PubMed Health⌕ Search

Biomedical subjects

Michael Sandborg

Publications and source records attributed to Michael Sandborg.

11 recordsLinked to original sources

Estimation of dose to the unborn child at diagnostic X-ray examinations based on data registered in RIS/PACS.

The aim of this work was to determine mean absorbed doses to the unborn child in common conventional X-ray and computed tomography (CT) examinations and to find an approach for estimating foetal dose based on data registered in the Radiological Information System/Picture Archive and Communication System (RIS/PACS). The kerma-area product (KAP) and CT dose index (CTDI(vol)) in common examinations were registered using a human-shaped female dosimetry phantom. Foetal doses, D(f), were measured using thermoluminescent dosimeters placed inside the phantom and compared with calculated values. Measured foetal doses were given in relation to the KAP and the CTDI(vol) values, respectively. Conversion factor D(f)/KAP varies between 0.01 and 3.8 mGy/Gycm(2), depending on primary beam position, foetus age and beam quality (tube voltage and filtration). Conversion factors D(f)/CTDI(vol) are in the range 0.02 - 1.2 mGy/mGy, in which the foetus is outside or within the primary beam. We conclude that dose conversion factors based on KAP or CTDI(vol) values automatically generated by the RIS/PACS system can be used for rapid estimations of foetal dose for common examination techniques.

Female↗

Towards optimization in digital chest radiography using Monte Carlo modelling.

A Monte Carlo based computer model of the x-ray imaging system was used to investigate how various image quality parameters of interest in chest PA radiography and the effective dose E vary with tube voltage (90-150 kV), additional copper filtration (0-0.5 mm), anti-scatter method (grid ratios 8-16 and air gap lengths 20-40 cm) and patient thickness (20-28 cm) in a computed radiography (CR) system. Calculated quantities were normalized to a fixed value of air kerma (5.0 microGy) at the automatic exposure control chambers. Soft-tissue nodules were positioned at different locations in the anatomy and calcifications in the apical region. The signal-to-noise ratio, SNR, of the nodules and the nodule contrast relative to the contrast of bone (C/C(B)) as well as relative to the dynamic range in the image (C(rel)) were used as image quality measures. In all anatomical regions, except in the densest regions in the thickest patients, the air gap technique provides higher SNR and contrast ratios than the grid technique and at a lower effective dose E. Choice of tube voltage depends on whether quantum noise (SNR) or the contrast ratios are most relevant for the diagnostic task. SNR increases with decreasing tube voltage while C/C(B) increases with increasing tube voltage.

Humans↗

Comparison of clinical and physical measures of image quality in chest and pelvis computed radiography at different tube voltages.

The aim of this work was to study the dependence of image quality in digital chest and pelvis radiography on tube voltage, and to explore correlations between clinical and physical measures of image quality. The effect on image quality of tube voltage in these two examinations was assessed using two methods. The first method relies on radiologists' observations of images of an anthropomorphic phantom, and the second method was based on computer modeling of the imaging system 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 the same effective dose was achieved for each projection. Two x-ray units were employed using a computed radiography (CR) image detector with standard tube filtration and antiscatter 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 a Monte Carlo computer model in terms of the signal-to-noise ratio, SNR, of anatomical structures corresponding to the image criteria. Both the VGAS (visual grading analysis score) and SNR decrease with increasing tube voltage in both chest PA and pelvis AP examinations, indicating superior performance if lower tube voltages are employed. Hence, 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 analog screen-film radiography are discussed, as well as the relevance of using VGAS and quantum-noise SNR as measures of image quality in pelvis and chest radiography.

Algorithms↗

A search for optimal x-ray spectra in iodine contrast media mammography.

