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| 5. |
- Herrmann, C., et al.
(författare)
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Simulation of nodule-like pathology in radiographs of the lumbar spine
- 2000
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Ingår i: Radiation Protection Dosimetry. - 1742-3406. ; 90:1-2, s. 113-116
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Tidskriftsartikel (refereegranskat)abstract
- For the evaluation of the imaging properties of medical radiographic systems there are well-established standards for measuring techniques available, e.g. ISO 9236 for the measurement of the H/D curve. However, such measuring techniques require sophisticated equipment which is not available in a clinical environment. For a clinical routine of image evaluation, techniques like contrast-detail diagrams or the visual inspection of radiographs of grid pattern with varying contrast and spatial resolution are very common. The disadvantage of these techniques is that the corresponding results are very hard to be transferred to real patient images. Therefore, observer studies on the detection of certain pathology are commonly used to e.g. investigate the influence of different radiographic techniques on diagnostic image quality. As it is very difficult to find a sufficient number of patients with real pathologies for such studies, the pathologies are often simulated by fixing e.g. aluminium disks or other nodule-like objects to healthy volunteers when the radiograph is produced. This approach is relatively simple and rather successful in chest imaging. For lumbar spine images, however, the situation is different because nodule-like tumours cannot only consist of bony material which is increasing the X-ray absorption, but tumours can also destroy the bone material resulting in an increased transparency of the corresponding anatomical region. Such a behaviour is extremely hard to be simulated by fixing an external object to the patient. However, it can be easily simulated in a computer and applied to digital radiographic data. The current paper presents a computer model for the simulation of nodules in lumbar spine images. The model has been applied within a CEC founded research project, which was investigating the influence of MTF and noise power spectra on the diagnostic quality of radiographs of the lumbar spine.
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| 8. |
- Lanhede, B., et al.
(författare)
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The Influence of Different Technique Factors on Image Quality for Chest Radiographs: Application of the Recent CEC Image Quality Criteria
- 2000
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Ingår i: Radiation Protection Dosimetry. - 1742-3406. ; 90:1-2, s. 203-206
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the first this work part of the EU-project, Trial I, was to evaluate and possibly improve the CEC image criteria for radiographic chest images. Chest images of healthy volunteers were acquired using different technique factors. The image criteria were used as a tool to discriminate between the different images. The technique factors were chosen so that the image quality would differ slightly. Four different technique parameters, each with two possible settings, used in clinical practice today, were used: tube voltage - 102 and 141 kV; screen/film speed - 160 and 320; maximum optical density in the parenchyma - 1.3 and 1.8; method for scatter reduction - air gap 30/390 and moving grid40/12. The results showed that the image criteria were able to separate between different technique groups. Some conclusions can be drawn from the results Optical density 1.8 was better than 1.3 independent of the other parameters. . Among the six combinations ranked best , four used tube voltage 141 kV and four used air gap technique for scatter reduction. No difference was seen for screen/film speed. No correlation was seen between the ranking of the systems and patient dose.
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| 9. |
- Lanhede, B, et al.
(författare)
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The influence of different technique factors on image quality of chest radiographs as evaluated by modified CEC image quality criteria.
- 2002
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 75:889, s. 38-49
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Tidskriftsartikel (refereegranskat)abstract
- The Commission of the European Communities (CEC) research project "Predictivity and optimisation in medical radiation protection" addressed fundamental operational limitations in existing radiation protection mechanisms. The first part of the project aimed at investigating (1) whether the CEC image quality criteria could be used for optimization of a radiographic process and (2) whether significant differences in image quality based on these criteria could be detected in a controlled project with well known physical and technical parameters. In the present study, chest radiographs on film were produced using healthy volunteers. Four physical/technical parameters were varied in a carefully controlled manner: tube voltage (102 kVp and 141 kVp), nominal speed class (160 and 320), maximum film density (1.3 and 1.8) and method of scatter reduction (grid (R=12) and air gap). The air kerma at the entrance surface was measured for all patients and the risk-related dose H(Golem), based on calculated organ-equivalent dose conversion coefficients and the measured entrance air kerma values, was calculated. Image quality was evaluated by a group of European expert radiologists using a modified version of the CEC quality criteria. For the two density levels, density level 1.8 was significantly better than 1.3 but at the cost of a higher patient radiation exposure. The correlation between the number of fulfilled quality criteria and H(Golem) was generally poor. An air gap technique resulted in lower doses than scatter reduction with a grid but provided comparable image quality. The criteria can be used to highlight optimum radiographic technique in terms of image quality and patient dose, although not unambiguously. A recommendation for good radiographic technique based on a compromise between image quality and risk-related radiation dose to the patient is to use 141 kVp, an air gap, a screen-film system with speed 320 and an optical density of 1.8.
