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Bouchez Q, Vandenbroucke D, Pittomvils G, Boterberg T, van Eijkeren M, Leblans P, Vanderstraeten B. Computed chest radiography for total body irradiation: image quality and clinical feasibility. Biomed Phys Eng Express 2024; 10:045032. [PMID: 38788700 DOI: 10.1088/2057-1976/ad5018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/24/2024] [Indexed: 05/26/2024]
Abstract
Objective.In myeloablative total body irradiation (TBI), lung shielding blocks are used to reduce the dose to the lungs and hence decrease the risk of radiation pneumonitis. Some centers are still using mega-Volt (MV) imaging with dedicated silver halide-based films during simulation and treatment for lung delineation and position verification. However, the availability of these films has recently become an issue. This study examines the clinical performance of a computed radiography (CR) solution in comparison to radiographic films and potential improvement of image quality by filtering and post-processing.Approach.We compared BaFBrI-based CR plates to radiographic films. First, images of an aluminum block were analyzed to assess filter impact on scatter reduction. Secondly, a dedicated image quality phantom was used to assess signal linearity, signal-to-noise ratio (SNR), contrast and spatial resolution. Ultimately, a clinical performance study involving two impartial observers was conducted on an anthropomorphic chest phantom, employing visual grading analysis (VGA). Various filter materials and positions as well as post-processing were examined, and the workflow between CR and film was compared.Main results.CR images exhibited high SNR and linearity but demonstrated lower spatial and contrast resolution when compared to film. However, filtering improved contrast resolution and SNR, while positioning filters inside the cassette additionally enhanced sharpness. Image processing improved VGA scores, while additional filtering also resulted in higher spine visibility scores. CR shortened TBI simulation by over 10 minutes for one patient, alongside a dose reduction by order of 0.1 Gy.Significance.This study highlights potential advantages of shifting from conventional radiographic film to CR for TBI. Overall, CR with the incorporation of processing and filtering proves to be suitable for TBI chest imaging. When compared to radiographic film, CR offers advantages such as reduced simulation time and dose delivery, re-usability of image plates and digital workflow integration.
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Affiliation(s)
- Quentin Bouchez
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | | | - Geert Pittomvils
- Department of Radiotherapy-Oncology, Ghent University Hospital, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Tom Boterberg
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
- Department of Radiotherapy-Oncology, Ghent University Hospital, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Marc van Eijkeren
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
- Department of Radiotherapy-Oncology, Ghent University Hospital, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Paul Leblans
- R&D Imaging, Agfa N.V., Septestraat 27, B-2640 Mortsel, Belgium
| | - Barbara Vanderstraeten
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
- Department of Radiotherapy-Oncology, Ghent University Hospital, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
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Håkansson I, Ahlander BM, Höök A, Kihlberg J. Retrospective comparison between MRI examinations during radiographer-administered intranasal sedation or general anesthesia. Radiography (Lond) 2024; 30:296-300. [PMID: 38071937 DOI: 10.1016/j.radi.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/20/2023] [Accepted: 11/26/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION In order for young children to be able to undergo a Magnetic Resonance Imaging (MRI) examination, general anesthesia is often required. The aim of this study was to compare the image quality, times, and costs of the examinations of infant brains performed with MRI either during sedation with dexmedetomidine administered by radiographers or anesthesia with propofol administered by anesthesia staff. METHODS This study was a quantitative retrospective study of 27 consecutive standard brain examinations performed under sedation or anesthesia, involving 15 children under sedation and 12 under anesthesia. The age of the children was from 0.5 to five years old. The image quality was evaluated by three radiologists experienced in pediatric MRI examinations. Information such as examination time and the expense of the examination was also collected. RESULTS There was no statistically significant difference in the general image quality, but one image series was assessed to have significantly better image quality under sedation than under anesthesia, but all images had very high quality. However, it emerged that children under anesthesia were at the hospital on average 55 min longer and the scanner room was occupied 20 min longer on average. The anesthesia examinations were three times more expensive. CONCLUSION This study demonstrated equivalent image quality between sedation and anesthesia. In addition, sedation was less time-consuming and had a lower price, partly because no extra anesthetic staff were required. The use of intranasal sedation offers a possibility to expand the competence area for radiographers. IMPLICATIONS FOR PRACTICE If radiographers learn to perform intranasal sedation, examinations can be performed in less time, at a third of the staff costs while maintaining image quality.
