Optimal photon energy comparison between digital breast tomosynthesis and mammography: A case study

A comparison, in terms of the optimal energy that maximizes the image quality between digital breast tomosynthesis (DBT) and digital mammography (DM) was performed in a MAMMOMAT Inspiration system (Siemens) based on amorphous selenium flat panel detector. In this paper we measured the image quality by the signal difference-to-noise ratio (SDNR), and the patient risk by the mean glandular dose (MGD). Using these quantities we compared the optimal voltage that maximizes the image quality both in breast tomosynthesis and standard mammography acquisition mode. The comparison for the two acquisition modes was performed for a W/Rh anode filter combinations by using a 4.5 cm tissue equivalent mammography phantom. Moreover, in order to check if the used equipment was quantum noise limited, the relation of the relative noise with respect to the detector dose was evaluated. Results showed that in the tomosynthesis acquisition mode the optimal voltage is 28 kV, whereas in standard mammography the optimal voltage is 30 kV. The automatic exposure control (AEC) of the system selects 28 kV as optimal voltage both for DBT and DM. Monte Carlo simulations showed a qualitative agreement with the AEC selection system, since an optimal monochromatic energy of 20 keV was found both for DBT and DM. Moreover, the check about the noise showed that the system is not completely quantum noise limited, and this issue could explain the experimental slight difference in terms of optimal voltage between DBT and DM. According to these results, the use of higher voltage settings is not justified for the improvement of the image quality during a DBT examination.     

Evaluation of the technical performance of three different commercial digital breast tomosynthesis systems in the clinical environment

The aim of this work was to research and evaluate the performance of three different digital breast tomosynthesis (DBT) systems in the clinical environment (Siemens Mammomat Inspiration, Hologic Selenia Dimensions, and Fujifilm Amulet Innovality). The characterization included the study of the detector, the automatic exposure control, and the resolution of DBT projections and reconstructed planes.The modulation transfer function (MTF) of the DBT projections was measured with a 1 mm thick steel edge, showing a strong anisotropy (30–40% lower MTF_0.5 frequencies in the tube travel direction). The in-plane MTF_0.5, measured with a 25 μm tungsten wire, ranges from 1.3 to 1.8 lp/mm in the tube-travel direction and between 2.4 and 3.7 lp/mm in the chest wall–nipple. In the latter direction, the MTF peak shift is more emphasized for large angular range systems (2.0 versus 1.0 lp/mm). In-depth resolution of the planes, via the full width at half maximum (FWHM) from the point spread function of a 25 μm tungsten wire, is not only influenced by angular range and yields 1.3–4.6 mm among systems. The artifact spread function from 1 mm diameter tungsten beads depends mainly on angular range, yielding two tendencies whether large (FWHM is 4.5 mm) or small (FWHM is 10 mm) angular range is used. DBT delivers per scan a mean glandular dose between 1.4 and 2.7 mGy for a 45 mm thick polymethyl methacrylate (PMMA) block.In conclusion, we have identified and analysed specific metrics that can be used for quality assurance of DBT systems.     

Visualizing the internal structure of polyethylene glycol-impregnated wood by digital breast tomosynthesis

This study proposes digital breast tomosynthesis (DBT) as a low-tube-voltage method for imaging wood artifacts treated with polyethylene glycol (PEG). In case of general clinical X-ray Computed Tomography (X-CT), PEG-impregnated wood images typically suffer from low contrast between the PEG and the tree-ring. Because X-CT uses high-tube-voltage X-rays that have high energy, they are transmitted regardless of the X-ray absorption difference of the substance, and therefore, it is not suitable for imaging PEG-impregnated wood. Mammography uses low-tube-voltage X-rays, and therefore, it is suitable for delineating substances with small X-ray absorption differences. However, although mammography can produce high-contrast images of wood, it cannot distinguish three-dimensional (3D) structures such as tree rings, because those are projection images. DBT is a type of mammography used to enhance contrast using low-tube voltage, and it enables imaging 3D structures by exposure X-rays to objects several times changing the exposure angle, and it can obtain quasi-computed tomography. Therefore, we believe that by applying DBT to dendroarchaeology, it would be possible to obtain high-contrast, high-resolution images in the visualization of the internal structure of wood.In this study, we used clinical X-CT, mammography, and DBT to obtain images of wood after PEG impregnation, and we evaluated the internal structure of the wood and the visibility of annual rings. We obtained DBT images as a tomogram with a thickness of 1 mm, which eliminated the distortion of tree rings in the sagittal direction and duplication of the PEG and the tree-ring. Further, tree-rings were easily visualized without a noticeable blur, and the DBT contrast was improved compared to clinical X-CT contrast because DBT was performed at low voltage. Important wooden artifacts excavated from ruins were preserved by PEG. Therefore, this method can be expected to become a very useful tool for dendroarchaeology when used as a complementary tool for microfocus X-CT.     

