Factors affecting x-ray spectra

Optimising image quality in intravenous cerebral cone beam computed tomography

INTRODUCTION

The efficacy of intravenous cerebral Cone Beam Computed Tomography (IV CBCT) is well established; however, image quality has only ever been authenticated by subjective evaluation. The aim of this study was to quantify the factors pertinent to achieving consistent and optimal image quality when performing IV CBCT.

METHODS

Between 1 March 2021 and 30 October 2022, 79 patients received IV CBCT. These candidates were divided into three main acquisition field size categories (22/32, 42 and 48 cm) according to the clinical indication. The images were analysed using both a quantitative assessment and a subjective evaluation. Here, a comparison of Hounsfield units (HUs), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and noise index was conducted for each study and compared relative to the acquisition field size. The subjective analysis was performed in a non-blinded fashion where the diagnostic value (DV) of the exam was determined according to a graded scale. A phantom analysis for each of the acquisition field sizes was conducted and modulation transfer function (MTF) graphed.

RESULTS

Significantly higher HU, SNR, CNR and lower noise indices were achieved with the 42-cm protocol than the 22/32 and 48-cm protocols. Here a greater DV was also reported. The MTF demonstrates marginally improved spatial resolution for the 22-cm protocol, but this is near equivocal for the 32-, 42 and 48-cm protocols.

CONCLUSION

The use of larger acquisition field sizes provides improved image quality when performing IV CBCT as an alternative to intra-arterial (IA) CBCT.

Feasibility of low-dose CT protocols for evaluating the sinonasal cavity and reducing radiation exposure in dogs

With the increasing use of radiation therapy for treatment of canine sinonasal neoplasia, there is a need for developing low-dose CT protocols to help minimize radiation exposure. The purpose of this study was to assess the trade-off between image quality and reduced radiation exposure of a low-dose CT technique in the canine sinonasal cavity. In this prospective, experimental study, CT images of the sinonasal cavities from 10 normal Beagles were acquired using high-dose (130 kVp) or low-dose (110 kVp, 80 kVp) protocol. Radiation dose and image quality were compared. Radiation exposure measured by the volume-weighted CT dose index and dose-length product was reduced by 36% at 110 kVp and 74% at 80 kVp respectively, compared to the corresponding values at 130 kVp (P = 0.000). Low-dose protocol resulted in higher image noise and reduced signal-to-noise ratio and contrast-to-noise ratio than 130 kVp in most evaluated regions of interest (P < 0.05). CT numbers of the contrast-enhanced structures were highest at 80 kVp (P = 0.000). Conspicuity of most sinonasal structures was similar for high dose and both lower dose protocols. The results of this study indicate that 80 or 110 kVp can be used for sinonasal CT examinations to reduce radiation exposure to the patient without compromising image quality.

Green conversion of hazardous red mud into diagnostic X-ray shielding tiles

Red mud is a solid hazardous alumina industrial waste, which is rich in iron, titanium, aluminum, silicon, calcium, etc. The red mud contains 30-60% of hematite, which is suitable for shielding high energy X- and gamma rays. So, the iron rich red mud was converted into diagnostic X-ray shielding tiles through ceramic route by adding a certain weight percentage of BaSO₄ and binders (kaolin clay or sodium hexametaphosphate) with it. The kaolin clay tile possess sufficient impact strength (failure point is 852 mm for 19 mm steel ball) and flexural strength of ~25 N/mm², which is suitable for wall applications. The 10.3 mm and 14.7 mm thick red mud:BaSO₄:kaolin clay tile possess the attenuation equivalent to 2 mm and 2.3 mm lead at 125 kVp and 140 kVp, respectively. No heavy elements were found to leach out except chromium and arsenic from the sintered tiles. However, the leaching of Cr (0.6 ppm) and As (0.015 ppm) was found to be well below the permissible limit. These tiles can be used in the X-ray diagnosis, CT scanner, bone densitometry, and cath labs instead of toxic lead sheet and thereby to protect the operating personnel, public, and environment from radiation hazards.

