The imaging characteristics of microcalcifications in both benign and malignant breast conditions... more The imaging characteristics of microcalcifications in both benign and malignant breast conditions were analyzed in 48 digitized film mammograms. Each case included in this analysis had findings considered suggestive of malignancy by the radiologist, with the underlying histologic structure determined by excisional biopsy. Imaging properties of each microcalcification--such as pixel intensity, relative location, distribution, size, and local neighborhood intensities--were recorded. This information was statistically analyzed at the population level according to such selection criteria as histologic type, size of calcification, and cluster size. Distribution ranges were determined for these criteria. Statistical differences between data from benign and malignant cases show the average distance between calcifications in malignant conditions was greater than in benign conditions, and tissue region averages surrounding calcifications associated with malignant conditions were consistently higher than those for benign conditions.
An algorithmic process for the detection and marking of clustered calcifications in digitized fil... more An algorithmic process for the detection and marking of clustered calcifications in digitized film-screen mammograms has been applied to mammograms from 50 clinical cases sampled at two digitization levels, in both the craniocaudal and mediolateral views. In all but one case the detector accurately located suggestive clusters found by radiologists in normal screening. In five cases additional clusters were also found by the detector. The detector has a negligible false-positive rate for the detection of clustered calcifications, although it is sensitive to clusters of emulsion defects displayed as artifactual calcification densities in the original film. The detector is flexible in structure and is easily adapted to various calcification/cluster criteria. The detector shows considerable promise when applied to clinical examples but will require refinement before formal testing.
An efficient algorithm has been developed for the detection of clustered micro-calcifications in ... more An efficient algorithm has been developed for the detection of clustered micro-calcifications in digitized film-screen mammograms. The calcification cluster detection algorithm involves a decision-theoretic mechanism which identifies calcifications meeting specific size, density, and clustering criteria. The algorithm first utilizes a pixel testing and region grouping procedure to identify pixels with specific intensity characteristics. A region growing procedure is then applied to identify pixels belonging to contiguous structures. Each single- and multi-pixel structure is subsequently tested against criteria for size, shape, contrast, and intensity to determine if the composite structure matches the expected characteristics of mammographic calcifications. Detected calcifications are then tested to determine if they fall within a cluster meeting specific density constraints. Only calcifications located in such clusters are marked in the processed image. This algorithmic process has been applied to mammograms from 40 clinical cases in which a biopsy was performed based on the presence of suspicious calcifications. The algorithm accurately identified the suspicious calcifications in each situation; in several cases, it also detected other clusters which were so fine as not to be visible in clinical screening.
European Heart Journal - Cardiovascular Imaging, 2013
Purpose: Cardiac deconditioning due to immobilization is a risk factor for cardiovascular disease... more Purpose: Cardiac deconditioning due to immobilization is a risk factor for cardiovascular disease. The physiology of cardiac adaptation to deconditioning has not been fully elucidated. The purpose of the present study was to assess the effects of 21-days of strict headdown (-6 degrees) bed-rest (BR) deconditioning on left ventricular (LV) dimensions and mass measured by MRI. Methods: Ten healthy men (mean age 32+6) were enrolled; the experiment was conducted at DLR (Koln, Germany) as part of the European Space Agency BR studies. Steady-state free precession MRI images (7mm thickness, no gap, no overlap) were obtained (Symphony 1.5T, Siemens) in a stack of short-axis views from LV base to LV apex, before (PRE), at the end of BR (HDT20), and four days after the BR conclusion (POST). Endocardial and epicardial semi-automated contouring was performed using freely available software (Segment). Results: At HDT20, significant reductions in LV mass (16%), end-diastolic (26%) and endsystolic (27%) volumes and stroke volume (27%) were observed, while ejection fraction did not change. These changes were accompanied by a measured decrease (14%) in plasma and blood volume (by gas-rebreathing technique), as well as by a significant reduction (14%) in VO2max aerobic power, measured using a graded cycle ergometer test protocol to volitional fatigue, at one day after the BR conclusion, while expiratory exchange ratio did not change. At POST, LV volumes were restored, while LV mass was still trending towards control values. Conclusions: Cardiac adaptation to deconditioning affected LV mass and dimensions, as a combined result of LV remodeling and fluids loss, accompanied by worsening in aerobic power. This should be taken into account in patients with cardiovascular diseases, when immobilized in bed, to proper adjust the therapy, or to define appropriate physical exercises when possible, in order to avoid further complications.
