Photography of the endoscopic picture with a consumer-grade digital camera

In spite of the progress of digital camera technology, photography of the endoscopic picture, with a digital still camera, has not spread in the urologic setting. We attempted to photograph an endoscopic picture with a consumer-grade digital camera. An attachment was produced by pasting step-up rings for digital cameras on a coupler, or eye piece, for endoscopes. An endoscope lens, attachment, and the digital camera were connected, and the endoscopic picture was photographed. The endoscopic picture taken with the digital still camera was high definition compared to the one with the video camera for endoscopes. The conditions of the digital camera, which can be used, require having mounting threads for filters on the lens. Although a way of sterilizing and waterproofing a camera must first be discovered, a digital still camera enables one to obtain a high-definition image inexpensively, and to store and arrange the picture.     

Telepathology as an Aid in Mohs Micrographic Surgery

BACKGROUND: Mohs surgeons are occasionally confronted by challenging pathology ideally requiring the advice of a dermatopathologist. The Internet transmission of digital images of the pathology (telepathology) allows for such opinions to be easily and rapidly obtained. OBJECTIVE: The objective was to obtain images utilizing a digital camera focused directly through one microscope eyepiece with subsequent e-mail to a pathologist for an immediate opinion. METHODS: The particular area of interest on the slide is selected. The lens of the digital camera is placed directly on one eyepiece of the microscope and using the zoom and autofocus options of the camera a sharp image is obtained. The camera flash must be disabled. The images are immediately downloaded to computer and e-mailed to the pathologist for an opinion. RESULTS: Three case reports illustrate that the pathologist is able to offer suggestions on a diagnosis with a high degree of confidence using the e-mailed images. CONCLUSION: Digital camera technology now allows for images to be taken directly through an eyepiece of the microscope. These images can be almost instantaneously e-mailed to a pathologist anywhere in the world for an immediate opinion. The technique provides for greater surety where doubt exists about the pathology during Mohs surgery.     

Easy method of capturing microscopical images by using a consumer-type digital camera

Taking pictures of microstructures is difficult, requiring sophisticated cameras coupled by the microscopes. Furthermore, it may not be feasible to find an operating microscope paired with a camera, especially in laboratory conditions. Considering the difficulty of obtaining microscopic photographs in clinical and laboratory settings, this report describes a practical method of digital photography of microstructures using a consumer-type digital camera. The technique can be summarized simply as placing the lens of a consumer-type digital camera over the eyepieces of a surgical microscope, whereby the anatomic structure of interest is focused. The image thus obtained is transferred to the computer, using easily available software programs. The authors conclude that this method is an inexpensive and practical way of capturing photographs of microstructures, obviating the need for using microscopes coupled by the cameras.     

Value of high-definition imaging in neuroendoscopy

To compare the image quality of a standard definition (SD) three-chip camera with a new high-definition (HD) three-chip camera. In five neurosurgical interventions, an SD three-chip camera and an HD three-chip camera were used with the same endoscopic equipment. Both cameras were used while performing one endoscopic third ventriculostomy, one endoscope-assisted microvascular decompression, one endoscope-assisted removal of a vestibular schwannoma, and two endonasal pituitary surgeries. To provide comparable conditions, the outputs of both cameras were displayed on the same flat screen and were recorded on hard disk with an appropriate workstation using a visually lossless codec. Both cameras were used with full light intensity and maximal zoom. The cameras were connected to the same rod-lens endoscopes (2.7- and 1.7-mm lens) one after the other. The image quality of the HD camera was far superior in all applications. Especially in pituitary surgery, the difference was striking when the tumor had to be differentiated from the normal pituitary tissue. Improved resolution and color information explained the better images in HD imaging. Additionally, because of the 16:9 aspect ratio, the viewing field of the HD camera was larger than with the 4:3 aspect ratio of the SD camera. The progressive image processing of the HD camera provided a much clearer image than the interlaced image processing of the SD camera, especially with a modern flat panel screen. HD imaging provides a much better image quality compared to SD imaging. Therefore, we recommend use of HD cameras in neuroendoscopic procedures.     

