Scatter rejection and low-contrast performance of a slot-scan digital chest radiography system with electronic aft-collimation: a chest phantom study

Anti-scatter grids have been widely used to reject scatter and increase the perceptibility of low-contrast object in chest radiography; however they also attenuate the primary x-rays, resulting in a substantial degradation of primary information. Compensation for this degradation requires the use of higher exposure technique hence higher dose to the patient. A more efficient approach to reject scatter is the slot-scan imaging technique which employs a narrow scanning x-ray fan beam in conjunction with a slit or slot shaped solid state detector or an area detector used with an aft-collimator. With this approach, scatter can be rejected effectively without the need to attenuate primary x-rays. This paper demonstrates an electronic aft-collimation method, referred to as the alternate line erasure and readout (ALER) technique, for implementing the slot-scan digital radiography with a modern flat-panel detector. With this technique, instead of first exposing the detector and then reading the image line by line, the image line on the leading edge of the scanning fan beam is reset to erase the scatter accumulated prior to the arrival of the fan beam x-rays, while the image line on the trailing edge of the scanning fan beam is read out to acquire the image signals following the fan-beam exposure. These reset and readout processes are alternated and repeated as the x-ray fan beam scans across the detector. An anthropomorphic chest phantom was imaged to evaluate the scatter rejection ability and the low-contrast performance for the ALER technique and compare them with those for the anti-scatter grid method in full-field chest imaging. With a projected beam width of 16 mm, the slot-scan/ALER technique resulted in an average reduction of the scatter-to-primary ratios by 81%, 84%, 82%, and 86% versus 65%, 73%, 74%, and 73% with the anti-scatter grid method in the lungs, mediastinum, retrocardium, and subdiaphragm, respectively. The average CNR for the slot-scan/ALER technique was found to improve by 135%, 133%, 176%, and 87% versus 15%, 15%, 38%, and -11% with the anti-scatter grid method in the mediastinum, retrocardium, subdiaphragm, and lungs, respectively. These results demonstrated that the slot-scan/ALER technique can be used to achieve equally effective scatter rejection but substantially higher low-contrast performance than the anti-scatter grid method.     

The x-ray light valve: a low-cost digital radiographic imaging system

In recent years new digital x-ray radiographic and fluoroscopic systems based on large-area flat-panel technology have revolutionized our capability of producing x-ray images. However, such imagers are extraordinarily expensive and their rapid image acquisition capability is not required for many applications such as radiography. Here we report a novel approach to achieve a high-quality digital radiographic system at a cost which is only a small fraction of competitive digital technologies. The results demonstrate that our proposed x-ray light valve system has excellent spatial resolution and adequate sensitivity compared to existing technologies.     

Evaluation of a flat panel digital radiographic system for low-dose portable imaging of neonates

The purpose of this study was to evaluate the clinical utility of an investigational flat-panel digital radiography system for low-dose portable neonatal imaging. Thirty image-pairs from neonatal intensive care unit patients were acquired with a commercial Computed Radiography system (Agfa, ADC 70), and with the investigational system (Varian, Paxscan 2520) at one-quarter of the exposure. The images were evaluated for conspicuity and localization of the endings of ancillary catheters and tubes in two observer performance experiments with three pediatric radiologists and three neonatologists serving as observers. The results indicated no statistically significant difference in diagnostic quality between the images from the investigational system and from CR. Given the investigational system's superior resolution and noise characteristics, observer results suggest that the high detective quantum efficiency of flat-panel digital radiography systems can be utilized to decrease the radiation dose/exposure to neonatal patients, although post-processing of the images remains to be optimized. The rapid availability of flat-panel images in portable imaging was found to be an added advantage for timely clinical decision-making.     