The aim of this work was to search for the optimal x-ray tube voltage and anode-filter combination in digital iodine contrast media mammography. In the optimization, two entities were of interest: the average glandular dose, AGD, and the signal-to-noise ratio, SNR, for detection of diluted iodine contrast medium. The optimum is defined as the technique maximizing the figure of merit, SNR2/AGD. A Monte Carlo computer program was used which simulates the transport of photons from the x-ray tube through the compression plate, breast, breast support plate, anti-scatter grid and image detector. It computes the AGD and the SNR of an iodine detail inside the compressed breast. The breast thickness was varied between 2 and 8 cm with 10-90% glandularity. The tube voltage was varied between 20 and 55 kV for each anode material (Rh, Mo and W) in combination with either 25 microm Rh or 0.05-0.5 mm Cu added filtration. The x-ray spectra were calculated with MCNP4C (Monte Carlo N-Particle Transport Code System, version 4C). A CsI scintillator was used as the image detector. The results for Rh/0.3 mmCu, Mo/0.3 mmCu and W/0.3 mmCu were similar. For all breast thicknesses, a maximum in the figure of merit was found at approximately 45 kV for the Rh/Cu, Mo/Cu and W/Cu combinations. The corresponding results for the Rh/Rh combination gave a figure of merit that was typically lower and more slowly varying with tube voltage. For a 4 cm breast at 45 kV, the SNR2/AGD was 3.5 times higher for the Rh/0.3 mmCu combination compared with the Rh/Rh combination. The difference is even larger for thicker breasts. The SNR2/AGD increases slowly with increasing Cu-filter thickness. We conclude that tube voltages between 41 and 55 kV and added Cu-filtration will result in significant dose advantage in digital iodine contrast media mammography compared to using the Rh/Rh anode/filter combination at 25-32 kV.

Algorithms↗

Inter-observer variation in masked and unmasked images for quality evaluation of clinical radiographs.

PURPOSE: To investigate the influence of masking on the inter-observer variation in image quality evaluation of clinical radiographs of chest and lumbar spine. BACKGROUND: Inter-observer variation is a big problem in image quality evaluation since this variation is often much bigger than the variation in image quality between, for example, two radiographic systems. In this study, we have evaluated the effect of masking on the inter-observer variation. The idea of the masking was to force every observer to view exactly the same part of the image and to avoid the effect of the overall 'first impression' of the image. A discussion with a group of European expert radiologists before the study indicated that masking might be a good way to reduce the inter-observer variation. METHODS: Five chest and five lumbar spine radiographs were collected together with detailed information regarding exposure conditions. The radiographs were digitised with a high-performance scanner and five different manipulations were performed, simulating five different exposure conditions. The contrast, noise and spatial resolution were manipulated by this method. The images were printed onto the film and the individual masks were produced for each film, showing only the parts of the images that were necessary for the image quality evaluation. The quality of the images was evaluated on ordinary viewing boxes by a large group of experienced radiologists. The images were examined with and without the masks with a set of image criteria (if fulfilled, 1 point; and not fulfilled, 0 point), and the mean score was calculated for each simulated exposure condition. RESULTS: The results of this study indicate that-contrary to what was supposed-the inter-observer variation increased when the images were masked. In some cases, especially for chest, this increase was statistically significant. CONCLUSIONS: Based on the results of this study, image masking in studies of fulfilment of image criteria cannot be recommended.

Computers↗

Distributions of scatter-to-primary and signal-to-noise ratios per pixel in digital chest imaging.

The aim of this work was to calculate distributions of scatter-to-primary ratios (epsilon(s)/epsilon(p)) and signal-to-noise ratios per pixel (SNRp) in chest images. Such distributions may provide useful information on how physical image quality (contrast, SNR) is distributed over the posterior/anterior (PA) chest image. A Monte Carlo computer program was used for the calculations, including a model of both the patient (voxel phantom) and the imaging system (X-ray tube, anti-scatter grid and image detector). The calculations were performed for three PA thicknesses 20, 24 and 28 cm. For a 24 cm patient, the epsilon(s)/epsilon(p) varies between 0.5 in the lung to 2.5 behind the spine and heart. The corresponding variation of the SNRp is a factor of 3, with the highest values in the lung. Increasing the patient thickness from 20 to 28 cm increases the epsilon(s)/epsilon(p) by a factor of 2.2 behind the spine and heart.

Computers↗

Effect of scatter on reconstructed image quality in cone beam computed tomography: evaluation of a scatter-reduction optimisation function.