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| 11. |
- Sandborg, Michael, 1961-, et al.
(författare)
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Demonstration of correlation between physical and clinical image quality measures in chest and lumbar spine imaging.
- 2000
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Ingår i: Digest of papers of the 2000 world congress on medical physics. CD-Rom Chicago July 23-28,2000. - : IEEE. - 0780364651 ; , s. 3078-3081 vol.4
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Konferensbidrag (refereegranskat)abstract
- Clinical and physical assessments of image quality are compared and the correlation between the two derived. Clinical assessment has been made by a group of expert radiologists who evaluated the fulfillment of the European Image Criteria for chest and lumbar spine radiography; yielding the so-called Image Criteria Score, ICS. Physical measures of image quality were calculated using a Monte Carlo model of the complete imaging system. This model includes a voxelised male anatomy and calculates contrast and signal-to-noise ratio of various anatomical details and a measure of useful dynamic range. Correlations between the ICS and the physical image quality measures were sought. Four lumbar spine and 16 chest imaging systems were evaluated and simulated with the model. The most useful physical quantities for chest radiography were the dynamic range and contrast of blood vessels in the retro-cardiac area. In lumbar spine, it was the signal-to-noise ratio of trabecular structures. The significant correlation is encouraging and shows that clinical image quality can be predicted provided the imaging conditions are well known and that relevant measures of physical image quality are used to assess the quality of the image
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| 12. |
- Sandborg, Michael, 1961-, et al.
(författare)
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Demonstration of correlations between clinical and physical image quality measures in chest and lumbar spine screen-film radiography
- 2001
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 74:882, s. 520-528
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Tidskriftsartikel (refereegranskat)abstract
- The ability to predict clinical image quality from physical measures is useful for optimization in diagnostic radiology. In this work, clinical and physical assessments of image quality are compared and correlations between the two are derived. Clinical assessment has been made by a group of expert radiologists who evaluated fulfilment of the European image criteria for chest and lumbar spine radiography using two scoring methods: image criteria score (ICS) and visual grading analysis score (VGAS). Physical image quality measures were calculated using a Monte Carlo simulation model of the complete imaging system. This model includes a voxelized male anatomy and was used to calculate contrast and signal-to-noise ratio of various important anatomical details and measures of dynamic range. Correlations between the physical image quality measures on the one hand and the ICS and VGAS on the other were sought. 16 chest and 4 lumbar spine imaging system configurations were compared in frontal projection. A statistically significant correlation with clinical image quality was found in chest posteroanterior radiography for the contrast of blood vessels in the retrocardiac area and a measure of useful dynamic range. In lumbar spine anteroposterior radiography, a similar significant correlation with clinical image quality was found between the contrast and signal-to-noise ratio of the trabecular structures in the L1-L5 vertebrae. The significant correlation shows that clinical image quality can, at least in some cases, be predicted from appropriate measures of physical image quality.
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| 13. |
- Sund, P., et al.
(författare)
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Comparison of two methods for evaluating image quality of chest radiographs
- 2000
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Ingår i: Proceedings of SPIE. - : SPIE. ; 3981, s. 251-258
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Konferensbidrag (refereegranskat)abstract
- A set of 15 analog chest images was digitized with a high performance scanner and manipulated in terms of noise and resolution to yield three sets of images; the original plus two with different noise and resolution properties. These sets were evaluated with Visual Grading Analysis (VGA) where the observer rates the visibility of certain normal anatomical structures (as described by the European Quality Criteria) compared to a reference image. One of the non-manipulated digitized images was used in an ROC-related method – the Free response Forced Error experiment. Simulated lesions of different contrast and size were randomly superimposed on 50 copies of this image. The images were then manipulated in the same way as the images used for VGA. All observations were done by a group of seven expert radiologists from six different European countries and all images were printed back to film before evaluation. The ranking of the image manipulations was the same for the two methods. Although a strong correlation cannot be predicted with only three sets of images, it is encouraging that the simpler VGA study in some cases might be used as a replacement for the more time- and effort-consuming ROC analysis.
