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Beth A Schueler

Publications and source records attributed to Beth A Schueler.

9 recordsLinked to original sources

Performance evaluation of a computed radiography imaging device using a typical "front side" and novel "dual side" readout storage phosphors.

The Fourier-space modulation transfer function (MTF), normalized noise power spectrum (nNPS), and detective quantum efficiency (DQE) of a computed radiography (CR) x-ray imaging device were measured. Two different storage phosphor screens were used in conjunction with a single CR reader (Fuji, Clearview, CS). One of the storage phosphor plates (ST-BD) had a clear backing material which allowed "dual side read" of the latent image from both the "front" and "back" sides of the phosphor. The other phosphor plate had a light occluding backing material, limiting the readout to front side only (ST-VI). The standard RQA-5 beam quality was used. The MTF was measured using a 1 mm thick tungsten edge device. Compared to the ST-55BD phosphor, the ST-VI phosphor was found to have modestly higher MTF at all spatial frequencies. The nNPS(f) and DQE(f) were measured for nominal incident exposure levels ranging from 0.1 to 10 mR. The dual side read phosphor demonstrated superior DQE, especially at low spatial frequencies. At the frequency 0.5 cycles/mm, the DQE values for the 1 mR exposure were 0.36 and 0.21 for the ST-55BD and ST-VI phosphor plates, respectively. The differences between the spatial-frequency dependent DQE of the two plates can be attributed to the increased signal collection efficiency of the dual side read plates and differences in storage phosphor structure noise.

Humans↗

Reference values for diagnostic radiology: application and impact.

Reference values (RVs) are recommended by the American Association of Physicists in Medicine for four radiographic projections, computed tomography, fluoroscopy, and dental radiography. RVs are used to compare radiation doses from individual pieces of radiographic equipment with doses from similar equipment assessed in national surveys. RVs recommended by the American Association of Physicists in Medicine have been developed from the Nationwide Evaluation of X-ray Trends survey performed by the state radiation protection agencies with the cooperation and support of the U.S. Food and Drug Administration, the Conference of Radiation Control Program Directors, and the American College of Radiology. The RVs selected by the American Association of Physicists in Medicine represent, approximately, the 80th percentile of the survey distributions. Consequently, equipment exceeding the RVs is using higher radiation doses than is 80% of the equipment in the surveys. Radiation doses for specific projections, with standard phantoms, should be measured annually, as recommended by the American College of Radiology. When the RVs are exceeded, the medical physicist should investigate the cause and determine, in cooperation with the responsible radiologist, whether these doses are justified or the imaging system should be optimized to reduce patient radiation doses. RVs are a useful tool for comparing patient radiation doses at institutions throughout the United States and for providing information about radiographic equipment performance.

Equipment Safety↗

3D cerebral angiography: radiation dose comparison with digital subtraction angiography.

BACKGROUND AND PURPOSE: As the use of 3D rotational angiography (3D RA) for the evaluation of cerebral vasculature becomes more widespread, it is important to evaluate this imaging method's effect on patient radiation dose. The purpose of the study is to measure 3D RA radiation dose as compared with biplanar digital subtraction angiography (DSA). METHODS: The distribution and peak skin dose were measured for 3D RA and biplanar DSA by using an anthropomorphic skull phantom. In addition, the cumulative incident dose, summed over all images in each acquisition, was determined. Measurements were acquired for our facility's standard 3D RA acquisition mode (25 degrees /s rotational speed; 162 total frames) and other available acquisition mode selections. RESULTS: For 3D RA, the skin dose was found to be distributed across the back and sides of the skull with the peak skin dose located at the center of the back of the skull. The peak skin dose for the standard 3D RA acquisition mode was 15 mGy. For a biplanar DSA run, the peak skin dose was 58 mGy, also located at the back of the skull. The cumulative incident dose for the standard 3D RA acquisition mode was 33 mGy, compared with 53 mGy for biplanar DSA. CONCLUSION: The patient radiation dose for 3D RA is significantly lower than for biplanar DSA, by nearly a factor of 4 in peak skin dose and 40% lower in cumulative incident dose.

Angiography, Digital Subtraction↗

Radiation doses in interventional radiology procedures: the RAD-IR Study. Part III: Dosimetric performance of the interventional fluoroscopy units.

