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The Toy Industry Association (TIA)'s Shifting Channels: Strategies for Growth in the Toy Industry webinar is scheduled to take place on August 6 from 2 to 3 p.m. ET. It will highlight key findings from a Vanderbilt University study on distribution channel trends in the toy industry as well as potential pathways to success.
TIA Webinar Focuses on Distribution Channel Trends and Growth Strategies
TIA Announces Business-Savvy Line-Up of Speakers for Fall Toy Preview
As reported by the Toy Industry Association (TIA), speakers at this year's Fall Toy Preview include Mark Cuban, the Dallas Mavericks owner and billionaire investor from the hit TV show, Shark Tank. He will deliver his address at the Women in Toys Empowerment Day, a mentoring and networking event for female business owners taking place on October 5, the day before Fall Toy Preview officially opens its doors.
TIA Reports Information Technology Agreement Will Extend Duty-Free Treatment to Electronic Toys
As reported by the Toy Industry Association (TIA), a landmark deal was reached between 54 members of the World Trade Organization (WTO) last week that will extend duty-free treatment to more than 200 information technology products, including certain types of electronic games, toys, and other electronic accessories.
TIA Calls for Further Third-Party Testing Reduction, Following CPSC Exemption for Unfinished Trunk Wood
As reported by the Toy Industry Association (TIA), the U.S. Consumer Product Safety Commission (CPSC) has issued a direct final rule exempting unfinished and untreated trunk wood from third party testing for the eight heavy metals listed in the ASTM F963-11 toy safety standard. The rule is slated to come into effect on September 15.
GUEST COMMENTARY: Take Action: Urge Your Senator to Support TSCA Reform
by Ed Desmond, executive vice president of external affairs, Toy Industry Association (TIA)
One of the biggest threats facing your business today is the increasing problem of state after state seeking to ban certain chemicals used in toys. Individual state legislatures—and even counties—have been creating their own flawed chemical management laws, which could force retailers to pull perfectly safe products from store shelves. While the TIA is working to prevent such state laws, we are also actively engaged in addressing this threat by urging Congress to pass a federal, uniform chemical management policy that will help preempt state-by-state activity.
GUEST COMMENTARY: Game Stores versus Toy Stores: There's More than Enough Fun to Go Around
by Sara Erickson, owner, Rook's Comics and Games
Sitting in my game store on a warm Saturday afternoon, I watch as customers stream in with tote bags full of games they plan on playing during the next three or four hours. I know most of them by name and would consider many of them my friends. They've been shopping and playing at my store for the past nine years, and I've seen them grow from awkward teenagers into professional adults. Many have even outgrown my store and are now shopping at the local toy store across the street for their own kids. Eventually, the cycle will repeat and I'll be selling the newest hot game to the next generation.
COMMENTARY: What I've Learned About the Toy Industry—An Intern's Perspective
After quarterly report cards and end-of-the-year science projects, if my grades were above a B+—and my teacher's comments weren't scolding—my mother would drive me to Toys "R" Us in Massapequa, N.Y., to pick up a Summertime Beach Barbie.
TIA's Genius of Play Campaign Collects 58,000 Hours After One Week
As reported by the Toy Industry Association (TIA), the Genius of Play campaign was launched last week, and parents and caregivers across the U.S. have already pledged to play a collective 58,000 hours with the children in their lives. In addition, more than 50 TIA member companies have shared the campaign's inaugural Facebook post and its message about the essential role of play in the development of children.
TIA Members Can Register for RILA Retail Sustainability Conference at Discounted Rate
The Retail Industry Leaders Association (RILA) Retail Sustainability Conference will take place in Austin, Texas, from September 15 to 18 at the JW Marriott. Registration for the conference is now open, and members of the Toy Industry Association (TIA) are eligible for the discounted RILA member registration rate.

subset: commoncrawl


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"Expanding on the pros, other likes- - These cans are pretty comfortable imo, with the velour pads and soft headband. I havent had any problems with pressure points on the headband, and have been able to wear them for several hours on end without much fatigue. Clamping force is just right. Tighter than, for example, a Creative Aurvana Live, but looser than my FA-011s. Fairly light weight. -..." --kidcharlemagne
iHome 2 IN 1 Stereo Speaker/Headphone System
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corporate revenue |
Reviewer: phokme
big cheese=money she eats glue=she shuts up. her mouths glued shut this song is about the demands and expectations of show business(record company w/e) and how controlling and manipulative they were just to get money. they would tell him to go to the office, play the ssame songs 50 times i mean come on its so obvious. black is black> its all in the contract hes owned ya know so "no trading back" . it all makes sense, its not about school thats for sure ya dummies.
Big Cheese |
Reviewer: Lorenzo Jackson
If you have just looked for the lyrics to this song like me , this is an amazing song. I feel that Kurdt was addressing the fact that authority in school is maybe a little too quick to label the students that they teach. This goes the same for students And the way that stereotyping each other is doing them all no favours either.
intensity |
Reviewer: vinsanity
lots of it in this song. he's really pissed on this song. the last line makes me think it's all about authority acting like they have a reason to punish and "show you all what a man is".
Kurt Cobain is God. Or, at the very least, with him. |
Reviewer: Anonymous
I love this song, and Nirvana, with a passion. In my opinion, they're the best band of all time - they virtually created grunge, and other various rock-based genres, and have influenced a vast majority of the music we have today. Kurt Cobain was a genius and it's devastating that he's not here today. He'll always be a God-like figure in my eyes. <3
Nirvana |
Reviewer: Anonymous
Big cheese, big anthem, bleach is an amazing album, i like it more n more everytime i listen 2 it, if u havent listened 2 nirvana before definatly give em a go unreal music no 1 else compares, R.I.P Kurt Cobain.
