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- Geijer, Håkan, et al.
(author)
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Digital Radiography of Scoliosis with a Scanning Method : Initial Evaluation
- 2001
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In: Radiology. - 0033-8419 .- 1527-1315. ; 218, s. 402-410
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Journal article (peer-reviewed)abstract
- PURPOSE: To evaluate the radiation dose, image quality, and Cobb angle measurements obtained with a digital scanning method of scoliosis radiography.MATERIALS AND METHODS: Multiple images were reconstructed into one image at a workstation. A low-dose alternative was to use digital pulsed fluoroscopy. Dose measurements were performed with thermoluminescent dosimeters in an Alderson phantom. At the same time, kerma area-product values were recorded. A Monte Carlo dose calculation also was performed. Image quality was evaluated with a contrast-detail phantom and visual grading system. Angle measurements were evaluated with an angle phantom and measurements obtained on patient images.RESULTS: The effective radiation dose was 0.087 mSv for screen-film imaging, 0.16 mSv for digital exposure imaging, and 0.017 mSv for digital fluoroscopy; the corresponding kerma area-product values were 0.43, 0.87, and 0.097 Gy · cm2, respectively. The image quality of the digital exposure and screen-film images was about equal at visual grading, whereas fluoroscopy had lower image quality. The angle phantom had lower angle values with digital fluoroscopy, although the difference in measured angles was less than 0.5°. The patient images showed no difference in angles.CONCLUSION: The described digital scanning method has acceptable image quality and adequate accuracy in angle measurements. The radiation dose required for digital exposure imaging is higher than that required for screen-film imaging, but that required for digital fluoroscopy is much lower.
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2. |
- Geijer, Håkan, et al.
(author)
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Digital Radiography of Scoliosis with a Scanning Method : Radiation Dose Optimization
- 2003
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In: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 13:3, s. 543-551
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Journal article (peer-reviewed)abstract
- The aim of this study was optimization of the radiation dose–image quality relationship for a digital scanning method of scoliosis radiography. The examination is performed as a digital multi-image translation scan that is reconstructed to a single image in a workstation. Entrance dose was recorded with thermoluminescent dosimeters placed dorsally on an Alderson phantom. At the same time, kerma area product (KAP) values were recorded. A Monte Carlo calculation of effective dose was also made. Image quality was evaluated with a contrast-detail phantom and Visual Grading. The radiation dose was reduced by lowering the image intensifier entrance dose request, adjusting pulse frequency and scan speed, and by raising tube voltage. The calculated effective dose was reduced from 0.15 to 0.05 mSv with reduction of KAP from 1.07 to 0.25 Gy cm2 and entrance dose from 0.90 to 0.21 mGy. The image quality was reduced with the Image Quality Figure going from 52 to 62 and a corresponding reduction in image quality as assessed with Visual Grading. The optimization resulted in a dose reduction to 31% of the original effective dose with an acceptable reduction in image quality considering the intended use of the images for angle measurements.
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- Geijer, Håkan, et al.
(author)
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Image quality vs radiation dose for a flat-panel amorphous silicon detector : a phantom study
- 2001
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In: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 11:9, s. 1704-1709
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate the image quality for a flat-panel amorphous silicon detector at various radiation dose settings and to compare the results with storage phosphor plates and a screen-film system. A CDRAD 2.0 contrast-detail phantom was imaged with a flat-panel detector (Philips Medical Systems, Eindhoven, The Netherlands) at three different dose levels with settings for intravenous urography. The same phantom was imaged with storage phosphor plates at a simulated system speed of 200 and a screen-film system with a system speed of 160. Entrance surface doses were recorded for all images. At each setting, three images were read by four independent observers. The flat-panel detector had equal image quality at less than half the radiation dose compared with storage phosphor plates. The difference was even larger when compared with film with the flat-panel detector having equal image quality at approximately one-fifth the dose. The flat-panel detector has a very favourable combination of image quality vs radiation dose compared with storage phosphor plates and screen film.
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4. |
- Geijer, Håkan
(author)
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Radiation dose and image quality in diagnostic radiology : optimization of the dose - image quality relationship with clinical experience from scoliosis radiography, coronary intervention and a flat-panel digital detector
- 2001
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Doctoral thesis (other academic/artistic)abstract
- Det är känt att röntgenstrålning kan orsaka cancersjukdomar, hudskador och andra sidoeffekter. Därför är det viktigt och även föreskrivet i lag att strålexpaneringen inom diagnostisk radiologi skall sänkas så långt som möjligt. Detta kallas på engelska ALARA-principen (As Low As Reasonably Achievable). stråldosen är kopplad till bildkvalitet och denna får inte sänkas så långt att det diagnostiska värdet av en undersökning äventyras. Processen att nå en sådan balans mellan dos och bildkvalitet kallas optimering. Syftet med denna avhandling är att fmna och utvärdera metoder för att optimera förhållandet mellan stråldos och bildkvalitet inom diagnostisk radiologi med fokus på klinisk användbarhet. Arbetet utfördes i tre huvuddelar.Optimering av skoliosröntgen: I första delen utvärderades två nyligen utvecklade metoder får digital skoliosröntgen (digital exponering och pulsad genomlysning). De järnfårdes även med film-skärmsystem som var den tidigare standardmetoden. Stråldosen mättes som Kerma area-produkt (KAP), ytdos (Entrance surface dose, ESD) och effektiv dos; bildkvaliteten värderades med ett kontrast-detaljfantom och genom visuell analys på kliniska bilder. Noggrannheten i vinkelmätningar värderades också. stråldosen för digital exponering var nästan dubbelt så hög som för film med jämförbar bildkvalitet medan pulsad genomlysning hade en mycket låg dos men betydligt sämre bildkvalitet. Variabiliteten i vinkelmätningar var tillräckligt låg i alla metoder. Därefter optimerades inställningarna för digital exponering till en betydligt lägre stråldos med viss sänkning av bildkvaliteten jämfört med utgångsläget.Direktdigital detektor: I den andra delstudien utvärderades en direktdigital detektor med ett kontrast-detaljfantom där stråldosen mättes som ingångsdos i fantomet. Den direktdigitala detektorn gav bättre bildkvalitet vid lägre dos jämfört med både bildplattor och film. Jämförbar bildkvalitet med bildplattor nåddes vid ungefär en tredjedel av dosen.Optimering av perkutan koranar intervention (PCI): I tredje delstudien undersöktes påverkan på stråldos och bildkvalitet av olika inställningar vid kranskärlsröntgen och PCI. Utifrån dessa fynd sänktes dosraten för genomlysning till en tredjedel. Dossänkningen utvärderades i en serie bestående av 154 PCI-procedurer före och 138 efter optimeringen. Genom denna optimering sänktes det totala KAP-värdet signifikant till två tredjedelar av ursprungsvärdet.Sammanfattningsvis påvisar denna avhandling möjligheterna till dossänkning i diagnostisk radiologi genom optimering av den radiografiska processen.