Capsule endoscopy is a new technology developed to investigate diseases of the small intestine. I... more Capsule endoscopy is a new technology developed to investigate diseases of the small intestine. It has been shown to be superior to current modalities such as small-bowel radiography and enteroscopy. We describe a patient with long-standing celiac disease who presented with abdominal pain, diarrhea, and weight loss, after many years on a gluten-free diet. The symptom complex and results from small-bowel radiography and computerized tomography raised concern about progression to lymphoma, and ultimately a laparoscopy and small-bowel resection were done for diagnosis. A capsule endoscopy was performed to assess the extent of the patient's enteropathy-type intestinal T-cell lymphoma after three cycles of chemotherapy. We report the first use of capsule endoscopy in the setting of celiac disease associated enteropathy-type intestinal T-cell lymphoma. These endoscopic findings are correlated with those from gross and microscopic pathology and barium small-bowel radiography.
ologic and endoscopic organizations, barium esophagography either is not recommended or not even ... more ologic and endoscopic organizations, barium esophagography either is not recommended or not even mentioned as an option for the workup of GERD [3-5]. Despite this literature, barium esophagography has been recognized as a global examination that can simultaneously evaluate swallowing function, esophageal motility, gastroesophageal reflux (GER), and morphologic abnormalities in the pharynx and esophagus [6]. It is also a noninvasive and inexpensive procedure that does not require sedation and is widely available. The barium study, therefore, is a useful test for detecting GERD and its complications, distinguishing GERD from other pathologic conditions involving the esophagus, facilitating selection of additional diagnostic tests, and guiding decisions about medical, endoscopic, or surgical treatment of these patients. The Society of Abdominal Radiology recently established a disease-focused panel on GERD whose mission is to advance the concept of a multidisciplinary approach to GERD that recognizes the important role of barium esophagography in conjunction with endoscopy and other diagnostic tests. The panel is composed of 10 gastrointestinal and abdominal radiologists, one gastroenterologist, one gastrointestinal surgeon, and one speech language pathologist. After review of the scientific literature and discussion among the panelists, our panel has developed a consensus statement on the role of barium esophagography for GERD, recommended techniques for performing
Crohn's Disease is an inflammatory condition of the digestive tract that affects children and adu... more Crohn's Disease is an inflammatory condition of the digestive tract that affects children and adults. The cause of Crohn's disease is unknown. Common features of Crohn's disease include mouth sores, diarrhea, abdominal pain, weight loss, and fever. Patients can also have problems outside of the digestive tract, including a skin rash, joint pain, eye redness, and, less commonly, liver problems. Although Crohn's disease is usually chronic, medical and surgical treatment can help control the course of the disease, allowing many patients to experience long periods of symptom-free remission.
A case is presented of xanthogranulomatous cholecystitis that resembled carcinoma of the gallblad... more A case is presented of xanthogranulomatous cholecystitis that resembled carcinoma of the gallbladder on computed tomography. The large, infiltrating mass satisfied the criteria for massive carcinoma of the gallbladder.
The imaging characteristics of microcalcifications in both benign and malignant breast conditions... more The imaging characteristics of microcalcifications in both benign and malignant breast conditions were analyzed in 48 digitized film mammograms. Each case included in this analysis had findings considered suggestive of malignancy by the radiologist, with the underlying histologic structure determined by excisional biopsy. Imaging properties of each microcalcification--such as pixel intensity, relative location, distribution, size, and local neighborhood intensities--were recorded. This information was statistically analyzed at the population level according to such selection criteria as histologic type, size of calcification, and cluster size. Distribution ranges were determined for these criteria. Statistical differences between data from benign and malignant cases show the average distance between calcifications in malignant conditions was greater than in benign conditions, and tissue region averages surrounding calcifications associated with malignant conditions were consistently higher than those for benign conditions.
An algorithmic process for the detection and marking of clustered calcifications in digitized fil... more An algorithmic process for the detection and marking of clustered calcifications in digitized film-screen mammograms has been applied to mammograms from 50 clinical cases sampled at two digitization levels, in both the craniocaudal and mediolateral views. In all but one case the detector accurately located suggestive clusters found by radiologists in normal screening. In five cases additional clusters were also found by the detector. The detector has a negligible false-positive rate for the detection of clustered calcifications, although it is sensitive to clusters of emulsion defects displayed as artifactual calcification densities in the original film. The detector is flexible in structure and is easily adapted to various calcification/cluster criteria. The detector shows considerable promise when applied to clinical examples but will require refinement before formal testing.
An efficient algorithm has been developed for the detection of clustered micro-calcifications in ... more An efficient algorithm has been developed for the detection of clustered micro-calcifications in digitized film-screen mammograms. The calcification cluster detection algorithm involves a decision-theoretic mechanism which identifies calcifications meeting specific size, density, and clustering criteria. The algorithm first utilizes a pixel testing and region grouping procedure to identify pixels with specific intensity characteristics. A region growing procedure is then applied to identify pixels belonging to contiguous structures. Each single- and multi-pixel structure is subsequently tested against criteria for size, shape, contrast, and intensity to determine if the composite structure matches the expected characteristics of mammographic calcifications. Detected calcifications are then tested to determine if they fall within a cluster meeting specific density constraints. Only calcifications located in such clusters are marked in the processed image. This algorithmic process has been applied to mammograms from 40 clinical cases in which a biopsy was performed based on the presence of suspicious calcifications. The algorithm accurately identified the suspicious calcifications in each situation; in several cases, it also detected other clusters which were so fine as not to be visible in clinical screening.
