Lung iodine mapping images of acute postpartum dyspnea without pulmonary thromboembolism using dual-energy CT.

BACKGROUND: Postpartum dyspnea is commonly observed, but its cause is often unknown. PURPOSE: To investigate postpartum dyspnea, we compared lung iodine mapping (LIM) using dual-energy computed tomography (DECT) between postpartum women and women suspected of having pulmonary thromboembolism (PTE). MATERIAL AND METHODS: In this retrospective study, 109 women of reproductive age (50 postpartum women, 59 women unrelated to pregnancy) underwent DECT between March 2009 and August 2020. Among the postpartum women, 23 patients were excluded due to late-onset dyspnea (n=20: >48 h after delivery) or the presence of PTE (n=3). A total of 86 patients were divided into three groups (27 postpartum women [postpartum group], 19 women with PTE [PTE group], and 40 women without PTE [non-PTE group]). Quantitation was applied to a decreased LIM value (LIM5; defined as <5 HU) and the relative value of LIM5 to whole LIM volume (%LIM5). LIM defects were classified into five patterns (0 = none, 1 = wedge-shaped, 2 = reticular/liner, 3 = diffuse granular/patchy, 4 = massive defects) based on a consensus between two readers. RESULTS: There were significant differences in the LIM5 and %LIM5 values among the three groups. The LIM5 and %LIM5 were largest in the PTE group, and postpartum women showed intermediate values between the non-PTE and PTE groups. Wedge-shaped defects were prominent in the PTE group, and diffuse granular/patchy defect was a typical feature in the postpartum group. CONCLUSION: Postpartum women with dyspnea showed granular/patchy defects on DECT with a median quantitative value between the PTE and non-PTE groups.

A Triphasic Split-bolus Contrast Injection Protocol for Artery-vein Separation During Pulmonary Computed Tomographic Angiography.

PURPOSE: Accurate artery-vein separation on pulmonary computed tomographic (CT) angiography is desirable for preoperative 3-dimensional image simulation, while using a minimal amount of contrast medium. This study aimed to verify whether a split-bolus contrast enhancement protocol with test-bolus tracking would provide contrast differentiation between the pulmonary arteries (PA) and pulmonary veins (PV) during high-pitch single-pass CT angiography. MATERIALS AND METHODS: Fifty patients underwent pulmonary CT angiography with a triphasic split-bolus injection protocol with the main bolus of contrast medium for 6 seconds, followed by a subsequent bolus of 20% diluted contrast medium/80% saline for another 6 seconds and a 5-second saline chaser. The single-scan timing was individually tailored to the peak enhancement at the left atrium, that is, the pulmonary-venous dominant phase, by monitoring a time-enhancement curve with test bolus. RESULTS: Time-enhancement curves of the test bolus demonstrated that the interval times between the peak enhancements at the PA and PV were ~6 seconds. For contrast enhancement image analyses with our protocol, the attenuation measurements at the main PA and left atrium were performed. The mean (SD) CT numbers were 246.4 (50.0) HU at the main PA, and 410.8 (59.0) HU at the left atrium. The mean difference in the CT numbers was 164.4 HU (95% confidence interval: 149.2-179.6, P <0.001) between the main PA and left atrium. CONCLUSIONS: Our contrast enhancement protocol for high-pitch single-pass pulmonary CT angiography could provide the desired artery-vein separation while maintaining adequate attenuations of the pulmonary vasculature.

A novel algorithm for comprehensive quality assessment of clinical magnetic resonance images based on natural scene statistics in spatial domain.

BACKGROUND: A magnetic resonance imaging (MRI)-specific objective image quality assessment (IQA) algorithm, the quality evaluation using multidirectional filters for MRI (QEMDIM), was previously reported. QEMDIM requires a set of reference images to calculate the quality score (SQ) for an assessed image. SQ may be affected by the quality of the reference set owing to the calculation procedure. PURPOSE: To propose a modified version of the IQA algorithm and compare the IQA performance of the original and modified algorithms. ASSESSMENT: Brain axial T1- and T2-weighted spin-echo images of varying quality levels (noise and blurring) were acquired from seven healthy men. Subjective IQA (paired comparisons) was conducted on the images, and subjective quality scores were obtained. With reference sets of various quality levels, QEMDIM and modified IQA were applied to the same images that underwent the subjective IQA. The correlation of each SQ and modified score (Smod) with the subjective scores was evaluated for content-related subsets of assessed images and for each reference set. The effect of the reference-set quality on the distribution of the correlation coefficients (CCs) was statistically evaluated for SQ and Smod using a one-way analysis of variance test with a significance level of 0.05. We also evaluated the variation in Smod for images with almost the same qualities using the standard deviation (SD). RESULTS: The CCs of SQ varied significantly with the quality of the reference set, whereas that of Smod did not. The SD of Smod for almost-same-quality images was less than that corresponding to the confidence interval of the subjective scores. CONCLUSION: Our modified algorithm was superior to QEMDIM in terms of IQA performance in clinical practice, especially in terms of accuracy, robustness, and reproducibility.