She eats glue????????? |
Reviewer: ♥♥Nikki Armageddon♥♥
I love this song and nirvana, but i am so puzzeled by these lyrics. She eats glue? really?
But i know that kurt wouldnt have wanted me to take the lyrics too seriously. he actualyy wrote one of his songs (i frogot the name) because peeps were overthinking the lyrics. so yeah.
?!? |
If this is your favorite Nirvana tune, and they are your favorite band of the 90's, then, for you, they must be the best of the 80's as well.
Have a nice day.
firstname.lastname@example.com |
Reviewer: Anonymous
this is one of nirvana's best. if you have not heard of this song OR nirvana you havent lived. in my opinion nirvana is one of the greatest rock bands of all time and the best rock band of the 90s.


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Automating compliance processes
Automating compliance
Automating compliance processes News
August 05, 2016
Sparta counters DevOps naysayers with compliance automation
Compliance can be automated along with the app development process as part of a DevOps transformation, one life sciences company found.
October 25, 2012
Product Spotlight: IT GRC, security tools for the business
Our latest roundup of IT compliance products features two IT GRC management tools that help businesses evaluate their assets' and programs' security.
June 12, 2012
How leveraging technology can help regulatory compliance management
In the corporate world, keeping track of compliance mandates can be a challenge. Here's how technology can help with regulatory compliance management.
June 08, 2012
New MetricStream, RSA tools target regulatory compliance management
Our latest compliance product roundup spotlights regulatory compliance management solutions recently released by MetricStream and RSA Security Management.
Automating compliance processes Get Started
Bring yourself up to speed with our introductory content
cyborg anthropologist
A cyborg anthropologist is an individual who studies the interaction between humans and technology, observing how technology can shape humans' lives. Cyborg anthropology as a discipline originated at the 1993 annual meeting of the American ... Continue Reading
Data governance due diligence key to GRC automation success
Information governance expert Jeffrey Ritter discusses how companies can successfully align GRC automation with existing data governance processes. Continue Reading
Mobility gets boost from automated compliance management systems
In this tip, learn how automated compliance management can overcome enterprise mobility complications and save valuable company resources. Continue Reading
Download: Top FAQs regarding the impact of 4 common compliance regulations
IT operations are sometimes unexpectedly affected by major audit regulations – is your IT team prepared? Explore the critical role your IT team plays in ensuring compliance and review the penalties for non-compliance by downloading this FREE e-guide, which covers any questions you might have regarding 4 major legislative regulations.
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Evaluate Automating compliance processes Vendors & Products
Weigh the pros and cons of technologies, products and projects you are considering.
Blockchain compliance raises questions of regulatory scope, intent
Calls for blockchain compliance regulation are getting louder as digital currencies grow in popularity, but will these rules hinder innovation? Continue Reading
Managing unstructured data vital to digital age info governance
Managing unstructured data is crucial for businesses in the digital age, and integrating automated information governance processes can help. Continue Reading
Bitcoin and blockchain technology use raise cybersecurity questions
As Bitcoin and blockchain technology increasingly move into the mainstream, cybersecurity regulations could be on the horizon for virtual currencies. Continue Reading
Manage Automating compliance processes
Learn to apply best practices and optimize your operations.
Data governance for legal and regulatory compliance
Digitization is forcing companies to make big changes to information governance processes to ensure data maintains legal and regulatory compliance. Continue Reading
Information governance 2015: The year of digital evidence as truth
Businesses saw major shifts to their information governance 2015 processes as legal and compliance rules more heavily relied on digital evidence as truth. Continue Reading
Big changes to Adobe licensing may increase audits in short term
Adobe's transition to a subscription-based cloud system creates many new user agreement options. But will the change also increase users' audits? Continue Reading
Problem Solve Automating compliance processes Issues
We've gathered up expert advice and tips from professionals like you so that the answers you need are always available.
Businesses look beyond the finance benefits of blockchain innovation
Companies from a variety of industries have started exploring how blockchain governance strategies can reduce costs, speed interactions and expand business capabilities. Continue Reading
Cipher block chaining technology: How will it influence information governance?
What can IT professionals learn from Bitcoin and other cipher block chaining technologies about improving the value of digital information? Continue Reading
Predictive coding assists in e-discovery, doesn't replace human review
Predictive coding has become a valuable legal tool, but experts caution its benefits are only as good as the human programmers running the system. Continue Reading


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|Jeep-Mid-Sized All discussion of mid-sized Jeeps: Cherokee, Grand Cherokee
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Jeep Transfer Case and Transmission Problem
Vehicle: 1999 Jeep Grand Cherokee 5.7L.
We took it to the dealer in the summer of 05 and they diagnosed our clacking noise as the transfer case going bad, but they said it was driveable and they recommended fixing it as soon as possible or it would eventually go out.
A year later, last month, the noise suddenly got worser and we started hearing faster clacks and quicker taps. Anytime we accelerated it got louder and worser until eventually over 30mph it'll make a loud snapping noise like a chain broke off center or something. We did that three times and the third time it gave out. The car cranks and sound great, but doesn't move at all in drive or reverse and the noise has stopped! We towed it back to the house.
We figured the transfer case finally went out. We paid hefty for the new transfer case. Loaded it in the jeep and had it professionally towed off to a transmission shop. After they inspected it, they said that the transfer case was fine because they took it out and turned it or something. They said the problem was probably inside the transmission. We were shocked and in disbelief because the dealer told us the transfer case and we paid $95 just for the dealer to look at it and tell us this a year ago.