Detectability comparison of simulated tumors in digital breast tomosynthesis using high-energy X-ray inline phase sensitive and commercial imaging systems

This study compared the detectability of simulated tumors using a high-energy X-ray inline phase sensitive digital breast tomosynthesis (DBT) prototype and a commercial attenuation-based DBT system. Each system imaged a 5-cm thick modular breast phantom with 50–50 adipose-glandular percentage density containing contrast-detail (CD) test objects to simulate different tumor sizes. A commercial DBT system acquired 15 projection views over 15 degrees (15d-15p) was used to acquire the attenuation-based projection views and to reconstruct the conventional DBT slices. Attenuation-based projection views were acquired at 32 kV, 46 mAs with a mean glandular dose (D_g) of 1.6 mGy. For acquiring phase sensitive projection views, the prototype utilized two acquisition geometries: 11 projection views were acquired over 15 degrees (15d-11p), and 17 projection views were acquired over 16 degrees (16d-17p) at 120 kV, 5.27 mAs with 1.51 mGy under the magnification (M) of 2. A phase retrieval algorithm based on the phase-attenuation duality (PAD) was applied to each projection view, and a modified Feldkamp-Davis-Kress (FDK) algorithm was used to reconstruct the phase sensitive DBT slices. Simulated tumor margins were rated as more conspicuous and better visualized for both phase sensitive acquisition geometries versus conventional DBT imaging. The CD curves confirmed the improvement in both contrast and spatial resolutions with the phase sensitive DBT imaging. The superiority of the phase sensitive DBT imaging was further endorsed by higher contrast to noise ratio (CNR) and figure-of-merit (FOM) values. The CNR improvements provided by the phase sensitive DBT prototype were sufficient to offset the noise reduction provided by the attenuation-based DBT imaging.     

乳腺三维断层技术结合乳腺超声对致密型乳腺病变的诊断价值

摘要 目的：探讨乳腺三维断层技术（DBT）结合乳腺超声(BUS)对致密型乳腺病变的诊断价值。方法：回顾分析2018年6月至2019年4月在我院就诊且有完整病理结果的149例致密型乳腺病变患者的影像资料,对比DBT、BUS两种检查方法的检出率;以病理结果为金标准,分析DBT、BUS、DBT联合BUS三种检查模式的诊断效能。结果：BUS对良性病变的检出率（97.87%）高于DBT（89.36%）,差异有统计学意义（x²=5.697,P＜0.05）;DBT与BUS对恶性病变的检出率分别为98.44%、95.31%,差异无统计学意义（x²=1.032,P>0.05）。DBT诊断致密型乳腺病变的敏感度为90.61%、特异度为93.55％、准确率为91.77％,BUS诊断致密型乳腺病变的敏感度为78.13%、特异度为89.36%、准确率为84.81%,DBT联合BUS诊断致密型乳腺病变的敏感度为95.31%、特异度为95.74%、准确率为95.57%。DBT联合BUS诊断致密型乳腺恶性病变的受试者工作特征曲线（ROC）的曲线下面积（AUC）为0.977,稍高于DBT的AUC（0.951）,明显高于BUS的AUC（0.885）。结论：BUS对良性病变的检出率显著高于DBT,DBT对致密型乳腺病变的诊断效能高于BUS,二者结合能提高病变的检出率与诊断效能。     

Characterization of the imaging settings in screening mammography using a tracking and reporting system: A multi-center and multi-vendor analysis

A tracking and reporting system was developed to monitor radiation dose in X-ray breast imaging. We used our tracking system to characterize and compare the mammographic practices of five breast imaging centers located in the United States and Brazil. Clinical data were acquired using eight mammography systems comprising three modalities: computed radiography (CR), full-field digital mammography (FFDM), and digital breast tomosynthesis (DBT). Our database consists of metadata extracted from 334,234 images. We analyzed distributions and correlations of compressed breast thickness (CBT), compression force, target-filter combinations, X-ray tube voltage, and average glandular dose (AGD). AGD reference curves were calculated based on AGD distributions as a function of CBT. These curves represent an AGD reference for a particular population and system. Differences in AGD and imaging settings were attributed to a combination of factors, such as improvements in technology, imaging protocol, and patient demographics. The tracking system allows the comparison of various imaging settings used in screening mammography, as well as the tracking of patient- and population-specific breast data collected from different populations.     

