Artifacts Found During Quality Assurance Testing of Computed Radiography and Digital Radiography Detectors

A series of artifact images, obtained over 5 years of performance testing, of both computed radiography (CR) and integrated digital radiographic X-ray imaging detectors are presented. The images presented are all either flat field or test object images and show artifacts previously either undescribed in the existing literature or meriting further comment. The artifacts described are caused by incorrect flat field corrections, a failing amplifier, damaged detector lines affecting their neighbors, lost information between neighboring detector tiles, image retention, delamination of a detector, poor setup of mechanical movements in CR, suckers damaging a CR plate, inappropriate use of grid suppression software, inappropriate use of a low pass spatial frequency filter, and unsharp masking filters. The causes and significance of the artifacts are explained and categorized as software or hardware related. Actions taken to correct the artifacts are described and explained. This work will help physicists, radiographers, and radiologists identify various image quality problems and shows that quality assurance is useful in identifying artifacts.     

Role of the lectin domain of Mac-1/CR3 (CD11b/CD18) in regulating intercellular adhesion

Leukocytediapedesis requires that Mac-1/CR3-dependent adhesion be regulated so that cells can move from one attachment site to another. The high affinity adhesion state of Mac-1/CR3 is generated when it forms alectin-dependent complex with the receptor for urokinase plasminogen activator (uPAR; CD87). The extensively glycosylated uPAR binds to the same C-terminal lectin domain of CD11b that had previously been shown to prime Mac-1/CR3 for cytotoxic degranulation in response to β-glucan uPAR and β-glucan compete for a lectin site that is near to the CBRM1/23 epitope (residues 943–1047) at the C-terminus of CD11b, and thus the lectin domain is critical to both the adhesion and cytotoxic functions of Mac-1/CR3. Adhesion is reversed when the uPA enzyme is captured by its receptor (uPAR), causing uPAR to bind to CD11b at a second site (residues 424–440) that is in between the N-terminal I-domain and the divalent cation binding region.     

Workflow Efficiency Comparison of a New CR System with Traditional CR and DR Systems in an Orthopedic Setting

Workflow efficiency is a crucial factor in selecting computed radiography (CR) versus digital radiography (DR) systems for digital projection radiography operations. DR systems can be more efficient, but present higher costs and limitations in performing some radiographic exams. A newly developed CR system presents a good alternative with its faster line-by-line instead of pixel-by-pixel image plate-scanning technology and a more efficient workstation. To evaluate workflow characteristics, a time–motion study was conducted to compare radiographic exam times of the new CR system with traditional CR and DR systems in a high-volume orthopedic operation. Approximately 200 exams for each modality were documented from the moment when a patient entered the X-ray room to the moment when all images were sent to the PACS archive using a timer and speech-recognition software. Applying Welch ANOVA and Tamhane’s T2 tests, average exam times for the new CR system were significantly faster (18–42%; P ≤ 0.025) than for the traditional CR system. Average exam times for the DR system were also faster than for the new CR system by 22–36% (P < 0.001) with one exception. In the case where the new CR system was located outside the X-ray room, using a one-technologist workflow model, average single-study exam times were not significantly different from those found when using DR. Therefore, the new CR system may be comparable in efficiency with the DR system for this particular setting and operation.     

Information Entropy Measure for Evaluation of Image Quality

This paper presents a simple and straightforward method for synthetically evaluating digital radiographic images by a single parameter in terms of transmitted information (TI). The features of our proposed method are (1) simplicity of computation, (2) simplicity of experimentation, and (3) combined assessment of image noise and resolution (blur). Two acrylic step wedges with 0–1–2–3–4–5 and 0–2–4–6–8–10 mm in thickness were used as phantoms for experiments. In the present study, three experiments were conducted. First, to investigate the relation between the value of TI and image noise, various radiation doses by changing exposure time were employed. Second, we examined the relation between the value of TI and image blurring by shifting the phantoms away from the center of the X-ray beam area toward the cathode end when imaging was performed. Third, we analyzed the combined effect of deteriorated blur and noise on the images by employing three smoothing filters. Experimental results show that the amount of TI is closely related to both image noise and image blurring. The results demonstrate the usefulness of our method for evaluation of physical image quality in medical imaging.     