Going on the dealer's notes I went ahead and told them to install the new transfer case and the car still doesn't move. We're back at square one after $1300 of towing, service, and labor. The transmission shop still has it.
I don't know whether to tow it back to the dealer to inspect the new problem or let them do it. I guess driving it for a year with the clacking noise cause transmission troubles.
Does anyone have any advice. I don't know who to trust now. The dealer or the shop.
Re: Jeep Transfer Case and Transmission Problem
It is entirely possible that you caused the transmission problem by driving with the bad transfercase that long. The dealer did tell you "as soon as possible". If the trans shop installed the transfer case; I'd let them replace or rebuild the transmission. They'll at least give you a warrentee on the workmanship to install the case and they'll give you a comprehensive warrentee on the new or rebuilt transmission. It makes little sense, it seem to me, to pay another tow bill. Chalk this one up to experience. Good Luck! [img]/ubbthreads/images/graemlins/smile.gif[/img]
Re: Jeep Transfer Case and Transmission Problem
The only thing dealers can do is selling you new vehicles. That's about the only thing they're good at. Maybe a few exceptions, but i'm convinced it's only excepcions that dealers know anything about the vehicles the're selling.
I always go to specialists like trannyshops or off road centers for advice, but mostly I would have done a better job myself. Only for work that requires special tools I sometimes need to pay them a visit...
Re: Jeep Transfer Case and Transmission Problem
Totally agree with NIX...........on my Z71 last year I had this weird sort of rotation thumping sound coming from the rear end.......I took it to the dealer and they said it was a bad rear wheel bearing......so they replaced that( and a rear rotor as they broke it taking it off) and it was still making the same noise after I picked it up. So then they were convinced it was the transfer case.....so I took the truck back and went to see a tranny shop.........they confirmed it was not the transfer case and was indeed the rear end..........they adjusted it and shimmed it and all is good. The dealer still ripped me off a couple of hundred bucks with their pathetic skill at diagnosing a noise. I will never take any of my trucks to a dealer!!
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Unusual Mixed Dal
|Bengal gram
|1⁄4 Cup (4 tbs), picked and washed
|Split green gram
|1⁄4 Cup (4 tbs), picked and washed
|White gram
|1⁄4 Cup (4 tbs), picked and washed
|6 Cup (96 tbs)
|Turmeric powder
|1⁄2 Teaspoon
|Ginger piece
|1 1⁄2 Inch, minutely cubed
|1 , finely chopped
|Black cardamom
|1 , pounded
|Cinnamon piece
|2 Small
|2 Tablespoon
|Cumin seeds
|1 Teaspoon (Roasted)
|1 Tablespoon, finely chopped
|Red chili powder
|To Taste
|To Taste
1 Soak the pulses in water for at least 1/2 an hour.
2 Bring the water to boil in the cooker and add to it all the ingredients including the pulses but excluding the cumin and oil. Close the cooker and after it reaches maximum pressure, reduce heat and keep for 10 minutes. Take off the fire and open the cooker after the pressure has reduced on its own.
3 Heat the oil. Add the cumin seeds. As soon as they start to darken, add to the cooked dal.
4 Serve garnished with the coriander.
Recipe Summary
Rate It
Nutrition Rank
Nutrition Facts
Serving size
Calories 160 Calories from Fat 57
% Daily Value*
Total Fat 7 g10.1%
Saturated Fat 0.84 g4.2%
Trans Fat 0 g
Cholesterol 0 mg
Sodium 79.3 mg3.3%
Total Carbohydrates 20 g6.6%
Dietary Fiber 4.9 g19.5%
Sugars 3.6 g
Protein 6 g13%
Vitamin A 4.1% Vitamin C 5.9%
Calcium 4.4% Iron 13.7%
*Based on a 2000 Calorie diet


text:
Description: K & L Contracting operates crushing, screening and wash plants at our site in Rosedale, BC. Our products include sand, gravel, road m...more
Have you hired Little John's Bulldozing? Write a review and share your experience!
Have you hired M & M Excavating? Write a review and share your experience!
Description: UTR Bobcat Services is a locally owned and a family operated company. We specialize in driveway prep, hardscaping, landscaping, back filli...more
Not sure which contractor to call for your excavation project? Post your project and let local, top-rated pros come to you and compete for your job!
If you can't find the company you hired and want to submit a review, add them to the TrustedPros directory.
Post your project and within hours you'll be comparing offers from top-rated and trusted
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Post your project and compare offers from top-rated pros.


text:
Let us know when your receive great advice so we can thank our lawyers and point others with similar questions in the right direction.Got it!
Can he receive income from the personal business. and file personal income tax return regarding the income and cost related? if he has two other business partners who also hold H1B visa, how can they file personal income tax returns regarding this business without set up any LLC or C company?
No. An H-1B can only work, whether paid or unpaid, for the H-1B employer.
J Charles Ferrari Eng & Nishimura 213.622.2255 The statement above is general in nature and does not constitute legal advice, as not all the facts are known. You should retain an attorney to review all the facts specific to your case in order to receive advise specific to your case. The statement above does not create an attorney/client relationship. Answers on Avvo can only be general ones, as specific answers would require knowledge of all the facts. As such, they may or may not apply to the question.
Only if contemporaneous employment is approved. At the same time, you can have dividends.
NYC EXPERIENCED IMMIGRATION ATTORNEYS www.myattorneyusa.com; email: email@example.com; Phone: (866) 456-8654; Fax: 212-964-0440; Cell: 212-202-0325. The information contained in this answer is provided for informational purposes only, and should not be construed as legal advice on any subject matter.
The Federal Courts are divided about this. Fortunately, the 9th Circuit Court of Appeals which has jurisdiction over California says "yes".
