Assessment of image quality of a standard and two dose-reducing protocols in paediatric pelvic CT

Background: Concerns exist regarding the effect of radiation dose from paediatric pelvic CT scans and the potential later risk of radiation-induced neoplasm and teratogenic outcomes in these patients. Objective: To assess the diagnostic quality of CT images of the paediatric pelvis using either reduced mAs or increased pitch compared with standard settings. Materials and methods: A prospective study of pelvic CT scans of 105 paediatric patients was performed using one of three protocols: (1) 31 at a standard protocol of 200 mA with rotation time of 0.75 s at 120 kVp and a pitch factor approximating 1.4; (2) 31 at increased pitch factor approaching 2 and 200 mA; and (3) 43 at a reduced setting of 100 mA and a pitch factor of 1.4. All other settings remained the same in all three groups. Image quality was assessed by radiologists blinded to the protocol used in each scan. Results: No significant difference was found between the quality of images acquired at standard settings and those acquired at half the standard mAs. The use of increased pitch factor resulted in a higher proportion of poor images. Conclusions: Images acquired at 120 kVp using 75 mAs are equivalent in diagnostic quality to those acquired at 150 mAs. Reduced settings can provide useful imaging of the paediatric pelvis and should be considered as a standard protocol in these situations.

Perceptual quality metrics applied to still image compression

We present a review of perceptual image quality metrics and their application to still image compression. The review describes how image quality metrics can be used to guide an image compression scheme and outlines the advantages, disadvantages and limitations of a number of quality metrics. We examine a broad range of metrics ranging from simple mathematical measures to those which incorporate full perceptual models. We highlight some variation in the models for luminance adaptation and the contrast sensitivity function and discuss what appears to be a lack of a general consensus regarding the models which best describe contrast masking and error summation. We identify how the various perceptual components have been incorporated in quality metrics, and identify a number of psychophysical testing techniques that can be used to validate the metrics. We conclude by illustrating some of the issues discussed throughout the paper with a simple demonstration. (C) 1998 Elsevier Science B.V. All rights reserved.

A wavelet visible difference predictor

In this paper, we describe a model of the human visual system (HVS) based on the wavelet transform. This model is largely based on a previously proposed model, but has a number of modifications that make it more amenable to potential integration into a wavelet based image compression scheme. These modifications include the use of a separable wavelet transform instead of the cortex transform, the application of a wavelet contrast sensitivity function (CSP), and a simplified definition of subband contrast that allows us to predict noise visibility directly from wavelet coefficients. Initially, we outline the luminance, frequency, and masking sensitivities of the HVS and discuss how these can be incorporated into the wavelet transform. We then outline a number of limitations of the wavelet transform as a model of the HVS, namely the lack of translational invariance and poor orientation sensitivity. In order to investigate the efficacy of this wavelet based model, a wavelet visible difference predictor (WVDP) is described. The WVDP is then used to predict visible differences between an original and compressed (or noisy) image. Results are presented to emphasize the limitations of commonly used measures of image quality and to demonstrate the performance of the WVDP, The paper concludes with suggestions on bow the WVDP can be used to determine a visually optimal quantization strategy for wavelet coefficients and produce a quantitative measure of image quality.

Wavelet-based image segment representation

An efficient representation method for arbitrarily shaped image segments is proposed. This method includes a smart way to select wavelet basis to approximate the given image segment, with improved image quality and reduced computational load.

The effect of bandwidth on the quality of transmitted pediatric echocardiograms

Background: Remote access to pediatric cardiology diagnostic services is enabled by real-time transmission of echocardiographic images. Several transmission bandwidths have been used but there has been little analysis of image quality provided by different bandwidths. We designed a study of the quality of transmitted images at various bandwidths. Methods: Two echocardiographers viewed randomly a series of 13 recorded pediatric echocardiographic images either directly or after transmission using 1 of 4 bandwidths: 256; 384; 512; or 768 kbps. An image clarity scoring scale was used to assess image quality of cardiac structures. Results: Measurable differences were found in image quality with different transmission bandwidths; 512 kbps was the minimum for consistently clear imaging of all cardiac structures examined. Conclusion: Bandwidth greater than 512 kbps confers sharper images subjectively although this could not be quantified by our methods.