Microcomputer image processing in gastrointestinal endoscopy

A computer-based system was developed to handle information and endoscopic images in a clinical setting. The system is based on an 80286 AT computer whose topology includes a 16-bit color image capture/display graphics adapter and a 256 gray scale 8-bit digital image analysis processor. Using its color capabilities, one may initiate a picture database of patient's endoscopic images, x rays, and relevant clinical data. The computer-based imaging system allows instant access to this information and minimizes subjective evaluation, improving comparison and follow-up of treatments in a more objective manner. The image analysis components permit digital characterization of lesions, which allows online measurements and image enhancement. This is a cost-effective method of handling information and images in the clinical setting, facilitating endoscopic management and follow-up of the patient with gastrointestinal disease, as well as an effective research and teaching tool.     

The PAR IS 2000: a new system for retinal digital image analysis

We describe the PAR IS 2000, a new system of digital image analysis of the optic disc. The system uses a simultaneous stereoscopic camera and a video camera to acquire images directly from the optic disc and from optic disc photographs, respectively. The image data are stored on an optical laser disk capable of handling large amounts of data (4000 monochrome images/disk). These images can be analyzed using a modified digital interactive mapping program to generate stereometric parameters, contour maps, section profiles, pallor maps, depth maps, and three-dimensional topographic plots of the retina. A skeletonizing program permits determination and measurement of shifts in the position of retinal vessels. The system's wide range of capabilities may be helpful in improving patient care and ophthalmic research.     

激光治疗面部雀斑疗效的定量判定

目的：通过计算机数字化分析，对激光治疗面部雀斑前后进行定量判定，探索一种客观、科学的疗效评定方法。方法：随机入选30名雀斑患者，治疗前在恒定的光强度下用图像采集系统摄取局部雀斑图像，用Q开关Nd：YAG激光治疗面部雀斑。分别让患者于治疗后2、4、6、8、15周进行复诊，再次摄取同一部位的局部皮损图像。将所荻取的图像在特定的图像分析系统下逐个进行分析，荻取各自的检测值，评判治疗效果。结果：运用色斑检测系统分析图像采集结果显示：经Q开关Nd：YAG激光治疗后，30名雀斑患者治愈率为53．3％，有效率为90％。结论：通过色斑检测系统对激光治疗面部雀斑前后的变化进行定量判定，提高了评价方法的客观性和科学性。     

Digital recording in neurosurgery

The purpose of this study is to examine the image quality of multi-media for digital recording of surgical procedure using an operating microscope in neurosurgery. For video recording, high vision recording, digital video recording and analogue VHS recording were used. For still pictures, an analogue camera with 35 mm silver halide film and a micro-digital camera were used. The quality of photographs taken with a microdigital camera was superior to the quality of those taken with the conventional 35 mm film camera. The micro-digital camera system is superior to the conventional 35 mm camera in neurosurgery in its quality and success rate. In video recording, high vision analogue recording was superior to any other media as far as its image quality is concerned although its practical convenience is limited and cost performance is not always good. On the other hand, digital video can record high quality images, including still pictures, with satisfactory quality to the neurosurgeon. These digital recording media are also space saving for storing the huge amount of data obtained during surgery and the cost-performance is superior to that of the conventional method. In the near future, most of surgical procedures are supposed to be expected using digital media.     

Thirty-five millimeter versus digital photography: comparison of photographic quality and clinical evaluation

The objective of this article is to assess the quality of digital images versus standard 35-mm photodocumentation and to undertake a comparative assessment of 35-mm and digital photography in a clinical setting in facial plastic surgery. For evaluation of image quality, 10 subjects had images captured via a conventional 35-mm single lens reflex (SLR) camera and a digital camera under identical lighting conditions. The digital images were transferred to computer hard drive and processed for production of slides. Direct side-by-side comparison of projected images was performed by the authors. The standard photographic slides were of slightly finer detail and crispness than the computer-generated images. In a clinical setting, the quality of both the 35-mm and digital photographs enables complete preoperative evaluation and assessment of postsurgical outcome.     