Introducing operator characteristic curves to define appropriate frequency of quality control tests: A case study involving whole breast radiotherapy image guidance

Background and purposeSampling theory and operator characteristic curves are methods that can determine an optimal schedule for quality control tests. We apply this method to positional data for whole breast radiotherapy since several surveys report inconsistent image guidance practice for this technique.Materials and methodsPositional errors were defined, for 55 consecutive breast cancer patients, by comparing the central lung distance measured on portal images with that obtained from the corresponding digitally reconstructed radiograph. From the distribution of positional errors, the probability of a setup error >5 mm in the direction of the mediastinum was established. Using operator characteristic curves, we compared the effectiveness of various image-guidance schedules in dealing with such errors. We also calculated the dosimetric impact of undetected errors.ResultsSetup errors >5 mm towards the mediastinum for this cohort were unlikely, at 2.7%. Imaging half of the fractions protects most patients against three or more undetected errors. Undetected, such an error increases, on average, the maximum dose to 10 cm³ of the heart by 50 cGy, the mean heart dose by 4 cGy, and the left lung V20Gy by 0.2%; therefore, the clinical impact is minute. Given that detected positional errors outside of tolerance are corrected, their residual likelihood decreases with the ratio of fractions being imaged.ConclusionsFor most tangential breast radiotherapy patients, setup errors >5 mm towards the mediastinum are unlikely, and their dosimetric impact is remote. Imaging half of the fractions of a course of whole breast radiotherapy prevents these errors to occur more than twice.     

188Re image performance assessment using small animal multi-pinhole SPECT/PET/CT system

PurposeThe goal of this study was to investigate the performance of a pre-clinical SPECT/PET/CT system for ¹⁸⁸Re imaging.MethodsPhantom experiments were performed aiming to assess the characteristics of two multi-pinhole collimators: ultra-high resolution collimator (UHRC) and high-energy ultra high resolution collimator (HE-URHC) for imaging ¹⁸⁸Re. The spatial resolution, image contrast and contrast-to-noise ratio (CNR) were investigated using micro-Jaszczak phantoms. Additionally, the quantification accuracy of ¹⁸⁸Re images was evaluated using two custom-designed phantoms. The ¹⁸⁸Re images were compared to those obtained with ^99mTc (gold standard); the acquired energy spectra were analyzed and Monte-Carlo simulations of the UHRC were performed. To verify our findings, a C57BL/6-mouse was injected with ¹⁸⁸Re-microspheres and scanned with both collimators.ResultsThe spatial resolution achieved in ¹⁸⁸Re images was comparable to that of ^99mTc. Acquisitions using HE-UHRC yielded ¹⁸⁸Re images with higher contrast and CNR than UHRC. Studies of quantitative accuracy of ¹⁸⁸Re images resulted in <10% errors for both collimators when the activity was calculated within a small VOI around the object of interest. Similar quantification accuracy was achieved for ^99mTc. However, ¹⁸⁸Re images showed much higher levels of noise in the background. Monte-Carlo simulations showed that ¹⁸⁸Re imaging with UHRC is severely affected by down-scattered photons from high-energy emissions. The mouse images showed similar biodistribution of ¹⁸⁸Re-microspheres for both collimators.ConclusionsVECTor/CT provided ¹⁸⁸Re images quantitatively accurate and with quality comparable to ^99mTc. However, due to large penetration of UHRC by high-energy photons, the use of the HE-UHRC for imaging ¹⁸⁸Re in VECTor/CT is recommended.     

