Evaluating the Relationship of Body Mass Index and Waist Circumference on the Image Quality of Abdominal Computed Radiography (Menilai Hubungan Indeks Jisim Badan dan Lilitan Pinggang pada Kualiti Imej Radiografi Berkomputer Abdomen) / Jurnal Sains Kesihatan Malaysia

@#Body sizes of patients undergoing x-ray examination vary in body mass index (BMI) and waist circumference (WC). This study aimed to evaluate the relationship between BMI and WC on the image quality of abdominal computed radiography (CR). Anteroposterior supine abdomen projection was conducted on 69 patients from Hospital Raja Perempuan Bainun, Ipoh using a Siemens Multixtop general x-ray unit, and the images were processed with CR Carestream Direct view Max. Samples were categorised into normal BMI (n = 23), overweight (n = 23) and obese (n = 23). Image quality was measured quantitatively in signal-to-noise ratio (SNR) and qualitatively by visual grading analysis (VGA) based on the Commission of the European Communities (CEC) image criteria. Data were analysed by analysis of variance (ANOVA) and Pearson’s correlation for comparison and determining the relationship among BMI, WC and image quality. Results showed a significant difference (p < 0.01) in image quality of VGAmean (normal = 4.40 ± 0.15, overweight = 4.35 ± 0.13, obese = 4.03 ± 0.34) and SNRmean (normal = 60.79 ± 2.19, overweight = 59.66 ± 1.68, obese = 55.78 ± 4.31). A moderate to high negative correlation existed between SNR (r = −0.73), VGA (r = −0.7) with BMI (p < 0.01) and between SNR (r = −0.83), VGA (r = −0.79) with WC (p < 0.01). This study suggests that WC has a higher negative linear relationship than BMI and can be used as an effective image quality predictor for abdominal CR examination.

Investigation and analysis on entrance surface dose of patients in radiography procedures in China / 中华放射医学与防护杂志

Objective To investigate the entrance surface dose to the examined patients in radiography using digital and screen-film system in hospitals at different levels in 15 provinces and municipalities in China,in order to provide data for developing diagnostic reference level of radiography suitable for our national physical characteristics.Methods According to the requirements of the Technical Study on Medical Radiation Hazard Assessment and Control,the examined patients aged 20-70 years were selected,with body weight ranging from 55 to 80 kg for male and 50 to 70 kg for female.TLDs were used to measure the entrance surface dose to adult patients in radiography.No less than 10 examined patients were required at each body position,with examined locations including head (PA,LAT),chest (PA,LAT),abdomen (AP),pelvis (AP),lumbar (AP,LAT),and thoracic vertebra (AP,LAT).Results A total of 19 975 individuals undergoing radiography and 1 813 radiographic equipment of different types including screen-film radiography,computed radiography (CR) and digital radiography (DR),were investigated in 342 hospitals in 15 provinces and municipalities throughout the country.For these three types of equipment,the average entrance surface dose to the examined were 1.75,1.9,and 1.15 mGy in head (PA),1.69,1.46and 1.03 mGy in head (LAT),0.75,0.65 and 0.36 mGy in chest (PA),1.81,1.26 and 0.88 mGy in chest (LAT),4.37,3.77 and 2.15 mGy in abdomen (AP),3.73,3.56 and 2.75 mGy in pelvis (AP),5.49,5.84 and 4.17 mGy in lumbar (AP),12.01,9.37 and 6.82 mGy in lumbar (LAT),4.53,3.65 and 2.49 mGy in thoracic vertebra (AP),and 6.91,6.43 and 4.15 Gy in thoracic vertebra (LAT).Conclusions Entrance surface dose caused by radiography examination varies dependent on different exposure locations.Entrance surface doses caused by digital radiography are all lower than by screen-film radiography;those caused by digital radiography are lower than by computed radiography,except for thoracic vertebra (AP).In all examinations,no difference of statistical significance is found between CR and screen-film radiography in entrance surface dose.

Dental Imaging Array Technologies: A Review and Update

Digital radiography has evolved and co-existed with the dental imaging since four decades. The complete replacement of digital imaging in place of conventional screen-film combination has proved to be beneficial to the new era of dentistry. Because of low cost, higher patient comfort, increased dose efficiency, and greater dynamic range of digital detectors with possible reduction of radiation exposure to the patient, the digital imaging has created a new place for itself not only in medical radiology but in dentistry as well. The future will be digital, irrespective of CCDs, CMOS, or phosphor plates the advancement in the field of imaging is rapid and progressive with constantly replacing the older ones. The present paper discusses thoroughly about the various advancements in digital imaging starting from CCDs to flexible phosphor plates. Digital imaging, a substitute for conventional film radiography, has ventured into the arena of dentistry as well and revolutionised the imaging concepts of Oral Health Care Professionals.

