Comparison of radiographic image quality from four digitization devices as viewed on computer monitors

The objective of this study was to compare the quality of radiographic images digitized from commercial-grade and consumer-grade digital cameras and scanners as viewed on computer monitor. Radiographic images were digitized from hardcopy film using a commercial-grade laser scanner, a consumer-grade desktop flatbed scanner, a commercial-grade digital camera, and a consumer-grade digital camera. The quality of images without and with grayscale histogram adjustment was evaluated subjectively by 10 board-certified radiologists. Optical density response was evaluated objectively using a grayscale test pattern. There was no significant difference in subjective quality among images digitized with the commercial scanner, consumer scanner, and commercial camera. The quality of images digitized with the consumer camera was lower than the other 3. Objective tests showed the commercial scanner to have the most linear optical density response. For the purpose of viewing images on a computer monitor, a consumer-grade desktop scanner can produce images of similar quality to those produced by more expensive laser commercial-grade scanners and digital cameras and provides cost-efficient means to digitize radiographic plain films. A consumer-grade camera may not be optimal for use in this setting.     

A time-lapse, image digitization videomicroscope system based on a mini computer with large peripheral memory

We describe a time-lapse image digitization videomicroscope system that uses a mini computer as the main processing unit in conjunction with a large peripheral memory for storing multiple digitized images. The advantage of the system lies in its ability to facilitate acquisition and analysis of data relative to size, location and optical density of cells and cellular structure using elementary image processing techniques. This system can also potentially control microscope stage movement, enabling acquisition of larger amounts of data per time-lapse experiment.     

A method for modifying the image quality parameters of digital radiographic images

A new computer simulation approach is presented that is capable of modeling several varieties of digital radiographic systems by their image quality characteristics. In this approach, the resolution and noise characteristics of ideal supersampled input images are modified according to input modulation transfer functions (MTFs) and noise power spectra (NPS). The modification process is separated into two routines-one for modification of the resolution and another for modification of the noise characteristics of the input image. The resolution modification routine blurs the input image by applying a frequency filter described by the input MTF. The resulting blurred image is then reduced to its final size to account for the sampling process of the digital system. The noise modification routine creates colored noise by filtering the frequency components of a white noise spectrum according to the input noise power. This noise is then applied to the image by a moving region of interest to account for variations in noise due to differences in attenuation. In order to evaluate the efficacy of the modification routines, additional routines were developed to assess the resolution and noise of digital images. The MTFs measured from the output images of the resolution modification routine were within 3% of the input MTF The NPS measured from the output images of the noise modification routine were within 2% of the input NPS. The findings indicate that the developed modification routines provide a good means of simulating the resolution and noise characteristics of digital radiographic systems for optimization or processing purposes.     

Tendon organs as monitors of muscle damage from eccentric contractions

Eccentric contractions, where the active muscle is stretched, can lead to muscle damage. One of the signs of damage is a rise in the whole-muscle passive tension. Here we have asked, how many eccentric contractions are necessary to produce a measurable rise in passive tension and can this be detected by the muscle's tension sensors, the tendon organs? Responses of tendon organs of the medial gastrocnemius muscle of the anaesthetised cat were recorded during and after a series of eccentric contractions. The contractions were arranged so that the length change to which the muscle was subjected lay symmetrically about the optimum length for active tension. Tendon organ responses were measured as a mean rate, calculated over a 1-mm length change during a slow stretch of the muscle. Progressive increases in passive tension and tendon organ response were measured after each of a series of 1-100 eccentric contractions of the whole muscle, bundles of motor units and single motor units. One to two eccentric contractions of a single motor unit were sufficient to produce measurable rises in passive tension and tendon organ response. After a series of eccentric contractions had been completed, passive tension and tendon organ response were seen to continue rising with similar time-courses over the next 50 min. Both tension and afferent response could be reduced by large passive stretches. There was also a large increase in the responses of tendon organs to combined stretch and vibration at 100 Hz after the eccentric contractions. All of this indicates that tendon organs are able to monitor the passive tension changes in the muscle, thought to result from muscle damage produced by the eccentric contractions. The findings are relevant to known changes in proprioception and motor control after eccentric exercise.     

