Image quality and dose analysis for a PA chest X-ray: comparison between AEC mode acquisition and manual mode using the 10 kVp ‘rule’

Purpose - To compare the image quality and effective dose applying the 10 kVp rule with manual mode acquisition and AEC mode in PA chest X-ray. Method - 68 images (with and without lesions) were acquired using an anthropomorphic chest phantom using a Wolverson Arcoma X-ray unit. These images were compared against a reference image using the 2 alternative forced choice (2AFC) method. The effective dose (E) was calculated using PCXMC software using the exposure parameters and the DAP. The exposure index (lgM provided by Agfa systems) was recorded. Results - Exposure time decreases more when applying the 10 kVp rule with manual mode (50%–28%) when compared with automatic mode (36%–23%). Statistical differences for E between several ionization chambers' combinations for AEC mode were found (p = 0.002). E is lower when using only the right AEC ionization chamber. Considering the image quality there are no statistical differences (p = 0.348) between the different ionization chambers' combinations for AEC mode for images with no lesions. Considering lgM values, it was demonstrated that they were higher when the AEC mode was used compared to the manual mode. It was also observed that lgM values obtained with AEC mode increased as kVp value went up. The image quality scores did not demonstrate statistical significant differences (p = 0.343) for the images with lesions comparing manual with AEC mode. Conclusion - In general the E is lower when manual mode is used. By using the right AEC ionising chamber under the lung the E will be the lowest in comparison to other ionising chambers. The use of the 10 kVp rule did not affect the visibility of the lesions or image quality.

Increasing source to image distance for AP pelvis imaging: impact on radiation dose and image quality

Aim - A quantative primary study to determine whether increasing source to image distance (SID), with and without the use of automatic exposure control (AEC) for antero-posterior (AP) pelvis imaging, reduces dose whilst still producing an image of diagnostic quality. Methods - Using a computed radiography (CR) system, an anthropomorphic pelvic phantom was positioned for an AP examination using the table bucky. SID was initially set at 110 cm, with tube potential set at a constant 75 kVp, with two outer chambers selected and a fine focal spot of 0.6 mm. SID was then varied from 90 cm to 140 cm with two exposures made at each 5 cm interval, one using the AEC and another with a constant 16 mAs derived from the initial exposure. Effective dose (E) and entrance surface dose (ESD) were calculated for each acquisition. Seven experienced observers blindly graded image quality using a 5-point Likert scale and 2 Alternative Forced Choice software. Signal-to-Noise Ratio (SNR) was calculated for comparison. For each acquisition, femoral head diameter was also measured for magnification indication. Results - Results demonstrated that when increasing SID from 110 cm to 140 cm, both E and ESD reduced by 3.7% and 17.3% respectively when using AEC and 50.13% and 41.79% respectively, when the constant mAs was used. No significant statistical (T-test) difference (p = 0.967) between image quality was detected when increasing SID, with an intra-observer correlation of 0.77 (95% confidence level). SNR reduced slightly for both AEC (38%) and no AEC (36%) with increasing SID. Conclusion - For CR, increasing SID significantly reduces both E and ESD for AP pelvis imaging without adversely affecting image quality.

Assessment of data-driven modeling strategies for water delivery canals

The aim of this paper is to develop models for experimental open-channel water delivery systems and assess the use of three data-driven modeling tools toward that end. Water delivery canals are nonlinear dynamical systems and thus should be modeled to meet given operational requirements while capturing all relevant dynamics, including transport delays. Typically, the derivation of first principle models for open-channel systems is based on the use of Saint-Venant equations for shallow water, which is a time-consuming task and demands for specific expertise. The present paper proposes and assesses the use of three data-driven modeling tools: artificial neural networks, composite local linear models and fuzzy systems. The canal from Hydraulics and Canal Control Nucleus (A parts per thousand vora University, Portugal) will be used as a benchmark: The models are identified using data collected from the experimental facility, and then their performances are assessed based on suitable validation criterion. The performance of all models is compared among each other and against the experimental data to show the effectiveness of such tools to capture all significant dynamics within the canal system and, therefore, provide accurate nonlinear models that can be used for simulation or control. The models are available upon request to the authors.

Developing corporate image in higher education sector: a case study of University of East Anglia Norwich, United Kingdom’ [de] Muhammad Amjad, Muhammad Moazam Fraz [recensão crítica]

Recensão crítica do livro "AMJAD, Muhammad; FRAZ, Muhammad Moazam - Developing corporate image in higher education sector: a case study of University of East Anglia Norwich, United Kingdom. Lisboa: LAP LAMBERT Academic Publishing, 2012”.

