planning

Computer Assisted Localizer for Pre- and Intraoperative Planning of Surgery and Intraoperative Orientation

G. Laborde, J.M. Gilsbach, A. Harders, R. Mosges, G. Schlondorff, A. Nachtsheim, L. Klimek, R. Ruger, D. Meyer-Ebrecht (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 861

IMAGE MANAGEMENT AND COMMUNICATION Picture Archiving and Communication Systems

Comparison between Conventional Radiography, Digital Radiography on Hard Copy and on PACS Display Workstation in the Detection of Pulmonary Nodules

M. Miceli, P. Burci, R. Stamati, M. Lipparini, S. Sartoni Galloni (I) . . . . . . . . . . . . . . . . . 862

An Intelligent Software Process for the Survey, Management and Error Detection in a PACS

M. Wiltgen, G. Gel/ (A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 863

Radiological Information System

Ad Hoc Reporting in Radiology Applications

M.E. Ebert (USA) . . . . . . . . . . . . . . . . . . . . . . . . . .

Experiences with the new MediRIS from the Informatics Point of View

S. Nissen-Meyer, J. Weber, Ch. Gartner, U. Rnk, Th. Hilbertz (FRG)

Optimal User Interface for a RIS by using Modern Input Devices

J. Weber, Ch. Gartner, S. Nissen-Meyer, U. Rnk, Th. Hilbertz (FRG)

.......... 864

............ 865

.......... 866

Patient Management System for Scheduling, Billing, and Account Collections

D. Macken, P. Marx, W. V. Glenn Jr. (USA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 867

XXIX

Data Bases

Functional Medical Imagery Database Development

M. W. Hedgcock Jr., W. Karshat, S. Smith, T.S. Levitt (USA) . . . . . . . . . . . . . . . . . . . . 868

PACS Concepts using ISDN

A. Hewett, L. KtJhler, N. Ri/inger, J. Schwanke, H. Niemann, P. Jensch (FRG) . . . . . . . . . . 869

MEDICAL WORKSTATIONS COmputer GraphlcsiCOmputer VIsion

Combining 3-D Processing and Ray Tracing

C. Hamitouche, J.L. Dillenseger, A. Bruno, J.L. Coatrieux (F) • . . . . . . . . . . . . . . . . . . 870

Texture Analysis of Cranial MR Images

P.J. Elliott, D.J. Prendergast (UK) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 871

Segmenting Cranial MR Images using Edge-Region Integration

G. Brelstaff, P.J. Elliott, M. /bison, J.M. Knapman (UK) . . . . . . . . . . . . . . . . . . . . . . . 872

Comparison of Different 3D Reconstruction and Classification Algorithms Based on the Extended Cell Enumeration Representation

U. Tronnier, F. Hasenbrink, A. Wittich (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . ... 873

A New 3D Algorithm

V. Panichelli, L. Simili (/) ....................................... 874

Systems Design and Applications

Streamlined Design of a Radiology Workstation for Clinical Applications

A. Gamboa-Aideco, L.L. Fellingham, Ch.G. Ullrich (USA). . . . . . . . . . . . . . . . . . . . . . 875

A First Approach to a Hyper-Media Radiological Workstation

M. Henke, G. von Voigt (FRG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 876

Information in Magnetic Resonance Images: The Parameterisation of Signal, Contrast and Noise

K. Straughan, J.P. Bean, A.M. Jennings, R.I. Kitney, A.J. Lunt (UK) . . . . . . . . . . . . . . . . 877

Development of an Integrated Diagnostic Workstation for the Display and Analysis of Multi-Modal Medical Images

K. Straughan, R.I. Kitney, D. W. Boyce, S.L. Free, J.P. Bean (UK) . . . . . . . . . . . . . . . . . 878

Unified Medical Workstation: Concept, Tools and Realization

G.-A. Schulze, H. Oswald, A. Wahle, E. Fleck (FRG) ........................ 879

An Application of PC-Based Digital Image Processing in Computer Assisted Radiology

I. Bajla, I. Hollilnder, P. Latta, S. Matej, A. Pisar, M. Sramek (CSFR) . . . . . . . . . . . . . . . 880

3 Dimensional Imaging of the Biliary Tree in Malignant Obstructive Jaundice

W.R. Lees, A. Gillams, J.E. Gardener, R. Richards, A. C. Tan, A.D. Linney (UK) . . . . . . ... 881

XXX

Social Implications

Design of a Cost-Effectiveness Analysis Study in Teleradiology

M. Gerneth, F.-R. Bartsch, M. Brado, R. Schosser(FRG) . ........ . . ...... 882

Quality Assurance of Radiologic Examinations in Large Mutticenter Study Settings

C.-C. Gliier, K.G. Faulkner, J.D. Rosin, M. Esti/o, H.K. Genant (USA) ............... 883

Teleradlology

Techniques for Teleradiology

T. Sund, E. Rinde, F. Kileng, J. St1rmer (N) ........ 884

Historical Efforts Concerning Videoconferences

W. Zendel, R. Felix (FRG). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 885

First Experience of Teleradiology Applied to Neurosurgical Patients

P. Burci, R. Stamati, M. Miceli, G. F. Cristi, M. Burzi, S. Sartoni Gal/ani (I) . . . . . . . . . . . . . 886

Tela-Radiology System for ISDN Networks

P. Marx, R. Kemper, D. Macken, W. V. Glenn Jr. (USA) . . . . . . . . . . . . . . . . . . . . . . . 887

APPENDIX

NEURES, a Generizable Approach to Computer Assisted Diagnosis of CT-Images with a Mixed Analytic and Connectivistic Model

G. Zollner, A. Wackenheim, J.F. Rapp, L Steib, B. Kastler (F) . . . . . . . . . . . . . . 891

Open System Characteristics

R. Hinde/ PhD (USA), Invited Speaker . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 897

Expanding the Dimension of PACS

M. Herforth, W. Beier, B. Luetke (FRG)

Servima: An Open PACS with a Distributed Image Data-Base and Display Server. Integrating a Mixed Workstation Environment by Software Standards

...... 905

G. Zollner, A. Wackenheim, J.F. Rapp, J.L. Dietemann (F) . . . . . . . . . . . . . . . . . . . . . 911

Proposal of a Medical Knowledge System for Biological Radiotherapy Planning

G. Becker, M. Bamberg, W. Schlegel (FAG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915

PINT: Pseudo-Inversion Null T2 Images to Enhance Contrast

R.J. Kurland, W.W. Woodruff Jr., G.R. Funkhouser, A.O. Jones(USA) . . . . . . . . . . . . . 919

A Neural Network for UHrasound Image Lesion Recognition

X. Magnisalis, M.G. Strintzis (GR) . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... 920

GLOSSARY . . . • . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . ... 921

LIST OF AUTHORS . . . . . . . . . • • . . . . . • . . . • . • • . . . . . . . . . . . . . . . . . . 929