Determination of radiation dose and low-dose protocol for digital chest tomosynthesis using radiophotoluminescent (RPL) glass dosimeters

PurposeThis study aimed to determine a low-dose protocol for digital chest tomosynthesis (DTS).MethodsFive simulated nodules with a CT number of approximately 100 HU with size diameter of 3, 5, 8, 10, and 12 mm were inserted into an anthropomorphic chest phantom (N1 Lungman model), and then scanned by DTS system (Definium 8000) with varying tube voltage, copper filter thickness, and dose ratio. Three radiophotoluminescent (RPL) glass dosimeters, type GD-352 M with a dimension of 1.5 × 12 mm, were used to measure the entrance surface air kerma (ESAK) in each protocol. The effective dose (ED) was calculated using the recorded total dose-area-product (DAP). The signal-to-noise ratio (SNR) was determined for qualitative image quality evaluation. The image criteria and nodule detection capability were scored by two experienced radiologists. The selected low-dose protocol was further applied in a clinical study with 30 pulmonary nodule follow-up patients.ResultsThe average ESAK obtained from the standard default protocol was 1.68 ± 0.15 mGy, while an ESAK of 0.47 ± 0.02 mGy was found for a low-dose protocol. The EDs for the default and low-dose protocols were 313.98 ± 0.72 µSv and 100.55 ± 0.28 µSv, respectively. There were small non-significant differences in the image criteria and nodule detection scoring between the low-dose and default protocols interpreted by two radiologists. The effective dose of 98.87 ± 0.08 µSv was obtained in clinical study after applying the low-dose protocol.ConclusionsThe low-dose protocol obtained in this study can substantially reduce radiation dose while preserving an acceptable image quality compared to the standard protocol.     

Synchrotron based planar imaging and digital tomosynthesis of breast and biopsy phantoms using a CMOS active pixel sensor

The SYRMEP (SYnchrotron Radiation for MEdical Physics) beamline at Elettra is performing the first mammography study on human patients using free-space propagation phase contrast imaging. The stricter spatial resolution requirements of this method currently force the use of conventional films or specialized computed radiography (CR) systems. This also prevents the implementation of three-dimensional (3D) approaches. This paper explores the use of an X-ray detector based on complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology as a possible alternative, for acquisitions both in planar and tomosynthesis geometry.Results indicate higher quality of the images acquired with the synchrotron set-up in both geometries. This improvement can be partly ascribed to the use of parallel, collimated and monochromatic synchrotron radiation (resulting in scatter rejection, no penumbra-induced blurring and optimized X-ray energy), and partly to phase contrast effects. Even though the pixel size of the used detector is still too large – and thus suboptimal – for free-space propagation phase contrast imaging, a degree of phase-induced edge enhancement can clearly be observed in the images.     

Quantitative cytological assessment of Ki67 and AgNORs using computer-digitized image analysis of four clinicopathological breast lesions

Analysis of silver-stained proteins associated with nucleolar organiser regions (AgNORs) is proposed as a marker of cellular proliferation. This study describes the application of AgNORs and Ki67 in breast lesions. Sixty-one cases including fibroadenoma (FA), fibrocystic disease (FCD), ductal carcinoma in situ (DCIS) and invasive carcinoma (IC) were studied by image analysis to evaluate quantitative changes in AgNORs in both Ki67-positive, and Ki67-negative smears. The Ki67 index was assessed. Morphometric features of cell nuclei and AgNORs were determined by digitized computer image analysis (Prodit 5.2). The growth fraction was 5.08 for FA, 5.71 for FCD, 16.75 for DCIS and 23.26 for IC. The mean nuclear area was significantly higher in malignant cells than those of fibroadenoma and fibrocystic disease. In Ki67-positive cells the total area, long axis and number of AgNORs increased progressively across disease groups. Eccentricity of AgNORs and AgNORs: nuclear area ratios were significantly increased in malignant breast lesion in comparison with benign lesion in Ki67 positive cells. In Ki67 negative cells, the highest value of AgNORs was observed in DCIS. The AgNORs: nuclear area ratio demonstrated a statistically significant trend across the disease groups. This study demonstrates that the growth fraction, mean nuclear area and selected AgNORs features have potential for differentiating benign from malignant breast tumours.     