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

Background - Pelvis and hip radiography are consistently found to be amongst the highest contributors to the collective effective dose (E) in all ten DOSE DATAMED countries in Europe, representing 2.8 to 9.4% of total collective dose (S) in the TOP 20 exams list. The level of image quality should provide all the diagnostic information in order not to jeopardise the diagnosis, but being able to provide the needed clinical information with the minimum dose. A recent study suggests further research to determine whether the “10 kVp rule” would have value for a range of examinations using Computed Radiography (CR) systems. As a “rule of thumb” increasing the kVp by 10 whilst halving the mAs is suggested to give a similar perceptual image quality when compared to the original exposure factors. Aims - In light of the 10kVp rule, this study aims to investigate the influence of tube potential (kVp) variation in relation to perceptual image quality and E for pelvis imaging using automatic exposure control (AEC) and non-AEC in a Computed Radiography (CR) system. Research questions - Does the 10kVp rule works for the pelvis in relation to image quality in a CR system? Does the image quality differs when the AEC is used instead of manual mode using the 10kVp rule and how this impacts on E?

A survey in Portuguese X-ray fluoroscopy equipment: dose rates and image quality

X-ray fluoroscopy is essential in both diagnosis and medical intervention, although it may contribute to significant radiation doses to patients that have to be optimised and justified. Therefore, it is crucial to the patient to be exposed to the lowest achievable dose without compromising the image quality. The purpose of this study was to perform an analysis of the quality control measurements, particularly dose rates, contrast and spatial resolution of Portuguese fluoroscopy equipment and also to provide a contribution to the establishment of reference levels for the equipment performance parameters. Measurements carried out between 2007 and 2013 on 143 fluoroscopy equipment distributed by 34 nationwide health units were analysed. The measurements suggest that image quality and dose rates of Portuguese equipment are congruent with other studies, and in general, they are as per the Portuguese law. However, there is still a possibility of improvements intending optimisation at a national level.

Modeling for control design of a multi-reach water canal

This article addresses the problem of obtaining reduced complexity models of multi-reach water delivery canals that are suitable for robust and linear parameter varying (LPV) control design. In the first stage, by applying a method known from the literature, a finite dimensional rational transfer function of a priori defined order is obtained for each canal reach by linearizing the Saint-Venant equations. Then, by using block diagrams algebra, these different models are combined with linearized gate models in order to obtain the overall canal model. In what concerns the control design objectives, this approach has the advantages of providing a model with prescribed order and to quantify the high frequency uncertainty due to model approximation. A case study with a 3-reach canal is presented, and the resulting model is compared with experimental data. © 2014 IEEE.

PV system modeling by five parameters and in situ test

This paper focuses on a novel formalization for assessing the five parameter modeling of a photovoltaic cell. An optimization procedure is used as a feasibility problem to find the parameters tuned at the open circuit, maximum power, and short circuit points in order to assess the data needed for plotting the I-V curve. A comparison with experimental results is presented for two monocrystalline PV modules.

A one-dimensional prescribed curvature equation modeling the corneal shape

We prove existence, uniqueness, and stability of solutions of the prescribed curvature problem (u'/root 1 + u'(2))' = au - b/root 1 + u'(2) in [0, 1], u'(0) = u(1) = 0, for any given a > 0 and b > 0. We also develop a linear monotone iterative scheme for approximating the solution. This equation has been proposed as a model of the corneal shape in the recent paper (Okrasinski and Plociniczak in Nonlinear Anal., Real World Appl. 13:1498-1505, 2012), where a simplified version obtained by partial linearization has been investigated.

OPTIMAX 2014 - Radiation dose and image quality optimisation in medical imaging

Medical imaging is a powerful diagnostic tool. Consequently, the number of medical images taken has increased vastly over the past few decades. The most common medical imaging techniques use X-radiation as the primary investigative tool. The main limitation of using X-radiation is associated with the risk of developing cancers. Alongside this, technology has advanced and more centres now use CT scanners; these can incur significant radiation burdens compared with traditional X-ray imaging systems. The net effect is that the population radiation burden is rising steadily. Risk arising from X-radiation for diagnostic medical purposes needs minimising and one way to achieve this is through reducing radiation dose whilst optimising image quality. All ages are affected by risk from X-radiation however the increasing population age highlights the elderly as a new group that may require consideration. Of greatest concern are paediatric patients: firstly they are more sensitive to radiation; secondly their younger age means that the potential detriment to this group is greater. Containment of radiation exposure falls to a number of professionals within medical fields, from those who request imaging to those who produce the image. These staff are supported in their radiation protection role by engineers, physicists and technicians. It is important to realise that radiation protection is currently a major European focus of interest and minimum competence levels in radiation protection for radiographers have been defined through the integrated activities of the EU consortium called MEDRAPET. The outcomes of this project have been used by the European Federation of Radiographer Societies to describe the European Qualifications Framework levels for radiographers in radiation protection. Though variations exist between European countries radiographers and nuclear medicine technologists are normally the professional groups who are responsible for exposing screening populations and patients to X-radiation. As part of their training they learn fundamental principles of radiation protection and theoretical and practical approaches to dose minimisation. However dose minimisation is complex – it is not simply about reducing X-radiation without taking into account major contextual factors. These factors relate to the real world of clinical imaging and include the need to measure clinical image quality and lesion visibility when applying X-radiation dose reduction strategies. This requires the use of validated psychological and physics techniques to measure clinical image quality and lesion perceptibility.

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.

