PubMed Health⌕ Search

Biomedical subjects

Walter Huda

Publications and source records attributed to Walter Huda.

At least 19 recordsLinked to original sources

How do lesion size and random noise affect detection performance in digital mammography?

RATIONALE AND OBJECTIVES: We investigated the effect of random noise and lesion size on detection performance in mammography. MATERIALS AND METHODS: Digital mammograms were obtained of an anthropomorphic breast phantom with and without simulated mass lesions. Digital versions of the mass lesions, ranging in size from 0.8 to 12 mm, were added back to the breast phantom image. Four alternate forced choice experiments were performed to determine the lesion contrast required to achieve a 92% correct lesion detection rate, denoted I92. Experiments were performed using identical phantom images and different versions of phantom images obtained using the same techniques but with different random noise patterns. RESULTS: For lesions larger than 1 mm, the slope of the contrast detail curves was always positive. This behavior contrasts with conventional contrast-detail curves in uniform backgrounds in which the slope is approximately -0.5. There was no difference between twinned experiments and those obtained using different patterns of random noise for lesions greater than 1 mm. When the lesion size was reduced below 1 mm, the detection threshold increased indicating a deterioration of lesion detectability, and detection performance was significantly lower when random noise patterns were used. CONCLUSION: Our results suggest that lesion detection is dominated by anatomical structure for lesions with a size >1 mm, but by random noise for submillimeter sized lesions.

Artificial Intelligence↗

Computed tomography in the evaluation of cystic fibrosis lung disease.

The first report of computed tomography (CT) scanning to monitor cystic fibrosis (CF)-related lung disease was published in 1986. Further publications followed, but in general there was little interest in this technique until recently. Two factors in particular have led to this increased interest. First is an increasing realization that pulmonary function tests, long the mainstay of CF evaluation, often underestimate the presence and severity of mild and moderate lung disease. Second is the need for more sensitive outcome measures to assess new therapies. This had led to new interest and a series of important publications. The goal of this article is to present the current status of CT scanning in CF.

Cystic Fibrosis↗

Performance of a single lookup table (LUT) for displaying chest CT images.

RATIONALE AND OBJECTIVES: To evaluate the ability to view mediastinal and lung information on one window setting by processing images with a bilinear lookup table (LUT). MATERIALS AND METHODS: Chest computed tomography (CT) studies were obtained from 32 consecutive adult patient studies, which included 7 iodine contrast studies. From each CT examination, four sections were selected containing the suprasternal notch, carina, right inferior pulmonary vein, and the dome of the lower hemidiaphragm. Each image was processed with a bilinear LUT in addition to the lung setting (window width 1500 and window level -500) and mediastinal setting (window width 450 and window level 50) normally used. Seven radiologists compared the quality of the bilinear LUT with the corresponding lung and mediastinum display settings. A five-point scale was used to assess image quality, with a score of 5 being equivalent to the corresponding lung (or mediastinum) display, 3 being acceptable, and 1 being unacceptable. RESULTS: The average score of the bilinear LUT for all images and readers was 3.90 +/- 0.93 for lung information and 3.17 +/- 1.00 for mediastinum information. Use of the bilinear LUT resulted in unacceptable images in 0.3% cases for lung information and 5.9% for mediastinum information. Chest CT images that contained iodinated contrast resulted in a higher score than those obtained without contrast, but these differences did not achieve statistical significance. CONCLUSION: Use of a bilinear LUT has the potential to significantly improve operational efficiency with acceptable image quality for most chest CT images.

Adult↗

Use of the VIP-Man model to calculate energy imparted and effective dose for x-ray examinations.

A male human tomographic model was used to calculate values of energy imparted (epsilon) and effective dose (E) for monoenergetic photons (30-150 keV) in radiographic examinations. Energy deposition in the organs and tissues of the human phantom were obtained using Monte Carlo simulations. Values of E/epsilon were obtained for three common projections [anterior-posterior (AP), posterior-anterior (PA), and lateral (LAT)] of the head, cervical spine, chest, and abdomen, respectively. For head radiographs, all three projections yielded similar E/epsilon values. At 30 keV, the value of E/epsilon was approximately 1.6 mSv J(-1), which is increased to approximately 7 mSv J(-1) for 150 keV photons. The AP cervical spine was the only projection investigated where the value of E/epsilon decreased with increasing photon energy. Above 70 keV, cervical spine E/epsilon values showed little energy dependence and ranged between approximately 8.5 mSv J(-1) for PA projections and approximately 17 mSv J(-1) for AP projections. The values of E/epsilon for AP chest examinations showed very little variation with photon energy, and had values of approximately 23 mSv J(-1). Values of E/epsilon for PA and LAT chest projections were substantially lower than the AP projections and increased with increasing photon energy. For abdominal radiographs, differences between the PA and LAT projections were very small. All abdomen projections showed an increase in the E/epsilon ratio with increasing photon energy, and reached a maximum value of approximately 13.5 mSv J(-1) for AP projections, and approximately 9.5 mSv J(-1) for PA/lateral projections. These monoenergetic E/epsilon values can generate values of E/epsilon for any x-ray spectrum, and can be used to convert values of energy imparted into effective dose for patients undergoing common head and body radiological examinations.