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Affiliation(s)
- I Håkansson
- Ryhov County Hospital, Department of Radiology, Jönköping, Sweden
| | - B-M Ahlander
- Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Gjuterigatan 5, SE-553 18, Jönköping, Sweden
| | - A Höök
- Department of Anaesthesiology and Intensive Care in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - J Kihlberg
- Department of Radiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
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Seeber M, Lederer KA, Rowan C, Strohmayer C, Ludewig E. Image processing setting adaptions according to image dose and radiologist preference can improve image quality in computed radiography of the equine distal limb: A cadaveric study. Vet Radiol Ultrasound 2024; 65:19-30. [PMID: 38098240 DOI: 10.1111/vru.13321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/19/2023] [Accepted: 11/22/2023] [Indexed: 02/07/2024] Open
Abstract
Image processing (IP) in digital radiography has been steadily refined to improve image quality. Adaptable settings enable users to adjust systems to their specific requirements. This prospective, analytical study aimed to investigate the influence of different IP settings and dose reductions on image quality. Included were 20 cadaveric equine limb specimens distal to the metacarpophalangeal and metatarsophalangeal joints. Images were processed with the Dynamic Visualization II system (Fujifilm) using five different IP settings including multiobjective frequency processing, flexible noise control (FNC), and virtual grid processing (VGP). Seven criteria were assessed by three veterinary radiology Diplomates and one veterinary radiology resident in a blinded study using a scoring system. Algorithm comparison was performed using an absolute visual grading analysis. The rating of bone structures was improved by VGP at full dose (P < .05; AUCVGC = 0.45). Überschwinger artifact perception was enhanced by VGP (P < .001; AUCVGC = 0.66), whereas image noise perception was suppressed by FNC (P < .001; AUCVGC = 0.29). The ratings of bone structures were improved by FNC at 50% dose (P < .05; AUCVGC = 0.44), and 25% dose (P < .001; AUCVGC = 0.32), and clinically acceptable image quality was maintained at 50% dose (mean rating 2.16; 95.8% ratings sufficient or better). The favored IP setting varied among observers, with higher agreement at lower dose levels. These findings supported using individualized IP settings based on the radiologist's preferences and situational image requirements, rather than using default settings.
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Affiliation(s)
- Matthias Seeber
- Clinical Unit of Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Kristina A Lederer
- Clinical Unit of Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Conor Rowan
- Clinical Unit of Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Carina Strohmayer
- Clinical Unit of Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Eberhard Ludewig
- Clinical Unit of Diagnostic Imaging, Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
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Brooke N, Elliott J, Murphy T, Vera Stimpson L. Development of a radiographic technique for porcine head ballistic research. Radiography (Lond) 2023; 29:980-983. [PMID: 37595528 DOI: 10.1016/j.radi.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023]
Abstract
INTRODUCTION The porcine model shows structural features comparable to that of humans and are routinely used within research, due to the ethical, legal, and practical use of post-mortem human samples. Methods for obtaining high quality and comparable reference data using standardised acquisition protocols are essential. METHODS The decapitated heads of three adult white sows were subjected to radiographic imaging before and after cranial trauma (9 mm, Heckler and Koch MP5). Digital radiographs were generated using a Siemens MULTIX TOP system with an Agfa digital detector, with foam blocks and sandbags as ancillary equipment. An iterative approach was adopted by the authors to generate reproducible radiographic views from two perpendicular angles. Specimens were kept at 5 °C and wrapped in polythene bags to reduce the impact of putrefaction. RESULTS Standardised head radiography technique was developed for superior-inferior and lateral views demonstrating porcine anatomy. Key parameters included: automatic exposure control for tube current (∼4 mAs), tube voltage of 73 kVp, 100 cm source to image receptor distance, and an anti-scatter grid. Slight variances in specimen morphology, developmental status, and soft tissue changes did not affect imaging outcomes. CONCLUSION The technique and positioning proposed in this study allows for the acquisition of high quality and reproducible radiographic images for comparable ballistic research datasets. Specimen positioning and centring of the primary beam may be applied across porcine breeds, although individual radiographic parameters may differ according to equipment specifications and specimen size. IMPLICATIONS FOR PRACTICE Development of a reproducible radiographic technique of porcine heads in forensic and veterinary research.
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Affiliation(s)
- N Brooke
- School of Law, Policing and Social Sciences, Canterbury Christ Church University, Kent, United Kingdom
| | - J Elliott
- School of Allied and Public Health Professions, Canterbury Christ Church University, Kent, United Kingdom
| | - T Murphy
- Kent Police Tactical Firearms Unit, Kent, United Kingdom
| | - L Vera Stimpson
- School of Law, Policing and Social Sciences, Canterbury Christ Church University, Kent, United Kingdom.
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Sá Dos Reis C, Caso M, Dolenc L, Howick K, Lemmen R, Meira A, Shatku F, Aymon E, Ghotra SS. Optimisation of exposure parameters using a phantom for thoracic spine radiographs in antero-posterior and lateral views. Radiography (Lond) 2023; 29:870-877. [PMID: 37419047 DOI: 10.1016/j.radi.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/09/2023]
Abstract
INTRODUCTION To investigate the exposure parameters for thoracic spine/(TS) radiography that allows the image acquisition at the lowest dose possible, while maintaining an adequate image quality/(IQ) to identify all relevant anatomical criteria. METHODS An experimental phantom study was conducted, and 48 different radiographs of TS (24 AP/24 lateral) were acquired. The Automatic Exposure Control/(AEC) with the central sensor was used to select the beam intensity, while Source-to-Detector-Distance/(SDD) (AP:115/125 cm; Lateral:115/150 cm), tube potential (AP:70/81/90 kVp; Lateral: 81/90/102 kVp), use of grid/no grid and focal spot (fine/broad) were manipulated. IQ was assessed by observers with ViewDEX. Effective Dose (ED) was estimated using PCXMC2.0 software. Descriptive statistics paired with intraclass correlation coefficient (ICC) were applied to analyse data. RESULTS The ED increased with a greater SDD for lateral-view, presenting a significant difference (p = 0.038), however IQ was not affected. For both AP and lateral, the use of grid had a significant effect on ED (p < 0.001). Despite the images acquired without grid had lower IQ scores, the observers considered the IQ adequate for clinical use. A 20% reduction in ED (0.042mSv-0.033 mSv) was observed when increasing the beam energy from 70 to 90 kVp for AP grid in. The observers ICC ranged from moderate to good (0.5-0.75) in lateral and good to excellent (0.75-0.9) for AP views. CONCLUSIONS The optimised parameters in this context were 115 cm SDD, 90 kVp with grid for the best IQ and lowest ED. Further studies in clinical setting are necessary to enlarge the context and cover different body habitus and equipment. IMPLICATIONS FOR PRACTICE The SDD impacts on dose for TS; Higher kVp and grid are necessary to better image quality.
