Evaluation of clinical full field digital mammography with the task specific system-model-based Fourier Hotelling observer (SMFHO) SNR.

PURPOSE: The purpose of this work is to evaluate the performance of the image acquisition chain of clinical full field digital mammography (FFDM) systems by quantifying their image quality, and how well the desired information is captured by the images. METHODS: The authors present a practical methodology to evaluate FFDM using the task specific system-model-based Fourier Hotelling observer (SMFHO) signal to noise ratio (SNR), which evaluates the signal and noise transfer characteristics of FFDM systems in the presence of a uniform polymethyl methacrylate phantom that models the attenuation of a 6 cm thick 20/80 breast (20% glandular/80% adipose). The authors model the system performance using the generalized modulation transfer function, which accounts for scatter blur and focal spot unsharpness, and the generalized noise power spectrum, both estimated with the phantom placed in the field of view. Using the system model, the authors were able to estimate system detectability for a series of simulated disk signals with various diameters and thicknesses, quantified by a SMFHO SNR map. Contrast-detail (CD) curves were generated from the SNR map and adjusted using an estimate of the human observer efficiency, without performing time-consuming human reader studies. Using the SMFHO method the authors compared two FFDM systems, the GE Senographe DS and Hologic Selenia FFDM systems, which use indirect and direct detectors, respectively. RESULTS: Even though the two FFDM systems have different resolutions, noise properties, detector technologies, and antiscatter grids, the authors found no significant difference between them in terms of detectability for a given signal detection task. The authors also compared the performance between the two image acquisition modes (fine view and standard) of the GE Senographe DS system, and concluded that there is no significant difference when evaluated by the SMFHO. The estimated human observer efficiency was 30 ± 5% when compared to the SMFHO. The results showed good agreement when compared to other model observers as well as previously published human observer data. CONCLUSIONS: This method generates CD curves from the SMFHO SNR that can be used as figures of merit for evaluating the image acquisition performance of clinical FFDM systems. It provides a way of creating an empirical model of the FFDM system that accounts for patient scatter, focal spot unsharpness, and detector blur. With the use of simulated signals, this method can predict system performance for a signal known exactly/background known exactly detection task with a limited number of images, therefore, it can be readily applied in a clinical environment.

CT head-scan dosimetry in an anthropomorphic phantom and associated measurement of ACR accreditation-phantom imaging metrics under clinically representative scan conditions.

PURPOSE: To measure radiation absorbed dose and its distribution in an anthropomorphic head phantom under clinically representative scan conditions in three widely used computed tomography (CT) scanners, and to relate those dose values to metrics such as high-contrast resolution, noise, and contrast-to-noise ratio (CNR) in the American College of Radiology CT accreditation phantom. METHODS: By inserting optically stimulated luminescence dosimeters (OSLDs) in the head of an anthropomorphic phantom specially developed for CT dosimetry (University of Florida, Gainesville), we measured dose with three commonly used scanners (GE Discovery CT750 HD, Siemens Definition, Philips Brilliance 64) at two different clinical sites (Walter Reed National Military Medical Center, National Institutes of Health). The scanners were set to operate with the same data-acquisition and image-reconstruction protocols as used clinically for typical head scans, respective of the practices of each facility for each scanner. We also analyzed images of the ACR CT accreditation phantom with the corresponding protocols. While the Siemens Definition and the Philips Brilliance protocols utilized only conventional, filtered back-projection (FBP) image-reconstruction methods, the GE Discovery also employed its particular version of an adaptive statistical iterative reconstruction (ASIR) algorithm that can be blended in desired proportions with the FBP algorithm. We did an objective image-metrics analysis evaluating the modulation transfer function (MTF), noise power spectrum (NPS), and CNR for images reconstructed with FBP. For images reconstructed with ASIR, we only analyzed the CNR, since MTF and NPS results are expected to depend on the object for iterative reconstruction algorithms. RESULTS: The OSLD measurements showed that the Siemens Definition and the Philips Brilliance scanners (located at two different clinical facilities) yield average absorbed doses in tissue of 42.6 and 43.1 mGy, respectively. The GE Discovery delivers about the same amount of dose (43.7 mGy) when run under similar operating and image-reconstruction conditions, i.e., without tube current modulation and ASIR. The image-metrics analysis likewise showed that the MTF, NPS, and CNR associated with the reconstructed images are mutually comparable when the three scanners are run with similar settings, and differences can be attributed to different edge-enhancement properties of the applied reconstruction filters. Moreover, when the GE scanner was operated with the facility's scanner settings for routine head exams, which apply 50% ASIR and use only approximately half of the 100%-FBP dose, the CNR of the images showed no significant change. Even though the CNR alone is not sufficient to characterize the image quality and justify any dose reduction claims, it can be useful as a constancy test metric. CONCLUSIONS: This work presents a straightforward method to connect direct measurements of CT dose with objective image metrics such as high-contrast resolution, noise, and CNR. It demonstrates that OSLD measurements in an anthropomorphic head phantom allow a realistic and locally precise estimation of magnitude and spatial distribution of dose in tissue delivered during a typical CT head scan. Additional objective analysis of the images of the ACR accreditation phantom can be used to relate the measured doses to high contrast resolution, noise, and CNR.