Techno Pearls for Digital Image Management

BACKGROUND: The past decade has provided a paradigm shift in image management. Technological advances have enabled affordable, high-quality digital clinical photography. In addition, this technology has enabled doctors to easily compose and present multimedia lectures with programs such as Microsoft PowerPoint. Since most practitioners already possess large numbers of conventional slides and photographs, digitization is required to convert these to a usable format. Depending on the type of image and resolution, it can take anywhere from 30 seconds to several minutes to scan each slide. This drawback delays or prevents many practitioners from switching to digital technology. OBJECTIVE: Using a digital camera and the XP version of Windows, some common tasks associated with digital images and PowerPoint presentations may be simplified and facilitated. METHODS: Using common digital cameras and computer image editing software, slides, photographs, radiographs, and textbook images may be digitized in seconds with adequate quality for most common clinical and educational applications. In addition, the use of new dual monitor functionality is discussed. This new technology comes standard with Windows XP and allows the use of two monitors simultaneously, allowing the user to view thumbnail images on one monitor and the PowerPoint presentation on the other monitor. Images may be dragged and dropped into the presentation, thereby avoiding repetitive menu commands. RESULTS: The author shows several techniques and shortcuts to assist the clinical practitioner in digitizing slides and facilitating the management of these images in PowerPoint presentations. CONCLUSION: A digital camera can be used to adequately digitize most slide pictures, and these images can be managed in a more simple and direct manner utilizing the Windows XP operating system that is shipping with most new computers.     

Quantification of 5-aminolevulinic acid induced fluorescence improves the specificity of bladder cancer detection

PURPOSE: 5-Aminolevulinic acid induced fluorescence endoscopy has outstanding sensitivity for detecting early stage bladder cancer. Nevertheless, a third of the lesions that show specific fluorescence are histologically benign. We decreased the false-positive rate of 5-aminolevulinic acid induced fluorescence endoscopy by incorporating protoporphyrin IX fluorescence quantification into the standard cystoscopy procedure. MATERIALS AND METHODS: In 25 cases (53 biopsies) of a history of or suspicion for bladder cancer 5-aminolevulinic acid induced fluorescence endoscopy and fluorescence image quantification were performed. For fluorescence image quantification images obtained with a target integrating color charge-coupled device camera were digitized and stored in a personal computer. Red-to-blue ratios were calculated from fluorescence positive lesions and results were correlated with hematoxylin and eosin histology. RESULTS: Malignant fluorescence positive lesions showed significantly stronger fluorescence intensity than fluorescing lesions with benign histology. A threshold was established that decreased the false-positive rate by 30% without affecting sensitivity. CONCLUSIONS: Fluorescence image quantification is a new endoscopic method for objectively selecting multicolor fluorescence bladder lesion images for biopsy. It has the potential of eliminating human error by different surgeons with variable experience in fluorescence endoscopy.     

Feasibility study of normal and septic tracheal imaging using optical coherence tomography