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Affiliation(s)
- C Sá Dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - M Caso
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - L Dolenc
- Medical Imaging and Radiotherapy Department, Faculty of Health Sciences, University of Ljubljana, Slovenia.
| | - K Howick
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland.
| | - R Lemmen
- Department of Medical Imaging and Radiation Therapy, Hanze University of Applied Sciences, Groningen, the Netherlands.
| | - A Meira
- Medical Imaging and Radiation Therapy, Lisbon School of Health Technology (ESTeSL)/IPL, Lisbon, Portugal.
| | - F Shatku
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - E Aymon
- Department of Radiology, Hospital of Sion, Avenue Du Grand-Champsec 80, 1950, Sion, Switzerland.
| | - S S Ghotra
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland; Department of Radiology, Hospital of Yverdon-les-Bains (eHnv), 1400 Yverdon-les-Bains, Switzerland.
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Lockwood P, Mitchell M. An assessment of the dose and image quality difference between AP and PA positioned adult radiographic knee examinations. J Med Imaging Radiat Sci 2023; 54:123-134. [PMID: 36646545 DOI: 10.1016/j.jmir.2022.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/10/2022] [Accepted: 12/07/2022] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Knee X-rays are a standard examination to diagnose multiple conditions ranging from traumatic injuries, degeneration, and cancer. This study explores the differences between adult Anterior-Posterior (AP) and Posterior-Anterior (PA) weight-bearing knee examinations using absorbed radiation dose data and image quality. METHODS The study modelled and compared AP and PA knee X-ray radiation dose data using Monte-Carlo software, an Ion Chamber, and thermoluminescence dosemeters (TLDs) on a Rando phantom. Imaging parameters used were 66kVp, 4mAs, 100cm distance and 13 × 24cm collimation. The interval data analysis used a two-tailed t-test. The image quality of a sample of the AP and PA knee X-rays was assessed using Likert 5-point ordinal Image Quality Scoring (IQS) and the Wilcoxon matched pairs test. RESULTS Monte-Carlo modelling provided limited results; the Ion Chamber data for absorbed dose provided no variation between AP and PA positions but was similar to the AP TLD dose. The absorbed doses recorded with batches of TLDs demonstrated a 27.4% reduction (46.1μGy; p=0.01) in Skin Entrance Dose (ESD) and 9 - 58% dose reduction (1.6 - 16.4μGy; p=0.00-0.2) to the tissues and organs while maintaining diagnostic image quality (p=0.67). CONCLUSION The study has highlighted the various challenges of using different dosimetry approaches to measure absorbed radiation dose in extremity (knee) X-ray imaging. The Monte-Carlo simulated absorbed knee dose was overestimated, but the simulated body organ/tissue doses were lower than the actual TLD absorbed doses. The Ion Chamber absorbed doses did not differentiate between the positions. The TLD organ/tissue absorbed doses demonstrated a reduction in dose in the PA position compared to the AP position, without a detrimental effect on image quality. The study findings in laboratory conditions raise awareness of opportunities and potential to lower radiation dose, with further study replicated in a clinical site recommended.
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Affiliation(s)
- Paul Lockwood
- School of Allied Health Professions, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Kent, United Kingdom.
| | - Martin Mitchell
- School of Allied Health Professions, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Kent, United Kingdom; Imaging Department, Medway Maritime Hospital, Medway NHS Foundation Trust, Gillingham, Kent, United Kingdom
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Kanzaki Y, Kuramoto T, Takarabe S, Shibayama Y, Yoshikawa H, Kato T. Effect of high- and low-energy entrance surface dose allocation ratio for two-shot dual-energy subtraction imaging on low-contrast resolution. Radiography (Lond) 2023; 29:240-246. [PMID: 36608378 DOI: 10.1016/j.radi.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/08/2022] [Accepted: 11/20/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Dual-energy subtraction (DES) imaging can obtain chest radiographs with high contrast between nodules and healthy lung tissue, and evaluating of chest radiography and evaluating exposure conditions is crucial to obtain a high-quality diagnostic image. This study aimed to investigate the effect of the dose allocation ratio of entrance surface dose (ESD) between high- and low-energy projection in low-contrast resolution of soft-tissue images for two-shot DES imaging in digital radiography using a contrast-detail phantom (CD phantom). METHODS A custom-made phantom mimicking a human chest that combined a CD phantom, polymethylmethacrylate square plate, and an aluminum plate (1-3 mm) was used. The tube voltage was 120 kVp (high-energy) and 60 kVp (low-energy). The ESD was changed from 0.1 to 0.5 mGy in 0.1 mGy increments. Dose allocation ratio of ESD between 120 kVp and 60 kVp projection was set at 1:1, 1:2, 1:3, and 2:1. Inverse image quality figure (IQFinv) was calculated from the custom-made phantom images. RESULTS When the total ESD and aluminum thickness were constant, no significant difference in IQFinv was observed under most conditions of varied dose allocation ratio. Similarly, when the total ESD and the dose allocation ratio were constant, there was no significant difference in IQFinv based on the aluminum plate thickness. CONCLUSION Using IQFinv to evaluate the quality of the two-shot DES image suggested that dose allocation ratio did not have a significant effect on low-contrast resolution of soft-tissue images. IMPLICATIONS FOR PRACTICE The present results provide useful information for determining exposure conditions for two-shot DES imaging.
