Effect of technical parameters on dose and image quality in a computed radiography system

The discovery of X-rays was undoubtedly one of the greatest stimulus for improving the efficiency in the provision of healthcare services. The ability to view, non-invasively, inside the human body has greatly facilitated the work of professionals in diagnosis of diseases. The exclusive focus on image quality (IQ), without understanding how they are obtained, affect negatively the efficiency in diagnostic radiology. The equilibrium between the benefits and the risks are often forgotten. It is necessary to adopt optimization strategies to maximize the benefits (image quality) and minimize risk (dose to the patient) in radiological facilities. In radiology, the implementation of optimization strategies involves an understanding of images acquisition process. When a radiographer adopts a certain value of a parameter (tube potential [kVp], tube current-exposure time product [mAs] or additional filtration), it is essential to know its meaning and impact of their variation in dose and image quality. Without this, any optimization strategy will be a failure. Worldwide, data show that use of x-rays has been increasingly frequent. In Cabo Verde, we note an effort by healthcare institutions (e.g. Ministry of Health) in equipping radiological facilities and the recent installation of a telemedicine system requires purchase of new radiological equipment. In addition, the transition from screen-films to digital systems is characterized by a raise in patient exposure. Given that this transition is slower in less developed countries, as is the case of Cabo Verde, the need to adopt optimization strategies becomes increasingly necessary. This study was conducted as an attempt to answer that need. Although this work is about objective evaluation of image quality, and in medical practice the evaluation is usually subjective (visual evaluation of images by radiographer / radiologist), studies reported a correlation between these two types of evaluation (objective and subjective) [5-7] which accredits for conducting such studies. The purpose of this study is to evaluate the effect of exposure parameters (kVp and mAs) when using additional Cooper (Cu) filtration in dose and image quality in a Computed Radiography system.

Wrong sign and symmetric limits and non-decoupling in 2HDMs

We analyse the possibility that, in two Higgs doublet models, one or more of the Higgs couplings to fermions or to gauge bosons change sign, relative to the respective Higgs Standard Model couplings. Possible sign changes in the coupling of a neutral scalar to charged ones are also discussed. These wrong signs can have important physical consequences, manifesting themselves in Higgs production via gluon fusion or Higgs decay into two gluons or into two photons. We consider all possible wrong sign scenarios, and also the symmetric limit, in all possible Yukawa implementations of the two Higgs doublet model, in two different possibilities: the observed Higgs boson is the lightest CP-even scalar, or the heaviest one. We also analyse thoroughly the impact of the currently available LHC data on such scenarios. With all 8 TeV data analysed, all wrong sign scenarios are allowed in all Yukawa types, even at the 1 sigma level. However, we will show that B-physics constraints are crucial in excluding the possibility of wrong sign scenarios in the case where tan beta is below 1. We will also discuss the future prospects for probing the wrong sign scenarios at the next LHC run. Finally we will present a scenario where the alignment limit could be excluded due to non-decoupling in the case where the heavy CP-even Higgs is the one discovered at the LHC.

The effects of clinical support surfaces on pressure as a risk factor in the development of pressure ulcers, from a radiographical perspective: a narrative literature review

Purpose: Pressure ulcers are a high cost, high volume issue for health and medical care providers, having a detrimental effect on patients and relatives. Pressure ulcer prevention is widely covered in the literature, but little has been published regarding the risk to patients in the radiographical setting. This review of the current literature is to identify findings relevant to radiographical context. Methods: Literature searching was performed using Science Direct and Medline databases. The search was limited to articles published in the last ten years to remain current and excluded studies containing participants less than 17 years of age. In total 14 studies were acquired; three were excluded as they were not relevant. The remaining 11 studies were compared and reviewed. Discussion: Eight of the studies used ‘healthy’ participants and three used symptomatic participants. Nine studies explored interface pressure with a range of pressure mat technologies, two studies measured shear (MRI finite element modelling, and a non-invasive instrument), and one looked at blood flow and haemoglobin oxygenation. A range of surfaces were considered from trauma, nursing and surgical backgrounds for their ability to reduce pressure including standard mattresses, high specification mattresses, rigid and soft layer spine boards, various overlays (gel, air filled, foam). Conclusion: The current literature is not appropriate for the radiographic patient and cannot be extrapolated to a radiologic context. Sufficient evidence is presented in this review to support the need for further work specific to radiography in order to minimise the development of PU in at risk patients.

10 kVp rule - An anthropomorphic pelvis phantom imaging study using a CR system: impact on image quality and effective dose using AEC and manual mode

Purpose: This study aims to investigate the influence of tube potential (kVp) variation in relation to perceptual image quality and effective dose for pelvis using automatic exposure control (AEC) and non-AEC in a computed radiography (CR) system. Methods and Materials: To determine the effects of using AEC and non-AEC by applying the 10 kVp rule in two experiments using an anthropomorphic pelvis phantom. Images were acquired using 10 kVp increments (60-120 kVp) for both experiments. The first experiment, based on seven AEC combinations, produced 49 images. The mean mAs from each kVp increment were used as a baseline for the second experiment producing 35 images. A total of 84 images were produced and a panel of 5 experienced observers participated for the image scoring using the 2 AFC visual grading software. PCXMC software was used to estimate the effective dose. Results: A decrease in perceptual image quality as the kVp increases was observed both in non-AEC and AEC experiments, however no significant statistical differences (p> 0.05) were found. Image quality scores from all observers at 10 kVp increments for all mAs values using non-AEC mode demonstrates a better score up to 90 kVp. Effective dose results show a statistical significant decrease (p=0.000) on the 75th quartile from 0.3 mSv at 60 kVp to 0.1 mSv at 120 kVp when applying the 10 kVp rule in non-AEC mode. Conclusion: No significant reduction in perceptual image quality is observed when increasing kVp whilst a marked and significant effective dose reduction is observed.

Hyperspectral imagery framework for unmixing and dimensionality estimation

In hyperspectral imagery a pixel typically consists mixture of spectral signatures of reference substances, also called endmembers. Linear spectral mixture analysis, or linear unmixing, aims at estimating the number of endmembers, their spectral signatures, and their abundance fractions. This paper proposes a framework for hyperpsectral unmixing. A blind method (SISAL) is used for the estimation of the unknown endmember signature and their abundance fractions. This method solve a non-convex problem by a sequence of augmented Lagrangian optimizations, where the positivity constraints, forcing the spectral vectors to belong to the convex hull of the endmember signatures, are replaced by soft constraints. The proposed framework simultaneously estimates the number of endmembers present in the hyperspectral image by an algorithm based on the minimum description length (MDL) principle. Experimental results on both synthetic and real hyperspectral data demonstrate the effectiveness of the proposed algorithm.