Impedance of goat eye lens at different DC voltages

A computer assisted AC impedance system is used to measure the DC voltage—current (V-I) characteristics and AC impedance of a goat eye lens using a two-probe Ag−AgCl electrode system. The measurement of the V-I characteristics shows that when a DC voltage from 0mV to 30mV is applied, the resultant current decreases from an initial value of 0.58μA to 0.006μA. However, when the voltage is increases beyond 30mV, the current increases and reaches a value of 0.9μA at 100mV. The data on the frequency response (0.01–10 Hz) of the impedance of lens tissue show an inverse relationship with frequency. The effect of various DC voltages, namely 0, 30, 50, 100 and 200 mV, on the impedance of the eye lens is also investigated over a frequency range of 0.01–10 Hz. The measurement results for both V-I characteristics and AC impedance further suggest the presence of a 30 mV voltage compartment in the goat eye lens.     

Comparison of three mobile devices for measuring R–R intervals and heart rate variability: Polar S810i, Suunto t6 and an ambulatory ECG system

The first aim of this study was to compare an ambulatory five-lead ECG system with the commercially available breast belt measuring devices; Polar S810i and Suunto t6, in terms of R–R interval measures and heart rate variability (HRV) indices. The second aim was to compare different HRV spectral analysis methods. Nineteen young males (aged between 22 and 31 years, median 24 years) underwent simultaneous R–R interval recordings with the three instruments during supine and sitting rest, moderate dynamic, and moderate to vigorous static exercise of the upper and lower limb. For each subject, 17 R–R interval series of 3-min length were extracted from the whole recordings and then analyzed in frequency domain using (1) a fast Fourier transform (FFT), (2) an autoregressive model (AR), (3) a Welch periodogram (WP) and (4) a continuous wavelet transform (CWT). Intra-class correlation coefficients (ICC) and Bland–Altman limits of agreement (LoA) method served as criteria for measurement agreement. Regarding the R–R interval recordings, ICC (lower ICC 95% confidence interval >0.99) as well as LoA (maximum LoA: −15.1 to 14.3 ms for ECG vs. Polar) showed an excellent agreement between all devices. Therefore, the three instruments may be used interchangeably in recording and interpolation of R–R intervals. ICCs for HRV frequency parameters were also high, but in most cases LoA analysis revealed unacceptable discrepancies between the instruments. The agreement among the different frequency transform methods can be taken for granted when analyzing the normalized power in low and high frequency ranges; however, not when analyzing the absolute values.     

Segmentation of Holter ECG Waves Via Analysis of a Discrete Wavelet-Derived Multiple Skewness–Kurtosis Based Metric

In this study, a simple mathematical-statistical based metric called Multiple Higher Order Moments (MHOM) is introduced enabling the electrocardiogram (ECG) detection–delineation algorithm to yield acceptable results in the cases of ambulatory holter ECG including strong noise, motion artifacts, and severe arrhythmia(s). In the MHOM measure, important geometric characteristics such as maximum value to minimum value ratio, area, extent of smoothness or being impulsive and distribution skewness degree (asymmetry), occult. In the proposed method, first three leads of high resolution 24-h holter data are extracted and preprocessed using Discrete Wavelet Transform (DWT). Next, a sample to sample sliding window is applied to preprocessed sequence and in each slid, mean value, variance, skewness, and kurtosis of the excerpted segment are superimposed called MHOM. The MHOM metric is then used as decision statistic to detect and delineate ECG events. To show advantages of the presented method, it is applied to MIT-BIH Arrhythmia Database, QT Database, and T-Wave Alternans Database and as a result, the average values of sensitivity and positive predictivity Se = 99.95% and P+ = 99.94% are obtained for the detection of QRS complexes, with the average maximum delineation error of 6.1, 4.1, and 6.5 ms for P-wave, QRS complex, and T-wave, respectively showing marginal improvement of detection–delineation performance. In the next step, the proposed method is applied to DAY hospital high resolution holter data (more than 1,500,000 beats including Bundle Branch Blocks—BBB, Premature Ventricular Complex—PVC, and Premature Atrial Complex—PAC) and average values of Se = 99.97% and P+ = 99.95% are obtained for QRS detection. In summary, marginal performance improvement of ECG events detection–delineation process, reliable robustness against strong noise, artifacts, and probable severe arrhythmia(s) of high resolution holter data can be mentioned as important merits and capabilities of the proposed algorithm.     