CR artifacts causes and countermeasures / 中国医学装备

Objective:Through to the CR in imaging, scanning and transmission process of artifact analysis, find out the causes of artifacts, and to explore methods and countermeasures to reduce and eliminate artifacts, improve the quality of CR picture. Methods:Collected between September 2009 and mid-February 2012 CR images of 103 cases with artifacts, through the analysis of the morphology and characteristics of image artifacts on the causes of artifacts. Results:from 103 have artifacts in the image analysis and proof, the photography, scanning and so on ordinary maintenance produces CR image artifacts, most of the artifacts, through the corresponding processing, most of them can reduce and eliminate. Conclusion:As long as technicians and maintenance engineers to strengthen the sense of responsibility, familiar with the working principle of CR equipment and strengthen the ordinary maintenance, CR image artifacts can be avoided and eliminated.

Performance of CR and DR imaging characteristics and clinical application of comparative study / 中国医学装备

Objective: To evaluate CR (Computer X-ray imaging system) and DR (digital X-ray imaging system) imaging performance, features, advantages and disadvantages, and for application-level comparative analysis instrumentation for clinical application of scientific and rational resource reference. Methods:In the city diethyl hospital radiology shot 852 CR and DR tablets were retrospectively analyzed, focusing on the performance evaluation of two components as affecting the quality characteristics and radiography, focusing compare their clinical applications. Results:CR imaging quality was 89.9%, DR was 94.8%, DR radiography quality is higher than the CR, the difference was statistically significant(x2=7.864, P0.05). Conclusion: CR and DR mutual advantages and disadvantages, CR flexible, and lower cost, but the DR over CR has a higher spatial resolution, wider dynamic range and lower X-ray radiation, and a low rate of waste film radiography speed, high work efficiency. Suggest playing two advantages for clinical applications to provide more choices.

A comparative study of computed radiography-based mammography using digital phosphor storage plate and full field digital mammography.

Background: Two digital mammography systems, based on different physical concepts, have been introduced in the last few years namely the full-field digital mammography (FFDM) system and computed radiography-based mammography using digital storage phosphor plate (DSPM). Aims: The objective of this study was to compare the image quality for DSPM and FFDM using a grading scale based on previously published articles. Materials and Methods: This comparative diagnostic study was done for 5-month duration at the Breast Clinic. The system used was the Lorad Selenia FFDM system and the Mammomat 3000 Nova DSPM system. The craniocaudal and mediolateral oblique projections were done on both breast on 58 asymptomatic women using both DSPM and FFDM. The mammograms were evaluated for eight criteria of image quality: Tissue coverage, compression, exposure, contrast, resolution, noise, artifact, and sharpness by two independent radiologists. Statistical Analysis: Wilcoxon Signed Rank Test and Weighted Kappa. Results: FFDM was rated significantly better (P < 0.05) for five aspects: Tissue coverage, compression, contrast, exposure, and resolution and equal to DSPM for sharpness, noise, and artifact. Conclusion: FFDM was superior in five aspects and equal to DSPM for three aspects of image quality.

Evaluation of Mean Glandular Dose and Modulation Transfer Function for Different Tube Potentials and Target-Filter Combinations in Computed Radiography Mammography

Background: Different target-filter combinations in computed radiography have different impacts on the dose and image quality in digital radiography. This study aims to evaluate the mean glandular dose (MGD) and modulation transfer function (MTF) of various target-filter combinations by investigating the signal intensities of X-ray beams. Methods: General Electric (GE) Senographe DMR Plus mammography unit was used for MGD and MTF evaluation. The measured MGD was compared with the dose reference level (DRL), whereas the MTF was evaluated using ImageJ 1.46o software. A modified Mammography Accreditation Phantom RMI 156 was exposed using different target-filter combinations of molybdenum-molybdenum (Mo-Mo), molybdenum-rhodium (Mo-Rh) and rhodium-rhodium (Rh-Rh) at two different tube voltages, 26 kV and 32 kV with 50 mAs. Results: In the MGD evaluations, all target-filters gave an MGD value of 0.05). Conclusions: Higher tube voltage and atomic number target-filter yield higher MGD values. However, the MTF is independent of the X-ray energy and the type of target-filter combinations used.