Influence of monitor display resolution and displayed image size on the spatial resolution of ultra-high-resolution CT images: a phantom study.

To determine the optimal display conditions for ultra-high-resolution computed tomography (UHRCT) images in clinical practice, this study investigated the effects of liquid-crystal display (LCD) resolution and displayed image size on the spatial resolution of phantom images acquired using a UHRCT system. A phantom designed to evaluate the high-contrast resolution was scanned. The scan data were reconstructed into four types of UHRCT image series consisting of the following possible combinations: two types of reconstruction kernels on the filtered back-projection method (for the lung and mediastinum) and two types of matrix sizes (10242 and 20482). These images were displayed under eight types of display conditions: three image sizes displayed on a 2-megapixel (MP) and 3-MP color LCD and two image sizes on an 8-MP color LCD. A total of 32 samples (four image series × eight display conditions) were evaluated by eight observers for high-contrast resolution. The high-contrast resolution of the displayed UHRCT images was significantly affected by the displayed image size, although the largest (full-screen) displayed image size did not necessarily show the maximum high-contrast resolution. When the images were displayed in the full-screen size, LCD resolution affected the high-contrast resolution of only the 20482-matrix-size images reconstructed using the lung kernel. In conclusion, the spatial resolution of UHRCT images may be affected by LCD resolution and displayed image size. To optimize the clinical display conditions for UHRCT images, it is necessary to adopt an LCD with an adequate resolution for each viewing situation.

Medical display application for degraded image sharpness restoration based on the modulation transfer function: initial assessment for a five-megapixel mammography display monitor.

An image-display application for medical liquid-crystal display (LCD) monitors called the sharpness recovery (SR) function has been developed to compensate for image sharpness as a function of deficiencies in the modulation transfer function (MTF) of a monitor. We investigated the effects of the SR function for a five-megapixel (MP) mammography LCD monitor on the resolution and noise properties of the displayed images by measuring the MTF and overall noise power spectrum (NPS), respectively. Furthermore, the effectiveness of the SR function for the 5-MP monitor in displaying subtle microcalcifications on digital mammograms was verified using a two-alternative-forced-choice sensitivity measurement as an initial application for medical image interpretation. Four radiologists compared the visibility of 45 regions of interest with a malignant microcalcification cluster shown on SR-processed and unprocessed mammograms. SR processing improved the MTF of the displayed images by approximately 40% at the Nyquist frequency of the 5-MP monitor, whereas it slightly increased the overall NPS values. All observers indicated that the fraction of cases considered to have better visibility of microcalcifications with the SR processing was significantly greater than that without the processing (averaging 82%, with the 95% confidence interval ranging from 70 to 93%). The SR processing for the 5-MP monitor yielded a significant improvement in the resolution properties of the displayed images, with a certain increase in the image noise. The SR function has the potential to improve the observer performance of radiologists, particularly when reading subtle microcalcifications reproduced on 5-MP monitors.

[Assessment Tool of Image Quality for Medical Liquid-crystal Displays Using Commercially Available Digital Cameras].

We developed a simplified tool for measuring image quality of medical liquid-crystal displays (LCDs) using a commercially available color digital camera. This tool implemented as a plug-in software for ImageJ (open-source image processing program) was designed to compute modulation transfer functions (MTFs) and Wiener spectra (WS) of monochrome and color LCDs from LCD photographed images captured by a camera. The intensities of the red (R), green (G), and blue (B) signals of the unprocessed image data depend on the spectral sensitivity of the image sensor used in the camera. In order to evaluate image quality based on LCD luminance, the plug-in software calibrates the RGB signals from the camera using measured luminance of the LCD and converts them into grayscale signals that correspond to the luminance of the LCD. The MTFs and WS are determined based on the line response from a one-pixel line image and the one-dimensional noise profiles acquired by scanning the uniform image using numerically synthesized slit, respectively. With this plug-in software for ImageJ, we are able to readily compute MTFs and WS of both monochrome and color LCDs from unprocessed image data of cameras. Our simplified tool is helpful to evaluate and understand the physical performance of LCDs for a large number of display users in hospitals and medical centers.