Optimising the Use of Computed Radiography in Pediatric Chest Imaging

The objective of this study was to analyze image quality of chest examinations in pediatric patients using computed radiography (CR) obtained with a wide range of doses to suggest the appropriate parameters for optimal image quality. A sample of 240 chest images in four age ranges was randomly selected from the examinations performed during 2004. Images were obtained using a CR system and were evaluated independently by three radiologists. Each image was scored using criteria proposed by the European Guidelines on Quality Criteria in Pediatrics. Mean global scoring and scoring of individual criteria more sensitive to noise were used to evaluate image quality. Agfa dose level (DL) was in the range 1.20 to 2.85. It was found that there was not significant correlation (R < 0.5) between image quality and DL for any of the age ranges for either global score or for individual criteria more related to noise. The mean value of DL was in the ranges 1.9–2.1 for the four age bands. From this study, a DL value of 1.6 is proposed for pediatric CR chest imaging. This could yield a reduction of approximately a factor of 2.5 in mean patient entrance surface doses.     

Effects of constant frequency noise in magnetic resonance imaging with nonuniform k-space sampling

Magnetic resonance images can be compromised by constant frequency (CF) noise, such as radio frequency (RF) noise. We investigate the effects of CF noise in four imaging methods with non-uniform k-space sampling: single-shot echo-planar imaging (EPI) with sinusoidal readout gradients, phase-encoded echo-planar spectroscopic imaging (EPSI) with sinusoidal readout gradients, projection-reconstruction imaging, and single-shot spiral imaging. The characteristics of the CF artifacts in each imaging method are studied with numerical simulations. CF noise is found to cause artifacts of nonclassic forms in the reconstructed images. Specifically, dashed-line, streak, and spiral patterns of CF noise appear in EPI/EPSI with sinusoidal readout gradients, projection-reconstruction imaging, and spiral imaging, respectively. The analytical expression for dashed-line artifacts is found to be a weighted sum of Bessel functions and is verified with in vivo experiments. The CF artifacts can be removed during post-processing by eliminating the noise spikes in the Fourier domain of the raw data.     

A Filmless Radiology Teaching Conference System for Pertinent Displaying and Image Searching

To solve the problems of image displays in filmless radiology conferences for the purpose of teaching, we made an experimental design of a conference system with dual 50-in. plasma monitors for displaying larger images and a shared folder containing shortcuts to images for quick display during conferences on the desktop of each client computer in a picture archival and communication system. The image quality of the monitors was evaluated using the TG18-QC test pattern. The display time of images was measured in 20 cases when the shared folder was used and when it was not. Monitor screen size and image quality, operability, display time of images, and overall impression given by the system were evaluated subjectively by five radiologists. Although the image quality of the monitor was not as high as that of the high-resolution monitors used for diagnostic radiology, its performance was good enough for teaching. The average display time using the shared folder (2.6 ± 0.39 s) was significantly shorter than without it (16.9 ± 5.04 s; p = 2.85 × 10⁻⁶). Despite the need for certain improvements in monitor size and in the operability of the system, the radiologists considered the system suitable for radiology teaching conferences. We believe that this system is useful for institutions that intend to introduce a filmless system for filmless radiology teaching conferences.     