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5. |
- Geijer, Håkan
(author)
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Radiation dose and image quality in diagnostic radiology
- 2002
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In: Acta Radiologica. - 0284-1851 .- 1600-0455. ; 427
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Journal article (peer-reviewed)abstract
- Radiation dose and image quality in diagnostic radiology. Optimization of the dose-image quality relationship with clinical experience from scoliosis radiography, coronary intervention and a flat-panel detector.
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7. |
- Geijer, Håkan, et al.
(author)
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Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI) : I. Experimental studies
- 2002
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In: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:10, s. 2571-2581
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Journal article (peer-reviewed)abstract
- The objectives of this study were to evaluate the influence on image quality and dose to the patient and operator of various equipment settings for percutaneous coronary intervention (PCI), and to optimize the set-up. With an Alderson phantom, different settings, such as projection, protective screens, filtration, image intensifier size and collimation, were evaluated. Kerma-area product (KAP) was recorded as a measure of patient dose and scattered radiation was measured with an ionization chamber. Effective dose for a standardized PCI procedure was measured with thermoluminescent dosimeters inside the phantom. Image quality was evaluated with a contrast-detail phantom. Based on these findings, the equipment set-up was optimized to a low fluoroscopy dose rate with a sufficient image quality. Several operating parameters affected dose, particularly scattered radiation. The optimization reduced the fluoroscopy KAP rate from 44 to 16 mGy cm2/s using 15 cm of acrylic. The effective dose was reduced from 13 to 4.6 mSv for a standardized PCI procedure. Radiation dose to patient and operator in PCI is heavily dependent on both equipment set-up and operating parameters which can be influenced by the operator. With a careful optimization, a large reduction of radiation dose is possible.
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8. |
- Geijer, Håkan, et al.
(author)
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Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI) : II. Clinical evaluation
- 2002
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In: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:11, s. 2813-2819
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Journal article (peer-reviewed)abstract
- In a previous part of this study, the fluoroscopy dose rate was reduced in a cardiac catheterization laboratory. The objectives of the present study were to evaluate the effects in a clinical population undergoing percutaneous coronary intervention (PCI) of the dose-reducing measures detailed previously. Kerma area-product (KAP) values were first recorded for 154 patients undergoing PCI. Then, the fluoroscopy KAP rate was reduced from 44 to 16 mGy cm2/s by increasing filtration and reducing the image intensifier dose request. After this optimization, KAP was recorded for another 138 PCI procedures. After adjustment for differing proportions of combined procedures (coronary angiography+PCI), the total KAP was reduced to 67% of the original value with a 95% confidence interval from 57 to 78%, statistically significant. The mean total KAP values were 93.6 Gy cm2 before and 69.1 Gy cm2 after optimization. The KAP for digital acquisition did not change significantly. It is possible to make a large dose reduction in PCI by reducing the fluoroscopy dose rate. This dose reduction is beneficial for both patients and staff.
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9. |
- Kähäri, Anders, et al.
(author)
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Assessment of left ventricular function from M-mode measurement of circumflex artery motion recorded by coronary angiography.
- 2003
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In: Scandinavian Cardiovascular Journal. - : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 37:5, s. 259-265
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate the usefulness of M-mode measurement of circumflex artery motion (CAM) for assessment of left ventricular (LV) function.DESIGN: Seventy-two patients referred for coronary angiography and LV angiography were included. Ejection fraction (EF) was calculated from LV angiography and systolic and diastolic parameters of CAM were measured by M-mode from coronary angiography. Twenty-three patients, examined by echocardiography of mitral annulus motion (MAM) within 24 h before the angiographic examination, formed a subgroup for comparison between angiographic M-mode of CAM and echocardiographic M-mode of MAM.RESULTS: In addition to previous reported CAM amplitude and longitudinal fractional shortening (FSL) the maximal systolic velocity of CAM can be reliably recorded by M-mode. The diastolic indices, atrial contribution to the total amplitude and maximal early and late diastolic velocities, are also well monitored by M-mode of CAM in comparison with echocardiographic MAM.CONCLUSION: LV systolic and diastolic function can be assessed by M-mode of CAM.
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12. |
- Verdonck, B, et al.
(author)
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Image quality and x-ray dose for translation reconstruction overview imagaing of the spine, colon and legs. In : Lemke HU, Vannier MW, Inamura K, Farman AG, Doi K editors.
- 2001
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In: Elsevier Science. Proceedings of Computed Assisted Radiology and Surgery, Berlin 2001,2001. ; , s. 500-505
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Conference paper (peer-reviewed)
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