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Affiliation(s)
- Y Kanzaki
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - T Kuramoto
- Department of Radiological Technology, Faculty of Health Sciences, Kobe Tokiwa University, 2-6-2 Otanicho, Nagata-ku, Kobe 653-0838, Japan.
| | - S Takarabe
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Y Shibayama
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - H Yoshikawa
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - T Kato
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Mifsud K, Portelli J, Zarb F, Couto J. Evaluating the use of higher kVp and copper filtration as a dose optimisation tool in digital planar radiography. Radiography (Lond) 2022; 28:586-592. [DOI: 10.1016/j.radi.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 10/18/2022]
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Muhammad N, Karim M, Harun H, Rahman M, Azlan R, Sumardi N. The impact of tube current and iterative reconstruction algorithm on dose and image quality of infant CT head examination. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Genske U, Jahnke P. Human Observer Net: A Platform Tool for Human Observer Studies of Image Data. Radiology 2022; 303:524-530. [PMID: 35258375 DOI: 10.1148/radiol.211832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Current software applications for human observer studies of images lack flexibility in study design, platform independence, multicenter use, and assessment methods and are not open source, limiting accessibility and expandability. Purpose To develop a user-friendly software platform that enables efficient human observer studies in medical imaging with flexibility of study design. Materials and Methods Software for human observer imaging studies was designed as an open-source web application to facilitate access, platform-independent usability, and multicenter studies. Different interfaces for study creation, participation, and management of results were implemented. The software was evaluated in human observer experiments between May 2019 and March 2021, in which duration of observer responses was tracked. Fourteen radiologists evaluated and graded software usability using the 100-point system usability scale. The application was tested in Chrome, Firefox, Safari, and Edge browsers. Results Software function was designed to allow visual grading analysis (VGA), multiple-alternative forced-choice (m-AFC), receiver operating characteristic (ROC), localization ROC, free-response ROC, and customized designs. The mean duration of reader responses per image or per image set was 6.2 seconds ± 4.8 (standard deviation), 5.8 seconds ± 4.7, 8.7 seconds ± 5.7, and 6.0 seconds ± 4.5 in four-AFC with 160 image quartets per reader, four-AFC with 640 image quartets per reader, localization ROC, and experimental studies, respectively. The mean system usability scale score was 83 ± 11 (out of 100). The documented code and a demonstration of the application are available online (https://github.com/genskeu/HON, https://hondemo.pythonanywhere.com/). Conclusion A user-friendly and efficient open-source application was developed for human reader experiments that enables study design versatility, as well as platform-independent and multicenter usability. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Thompson in this issue.
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Affiliation(s)
- Ulrich Genske
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany (U.G., P.J.); Data Analytics and Computational Statistics, Hasso Plattner Institute, Digital Engineering Faculty, University of Potsdam, Potsdam, Germany (U.G.); and Berlin Institute of Health, Berlin, Germany (P.J.)
| | - Paul Jahnke
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany (U.G., P.J.); Data Analytics and Computational Statistics, Hasso Plattner Institute, Digital Engineering Faculty, University of Potsdam, Potsdam, Germany (U.G.); and Berlin Institute of Health, Berlin, Germany (P.J.)
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Bisgaard M, McEvoy FJ, Nielsen DH, Allberg C, Müller AV, Timm S, Meyer SN, Johansen LM, Pedersen S, Precht H. Collimation and Exposure Parameter Influence Image Quality and Potential Radiation Dose to the Eye Lens of Personnel in Computed Radiography of the Canine Pelvis. Front Vet Sci 2022; 8:684064. [PMID: 34970612 PMCID: PMC8713743 DOI: 10.3389/fvets.2021.684064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: The purpose of this study was to evaluate the effect of collimation on image quality and radiation dose to the eye lenses of the personnel involved in computed radiography of the canine pelvis. Materials and Methods: A retrospective study of canine pelvic radiographs (N = 54) was undertaken to evaluate the relationship between image quality and the degree of field the collimation used. This was followed by a prospective cadaver study (N = 18) that assessed the effects on image quality and on scattered radiation dose of different collimation field areas and exposure parameters. All radiographs were analyzed for image quality using a Visual Grading Analysis (VGA) with three observers. Finally, the potential scattered radiation dose to the eye lens of personnel restraining a dog for pelvic radiographs was measured. Results: The retrospective study showed a slightly better (statistically non-significant) VGA score for the radiographs with optimal collimation. Spatial and contrast resolution and image sharpness showed the greatest improvement in response to minimizing the collimation field. The prospective study showed slightly better VGA scores (improved image quality) with the optimal collimation. Increasing the exposure factors especially the tube current and exposure time (mAs) resulted in improved low contrast resolution and less noise in the radiographs. The potential eye lens radiation dose increased by 14, 28, and 40% [default exposures, increased the tube peak potential (kVp), increased mAs, respectively] as a result of reduced collimation (increased beam size). Conclusion: The degree of collimation has no statistically significant on image quality in canine pelvic radiology for the range of collimation used but does have an impact on potential radiation dose to personnel in the x-ray room. With regard to radiation safety, increases in kVp are associated with less potential scatter radiation exposure compared to comparable increases in mAs.