Studies of the Perception of Incomplete Outline Images of Different Sizes

The aim of the present work was to assess the range of angular sizes of fragmented images of objects at which perception of the images was scale-independent. Measurements were made of human subjects’ recognition thresholds for the shapes of the objects over a wide range of angular sizes (0.19–50°). The experiments used the Gollin test – a method for studying the recognition of fragmented outline images of objects with which the observer is familiar. The results obtained demonstrated that there is a wide range of angular sizes, from 1.0° to 50°, over which the perception thresholds of incomplete outline images do not change with changes in size, along with a narrow range of stimulus sizes, 0.19–1.0°, over which there is a significant size dependence. We suggest that the increase in thresholds and the failure to recognize images of small size occur as a result of an increased contribution of sampling noise at the level of the human retina.     

The effects of the experience of forming visual images on the spatial organization of the EEG

The spatial organization of biopotentials in the cerebral cortex of 23 subjects who were students at the Faculty of Graphic Arts (“professionals”) as well as 39 subjects lacking systematic experience of visual images (“non-professionals”) was compared with the aim of identifying EEG correlates of the experience of visual images (image formation) in humans. Changes in measures of the spatial organization of biopotentials (spatial synchronization, spatial disordering, coherence, and spectral power) were analyzed as subjects mentally composed visual images consisting of two simple graphic elements — right angles and oblique lines. The total number of image elements increased in each of four sequential tasks, from a number which could be analyzed at the conscious level (4–7 elements) to a number exceeding analysis at the conscious level (8–16). Intergroup differences, particularly increases in the spatial disordering of biopotentials (non-linear processes), were detected when large numbers of elements were used (tasks 3 and 4). This measure increased more markedly in professionals than in non-professionals. Changes were significant in the anterior areas of the right hemisphere. Spatial synchronization of biopotentials (linear processes) increased in non-professionals in the posterior areas of the right hemisphere. Coherence and spectral power increased in professionals in a larger number of narrow-band EEG frequency subranges than in non-professionals. These data show that experience of visual imagery results in a more complex neurodynamic process during the activity, with non-linear dynamics and a multitude of EEG resonance systems at different frequencies. __________ Translated from Zhurnal Vysshei Nervnoi Deyatel’nosti imeni I. P. Pavlova, Vol. 55, No. 6, pp. 812–821, November–December, 2005.     

Influence of Image Metrics When Assessing Image Quality from a Test Object in Cardiac X-ray Systems

Modern fluoroscopic systems used for invasive cardiology typically acquire digital images in a 1,024 × 1,024 × 12 bits. These images are maintained in the original format while they remain on the imaging system itself. However, images are usually stored using a reduced 512 × 512 × 8-bits format. This paper presents a method for digital analysis of test objects images. The results obtained using image-intensifier and flat-detector systems are given for the original and reduced matrices. Images were acquired using a test object (TO) and a range of polymethyl methacrylate (PMMA) thicknesses from 4 to 28 cm. Adult patient protocols were evaluated for 16–28 cm of PMMA using the image-intensifier system. Pediatric protocols were evaluated for 4–16 cm of PMMA using the flat-detector system. The TO contains disks of various thicknesses to evaluate low contrast sensitivity and a bar pattern to evaluate high-contrast spatial resolution (HCSR). All available fluoroscopic and cine modes were evaluated. Entrance surface air kerma was also measured. Signal-to-noise ratio (SNR) was evaluated using regions of interest (ROI). HCSR was evaluated by comparing the statistical analysis of a ROI placed over the image of the bar pattern against a reference ROI. For both systems, an improvement of approximately 20% was observed for the SNR on the reduced matrices. However, the HCSR parameter was substantially lower in the reduced metrics. Cardiologists should consider the clinical influence of reduced spatial resolution when using the archived images.     