Investigation of the Pulsing Characteristic of a Carbon Nanotube Emitter

The carbon nanotube (CNT) field emitter is suitable for the high frequency pulsing of X-ray. Pulsing reduces 49% of the dose in grid-controlled fluoroscopy and improves the image of moving objects. Various structures and manufacturing processes are being studied. However, more studies on the dynamic characteristic of a pulsing CNT and its application are needed. In this study, the combined dynamics including the field emission, MOSFET, and modified gate driver for MOSFET have been analyzed. In this configuration, between the cathode of the tube and ground, there is a MOSFET switch that turns the tube current on/off and a shunt resistor that measures the tube current. Due to the high impedance of the vacuum between the gate and cathode of the tube, about 85% of the gate voltage is still exerted between the Gate and cathode of the tube during the off-state of the MOSFET. Therefore, space charges are built during the off-state and then released at the beginning of the on-state of the MOSFET. The modified gate driver structure for MOSFET that we propose in this paper can limit the amount of current flow through the cathode. Tube current (boosted current) can be accurately controlled through a modified gate driver structure. Combining the boosted current and pulse control of MOSFET, the dynamic current performance of a CNT tube can be enhanced and the average tube current or dose can be accurately controlled. Experiments, simulation, and analysis have been conducted to study the combined dynamics and its applications.

Radiographic and fluoroscopic X-ray systems: Quality control of the X-ray tube and automatic exposure control using theoretical spectra to determine air kerma and dose to a homogenous phantom

PURPOSE

To develop a method to perform quality control (QC) of X-ray tubes and automatic exposure control (AEC) as a part of the QC of the radiographic and fluoroscopic X-ray system. Our aim is to verify the output from the X-ray tube by comparing the measured radiation output, or air kerma, to the theoretical output given the applied exposure settings and geometry, in addition to comparing the measured kV to the nominal kV. The AEC system for fluoroscopic and conventional X-ray systems is assessed by determining the absorbed dose to a homogenous phantom with different thicknesses.

METHOD

This study presents a model to verify the X-ray tube measurement results and a method to determine the dose to a homogenous phantom (Dphantom ). The following input is needed: a parameterized model of the X-ray spectrum, the X-ray tube measurements using a multifunctional X-ray meter, the exposure parameters recorded via imaging of polymethyl methacrylate (PMMA) slabs of different thickness that simulate the patient using AEC, and a parameterized model for calculating the dose to water from Monte Carlo simulations. The output is the entrance surface dose (ESD) and absorbed dose in the phantom, Dphantom (µGy). In addition, the parameterized X-ray spectrum is used to compare theoretical and measured air kerma as a part of the QC of the X-ray tube. To verify the proposed method, the X-ray spectrum provided in this study, SPECTRUM, was compared to two commercially available spectra, SpekCalc and Institute of Physics and Engineering in Medicine (IPEM) 78. The fraction of energy imparted to the homogenous phantom was compared to the imparted fraction calculated by PCXMC.

RESULTS

The spectrum provided in this study was in good agreement with two previously published X-ray spectra. The absolute percentage differences of the spectra varied from 0.05% to 3.9%, with an average of 1.4%, compared to SpekCalc. Similarly, the deviation from IPEM report 78 varied from 0.02% to 2.3%, with an average of 0.74%. The SPECTRUM was parameterized for calculation of the imparted fraction for target angles of 10°, 12°, and 15°, kV (50-150 kV) with the materials Al (2.2-8 mm), Cu (0-1 mm), and any combination of the filters, PMMA and water. The deviation of energy imparted from the results by PCXMC was less than 8% for all measurements across different kV, filtration, and vendors, obtained by using PMMA to record the exposure parameters, while the dose was calculated based on water with same thicknesses as the PMMA.

CONCLUSION

This study presents an accurate and suitable method to perform a part of the QC of fluoroscopic and conventional X-ray systems with respect to the X-ray tube and the associated AEC system. The method is suitable for comparing protocols within and between systems via the absorbed dose.

The Theoretical Value of Whole-Lung Irradiation for COVID-19 Pneumonia: A Reasonable and Safe Solution until Targeted Treatments are Developed

In this work, we considered the theoretical role of low-dose radiation therapy (approximately 0.5-1.0 Gy) in the treatment of respiratory distress syndrome associated with COVID-19 infection. Monte Carlo calculations were performed to gauge the ability to deliver low-dose radiation to the thoracic mid-plane using an orthovoltage machine. In addition, the potential harm of a single dose of 0.75 Gy (whole-lung irradiation) was assessed based on the recommendations of the BEIR-VII committee of the U.S. National Research Council. Based on the results of this work, it was determined that an orthovoltage machine (minimum 300 kVp) can be used to deliver 0.75 Gy dose to the lungs while respecting cutaneous tolerance. Using data from the BEIR-VII Committee, it is evident that the apparent benefits of such radiation treatment for patients suffering from severe manifestations of the COVID-19 infectious syndrome outweigh the potential loss of life due to radiation-induced malignancy. Although the vaccination against COVID-19 has become a reality, the spread and mortality in severely ill patients remain unacceptably high. The risk of outbreaks in the future is unknown. We suggest herein that low-dose radiotherapy at the bedside should be rigorously considered as a therapeutic option since it appears to be feasible and safe in the short and long term.