The HI Parkes All Sky Survey: southern observations, calibration and robust imaging

The acquisition of HI Parkes All Shy Survey (HIPASS) southern sky data commenced at the Australia Telescope National Facility's Parkes 64-m telescope in 1997 February, and was completed in 2000 March. HIPASS is the deepest HI survey yet of the sky south of declination +2 degrees, and is sensitive to emission out to 170 h(75)(-1) Mpc. The characteristic root mean square noise in the survey images is 13.3 mJy. This paper describes the survey observations, which comprise 23 020 eight-degree scans of 9-min duration, and details the techniques used to calibrate and image the data. The processing algorithms are successfully designed to be statistically robust to the presence of interference signals, and are particular to imaging point (or nearly point) sources. Specifically, a major improvement in image quality is obtained by designing a median-gridding algorithm which uses the median estimator in place of the mean estimator.

Refinements in stress echocardiographic techniques improve inter-institutional agreement in interpretation of dobutamine stress echocardiograms

Aims To determine the degree of inter-institutional agreement in the assessment of dobutamine stress echocardiograms using modern stress echo cardiographic technology in combination with standardized data acquisition and assessment criteria. Method and Results Among six experienced institutions, 150 dobutamine stress echocardiograms (dobutamine up to 40 mug.kg(-1) min(-1) and atropine up to I mg) were performed on patients with suspected coronary artery disease using fundamental and harmonic imaging following a consistent digital acquisition protocol. Each dobutamine stress echocardiogram was assessed at every institution regarding endocardial visibility and left ventricular wall motion without knowledge of any other data using standardized reading criteria. No patients were excluded due to poor image quality or inadequate stress level. Coronary angiography was performed within 4 weeks. Coronary angiography demonstrated significant coronary artery disease (less than or equal to50% diameter stenosis) in 87 patients. Using harmonic imaging an average of 5.2+/-0.9 institutions agreed on dobutamine stress echocardiogram results as being normal or abnormal (mean kappa 0.55; 95% CI 0.50-0.60). Agreement was higher in patients with no (equal assessment of dobutamine stress echocardiogram results by 5.5 +/- 0.8 institutions) or three-vessel coronary artery disease (5.4 +/- 0.8 institutions) and lower in one- or two- vessel disease (5.0 +/- 0.9 and 5.2 +/- 1.0 institutions, respectively-, P=0.041). Disagreement on test results was greater in only minor wall motion abnormalities. Agreement on dobutamine stress echocardiogram results was lower using fundamental imaging (mean kappa 0.49; 95% CI 0.44-0.54; P

Routine ultrasound screening in diabetic pregnancies

Objectives To assess the detection rate of congenital fetal malformations and specific problems related to routine ultrasound screening in women with pre-existing diabetes. Methods A retrospective study was carried out to assess the performance of routine ultrasound screening in women with pre-existing diabetes (Types 1 and 2) within a tertiary institution. The incidence, type and risk factors for congenital fetal malformations were determined. The detection rate of fetal anomalies for diabetic women was compared with that for the low-risk population. Factors affecting these detection rates were evaluated. Results During the study period, 12 169 low-risk pregnant women and 130 women with pre-existing diabetes had routine ultrasound screening performed within the institution. A total of 10 major anomalies (7.7%) and three minor anomalies (2.3%) were present in the fetuses of the diabetic women. Central nervous system and cardiovascular system anomalies accounted for 60% of the major anomalies. Peri-conceptional hemoglobin A 1 c of more than 9% was associated with a high prevalence of major anomalies (14311000). Women who had fetuses with major anomalies bad a significantly higher incidence of obesity (78% vs. 37%; P < 0.05). Ultrasound examination of these diabetic pregnancies showed high incidences of suboptimal image quality (37%), incomplete examinations, and repeat examinations (17%). Compared to the 'low-risk' non-diabetic population from the same institution, the relative risk for a major congenital anomaly among the diabetic women was 5.9-fold higher (95% confidence interval, 2.9-11.9). The detection rate for major fetal anomalies was significantly lower for diabetic women (30% vs. 73%; P < 0.01), and the mean body mass index for the diabetic group was significantly higher (29 vs. 23 kg/m(2); P < 0.001). Conclusion The incidence of congenital anomalies is higher in diabetic pregnancies. Unfortunately, the detection rate for fetal anomalies by antenatal ultrasound scan was significantly, worse than that for the low-risk population. This is likely to be related to the maternal body habitus and unsatisfactory examinations. Methods to overcome these difficulties are discussed.

