| 1. |
- Båth, Magnus, 1974-, et al.
(författare)
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Effective dose to patients from chest examinations with tomosynthesis
- 2010
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Ingår i: Radiation protection dosimetry. - 1742-3406. ; 139:1-3, s. 153-158
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Tidskriftsartikel (refereegranskat)abstract
- Chest tomosynthesis, which refers to the principle of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest, is an imaging technique recently introduced to health care. The main purpose of the present work was to determine the average effective dose to patients from clinical use of chest tomosynthesis. Exposure data for two chest radiography laboratories with tomosynthesis option (Definium 8000 with VolumeRAD option, GE Healthcare, Chalfont St. Giles, UK) were registered for 20 patients with a weight between 60 and 80 kg (average weight of 70.2 kg). The recorded data were used in the Monte Carlo program PCXMC 2.0 (STUK-Radiation and Nuclear Safety Authority, Helsinki, Finland) to determine the average effective dose for each projection. The effective dose for the chest tomosynthesis examination, including a scout view and the tomosynthesis acquisition, was finally obtained by adding the effective doses from all projections. Using the weighting factors given in ICRP 103, the average effective dose for the examination was found to be 0.13 mSv, whereas the average effective dose for the conventional two-view chest radiography examination was 0.05 mSv. A conversion factor of 0.26 mSv Gy(-1) cm(-2) was found suitable for determining the effective dose from a VolumeRAD chest tomosynthesis examination from the total registered kerma-area product. In conclusion, the effective dose to a standard-sized patient (170 cm/70 kg) from a VolumeRAD chest tomosynthesis examination is ~2 % of an average chest CT and only two to three times the effective dose from the conventional two-view chest radiography examination.
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| 2. |
- Håkansson, Markus, et al.
(författare)
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ViewDEX: an efficient and easy-to-use software for observer performance studies
- 2010
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Ingår i: Radiation protection dosimetry. - 1742-3406. ; 139:1-3, s. 42-51
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Tidskriftsartikel (refereegranskat)abstract
- The development of investigation techniques, image processing, workstation monitors, analysing tools etc. within the field of radiology is vast, and the need for efficient tools in the evaluation and optimisation process of image and investigation quality is important. ViewDEX (Viewer for Digital Evaluation of X-ray images) is an image viewer and task manager suitable for research and optimisation tasks in medical imaging. ViewDEX is DICOM compatible and the features of the interface (tasks, image handling and functionality) are general and flexible. The configuration of a study and output (for example, answers given) can be edited in any text editor. ViewDEX is developed in Java and can run from any disc area connected to a computer. It is free to use for non-commercial purposes and can be downloaded from http://www.vgregion.se/sas/viewdex. In the present work, an evaluation of the efficiency of ViewDEX for receiver operating characteristic (ROC) studies, free-response ROC (FROC) studies and visual grading (VG) studies was conducted. For VG studies, the total scoring rate was dependent on the number of criteria per case. A scoring rate of approximately 150 cases h(-1) can be expected for a typical VG study using single images and five anatomical criteria. For ROC and FROC studies using clinical images, the scoring rate was approximately 100 cases h(-1) using single images and approximately 25 cases h(-1) using image stacks ( approximately 50 images case(-1)). In conclusion, ViewDEX is an efficient and easy-to-use software for observer performance studies.
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| 3. |
- Johnsson, Åse (Allansdotter), 1966-, et al.
(författare)
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A phantom study of nodule size evaluation with chest tomosynthesis and computed tomography.
- 2010
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Ingår i: Radiation protection dosimetry. - 1742-3406. ; 139:1-3, s. 140-143
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate nodule size measurements with chest tomosynthesis (TS) and computed tomography (CT). A 26-mm thick phantom, composed of a Polylite block with embedded spheres of different materials and sizes (4-20 mm), was scanned by both CT and TS. Six observers without prior knowledge of the true diameters of the spheres independently measured the diameter of the spheres on the CT and TS images. Four observers were allowed to change the window settings and two of the observers used predetermined fixed viewing conditions. The mean relative errors for all observers and all measured spheres compared with the known diameter of the spheres were 1.4 % (standard deviation, SD: 5.4 %) on CT images and -1.1 % (SD: 5.0 %) on TS images. With regard to the four observers where the window settings were at the discretion of the observer, the mean relative errors were 1.4 % (SD: 6.4 %) on CT images and -1.7 % (SD: 5.7 %) on TS images. Regarding the two observers using identical viewing conditions the mean relative error was 1.5 % (SD: 2.8 %) on CT images and 0.2 % (SD: 2.6 %) on TS images. In conclusion, the study suggests that nodule size measurements on chest TS might be an alternative to measurements on CT.