A versatile imaging platform with fluorescence and CT imaging capabilities that detects myeloperoxidase activity and inflammation at different scales

Aberrant innate immune response drives the pathophysiology of many diseases. Myeloperoxidase (MPO) is a highly oxidative enzyme secreted by activated myeloid pro-inflammatory immune cells such as neutrophils and macrophages, and is a key mediator of the damaging innate immune response. Current technologies for detecting MPO activity in living organisms are sparse and suffer from any combination of low specificity, low tissue penetration, or low spatial resolution. We describe a versatile imaging platform to detect MPO activity using an activatable construct conjugated to a biotin moiety (MPO-activatable biotinylated sensor, MABS) that allows monitoring the innate immune response and its modulation at different scales and settings.

Methods:We designed and synthesized MABS that contains MPO-specific and biotin moieties, and validated its specificity and sensitivity combining with streptavidin-labeled fluorescent agent and gold nanoparticles imaging in vitro and in vivo in multiple mouse models of inflammation and infection, including Matrigel implant, dermatitis, cellulitis, cerebritis and complete Fraud's adjuvant (CFA)-induced inflammation.

Results: MABS MPO imaging non-invasively detected varying MPO concentrations, MPO inhibition, and MPO deficiency in vivo with high sensitivity and specificity. MABS can be used to obtain not only a fluorescence imaging agent, but also a CT imaging agent, conferring molecular activity information to a structural imaging modality. Importantly, using this method on tissue-sections, we found that MPO enzymatic activity does not always co-localize with MPO protein detected with conventional techniques (e.g., immunohistochemistry), underscoring the importance of monitoring enzymatic activity.

Conclusion:By choosing from different available secondary probes, MABS can be used to create systems suitable to investigate and image MPO activity at different scales and settings.

Alternative X-ray filters for an intra-oral digital radiographic system

OBJECTIVE

The aim of this study was to evaluate the effect of the modulation of the radiation spectrum with the use of alternative X-ray filters in the quality of intra-oral digital images from storage phosphor plates.

METHODS

The radiographic exposures were performed in a GE 1000 X-ray machine (General Electric Co., Milwaukee, WI), operating at 65 kVp, 10 mA, 40 cm focus receptor distance using three different exposure times: 0.05 s, 0.16 s and 0.35 s. The control filter (GC) was 100% aluminium (Al) with a thickness of 1.5 mm. The tested filters were: G1, 97% Al and 3% copper (Cu) with 1.47 mm thickness; G2, 96% Al and 4% Cu with 1.53 mm thickness; G3, 95% Al and 5% zinc (Zn) with 1.56 mm thickness; G4, 98% Al and 2% Zn with 1.5 mm thickness; and G5, 95% Cu and 5% Zn with 1.6 mm thickness. For formation of the image, a 12-step Al wedge (each step with increments of 1 mm in thickness) was radiographed 10 times. Pixel values measured in digital images were converted into optical density (OD).

RESULTS

All replicates showed OD with high reproducibility (r > 0.95) for all exposure times and tested filters. In comparison between filters, statistically significant differences in density (p < 0.05) were observed. The OD curve of the G5 filter in all exposure times and G3 filter in an exposure time of 0.05 s showed changes in shape (p < 0.05).

CONCLUSIONS

Excluding the G5 filter, all others tested filters can be used as a substitute for GC without losses in image quality.

Quantifying the effect of anode surface roughness on diagnostic x-ray spectra using Monte Carlo simulation

PURPOSE

The accurate prediction of x-ray spectra under typical conditions encountered in clinical x-ray examination procedures and the assessment of factors influencing them has been a longstanding goal of the diagnostic radiology and medical physics communities. In this work, the influence of anode surface roughness on diagnostic x-ray spectra is evaluated using MCNP4C-based Monte Carlo simulations.

METHODS

An image-based modeling method was used to create realistic models from surface-cracked anodes. An in-house computer program was written to model the geometric pattern of cracks and irregularities from digital images of focal track surface in order to define the modeled anodes into MCNP input file. To consider average roughness and mean crack depth into the models, the surface of anodes was characterized by scanning electron microscopy and surface profilometry. It was found that the average roughness (Ra) in the most aged tube studied is about 50 pm. The correctness of MCNP4C in simulating diagnostic x-ray spectra was thoroughly verified by calling its Gaussian energy broadening card and comparing the simulated spectra with experimentally measured ones. The assessment of anode roughness involved the comparison of simulated spectra in deteriorated anodes with those simulated in perfectly plain anodes considered as reference. From these comparisons, the variations in output intensity, half value layer (HVL), heel effect, and patient dose were studied.

