Biomedical subjects

A Almén

Publications and source records attributed to A Almén.

10 recordsLinked to original sources

PubMed2005

Unsolved or unsolvable problems with diagnostic reference levels.

Diagnostic reference levels (DRLs) for X-ray examinations have been introduced in many countries, among others in most European countries, as a consequence of the Directive on Medical Exposures from 1997. The concept seems to be straight forward, but when implementing it into practice a number of problems arise. The results are dependent on how the dose data are measured and assessed. The interpretation of the results must be performed with great care giving due consideration to the fact that X-ray examinations are very complex and hence not very well characterised by a single figure. In this presentation the various parameters influencing the patient dose are discussed and suggestions are given on how these are managed so as to get the best outcome. When these intentions are followed diagnostic reference levels will be a powerful tool for the optimisation process.

Body Weight↗

PubMed2004

The use of reference image criteria in X-ray diagnostics: an application for the optimisation of lumbar spine radiographs.

To ensure that sufficient image quality is obtained in diagnostic radiology, the image quality of clinical radiographs has to be evaluated. We present two methods herein for evaluating antero-posterior (AP) radiographs of the lumbar spine. One was using image criteria, including six anatomical details (absolute method). In the other, the visibility of anatomical details relative to a reference radiograph was evaluated (visual grading analysis). In total, 14 technique groups were evaluated. The technique groups differed in tube voltage and detector system characteristics. Six different gradients of the H&D curves were simulated. The visual grading analysis showed larger differences in image quality compared with the absolute method. The influence on the image quality due to a variation in tube voltage was easier to detect than the influence on the image quality from the detector characteristics. The visibility of the anatomical details was significantly dependent on the location in the spine. The visual grading analysis was found to be the preferable evaluation method in studies such as the present; however, it is necessary to guide and train the observer before the evaluation is performed.

Humans↗

PubMed2004

Influence of the characteristic curve on the clinical image quality of lumbar spine and chest radiographs.

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.

Computer Simulation↗

PubMed2002

The influence of different technique factors on image quality of chest radiographs as evaluated by modified CEC image quality criteria.

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.

Adult↗

PubMed2001

Demonstration of correlations between clinical and physical image quality measures in chest and lumbar spine screen-film radiography.

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 fulfillment 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.

Computer Simulation↗

PubMed2000

The influence of different technique factors on image quality of lumbar spine radiographs as evaluated by established CEC image criteria.

In this study we have investigated the image quality of lumbar spine radiographs taken after recording technical and physical parameters. Two technical parameters were altered, tube voltage (70 kV and 90 kV for the anteroposterior (AP) projection and 77 kV and 95 kV for the lateral projection) and sensitivity of the film-screen system (sensitivity class 400 and 600). In total, 85 images were included in the study. Entrance surface dose (ESD) was measured using thermoluminescent dosemeters. The mean value of ESD for the different technique groups varied between 1.9 mGy (90 kV, sensitivity class 400) and 4.6 mGy (70 kV, sensitivity class 400) for the AP projection, and between 6.4 mGy (95 kV, sensitivity class 600) and 20.4 mGy (70 kV, sensitivity class 400) for the lateral projection. Image criteria given in the "European Guidelines on Quality Criteria for Radiographic Images" were used to assess image quality. Two evaluation methods have been employed. A straightforward scoring of fulfilled image criteria, and visual grading analysis using the structures defined in the image criteria. The latter method provided a sharper distinction between groups of images taken using different radiographic techniques. The average number of fulfilled image criteria for the AP projections varied between 0.74 (90 kV, sensitivity class 400) and 0.87 (70 kV, sensitivity class 400). For the lateral projection this number varied between 0.79 (95 kV, sensitivity class 600) and 0.84 (77 kV, sensitivity class 600). This study shows that image criteria are useful tools in clinical studies of image quality.

Adolescent↗

PubMed1996

Simple methods for the estimation of dose distributions, organ doses and energy imparted in paediatric radiology.

