The effects of the imaging system on the validity limits of the ray-optical approach to phase contrast imaging.

A theoretical analysis of the x-ray phase contrast imaging and its validation via synchrotron radiation imaging is here presented. Two different mathematical models have been followed: the simpler ray-optical approach and the more rigorous Fresnel-Kirchoff diffraction theory. Subsequently, the conditions upon which the x-ray optical approximation can be used to describe the image formation mechanism have been analyzed, taking into account also the effects due to the finite source size and detector resolution. It is possible to demonstrate that the ray-optics results can also be obtained by opportunely developing the diffraction formalism only with some restrictions on the spatial frequencies present in the final image, without any limitation on the maximum phase shift. The conditions allowing the use of the simplified ray-optical approach to describe the phase contrast images have been here defined and their validation has been proved by means of computer simulations and phantom experiments.

On the use of DICOM cine header information for optimisation: results from the 2002 European DIMOND cardiology survey.

The paper explores the level of information contained within the DICOM header in images from various cardiology systems. Data were obtained in the European DIMOND survey on image quality (Italy, Ireland, Belgium, Greece and Spain). Images from five standard diagnostic cardiology procedures carried out in six European hospitals have been analysed. DICOM header information was extracted to a database in order to analyse how it could help in the optimisation of the procedures. The level of data contained in the headers differs widely between cardiology systems. None of the X-ray systems in the 2002 survey archives the dosimetric data in the DICOM header. The mean number of runs per procedure ranges between 7.5 and 15.4 and the mean number of frames per procedure between 575 and 1417. Differences in kVp, mA, pulse time, distances and C-arm angulations are substantial and suggest that there exists a wide range for optimisation.

Reference levels in PTCA as a function of procedure complexity.

The multicentre assessment of a procedure complexity index (CI) for the introduction of reference levels (RLs) in percutaneous transluminal coronary angioplasties (PTCA) is presented here. PTCAs were investigated based on methodology proposed by Bernardi et al. Multiple linear stepwise regression analysis, including clinical, anatomical and technical factors, was performed to obtain fluoroscopy time predictors. Based on these regression coefficients, a scoring system was defined and CI obtained. CI was used to classify dose values into three groups: low, medium and high complexity procedures, since there was good correlation (r = 0.41; P < 0.001) between dose-area product (DAP) and CI. CI groups were determined by an ANOVA test, and the resulting DAP and fluoroscopy time third quartiles suggested as preliminary RLs in PTCA, as a function of procedure complexity. PTCA preliminary RLs for DAP are 54, 76 and 127 Gy cm2, and 12, 20 and 27 min for fluoroscopy time, for the three CI groups.

Performance of the K-edge digital subtraction angiography imaging system at the European synchrotron radiation facility.

In this work we have characterised the K-edge digital subtraction angiography imaging system at the European Synchrotron Radiation Facility (ESRF, Grenoble, France). With this technique, after the minimally invasive intravenous injection of a contrast agent (iodine), two images are recorded simultaneously using monochromatic beams with energies bracketing the iodine K-edge. The image receptor consists of a two-line 432-pixel germanium detector. The logarithmic subtraction of the image set produced results in an iodine-enhanced image, where vessels are clearly visualised and contrast agent concentration can be precisely quantified. We have studied the imaging system in terms of the modulation transfer function, which was measured at the patient position, the 2-D normalised noise power spectrum, calculated for both raw and processed data, and the frequency-dependent detective quantum efficiency, which was calculated directly for final images. In addition, images of cylindrical phantoms with different concentrations of iodine, were also acquired.

The application of image quality measurements for digital angiography.

The image quality (IQ) evaluation of a charge-coupled device (CCD)-based digital angiography system was assessed with respect to modulation transfer function and noise power spectrum. These values were used to calculate the system's frequency-dependent detective quantum efficiency (DQE). The X-ray image detector was an image intensifier (II) lens coupled to a CCD camera. Two measurement setups were used. Setup A is standard IQ assessment, while Setup B more closely represented clinical conditions (polymethyl methacrylate (PMMA) of varying thickness placed between the X-ray tube and II, with test object positioned between PMMA slices 30 cm from the II). Exposure parameters varied according to automatic brightness control settings. Setup B included X-ray radiation scattered by the patient-PMMA. A clinical DQE, describing the transmission of the input signal-to-noise ratio associated with both primary and secondary X-ray spectra, was defined.

A study to validate the method based on DIMOND quality criteria for cardiac angiographic images.

A method based on image quality criteria (QC) for cine-angiography was developed to measure the quality of cine-angiograms (CA). A series of 30 CA for left ventriculography (LV) and left and right coronary angiography (LCA, RCA) have been scored and 172 readings were obtained. Standard deviation of quality scores indicated the reproducibility of the method. Each part of CA was examined separately, giving scores for LV, LCA and RCA and a total score (TS), with clinical (C) and technical (T) criteria defined and examined separately. In 83% of the studies TS was >0.8 and with standard deviation from 0.02 to 0.21. In general, LV had a lower score and greater disagreement compared with RCA and LCA. Disagreement was greater in T, compared with C. In conclusion, these results indicate that QC, translated into a scoring system, yields reproducible data on the quality of cardiac images.