Experimental estimates of peak skin dose and its relationship to the CT dose index using the CTDI head phantom.

A straightforward method is presented to estimate peak skin doses (PSDs) delivered by computed tomography (CT) scanners. The measured PSD values are related to the well-known volume CT dose index (CTDI(vol)), displayed on the console of CT scanners. PSD measurement estimates were obtained, in four CT units, by placing radiochromic film on the surface of a CTDI head phantom. Six different X-ray tube currents including the maximum allowed value were used to irradiate the phantom. PSD and CTDI(vol) were independently measured and later related to the CTDI(vol) value displayed on the console. A scanner-specific relationship was found between the measured PSD and the associated CTDI(vol) displayed on the console. The measured PSD values varied between 27 and 136 mGy among all scanners when the routine head scan parameters were used. The results of this work allow relating the widely used CTDI(vol) to an actual radiation dose delivered to the skin of a patient.

Contrast-detail phantom scoring methodology.

Published results of medical imaging studies which make use of contrast detail mammography (CDMAM) phantom images for analysis are difficult to compare since data are often not analyzed in the same way. In order to address this situation, the concept of ideal contrast detail curves is suggested. The ideal contrast detail curves are constructed based on the requirement of having the same product of the diameter and contrast (disk thickness) of the minimal correctly determined object for every row of the CDMAM phantom image. A correlation and comparison of five different quality parameters of the CDMAM phantom image determined for obtained ideal contrast detail curves is performed. The image quality parameters compared include: (1) contrast detail curve--a graph correlation between "minimal correct reading" diameter and disk thickness; (2) correct observation ratio--the ratio of the number of correctly identified objects to the actual total number of objects multiplied by 100; (3) image quality figure--the sum of the product of the diameter of the smallest scored object and its relative contrast; (4) figure-of-merit--the zero disk diameter value obtained from extrapolation of the contrast detail curve to the origin (e.g., zero disk diameter); and (5) k-factor--the product of the thickness and the diameter of the smallest correctly identified disks. The analysis carried out showed the existence of a nonlinear relationship between the above parameters, which means that use of different parameters of CDMAM image quality potentially can cause different conclusions about changes in image quality. Construction of the ideal contrast detail curves for CDMAM phantom is an attempt to determine the quantitative limits of the CDMAM phantom as employed for image quality evaluation. These limits are determined by the relationship between certain parameters of a digital mammography system and the set of the gold disks sizes in the CDMAM phantom. Recommendations are made on selections of CDMAM phantom regions which should be used for scoring at different image quality and which scoring methodology may be most appropriate. Special attention is also paid to the use of the CDMAM phantom for image quality assessment of digital mammography systems particularly in the vicinity of the Nyquist frequency.