Please click the link below for additional information.
Carl Shusterman, Esq.
Former INS Trial Attorney (1976-82)
Board Certified Immigration Attorney (1986 - Present)
Schedule a Legal Consultation - Know Your Rights!
600 Wilshire Blvd., Suite 1550
Los Angeles, CA 90017
(213) 394-4554 x0
Web: www.shusterman.com (English)
www.inmigracion-abogado.com (Spanish)
(213) 394-4554 x0 Mr. Shusterman is a former INS Trial Attorney (1976-82) with over 35 years of immigration experience. His response to your question is general in nature, as not all the facts are known to him. You should retain an attorney experienced in immigration law to review all the facts in your case in order to receive advice specific to your case. Mr. Shusterman's statement above does not create an attorney/client relationship.
Thank you Carl! Does that mean H1B holder can do side business and have income from it? Is there any condition associate with this? Thank you!
Yes. Please see http://shusterman.com/newsletterusimmigrationmay2013.html
Post a free question on our public forum.Ask a Question
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text:
|2 1⁄2 Pound (1 Butt)
|1⁄4 Cup (4 tbs)
|Minced onions
|1⁄2 Cup (8 tbs)
|1 Clove (5 gm), minced
|Brown sugar
|2 Teaspoon
|1⁄4 Cup (4 tbs)
|Dry mustard
|1 Teaspoon
|Canned kidney beans
|34 Ounce, drained (2 Cans, 17 Ounce Each)
|Canned green lima beans
|16 Ounce, drained (1 Can)
|1⁄2 Cup (8 tbs)
|To Taste
|To Taste
About 3 hours before serving: Place butt in deep kettle; add boiling water to cover.
Simmer, covered, allowing about 50 minutes per pound, or until fork-tender.
About 10 minutes before butt is done, preheat oven to 350°F.
In skillet, in butter, saute onions and garlic 5 minutes or until tender.
Add sugar, vinegar, mustard, beans and catchup; mix well.
Taste, then add salt and pepper if needed; set aside.
Drain butt; cut into 3/4-inch slices.
Pour bean mixture into 2-quart casserole; arrange butt slices on top.
Cover and bake 15 minutes; uncover and bake 15 minutes more.
Recipe Summary
Rate It
Nutrition Rank
Nutrition Facts
Serving size
Calories 1685 Calories from Fat 439
% Daily Value*
Total Fat 49 g75.8%
Saturated Fat 24.5 g122.4%
Trans Fat 0 g
Cholesterol 360.5 mg120.2%
Sodium 8785.4 mg366.1%
Total Carbohydrates 176 g58.6%
Dietary Fiber 29.4 g117.8%
Sugars 46.1 g
Protein 128 g255.5%
Vitamin A 25.3% Vitamin C 40.8%
Calcium 31.7% Iron 22.6%
*Based on a 2000 Calorie diet


text:
Dowd Restoration is a Remodeling Contractor known in the Denver residential, commercial, retail and hospitality communities for their excellence in Remodeling and Restoration.
Our objective is to supply remodeling and restoration services to homeowners and professionals alike. We provide the skilled resources, knowledge and experience to restore and remodel residential and commercial projects in a professional manner.
We always listen to our customer's ideas and convert them into tastefully designed spaces. We read and translate the customers designs and transform them into amazing and tangible spaces.
Dowd Restoration has the expertise to recreate historic architecture to both private homes and commercial properties. Restoring a classic Victorian house to be a more efficient with modern conveniences or into a bed and breakfast is the type of remodeling projects Dowd Restoration is known for. Hiring Dowd Restoration to renovate an old derelict building into an income producing property with valuable store fronts, office spaces, studios or apartments, ensures the historical integrity remains in tack and the remodeling project is completed on time. We manage all stages of your project. From the pre-design phase through remodeling and delivery.
We have the right people, skilled, dynamic, and concerned for our clients. All of our employees are committed to excellence, reliability and most of all customer satisfaction in all of our Remodeling Projects.
Specializing in High-End Renovation
Residential and Commercial.
- Complete Custom Remodels, from Tear Out to Build Out
- Innovative Designs
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At DOWD RESTORATION we understand that a quality end result when Remodeling your Denver home or business is of high importance to you. We believe that it is the "little" things that can make a BIG difference in your overall satisfaction. Call us for a free estimate on your next Remodeling Project! 303-522-8730
Dowd Restoration recently finished painting the exterior of my house. Jim made the entire experience very smooth and trouble-free. The preliminary work-scraping, priming, patching, etc.-was very expertly done, and everything was completed in a timely manner. There were some complications due to a new roof and some woodwork repairs being done during the same time period, once that was completed, Jim was over quickly to take care of all the touching up and additional repainting necessary.
The crew was very friendly and polite. They also worked very hard and answered all questions we had. We were also amazed at how a new paint job and colors can totally change the look of a house. We love the new look. Definite two thumbs up!
I was very pleased with the work Jim and his crew did! I had a huge hole in my ceiling left by a plumber fixing a leak, and had a 2nd hole in the ceiling left from my ac installers. They fixed both of these areas and the place looks like new! They even fixed a small issue in the wall that I caused when trying to replace my curtain rod. I highly recommend Dowd Restoration and I'll definitely be calling them again.