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Affiliation(s)
- Malene Bisgaard
- Department of Radiology, Lillebaelt Hospital, University Hospitals of Southern Denmark, Kolding, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Fintan J McEvoy
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Dorte Hald Nielsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Clara Allberg
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Anna V Müller
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Signe Timm
- Department of Regional Health Research, University of Southern Denmark, Kolding, Denmark.,Lillebaelt Hospital, University Hospitals of Southern Denmark, Kolding, Denmark
| | - Signe N Meyer
- Department of Radiology, Lillebaelt Hospital, University Hospitals of Southern Denmark, Kolding, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark
| | | | - Stine Pedersen
- Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Helle Precht
- Department of Radiology, Lillebaelt Hospital, University Hospitals of Southern Denmark, Kolding, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark.,Department of Regional Health Research, University of Southern Denmark, Kolding, Denmark
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Visual Evaluation of Image Quality of a Low Dose 2D/3D Slot Scanner Imaging System Compared to Two Conventional Digital Radiography X-ray Imaging Systems. Diagnostics (Basel) 2021; 11:diagnostics11101932. [PMID: 34679630 PMCID: PMC8534907 DOI: 10.3390/diagnostics11101932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to assess the image quality of the low dose 2D/3D slot scanner (LDSS) imaging system compared to conventional digital radiography (DR) imaging systems. Visual image quality was assessed using the visual grading analysis (VGA) method. This method is a subjective approach that uses a human observer to evaluate and optimise radiographic images for different imaging technologies. Methods and materials: ten posterior-anterior (PA) and ten lateral (LAT) images of a chest anthropomorphic phantoms and a knee phantom were acquired by an LDSS imaging system and two conventional DR imaging systems. The images were shown in random order to three (chest) radiologists and three experienced (knee) radiographers, who scored the images against a number of criteria. Inter- and intraobserver agreement was assessed using Fleiss’ kappa and weighted kappa. Results: the statistical comparison of the agreement between the observers showed good interobserver agreement, with Fleiss’ kappa coefficients of 0.27–0.63 and 0.23–0.45 for the chest and knee protocols, respectively. Comparison of intraobserver agreement also showed good agreement with weighted kappa coefficients of 0.27–0.63 and 0.23–0.45 for the chest and knee protocols, respectively. The LDSS imaging system achieved significantly higher VGA image quality compared to the DR imaging systems in the AP and LAT chest protocols (p < 0.001). However, the LDSS imaging system achieved lower image quality than one DR system (p ≤ 0.016) and equivalent image quality to the other DR systems (p ≤ 0.27) in the knee protocol. The LDSS imaging system achieved effective dose savings of 33–52% for the chest protocol and 30–35% for the knee protocol compared with DR systems. Conclusions: this work has shown that the LDSS imaging system has the potential to acquire chest and knee images at diagnostic quality and at a lower effective dose than DR systems.
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Precht H, Outzen CB, Kusk MW, Bisgaard M, Waaler D. COMPARISON OF CONVENTIONAL HAND EXAMINATION ON SIX OPTIMISED DR SYSTEMS. RADIATION PROTECTION DOSIMETRY 2021; 194:27-35. [PMID: 33969425 PMCID: PMC8808537 DOI: 10.1093/rpd/ncab067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/23/2021] [Accepted: 04/13/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to investigate the challenges in comparing digital radiography (DR) systems from different vendors for various combinations of exposure factors in posterior-anterior hand radiographs. Image quality was evaluated for a range of tube voltages and tube current-time products using a technical contrast-detail (CDRAD) phantom and an anthropomorphic hand phantom. 900 technical CDRAD images were analysed providing quality figures of merit (IQFinv) and two experienced reporting radiographers using visual grading analysis (VGA) scored 108 anthropomorphic images. This study demonstrates the differences between the DR systems included. When compensating for variations in dose, Canon showed superior results for technical image quality and Fuji for visual image quality for a standard dose point at DR hand examination (ln(DAP) 1.1, 50 kV and 2.5 mAs).
