PubMed Health⌕ Search

Biomedical subjects

J F Valley

Publications and source records attributed to J F Valley.

At least 19 recordsLinked to original sources

[CT utilisation in Switzerland: frequency and secular trends].

PURPOSE: This study analyzes CT examinations in Switzerland. MATERIALS AND METHODS: Using different sources (administrative data on the equipment, a 1998 nationwide inquiry into practices, and data provided by the Swiss University Hospitals of Basel, Zurich, and Lausanne), we determined the frequency of CT examinations (hospitals and private radiologists) in 1998 according to different descriptive variables and studied the progression in CT use over time. RESULTS: CT scanners increased by 7% between 1998 and 2004. The average annual number of CT examinations in 1998 was 46.3/1000 population, 3.4% of all radiological examinations in Switzerland in 1997-1998. The most frequent examination was CT of the skull (24%), while private radiology institutes perform more CTs of the spine. More CT examinations were performed for men than for women (sex ratio M/F=1.17). The average annual increase in CT in Swiss hospitals varied from 8% for Basel to 18% for Lausanne. Finally, the proportion of pediatric examinations was 5%; their numbers appear to be stabilizing. CONCLUSION: There is a significant increase in CT examinations. It is hoped that our study will heighten awareness among doctors of CT examinations in order to optimize their use.

Humans↗

Performance comparison of an active matrix flat panel imager, computed radiography system, and a screen-film system at four standard radiation qualities.

Four standard radiation qualities (from RQA 3 to RQA 9) were used to compare the imaging performance of a computed radiography (CR) system (general purpose and high resolution phosphor plates of a Kodak CR 9000 system), a selenium-based direct flat panel detector (Kodak Direct View DR 9000), and a conventional screen-film system (Kodak T-MAT L/RA film with a 3M Trimax Regular screen of speed 400) in conventional radiography. Reference exposure levels were chosen according to the manufacturer's recommendations to be representative of clinical practice (exposure index of 1700 for digital systems and a film optical density of 1.4). With the exception of the RQA 3 beam quality, the exposure levels needed to produce a mean digital signal of 1700 were higher than those needed to obtain a mean film optical density of 1.4. In spite of intense developments in the field of digital detectors, screen-film systems are still very efficient detectors for most of the beam qualities used in radiology. An important outcome of this study is the behavior of the detective quantum efficiency of the digital radiography (DR) system as a function of beam energy. The practice of users to increase beam energy when switching from a screen-film system to a CR system, in order to improve the compromise between patient dose and image quality, might not be appropriate when switching from screen-film to selenium-based DR systems.

Radiographic Image Enhancement↗

Quantitative characterization of edge enhancement in phase contrast x-ray imaging.

The aim of this study was to model the edge enhancement effect in in-line holography phase contrast imaging. A simple analytical approach was used to quantify refraction and interference contrasts in terms of beam energy and imaging geometry. The model was applied to predict the peak intensity and frequency of the edge enhancement for images of cylindrical fibers. The calculations were compared with measurements, and the relationship between the spatial resolution of the detector and the amplitude of the phase contrast signal was investigated. Calculations using the analytical model were in good agreement with experimental results for nylon, aluminum and copper wires of 50 to 240 microm diameter, and with numerical simulations based on Fresnel-Kirchhoff theory. A relationship between the defocusing distance and the pixel size of the image detector was established. This analytical model is a useful tool for optimizing imaging parameters in phase contrast in-line holography, including defocusing distance, detector resolution and beam energy.

Biophysical Phenomena↗

Nation-wide survey on radiation doses in diagnostic and interventional radiology in Switzerland in 1998.

A nation-wide survey on radiation doses in diagnostic and interventional radiology was conducted in Switzerland in 1998 aiming at establishing their collective radiological impact on the Swiss population. The study consisted on the one hand of surveying the frequency of more than 250 types of examinations, covering conventional radiology, mammography, fluoroscopy, angiography, interventional radiology, CT, bone densitometry, conventional tomography and dental radiology. On the other hand, for each type of examination the associated patient dose was established by modeling. The results of this study show that about 9.5 million diagnostic and interventional examinations are performed annually in Switzerland (1.34 per caput) and that the associated annual collective dose is of the order of 7100 person.Sv (1.0 mSv per caput). Switzerland is similar to other European countries in terms of the frequency of examinations and the collective dose.

Environmental Exposure↗

Dosimetric aspects of a national survey of diagnostic and interventional radiology in Switzerland.