European Heart Journal - Cardiovascular Imaging, 2013
Purpose: Cardiac deconditioning due to immobilization is a risk factor for cardiovascular disease... more Purpose: Cardiac deconditioning due to immobilization is a risk factor for cardiovascular disease. The physiology of cardiac adaptation to deconditioning has not been fully elucidated. The purpose of the present study was to assess the effects of 21-days of strict headdown (-6 degrees) bed-rest (BR) deconditioning on left ventricular (LV) dimensions and mass measured by MRI. Methods: Ten healthy men (mean age 32+6) were enrolled; the experiment was conducted at DLR (Koln, Germany) as part of the European Space Agency BR studies. Steady-state free precession MRI images (7mm thickness, no gap, no overlap) were obtained (Symphony 1.5T, Siemens) in a stack of short-axis views from LV base to LV apex, before (PRE), at the end of BR (HDT20), and four days after the BR conclusion (POST). Endocardial and epicardial semi-automated contouring was performed using freely available software (Segment). Results: At HDT20, significant reductions in LV mass (16%), end-diastolic (26%) and endsystolic (27%) volumes and stroke volume (27%) were observed, while ejection fraction did not change. These changes were accompanied by a measured decrease (14%) in plasma and blood volume (by gas-rebreathing technique), as well as by a significant reduction (14%) in VO2max aerobic power, measured using a graded cycle ergometer test protocol to volitional fatigue, at one day after the BR conclusion, while expiratory exchange ratio did not change. At POST, LV volumes were restored, while LV mass was still trending towards control values. Conclusions: Cardiac adaptation to deconditioning affected LV mass and dimensions, as a combined result of LV remodeling and fluids loss, accompanied by worsening in aerobic power. This should be taken into account in patients with cardiovascular diseases, when immobilized in bed, to proper adjust the therapy, or to define appropriate physical exercises when possible, in order to avoid further complications.
Capsule endoscopy is a new technology developed to investigate diseases of the small intestine. I... more Capsule endoscopy is a new technology developed to investigate diseases of the small intestine. It has been shown to be superior to current modalities such as small-bowel radiography and enteroscopy. We describe a patient with long-standing celiac disease who presented with abdominal pain, diarrhea, and weight loss, after many years on a gluten-free diet. The symptom complex and results from small-bowel radiography and computerized tomography raised concern about progression to lymphoma, and ultimately a laparoscopy and small-bowel resection were done for diagnosis. A capsule endoscopy was performed to assess the extent of the patient's enteropathy-type intestinal T-cell lymphoma after three cycles of chemotherapy. We report the first use of capsule endoscopy in the setting of celiac disease associated enteropathy-type intestinal T-cell lymphoma. These endoscopic findings are correlated with those from gross and microscopic pathology and barium small-bowel radiography.
ologic and endoscopic organizations, barium esophagography either is not recommended or not even ... more ologic and endoscopic organizations, barium esophagography either is not recommended or not even mentioned as an option for the workup of GERD [3-5]. Despite this literature, barium esophagography has been recognized as a global examination that can simultaneously evaluate swallowing function, esophageal motility, gastroesophageal reflux (GER), and morphologic abnormalities in the pharynx and esophagus [6]. It is also a noninvasive and inexpensive procedure that does not require sedation and is widely available. The barium study, therefore, is a useful test for detecting GERD and its complications, distinguishing GERD from other pathologic conditions involving the esophagus, facilitating selection of additional diagnostic tests, and guiding decisions about medical, endoscopic, or surgical treatment of these patients. The Society of Abdominal Radiology recently established a disease-focused panel on GERD whose mission is to advance the concept of a multidisciplinary approach to GERD that recognizes the important role of barium esophagography in conjunction with endoscopy and other diagnostic tests. The panel is composed of 10 gastrointestinal and abdominal radiologists, one gastroenterologist, one gastrointestinal surgeon, and one speech language pathologist. After review of the scientific literature and discussion among the panelists, our panel has developed a consensus statement on the role of barium esophagography for GERD, recommended techniques for performing
Crohn's Disease is an inflammatory condition of the digestive tract that affects children and adu... more Crohn's Disease is an inflammatory condition of the digestive tract that affects children and adults. The cause of Crohn's disease is unknown. Common features of Crohn's disease include mouth sores, diarrhea, abdominal pain, weight loss, and fever. Patients can also have problems outside of the digestive tract, including a skin rash, joint pain, eye redness, and, less commonly, liver problems. Although Crohn's disease is usually chronic, medical and surgical treatment can help control the course of the disease, allowing many patients to experience long periods of symptom-free remission.
A case is presented of xanthogranulomatous cholecystitis that resembled carcinoma of the gallblad... more A case is presented of xanthogranulomatous cholecystitis that resembled carcinoma of the gallbladder on computed tomography. The large, infiltrating mass satisfied the criteria for massive carcinoma of the gallbladder.
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Papers by Francis Scholz