Trial of low-cost teledermatology in primary care

We examined the feasibility of a low-cost, store-and-forward teledermatology service for general practitioners (GPs) in regional Queensland. Digital pictures and a brief case history were transmitted by email. A service coordinator carried out quality control checks and then forwarded these email messages to a consultant dermatologist. On receiving a clinical response from the dermatologist, the service coordinator returned the message to the referring GP. The aim was to provide advice to rural Gps within one working day. Over six months, 63 referrals were processed by the teledermatology service, covering a wide range of dermatological conditions. In the majority of cases the referring doctors were able to treat the condition after receipt of email advice from the dermatologist; however, in 10 cases (16%) additional images or biopsy results were requested because image quality was inadequate. The average time between a referral being received and clinical advice being provided to the referring GPs was 46 hours. The number of referrals in the present study, 1.05 per month per site, was similar to that reported in other primary care studies. While the use of low-cost digital cameras and public email is feasible, there may be other issues, for example remuneration, which will militate against the widespread introduction of primary care teledermatology in Australia.

Multiple-acquisition parallel imaging combined with a transceive array for the amelioration of high-field RF distortion: a modeling study

A new method for ameliorating high-field image distortion caused by radio frequency/tissue interaction is presented and modeled, The proposed method uses, but is not restricted to, a shielded four-element transceive phased array coil and involves performing two separate scans of the same slice with each scan using different excitations during transmission. By optimizing the amplitudes and phases for each scan, antipodal signal profiles can be obtained, and by combining both images together, the image distortion can be reduced several-fold. A hybrid finite-difference time-domain/method-of-moments method is used to theoretically demonstrate the method and also to predict the radio frequency behavior inside the human head. in addition, the proposed method is used in conjunction with the GRAPPA reconstruction technique to enable rapid imaging. Simulation results reported herein for IIT (470 MHz) brain imaging applications demonstrate the feasibility of the concept where multiple acquisitions using parallel imaging elements with GRAPPA reconstruction results in improved image quality. (c) 2006 Wiley Periodicals, Inc.

The effect of manipulations to target contrast on emmetropization in chick

Emmetropization is dependent on visual feedback and presumably some measure of the optical and image quality of the eye. We investigated the effect of simple alterations to image contrast on eye growth and refractive development. A 1.6 cyc/deg square-wave-grating target was located at the end of a 3.3 cm cone,, imaged by a +30 D lens and applied monocularly to the eyes of 8-day-old chicks. Eleven different contrast targets were tested: 95, 67, 47.5, 33.5, 24, 17, 12, 8.5, 4.2, 2.1, and 0%. Refractive error (RE), vitreous chamber depth (VC) and axial length (AL) varied with the contrast of the image (RE diff. F-10.86 = 12.420, p < 0.0005; VC diff. F-10.86 = 8.756, p < 0.0005; AL diff. F-10.86 = 9.240, p < 0.0005). Target contrasts 4.2% and lower produced relative myopia (4.2%: RE diff = -7.48 +/- 2.26 D, p = 0.987; 2.1%: RE diff = -7.22 +/- 2.77 D, p = 0.951) of similar amount to that observed in response to a featureless 0% contrast target (RE diff = -9.11 +/- 4.68 D). For target contrast levels 47.5% and greater isometropia was maintained (95%: RE diff = 1.83 +/- 2.78 D; 67%: RE diff = 0.14 +/- 1.84 D; 47.5% RE diff = 0.25 +/- 1.82 D). Contrasts in between produced an intermediate amount of myopia (33.5%: RE diff = -2.81 +/- 1.80 D; 24%: RE diff = -3.45 +/- 1.64 D; 17%: RE diff = -3.19 +/- 1.54 D; 12%: RE diff = -4.08 +/- 3.56 D; 8.5%: RE diff = -4.09 +/- 3.60 D). We conclude that image contrast provides important visual information for the eye growth control system or that contrast must reach a threshold value for some other emmetropization signal to function. (c) 2005 Elsevier Ltd. All rights reserved.

