| 1. |
- Arvidsson, Jonathan, 1986, et al.
(författare)
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Automated estimation of in-plane nodule shape in chest tomosynthesis images
- 2015
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Ingår i: International Federation for Medical and Biological Engineering Proceedings. - Cham : Springer International Publishing. - 1680-0737. - 9783319129679 ; 48, s. 20-23
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Konferensbidrag (refereegranskat)abstract
- The purpose of this study was to develop an automated segmentation method for lung nodules in chest tomo-synthesis images. A number of simulated nodules of different sizes and shapes were created and inserted in two different locations into clinical chest tomosynthesis projections. The tomosynthesis volumes were then reconstructed using standard cone beam filtered back projection, with 1 mm slice interval. For the in-plane segmentation, the central plane of each nodule was selected. The segmentation method was formulated as an optimization problem where the nodule boundary corresponds to the minimum of the cost function, which is found by dynamic programming. The cost function was composed of terms related to pixel intensities, edge strength, edge direction and a smoothness constraint. The segmentation results were evaluated using an overlap measure (Dice index) of nodule regions and a distance measure (Hausdorff distance) between true and segmented nodule. On clinical images, the nodule segmentation method achieved a mean Dice index of 0.96 ± 0.01, and a mean Hausdorff distance of 0.5 ± 0.2 mm for isolated nodules and for nodules close to other lung structures a mean Dice index of 0.95 ± 0.02 and a mean Hausdorff distance of 0.5 ± 0.2 mm. The method achieved an acceptable accuracy and may be useful for area estimation of lung nodules.
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| 2. |
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| 3. |
- Asplund, Sara, 1976, et al.
(författare)
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Extended analysis of the effect of learning with feedback on the detectability of pulmonary nodules in chest tomosynthesis
- 2011
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Ingår i: Progress in Biomedical Optics and Imaging - Proceedings of SPIE. - : SPIE. - 1605-7422. ; 7966
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In chest tomosynthesis, low-dose projections collected over a limited angular range are used for reconstruction of section images of the chest, resulting in a reduction of disturbing anatomy at a moderate increase in radiation dose compared to chest radiography. In a previous study, we investigated the effects of learning with feedback on the detection of pulmonary nodules in chest tomosynthesis. Six observers with varying degrees of experience of chest tomosynthesis analyzed tomosynthesis cases for presence of pulmonary nodules. The cases were analyzed before and after learning with feedback. Multidetector computed tomography (MDCT) was used as reference. The differences in performance between the two readings were calculated using the jackknife alternative free-response receiver operating characteristics (JAFROC-2) as primary measure of detectability. Significant differences between the readings were found only for observers inexperienced in chest tomosynthesis. The purpose of the present study was to extend the statistical analysis of the results of the previous study, including JAFROC-1 analysis and FROC curves in the analysis. The results are consistent with the results of the previous study and, furthermore, JAFROC-1 gave lower p-values than JAFROC-2 for the observers who improved their performance after learning with feedback. © 2011 SPIE.
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| 4. |
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| 5. |
- Asplund, Sara, 1976, et al.
(författare)
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Learning aspects and potential pitfalls regarding detection of pulmonary nodules in chest tomosynthesis and proposed related quality criteria.
- 2011
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Ingår i: Acta radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 52:5, s. 503-512
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Tidskriftsartikel (refereegranskat)abstract
- Background In chest tomosynthesis, low-dose projections collected over a limited angular range are used for reconstruction of an arbitrary number of section images of the chest, resulting in a moderately increased radiation dose compared to chest radiography. Purpose To investigate the effects of learning with feedback on the detection of pulmonary nodules for observers with varying experience of chest tomosynthesis, to identify pitfalls regarding detection of pulmonary nodules, and present suggestions for how to avoid them, and to adapt the European quality criteria for chest radiography and computed tomography (CT) to chest tomosynthesis. Material and Methods Six observers analyzed tomosynthesis cases for presence of nodules in a jackknife alternative free-response receiver-operating characteristics (JAFROC) study. CT was used as reference. The same tomosynthesis cases were analyzed before and after learning with feedback, which included a collective learning session. The difference in performance between the two readings was calculated using the JAFROC figure of merit as principal measure of detectability. Results Significant improvement in performance after learning with feedback was found only for observers inexperienced in tomosynthesis. At the collective learning session, localization of pleural and subpleural nodules or structures was identified as the main difficulty in analyzing tomosynthesis images. Conclusion The results indicate that inexperienced observers can reach a high level of performance regarding nodule detection in tomosynthesis after learning with feedback and that the main problem with chest tomosynthesis is related to the limited depth resolution.
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| 6. |
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| 7. |
- Baubeta Fridh, Erik, et al.