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| 14. |
- Tingberg, Anders, et al.
(författare)
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Comparison of two methods for evaluation of image quality of lumbar spine radiographs
- 2004
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Ingår i: Progress in Biomedical Optics and Imaging - Proceedings of SPIE. - : SPIE. - 1605-7422. ; 5372, s. 251-262
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Purpose To evaluate the image quality of clinical radiographs with two different methods, and to find correlations between the two methods. Methods Based on fifteen lumbar spine radiographs, two new sets of images were created. A hybrid image set was created by adding two distributions of artificial lesions to each original image. The image quality parameters spatial resolution and noise were manipulated and a total of 210 hybrid images were created. A set of 105 disease-free images was created by applying the same combinations of spatial resolution and noise to the original images. The hybrid images were evaluated with the free-response forced error experiment (FFE) and the normal images with visual grading analysis (VGA) by nine experienced radiologists. Results The VGA study showed that images with low noise are preferred over images with higher noise levels. The alteration of the MTF had a limited influence on the VGA score. For the FFE study the visibility of the lesions was independent of the spatial resolution and the noise level. Discussion In this study we found no correlation between the two methods, probably because the detectability of the artificial lesions was not influenced by the manipulations of noise level and resolution. Hence, the detection of lesions in lumbar spine radiography may not be a quantum-noise limited task. The results show the strength of the VGA technique in terms of detecting small changes in the two image quality parameters. The method is more robust and has a higher statistical power than the ROC related method and could therefore, in some cases, be more suitable for use in optimization studies.
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| 15. |
- Tingberg, Anders, et al.
(författare)
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Comparison of two methods for evaluation of the image quality of lumbar spine radiographs
- 2000
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Ingår i: Radiation Protection Dosimetry. - 1742-3406. ; 90:1, s. 165-168
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Tidskriftsartikel (refereegranskat)abstract
- Two methods for visual evaluation of image quality of clinical radiographs have been compared. In visual grading analysis (VGA) specified anatomical structures in an image are visually compared with the same structures in a reference image, and in a free-response forced error (FFE) experiment - an extension of conventional ROC (receiver operating characteristics) analysis - the objective is to correctly localise known lesions. The spatial resolution and noise of digitised clinical radiographs of the lumbar spine were altered by image processing, and pathological structures were added to the images for the FFE experiment. The images were printed to film and evaluated by seven European expert radiologists using VGA and FFE. The results of these two different methods showed a very good agreement. In conclusion, VGA methodology can be made as solid as the FFE experiment for evaluating image quality. The simplicity of VGA makes it very suitable for implementation in clinical practice.
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| 16. |
- Tingberg, Anders, et al.
(författare)
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Evaluation of lumbar spine images with added pathology
- 2000
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Ingår i: Proceedings of SPIE. - : SPIE. - 0819435988 ; 3981, s. 34-42
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Konferensbidrag (refereegranskat)abstract
- Optimisation of radiographic procedures require solid tools for evaluation of the image quality in order to ensure that it is sufficient to answer the clinical question at the lowest possible absorbed dose to the patient. Lumbar spine radiography is an examination giving a relatively high dose and good methods for evaluation of image quality as well as dose are needed. We have developed and used a method for the addition of artificial pathological structures into clinical images. The new images were evaluated in a study of detectability (free-response forced error experiment). The results from the study showed that the methodology can be used to detect differences in the screen-film systems used to produce the images, indicating that the method can be used in a study of image quality. The results of the study of detectability were compared with the outcome of a visual grading analysis based on the structures mentioned in the European Quality Criteria. The comparison indicated that a linear correlation exists between the two methods. This means that the simpler VGA can be used in the evaluation of clinical image quality.
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| 17. |
- Tingberg, Anders, et al.
(författare)
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Influence of the characteristic curve on the clinical image quality of lumbar spine and chest radiographs.