text:
Slave cylinder is a Lockheed, the master is missing so I don't have much to go on. The mounting bolts are 3/8" diameter on a 3" center mounted in the horizontel position. It uses a Dodge slant 6 engine with 4 speed manual trans. The truck is about the size of a Subaru SW for use in a shop. Anyone got any ideas. Thanks Jeff
Asked by for the 1990 Dodge W150


text:
E Commerce Website
This project received 25 bids from talented freelancers with an average bid price of $246 USD.Get free quotes for a project like this
Project BudgetN/A
Total Bids25
Project Description
Ok I have had an os commerce website up and runnign for a few years ... i have a template of the site etc, but the problem is that the site has been repeatedly hacked over the past month so i have pulled it down..... im begining to believe os commerce is not the best thing to use for the site ......
anyway i want a compitent developer who can take my template and add it to an ecommerce shop, the content of the shop is generated from am excell spreadsheet supplied to me by the supplier monthly and he has links on his site to the videos for the products and product images that can be directly grabbed from his site
the server space i already have is linux and a mysql database......
this is an urgent project as the site is currently down and everytime i put up a new copy of the site after a couple of days some joker hacks it
Skills Required
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- Set your budget and the timeframe
- Outline your proposal
- Get paid for your work
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text: Gadget Girls Have the Sexiest Spy AdventuresKwame Opam8/06/11 12:00pmFiled to: watch thisYuki 7 and the gadget girlskevin dartSpiesAdventure25EditPromoteShare to KinjaToggle Conversation toolsGo to permalink This short film, created by Kevin Dart, shows of Yuki 7 and the Gadget Girls, a group of 60s-style spies who love to blow things up. Dart already has a book and DVD out on them. I'm already a fan. Advertisement [Yuki 7 via The Mary Sue]Reply25 repliesLeave a reply


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text:
|Publication number
|Publication type
|Application number
|Publication date
|Dec 27, 2011
|Filing date
|Feb 11, 2010
|Priority date
|Nov 21, 2001
|Fee status
|Also published as
|Publication number
|Jimmy R. Roehrig, Julian Marshall
|Original Assignee
|Hologic, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (6), Classifications (12), Legal Events (7)
|External Links: USPTO, USPTO Assignment, Espacenet
This application is a continuation of 10/622,978, file Jul. 18, 2003, now U.S. Pat. No. 7,680,315 which is a continuation-in-part of application Ser. No. 09/992,059, filed Nov. 21, 2001 now U.S. Pat. No. 7,054,473 for "A Method and Apparatus for an Improved Computer Aided Diagnosis System," and application Ser. No. 10/079,327 filed Feb. 19, 2002, now U.S. Pat. No. 7,072,498 for "A Method and Apparatus for Expanding the Use of Existing Computer-Aided Detection Code" which applications are incorporated herein by reference.
The subject matter of the present application is related to commonly assigned U.S. Pat. No. 7,668,358 for "Model-Based Grayscale Registration of Medical Images". This application is incorporated herein by reference.
The present invention relates to facilitating computer-aided detection, comparison and/or display of medical images. A particularly useful application of the invention is in the field of radiographic mammography and the invention will be described in detail in that context. The invention may also be practiced in numerous other contexts.
Mammography is a specialized form of radiography designed to detect the subtle changes in x-ray attenuation that are caused by cancerous tissue when x-rays irradiate the human breast. While there is presently no means for preventing breast cancer, early detection of the disease prolongs life expectancy and decreases the likelihood of the need for a total mastectomy. Radiographic mammography is currently the most common method of detecting and analyzing breast lesions. The American Medical Association, The American Cancer Society, and the American College of Radiology recommend yearly mammograms for women beginning at age 40.
Particular features in mammograms that are indicative of breast cancer include spiculated, or stellar-shaped, lesions and microcalcifications. While both features have a relatively high probability of being malignant, both features are also difficult to detect. To detect any feature at all, the x-ray attenuation of that feature must differ appreciably from that of its environment. In the case of cancerous tissue, there is very little difference in attenuation between cancerous tissue and the glandular tissue in which it is found at x-ray energies above about 35 keV and a difference of only about 10% at x-ray energies of about 20 keV. Detection of spiculated masses is further complicated by the presence in typical mammograms of myriad lines corresponding to fibrous breast tissue. In the case of microcalcifications, while they are almost radiopaque, they are usually very small and faint in a mammogram and it is very difficult to distinguish cancerous microcalcifications from numerous other artifacts that are of similar size and appearance.
A typical analog or film-based mammography system 100 is shown in
To make a mammogram, a patient's breast is compressed between a lower surface 132 of the upper compression paddle 130 and an upper surface 137 of the lower compression paddle; and the x-ray tube is turned on. Motor 118 rotates anode 114 while high energy electrons bombard the rotating anode causing the anode to emit x-rays. Some of the x-rays are emitted through tube port 120 in the direction of the breast located between the two compression paddles. The x-rays are band pass filtered by filter 122 to eliminate x-rays of especially high or low energies and are collimated by collimator 124 to eliminate those x-rays traveling in unwanted directions. The remaining x-rays pass through the breast where they are selectively attenuated and are incident on the anti-scatter grid 140. The x-rays that pass through the anti-scatter grid then pass through the x-ray film with little interaction with the film and are incident on the fluorescent screen 154. The x-rays interact with the fluorescent material in the screen, causing this material to emit radiation that interacts with the x-ray film to produce the x-ray image. Some of the x-rays also pass through the fluorescent screen and are incident on the phototimer detector 160.
A variety of choices are available in the physical properties of these systems. The optimal x-ray energy range for these systems is about 17 to 23 keV. Within this range, molybdenum has characteristic x-ray peaks at 17.5 and 19.6 keV and rhodium has such peaks at 20.2 and 22.7 keV; and anodes made of one or the other of these elements are widely used. Typically, the tube port is made of beryllium which has low attenuation. The filters are typically made of the same material as the anode but a rhodium filter is also used with a molybdenum anode for imaging thicker and denser breasts.