The x-ray light valve: a potentially low-cost, digital radiographic imaging system--a liquid crystal cell design for chest radiography

Digital x-ray radiographic systems are desirable as they offer high quality images which can be processed, transferred, and stored without secondary steps. However, current clinical systems are extraordinarily expensive in comparison to film-based systems. Thus, there is a need for an economical digital imaging system for general radiology. The x-ray light valve (XLV) is a novel digital x-ray detector concept with the potential for high image quality and low cost. The XLV is comprised of a photoconductive detector layer and liquid crystal (LC) cell physically coupled in a sandwich structure. Upon exposure to x rays, charge is collected at the surface of the photoconductor, causing a change in the reflective properties of the LC cell. The visible image so formed can subsequently be digitized with an optical scanner. By choosing the properties of the LC cell in combination with the appropriate photoconductor thickness and bias potentials, the XLV can be optimized for various diagnostic imaging tasks. Specifically for chest radiography, we identified three potentially practical reflective cell designs by selecting from those commonly used in LC display technology. The relationship between reflectance and x-ray exposure (i.e., the characteristic curve) was determined for all three cells using a theoretical model. The results indicate that the reflective electrically controlled birefringence (r-ECB) cell is the preferred choice for chest radiography, provided that the characteristic curve can be shifted towards lower exposures. The feasibility of the shift of the characteristic curve is shown experimentally. The experimental results thus demonstrate that an XLV based on the r-ECB cell design exhibits a characteristic curve suitable for chest radiography.     

Evaluation of the imaging properties of two generations of a CCD-based system for digital chest radiography

Two generations of a CCD-based detector system with lens-based optical coupling for digital chest radiography were evaluated in terms of presampling MTF, NPS, NEQ, DQE, linearity in response, and SNR over the detector area. Measurements were performed over a wide exposure range and at several different beam qualities. Neither the presampling MTF nor the DQE showed any general strong beam quality dependence, whereas the NPS and NEQ did when compared at specific entrance air kerma values. The exposure dependency for the DQE was found to be considerable, with the detectors showing low DQE at low exposures, and higher DQE at higher exposures. It was found that the second generation has been substantially improved compared to its predecessor regarding all the relevant parameters. The DQE(0) at an entrance air kerma of 5 microGy increased from 9% to 15%, mainly due to a better system gain (including optical coupling efficiency and matching of the energy of the emitted light photons to the sensitivity of the CCD camera). The first generation of detectors was found to have problems with bad peripheral resolution [MTF(muN/2) <0.1]. This problem was nonexistent for the second generation for which uniform resolution has been obtained [MTF(muN/2)=0.3]. A theoretical calculation of the DQE of two model systems similar to the ones evaluated was also performed, and the results were comparable to the experimentally determined data at high exposures. The model shows that both systems suffer from low optical coupling efficiency due to the large demagnification used. The main conclusion is that although the second generation has been improved, there is still a problem with low system gain leading to relatively modest DQE values, especially at low exposures.     

Performance of high-resolution monitors for digital chest imaging

High-resolution cathode-ray tubes (CRT's) are currently the most viable soft-copy display for digital radiography. We present here methods for measuring large-area contrast ratio and detail contrast ratio. A two-dimensional charge coupled device (ccd) array signal-averaged with a video frame buffer permits linear microradiometric measure of individual beam lines. Results from three different 1000-line monitors demonstrate the shift variance of resolution. The detail contrast ratio (or modulation depth) was found to vary from 100% to less than 10% across the face of one CRT. Dynamic focus in both the horizontal and vertical deflection circuitry proved effective in reducing this shift variance. Comparisons of three phosphors demonstrate the utility of long persistence phosphors (P164) for static display in producing brighter images with less flicker. Recommendations for CRT design and selection for high-resolution digital radiography are included.     

Scatter estimation for a digital radiographic system using convolution filtering

The use of a convolution-filtering method to estimate the scatter distribution in images acquired with a digital subtraction angiography (DSA) imaging system has been studied. Investigation of more than 175 convolution kernels applied to images of anthropomorphic head, chest, and pelvic phantoms using 15-, 25-, and 36-cm fields of view (digitized onto a 512 X 512 pixel image matrix) showed that two-dimensional exponential kernels with a full width at half maximum (FWHM) of 50-150 pixels best reproduced the scatter fields within these images with a root-mean-square percentage error from 4% to 8%. A two-dimensional exponential kernal with a FWHM of 75 pixels in each dimension applied to ten different anatomic presentations and fields of view, resulted in an average root-mean-square percentage error of 6.6% for the ten cases studied. The method should be implementable using an array of small lead beam stops placed in the field of only a single mask image and the above described convolution kernel applied to both mask and postopacification images. The mask beam-stop data are used to scale both mask and postopacification convolution-filtered images. This scaled, convolution-filtered image is then subtracted from the original image to produce a largely scatter-corrected image.     