Removing electroencephalographic artifacts by blind source separation

Eye movements, eye blinks, cardiac signals, muscle noise, and line noise present serious problems for electroencephalographic (EEG) interpretation and analysis when rejecting contaminated EEG segments results in an unacceptable data loss. Many methods have been proposed to remove artifacts from EEG recordings, especially those arising from eye movements and blinks. Often regression in the time or frequency domain is performed on parallel EEG and electrooculographic (EOG) recordings to derive parameters characterizing the appearance and spread of EOG artifacts in the EEG channels. Because EEG and ocular activity mix bidirectionally, regressing out eye artifacts inevitably involves subtracting relevant EEG signals from each record as well. Regression methods become even more problematic when a good regressing channel is not available for each artifact source, as in the case of muscle artifacts. Use of principal component analysis (PCA) has been proposed to remove eye artifacts from multichannel EEG. However, PCA cannot completely separate eye artifacts from brain signals, especially when they have comparable amplitudes. Here, we propose a new and generally applicable method for removing a wide variety of artifacts from EEG records based on blind source separation by independent component analysis (ICA). Our results on EEG data collected from normal and autistic subjects show that ICA can effectively detect, separate, and remove contamination from a wide variety of artifactual sources in EEG records with results comparing favorably with those obtained using regression and PCA methods. ICA can also be used to analyze blink-related brain activity.     

Comprehensive Breast Cancer Adjuvant Digital Summary

Background Patients with breast cancer often fail to recall the details of their original diagnosis and adjuvant therapy with the passage of time. Subsequent follow-up and treatment at a later time and a different institution wastes valuable time and effort to retrieve the original data. Patients and Methods Twenty-five consecutive patients with breast cancer of all stages admitted for adjuvant/neoadjuvant treatment and surgical excision were entered on study. An individualized comprehensive visual evaluation summary sheet (VESS) was created that detailed initial diagnosis, preceding relevant investigations, drug scheduling, and dosages of adjuvant therapy. Completion of a VESS required a computer, a digital camera with connection to a microscope, and radiology images over the PACS system. The completed one-page summary can be printed or stored. Results A VESS takes up an average of 4.4 MB (1.24–8 MB), each containing 11.5 images (range, 4–23 images), spanning a time period of around 216 days (range, 125–558 days). Conclusions Patients received a complete summary of pertinent information concerning their diagnosis and adjuvant therapy.     

A biopsy tool with integrated piezoceramic elements for needle tract cauterization and cauterization monitoring

This paper reports the feasibility of biopsy needle tract cauterization and cauterization monitoring using an embedded array of piezoceramic microheaters. Circular heaters of lead zirconate titanate (PZT-5A), with 200 μm diameter and 70–80 μm thickness, are fabricated using a batch mode micro ultrasonic machining process. These are then assembled into cavities in the walls of 20-gauge stainless steel needles and sealed with epoxy. Experiments are performed by inserting the proposed biopsy needle into porcine tissue samples. The needle surface exceeds the minimum target temperature rise of 33°C for either radial or thickness mode vibrations. The corresponding input power levels are 236 mW and 325 mW, respectively. The tissue cauterization extends 1–1.25 mm beyond the perimeter of the needle and is uniform in all directions. After cauterization, the fundamental anti-resonance frequency and the corresponding impedance magnitude of the PZT heater decrease by 4.1% and 42.6%, respectively, thereby providing a method to monitor the extent of tissue cauterization. A sensing interface circuit capable of measuring the resonance frequency shift of the PZT elements is built and tested using discrete integrated circuit components. The circuit detects the resonance frequency shift from 8.22 MHz to 7.96 MHz of the PZT elements when the biopsy needle is inserted into wax medium. An interface circuit for actuation of the PZT elements for tissue cauterization is also described.     