Ideally, the mammography system forms on film 152 a projection image of the attenuation of x-ray photons that traveled on straight lines from the anode through the breast to the film. However, the distribution of photons incident per unit area on the film is not uniform. Absorption of photons within the anode creates a "heel effect" as a result of which the area of the film directly under the anode will receive significantly fewer photons per unit area than the area of the film under the cathode.
The photons may also be redirected by Compton or Rayleigh scattering and arrive at the film from many different angles other than angles corresponding to a straight line from the anode. Such scattered photons reduce the contrast in the mammogram. The amount of scatter in mammography varies with increasing breast thickness and breast area. For a typical 5 cm-thick breast, the contrast reduction due to scatter is on the order of 33%. To reject scatter, parallel linear grids with a grid ratio of 4:1 to 5:1 are commonly used. While the film is exposed, the grids are oscillated over a short distance to blur the grid lines. A cellular grid structure is also used in some systems to reject scatter in two dimensions.
Various screen film systems are available from suppliers such as Agfa, Fuji and Kodak. All of these systems have a single gadolinium oxysulfide phosphor screen which produces green light and a green-sensitive single emulsion film. A variety of different speed films are available; and the characteristic curves of optical density versus exposure of these films can be quite different. Typical characteristic curves for two screen-film systems are shown in
Recently, mammography systems have become available that use digital detectors in place of a screen-film system. These systems produce digital mammograms without the intervening steps of processing a film and then digitizing it. The digital systems introduce considerably more variability in the process conditions. In addition to replacing the screen film combination, they also use different anode targets (typically, tungsten) and possibly other filters.
In addition to variations in the physical properties of the mammography system, numerous operational parameters are within the control of the operator. These include the x-ray energy, typically specified in peak voltage (kVp), the exposure, typically specified in milli-Ampere-seconds (mAs), and the processing of the x-ray film. Another factor that clearly affects the optical density recorded on the film is the thickness of the breast being x-rayed and its density (or proportion of glandular tissue to total breast thickness). To a limited degree, the thickness of the breast being x-rayed can be controlled by the operator by adjusting the pressure exerted by the upper compression paddle.
Despite the large number of physical and operational variables that exist in mammography systems, these differences are not an issue when reading a single set of mammograms taken at the same time under the same conditions. In reading the mammograms, the radiologist's attention is focused on the relative difference between adjacent regions of the mammogram; and since the mammogram was made under one set of conditions; these conditions have little effect on relative differences. However, the radiologist frequently wants to compare one set of mammograms with another set of mammograms, for example, a set of mammograms taken the previous year for the same person. In this case, there may be substantial differences between the two sets, for example, because they were taken on different systems, or recorded on different films, or taken with x-rays of different energy, or for different exposures. Needless to say, there are also substantial differences between film-based mammograms and digital mammograms. Similar issues arise in analyzing mammograms of different persons.
Efforts have been made to address these problems by abstracting out at least some of the differences attributable to the physical and operational variables. In Mammographic Image Analysis (Kluver 1999), Ralph Highnam and Michael Brady describe how to correct and remove the effects of x-ray scatter, x-ray energy (kVp), exposure (mAs) and breast thickness. See also, their PCT application PCT/GB00/00617 filed Feb. 21, 2000 and published as publication WO 00/52641 on Sep. 8, 2000, which is incorporated herein by reference. The result is a completely physical description of the breast in terms of thickness and type of material—fat or glandular tissue. Their interest is in the glandular or interesting tissue and they call this description Hint, which is expressed in units of centimeters. A complete physical description of the breast would require a combination of Hint and either the total breast thickness, Htot, or the fat thickness, Hfat, where Htot=Hint+Hfat.
However, the Hint image is very difficult for the radiologist to interpret since it is radically different from the conventional image the radiologist has been trained to interpret. Moreover, the computations needed to produce the Hint image are extensive and require substantial amounts of processing time.
Another approach is described in U.S. Pat. No. 6,516,045 for "Device and Method for Determining Proportions of Body Materials", which is incorporated herein by reference. As shown in
Still another approach is described in the co-pending applications Ser. No. 09/992,059 for "A Method and Apparatus for an Improved Computer Aided Diagnosis System," and Ser. No. 10/079,327 for "A Method and Apparatus for Expanding the Use of Existing Computer-Aided Detection Code" of which the present application is a continuation-in-part. In those applications, various normalization techniques are described to remove the differences caused by different detectors. In particular, the applications describe a variety of techniques for equalizing the contrast response in which analytic expressions or "look-up" tables are developed that convert the response measured by one system to what the response would be if measured by another system. While these techniques facilitate the analysis and comparison of mammograms made using different detectors, they do not address differences arising from different exposure parameters or differences in breast thickness.
Another area in which it would be advantageous to compensate for differences arising from different exposure parameters or differences in breast thickness is in the development of algorithms for computer aided detection and diagnosis of abnormalities in medical images such as mammograms.
The algorithms that are presently used are heavily dependent on the training of the algorithms using groups of mammograms. See, for example, U.S. Pat. No. 5,491,627 to Zhang et al., U.S. Pat. No. 6,075,879 to Roehrig et al., and the above-referenced Ser. No. 10/079,327 for "A Method and Apparatus for Expanding the Use of Existing Computer-Aided Detection Code." At present, to obtain a sufficient number of mammograms for training purposes, the set of training mammograms includes mammograms formed on different mammographic systems. As a result, the performance of the computer aided detection system is not as great as it would be if the training had been performed on the same sized set of mammograms made on a single system. It would be advantageous to be able to train the detection algorithm using larger sets of mammograms made on effectively the same mammographic system.