Absorbed dose and image quality of Varian TrueBeam CBCT compared with OBI CBCT

Purpose: Nowadays, patient positioning and target localization can be verified by using kilovolt cone beam computed tomography (kV-CBCT). There have been various studies on the absorbed doses and image qualities of different kV-CBCT systems. However, the Varian TrueBeam CBCT (TB CBCT) system has not been investigated so far. We assess the image quality and absorbed dose of TB CBCT through comparison with those of on-board imager (OBI) CBCT.Methods: The image quality was evaluated using two phantoms. A CATPHAN phantom measured the image quality parameters of the American Association of Physicists in Medicine Task Group 142 (AAPM TG-142) report. These factors are the pixel value stability and accuracy, noise, high-contrast resolution, low-contrast resolution, and image uniformity. A H₂SO₄ phantom was used to evaluate the image uniformity over a larger region than the CATPHAN phantom. In evaluating the absorbed dose, the radial dose profile and the patient organ doses at the prostate and rectum levels were evaluated.Results: The image quality parameters of AAPM TG-142 using TB CBCT are equal to or greater than those of OBI CBCT. In particular, the contrast-to-noise ratio with TB CBCT is 2.5 times higher than that with OBI CBCT. For the test of a large field uniformity, the maximum difference in the Hounsfield unit (HU) values between the centre and peripheral regions is within 30 HU with TB CBCT and 283 HU with OBI CBCT. The maximum absorbed dose with TB CBCT is decreased by 60%.Conclusions: We find that the image quality improved and the absorbed dose decreased with TB CBCT in comparison to those with OBI CBCT. Its image uniformity is also superior over a larger scanning range.     

A novel quantitative measure of image quality in fluoroscopy

Assessment of fluoroscopic image quality has not kept pace with technological developments in interventional imaging equipment. Access to ‘for presentation’ data on these systems has motivated this investigation into a novel quantitative method of measuring image quality. We have developed a statistical algorithm as an alternative to subjective assessment using threshold contrast detail detectability techniques. Using sets of uniformity exposed fluoroscopy frames, the algorithm estimates the minimum contrast necessary for conspicuity of a range of virtual target object areas A. Pixel mean value distributions in a central image region are Gaussian, with standard deviation σ Pixel binning produces background distributions with area A. For 95% confidence of conspicuity a target object must exhibit a minimum contrast of 3.29σ. A range of threshold contrasts are calculated for a range of virtual areas. Analysis on a few seconds of fluoroscopy data is performed remotely and no test object is required. In this study Threshold Index and Contrast Detail curves were calculated for different incident air kerma rates at the detector, different levels of electronic magnification and different types of image processing. A limited number of direct comparisons were made with subjective assessments using the Leeds TO.10 test object. Results obtained indicate that the statistical algorithm is not only more sensitive to changes in levels of detector dose rate and magnification, but also to levels of image processing, including edge-enhancement. Threshold Index curves thus produced could be used as an interventional system optimisation tool and to objectively compare image quality between vendor systems.     

Dose to contralateral breast from whole breast irradiation by automated tangential IMRT planning: comparison of flattening-filter and flattening-filter-free modes

BackgroundThe most common secondary cancer is contralateral breast (CLB) cancer after whole breast irradiation (WBI). The aim of this study was to quantify the reduction of CLB dose in tangential intensity modulated radiotherapy (t-IMRT) for WBI using flattening-filter-free (FFF) beams.Materials and methodsWe generated automated planning of 20 young breast cancer patients with limited user interaction. Dose-volume histograms of the planning target volume (PTV), ipsilateral lung, heart, and CLB were calculated. The dose of PTV, the most medial CLB point, and the CLB point below the nipple was measured using an ionization chamber inserted in a slab phantom. We compared the two t-IMRT plans generated by FFF beams and flattening-filter (FF) beams.ResultsAll plans were clinically acceptable. There was no difference in the conformal index, the homogeneity for FFF was significantly worse. For the ipsilateral lung, the maximum dose (D_max) was significantly higher; however, V₂₀ showed a tendency to be lower in the FFF plan. No differences were found in the D_max and V₃₀ to the heart of the left breast cancer. FF planning showed significantly lower D_max and mean dose to the CLB. In contrast to the calculation results, the measured dose of the most medial CLB point and the CLB point below the nipple were significantly lower in FFF mode than in FF mode, with mean reductions of 21.1% and 20%, respectively.ConclusionsT-IMRT planning using FFF reduced the measured out-of-field dose of the most medial CLB point and the CLB point below the nipple.     