Adult↗

Patient size and x-ray transmission in body CT.

Physical characteristics were obtained for 196 patients undergoing chest and abdomen computed tomography (CT) examinations. Computed tomography sections for these patients having no evident pathology were analyzed to determine patient dimensions (AP and lateral), together with the average attenuation coefficient. Patient weights ranged from approximately 3 kg to about 120 kg. For chest CT, the mean Hounsfield unit (HU) fell from about -120 HU for newborns to about -300 HU for adults. For abdominal CT, the mean HU for children and normal-sized adults was about 20 HU, but decreased to below -50 HU for adults weighing more than 100 kg. The effective photon energy and percent energy fluence transmitted through a given patient size and composition was calculated for representative x-ray spectra at 80, 100, 120, and 140 kV tube potentials. A 70-kg adult scanned at 120 kVp transmits 2.6% of the energy fluence for chest and 0.7% for abdomen CT examinations. Reducing the patient size to 10 kg increases transmission by an order of magnitude. For 70 kg patients, effective energies in body CT range from approximately 50 keV at 80 kVp to approximately 67 keV at 140 kVp; increasing patient size from 10 to 120 kg resulted in an increase in effective photon energy of approximately 4 keV. The x-ray transmission data and effective photon energy data can be used to determine CT image noise and image contrast, respectively, and information on patient size and composition can be used to determine patient doses.

Abdomen↗

Patient size and x-ray technique factors in head computed tomography examinations. I. Radiation doses.

We investigated how patient age, size and composition, together with the choice of x-ray technique factors, affect radiation doses in head computed tomography (CT) examinations. Head size dimensions, cross-sectional areas, and mean Hounsfield unit (HU) values were obtained from head CT images of 127 patients. For radiation dosimetry purposes patients were modeled as uniform cylinders of water. Dose computations were performed for 18 x 7 mm sections, scanned at a constant 340 mAs, for x-ray tube voltages ranging from 80 to 140 kV. Values of mean section dose, energy imparted, and effective dose were computed for patients ranging from the newborn to adults. There was a rapid growth of head size over the first two years, followed by a more modest increase of head size until the age of 18 or so. Newborns have a mean HU value of about 50 that monotonically increases with age over the first two decades of life. Average adult A-P and lateral dimensions were 186+/-8 mm and 147+/-8 mm, respectively, with an average HU value of 209+/-40. An infant head was found to be equivalent to a water cylinder with a radius of approximately 60 mm, whereas an adult head had an equivalent radius 50% greater. Adult males head dimensions are about 5% larger than for females, and their average x-ray attenuation is approximately 20 HU greater. For adult examinations performed at 120 kV, typical values were 32 mGy for the mean section dose, 105 mJ for the total energy imparted, and 0.64 mSv for the effective dose. Increasing the x-ray tube voltage from 80 to 140 kV increases patient doses by about a factor of 5. For the same technique factors, mean section doses in infants are 35% higher than in adults. Energy imparted for adults is 50% higher than for infants, but infant effective doses are four times higher than for adults. CT doses need to take into account patient age, head size, and composition as well as the selected x-ray technique factors.

Adolescent↗

Patient size and x-ray technique factors in head computed tomography examinations. II. Image quality.