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| 4. |
- Johnsson, Åse (Allansdotter), 1966-, et al.
(författare)
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Overview of two years of clinical experience of chest tomosynthesis at Sahlgrenska University Hospital.
- 2010
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Ingår i: Radiation protection dosimetry. - 1742-3406. ; 139:1-3, s. 124-129
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Tidskriftsartikel (refereegranskat)abstract
- Since December 2006, approximately 3800 clinical chest tomosynthesis examinations have been performed at our department at Sahlgrenska University Hospital. A subset of the examinations has been included in studies of the detectability of pulmonary nodules, using computed tomography (CT) as the gold standard. Visibility studies, in which chest tomosynthesis and CT have been compared side-by side, have been used to determine the depiction potential of chest tomosynthesis. Comparisons with conventional chest radiography have been made. In the clinical setting, chest tomosynthesis has mostly been used as an additional examination. The most frequent indication for chest tomosynthesis has been suspicion of a nodule or tumour. In visibility studies, tomosynthesis has depicted over 90 % of the nodules seen on the CT scan. The corresponding figure for chest radiography has been <30 %. In the detection studies, the lesion-level sensitivity has been approximately 60 % for tomosynthesis and 20 % for chest radiography. In one of the detection studies, an analysis of all false-positive nodules was performed. This analysis showed that all findings had morphological correlates on the CT examinations. The majority of the false-positive nodules were localised in the immediate subpleural region. In conclusion, chest tomosynthesis is an improved chest radiography method, which can be used to optimise the use of CT resources, thereby reducing the radiation dose to the patient population. However, there are some limitations with chest tomosynthesis. For example, patients undergoing tomosynthesis have to be able to stand still and hold their breath firmly for 10 s. Also, chest tomosynthesis has a limited depth resolution, which may explain why pathology in the subpleural region is more difficult to interpret and artefacts from medical devices may occur.
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| 5. |
- Svalkvist, Angelica, et al.
(författare)
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Monte Carlo simulations of the dosimetry of chest tomosynthesis
- 2010
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Ingår i: Radiation protection dosimetry. - 1742-3406. ; 139:1-3, s. 144-152
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this work were to explore the dosimetry of chest tomosynthesis and to determine conversion factors between air kerma-area product (KAP) and the effective dose for different system configurations and patient sizes. Tomosynthesis systems were modelled with different angular intervals and tube voltages for the collection of the projection images as well as different distributions of the total exposure over the projections. The Monte Carlo-based computer software PCXMC developed by STUK (Radiation and Nuclear Safety Authority in Finland) was used to calculate the effective doses for each modelled tomosynthesis system for various patient sizes. The conversion factor between KAP and effective dose was obtained both for the zero-degree projection alone and for the entire tomosynthesis examination for each system configuration and patient size. The results reveal that the conversion factor for the zero-degree projection can be used to estimate the total effective dose from a tomosynthesis examination with acceptable accuracy, leading to an error smaller than 10 % irrespective of the system configuration and patient size. For higher accuracy, conversion factors between the total KAP and the total effective dose that take the angular interval and exposure configuration into account are presented for each system.
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| 6. |
- Svalkvist, Angelica, et al.
(författare)
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Simulation of dose reduction in tomosynthesis.