(författare)
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Comparison of Magnetic Resonance Angiography and Digital Subtraction Angiography for the Assessment of Infrapopliteal Arterial Occlusive Lesions, Based on the TASC II Classification Criteria
- 2020
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Ingår i: Diagnostics (Basel). - : MDPI. - 2075-4418. ; 10:11
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Tidskriftsartikel (refereegranskat)abstract
- This paper aimed to study the agreement and repeatability, both intra- and interobserver, of infrapopliteal lesion assessment with magnetic resonance angiography (MRA), using the TransAtlantic Inter-Society Consensus (TASC) II criteria, with perioperative digital subtraction angiography (DSA) as a reference. Sixty-eight patients with an MRA preceding an endovascular infrapopliteal revascularization were included. Preoperative MRAs and perioperative DSAs were evaluated in random order by three independent observers using the TASC II classification. The results were analyzed using visual grading characteristics (VGC) analysis and Krippendorffs alpha. No systematic difference was found between modalities: area under the VGC curve (AUC(VGC)) = 0.48 (p = 0.58) or intraobserver; AUC(VGC) for Observer 1 and 2 respectively, 0.49 (p = 0.85) and 0.53 (p = 0.52) for MRA compared with 0.54 (p = 0.30) and 0.49 (p = 0.81) for DSA. Interobserver differences were seen: AUC(VGC) of 0.63 (p < 0.01) for DSA and 0.80 (p < 0.01) for MRA. These results were confirmed using Krippendorffs alpha for the three observers showing 0.13 (95% confidence interval (CI) -0.07-0.31) for MRA and 0.39 (95% CI 0.23-0.53) for DSA. Poor interobserver agreement was also found in the choice of a target vessel on preoperative MRA: Krippendorffs alpha = 0.19 (95% CI 0.01-0.36). In conclusion, infrapopliteal lesions can be reliably determined on preoperative MRA, but interobserver variability regarding the choice of a target vessel is a major concern that appears to affect the overall TASC II grade.
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| 8. |
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| 9. |
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| 10. |
- 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. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 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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| 11. |
- Båth, Magnus, et al.
(författare)
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OPTIMISATION in X-RAY and MOLECULAR IMAGING 2020
- 2021
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Ingår i: Radiation Protection Dosimetry. - : Oxford University Press (OUP). - 0144-8420 .- 1742-3406. ; 195:3-4, s. 133-133
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 12. |
- Båth, Magnus, 1974, et al.
(författare)
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RETROSPECTIVE ESTIMATION OF PATIENT DOSE-AREA PRODUCT IN THORACIC SPINE TOMOSYNTHESIS PERFORMED USING VOLUMERAD.
- 2016
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Ingår i: Radiation protection dosimetry. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 169:1-4, s. 281-285
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the use of a recently developed method of retrospectively estimating the patient dose-area product (DAP) of a chest tomosynthesis examination, performed using VolumeRAD, in thoracic spine tomosynthesis and to determine the necessary field-size correction factor. Digital imaging and communications in medicine (DICOM) data for the projection radiographs acquired during a thoracic spine tomosynthesis examination were retrieved directly from the modality for 17 patients. Using the previously developed method, an estimated DAP for the tomosynthesis examination was determined from DICOM data in the scout image. By comparing the estimated DAP with the actual DAP registered for the projection radiographs, a field-size correction factor was determined. The field-size correction factor for thoracic spine tomosynthesis was determined to 0.92. Applying this factor to the DAP estimated retrospectively, the maximum difference between the estimated DAP and the actual DAP was <3 %. In conclusion, the previously developed method of retrospectively estimating the DAP in chest tomosynthesis can be applied to thoracic spine tomosynthesis.
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| 13. |
- Båth, Magnus, 1974, et al.
(författare)
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Retrospective estimation of patient dose-area product in thoracic spine tomosynthesis performed using VolumeRAD
- 2015
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Ingår i: Optimisation in X-ray and Molecular Imaging 2015 - the Fourth Malmö Conference on Medical Imaging, Gothenburg, Sweden, 28-30 May 2015.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: For a tomosynthesis examination performed using the VolumeRAD system (GE Healthcare, Chalfont St. Giles, UK), the scout image is normally the only image stored in the picture archiving and communication system (PACS) that contains dose data in the digital imaging and communications in medicine (DICOM) header. Recently, a method of retrospectively estimating the patient dose-area product (DAP) of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data available in the scout image was presented (Båth et al, Med Phys 2014). The purpose of the present work was to evaluate the application of the method to thoracic spine tomosynthesis. Material and Methods: DICOM data for the projection radiographs acquired during the examination were retrieved directly from the modality for 17 patients undergoing thoracic spine tomosynthesis with VolumeRAD. Using information about how the exposure parameters for the tomosynthesis examination are determined by the scout image, an estimated DAP for the tomosynthesis examination was determined from DICOM data in the scout image. Based on comparing the estimated DAP with the actual DAP registered for the projection radiographs acquired during the tomosynthesis examination, a correction factor for the adjustment in field size with projection angle was determined. Results: The field-size correction factor for thoracic spine tomosynthesis was determined to 0.92. Applying this factor to the DAP estimated retrospectively from the scout image, the maximum difference between the estimated DAP and the actual DAP was smaller than 3% for all patients. Conclusions: The previously developed method of retrospectively estimating the DAP of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data in the scout image can be applied also to thoracic spine tomosynthesis. The method may thus be of value for retrospectively estimating patient dose in clinical use of thoracic spine tomosynthesis.