BACKGROUND AND OBJECTIVES: Optical coherence tomography (OCT) is an imaging technology that may be adapted for use with flexible fiberoptic bronchoscopy, potentially allowing it to play an important role in pulmonary diagnostics. The goal of this study was to evaluate the feasibility of OCT to image tracheal pathology. STUDY DESIGN/MATERIALS AND METHODS: Tracheas were harvested from normal and septic New Zealand White rabbits and imaged using OCT. Two delivery devices were employed. One was a moving stage with an objective lens and collimator, the other a linear scanning flexible fiberoptic catheter using a GRIN lens and prism for endoscopic OCT. After OCT images were obtained from normal and septic tracheas, the excised tissues were prepared for standard histologic examination. Areas imaged by OCT were compared with corresponding histology slides. RESULTS: OCT images demonstrated in detail tracheal sub-surface structures such as the epithelium, lamina propria, submucosa, and cartilage. The appearance of structures imaged by OCT corresponded very well with histologic pictures obtained by light microscopy. The OCT images from septic tracheas showed marked swelling of the mucosal and submucosal layers. Such pathology was equally imaged by either the moving stage or fiberoptic catheter for endoscopic OCT. CONCLUSIONS: OCT images of the trachea can distinguish many sub-surface structural features usually requiring biopsy and light microscopy for visualization. Marked differences between normal and septic trachea were apparent in OCT images. In the future, OCT may be a valuable tool for evaluating tracheal pathology in situ with high image resolution.     

From the echocardiography machine to the lecture room: a simple method for transferring echocardiographic frames and loops to a personal computer

The use of computers in scientific and educational presentations is rapidly increasing. As a digital presentation is ideal for showing moving images, the use of multimedia files, e.g., echocardiographic loops within these presentations, is common. Even though recent echocardiography machines store acquired data in a digital format, these data are often not readily accessible to be transferred to a personal computer. We present an easy and cost-efficient method for transferring frames and loops from any echocardiography machine into a personal computer using a digital video camera equipped with a standard analog input and flash memory. Still images and movies are stored in the camera to be subsequently transferred to a personal computer. In the computer, still images and movies are post-processed with graphical and video editing software. Finally, the still images and movies can be projected from the video camera or presented with specialized software such as PowerPoint. The images can also be used for Web-based publications and production of educational material or books on electronic media such as CD-ROM. The described method can also be used to transfer images from other proprietary devices and programs, as long as the devices are equipped with an analog video outlet. IMPLICATIONS: The transfer of frames and loops from echocardiographic machines to personal computers is often useful for publication, teaching, and educational purposes. We present an easy and cost-effective method for transferring frames and loops from any echocardiography machine into a personal computer using a digital video camera.     

Digital Photography for Mapping Mohs Micrographic Surgery Sections

BACKGROUND: Instant photographic print images have been used to diagram tissue sections excised for Mohs micrographic surgery (MMS). This approach is limited by the size of the print image, the potential difficulty of writing on a glossy photo print, and the cost of film. OBJECTIVE: We describe the use of digital photographic images as templates for making maps of tissue excised for MMS. METHODS: Digital photographic images of patients undergoing MMS are downloaded to a computer and printed onto plain paper. A map of the tissue excised for MMS is drawn directly onto the digital print. RESULTS: Several methods of creating MMS maps using digital photographic print images are described. CONCLUSION: Advantages of using digital photographs in MMS include speed of producing images, low cost of materials, greater accuracy of depicting the MMS excision defect, and ease of correlating the MMS map to the patient for subsequent stages of excision.     

A simple method for making photographic records under sterile conditions

Digital photography has become a practical alternative to conventional film photography for medical documentation, communication, and education. The use of digital cameras has become increasingly popular in recent years for documenting perioperative conditions, intraoperative findings, and imaging studies. However, taking intraoperative pictures or video clips may be technically demanding for assistants or nurses. Herein, we describe a simple and effective method for surgeons to create photographic and video records of operations under sterile conditions involving the use of a digital camera encased in commercially available protective housing.     

数码相机在口腔摄影中的选择与应用

目的：介绍数码摄影在口腔摄影应用中的优点和用于口腔摄影的数码相机的选择要求。方法：分析市场上常见数码相机的类型和相关配件的性能特点，探讨其在口腔摄影中应用的可行性，选择适用于口腔摄影的数码相机及环形闪光灯配置。结果：Canon Powershot Gl等型号的数码相机在口腔摄影中可以取得良好的应用效果。结论：数码摄影为牙科医生提供了一个优异的获得临床资料的手段。     

Use of a digital camera in the urologic setting

Urologists are faced with increasing demands for clear documentation of their work. We report the use of a digital camera in our practice to capture images throughout the urologic setting. The digital camera was a quick and convenient means of obtaining good quality reproductions of radiographic and pathologic findings. Use of the camera greatly enhanced the efficiency of our practice by allowing incorporation of images into patient records and an image library.     