Comparison of actual porcine tooth crown development stages and computer image analysis

Tooth developmental stage evaluation is important in dental and chronological age estimation, and it is important for accurate diagnoses and appropriate treatment in dental practice. It is routinely assessed by clinical observations and radiographic techniques. This study aimed at ascertaining tooth developmental stage judgments made by examiners and Mimics software according to the Nolla method with radiographs. Meanwhile, the true tooth developmental stages would be explored with histological analysis. Twenty freshly slaughtered porcine heads were collected and hemisected, and both the left and right mandibular samples were numbered. The developmental stages of the second and third permanent molars (M2 and M3) were evaluated by examiners and Mimics software analysis. The ratio of the radiopaque calcified area to the dental follicle (RCA/DF) at different stages was calculated. Both non-decalcified and decalcified samples were processed for histologic observation. The results showed significant differences between RCA/DF ratios from different developmental stages. There was a high positive correlation between the examiners' evaluation results and Mimics analysis results. Radiograph judgments and histology observation results were consistent from Stages 2–6. However, radiograph images of Stage 1 samples showed only crypts present, while under a surgical operating microscope, a bell-shaped tooth germ was observed. This was also confirmed by normal and hard tissue histology. In conclusion, radiograph judgments made by either examiners or Mimics software were both reliable. Mimics analysis can be a useful tool in evaluating tooth developmental stages. However, judgments need to be made cautiously in early developmental stages.     

Recommendations for image prefetch or film digitization strategy based on an analysis of an historic radiology image database

Picture archiving and communications systems (PACS) utilize short- and long-term storage to provide both rapid retrieval and large storage capacity. Owing to the practical limitations imposed on the size of the much faster short-term storage, it is important to use an effective algorithm in the retrieval of comparison images from long to short-term storage. A strategy must be used to maximize the likelihood that the relevant historic images have been previously retrieved into short-term memory. Data were collected with a database consisting of 754 consecutive examinations and 7,723 associated historic studies. The most frequent number of previous examinations was zero (11% of patients). In 45% of cases, no previous matching examinations had been performed. Two basic strategies of image retrieval were evaluated. The first algorithm retrieved the lastn studies in chronological order. The second strategy tested was retrieval based on a defined interval of time. This strategy was found to be less efficient. By using the former strategy, a 91% success rate (defined as successful retrieval of the previous matching exam) was achieved with retrieval of only 30% of the prior exams. The second approach required retrieval of 70% of the prior exams to achieve a 90% success rate for the previous matching exam. However, the data from this latter strategy suggest that examinations are often ordered in clusters. Thus, there was found to be a 72% likelihood that a previous matching exam, if present, would available on a PACS after only 1 week of operation, and an 80% chance after only 1 month of operation. The data therefore suggest that digitization of film in a new PACS environment might not be necessary owing to the relatively short period of time required to populate the database with historical studies.     

External quality assurance as a revalidation method for pathologists in pediatric histopathology: Comparison of four international programs

Aim  

External quality assurance (EQA) is an extremely valuable resource for clinical pathologists to maintain high standards, improve diagnostic skills, and possibly revalidate medical license. The aim of this study was to participate in and compare four international slide survey programs (UK, IAP-Germany, USA-Canada, Australasia) in pediatric histopathology for clinical pathologists with the aim to use it as a revalidation method.     

Effect of radiographic techniques (kVp and mAs) on image quality and patient doses in digital subtraction angiography

We investigated how varying the x-ray tube voltage and image receptor input exposure affected image quality and patient radiation doses in interventional neuroradiologic imaging. Digital subtraction angiography (DSA) images were obtained of a phantom with 1 mm diameter vessels containing iodine at concentrations between 4.5 and 50 mg/cc. The detection threshold concentration of iodine was determined by inspecting DSA images obtained at a range of x-ray tube voltages and input exposure levels. Surface doses were obtained from measured x-ray tube output data, and corresponding values of energy imparted were determined using the exposure-area product incident on the phantom. In one series of experiments, the air kerma at the image intensifier (X) was varied between 0.44 microGy per frame and 8.8 microGy per frame at a constant x-ray tube voltage of 70 kVp. In a second series of experiments, the tube voltage was varied between 50 and 100 kVp, and the mAs adjusted to maintain a constant exposure level at the input of the image intensifier. At a constant x-ray tube voltage, the surface dose and energy imparted were directly proportional to the input exposure per frame used to acquire the DSA images. On our DSA system operated below 2.2 microGy per frame, the threshold iodine concentration was found to be proportional to X(-0.57), which is in reasonable agreement with the theoretical prediction for a quantum noise limited imaging system. Above 2.2 microGy per frame, however, the threshold iodine concentration was proportional to X(-0.26), indicating that increasing the input exposure above this value will only achieve modest improvements in image quality. At a constant image intensifier input exposure level, increasing the x-ray tube voltage from 50 kVp to 100 kVp reduced the surface dose by a factor of 6.1, and the energy imparted by a factor of 3.5. The detection threshold iodine concentration was found to be proportional to kVp(n), where n was 2.1 at 1.1 microGy per frame, and 1.6 at 3.9 microGy per frame. For clinical situations that can be modeled by a uniform phantom, reducing the x-ray tube voltage rather than increasing the exposure level would best achieve improvements on our DSA imaging system performance.     