Value of a lower limb immobilization device for SPECT/CT image fusion optimization

The foot and the ankle are small structures commonly affected by disorders, and their complex anatomy represent significant diagnostic challenges. SPECT/CT Image fusion can provide missing anatomical and bone structure information to functional imaging, which is particularly useful to increase diagnosis certainty of bone pathology. However, due to SPECT acquisition duration, patient’s involuntary movements may lead to misalignment between SPECT and CT images. Patient motion can be reduced using a dedicated patient support. We aimed at designing an ankle and foot immobilizing device and measuring its efficacy at improving image fusion. Methods: We enrolled 20 patients undergoing distal lower-limb SPECT/CT of the ankle and the foot with and without a foot holder. The misalignment between SPECT and CT images was computed by manually measuring 14 fiducial markers chosen among anatomical landmarks also visible on bone scintigraphy. Analysis of variance was performed for statistical analysis. Results: The obtained absolute average difference without and with support was 5.1±5.2 mm (mean±SD) and 3.1±2.7 mm, respectively, which is significant (p<0.001). Conclusion: The introduction of the foot holder significantly decreases misalignment between SPECT and CT images, which may have clinical influence in the precise localization of foot and ankle pathology.

Image quality and dose analysis in PA chest x-ray: comparison between AEC and manual mode acquisition using the 10 kVp rule

Purpose: To compare image quality and effective dose when the 10 kVp rule is applied with manual and AEC mode in PA chest X-ray. Methods and Materials: A total of 68 images (with and without lesions) were acquired of an anthropomorphic chest phantom in a Wolverson Arcoma X-ray unit. The images were evaluated against a reference image using image quality criteria and the 2 alternative forced choice (2 AFC) method by five radiographers. The effective dose was calculated using PCXMC software using the exposure parameters and DAP. The exposure index (lgM) was recorded. Results: Exposure time decreases considerably when applying the 10 kVp rule in manual mode (50%-28%) compared to AEC mode (36%-23%). Statistical differences for effective dose between several AEC modes were found (p=0.002). The effective dose is lower when using only the right AEC ionization chamber. Considering image quality, there are no statistical differences (p=0.348) between the different AEC modes for images with no lesions. Using a higher kVp value the lgM values will also increase. The lgM values showed significant statistical differences (p=0.000). The image quality scores did not present statistically significant differences (p=0.043) for the images with lesions when comparing manual with AEC modes. Conclusion: In general, the dose is lower in the manual mode. By using the right AEC ionising chamber the effective dose will be the lowest in comparison to other ionising chambers. The use of the 10 kVp rule did not affect the detectability of the lesions.

Failure on clinical image quality criteria in digital mammography: how can radiographers do better?

Purpose: To assess image quality using PGMI (perfect, good, moderate, inadequate) scale in digital mammography examinations acquired in DR systems. Identify the main failures and propose corrective actions. Evaluate the most typical breast density. Methods and Materials: Clinical image quality criteria were evaluated considering mammograms acquired in 13 DR systems and classified according to PGMI scale using the criteria described in European Commission guidelines for radiographers. The breast density was assessed according to ACR recommendations. The data were collected on the acquisition system monitor to reproduce the daily practice of the radiographer. Results: The image quality criteria were evaluated in 3044 images. The criteria were fully achieved in 41% of the images that were classified as P (perfect), 31 % of the images were classified as M (moderate), 20% G (good) and 9% I (inadequate). The main cause of inadequate image quality was absence of all breast tissue in the image, skin folders in the pectoral muscle and in the infra-mammary angle. The higher number of failures occurred in MLO projections (809 out of 1022). The most represented (36%) breast type was type 2 (25-50% glandular tissue). Conclusion: Incorrect radiographic technique was frequently detected suggesting potential training needs and poor communication between the team members (radiographer and radiologists). Further correlations are necessary to identify the main causes for the failures, namely specific education and training in digital mammography and workload.

Correlation modeling for a distributed scalable video codec based on the HEVC standard

The growing heterogeneity of networks, devices and consumption conditions asks for flexible and adaptive video coding solutions. The compression power of the HEVC standard and the benefits of the distributed video coding paradigm allow designing novel scalable coding solutions with improved error robustness and low encoding complexity while still achieving competitive compression efficiency. In this context, this paper proposes a novel scalable video coding scheme using a HEVC Intra compliant base layer and a distributed coding approach in the enhancement layers (EL). This design inherits the HEVC compression efficiency while providing low encoding complexity at the enhancement layers. The temporal correlation is exploited at the decoder to create the EL side information (SI) residue, an estimation of the original residue. The EL encoder sends only the data that cannot be inferred at the decoder, thus exploiting the correlation between the original and SI residues; however, this correlation must be characterized with an accurate correlation model to obtain coding efficiency improvements. Therefore, this paper proposes a correlation modeling solution to be used at both encoder and decoder, without requiring a feedback channel. Experiments results confirm that the proposed scalable coding scheme has lower encoding complexity and provides BD-Rate savings up to 3.43% in comparison with the HEVC Intra scalable extension under development. © 2014 IEEE.