We investigated how patient head characteristics, as well as the choice of x-ray technique factors, affect lesion contrast and noise values in computed tomography (CT) images. Head sizes and mean Hounsfield unit (HU) values were obtained from head CT images for five classes of patients ranging from the newborn to adults. X-ray spectra with tube voltages ranging from 80 to 140 kV were used to compute the average photon energy, and energy fluence, transmitted through the heads of patients of varying size. Image contrast, and the corresponding contrast to noise ratios (CNRs), were determined for lesions of fat, muscle, and iodine relative to a uniform water background. Maintaining a constant image CNR for each lesion, the patient energy imparted was also computed to identify the x-ray tube voltage that minimized the radiation dose. For adults, increasing the tube voltage from 80 to 140 kV changed the iodine HU from 2.62 x 10(5) to 1.27 x 10(5), the fat HU from -138 to -108, and the muscle HU from 37.1 to 33.0. Increasing the x-ray tube voltage from 80 to 140 kV increased the percentage energy fluence transmission by up to a factor of 2. For a fixed x-ray tube voltage, the percentage transmitted energy fluence in adults was more than a factor of 4 lower than for newborns. For adults, increasing the x-ray tube voltage from 80 to 140 kV improved the CNR for muscle lesions by 130%, for fat lesions by a factor of 2, and for iodine lesions by 25%. As the size of the patient increased from newborn to adults, lesion CNR was reduced by about a factor of 2. The mAs value can be reduced by 80% when scanning newborns while maintaining the same lesion CNR as for adults. Maintaining the CNR of an iodine lesion at a constant level, use of 140 kV increases the energy imparted to an adult patient by nearly a factor of 3.5 in comparison to 80 kV. For fat and muscle lesions, raising the x-ray tube voltage from 80 to 140 kV at a constant CNR increased the patient dose by 37% and 7%, respectively. Our two key findings are that for head CT examinations performed at a constant CNR, the mAs can be substantially reduced when scanning infants, and that use of the lowest x-ray tube voltage will generally reduce patient doses.

Adolescent↗

Experimental investigation of the dose and image quality characteristics of a digital mammography imaging system.

Our purpose in this study was to investigate the image quality and absorbed dose characteristics of a digital mammography imaging system with a CsI scintillator, and to identify an optimal x-ray tube voltage for imaging simulated masses in an average size breast with 50% glandularity. Images were taken of an ACR accreditation phantom using a LORAD digital mammography system with a Mo target and a Mo filter. In one experiment, exposures were performed at 80 mAs with x-ray tube voltages varying between 24 and 34 kVp. In a second experiment, the x-ray tube voltage was kept constant at 28 kVp and the technique factor was varied between 5 and 500 mAs. The average glandular dose at each x-ray tube voltage was determined from measurements of entrance skin exposure and x-ray beam half-value layer. Image contrast was measured as the fractional digital signal intensity difference for the image of a 4 mm thick acrylic disk. Image noise was obtained from the standard deviation in a uniformly exposed region of interest expressed as a fraction of the background intensity. The measured digital signal intensity was proportional to the mAs and to the kVp5.8. Image contrast was independent of mAs, and dropped by 21% when the x-ray tube voltage increased from 24 to 34 kVp. At a constant x-ray tube voltage, image noise was shown to be approximately proportional to (mAs)(-05), which permits the image contrast to noise ratio (CNR) to be modified by changing the mAs. At 80 mAs, increasing the x-ray tube voltage from 24 to 34 kVp increased the CNR by 78%, and increased the average glandular dose by 285%. At a constant lesion CNR, the lowest average glandular dose value occurred at 27.3 kVp. Increasing or decreasing the x-ray tube voltage by 2.3 kVp from the optimum kVp increased the average glandular dose values by 5%. These results show that imaging simulated masses in a 4.2 cm compressed breast at approximately 27 kVp with a Mo/Mo target/filter results in the lowest average glandular dose.

Equipment Failure Analysis↗

How do radiographic techniques affect image quality and patient doses in CT?

The radiation dose received by patients who undergo CT examinations has become a subject of considerable interest. Adult effective doses for head CT examinations are of the order of 1 to 2 mSv, and for single body examinations, patient doses are typically between 4 and 6 mSv. These doses are high in comparison to most other types of radiological examinations that use ionizing radiation. Patient CT doses may also be compared with natural background (3 mSv/year), dose limits to members of the public (1 mSv/year), and the highest level of occupational exposure, which is about 5 mSv/year. The advent of multi-slice technology will serve to increase CT utilization, as well as individual doses for any given examination. Radiologists are responsible for medical radiation doses to their patients, and it is imperative that they understand the relationship between radiation dose and image quality. In this review, we address the impact that variations in radiographic techniques (ie, selected values of X-ray kVp and mAs) have on patient doses as well as the quality of the resultant CT images.

Humans↗

How good is the ACR accreditation phantom for assessing image quality in digital mammography?