Development of a digital duplication system for portable chest radiographs

To provide high-quality duplicate chest images for the intensive care units, we have developed a digital duplication system in which film digitization is performed in conjunction with nonlinear density correction, contrast adjustment, and unsharp mask filtering. This system provides consistent image densities over a wide exposure range and enhancement of structures in the mediastinum and upper abdominal areas, improving visibility of catheters and tubes. The image quality is often superior to that of the original radiograph and is more consistent from day to day. Repeat rates for portable chest radiographs have been reduced by more than a factor of two since implementation of digitization in December 1991, and the number of repeat examinations caused by exposure errors have been substantially reduced.     

The x-ray light valve: a low-cost, digital radiographic imaging system--spatial resolution

An x-ray light valve (XLV) coupled with an optical scanner has the potential to meet the need for a low-cost, high quality digital imaging system for general radiography. The XLV/scanner concept combines three well-established, and hence, low-cost technologies: An amorphous selenium (a-Se) layer as an x-ray-to-charge transducer, a liquid crystal (LC) cell as an analog display, and an optical scanner for image digitization. The XLV consists of an a-Se layer and LC cell in a sandwich structure which produces an optical image in the LC layer upon x-ray exposure. The XLV/scanner system consists of an XLV in combination with an optical scanner for image readout. Here, the effect of each component on the spatial resolution of an XLV/scanner system is investigated. A theoretical model of spatial resolution of an XLV is presented based on calculations of the modulation transfer function (MTF) for a-Se and a LC cell. From these component MTFs, the theoretical MTF of the XLV is derived. The model was validated by experiments on a prototype XLV/scanner system. The MTF of the scanner alone was obtained by scanning an optical test target and the MTF of the XLV/scanner system was measured using x rays. From the measured MTF of the scanner, the theoretical MTF of the XLV/scanner system was established and compared with the experimental results. Good general agreement exists between experimental and theoretical results in the frequency range of interest for general radiography, although the theoretical curves slightly overstate the measured MTFs. The experimental MTF of the XLV was compared with the MTF of two clinical systems and was shown to have the capability to exceed the resolution of flat-panel detectors. From this, the authors can conclude that the XLV has an adequate resolution for general radiography. The XLV/scanner also has the potential to eliminate aliasing while maintaining a MTF that exceeds that of a flat-panel imager.     

Mammographic imaging with a small format CCD-based digital cassette: physical characteristics of a clinical system

The physical characteristics of a clinical charge coupled device (CCD)-based imager (Senovision, GE Medical Systems, Milwaukee, WI) for small-field digital mammography have been investigated. The imager employs a MinR 2000 (Eastman Kodak Company, Rochester, NY) scintillator coupled by a 1:1 optical fiber to a front-illuminated 61 x 61 mm CCD operating at a pixel pitch of 30 microns. Objective criteria such as modulation transfer function (MTF), noise power spectrum (NPS), detective quantum efficiency (DQE), and noise equivalent quanta (NEQ) were employed for this evaluation. The results demonstrated a limiting spatial resolution (10% MTF) of 10 cy/mm. The measured DQE of the current prototype utilizing a 28 kVp, Mo-Mo spectrum beam hardened with 4.5 cm Lucite is approximately 40% at close to zero spatial frequency at an exposure of 8.2 mR, and decreases to approximately 28% at a low exposure of 1.1 mR. Detector element nonuniformity and electronic gain variations were not significant after appropriate calibration and software corrections. The response of the imager was linear and did not exhibit signal saturation under tested exposure conditions.     