Set-up error of CR in total body irradiation localization and lung shielding / 中华放射医学与防护杂志

Objective To investigate the set-up error of CR in total body irradiation localization and lung shielding.Methods TOR 18FG software was employed to measure the image quality of images at kV and MV levels.The clinical processes were established and the positioning error was analyzed.Results The low contrast resolution and spatial resolution of MV level images were much worse than those at kV level in the condition of total body irradiation,but the image at MV level could be used to identify the high contrast tissues and employed in total body irradiation.The longitudinal errors were (0.50 ± 1.65) cm for left lung and (1.16 ± 1.56)cm for right lung in A P direction,while (1.12 ± 2.22)cm and (0.41 ± 2.16)cm respectively in PA direction.The errors of lateral were (0.81 ± 1.19)cm for left lung and (0.43 ±1.20)cm for right lung in AP direction,while (0.31 ± 1.64)cm and (0.55 ± 1.49)cm respectively in PA direction.Conclusions Application of CR in total body irradiation could make positioning in treatment much easily and reduce the localization errors.

DR bedside and CR bedside photographic quality comparative analysis in chest / 中华放射医学与防护杂志

Objective To explore the advantages of the bedside DR,taking the quality analysis of the chest image taken from the bedside digital radiography systems (DR) and computed radiography system (CR).Method All of the 900 pieces chest image taken by bedside DR,compared with the 900 pieces CR image randomly chosen.Results Bedside DR could further reduce the rate of the remake and the radiation dose,and provided more excellent image information.Conclusion The chest image taken by bedside DR has obviously advantage than CR.It can play a positive role in the diagnosis and treatment of the critical patient and surgical patient.

Setting Up a CR Based Filmless Environment for the Radiation Oncology / 의학물리

The analog image based system consisted of a simulator and medical linear accelerator (LINAC) for radiotherapy was upgraded to digital medical image based system by exchanging the X-ray film with Computed Radiography (CR). With minimum equipments shift and similar treatment process, it was possible that the new digital image system was adapted by the users in short time. The film cassette and the film developer device were substituted with a CR cassette and a CR Reader, where the ViewBox was replaced with a small size PC and a monitor. The viewer software suitable for radiotherapy was developed to maximize the benefit of digital image, and as the result the convenience and the effectiveness was improved. It has two windows to display two different images in the same time and equipped various search capability, contouring, window leveling, image resizing, translation, rotation and registration functions. In order to avoid any discontinuance of the treatment while the transition to digital image, the film and the CR was used together for 1 week, and then the film developer was removed. Since then the CR System has been operated stably for 2 months, and the various requests from users have been reflected to improve the system.

Estudo comparativo da qualidade da imagem e do kerma, de entrada e de saída, em simulador de tórax utilizando sistemas analógico e digitalizado CR de aquisição de imagens / Comparative study of image quality and entrance and exit air kerma measurements on chest phantom utilizing analog and CR digital imaging systems

OBJETIVO: O processo de migração de sistemas analógicos para digitalizados, para aplicações diagnósticas, requer cuidados específicos, a fim de manter a qualidade das imagens e minimizar a dose no paciente. Este trabalho tem como objetivo analisar e comparar a qualidade da imagem e o kerma num simulador não antropomórfico de tórax gerados por sistemas analógicos e digitalizados CR. MATERIAIS E MÉTODOS: Foram analisados a qualidade da imagem e o kerma, de entrada e saída, no simulador para dois equipamentos de raios X diferentes (Siemens e Emic), com diferentes sistemas de retificação de onda (12 pulsos e alta frequência). Ambos os sistemas (analógico e digitalizado) estavam sendo utilizados no mesmo local. Foram geradas imagens em filme e em image plates. RESULTADOS: Foi observado aumento na tensão e/ou na carga transportada pelo tubo de raios X quando houve a migração para o sistema CR, para manutenção das características diagnósticas da imagem. Isto resultou em aumento de kerma coletado. CONCLUSÃO: As maiores diferenças determinadas (aumento de dose e redução da qualidade da imagem) foram observadas no equipamento com retificação de onda de 12 pulsos e transdutor de imagem CR (image plates).

OBJECTIVE: The process of migration from analog to digital imaging system requires specific attention to preserve images quality and minimizing the dose to the patients. The present study was aimed at analyzing and comparing images quality and entrance and exist air kerma measurements in a non-anthropomorphic chest phantom with analog and CR digital imaging systems. MATERIALS AND METHODS: Two different X-ray units (Siemens and Emic) with different wave rectification systems (12-pulse and high-frequency) were utilized in a single institution along the process of migration from analog to CR digital imaging system. Images were acquired on films and image plates. RESULTS: An increase on the X-ray tube peak voltage and/or load was observed in the migration from analog to CR digital system to preserve the diagnostic quality of the image. As a result, an increase in the air kerma rate was observed. CONCLUSION: The greatest differences (increase in dose and decrease in image quality) were observed with the 12-pulse wave rectification system with the CR image transducer (imaging plates).