A comparison of physical image quality indices and observer performance in the radiographic detection of nylon beads

Although various models have been proposed in an attempt to predict the usefulness of a radiographic image in terms of its physical characteristics, no previous work has shown whether a single physical image quality index, such as a signal-to-noise ratio, can reliably predict the performance of a human observer over a broad range of image characteristics. We studied the relationship between physical and visual image quality for the task of detecting nylon beads in radiographs. Thirty-seven imaging cases with different combinations of physical image characteristics were considered; these included variations in object size and magnification, X-ray beam quality, screen-film system, screen-film contact, film density and illumination, and viewing distance. For each imaging case, visual image quality was quantified in terms of observer performance in a 2AFC visual detection experiment. Physical image quality indices were calculated according to eight different models of the detection process; these indices combined data regarding object size and attenuation, screen-film system MTF, film gradient, noise Wiener spectrum, and visual system response. The results of this work indicate that, for the conditions studied, human observer detection performance most closely resembles that of a sub-optimal statistical decision process.     

Preliminary validation of a new variable pattern for daily quality assurance of medical image display devices

This paper reports on a comparative study between the well-established test patterns for daily quality assurance (QA) of monitors of the American Association of Medical Physicists, Task Group 18 (AAPMtg18) and the Deutsches Institut für Normung e.V (DIN), and a newly proposed variable test pattern. A characteristic of the test patterns currently used for the QA of monitors is their static nature: The same test pattern is always used. This enables a learning effect that may bias the results over time. To address this problem we have developed a variable pattern for the quality assurance of monitors (MoniQA) that allows an evaluation of contrast visibility, geometric distortion, resolution, global image quality including uniformity, and artifacts. The test pattern includes randomly generated elements intended to prevent the observer from learning the test. Examples are random characters that have to be discriminated from the background to evaluate the threshold luminance difference and variable positions of different features in the test pattern. The newly proposed test patterns were generated and visualized on different viewing stations with a software tool developed in JAVA. In this study, we validated these patterns against the well-known AAPMtg18 and DIN test patterns on 22 monitors. The results showed that the MoniQA test can indicate the same monitor problems as the other well-known patterns and is significantly quicker to evaluate than the AAPMtg18 test patterns. The MoniQA pattern is a promising alternative for daily quality control of medical viewing stations.     

Comparison of radiographic texture analysis from computed radiography and bone densitometry systems

Osteoporosis is a disease that results in an increased risk of bone fracture due to a loss of bone mass and deterioration of bone structure. Bone mineral density (BMD) provides a measure of bone mass and is frequently measured by bone densitometry systems to diagnose osteoporosis. In addition, computerized radiographic texture analysis (RTA) is currently being investigated as a measure of bone structure and as an additional diagnostic predictor of osteoporosis. In this study, we assessed the ability of a peripheral bone densitometry (PD) system to yield images useful for RTA. The benefit of such a system is that it measures BMD by dual-energy x-ray absorptiometry and therefore provides high- and low-energy digital radiographic images. The bone densitometry system investigated was the GE/Lunar PIXI, which provides 512 x 512 digital images of the heel or forearm (0.2 mm pixels). We compared texture features of heel images obtained with this PD system to those obtained on a Fuji computed radiography (CR) system (0.1 mm pixels). Fourier and fractal-based texture features of images from 24 subjects who had both CR and BMD exams were calculated, and correlation between the two systems was analyzed. Fourier-based texture features characterize the magnitude, frequency content, and orientation of the trabecular bone pattern. Good correlation was found between the two modalities for the first moment (FMP) with r=0.71 (p value<0.0001) and for minimum FMP with r=0.52 (p value=0.008). Root-mean-square (RMS) did not correlate with r=0.31 (p value>0.05), while the standard deviation of the RMS did correlate with r=0.79 (p value<0.0001). Good correlation was also found between the two modalities for the fractal-based texture features with r=0.79 (p value<0.0001) for the global Minkowski dimension and r=0.63 (p value=0.0007) for the fractal dimension from a box counting method. The PD system therefore may have the potential for yielding heel images suitable for RTA.     