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| 14. |
- Ceder, Erik, et al.
(författare)
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THORACIC SPINE IMAGING: A COMPARISON BETWEEN RADIOGRAPHY AND TOMOSYNTHESIS USING VISUAL GRADING CHARACTERISTICS
- 2016
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Ingår i: Radiation protection dosimetry. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 169:1-4, s. 204-210
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to evaluate digital tomosynthesis (DTS) in thoracic spine imaging, comparing the reproduction of anatomical structures with that achieved using digital radiography (DR). In a prospective visual grading study, 23 patients referred in 2014 for elective radiographic examination of the thoracic spine were examined using lateral DR and DTS. The DR image and the DTS section images were read in random order by four radiologists, evaluating the ability of the modalities to present a clear reproduction of nine specific relevant structures of the thoracic vertebrae 3, 6 and 9 (T3, T6 and T9). The data were analysed using visual grading characteristics (VGC) analysis. The VGC analysis revealed a statistically significant difference in favour of DTS for all evaluated structures, except for the anterior vertebral edges and lower end plate surfaces of T6 and T9 and the cancellous bone of T9. The difference was most striking in T3 and for posterior structures. For no structure in any vertebra was the reproduction rated significantly better for DR. In conclusion, DTS of the thoracic spine appears to be a promising alternative to DR, especially in areas where the problem of overlaying anatomy is accentuated, such as posterior and upper thoracic structures.
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| 15. |
- Chodorowski, Artur, 1959, et al.
(författare)
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An attempt to estimate out-of-plane lung nodule elongation in tomosynthesis images
- 2015
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Ingår i: Medical Imaging 2015: Physics of Medical Imaging (SPIE Proceedings). Conference on Medical Imaging - Physics of Medical Imaging. February 22-25, 2015, Orlando, Florida, USA.. - : SPIE. - 0277-786X .- 1605-7422. - 9781628415025
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Konferensbidrag (refereegranskat)abstract
- In chest tomosynthesis (TS) the most commonly used reconstruction methods are based on Filtered Back Projection (FBP) algorithms. Due to the limited angular range of x-ray projections, FBP reconstructed data is typically associated with a low spatial resolution in the out-of-plane dimension. Lung nodule measures that depend on depth information such as 3D shape and volume are therefore difficult to estimate. In this paper the relation between features from FBP reconstructed lung nodules and the true out-of-plane nodule elongation is investigated and a method for estimating the out-of-plane nodule elongation is proposed. In order to study these relations a number of steps that include simulation of spheroidal-shaped nodules, insertion into synthetic data volumes, construction of TS-projections and FBP-reconstruction were performed. In addition, the same procedure was used to simulate nodules and insert them into clinical chest TS projection data. The reconstructed nodule data was then investigated with respect to in-plane diameter, out-of-plane elongation, and attenuation coefficient. It was found that the voxel value in each nodule increased linearly with nodule elongation, for nodules with a constant attenuation coefficient. Similarly, the voxel value increased linearly with in-plane diameter. These observations indicate the possibility to predict the nodule elongation from the reconstructed voxel intensity values. Such a method would represent a quantitative approach to chest tomosynthesis that may be useful in future work on volume and growth rate estimation of lung nodules.
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| 16. |
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| 17. |
- Håkansson, Markus, et al.
(författare)
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ViewDEX 2.0: A Java-based DICOM-compatible software for observer performance studies
- 2009
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Ingår i: Progress in Biomedical Optics and Imaging - Proceedings of SPIE. - : SPIE. - 1605-7422. ; 7263
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- ViewDEX (Viewer for Digital Evaluation of X-ray images) is a Java-based DICOM-compatible software tool for observer performance studies that can be used to display medical images with simultaneous registration of the observer's response. The current release, ViewDEX 2.0, is a development of ViewDEX 1.0, which was released in 2007. Both versions are designed to run in a Java environment and do not require any special installation. For example, the program can be located on a memory stick or stand alone hard drive and be run from there. ViewDEX is managed and configured by editing property files, which are plain text files where users, tasks (questions, definitions, etc.) and functionality (WW/WL, PAN, ZOOM, etc.) are defined. ViewDEX reads most common DICOM image formats and the images can be stored in any location connected to the computer. ViewDEX 2.0 is designed so that the user in a simple way can alter if the questions presented to the observers are related to localization or not, enabling e.g. free-response ROC, standard ROC and visual grading studies, as well as combinations of these, to be conducted in a fast and efficient way. The software can also be used for bench marking and for educational purposes. The results from each observer are saved in a log file, which can be exported for further analysis. The software is freely available for non-commercial purposes.
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| 18. |
- 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. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 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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| 19. |
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| 22. |
- 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. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 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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| 23. |
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| 24. |
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| 25. |
- 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. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 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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