The energy imparted and the effective dose can both be used to describe the risk to the patient in diagnostic radiology. Simple methods must be employed to determine these quantities in clinical situations. Methods using measured relative depth-dose distributions are presented and evaluated here. Measurements of depth-dose distributions for x-ray beams were performed with an ionization chamber, a diode and a number of TL dosimeters. The energy imparted was calculated from measurements with both phantoms and patients. The method of calculating the mean absorbed dose to organs was applied to pelvis and lumbar spine examinations. TL dosimeters were found to be an appropriate detector for measuring depth-dose distributions. When calculating the energy imparted the entrance beam area must be accurately known. The mean absorbed dose to organs can be derived from measured relative depth-dose curves if accurate information on entrance beam position and area is available for the particular examination technique used. The advantage of these methods is that the dose distribution is measured for the photon beam used for the examination of the patients.

Adolescent↗

PubMed1996

Examination technique, image quality, and patient dose in paediatric radiology. A survey including 19 Swedish hospitals.

PURPOSE: Investigation of examination technique, image quality, and absorbed dose to the patients in paediatric radiology. MATERIAL AND METHODS: In total, 19 Swedish hospitals participated in the study. Using a questionnaire, the hospitals described their examination technique for the pelvis, urinary tract, colon, scoliosis, and lung. The image quality and patient dose were experimentally studied for the simulated pelvis examination of a 1-year-old child. This examination was carried out with a test object containing a contrast-detail phantom. TL dosimeters were used to determine the absorbed dose on the surface of the phantom, approximately corresponding to the absorbed dose on the surface of the patient. RESULTS: Examination techniques varied considerably among the hospitals, the most striking difference concerning the film-screen sensitivity. Consequently, there was a variation in the absorbed dose on the surface of the phantom, from 0.09 mGy to 1.7 mGy (mean 0.65 mGy). For a large range of doses, 0.4-1.7 mGy, the image quality was not significantly different. CONCLUSION: The unharmonized, and in many places unoptimized, examination techniques led to a great variation in the absorbed dose to the children examined.

Child↗

PubMed1995

The radiation dose to children from X-ray examinations of the pelvis and the urinary tract.

X-ray examinations of the pelvis and the urinary tract are frequent examinations of children, in which a large part of the trunk is irradiated. The irradiated volume contains many of the most radiation sensitive organs and tissues. The absorbed dose to children during the examination was estimated from measurements with a dose-area product meter and thermoluminescent dosemeters (TLDs). Entrance surface dose and the dose-area product results are presented. Conversion factors between the entrance surface dose and the organ dose were derived. The energy imparted, organ dose and effective dose were determined. The entrance surface dose for one single exposure varied between 0.32 mGy and 8.6 mGy for the urinary tract examination and between 0.26 mGy and 2.89 mGy per exposure for the pelvis examination. These variations are mainly influenced by the body size of the patient. The number of images taken during one examination varied. For the urinary tract investigation, the average number of exposures was six, while the corresponding number for the pelvis examination was two. The average effective dose for a typical urinary tract investigation ranged from 0.9 mSv to 8.5 mSv and from 0.3 mSv to 1.4 mSv for the pelvis examination. The radiation dose depends greatly on the body size. The recommendations to present the results in relation to age have been followed; however, the variation of body size even within each specified age range is significant. It is suggested that doses should be quoted in relation to a more critical parameter than age.

Adolescent↗

PubMed1991

Absorbed dose to technicians due to induced activity in linear accelerators for radiation therapy.

Absorbed dose to the trunk and to the hands of technicians working with accelerators for radiotherapy have been measured with TL dosimeters for seven different accelerators. The contribution from induced activity in the accelerator and from radiation transmitted through the walls of the treatment room have been estimated separately. The total annual absorbed dose to the trunk and to the hands have been estimated to be 2 mGy, of which the induced activity contributes one-third (0.7 mGy). The exposure of the technicians was found to be dominated by radiation penetrating the walls of the treatment room. For one accelerator the absorbed dose rate in the treatment room was measured continuously between 0.5 min and 48 h after end of treatment. Immediately after irradiation with high-energy photons the radiation is dominated by 28Al and 62Cu T1/2 = 2.3 and 9.7 min respectively) and later by radionuclides with longer half-lives, 187W and 57Ni (T1/2 = 24 and 36 h respectively). Due to these radionuclides the radioactivity in the accelerator will build up and the technicians will therefore be irradiated every time they enter the treatment room and not only directly after a treatment with high-energy photons.

Electrons↗