Experimental investigation of the dose and image quality characteristics of a digital mammography imaging system

Our purpose in this study was to investigate the image quality and absorbed dose characteristics of a digital mammography imaging system with a CsI scintillator, and to identify an optimal x-ray tube voltage for imaging simulated masses in an average size breast with 50% glandularity. Images were taken of an ACR accreditation phantom using a LORAD digital mammography system with a Mo target and a Mo filter. In one experiment, exposures were performed at 80 mAs with x-ray tube voltages varying between 24 and 34 kVp. In a second experiment, the x-ray tube voltage was kept constant at 28 kVp and the technique factor was varied between 5 and 500 mAs. The average glandular dose at each x-ray tube voltage was determined from measurements of entrance skin exposure and x-ray beam half-value layer. Image contrast was measured as the fractional digital signal intensity difference for the image of a 4 mm thick acrylic disk. Image noise was obtained from the standard deviation in a uniformly exposed region of interest expressed as a fraction of the background intensity. The measured digital signal intensity was proportional to the mAs and to the kVp5.8. Image contrast was independent of mAs, and dropped by 21% when the x-ray tube voltage increased from 24 to 34 kVp. At a constant x-ray tube voltage, image noise was shown to be approximately proportional to (mAs)(-05), which permits the image contrast to noise ratio (CNR) to be modified by changing the mAs. At 80 mAs, increasing the x-ray tube voltage from 24 to 34 kVp increased the CNR by 78%, and increased the average glandular dose by 285%. At a constant lesion CNR, the lowest average glandular dose value occurred at 27.3 kVp. Increasing or decreasing the x-ray tube voltage by 2.3 kVp from the optimum kVp increased the average glandular dose values by 5%. These results show that imaging simulated masses in a 4.2 cm compressed breast at approximately 27 kVp with a Mo/Mo target/filter results in the lowest average glandular dose.     

Development of radiographic chest phantoms

Diagnostic imaging studies, particularly in chest radiography, require adequate phantoms. Two such phantoms have been made and used; one is a semianthropomorphic phantom and the other is a geometric phantom with embedded test objects. These phantoms, constructed of epoxy resin-based solid water, are described in detail and compared to a common commercial phantom.     

Basic imaging properties of a computed radiographic system with photostimulable phosphors

We measured the characteristic curve, modulation transfer function (MTF), and the Wiener spectrum of a commercially available computed radiographic (CR) system with photostimulable phosphor plate (imaging plate, IP). The characteristic curve (system response) obtained by an inverse-square x-ray sensitometry showed a wide dynamic range (order of 10(3) in maximum). The slit technique was employed to determine the MTF's, such as IP MTF, presampling MTF including the unsharpness of the detector (IP) and the blurring effect of the sampling aperture, and laser-printer MTF. It was found that the MTF of the standard type of IP was comparable to that of medium-speed screen/film systems. The noticeable degradation of resolution in our CR system, however, occurred at the stage of image data sampling: the presampling MTF was inferior to the IP MTF due to the effect of the scattering and resultant spreading of the incidence laser beam and the emitted luminescence. The noise was characterized by means of digital Wiener spectrum using uniformly exposed noise data. Exposure ranges could be separated into different sections depending upon the noise sources, such as quantum mottle at low exposure and system structure noise at high exposure.     

The performance of a CCD digital autoradiography imaging system

Autoradiography is a widely used technique for imaging trace quantities of radioactivity within biological samples, conventionally using photographic film. This method produces images with high spatial resolution, but it suffers from very low sensitivity and poor dynamic range. Digital autoradiography systems with greatly improved sensitivity and linearity are commercially available, but the spatial resolution is usually much less than that achieved using film. We report here the design, construction and characterization of a novel digital autoradiography system based on scientific-grade charged coupled devices (CCDs). Images of x-ray and beta emissions from radionuclides commonly used in autoradiography show that the system can perform high-speed quantitative imaging with a spatial resolution of approximately 30, microm. Using a frame by frame acquisition method the dynamic range is shown to be at least three orders of magnitude. The absolute detection efficiency is comparable to the best of the currently available digital systems. CCD images of 125I and 14C radioisotope distributions in tissue samples are superior to the equivalent film images and have been acquired in 1-10% of the time.     