High-field magnetic resonance imaging with reduced field/tissue RF artefacts - A modeling study using hybrid MoM/FEM and FDTD technique

Due to complex field/tissue interactions, high-field magnetic resonance (MR) images suffer significant image distortions that result in compromised diagnostic quality. A new method that attempts to remove these distortions is proposed in this paper and is based on the use of transceiver-phased arrays. The proposed system uses, in the examples presented herein, a shielded four-element transceive-phased array head coil and involves performing two separate scans of the same slice with each scan using different excitations during transmission. By optimizing the amplitudes and phases for each scan, antipodal signal profiles can be obtained, and by combining both the images together, the image distortion can be reduced several fold. A combined hybrid method of moments (MoM)/finite element method (FEM) and finite-difference time-domain (FDTD) technique is proposed and used to elucidate the concept of the new method and to accurately evaluate the electromagnetic field (EMF) in a human head model. In addition, the proposed method is used in conjunction with the generalized auto-calibrating partially parallel acquisitions (GRAPPA) reconstruction technique to enable rapid imaging of the two scans. Simulation results reported herein for 11-T (470-MHz) brain imaging applications show that the new method with GRAPPA reconstruction theoretically results in improved image quality and that the proposed combined hybrid MoM/FEM and FDTD technique is. suitable for high-field magnetic resonance imaging (MRI) numerical analysis.

An analysis of the images attached to referral messages in an e-mail based telemedicine system for developing countries

Little is known about the quality of the images transmitted in email telemedicine systems. The present study was designed to survey the quality of images transmitted in the Swinfen Charitable Trust email referral system. Telemedicine cases were examined for a 3 month period in 2002 and a 3 month period in 2006. The number of cases with images attached increased from 8 (38%) to 37 (53%). There were four types of images (clinical photographs, microscope pictures, notes and X-ray images) and the proportion of radiology images increased from 27 to 48%. The cases in 2002 came from four different hospitals and were associated with seven different clinical specialties. In 2006, the cases came from 19 different hospitals and 20 different specialties. The 46 cases (from both study periods) had a total of 159 attached images. The quality of the images was assessed by awarding each image a score in four categories: focus, anatomical perspective, composition and lighting. The images were scored on a five-point scale (1 = very poor to 5 =very good) by a qualified medical photographer. In comparing image quality between the two study periods, there was some evidence that the quality had reduced, although the average size of the attached images had increased. The median score for all images in 2002 was 16 (interquartile range 14-19) and the median score in 2006 was 15 (13-16). The difference was significant (P < 0.001, Mann-Whitney test).

Image calibration to like-values in mapping shallow water quality from multitemporal data

The applicability of image calibration to like-values in mapping water quality parameters from multitemporal images is explored, Six sets of water samples were collected at satellite overpasses over Moreton Bay, Brisbane, Australia. Analysis of these samples reveals that waters in this shallow bay are mostly TSS-dominated, even though they are occasionally dominated by chlorophyll as well. Three of the images were calibrated to a reference image based on invariant targets. Predictive models constructed from the reference image were applied to estimating total suspended sediment (TSS) and Secchi depth from another image at a discrepancy of around 35 percent. Application of the predictive model for TSS concentration to another image acquired at a time of different water types resulted in a discrepancy of 152 percent. Therefore, image calibration to like-values could be used to reliably map certain water quality parameters from multitemporal TM images so long as the water type under study remains unchanged. This method is limited in that the mapped results could be rather inaccurate if the water type under study has changed considerably. Thus, the approach needs to be refined in shallow water from multitemporal satellite imagery.