Implications of white striping and wooden breast abnormalities on quality traits of raw and marinated chicken meat

One of the consequences of intense genetic selection for growth of poultry is the recent appearance of abnormalities in chicken breast muscles, such as white striping (characterised by superficial white striations) and wooden breast (characterised by pale and bulged areas with substantial hardness). The aim of this study was to evaluate the quality traits of chicken fillets affected by white striping and wooden breast abnormalities. In two replications, 192 fillets were divided into the following four classes: normal (n=48; absence of any visual defects), white striping (n=48, presence of white striations), wooden breast (n=48; diffusely presence of hardened areas) and white striping/wooden breast (n=48; fillets affected by both abnormalities). Morphology, raw meat texture and technological properties were assessed in both unprocessed (pH, colour, drip loss, cooking loss and cooked meat shear force) and marinated meat (marinade uptake, purge loss, cooking loss and cooked meat shear force). Fillets affected by white striping, wooden breast or both abnormalities exhibited higher breast weights compared with normal fillets (305.5, 298.7, 318.3 and 244.7 g, respectively; P<0.001). Wooden breast, either alone or in combination with white striping, was associated with a significant (P<0.001) increase of fillet thickness in the caudal area and raw meat hardness compared with both normal and the white striping abnormality, for which there was no difference. Overall, the occurrence of the individual and combined white striping and wooden breast abnormalities resulted in substantial reduction in the quality of breast meat, although these abnormalities are associated with distinct characteristics. Wooden breast fillets showed lower marinade uptake and higher cooking losses than white-striped fillets for both unprocessed and marinated meats. On the other hand, white-striped fillets showed a moderate decline in marinade and cooking yield. Fillets affected by both abnormalities had the highest (P<0.001) ultimate pH values. In contrast, the effects on colour of raw and cooked meat, drip loss, purge loss and cooked meat shear force were negligible or relatively low and of little practical importance. Thus, the presence of white striping and wooden breast abnormalities impair not only breast meat appearance but also the quality of both raw and marinated meats mainly by reducing water holding/binding abilities.     

Effect of white striping on turkey breast meat quality

In the past decades, the intense selection practices carried out in order to develop fast growing and high breast-yield turkey hybrids profoundly modified the muscle physiology leading to the development of growth-related alterations and muscular abnormalities. White striations of variable thickness have been particularly observed on the ventral surface of Pectoralis major muscle belonging from heavy male turkeys since several years. However, although the effects of white striping (WS) have been extensively studied on broilers, this condition was not considered as a main quality issue by both turkey producers and meat industry. Thus, this study aimed at evaluating whether the occurrence of WS in heavy male turkeys affects the quality traits and technological properties of meat to the same extent previously observed for broilers. In two replications, 72 Pectoralis major muscles were classified as: normal (NORM), moderate WS (MOD) and severe WS (SEV) cases. The whole muscle was weighed and cut in order to assess colour, ultimate pH, water holding (drip and cooking losses) and binding (marinade uptake) capacities, NMR relaxation properties, shear force as well as proximate composition of meat. The Pectoralis major muscles affected by WS (both moderate and severe cases) exhibited a one-fifth increased weight in comparison with their NORM counterpart. However, the occurrence of WS only partially affected the proximate composition of the meat. In detail, although moisture, collagen and protein contents did not differ among the groups, if compared with NORM, higher lipid levels were found in SEV muscles, whereas MOD had intermediate values. On the other hand, both MOD and SEV exhibited lower ash content. Despite these variations in proximate composition, both water holding and binding capacities of turkey breast meat were not affected by WS. Indeed, quality traits of raw (pH, colour, cooking losses and shear force) and marinated (uptake, cooking losses and shear force) meat as well as water distribution within the muscle tissue did not differ between NORM and WS cases. Overall, if compared with broilers, WS only marginally affected quality traits of turkey breast meat. It might thus be hypothesised a diverse specie-specific physiological response to the pressure in muscle tissue induced by the selection in turkeys that, although analogously led to the occurrence of WS, results in limited effects on meat quality.     

Optimization of dose and image quality of paediatric cardiac catheterization procedure

The purpose of this study is to quantify the quality of the available imaging modes for various iodine-based contrast agent concentration in paediatric cardiology. The figure of merit (FOM) was defined as the squared signal to noise ratio divided by a patient dose related parameter. An in house constructed phantom simulated a series of vessel segments with iodine concentrations from 10% or 30 mg/cc to 16% or 48 mg/cc of iodine in a blood plasma solution, all within the dimensional constraints of a paediatric patient. The phantom also used test inserts of tin (Sn). Measurements of Entrance Surface Air Kerma (ESAK) and exit dose rate were performed along with calculations of the signal-to-noise ratio (SNR) of all the objects. A first result showed that it was favourable to employ low dose fluoroscopy mode and lower frame rate modes in cine acquisition if dynamic information is not critical. Normal fluoroscopy dose mode provided a considerably higher dose level (in comparison to low dose mode) with only a slight improvement in SNR. Higher frame rate cine modes should be used however when the clinical situation dictates so. This work also found that tin should not be intended as iodine replacement material for research purposes due to the mismatching SNR, particularly on small vessel sizes.     