The effective dose delivered to the patient was determined, by modeling, for 257 types of examinations covering the different modalities of diagnostic and interventional radiology. The basic operational dosimetric quantities considered were obtained from the parameters of the examinations on the basis of dosimetric models. These models required a precise characterization of each examination. The operational dosimetric quantities were converted into doses to organs and effective doses using appropriate conversion factors. The determination of the collective effective dose to the Swiss population requires a number of corrections to account for the variability of several parameters: sensitivity of the detection system, age, gender, and build of the patient. The use of various dosimetric models is illustrated in this paper for a limited number of examination types covering the different radiological modalities, for which the established typical effective doses are given. With regard to individual doses, the study indicated that the average effective doses per type of examination can be classified into three levels: (a) the weakly irradiating examinations (less than 0.1 mSv), which represent 78% of the examinations and 4% of the collective dose, (b) the moderately irradiating examinations (between 0.1 mSv and 10 mSv), which represent 21% of the examinations and 72% of the collective dose, (c) the strongly irradiating examinations (more than 10 mSv), which represent 1% of the examinations and 24% of the collective dose.

Adolescent↗

Calibration of ionization chambers in air kerma length.

Pencil ionization chambers are employed for the direct determination of the computed tomography dose index (CTDI), which is used for patient dosimetry in CT examinations. The chambers are calibrated in air kerma length in a reference x-ray field. The precision of calibration is influenced by several factors which are investigated in the present work. It is shown that the best irradiation length is 50% of the chamber rated length. The reading must be corrected for a residual signal due to the irradiation of the sensitive chamber volume by scattered radiation. The origin of this radiation is identified mainly at the edges of the diaphragm limiting the useful field. The residual signal is determined by a linear fit of measurements performed at minimum of three diaphragm apertures. The optimum geometric conditions are also discussed.

Air↗

Objective comparison of image quality and dose between conventional and synchrotron radiation mammography.

The shape of the energy spectrum produced by an x-ray tube has a great importance in mammography. Many anode-filtration combinations have been proposed to obtain the most effective spectrum shape for the image quality-dose relationship. On the other hand, third generation synchrotrons such as the European Synchrotron Radiation Facility in Grenoble are able to produce a high flux of monoenergetic radiation. It is thus a powerful tool to study the effect of beam energy on image quality and dose in mammography. An objective method was used to evaluate image quality and dose in mammography with synchrotron radiation and to compare them to standard conventional units. It was performed systematically in the energy range of interest for mammography through the evaluation of a global image quality index and through the measurement of the mean glandular dose. Compared to conventional mammography units, synchrotron radiation shows a great improvement of the image quality-dose relationship, which is due to the beam monochromaticity and to the high intrinsic collimation of the beam, which allows the use of a slit instead of an anti-scatter grid for scatter rejection.

Dose-Response Relationship, Radiation↗

A real-time flat-panel X-ray pixel imaging system for low-dose medical diagnostics and craniofacial applications.

The aim of this study was to evaluate on-line performance of a real-time digital imaging system based on amorphous silicon technology and to compare it with conventional film-screen equipment. The digital detecting imager consists of (1) a converter, which transforms the energy of the incident X rays into light; (2) a real-time digital detecting system, capable of producing as many as 10 pictures per second using a large-area pixel matrix (20 x 20 cm2) based on solid-state amorphous silicon sensor technology with a pitch of 400 microns; and (3) appropriate computer tools for control, real-time image treatment, data representation, and off-line analysis. Different phantoms were used for qualitative comparison with the conventional film-screen technique, with images obtained with both systems at the normal dose (used as a reference), as well as with dose reduction by a factor of 10 to 100. Basic image quality parameters evaluated showed that the response of the detector is linear in a wide range of entrance air kerma; the dynamic range is higher compared with the conventional film-screen combination; the spatial resolution is 1.25 lp per millimeter, as expected from the pixel size; and good image quality is ensured at doses substantially lower than for the film-screen technique. The flat-panel X-ray imager based on amorphous silicon technology implemented in standard radiographic equipment permits acquisition of real-time images in radiology (as many as 10 images per second) of diagnostic quality with a marked reduction of dose (as much as 100 times) and better contrast compared with the standard film technique. Preliminary results obtained with a 100-micron pitch imager based on the same technology show better quality but a less substantial dose reduction. Applications in craniofacial surgery look promising.

Analog-Digital Conversion↗

Radiation doses delivered to radiologists during contrast-enhanced helical-CT examinations.