介入器械放置与血流影响的仿真分析

心血管介入器械的使用越来越广泛,而综合考虑血流、器械和血管的作用情况,研究器械的放置和设计问题,有助于减少器械诱发的并发症,提高其使用的效果.本文以腔静脉滤器为例,采用计算机建模,有限体积法生成网格,通过计算流场来分析器械与血流的相互作用.结果表明介入器械的结构(如器械的支腿类型、附着方式)和放置对血管及血流有显著的影响,而器械的放置位置也可依据血管流场的情况来进行优化选择.     

Optimization of image quality and dose for Varian aS500 electronic portal imaging devices (EPIDs)

This study was carried out to investigate whether the electronic portal imaging (EPI) acquisition process could be optimized, and as a result tolerance and action levels be set for the PIPSPro QC-3V phantom image quality assessment. The aim of the optimization process was to reduce the dose delivered to the patient while maintaining a clinically acceptable image quality. This is of interest when images are acquired in addition to the planned patient treatment, rather than images being acquired using the treatment field during a patient's treatment. A series of phantoms were used to assess image quality for different acquisition settings relative to the baseline values obtained following acceptance testing. Eight Varian aS500 EPID systems on four matched Varian 600C/D linacs and four matched Varian 2100C/D linacs were compared for consistency of performance and images were acquired at the four main orthogonal gantry angles. Images were acquired using a 6 MV beam operating at 100 MU min(-1) and the low-dose acquisition mode. Doses used in the comparison were measured using a Farmer ionization chamber placed at d(max) in solid water. The results demonstrated that the number of reset frames did not have any influence on the image contrast, but the number of frame averages did. The expected increase in noise with corresponding decrease in contrast was also observed when reducing the number of frame averages. The optimal settings for the low-dose acquisition mode with respect to image quality and dose were found to be one reset frame and three frame averages. All patients at the Northern Ireland Cancer Centre are now imaged using one reset frame and three frame averages in the 6 MV 100 MU min(-1) low-dose acquisition mode. Routine EPID QC contrast tolerance (+/-10) and action (+/-20) levels using the PIPSPro phantom based around expected values of 190 (Varian 600C/D) and 225 (Varian 2100C/D) have been introduced. The dose at dmax from electronic portal imaging has been reduced by approximately 28%, and while the image quality has been reduced, the images produced are still clinically acceptable.     

基于超声序列图像的心脏四腔运动同步特性提取

目的心脏四腔运动的同步特性对于精确描述心脏机械活动有重要作用,特别对于心脏再同步治疗患者的诊断和术后评估非常重要,但目前此特性尚无较好的无创定量测定方法。全心脏B型超声序列图像含有丰富的心脏运动信息,可从超声心脏序列图像中提取心脏四腔运动的同步特性。方法首先将全心脏超声序列图像中每一帧图像的四腔分割出来,得到四腔的切面面积,进而从时间序列图像得到四腔面积随时间变化数据,通过特征分析得到心脏四腔运动的同步特性。为克服超声图像空间分辨率不高、信噪比较低及四腔边界不清晰的缺点,本文以主动形状模型(active shape model,ASM)为主,并针对此方法的不足提出了基于图像局部方差的改进方法。结果仿真超声图像序列和实际超声图像序列的实验结果初步证明本文提出的方法可行。结论基于改进的ASM分割方法,可达到较好的分割结果,并获得比较准确的心脏四腔运动的同步特性。     

Performance of electronic portal imaging devices (EPIDs) used in radiotherapy: image quality and dose measurements