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Affiliation(s)
| | - Claus Bjørn Outzen
- Health Sciences Research Centre, UCL University College, Niels Bohrs Allé 1, 5230 Odense M, Denmark
| | - Martin Weber Kusk
- Department of Radiology and Nuclear Medicine, University Hospital of Southwest Denmark, Finsensgade 35, 6700 Esbjerg, Denmark
| | - Malene Bisgaard
- Health Sciences Research Centre, UCL University College, Niels Bohrs Allé 1, 5230 Odense M, Denmark
| | - Dag Waaler
- Department of Health Sciences, Gjøvik, Norwegian University of Science and Technology, Teknologiveien 22, 2803 Gjøvik, Norway
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Outzen CB, Maron D, Nissen J, Munk J, Grau LM, Juhl D, Precht H. The influence of a novel edge enhancement software on image quality of DR hand images of patients with rheumatoid arthritis. Radiography (Lond) 2021; 27:877-882. [PMID: 33676836 DOI: 10.1016/j.radi.2021.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aimed to evaluate the effects of a newly developed Advanced Edge Enhancement software (AEE) (Canon Europe, Amsterdam, NL) on image quality (IQ) of Digital Radiography (DR) hand images focusing on rheumatoid arthritis (RA). METHODS AND MATERIALS Fifty posterior-anterior hand images with or suspected for RA were collected. For each of the 50 images, six copies were made with each their AEE algorithm settings. A total of 330 images (30 images iterated) were evaluated using relative Visual Grading Analysis (VGA) by three observers and combined into a VGA Score (VGAS). Second, 50 images of a technical Contrast Detail Radiography Phantom (CDRAD) was produced with three different AEE software settings, each at level 1,5 and without the AEE software yielding 350 CDRAD images. All images was analysed by the CDRAD Analyser and included for an objective analysis of the AEE software. RESULTS The VGA study showed a significant difference in image quality between a standard image and images with AEE software applied. The average VGA score of the AEE software was better than the standard images (interval between 0.2 and 0.9). The AEE algorithms at level 5 scored significantly lower for noise but significantly higher for spatial resolution, sharpness and contrast in the VGA. The CDRAD images showed that all AEE algorithms had a statistically significant improvement for level 1 and deterioration for level 5 compared to the standard image. CONCLUSION Overall the AEE algorithm: small structure level 1 showed an improvement of all IQ criteria in the VGA and a better technical IQ. IMPLICATIONS FOR PRACTICE The AEE software ought to be considered as a useful addition to the current software, possibly enabling visualisation of structures currently visible.
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Affiliation(s)
- C B Outzen
- Health Sciences Research Centre, UCL University College, Niels Bohrs Alle 1, 5230, Odense M, Denmark.
| | - D Maron
- Health Sciences Research Centre, UCL University College, Niels Bohrs Alle 1, 5230, Odense M, Denmark.
| | - J Nissen
- Health Sciences Research Centre, UCL University College, Niels Bohrs Alle 1, 5230, Odense M, Denmark.
| | - J Munk
- Health Sciences Research Centre, UCL University College, Niels Bohrs Alle 1, 5230, Odense M, Denmark.
| | - L M Grau
- Department of Radiology, Hospital Sonderjylland, University Hospitals of Southern Denmark, Kresten Philipsens Vej 15, 6200, Aabenraa, Denmark.
| | - D Juhl
- Department of Radiology, Hospital Sonderjylland, University Hospitals of Southern Denmark, Kresten Philipsens Vej 15, 6200, Aabenraa, Denmark.
| | - H Precht
- Health Sciences Research Centre, UCL University College, Niels Bohrs Alle 1, 5230, Odense M, Denmark; Department of Regional Health Research, University of Southern Denmark; Department of Radiology, Lillebaelt Hospital, University Hospitals of Southern, Kolding, Denmark.
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Boita J, Bolejko A, Zackrisson S, Wallis MG, Ikeda DM, Van Ongeval C, van Engen RE, Mackenzie A, Tingberg A, Bosmans H, Pijnappel R, Sechopoulos I, Broeders M. Development and content validity evaluation of a candidate instrument to assess image quality in digital mammography: A mixed-method study. Eur J Radiol 2021; 134:109464. [PMID: 33307458 DOI: 10.1016/j.ejrad.2020.109464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To develop a candidate instrument to assess image quality in digital mammography, by identifying clinically relevant features in images that are affected by lower image quality. METHODS Interviews with fifteen expert breast radiologists from five countries were conducted and analysed by using adapted directed content analysis. During these interviews, 45 mammographic cases, containing 44 lesions (30 cancers, 14 benign findings), and 5 normal cases, were shown with varying image quality. The interviews were performed to identify the structures from breast tissue and lesions relevant for image interpretation, and to investigate how image quality affected the visibility of those structures. The interview findings were used to develop tentative items, which were evaluated in terms of wording, understandability, and ambiguity with expert breast radiologists. The relevance of the tentative items was evaluated using the content validity index (CVI) and modified kappa index (k*). RESULTS Twelve content areas, representing the content of image quality in digital mammography, emerged from the interviews and were converted into 29 tentative items. Fourteen of these items demonstrated excellent CVI ≥ 0.78 (k* > 0.74), one showed good CVI < 0.78 (0.60 ≤ k* ≤ 0.74), while fourteen were of fair or poor CVI < 0.78 (k* ≤ 0.59). In total, nine items were deleted and five were revised or combined resulting in 18 items. CONCLUSIONS By following a mixed-method methodology, a candidate instrument was developed that may be used to characterise the clinically-relevant impact that image quality variations can have on digital mammography.