RESULTS

An intensity loss of 4.5% and 16.8% was predicted for anodes aged by 5 and 50 microm deep cracks (50 kVp, 6 degrees target angle, and 2.5 mm A1 total filtration). The variations in HVL were not significant as the spectra were not hardened by more than 2.5%; however, the trend for this variation was to increase with roughness. By deploying several point detector tallies along the anode-cathode direction and averaging exposure over them, it was found that for a 6 degrees anode, roughened by 50 microm deep cracks, the reduction in exposure is 14.9% and 13.1% for 70 and 120 kVp tube voltages, respectively. For the evaluation of patient dose, entrance skin radiation dose was calculated for typical chest x-ray examinations. It was shown that as anode roughness increases, patient entrance skin dose decreases averagely by a factor of 15%.

CONCLUSIONS

It was concluded that the anode surface roughness can have a non-negligible effect on output spectra in aged x-ray imaging tubes and its impact should be carefully considered in diagnostic x-ray imaging modalities.

Overview of patient dosimetry in diagnostic radiology in the USA for the past 50 years

This review covers the role of medical physics in addressing issues directly related to patient dosimetry in radiography, fluoroscopy, mammography, and CT. The sections on radiography and fluoroscopy radiation doses review the changes that have occurred during the last 50 to 60 years. A number of technological improvements have contributed to both a significant reduction in patient and staff radiation doses and improvements to the image quality during this period of time. There has been a transition from film-screen radiography with hand dip film processing to electronic digital imaging utilizing CR and DR. Similarly, fluoroscopy has progressed by directly viewing image intensifiers in darkened rooms to modern flat panel image receptor systems utilizing pulsed radiation, automated variable filtration, and digitally processed images. Mammography is one of the most highly optimized imaging procedures performed, because it is a repetitive screening procedure that results in annual radiation exposure. Mammography is also the only imaging procedure in the United States in which the radiation dose is regulated by the federal government. Consequently, many medical physicists have studied the dosimetry associated with screen-film and digital mammography. In this review, a brief history of mammography dose assessment by medical physicists is discussed. CT was introduced into clinical practice in the early 1970s, and has grown into one of the most important modalities available for diagnostic imaging. CT dose quantities and measurement techniques are described, and values of radiation dose for different types of scanner are presented. Organ and effective doses to adult patients are surveyed from the earliest single slice scanners, to the latest versions that include up to two x-ray tubes and can incorporate as many as 256 detector channels. An overview is provided of doses received by pediatric patients undergoing CT examinations, as well as methods, and results, of studies performed to assess the radiation absorbed by the conceptus of pregnant patients.

Comparison of single-phase and high-frequency generators for x-ray units

The purpose of this study was to compare characteristics and performances between single-phase (SP) and high-frequency (HF) generators for x-ray units dedicated to veterinary radiology practice. A 30-kW SP and a 30-kW high HF generator connected to a rotating anode x-ray tube were used for the study. Source-film distance, screen/film combination, and film processing were kept the same during the experiment. The mAs value yielding a similar film optical density of a stair step phantom, as assessed by a densitometer and a similar dose, as assessed by a solid state detector, was estimated for different kVp values. The ratio of the mAs used with the SP generator to the equivalent mAs used with the HF generator to produce similar film density or radiation dose was calculated. Subject contrast was measured for different kVp values as the relative difference in film optical density between two steps of the phantom. The waveform of the tube current was recorded for the two generators using an oscilloscope. Motion artifact was produced on a lateral radiograph of a canine tarsus using the two generators. Reproducibility was assessed by comparing the variances of film density measurements made on the central step of the phantom on 10 consecutive images produced with the two generators. mAs ratios (SP/HF) to obtain similar film optical density ranged from 2 (for 90kVp) to 2.5 (for 70 kVp), and mAs ratios to obtain similar radiation dose ranged from 1.2 (for 100 kVp) to 1.4 (for 70 kVp). Image contrast was slightly higher for the SP than for the HF generator. Current waveform for the SP generator was half-sinusoidal and it was almost continuous for the HF generator. Motion artifact appeared as blur for the HF generator and as several regularly placed images of the subject for the SP generator. Reproducibility was significantly better for the HF than for the SP generator (P = 0.047). It was concluded that the HF generator was approximately two times more efficient, had a better reproducibility, and produced images with a lower contrast than the SP generator. Motion artifact appears differently due to different current waveform.