The aim of our study was to compare the image and dosimetric quality of two different imaging systems. The first one is a fluoroscopic electronic portal imaging device (first generation), while the second is based on an amorphous silicon flat-panel array (second generation). The parameters describing image quality include spatial resolution [modulation transfer function (MTF)], noise [noise power spectrum (NPS)], and signal-to-noise transfer [detective quantum efficiency (DQE)]. The dosimetric measurements were compared with ionization chamber as well as with film measurements. The response of the flat-panel imager and the fluoroscopic-optical device was determined performing a two-step Monte Carlo simulation. All measurements were performed in a 6 MV linear accelerator photon beam. The resolution (MTF) of the fluoroscopic device (f 1/2 = 0.3 mm(-1)) is larger than of the amorphous silicon based system (f 1/2 = 0.21 mm(-1)), which is due to the missing backscattered photons and the smaller pixel size. The noise measurements (NPS) show the correlation of neighboring pixels of the amorphous silicon electronic portal imaging device, whereas the NPS of the fluoroscopic system is frequency independent. At zero spatial frequency the DQE of the flat-panel imager has a value of 0.008 (0.8%). Due to the minor frequency dependency this device may be almost x-ray quantum limited. Monte Carlo simulations verified these characteristics. For the fluoroscopic imaging system the DQE at low frequencies is about 0.0008 (0.08%) and degrades with higher frequencies. Dose measurements with the flat-panel imager revealed that images can only be directly converted to portal dose images, if scatter can be neglected. Thus objects distant to the detector (e.g., inhomogeneous dose distribution generated by a modificator) can be verified dosimetrically, while objects close to a detector (e.g., a patient) cannot be verified directly and must be scatter corrected prior to verification. This is justified by the response of the flat-panel imaging device revealing a strong dependency at low energies.     

常规头部CT螺旋扫描与轴扫描模式的影像质量对照

目的通过头部CT螺旋扫描和轴扫描两种不同扫描模式的影像质量对照,探讨常规头部CT采用螺旋扫描模式取代轴扫描模式的可行性。方法 40例患者,其中男性24例,女性16例;年龄18～74岁,平均年龄46岁。分别接受头部CT螺旋扫描和轴扫描两种不同模式扫描,轴扫描参数:140kV、170mA用于颅底部;120kV、150mA用于颅脑部,每周2s。螺旋扫描参数:120kV,150mA,每周0.6s。扫描剂量直接取自设备剂量指示值(CTDI和DLP)。影像质量分别由2位专家采用双盲法,对头部CT的颅底、脑灰-白质层面及全部影像逐层进行CT值测量评估。结果常规头部CT螺旋扫描模式较轴扫描模式可有效去除颅底部伪影,并能减少扫描时间和扫描剂量(轴扫描模式与螺旋扫描模式对比,CTDI 55.43 mGy/37.80 mGy;DLP 662.10 mGy.cm/498.28 mGy.cm;扫描时间12.0 s/7.2 s)(P<0.001)。结论常规头部CT螺旋扫描模式的影像质量完全可与轴扫描模式相媲美,并可取代轴扫描模式。同时常规头部CT螺旋扫描模式还具有可减少扫描时间和辐射剂量,并可进行影像的二维和三维后处理,有利于提高微小病灶正确诊断率的优越性。     

Comparison of four mechanical methods to retrieve spermatozoa from testicular tissue

To maximize the total number of spermatozoa which can be retrievedfrom a testicular biopsy, four mechanical methods for preparationwere compared. In all, 17 biopsies were divided into four equalfractions, which were weighed individually and prepared by roughshredding (control), fine mincing, vortexing and crushing (electricalPotter). After resuspension in an erythrocyte-lysing buffer,removal of the remaining tissue pieces, washing and centrifugation,the following parameters were evaluated: number of spermatozoaper 100 mg tissue, percentage motility, percentage vitalityand percentage normal morphology (strict Kruger criteria). Afterfurther purification by discontinuous Percoll centrifugation,the same parameters were assessed again. This procedure wasefficient in obtaining only spermatozoa in the final fraction.Before Percoll centrifugation, only minor differences betweenmethods were observed. Percoll centrifugation generally resultedin a pronounced loss of sperm cells, partly because of the abnormaldimensions of the eliminated cells. After Percoll centrifugation,treatment of the testicular tissue by fine mincing was the mosteffective method in terms of the total number of motile spermatozoaand percentage normal morphology.