- 2010
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Ingår i: Medical physics. - 0094-2405. ; 37:1, s. 258-69
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Methods for simulating dose reduction are valuable tools in the work of optimizing radiographic examinations. Using such methods, clinical images can be simulated to have been collected at other, lower, dose levels without the need of additional patient exposure. A recent technology introduced to healthcare that needs optimization is tomosynthesis, where a number of low-dose projection images collected at different angles is used to reconstruct section images of an imaged object. The aim of the present work was to develop a method of simulating dose reduction for digital radiographic systems, suitable for tomosynthesis. METHODS: The developed method uses information about the noise power spectrum (NPS) at the original dose level and the simulated dose level to create a noise image that is added to the original image to produce an image that has the same noise properties as an image actually collected at the simulated dose level. As the detective quantum efficiency (DQE) of digital detectors operating at the low dose levels used for tomosynthesis may show a strong dependency on the dose level, it is important that a method for simulating dose reduction for tomosynthesis takes this dependency into account. By applying an experimentally determined relationship between pixel mean and pixel variance, variations in both dose and DQE in relevant dose ranges are taken into account. RESULTS: The developed method was tested on a chest tomosynthesis system and was shown to produce NPS of simulated dose-reduced projection images that agreed well with the NPS of images actually collected at the simulated dose level. The simulated dose reduction method was also applied to tomosynthesis examinations of an anthropomorphic chest phantom, and the obtained noise in the reconstructed section images was very similar to that of an examination actually performed at the simulated dose level. CONCLUSIONS: In conclusion, the present article describes a method for simulating dose reduction suitable for tomosynthesis. However, the method applies equally well to any digital radiographic system, although the benefits of correcting for DQE variations may be smaller.
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| 7. |
- Svalkvist, Angelica, et al.
(författare)
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Simulation of lung nodules in chest tomosynthesis
- 2010
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Ingår i: RADIATION PROTECTION DOSIMETRY. - Oxford University Press. - 0144-8420. ; 139:1-3, s. 130-139
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present work was to develop an adequate method for simulating lung nodules in clinical chest tomosynthesis images. Based on the visual appearance of real nodules, artificial, three-dimensional nodules with irregular shape and surface structure were created using an approach of combining spheres of different sizes and central points. The nodules were virtually positioned at the desired locations inside the patient and by using the known geometry of the tomosynthesis acquisition, the radiation emitted from the focal spot, passing through the nodule and reaching the detector could be simulated. The created nodules were thereby projected into raw-data tomosynthesis projection images before reconstruction of the tomosynthesis section images. The focal spot size, signal spread in the detector, scattered radiation, patient motion and existing anatomy at the location of the nodule were taken into account in the simulations. It was found that the blurring caused by the modulation transfer function and the patient motion overshadows the effects of a finite focal spot and aliasing and also obscures the surface structure of the nodules, which provides an opportunity to simplify the simulations and decrease the simulation times. Also, the limited in-depth resolution of the reconstructed tomosynthesis section images reduces the necessity to take details of the anatomical structures at the location of the inserted nodule into account.
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| 8. |
- Svalkvist, Angelica, et al.
(författare)
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The benefit of accounting for DQE variations in simulated dose reduction of digital radiographic systems
- 2010
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Ingår i: Radiation protection dosimetry. - 1742-3406. ; 139:1-3, s. 57-61
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Tidskriftsartikel (refereegranskat)abstract
- Adding noise to clinical radiographs to simulate dose reduction can be used to investigate the relationship between dose level and clinical image quality without exposing patients to additional radiation. The purpose of the present paper was to examine the benefits of using a method that accounts for detective quantum efficiency (DQE) variations that may occur in different dose ranges in the simulated dose reduction process. A method initially intended for simulated dose reduction in tomosynthesis was applied to extremely low-dose posterioanterior radiographs of an anthropomorphic chest phantom, selected from a group of projection images included in a tomosynthesis examination and compared with a previous method that do not account for DQE variations. A comparison of images simulated to be collected at a lower dose level (73 % of the original dose level) and images actually collected at this lower dose level revealed that the error in the integrated normalised noise power spectrum was smaller than 4 % for the method that accounts for DQE variations in the simulated dose reduction, whereas the error was larger than 20 % for the previous method. This indicates that an increased validity in dose reduction simulation of digital radiographic systems is obtained with a method accounting for DQE variations.
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