This work monitors the radiation doses to a radiologist during supervision of automatic contrast media injections during helical-CT examinations of the chest and abdomen. Forty consecutive standard helical-CT examinations of adult's chest and/or abdomen were monitored with five dosimeters worn by the radiologist supervising the entire injection with the hand on the injection site. Mean doses per examination measured at chest, thyroid gland, and hand levels were 11, 16, and 130 microGy, respectively, during chest examinations, and 5, 7, and 55 microGy during abdominal examinations. According to the high number of CT examinations performed, wearing lead apron, special lead glove protection, and thyroid shield is highly recommended.

Adult↗

Estimation of the noisy component of anatomical backgrounds.

The knowledge of the relationship that links radiation dose and image quality is a prerequisite to any optimization of medical diagnostic radiology. Image quality depends, on the one hand, on the physical parameters such as contrast, resolution, and noise, and on the other hand, on characteristics of the observer that assesses the image. While the role of contrast and resolution is precisely defined and recognized, the influence of image noise is not yet fully understood. Its measurement is often based on imaging uniform test objects, even though real images contain anatomical backgrounds whose statistical nature is much different from test objects used to assess system noise. The goal of this study was to demonstrate the importance of variations in background anatomy by quantifying its effect on a series of detection tasks. Several types of mammographic backgrounds and signals were examined by psychophysical experiments in a two-alternative forced-choice detection task. According to hypotheses concerning the strategy used by the human observers, their signal to noise ratio was determined. This variable was also computed for a mathematical model based on the statistical decision theory. By comparing theoretical model and experimental results, the way that anatomical structure is perceived has been analyzed. Experiments showed that the observer's behavior was highly dependent upon both system noise and the anatomical background. The anatomy partly acts as a signal recognizable as such and partly as a pure noise that disturbs the detection process. This dual nature of the anatomy is quantified. It is shown that its effect varies according to its amplitude and the profile of the object being detected. The importance of the noisy part of the anatomy is, in some situations, much greater than the system noise. Hence, reducing the system noise by increasing the dose will not improve task performance. This observation indicates that the tradeoff between dose and image quality might be optimized by accepting a higher system noise. This could lead to a better resolution, more contrast, or less dose.

Biophysics↗

Quality assurance of the EORTC radiotherapy trial 22931 for head and neck carcinomas: the dummy run.

PURPOSE: A dummy run was organized to test the compliance of participating centres with the guidelines of EORTC protocol 22931, which compares high dose radiotherapy with concomitant radiochemotherapy in a postoperative setting for patients presenting with locally advanced head and neck carcinomas. METHODS: In a first step the participants (seven centres, six replies) were asked to define the planning target volume (PTV) in a given patient on the basis of clinical, surgical and radiological (CT-images) data-sets and according to the protocol guidelines. In a second phase a series of CT-reconstructed slices with on- and off-axis PTV outlines were sent to 11 centres (10 replies), which were asked to plan a treatment following the recommendations made in the frame of the trial. RESULTS: The first step of this dummy run emphasized wide intercentre variations in PTV extensions. This fact raises the question of the reproducibility when pooling patients in multicentric trials. The second step indicated a large variability in the field arrangements which was left to the discretion of the investigators. Only three out of 10 of the institutions followed the ICRU 50 recommendations for dose reporting. Moreover, protocol requirements were not met for dose distribution homogeneity in any centre. CONCLUSIONS: In order to reduce intercentre treatment heterogeneities, several actions have been taken by the EORTC Radiotherapy Group, e.g. amendments have been brought to protocol 22931 regarding a better definition of clinical and planning target volumes. Furthermore, a stricter application of the ICRU 50 recommendations for dose reporting has been sought.

Carcinoma, Squamous Cell↗

Transfer of information between angiographic films and CT images: a technique to control the drawing of target volumes.

BACKGROUND AND PURPOSE: This work was undertaken to improve the definition of target volumes for radiosurgery using the angiographic and CT data. MATERIALS AND METHODS: The basis of this new method is to combine both imaging modalities and to compare them in each representation, i.e. to plot the volume obtained by angiography on CT images and also the contours defined by the CT on angiographic films. To obtain the angiographic volume, the radiographs are taken at several incidence angles. The X-ray sources position and the position of the films are determined using rectangular markers, then the intersection of all the loci of the target volume are calculated. RESULTS: Verifications with a phantom show the accuracy of the procedure and the benefit obtained by increasing the number of angles of incidence in the angiographic imaging. The centre of gravity of the experimental target could be localized to an accuracy of better than 0.4 mm. The method was used in 11 clinical cases with excellent clinical results. CONCLUSIONS: The method can be easily applied and improves the delineation of target volumes in radiosurgery. CT data counterbalances the relative weakness of angiography concerning the three-dimensional geometry. Angiography adds useful information on the blood flow that is not shown in CT. Almost all the presented clinical cases benefit from the technique described here.