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Affiliation(s)
- Joana Boita
- Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, the Netherlands; Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands
| | - Anetta Bolejko
- Department of Medical Imaging and Physiology, Translational Medicine Malmö, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, SE-20502, Malmö, Sweden
| | - Sophia Zackrisson
- Department of Medical Imaging and Physiology, Translational Medicine Malmö, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, SE-20502, Malmö, Sweden
| | - Matthew G Wallis
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge & NIHR Cambridge Biomedical Research Centre, Cambridge, CB2 0QQ, UK
| | - Debra M Ikeda
- Department of Radiology, Stanford University School of Medicine, 875 Blake Wilbur Dr. Stanford, CA, 94305, USA
| | - Chantal Van Ongeval
- Department of Radiology, Radiology, UZ Gasthuisberg, Herestraat 49, Leuven, B-3000, Belgium
| | - Ruben E van Engen
- Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands
| | - Alistair Mackenzie
- National Coordinating Centre for the Physics of Mammography, Royal Surrey NHS Foundation Trust, Guildford, GU2 7XX, UK
| | - Anders Tingberg
- Department of Medical Radiation Physics, Translational Medicine Malmö, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, SE-20502, Malmö, Sweden
| | - Hilde Bosmans
- Department of Radiology, Radiology, UZ Gasthuisberg, Herestraat 49, Leuven, B-3000, Belgium; Department of Imaging and Pathology, Radiology, KUL, Herestraat 49, Leuven, B-3000, Belgium
| | - Ruud Pijnappel
- Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands; Department of Radiology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, Utrecht University, the Netherlands
| | - Ioannis Sechopoulos
- Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, the Netherlands; Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands
| | - Mireille Broeders
- Dutch Expert Centre for Screening (LRCB), Wijchenseweg 101, 6538 SW, Nijmegen, the Netherlands; Department for Health Evidence, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, the Netherlands.
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Mathews J, Grewal H, Gillan C, Menezes R, Cornacchione P, Catton J. Development of nuclear medicine image quality assessment criteria for use in a technologist peer review program. J Med Imaging Radiat Sci 2020; 52:29-36. [PMID: 33308950 DOI: 10.1016/j.jmir.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION/BACKGROUND A peer learning program includes the process of peer review, which is the act of performing a secondary review of a peer's work using pre-defined criteria. The Technologist Image Quality Assessment Criteria Project (TIQACP) was initiated to develop and evaluate such criteria for use by technologists for assessment of image quality in Nuclear Medicine (NM). METHODS A NM clinical expert panel was assembled, comprising 14 technologists, radiologists, and educators from five imaging centres and an academic institution with associated medical imaging training programs. Project design was guided by consensus-based methodology that included three phases: (1) image quality assessment criteria development, based on literature search and expert review (2) image quality assessment criteria refinement, based on consensus-building exercises (panel surveys, discussions, ranking exercise, and time trial) (3) external validation performed via a national survey of NM technologists, facilitated by the Canadian Association of Medical Radiation Technologists. RESULTS The first phase generated 8 key evidence sources, including textbooks, NM journals and guidelines from professional associations that were reviewed by the expert panel leads and led to a preliminary list of 11 criteria. As part of the second phase, the preliminary list was reviewed via online surveys and panel discussions. Preliminary discussions led to an initial expansion of the list to include 18 criteria. This list required an average of 9 min (range: 7-11 min) for review, which was deemed prohibitive by the panel. A ranking exercise identified 'all required anatomy is clearly identified' as the most relevant criteria and 'Image quality demonstrates no breakdown of the radiopharmaceutical' as the least relevant criteria. Panel discussion also highlighted need to eliminate criteria that were not applicable to all settings. These insights led to an updated list of nine criteria organized into four categories. National validation was supported by 47 NM technologists from across Canada. Respondents were in agreement that the criteria reflected the core elements of image quality in NM (94% agree to strongly agree), were familiar (97%) and were relevant to their current practice setting (88%). The final list was thus not changed based on the survey. DISCUSSION/CONCLUSION The TIQACP utilized an inclusive process that engaged a range of subject matter experts and the broader NM community to ensure buy-in of the final criteria. These criteria have subsequently been embedded in peer review software that has been implemented into a robust peer learning program for technologists designed to promote a culture of continuous improvement and knowledge sharing amongst front-line staff.
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Affiliation(s)
- Jisla Mathews
- Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, Women's College Hospital, Toronto, Ontario, Canada.