A method for evaluating luminance non-uniformity of displays by use of a commercially available digital camera.

The luminance uniformity of liquid-crystal displays (LCDs) deteriorates with their prolonged use. In this paper, we present a method for evaluating the degree of luminance non-uniformity of LCDs with the use of a commercially available digital camera. In this study, seven monochrome LCDs, which were used during various operating times ranging from 5000 to 25,000 h, were evaluated with use of a camera. The maximum luminance deviation (MLD) was measured on the two-dimensional (2D) images obtained with the camera. In addition, an index of the luminance non-uniformity was calculated as the ratio of the area exhibiting luminance non-uniformity to the area of the entire LCD screen. We determined the area with the luminance non-uniformity by setting the allowable luminance deviation as the judgment criterion to evaluate the degree of luminance non-uniformity. The MLD values were less than 20% for all conditions, and they varied depending on the locations of the luminance measurement. The area ratios of the luminance non-uniformity based on 2D luminance distributions tended to increase with the duration of use of LCDs, and they indicated the degree of luminance non-uniformity of the LCDs regardless of the measurement locations. Our approach of using a commercially available digital camera showed its potential usefulness for providing more detailed and consistent evaluations of the degree of luminance non-uniformity of LCDs based on the 2D luminance distributions.

A method for evaluating image quality of monochrome and color displays based on luminance by use of a commercially available color digital camera.

PURPOSE: The aim of this study is to propose a method for the quantitative evaluation of image quality of both monochrome and color liquid-crystal displays (LCDs) using a commercially available color digital camera. METHODS: The intensities of the unprocessed red (R), green (G), and blue (B) signals of a camera vary depending on the spectral sensitivity of the image sensor used in the camera. For consistent evaluation of image quality for both monochrome and color LCDs, the unprocessed RGB signals of the camera were converted into gray scale signals that corresponded to the luminance of the LCD. Gray scale signals for the monochrome LCD were evaluated by using only the green channel signals of the camera. For the color LCD, the RGB signals of the camera were converted into gray scale signals by employing weighting factors (WFs) for each RGB channel. A line image displayed on the color LCD was simulated on the monochrome LCD by using a software application for subpixel driving in order to verify the WF-based conversion method. Furthermore, the results obtained by different types of commercially available color cameras and a photometric camera were compared to examine the consistency of the authors' method. Finally, image quality for both the monochrome and color LCDs was assessed by measuring modulation transfer functions (MTFs) and Wiener spectra (WS). RESULTS: The authors' results demonstrated that the proposed method for calibrating the spectral sensitivity of the camera resulted in a consistent and reliable evaluation of the luminance of monochrome and color LCDs. The MTFs and WS showed different characteristics for the two LCD types owing to difference in the subpixel structure. The MTF in the vertical direction of the color LCD was superior to that of the monochrome LCD, although the WS in the vertical direction of the color LCD was inferior to that of the monochrome LCD as a result of luminance fluctuations in RGB subpixels. CONCLUSIONS: The authors' method based on the use of a commercially available color camera is useful to evaluate and understand the display performances of both monochrome and color LCDs in radiology departments.

Effect of ambient lighting on liquid-crystal displays with different types of surface treatment.

Liquid-crystal displays (LCDs) with different types of surface treatment have been developed for decreasing the effect of ambient lighting on a displayed image. The effect of ambient lighting on LCDs with different surface treatments, namely, glare (G)-type, anti-glare (AG)-type, and anti-reflection (AR)-coating LCDs, was evaluated quantitatively in this study for appropriate selection. The effect of ambient lighting on diffuse reflection and specular reflection was investigated. The coefficient of diffuse reflection of the AR-coating LCD was smaller than the others. The effect of diffuse reflection on the display function of each LCD was evaluated in terms of the deviation of the contrast response at the lowest luminance level when the illuminance changed from the condition that was used for calibration of the grayscale standard display function. The display function of the AR-coating LCD was affected less by diffuse reflection compared to the others. On the other hand, the coefficient of specular reflection of the AG-type LCD was the smallest until the angle of aperture of the light source was 4.6°. The specular-reflected image on the AG-type LCD had a remarkably broad distribution compared to the others. Our results are merely examples for a limited number of LCDs; however, we clarified quantitatively that the AR-coating and the AG-type LCDs were affected less by diffuse and specular reflection than the G-type LCD.