PURPOSE: To present the physics data supporting the validity of the clinical dose data from the RAD-IR study and to document the performance of dosimetry-components of these systems over time. MATERIALS AND METHODS: Sites at seven academic medical centers in the United States prospectively contributed data for each of 12 fluoroscopic units. All units were compatible with International Electrotechnical Commission (IEC) standard 60601-2-43. Comprehensive evaluations and periodic consistency checks were performed to verify the performance of each unit's dosimeter. Comprehensive evaluations compared system performance against calibrated ionization chambers under nine combinations of operating conditions. Consistency checks provided more frequent dosimetry data, with use of each unit's built-in dosimetry equipment and a standard water phantom. RESULTS: During the 3-year study, data were collected for 48 comprehensive evaluations and 581 consistency checks. For the comprehensive evaluations, the mean (95% confidence interval range) ratio of system to external measurements was 1.03 (1.00-1.05) for fluoroscopy and 0.93 (0.90-0.96) for acquisition. The expected ratio was 0.93 for both. For consistency checks, the values were 1.00 (0.98-1.02) for fluoroscopy and 1.00 (0.98-1.02) for acquisition. Each system was compared across time to its own mean value. Overall uncertainty was estimated by adding the standard deviations of the comprehensive and consistency measurements in quadrature. The authors estimate that the overall error in clinical cumulative dose measurements reported in RAD-IR is 24%. CONCLUSION: Dosimetric accuracy was well within the tolerances established by IEC standard 60601-2-43. The clinical dose data reported in the RAD-IR study are valid.

Fluoroscopy↗

Radiation doses in interventional radiology procedures: the RAD-IR study: part I: overall measures of dose.

PURPOSE: To determine patient radiation doses for interventional radiology and neuroradiology procedures, to identify procedures associated with higher radiation doses, and to determine the effects of various parameters on patient doses. MATERIALS AND METHODS: A prospective observational study was performed at seven academic medical centers. Each site contributed demographic and radiation dose data for subjects undergoing specific procedures in fluoroscopic suites equipped with built-in cumulative dose (CD) and dose-area-product (DAP) measurement capability compliant with International Electrotechnical Commission standard 60601-2-43. The accuracy of the dosimetry was confirmed by comprehensive measurements and by frequent consistency checks performed over the course of the study. RESULTS: Data were collected on 2,142 instances of interventional radiology procedures, 48 comprehensive physics evaluations, and 581 periodic consistency checks from the 12 fluoroscopic units in the study. There were wide variations in dose and statistically significant differences in fluoroscopy time, number of images, DAP, and CD for different instances of the same procedure, depending on the nature of the lesion, its anatomic location, and the complexity of the procedure. For the 2,142 instances, observed CD and DAP correlate well overall (r = 0.83, P <.000001), but correlation in individual instances is poor. The same is true for the correlation between fluoroscopy time and CD (r = 0.79, P <.000001). The correlation between fluoroscopy time and DAP (r = 0.60, P <.000001) is not as good. In 6% of instances (128 of 2,142), which were principally embolization procedures, transjugular intrahepatic portosystemic shunt (TIPS) procedures, and renal/visceral artery stent placements, CD was greater than 5 Gy. CONCLUSIONS: Most procedures studied can result in clinically significant radiation dose to the patient, even when performed by trained operators with use of dose-reducing technology and modern fluoroscopic equipment. Embolization procedures, TIPS creation, and renal/visceral artery stent placement are associated with a substantial likelihood of clinically significant patient dose. At minimum, patient dose data should be recorded in the medical record for these three types of procedures. These data should include indicators of the risk of deterministic effects as well as the risk of stochastic effects.

Adolescent↗

Radiation doses in interventional radiology procedures: the RAD-IR study: part II: skin dose.