- 2004
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 77:915, s. 204-15
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Tidskriftsartikel (refereegranskat)abstract
- The "European Guidelines on Quality Criteria for Diagnostic Radiographic Images" do not address the choice of the film characteristic (H&D) curve, which is an important parameter for the description of a radiographic screen-film system. The image contrast of clinical lumbar spine and chest radiographs was altered by digital image processing techniques, simulating images with different H&D curves, both steeper and flatter than the original. The manipulated images were printed on film for evaluation. Seven experienced radiologists evaluated the clinical image quality by analysing the fulfilment of the European Image Criteria (ICS) and by visual grading analysis (VGA) of in total 224 lumbar spine and 360 chest images. A parallel study of the effect of the H&D curve has also been made using a theoretical model. The contrast (DeltaOD) of relevant anatomical details was calculated, using a Monte Carlo simulation-model of the complete imaging system including a 3D voxel phantom of a patient. Correlations between the calculated contrast and the radiologists' assessment by VGA were sought. The results of the radiologists' assessment show that the quality in selected regions of lumbar spine and chest images can be significantly improved by the use of films with a steeper H&D curve compared with the standard latitude film. Significant (p<0.05) correlations were found between the VGA results and the calculations of the contrast of transverse processes and trabecular details in the lumbar spine vertebrae, and with the contrast of blood vessels in the retrocardiac area of the chest.
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| 19. |
- Tingberg, Anders
(författare)
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Quantifying the quality of medical x-ray images. An evaluation based on normal anatomy for lumbar spine and chest radiography.
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Optimisation in diagnostic radiology requires accurate methods for determination of patient absorbed dose and clinical image quality. Simple methods for evaluation of clinical image quality are at present scarce and this project aims at developing such methods. Two methods are used and further developed; fulfilment of image criteria (IC) and visual grading analysis (VGA). Clinical image quality descriptors are defined based on these two methods: image criteria score (ICS) and visual grading analysis score (VGAS), respectively. For both methods the basis is the Image Criteria of the “European Guidelines on Quality Criteria for Diagnostic Radiographic Images”. Both methods have proved to be useful for evaluation of clinical image quality. The two methods complement each other: IC is an absolute method, which means that the quality of images of different patients and produced with different radiographic tech-niques can be compared with each other. The separating power of IC is, however, weaker than that of VGA. VGA is the best method for comparing images produced with different radiographic techniques and has strong separating power, but the re-sults are relative, since the quality of an image is compared to the quality of a refer-ence image. The usefulness of the two methods has been verified by comparing the results from both of them with results from a generally accepted method for evaluation of clinical image quality, receiver operating characteristics (ROC). The results of the comparison between the two methods based on visibility of anatomical structures and the method based on detection of pathological structures (free-response forced error) indicate that the former two methods can be used for evaluation of clinical image quality as efficiently as the method based on ROC. More studies are, however, needed for us to be able to draw a general conclusion, including studies of other organs, using other radiographic techniques, etc. The results of the experimental evaluation of clinical image quality are compared with physical quantities calculated with a theoretical model based on a voxel phantom, and correlations are found. The results demonstrate that the computer model can be a useful tool in planning further experimental studies.
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| 20. |
- Tingberg, Anders, et al.
(författare)
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Search for optimal tube voltage for image plate radiography
- 2003
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Ingår i: Proceedings of SPIE. - : SPIE. - 3540235957 ; 5034, s. 187-196
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Konferensbidrag (refereegranskat)abstract
- Purpose: To search for the tube voltage which results in the highest clinical image quality per effective dose unit for chest and pelvis radiography respectively, using image plates. Methods: Two anthropomorphic phantoms were imaged with several different tube voltages. For the chest phantom, the tube voltage was varied between 70 and 150 kV, and for the pelvis phantom between 50 and 102 kV. The mAs settings were chosen so that the effective dose to the phantom was the same, regardless of the tube voltage, for the two examinations respectively. The clinical image quality of the resulting images was evaluated by a panel of experienced radiologists with visual grading analysis of defined anatomical structures taken from the European Image Criteria. Images produced with the standard tube voltage settings (125 kV for chest and 70 kV for pelvis) were used as reference. These two kV settings were previously used for screen film radiography. Results: For both the chest and the pelvis examinations the image quality at a constant level of effective dose increased when the tube voltage was reduced. Conclusions: The image quality of image plate radiography can be increased by lowering the tube voltage compared to what was used for screen film radiography.