A prototype digital ionographic imaging system

A prototype digital ionographic imaging system is described. The process involves direct electrical reading of a latent electrostatic image which has been produced by an ionographic technique. The main design features of the system are outlined and their effect on its imaging performance highlighted. A preliminary assessment of the performance of the system in terms of resolution, noise, contrast and sensitivity is presented and compared with that of a conventional screen-film combination.     

The x-ray light valve: a potentially low-cost, digital radiographic imaging system-concept and implementation considerations

New x-ray radiographic systems based on large-area flat-panel technology have revolutionized our capability to produce digital x-ray images. However, these imagers are extraordinarily expensive compared to the systems they are replacing. Hence, there is a need for a low-cost digital imaging system for general applications in radiology. A novel potentially low-cost radiographic imaging system based on established technologies is proposed-the X-Ray Light Valve (XLV). This is a potentially high-quality digital x-ray detector made of a photoconducting layer and a liquid-crystal cell, physically coupled in a sandwich structure. Upon exposure to x rays, charge is collected on the surface of the photoconductor. This causes a change in the optical properties of the liquid-crystal cell and a visible image is generated. Subsequently, it is digitized by a scanned optical imager. The image formation is based on controlled modulation of light from an external source. The operation and practical implementation of the XLV system are described. The potential performance of the complete system and issues related to sensitivity, spatial resolution, noise, and speed are discussed. The feasibility of clinical use of an XLV device based on amorphous selenium (a-Se) as the photoconductor and a reflective electrically controlled birefringence cell is analyzed. The results of our analysis indicate that the XLV can potentially be adapted to a wide variety of radiographic tasks.     

A digital imaging and communications in medicine (DICOM) print service for chest imaging

Large-scale picture archiving and communication systems (PACS) have not been widely implemented in this or other countries. In almost all radiology departments film remains the medium for diagnostic interpretation and image archive. Chest imaging is the dominant screening examination performed within most imaging departments and as such, is an extremely high-volume, low-margin examination. Digital technologies are being applied to chest imaging to overcome limitations of screen-film receptors (limited latitude) and current film management systems (singleimage copy). Efficient management of images and information is essential to the success of a chest imaging program. In this article we report on a digital imaging and communications in medicine (DICOM)-based centralized printing network for chest imaging. The system components and their operational characteristics are described. Our experience integrating DICOM-compliant equipment supplied by several vendors is described. We conclude that the print model supported by DICOM is adequate for cross-sectional (eg, computed tomography and magnetic resonance) imaging but is too simplistic to be generally applied to projection radiography.     

On modelling the kinestatic charge detector for digital radiographic diagnostic and portal imaging

The kinestatic charge detection (KCD) principle has been a digital radiography technique for more than a decade. The advances of the KCD technique have gone from diagnostic imaging to portal imaging. However, little work has been done on understanding the selection of key KCD parameters and relationships between them. In the present study, an engineering model was established that could be used to optimize the placements of key parameters in terms of KCD system mechanical design. In the proposed KCD engineering model, the basic energy conservation law was applied to the process of ion transmission. It allows for the computation of the KCD design parameters such as the optimum grid placement, high voltage board tilt angle and grid wire space, as well as to provide recommendations on high voltage board and electric potentials and their ratio.     

On modelling the kinestatic charge detector for digital radiographic diagnostic and portal imaging

The kinestatic charge detection (KCD) principle has been a digital radiography technique for more than a decade. The advances of the KCD technique have gone from diagnostic imaging to portal imaging. However, little work has been done on understanding the selection of key KCD parameters and relationships between them. In the present study, an engineering model was established that could be used to optimize the placements of key parameters in terms of KCD system mechanical design. In the proposed KCD engineering model, the basic energy conservation law was applied to the process of ion transmission. It allows for the computation of the KCD design parameters such as the optimum grid placement, high voltage board tilt angle and grid wire space, as well as to provide recommendations on high voltage board and electric potentials and their ratio.