The effect of scatter on reconstructed image quality in cone beam computed tomography was investigated and a function which can be used in scatter-reduction optimisation tasks was tested. Projections were calculated using the Monte Carlo method in an axially symmetric cone beam geometry consisting of a point source, water phantom and a single row of detector elements. Image reconstruction was performed using the filtered backprojection method. Image quality was assessed by the L2-norm-based difference relative to a reference image derived from (1) weighted linear attenuation coefficients and (2) projections by primary photons. It was found that the former function was strongly affected by the beam hardening artefact and did not properly reflect the amount of scatter but the latter function increased with increasing beam width, was higher for the larger phantom and exhibited properties which made it a good candidate for scatter-reduction optimisation tasks using polyenergetic beams.

Algorithms↗

The influence of patient thickness and imaging system on patient dose and physical image quality in digital chest imaging.

The aim of this work was to study the influence of patient thickness, tube voltage and image detector on patient dose, contrast and ideal observer signal-to-noise ratio (SNR(I)), for pathological details positioned at different regions in the image in posterior-anterior (PA) chest radiology. A Monte Carlo computational model was used to compute measures of physical image quality (contrast, SNR(I)) and patient effective dose, E. Two metastasis-like details positioned in the central right lung and right lung near the spine, respectively, were studied. The tube voltage was varied between 100 and 150 kV and the patient thickness between 20 and 28 cm. Both, a computed radiography (CR) system and a direct radiography (DR) system, were investigated. The DR system provides both lower doses and better image quality compared with the CR system. The SNR(I)2/E is approximately 2.9 times higher for the DR system compared with the CR system.

Artifacts↗

Evaluation of image quality of lumbar spine images: a comparison between FFE and VGA.

PURPOSE: The aim of the present study is to compare two different methods for evaluation of the quality of clinical X-ray images. 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: In the VGA study, images with low noise were 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 sharpness and the noise level. No correlation was found between the two image quality measures. CONCLUSIONS: FFE is a precise method for evaluation of image quality, but the results are only valid for the type of lesion used in the study, whereas VGA is a more general method for clinical image quality assessment. The results of the FFE study indicate that there might be a potential to lower the dose levels in lumbar spine radiography without losing important diagnostic information.

Calibration↗

How should low-contrast detail detectability be measured in fluoroscopy?

The relationship and precision of four methods for measuring the low-contrast detail detectability in fluoroscopic imaging were studied. These included the physical measurement of the accumulation rate of the square of the signal-to-noise ratio (SNR(rate)2), two-alternative forced-choice (2-AFC) experiments, sixteen-alternative forced-choice (16-AFC) experiments and subjective determination of the threshold contrast. The precision and sensitivity of the threshold contrast measurement were seen to be modest in the constancy testing of fluoroscopic equipment: only large changes in system performance could be reliably detected by that method. The measurement of the SNR(rate)2 is suggested instead. The relationship between the results of the various methods were studied, and it was found that human performance can be related to SNR(rate)2 by introducing the concept of the effective image information integration time (t(eff)). When measured for an unlimited observation time, it depicts the saturation of human performance in detecting a static low-contrast detail in dynamic image noise. Here, t(eff) was found to be about 0.6 s in 2-AFC tests and 0.3 s in 16-AFC tests.

Algorithms↗

Evaluation of patient-absorbed doses during coronary angiography and intervention by femoral and radial artery access.

The aim of this study was to compare the radiation dose to patients during coronary angiography (CA) and coronary intervention (percutaneous transluminal coronary angioplasty, PTCA) by the femoral or radial artery access routes. A plane-parallel ionisation chamber, mounted on an under-couch X-ray tube (Siemens Coroskop TOP with an optional dose reduction system), recorded the dose-area product (DAP) to the patient from 40 coronary angiographies and 42 coronary interventions by the femoral route. The corresponding numbers for radial access were 36 and 24, respectively. Using a human-shaped phantom, conversion factors between maximum entrance surface dose and DAP were derived for CA and CA plus PTCA, respectively. The dose to the staff was measured with TL dosimeters for 22 examinations. Fluoroscopy time and DAP were significantly (p=0.003) larger using the radial access route for coronary angiography (7.5 min, 51 Gy cm2) than the corresponding values obtained from femoral access route (4.6 min, 38 Gy cm2). For CA plus PTCA the fluoroscopy time and DAP were larger for radial access (18.4 min, 75 Gy cm2) than for femoral access (12.5 min, 47 Gy cm2; p=0.013). In our experience, radial access did significantly prolong the fluoroscopy time and increase the patient doses.

Aged↗