膝关节镜的计算机图像处理系统

目的 介绍膝关节镜手术资料计算机采集，编辑，管理，保存的方法和经验。方法 利用视 卡实现计算机对关节镜动静态图像的采集，应用计算机各种软件完成对各种图像的编辑，管理，应用可写光盘永久保存。结果 计算机采集图像分辨率高，编辑，管理方便，打印照片清晰资料可永久保存。结论多媒体计算机的应用为关节镜图像资料的处理提供了一种快捷，简便，可靠的方法。     

Methods for the endoscopic photographic and visual detection of helium cadmium laser-induced fluorescence of Photofrin II

Endoscopic detection of small tumors is key to the early diagnosis and treatment of malignancy. This paper describes a simple, endoscopic detection system which enables tumor localization and a permanent record based on the laser-induced fluorescence of dihematoporphyrin ether (LIFD). Spectral analysis of dihematoporphyrin ether (DHE, Photofrin II) was performed with a Perkin Elmer LS-5 scanning fluorimeter. DHE at concentrations of 50 micrograms/ml and 5 micrograms/ml in 95% ethanol were tested, demonstrating fluorescence quenching at 50 micrograms/ml DHE at 406 nm excitation. This phenomenon was not observed at 442 nm excitation. Based on this data and the availability of the helium cadmium laser, a series of endoscopic detection systems was developed and tested utilizing a LiConix 4240NB helium cadmium laser (TEMoo, 442 nm, 40 mW). A fiber with a microdiverging (MDL) lens was used. Irradiance achieved at the tip of the fiber was 31.58 mW/cm2 for MDL. A Corning 34832 (550 nm) sharp cutoff barrier filter was coupled to an Olympus OES BF2T10 bronchoscope. Successful detection of LIFD was obtained. Direct observation of LIFD is possible when wearing Laserguard argon safety goggles (OD 15 at 488 nm, OD 11 at 514 nm). Photographic recording of LIFD was performed with the following cameras and parameters: Olympus OM-2S camera (OM2) with EES135 film (ISO 1600) with a 4-second exposure (method 1) and the Olympus OES SCP-10 instant camera with Polaroid 779 (ISO 640) film and a 120-second exposure (method 2). The photographic methods demonstrate the red fluorescence of DHE on filter paper disks at concentrations of 0.5 micrograms/ml (500 ng/ml). (ABSTRACT TRUNCATED AT 250 WORDS)     

Real Photographic Prints from Digital Images

BACKGROUND: Digital photography is emerging as a standard method of documenting preoperative, intraoperative, and postoperative results in the clinical setting. While hard copies of these electronic images can be quickly and easily generated on color laser or inkjet printers, there are times when it is necessary to generate a true photographic print of an image, either for insurance documentation or to meet the publication requirements of a peer-reviewed journal. Standard inkjet and laser printers are unable to generate true photographic prints. OBJECTIVE: To identify a rapid, cost-effective means of generating high-quality photographs of digital images. METHODS: We describe the use of on-line service bureaus with digital photographic printers to obtain high-quality photographic prints of patient images. RESULTS: From as little as 49 cents per print, a color or black-and-white print of a color image can be generated by an on-line service bureau to satisfy the need for a photographic quality hard copy. CONCLUSIONS: While color laser or inkjet printers allow physicians to generate their own hard copies of electronic patient images, photographic quality images are at times needed to satisfy requirements for insurance documentation or publication in peer-reviewed journals. Use of on-line service bureaus is the most cost-effective way that we have found to obtain high-quality photographic color or black-and-white prints from electronically stored patient images.