Application value of computed radiography energy subtraction in detecting pulmonary soft-tissue:comparison with direct digital radiography / 中华放射医学与防护杂志

Objective To compare the efficiency of computed radiography energy subtraction (ES-CR) with direct digital radiography (DR) in detecting the pulmonary soft-tissue signals.Methods The adult chest phantom including TRG was imaged by ES-CR and DR separately and was estimated by 6 radiologists with 5-value-differentiation method. ROC was used to analyze the performance of two systems. Images of DR and ES-CR of 28 patients with small lung cancer were diagnosed by 3 radiologists. Results The area under the ROC curves was 0. 727 in ES-CR and 0.827 in DR (Z= 2.96,P ＜ 0. 05). 28 small lung cancer patients were significantly different between two systems (x2 = 5.14,P ＜0. 05). Conclusions The true positive proportion of DR might be higher than that of ES-CR. ES-CR is inferior to DR in detecting pulmonary soft-tissue signals.

Slot-Scan Digital Radiography of the Lower Extremities: a Comparison to Computed Radiography with Respect to Image Quality and Radiation Dose

OBJECTIVE: To compare the slot-scan digital radiography (SSDR) of the lower extremity region and the computed radiography (CR) method with respect to the image quality and radiation exposure. MATERIALS AND METHODS: We enrolled 54 patients who underwent both the SSDR and CR of the lower extremities. The study evaluated and statistically compared the image quality of four features (outer cortex, inner cortex, trabeculae and intermuscular fat) at six different levels (pelvis, hip, femur, knee, tibia and ankle) between each method. The image quality was evaluated using a visibility scale, and the entrance skin dose was measured using a dosimeter at three different levels of a phantom (hip, knee, and ankle). RESULTS: The mean image visibility scale values for the SSDR method were significantly higher than for the CR method. The entrance skin dose for the SSDR method was 278 micro Gy at each level, compared to the entrance skin doses of the CR method, which were 3,410 micro Gy for the hip, 1,152 micro Gy for the knee, and 580 microGy for the ankle. CONCLUSION: Both the image quality and patient entrance skin dose data suggest that the SSDR method is superior to the CR method for the lower extremity musculoskeletal examination.

Abdome agudo obstrutivo: revisando pontos fundamentais / Obstructive acute abdomen: reviewing important points

O abdome agudo obstrutivo é uma doença comum, cujo manejo seguro e efetivo depende do diagnóstico rápido e preciso. A radiografia simples permanece a primeira escolha dentre os exames de imagem, por possuir fácil acesso, baixo custo e poder ser realizada seriada conforme a evoluçãoclínica do paciente. A ultra-sonografia não possui radiação ionizante, é um exame dinâmico e em tempo real. A tomografia computadorizada fornece informações adicionais não aparentes nas radiografias, como confirmação da obstrução, grau e local de uma oclusão, presença de isquemia e causas de obstrução. A ressonância magnética tem apresentado grandes avanços tecnológicos e, futuramente, pode ser uma opção viável. O objetivo deste ensaio pictórico é revisar os diferentes métodos de imagem usados no diagnóstico de abdome agudo obstrutivo.

The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost andthe possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomographyis used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presenceof ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen.

Comparison of the new and the used imaging plates on computed radiography / 中华放射医学与防护杂志

Objective To compare image quality and radiation dose of the new imaging plate (IP) with the used IP on computed radiography (CR),and to investigate the using principle in the two kinds of IP. Methods The dark noise, uniformity and erasure thoroughness of the new and the used IP were measured respectively.Based on threshold contrast-detail detectability(TCCD) technique,the phantom T0.16 photography was done at 75 kV,and with the two kinds of IP respectively.Three observers scored each image sequence using double blind method,calculated the threshold detection index (HT).The volunteers were randomly divided into three groups:the knee joint group,the chest group and the lumbar group.Each group had 50 cases and checked with the same condition as the phantom.Three radiologists using double blind method evaluated the imaging quality of knee joint,chest and lumbar.Results The physical characteristic indexes of the new and the used IP were similar to each other.Under the same condition,the detection ability of the new IP was better than that of the used one.When the dose of exposure was raised about 20%,the detection ability of the used IP was close to that of the new one.Conclusions The dose of exposure can be raised to keep the same imaging quality with the increase times of IP used.The detection ability of IP can decrease with the same dose as before,and the image quality decreases too.