| | - Harinder Grewal
- Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, Women's College Hospital, Toronto, Ontario, Canada
| | - Caitlin Gillan
- Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, Women's College Hospital, Toronto, Ontario, Canada
| | - Ravi Menezes
- Lumenus Community Services, Toronto, Ontario, Canada
| | - Paul Cornacchione
- Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, Women's College Hospital, Toronto, Ontario, Canada
| | - Jennifer Catton
- Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, Women's College Hospital, Toronto, Ontario, Canada
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Moorman L, Precht H, Jensen J, Svalastoga E, Nielsen DH, Proschowsky HF, McEvoy FJ. Assessment of Image Quality in Digital Radiographs Submitted for Hip Dysplasia Screening. Front Vet Sci 2019; 6:428. [PMID: 31850383 PMCID: PMC6901622 DOI: 10.3389/fvets.2019.00428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/13/2019] [Indexed: 11/25/2022] Open
Abstract
Digital radiography is widely seen to be forgiving of poor exposure technique and to provide consistent high quality diagnostic images. Optimal quality images are however not universal; sub-optimal images are encountered. Evaluators on hip dysplasia schemes encounter images from multiple practices produced on equipment from multiple manufacturers. For images submitted to the Danish Kennel Club for hip dysplasia screening, a range of quality is seen and the evaluators are of the impression that variations in image quality area associated with particular equipment. This study was undertaken to test the hypothesis that there is an association between image quality in digital radiography and the manufacturer of the detector equipment, and to demonstrate the applicability of visual grading analysis (VGA) for image quality evaluation in veterinary practice. Data from 16,360 digital images submitted to the Danish Kennel Club were used to generate the hypothesis that there is an association between detector manufacturer and image quality and to create groups for VGA. Image quality in a subset of 90 images randomly chosen from 6 manufacturers to represent high and low quality images, was characterized using VGA and the results used to test for an association between image quality and system manufacturer. The range of possible scores in the VGA was −2 to +2 (higher scores are better). The range of the VGA scores for the images in the low image quality group (n = 45) was −1.73 to +0.67, (median −1.2). Images in the high image quality group (n = 44) ranged from −1.52 to +0.53, (median −0.53). This difference was statistically significant (p < 0.001). The study shows an association between VGA scores of image quality and detector manufacturer. Possible causes may be that imaging hardware and/or software are not equal in terms of quality, that the level of support sought and given differs between systems, or a combination of the two. Clinicians purchasing equipment should be mindful that image quality can differ across systems. VGA is practical for veterinarians to compare image quality between systems or within a system over time.
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Affiliation(s)
- Lilah Moorman
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helle Precht
- Health Sciences Research Centre: Diagnosis and Treatment CONRAD, University College Lillebælt, Odense, Denmark
| | - Janni Jensen
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark.,Department of Radiology, Odense University Hospital, Odense, Denmark
| | - Eiliv Svalastoga
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte H Nielsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Fintan J McEvoy
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Eccles C, Adair Smith G, Bower L, Hafeez S, Herbert T, Hunt A, McNair H, Ofuya M, Oelfke U, Nill S, Huddart R. Magnetic resonance imaging sequence evaluation of an MR Linac system; early clinical experience. Tech Innov Patient Support Radiat Oncol 2019; 12:56-63. [PMID: 32095556 PMCID: PMC7033780 DOI: 10.1016/j.tipsro.2019.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To systematically identify the preferred magnetic resonance imaging (MRI) sequences following volunteer imaging on a 1.5 Tesla (T) MR-Linear Accelerator (MR Linac) for future protocol development. METHODS Non-patient volunteers were recruited to a Research and Ethics committee approved prospective MR-only imaging study on a 1.5T MR Linac system. Volunteers attended 1-3 imaging sessions that included a combination of mDixon, T1w, T2w sequences using 2-dimensional (2D) and 3-dimensional (3D) acquisitions. Each sequence was acquired over 2-7 minutes and reviewed by a panel of 3 observers to evaluate image quality using a visual grading analysis based on a 4-point Likert scale. Sequences were acquired and modified iteratively until deemed fit for purpose (online image matching or re-planning) and all observers agreed they were suitable in 3 volunteers. RESULTS 26 volunteers underwent 31 imaging sessions of six general anatomical regions. Images were acquired in one or two of six general anatomical regions: male pelvis (n = 9), female pelvis (n = 4), chestwall/breast (n = 5), lung/oesophagus (n = 5), abdomen (n = 3) and head and neck (n = 5). Images were acquired using a pre-defined exam-card that on average, included six sequences (range 2-10), with a maximum scan time of approximately one hour. The majority of observers preferred T2-weighted sequences. The thorax teams were the only groups to prefer T1-weighted imaging. CONCLUSIONS An iterative process identified sequence agreement in all anatomical regions. These sequences will now be evaluated in patient volunteers. ADVANCES IN KNOWLEDGE This manuscript is the first publication sharing the results of the first systematic selection of MRI sequences for use in on-board MRI-guided radiotherapy by end-users (therapeutic radiographers and clinical oncologists) in healthy volunteers.
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Affiliation(s)
- C.L. Eccles
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Christie NHS Foundation Trust, and the University of Manchester, Manchester, United Kingdom
| | - G. Adair Smith
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - L. Bower
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research/The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - S. Hafeez
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research/The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - T. Herbert
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A. Hunt
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research/The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - H.A. McNair
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research/The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Mercy Ofuya
- Clinical Trials and Statistic Unit, The Institute for Cancer Research, London, United Kingdom
| | - Uwe Oelfke
- Joint Department of Physics at the Royal Marsden and The Institute of Cancer Research, United Kingdom
| | - Simeon Nill
- Joint Department of Physics at the Royal Marsden and The Institute of Cancer Research, United Kingdom
| | - R.A. Huddart
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research/The Royal Marsden NHS Foundation Trust, London, United Kingdom
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England A, Thompson J. Evolving the Landscape of Research. Radiography (Lond) 2019; 25 Suppl 1:S1-S3. [DOI: 10.1016/j.radi.2019.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 11/28/2022]
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