Novel Approach to Segment the Inner and Outer Boundaries of the Bladder Wall in T2-Weighted Magnetic Resonance Images

Diagnosis of bladder-related conditions needs critical measurements which require the segmentation of the inner and outer boundaries of the bladder wall. In T2-weighted MR images, the low-signal intensity bladder wall can be identified due to the large contrast with the high-signal intensity urine and perivesical fat. In this article, two deformable models are proposed to segment the bladder wall. Based on the imaging features of the bladder, a modified geodesic active contour is proposed to segment the inner boundary. This method uses the statistical information of the bladder lumen and can handle the intensity variation in MR images. Having obtained the inner boundary, a shape influence field is formed and integrated with the Chan–Vese (C–V) model to segment the outer boundary. The shape-guided C–V model can prevent the overlapping between the two boundaries when the appearance of the bladder wall is blurred. Segmentation examples are presented and analyzed to demonstrate the effectiveness of this novel approach.     

Effect of radiation from personal computer monitor on free-radical processes in rats

Radiation from a personal computer monitor reduces antioxidant activity and the contents of diene conjugates and Schiff bases in rat serum and has no effect on chemiluminescence and the content of carbonyl derivatives. The radiation causes no significant changes in blood contents of nitrites and ceruloplasmin and activity of Cu,Zn-superoxide dismutase. The results obtained indicate that radiation from a monitor produces potentially hazardous biological effects. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 124, No. 8, pp. 192–194, August, 1997     

Time-frequency methods for detecting spike activity of stomach

It has been hypothesised by many researchers that the spike activity signals of the stomach are responsible for triggering peristaltic contractions. Since most gastric motility disorders include an abnormality in the contraction pattern, it is very important to access this information non-invasively. The aim in this study is to use abdominal electrogastrogram (EGG) signals to detect the spike activity signals generated by the serosa of the stomach, and hence provide clinicians with a better method to monitor the motility state of the stomach. Through second and third-order spectral estimations performed on the serosal data obtained from canine experiments, it was concluded that the spike activity in serosal signals occupies a frequency range of 50–80 cycles per minute. An increase in this frequency range during strong antral contractions was observed both in the serosal and cutaneous power spectra. By using the ‘continuous wavelet transform’ with respect to a modified Morlet wavelet, the spike activity signals generated from the serosa of the stomach can be detected and quantified in time from the cutaneous EGG records. During phase III contraction episodes, a detection accuracy of up to 96% from the cutaneous EGG recordings was calculated based on the scored serosal spike activities simultaneously recorded.     

Partitioning k‐space for cylindrical three‐dimensional rapid acquisition with relaxation enhancement imaging in the mouse brain

Three‐dimensional rapid acquisition with relaxation enhancement (RARE) scans require the assignment of each phase encode step in two dimensions to an echo in the echo train. Although this assignment is frequently made across the entire Cartesian grid, collection of only the central cylinder of k‐space by eliminating the corners in each phase encode dimension reduces the scan time by ~22% with negligible impact on image quality. The recipe for the assignment of echoes to grid points for such an acquisition is less straightforward than for the simple full Cartesian acquisition case, and has important implications for image quality. We explored several methods of partitioning k‐space—exploiting angular symmetry in one extreme or emulating a cropped Cartesian acquisition in the other—and acquired three‐dimensional RARE magnetic resonance imaging (MRI) scans of the ex vivo mouse brain. We evaluated each partitioning method for sensitivity to artifacts and then further considered strategies to minimize these through averaging or interleaving of echoes and by empirical phase correction. All scans were collected 16 at a time with multiple‐mouse MRI. Although all schemes considered could be used to generate images, the results indicate that the emulation of a standard Cartesian echo assignment, by partitioning preferentially along one dimension within the cylinder, is more robust to artifacts. Samples at the periphery of the bore showed larger phase deviations and higher sensitivity to artifacts, but images of good quality could still be obtained with an optimized acquisition protocol. A protocol for high‐resolution (40 μm) ex vivo images using this approach is presented, and has been used routinely with a success rate of 99% in over 1000 images.