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate the American College of Radiology (ACR) accreditation phantom for assessing image quality in digital mammography. MATERIALS AND METHODS: Digital images were obtained of an ACR accreditation phantom at varying mAs (constant kVp) and varying kVp (constant mAs). The average glandular dose for a breast with 50% glandularity was determined for each technique factor. Images were displayed on a 5 mega-pixel monitor, with the window width and level settings individually optimized for viewing the fibers, specks, and masses in the ACR phantom. Digital images of the ACR phantom were presented in a random manner to eight observers, each of whom indicated the number of objects visible in each image. RESULTS: Intraobserver variability was greater than interobserver variability for the detection of fibers and specks, but the reverse was true for the detection of masses. As the mAs increased, the number of fibers visible increased from less than one at 5 mAs to all six being visible at 80 mAs. The corresponding number of visible specks increased from 12 to 24, and the number of visible masses increased from 1.25 to about four. Above 26 kVp, object visibility was constant with increasing x-ray tube voltage. Reducing the x-ray tube voltage to 24 kVp, however, reduced the number of visible fibers from six to five, the number of visible specks from 24 to 21.1, and the number of visible masses from four to 3.1. Observer performance was approximately constant for average glandular doses greater than 1.6 mGy, so that the range of lesion detectability in the ACR phantom occurs at doses lower than those normally encountered in clinical practice. CONCLUSION: The current design of the ACR phantom is unsatisfactory for assessing image quality in digital mammography.

Accreditation↗

Adult patient doses in interventional neuroradiology.

We investigated radiation doses to 149 adult patients who underwent interventional neuroradiologic procedures, consisting of 132 patients who had diagnostic imaging examinations and 17 patients who had therapeutic procedures. The interventional procedures were carried out on a biplane system capable of performing fluoroscopy and digital subtraction angiography (DSA). The x-ray imaging system was interfaced to a patient dosimetry system, which computed surface (skin) doses based on the selected radiographic technique factors in each of the radiographic and fluoroscopic imaging modes. For each patient, an assessment was made of the maximum surface dose received during the procedure, which predicts the possibility of inducing deterministic effects. Knowledge of the surface doses, beam quality and x-ray cross sectional area permitted the computation of the total energy imparted to each patient. Energy imparted values were converted to effective dose, which provides an estimate of the stochastic radiation risk to the patient. The median surface dose for the frontal plane during diagnostic imaging examinations was 1.3 Gy, with a maximum surface dose of 5.1 Gy. The median surface dose for the frontal plane during therapeutic procedures was 2.8 Gy with a maximum surface dose of 5.0 Gy. Ratios of the lateral to frontal median surface doses were 0.47 for diagnostic examinations and 0.68 for interventional procedures. The median energy imparted was 1.8 J during fluoroscopy, and 4.3 J during radiography, showing that on average, 66% of the patient exposure comes from radiographic imaging (DSA). For diagnostic examinations, the median patient effective dose was 33 mSv, with a maximum of 152 mSv. For therapeutic procedures, the median patient effective dose was 74 mSv, with a maximum of 156 mSv. In interventional neuroradiology, surface doses could induce deterministic effects, and the corresponding effective doses are noticeably higher than those normally encountered in diagnostic radiology.

Adult↗

Effect of radiographic techniques (kVp and mAs) on image quality and patient doses in digital subtraction angiography.

We investigated how varying the x-ray tube voltage and image receptor input exposure affected image quality and patient radiation doses in interventional neuroradiologic imaging. Digital subtraction angiography (DSA) images were obtained of a phantom with 1 mm diameter vessels containing iodine at concentrations between 4.5 and 50 mg/cc. The detection threshold concentration of iodine was determined by inspecting DSA images obtained at a range of x-ray tube voltages and input exposure levels. Surface doses were obtained from measured x-ray tube output data, and corresponding values of energy imparted were determined using the exposure-area product incident on the phantom. In one series of experiments, the air kerma at the image intensifier (X) was varied between 0.44 microGy per frame and 8.8 microGy per frame at a constant x-ray tube voltage of 70 kVp. In a second series of experiments, the tube voltage was varied between 50 and 100 kVp, and the mAs adjusted to maintain a constant exposure level at the input of the image intensifier. At a constant x-ray tube voltage, the surface dose and energy imparted were directly proportional to the input exposure per frame used to acquire the DSA images. On our DSA system operated below 2.2 microGy per frame, the threshold iodine concentration was found to be proportional to X(-0.57), which is in reasonable agreement with the theoretical prediction for a quantum noise limited imaging system. Above 2.2 microGy per frame, however, the threshold iodine concentration was proportional to X(-0.26), indicating that increasing the input exposure above this value will only achieve modest improvements in image quality. At a constant image intensifier input exposure level, increasing the x-ray tube voltage from 50 kVp to 100 kVp reduced the surface dose by a factor of 6.1, and the energy imparted by a factor of 3.5. The detection threshold iodine concentration was found to be proportional to kVp(n), where n was 2.1 at 1.1 microGy per frame, and 1.6 at 3.9 microGy per frame. For clinical situations that can be modeled by a uniform phantom, reducing the x-ray tube voltage rather than increasing the exposure level would best achieve improvements on our DSA imaging system performance.

Angiography, Digital Subtraction↗