Clinical value of CR,CT and MRI in spinal tuberculosis / 中国矫形外科杂志

[Objective]To investigate the clinical value of computed radiography(CR),computed tomography(CT)and magnetic resonance imaging(MRI)in spinal tuberculosis.[Method]Forty-one patients with histologically confirmed spinal tuberculosis underwant imaging examinations.Forty-one patients were performed CR,22 CT and 31 MRI.[Result]CR of 38 patients clearly revealed bone changes and narrowed or disappeared disk space.CR of 30 patients well showed the abnormal soft tissue.CT scan of 22 patients clearly depicted calcification and no abnormal was found in pedicles in all the 22 CT scans.CT scan of 21 patients revealed bone changes of vertebral bodies and CT scan of 20 patients showed abnormal soft tissue.The soft tissue was involved in all 31 patients with spinal tuberculosis.Diskspaces were involved in 29 cases and the pedicles were normal in all 31 case.The lesions showed hypointense in T1 scan primarily,hyperintense in T2 scan primarily.[Conclusion]CR is the first imaging approach for spinal tuberculosis.CT well reveal the extent and minute calcification.The extent,abnormal soft-tissue and abnormal disk space are more dramatically demonstrated on MRI imaging.CR,in addition to CT and MRI,is helpful in diagnosis of spinaltubereuinsis.

The analyses of hip joint lesionin ankylosing spondylities in X ray and clinic / 中国基层医药

Objective To improve the recognization of hip joint lesion in ankylosing spondylitis and it's related factors.Methods Pelvis computed radiography(CR) and HLA-B27 were examined in 100 cases of ankylosing spondylitis proved by clinical.Results 58% cases appeared differed degree of narrowing of the interticular space,osteoporosis on head of femur and acctabulum,cystis under the surface of acctabulum and joint inosculated.This probability was higner at thoe patients that had diaease at youthful or HLA-B27(+).Conclusion Hip joint lesions of ankylosing spondylitis appear characteristic signs in CR.It relates with the age that the disease come on and HLA-B27.

Application of the Digital Radiographic Bone Trabecular Structure Analysis to the Mandible using Morphological Filter / Oral Science International

[Purpose] To develop a digital radiographic bone trabecular structure analyzing system and to applied it to mandible. [Methods] Structural change was simulated by removing spongy bone in human dried mandible. Using a morphological filter processing, the skeletal features were extracted from digital radiographic image data obtained by computed radiography before and after the removal of spongy bone. The skeletal volume, surface, thickness, number, separation, complexity, spacing continuity and connectivity on the skeletal binary images were determined by morphometric indices calculation, star volume analysis and node-strut analysis. Using these quantified skeletal feature parameters, a mapping sheet for the structural evaluation was produced. The correlation between the fluctuation rate of each parameter after the removal of spongy bone with respect to the value before the removal of spongy bone and simulated structural change was examined. [Results] The skeletal binary image data quantified sixteen skeletal feature parameters using morphometric indices calculation, star volume analysis and node-strut analysis. These parameters agreed with the theoretical fluctuation pattern in the simulated skeletal structure deterioration of the mandibular bone trabeculae. [Conclusion] Using a morphological filter and bone histomorphometry, the radiological bone-morphometric analyzing system is useful for the evaluation of the mandibular trabecular structure.

Discussion on application value of CR and DR / 医疗卫生装备

According to the comparison of CR and DR in such aspects as principle analysis,main parameters,software operation capability and development prospects,along with our experience,it is concluded that CR is now fit for the middle and small hospitals as an expedient intergrading digital image equipment,while for the hospitals with workload of over 100 persons per day,DR should be the primary digital image equipment and CR should work as auxililiary digital image equipment.

Improvement of Image Carrier Bracket of Orthopantomograph Dental Machine / 医疗卫生装备

Objective To introduce a kind of simple and practical digital dental photographic equipment. Methods PanouraULTRA Orthopantomograph dental equipment was adopted to improve its axletree pole of imaging carrier bracket and the position of the handle of film box, so as to make it possible to change the traditional screen film into the IP board carrying digital X-ray imaging to take pictures. By reading the IP board with FCR5000R read implement, dealing with the acquired images through terminal processor, and then using FUJIFILM DRY PIX7000 laser camera to print, a highly clear digital tooth image with high quality would be got. Results Taking Orthopantomograph photos with the improved imaging carrier bracket, successful photos were over 98% of the total. Conclusion This applied machine is characterized by several advantages as follows: appropriate design, convenient operation, low cost, energy-saving and environment protection; high quality of imaging and low quantity of radiation. It can be combined with PACS, which is convenient for distant consultation. This equipment has a promising future in the fields of clinical oral cavity, scientific research and teaching.