Digital image analysis of Zostera marina leaf injury

Current methods for assessing leaf injury in Zostera marina (eelgrass) utilize subjective indexes for desiccation injury and wasting disease. Because of the subjective nature of these measures, they are inherently imprecise making them difficult to use in quantifying complex leaf injuries from multiple sources. We have developed a method using color digital photography of eelgrass leaves which are then manipulated using image processing programs and analyzed using geographic digital image analysis. The resulting false color images are then assigned by the user into uninjured and injured groupings which may then be reported as a percentage of leaf area affected. If images are rectified, leaf area (cm²) of injured and uninjured leaf segments may be determined. Although this method is time consuming and still requires some subjective judgments, it does allow for precise analysis of highly complex leaf injuries and has the potential to be a substantial improvement over existing leaf injury indexes.     

Optimization of the exposure parameters in digital mammography using contrast-detail metrics

PurposeOptimization studies in digital mammography aid to assure the image quality and radiological protection of the patient. The aim of this work is to test effectiveness and applicability of a method based on a Figure of Merit (FOM = (IQF_inv)²/AGD) to improve all the exposure parameters (Target/Filter combination, kVp and mAs) in order to improve the image acquisition technique that will provide the best compromise between image quality and the average glandular dose (AGD).MethodsA contrast-detail analysis, employing the test object CDMAM, was carried out for the digital mammography unit manufactured by Lorad Hologic – model Selenia. We simulated two breast thicknesses using phantoms and a Figure of Merit as optimization tool, which includes an indicator of image quality, the IQF_inv and the average glandular dose. Images of the ACR and TORMAM phantoms were obtained with both, automatic and optimized exposure parameters. In order to compare the image quality, the SNR (Signal to Noise Ratio) was measured in each image.ResultsIn the two phantoms, for both 4.5 and 7.5 cm thicknesses, the AGDs obtained with the optimized parameters show a reduction. In addition, the images obtained with the optimized exposure parameters, had the same or a better image quality when compared to the images obtained using the automatic mode.ConclusionsThe proposed optimization methodology proved to be an effective tool to improve the digital mammography unit, due to the use of objective metrics for evaluation and validation of the results.     

Effect of diagnostic cone-beam computed tomography protocols on image quality,patient dose,and lesion detection

ObjectiveTo evaluate the effect of cone-beam computed tomography (CBCT) image acquisition protocols on image quality, lesion detection, delineation, and patient dose.Methods100-patients and a CTDI phantom combined with an electron density phantom were examined using four different CBCT-image acquisition protocols during image-guided transarterial chemoembolization (TACE). Protocol-1 (time: 6 s, tube rotation: 360°), protocol-2 (5 s, 300°), protocol-3 (4 s, 240°) and protocol-4 (3 s, 180°) were used. The protocols were first investigated using a phantom. The protocols that were found to be clinically appropriate in terms of image quality and radiation dose were then assessed on patients. A higher radiation dose and/or a poor image quality were inappropriate for the patient imaging. Patient dose (patient-entrance dose and dose-area product), image quality (Hounsfield Unit, noise, signal-to-noise ratio and contrast-to-noise ratio), and lesion delineation (tumor-liver contrast) were assessed and compared using appropriate statistical tests. Lesion detectability, sensitivity, and predictive values were estimated for CBCT-image data using pre-treatment patient magnetic resonance imaging.ResultsThe estimated patient dose showed no statistical significance (p > 0.05) between protocols-2 and -3; the assessed image quality between these protocols manifested insignificant difference (p > 0.05). Two other phantom protocols were not considered for patient imaging due to significantly higher dose (protocols-1) and poor image quality (protocol-4). Lesion delineation and detection were insignificant (p > 0.05) between protocols-2 and -3. Lesion sensitivities generated were 81–89% (protocol-2) and 81–85% (protocol-3) for different lesion types.ConclusionData acquisition using protocols-2 and -3 provided good image quality, lesion detection and delineation with acceptable patient dose during CBCT-imaging mainly due to similar frame numbers acquired.