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| 21. |
- Tingberg, Anders, et al.
(författare)
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The influence of the characteristic curve on the clinical image quality and patient absorbed dose in lumbar spine radiography
- 2001
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Ingår i: Proceedings of SPIE. - : SPIE. - 0819440108 ; 4324, s. 41503-41503
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Konferensbidrag (refereegranskat)abstract
- The 'European Guidelines on Quality Criteria for Diagnostic Radiographic Images' do not address the choice of film characteristic (H/D) curve, which is an important parameter for the description of a radiographic screen-film system. Since it is not possible to investigate this influence by taking repeated exposures of the same patients on films with systematically varied H/D curves, patient images of lumbar spine were digitised in the current study. The image contrast was altered by digital image processing techniques, simulating images with H/D curves varying from flat over standard latitude to a film type steeper than a mammography film. The manipulated images were printed on film for evaluation. Seven European radiologists evaluated the clinical image quality of in total 224 images by analysing the fulfilment of the European Image Criteria and by visual grading analysis of the images. The results show that the local quality can be significantly improved by the application of films with a steeper film H/D curve compared to the standard latitude film. For images with an average optical density of about 1.25, the application of the steeper film results in a reduction of patient absorbed dose by about 10-15% without a loss of diagnostically relevant image information. The results also show that the patient absorbed dose reduction obtained by altering the tube voltage from 70 kV to 90 kV coincides with a loss of image information that cannot be compensated for by simply changing the shape of the H/D curve.
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| 22. |
- Tingberg, Anders, et al.
(författare)
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What is worse: Decreased spatial resolution or increased noise?
- 2002
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Ingår i: Proceedings of SPIE. - : SPIE. - 9780819444318 ; 4686, s. 338-346
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Konferensbidrag (refereegranskat)abstract
- Purpose: To investigate the relative importance of spatial resolution and noise on the image quality of clinical radiographs. Methods: The spatial resolution and noise of fifteen digitised lumbar spine radiographs were altered with image processing. Three different MTF curves and three different Wiener spectra were combined into seven different combinations of spatial resolution and noise. These seven combinations were applied to the original data set, and the resulting images were printed on film. Seven expert radiologists evaluated the clinical image quality of the resulting images with visual grading analysis (VGA) of structures based on the European Image Criteria. Results: The results show that added noise is more deteriorating than reduced spatial resolution for the clinical image quality. For a given MTF and noise level, the worst was the one with increased noise followed by the one with both reduced MTF and added noise (mimicking a faster screen-film combination). Reduced MTF only gave the highest rating. Conclusions: It is more important to find methods for removing noise than to try to improve the MTF of a radiographic system. A noisy image can sometimes be improved by reducing the spatial resolution.
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| 24. |
- Ullman, Gustav, et al.
(författare)
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Comparison of clinical and physical measures of image quality in chest PA and pelvis AP views at varying tube voltages
- 2004
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Image quality in digital chest PA and pelvis AP was assessed using two different methods; one based on observations of images of an anthropomorphic phantom, one based on computer modelling using an anthropomorphic voxel phantom. The tube voltage was varied within a broad range (50-150 kV), including those values typically used with screen-film radiography. The tube charge was altered so that approximately the same effective dose was achieved in the modelled patient (anthropomorphic phantom). Two x-ray units were employed using a digital image detector (computed radiography, CR, system) with standard tube filtration and anti-scatter device. Clinical image quality was assessed by a group of radiologists using a visual grading analysis (VGA) technique based on the revised CEC image criteria. Physical image quality was derived from the computer model in terms of the signal-to-noise ratio, SNR for fixed effective dose in the voxel phantom. The computer model uses Monte Carlo simulations of the patient and complete imaging system. Both the VGAS (visual grading analysis score) and SNR increase with decreasing tube voltage in both chest PA and pelvis AP examinations, indicating superior performance if lower tube voltages than used today are employed in digital radiology. A positive correlation between clinical and physical measures of image quality was found. The pros and cons of using lower tube voltages with CR digital radiography than typically used in analogue screen-film radiography are discussed as well as the relevance of using VGAS and quantum noise SNR as measures of image quality.
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