Angiography↗

Use of passive detectors to characterize neutron field hardness.

Most personnel neutron dosimeters and field monitors suffer from an energy dependence. The knowledge of the energy distribution of the measured neutron field is necessary to correct the response of the detectors. However, the response of the detectors can be significantly improved when only a simple idea of the spectrum hardness is available. This paper describes a way of characterizing the neutron spectrum hardness in a large variety of neutron fields (with energies extending from thermal to 100 MeV) by using the various indications of different types of passive neutron detectors. These indications allow the choice of the appropriate factors established by calibration measurements or taken from the literature to correct the energy dependent response of personnel neutron dosimeters and field monitors.

Air Pollution, Indoor↗

Image quality and dose in spiral computed tomography.

Image quality and dose produced by a spiral CT with various pitch values were investigated on the basis of test-object images and measurements of CT dose indexes. No major difference in image quality or dose was observed when comparing sequential and spiral mode acquisition with a pitch of one. Increase in pitch value produces a loss of contrast which leads to a loss of detectability. Nevertheless, in realistic protocols the image quality in the transverse plane remains acceptable up to pitch values of 1.3-1.6.

Artifacts↗

The fission track detector revisited: application to individual neutron dosimetry.

A system based on fission fragment tracks had previously been developed for individual neutron dosimetry. The dosimeter detects both fast neutrons by means of the 232Th(n,f) reaction, and thermal and albedo neutrons by means of the 235U(n,f) reaction. The fission tracks produced in a plastic foil are chemically etched and counted by spark discharges. The response of the dosimeter has recently been re-investigated in 36 different neutron fields: monoenergetic beams, reference fields near isotopic sources, and radiation fields encountered in a variety of situations inside nuclear power plants. The results obtained have been compared to those computed by convolution of the neutron spectra with the energy response functions of the dosimeters. In practical situations, it is essential to know the shape of the neutron spectrum, approximately at least, in order to perform an acceptably accurate dose evaluation. For that purpose, the neutron fields encountered inside nuclear power plants have been grouped into four categories, for which algorithms for dose evaluation have been developed. Concerning the neutron equivalent dose, the error associated with this approach does not exceed a factor of 2, a performance which is comparable to other detection systems used in the field of individual neutron dosimetry.

Neutrons↗

Survey on image quality and dose levels used in Europe for mammography.

Quality assurance programmes are becoming a common practice in the field of mammography. At the present time several recommendations exist and different test objects are used to optimize this radiological procedure. The goal of this study was to check if geographically distant centres using different quality control procedures were comparable when using a common objective way of assessing image quality. The results show that consensus still needs to be found among radiologists to reach a satisfactory level of harmony between patient doses and image quality in Europe.

Europe↗

Comparison of treatment techniques for lung cancer.

A comparison of the treatment techniques for a typical case of lung cancer has been performed between 10 Swiss radiation oncology centers. The description and basic imaging data of a locally advanced non-metastatic lung cancer were sent to each institution and participants were asked to perform the treatment planning as for a routine case. The comparison shows that, in addition to a broad spectrum of treatment techniques, there was a significant variation in the major treatment parameters: definition of the target volume, prescription procedure, total dose to the tumor and dose per fraction. Although some reasons could be found to partially explain these differences, the lessons learned from this comparison are, first, that a standardization, in particular for dose prescription, is urgently needed, and, second, that a search for a better consensus in standard managements should be promoted in radiation oncology.

Carcinoma, Non-Small-Cell Lung↗

Image quality index (IQI) for screen-film mammography.

A suitable quantity for evaluating the image quality in mammography is the smallest visible size of an object. This quantity, called the image quality index (IQI), can be derived from the basic image parameters: contrast, MTF, Wiener spectrum. Several evaluation methods of the IQI, all based on statistical decision theory, have been considered. An experimental visibility test using simulated microcalcifications has been performed in order to compare the results obtained with different IQI models. A previous approach, based on simplifying assumptions, yields a good correlation with the visibility test but fails to predict the actual size of the visible objects. Improved models have been derived for an ideal observer and for a 'quasi-ideal' one with perfect or with realistic visual characteristics. The experimental visual results are well modelled by the IQI method, provided that a suitable threshold signal-to-noise ratio is used for each of these models.

Animals↗