The present invention is methods for processing medical images so as to remove certain effects of the physical characteristics of the object being imaged and/or of the apparatus used to form the images. The invention further provides for the formation of a standardized image from the processed image and for the use of the standardized image or the processed image in the training of computer-aided detection/diagnosis algorithms. These algorithms may then be used to detect abnormalities in other standardized or processed images derived from any of a variety of image acquisition systems.
These and other objects, features and advantages of the invention will be more readily apparent from the following detailed description of the invention in which:
These effects may include effects arising from physical characteristics of the mammography system such as anode material, source to image distance, anti-scatter grid geometry, film characteristics, and screen film system. They may also include operating characteristics of the mammography system that may vary from patient to patient even when using the same mammography system such as x-ray energy, and magnitude and duration of exposure as well as physical differences between patients such as thickness and density of the breast being imaged. In addition, processing preferably is performed to measure the relative fat content of the breast being imaged.
The processing of the digital or digitized mammogram is preferably performed by a computer. Preferably, the processing performed is essentially the same as that detailed by Highnam and Brady in their book Mammographic Image Analysis and in their PCT patent application PCT/GB00/00617. As indicated above, extensive processing is necessary to remove the effects of the mammography system as well as to remove the effects of the fat content of the breast which is not interesting to the radiologist.
The result of the processing is an image representative of the physical characteristics of the breast that was imaged by the first mammography system and, in particular, representative of its glandular (non-fatty) tissue content. This image is referred to by Highnam and Brady as the Hint (or interesting) image and comprises a two-dimensional array of numerical values representative of the thickness of glandular tissue at each point in the array.
At step 430, the processed image is converted from the Hint image to a standard-form mammogram by calculating what the original mammogram would have looked like had it been made on a standard-form mammography system having a standard set of physical characteristics and a standard set of operating parameters. These calculations are essentially the reverse of the calculations used to form the processed image but using in this case the physical characteristics and operating parameters of the standard-form mammography system. For example, for the standard-form system, the x-ray energy preferably is set to 25 kVp, the exposure to 100 mAs, and the breast thickness to 5 cm. These parameters are preferred in view of the energy dependence of breast x-ray attenuation. Alternatively, the x-ray energy may be set at a value within the range 25-28 kVp and the exposure at a value within the range 20-200 mAs, and the thickness to a value within 4-6 centimeters. The processing required to form the standard-form image is extensive and preferably is performed by a computer.
At step 440, the standard form mammogram is then stored.
In like fashion, other digital or digitized mammograms formed by the same mammography system or by different mammography systems are similarly processed by the system of the present invention to form processed images from which have been removed the same effects related to the physical characteristics and operating parameters of the mammography system as well as to the fat content of the breast; and the processed images are converted to standard-form mammograms and stored.
The standard-form mammograms are then available to be compared at step 450. In all cases, the standard-form mammograms are free of the differences that otherwise would be present arising from the use of different mammography systems and/or different operating parameters in the formation of the mammogram. In the case where the standard-form mammograms are images of the same breast, the images will be essentially the same except for any physiological changes that have occurred in the breast between the time the first mammogram was taken and the time any later mammogram was taken.
Comparisons may be made using a variety of modalities such as computer work stations, film display systems, and images printed on paper. Again, there are considerable differences in the display characteristics of the different modalities and significant differences in the display characteristics of different suppliers' products in the same modality. Of particular interest are differences in brightness and contrast in the displayed images. Advantageously, these differences can be controlled to meet the needs of the user. For example, analytic expressions and/or look-up tables can be developed that relate pixel values of standard-form images stored at step 440 to levels of brightness on a particular manufacturer's work station, to levels of optical density in a film or to gray scale values in an image printed on paper by a laser printer. These expressions or look-up tables are then used at step 450 to convert the standard form images to images having the desired brightness and contrast in the display modality of choice.
To understand how to obtain a purely physical description of the breast such as the Hint image, a simplified example of computing Hint is presented here for three hypothetical locations in a breast, including a first location that is 100% fat, a second location that is 50% fat and 50% glandular, and a third location that is 100% glandular. We will assume the breast is uniformly exposed to mono-energetic x-rays in a device such as shown in
The intensity of x-ray penetrating material is given by Beer's law:
I out =I in exp(−μΔh)
where μ is the attenuation of x-rays through matter, and Δh is the thickness of the material. Let us suppose the attenuation of fat is given by μfat and the attenuation of glandular tissue is μtissue. In reality the attenuation is also a function of energy of the x-ray, but here we will assume that the x-rays are mono-energetic and the attenuation can then be represented with a single number μ.
Then the intensity after passing through Htot of a fatty section, an equal proportion of fat and tissue, and a pure tissue regions will be:
I in exp(−μfat H tot)
I in exp(−(μfat+μtissue)H tot/2)
I in exp(−μtissue H tot)
We assume that the exposure parameters are somehow available so that Iin (in units of mAs or milliAmp-sec) is known, the values for attenuation μ in fat and tissue are known, and the thickness Htot has been measured. If the mammogram has been acquired on film/screen, these parameters are written onto the patient labels which appear on the margins of the films. Co-pending patent application Ser. No. 10/142,704 for "A Method and Apparatus to Associate User Data from a Radiograph" describes an automated technique for obtaining that information using optical character recognition (OCR). This application is incorporated herein by reference. If the mammogram has been acquired on a digital detector, the exposure parameters are entered into fields in the standard DICOM header which is created for each image.