PURPOSE: To determine peak skin dose (PSD), a measure of the likelihood of radiation-induced skin effects, for a variety of common interventional radiology and interventional neuroradiology procedures, and to identify procedures associated with a PSD greater than 2 Gy. MATERIALS AND METHODS: An observational study was conducted at seven academic medical centers in the United States. Sites prospectively contributed demographic and radiation dose data for subjects undergoing 21 specific procedures in a fluoroscopic suite equipped with built-in dosimetry capability. Comprehensive physics evaluations and periodic consistency checks were performed on each unit to verify the stability and consistency of the dosimeter. Seven of 12 fluoroscopic suites in the study were equipped with skin dose mapping software. RESULTS: Over a 3-year period, skin dose data were recorded for 800 instances of 21 interventional radiology procedures. Wide variation in PSD was observed for different instances of the same procedure. Some instances of each procedure we studied resulted in a PSD greater than 2 Gy, except for nephrostomy, pulmonary angiography, and inferior vena cava filter placement. Some instances of transjugular intrahepatic portosystemic shunt (TIPS) creation, renal/visceral angioplasty, and angiographic diagnosis and therapy of gastrointestinal hemorrhage produced PSDs greater than 3 Gy. Some instances of hepatic chemoembolization, other tumor embolization, and neuroembolization procedures in the head and spine produced PSDs greater than 5 Gy. In a subset of 709 instances of higher-dose procedures, there was good overall correlation between PSD and cumulative dose (r = 0.86; P <.000001) and between PSD and dose-area-product (r = 0.85, P <.000001), but there was wide variation in these relationships for individual instances. CONCLUSIONS: There are substantial variations in PSD among instances of the same procedure and among different procedure types. Most of the procedures observed may produce a PSD sufficient to cause deterministic effects in skin. It is suggested that dose data be recorded routinely for TIPS creation, angioplasty in the abdomen or pelvis, all embolization procedures, and especially for head and spine embolization procedures. Measurement or estimation of PSD is the best method for determining the likelihood of radiation-induced skin effects. Skin dose mapping is preferable to a single-point measurement of PSD.

Fluoroscopy↗

Performance evaluation of a "dual-side read" dedicated mammography computed radiography system.

The image quality of a dedicated mammography computed radiography (CR) system was characterized. A unique feature of this system is that it collects image signals from both sides of the storage phosphor. Measurements of the modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) were made. This work included improvements in our measurement methods to specifically account for the detrimental effects of system glare on the MTF and to accurately characterize the low-frequency NPS components. Image quality measurements were performed using a 25 kVp beam filtered with 2 mm Al and an exposure range of 1 to 100 mR (87 to 870 microGy). The DQE was found to decrease with increasing exposure due to an increased contribution of storage phosphor structure noise. The DQE of this system was compared to similar measurements made using a standard CR system. The dual-side read system demonstrated superior DQE compared to the standard system. The decrease in DQE with increasing exposure was more severe for the standard system than the dual-side read system. This finding suggests that the CR system noise was reduced for the dual-side read system compared to the standard system.

Equipment Failure Analysis↗

Measurement of the presampled two-dimensional modulation transfer function of digital imaging systems.

The purpose of this work was to develop methods to measure the presampled two-dimensional modulation transfer function (2D MTF) of digital imaging systems. A custom x-ray "point source" phantom was created by machining 256 holes with diameter 0.107 mm through a 0.5-mm-thick copper plate. The phantom was imaged several times, resulting in many images of individual x-ray "spots." The center of each spot (with respect to the pixel matrix) was determined to subpixel accuracy by fitting each spot to a 2D Gaussian function. The subpixel spot center locations were used to create a 5 x oversampled system point spread function (PSF), which characterizes the optical and electrical properties of the system and is independent of the pixel sampling of the original image. The modulus of the Fourier transform of the PSF was calculated. Next, the Fourier function was normalized to the zero frequency value. Finally, the Fourier transform function was divided by the first-order Bessel function that defined the frequency content of the holes, resulting in the presampled 2D MTF. The presampled 2D MTF of a 0.1 mm pixel pitch computed radiography system and 0.2 mm pixel pitch flat panel digital imaging system that utilized a cesium iodide scintillator was measured. Comparison of the axial components of the 2D MTF to one-dimensional MTF measurements acquired using an edge device method demonstrated that the two methods produced consistent results.

Biophysical Phenomena↗

An investigation of operator exposure in interventional radiology.

A study was conducted to investigate how operator exposure in interventional radiology is affected by various common fluoroscopic imaging conditions. Stray radiation levels surrounding the imaging chain of a C-arm angiographic system were measured with an anthropomorphic abdomen phantom under different imaging conditions, and isodose curves were constructed. Operator exposure was shown to increase with patient dose-area product as the imaging field of view (FOV) is changed, with the highest scatter levels occurring with an intermediate-sized FOV. Use of copper spectral beam filtration was found to result in decreased operator exposure, whereas use of wedge-shaped equalization filters was found to increase exposure. The effect of increasing patient abdomen thickness was simulated by surrounding the phantom with plastic bolus material. Increasing the thickness by 5 cm resulted in a doubling of exposure at the operator's waist. Exposure to the operator's upper body was significantly reduced when the FOV was positioned on the far side of the patient. Operator exposure can be maintained at an acceptable level by taking these variables into consideration and incorporating the suggested dose reduction techniques into routine practice to the greatest extent possible.

Body Burden↗