The equations above relate the intensity of x-rays at the detector to the exposure and material characteristics. To actually perform any actual operations in the computer, we must also know how the intensity maps into pixel value in the computer image. This mapping is given by the equation
PV=K ln(I/I′),
which is the linear portion of the film response shown in the characteristic curves of
PV 1=ln(I)−μfat H tot
PV 2=ln(I)−μfat H tot/2−μtissue H tot/2
PV 3=ln(I)−μtissue H tot
Or, subtracting the constant factor ln(I)−μfatHtot, and defining μΔ=μtissue−μfat, we can express the three pixel values as:
PV2=−μΔ H tot/2
PV3=−μΔ H tot
which are in the form PV=μintHint, where Hint is 0 in the portion that is 100% fat, � of Htot in the region with 50% tissue, and 1Htot in the region with 100% tissue. Thus, the pixel values are a function of the thickness of the glandular or interesting tissue in the breast. This is essentially the "Hint" image as used by Highnam and Brady, and provides a representation of the mammogram which is free of the exposure parameters kVp, mAs, and compression thickness.
The standard image formed at step 430 differs from the Hint image described in the above in that it will have the appearance of an x-ray mammogram with a known, "standard" thickness. Without loss of generality, we choose 5 cm as the "standard" thickness because this is a thickness that is quite common in actual mammograms. Further, we assume the mono-energetic x-ray energy to be 25 kVp, and the intensity to be I=100 mAs.
We convert the Hint image to the standard-form "normal" image as follows. The minimum pixel value of this particular Hint image is 0, which is the assigned value for pure fatty region of thickness 5 cm. Given a value of attenuation for fat at 25 kVp to be μfat(25), the Hint image can be converted to a standard form image by adding ln 100exp[μfat(25)*(5−Hint)] to each pixel value. The mapping of the Hint image to the standard form image expressed by this exponential can be implemented in a look up table (LUT). If it is desired to represent the image as it would appear with other exposure parameters, i.e., other Htot, intensity I, and attenuation corresponding to another kVp, this mapping can be implemented by:
PV new =PV norm+[ln(I new)−μfat(kVp)T],
which can be implemented in another LUT.
It remains to show how to map the appearance into the appearance of the standard form image of any given detector.
Whether formed directly by a digital mammography system in step 510 or by digitizing a file in step 515, the portion of the resulting image that is the image of the wedges will have pixel values ranging from a first value corresponding to 100% fatty tissue to a second value corresponding to 100% glandular tissue; and each pixel value in the image of the breast between the first and second values will be associable with a specific percentage of fatty and glandular tissue.
At step 520, a look-up table is created associating each pixel value in the image of the wedge with a specific percentage of fat and glandular tissue; and the pixel values in the digital or digitized image of the breast are converted to an image representative of the physical characteristics of the breast (i.e., percentage of fatty and glandular tissue) by using the table to convert pixel values in the breast image to percentages.
The physical image may then be used in the same fashion as the processed image produced at step 420 in the first embodiment. In particular, the physical image may be converted at step 530 to a standard form mammogram using a standard set of exposure parameters such as a peak energy level of 25 kVp and an exposure of 100 mAs for a breast having a thickness of 5 cm. The standard form mammogram may then be stored at step 540. Additional standard form mammograms may likewise be made and stored and any of these mammograms may later be retrieved at step 550 for display and comparison on suitable display modalities.
In addition to facilitating the comparison of mammograms, the present invention also facilitates the analysis of mammograms in computer aided detection and diagnosis systems. As indicated above, the algorithms used in such systems are typically trained on a large number of mammograms and this typically means that the mammograms were made on more than one mammography system.
In accordance with another embodiment of the present invention, algorithms are trained either on standard-form images or on physical images and mammograms are analyzed by applying the algorithm to either the standard-form image or the physical image of the mammogram.
At step 630 the CAD algorithm is used to analyze a mammogram that has been made on any mammogram system and then converted to a standard form mammogram.
Alternatively, the training of the CAD algorithm could be performed on the physical images of the group of mammograms formed at step 420 or step 520 in which case the analysis of the mammogram would be performed on its physical image.
By using either standard form mammograms or physical images to train the CAD algorithm and then analyzing the standard form mammogram or physical image, only one CAD algorithm is needed. Moreover, a much larger number of mammograms are available to train the CAD algorithms.
|Cited Patent
|Filing date
|Publication date
|Nov 5, 1993
|Oct 24, 1995
|University Of Hawaii
|Method and apparatus for enhanced sensitivity filmless medical x-ray imaging, including three-dimensional imaging
|Feb 24, 1995
|Aug 12, 1997
|Arch Development Corporation
|Automated method and system for computerized detection of masses and parenchymal distortions in medical images
|Nov 15, 1994
|Apr 14, 1998
|Echerer; Scott J.
|Radiographic image enhancement comparison and storage requirement reduction system
|Nov 12, 1997
|Sep 21, 1999
|Kabushiki Kaisha Toshiba
|Medical image processing apparatus
|Jul 25, 1997
|May 2, 2000
|Arch Development Corporation
|Methods for improving the accuracy in differential diagnosis on radiologic examinations
|Mar 2, 2001
|Aug 13, 2002
|Shih-Ping Wang
|Computer-aided diagnosis system and method
|U.S. Classification
|International Classification
|Cooperative Classification
|European Classification
|Jul 25, 2012
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Hurricane Isaac
Following Hurricane Isaac, the Credeur family, Belinda, Glenn, Jesi & Rusty Credeur, receive clean up kits and snacks from the American Red Cross Emergency Response Vehicle (ERV) in Lockport LA (Lafourche Parish).
The Credeurs have lived on the same street for 34 years, surviving Hurricane Katrina numerous other hurricanes. They are adamant that they are not moving and planning to live out their lives there. "The Red Cross has helped us in the past more than any other agency, and throughout all of the storms we have weathered, the Red Cross has always been there."
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