Contrast-detail Phantom Research Articles

A comparative study of limited-angle cone-beam reconstruction methods for breast tomosynthesis.

Digital tomosynthesis mammography (DTM) is a promising new modality for breast cancer detection. In DTM, projection-view images are acquired at a limited number of angles over a limited angular range and the imaged volume is reconstructed from the two-dimensional projections, thus providing three-dimensional structural information of the breast tissue. In this work, we investigated three representative reconstruction methods for this limited-angle cone-beam tomographic problem, including the backprojection (BP) method, the simultaneous algebraic reconstruction technique (SART) and the maximum likelihood method with the convex algorithm (ML-convex). The SART and ML-convex methods were both initialized with BP results to achieve efficient reconstruction. A second generation GE prototype tomosynthesis mammography system with a stationary digital detector was used for image acquisition. Projection-view images were acquired from 21 angles in 3 degrees increments over a +/- 30 degrees angular range. We used an American College of Radiology phantom and designed three additional phantoms to evaluate the image quality and reconstruction artifacts. In addition to visual comparison of the reconstructed images of different phantom sets, we employed the contrast-to-noise ratio (CNR), a line profile of features, an artifact spread function (ASF), a relative noise power spectrum (NPS), and a line object spread function (LOSF) to quantitatively evaluate the reconstruction results. It was found that for the phantoms with homogeneous background, the BP method resulted in less noisy tomosynthesized images and higher CNR values for masses than the SART and ML-convex methods. However, the two iterative methods provided greater contrast enhancement for both masses and calcification, sharper LOSF, and reduced interplane blurring and artifacts with better ASF behaviors for masses. For a contrast-detail phantom with heterogeneous tissue-mimicking background, the BP method had strong blurring artifacts along the x-ray source motion direction that obscured the contrast-detail objects, while the other two methods can remove the superimposed breast structures and significantly improve object conspicuity. With a properly selected relaxation parameter, the SART method with one iteration can provide tomosynthesized images comparable to those obtained from the ML-convex method with seven iterations, when BP results were used as initialization for both methods.

Amorphous selenium flat panel detectors for digital mammography: Validation of a NPWE model observer with CDMAM observer performance experiments

Model observers have been developed which incorporate a specific imaging task, system performance, and human observer characteristics and can potentially overcome some of the limitations in using detective quantum efficiency for optimization and comparison of detectors. In this paper, a modified nonprewhitening matched filter (NPWE) model observer was developed and validated to predict object detectability for an amorphous selenium (a-Se) direct flat-panel imager (FPI) where aliasing is severe. A preclinical a-Se digital mammography FPI with 85 microm pixel size was used in this investigation. Its physical imaging properties including modulation transfer function (MTF), noise power spectrum, and DQE were fully characterized. An observer performance study was conducted by imaging the CDMAM 3.4 contrast-detail phantom designed specifically for digital mammography and presenting these images to a panel of seven observers. X-ray attenuation and scatter due to the phantom were determined experimentally for use in development of the model observer. The observer study results were analyzed via threshold averaging and signal detection theory (SDT) based techniques to produce contrast-detail curves where threshold contrast is plotted as a function of disk diameter. Validity of the model was established using SDT analysis of the experimental data. The effect of aliasing on the detectability of small diameter disks was determined using the NPWE model observer. The signal spectrum was calculated using the presampling MTF of the detector with and without including the aliased terms. Our results indicate that the NPWE model based on Fourier domain parameters provides reasonable prediction of object detectability for the signal-known-exactly task in uniform image noise for a-Se direct FPI.

Image Quality and Radiation Dose on Digital Chest Imaging: Comparison of Amorphous Silicon and Amorphous Selenium Flat-Panel Systems

The aim of this study was to compare the image quality and radiation dose in chest imaging using an amorphous silicon flat-panel detector system and an amorphous selenium flat-panel detector system. In addition, the low-contrast performance of both systems with standard and low radiation doses was compared. In two groups of 100 patients each, digital chest radiographs were acquired with either an amorphous silicon or an amorphous selenium flat-panel system. The effective dose of the examination was measured using thermoluminescent dosimeters placed in an anthropomorphic Rando phantom. The image quality of the digital chest radiographs was assessed by five experienced radiologists using the European Guidelines on Quality Criteria for Diagnostic Radiographic Images. In addition, a contrast-detail phantom study was set up to assess the low-contrast performance of both systems at different radiation dose levels. Differences between the two groups were tested for significance using the two-tailed Mann-Whitney test. The amorphous silicon flat-panel system allowed an important and significant reduction in effective dose in comparison with the amorphous selenium flat-panel system (p < 0.0001) for both the posteroanterior and lateral views. In addition, clinical image quality analysis showed that the dose reduction was not detrimental to image quality. Compared with the amorphous selenium flat-panel detector system, the amorphous silicon flat-panel detector system performed significantly better in the low-contrast phantom study, with phantom entrance dose values of up to 135 muGy. Chest radiographs can be acquired with a significantly lower patient radiation dose using an amorphous silicon flat-panel system than using an amorphous selenium flat-panel system, thereby producing images that are equal or even superior in quality to those of the amorphous selenium flat-panel detector system.

Influence of monitor luminance and room illumination on soft-copy reading evaluation with electronically generated contrast-detail phantom: comparison of cathode-ray tube monitor with liquid crystal display.

The influence of monitor brightness and room illumination on soft-copy diagnosis by both cathode-ray tube (CRT) monitor and liquid crystal display (LCD) was evaluated and compared using a contrast-detail phantom. Nine observers (7 radiologists and 2 radiological technicians) interpreted six types of electronically generated contrast-detail phantom images using a 21-inch CRT (2,048x2,560) and a 21-inch LCD (2,048x2,560) under 6 kinds of viewing conditions, i.e. monitor brightness of 330 cd/m2 or 450 cd/m2, and room illumination of 20, 100 or 420 lux at the center of the display. Observers were requested to determine the visible borderline of the objects. Between 330 cd/m2 and 450 cd/m2, no significant difference in the visible area was found under any of the three lighting conditions. However, in two low-contrast phantom images, the visible area on the LCD was significantly larger than that on the CRT, independent of both monitor brightness and room illumination. (p<0.05). The effect of room illumination was not significant, suggesting that the use of LCD at high room illumination is acceptable.

SU‐FF‐I‐73: Comparison of the Effects of Viewing Conditions and Viewing Angle On Object Dectectability for Different AMLCD Displays

Purpose: The ability to interpret images displayed on active matrix liquid crystal displays (AMLCD) can be influenced by factors such as display luminance, surrounding background, room illuminance and viewing angle. We have been investigating how these parameters influence reader scores with images featuring both small objects and low contrast as typically seen in mammography. We are in a position to make some comparisons between the results obtained with displays from two different manufacturers. Method and Materials: Reader studies were conducted using a computer generated contrast detail phantom alternately presented against a display background of selected luminance levels. Luminance was also measured at different viewing angles and at four selected room illuminance levels. Image scoring was performed at each combination of background level, viewing angle and room illuminance level. Results: Image scoring performance was interpreted using k values, which reflect the contrast and diameter of the objects detected in the images. The best image scoring results were obtained when viewing angles were kept small, and also when room illuminance was at the level of 5 – 10 lux. Better scoring results were also obtained when the image background luminance was adjusted to 5 – 20 % of maximum. These results differ from what had previously been found when evaluating displays from a different manufacturer. In this case the best scoring results were obtained at zero background and the room illuminance did not seem to have a significant effect on the results obtained when kept in the range of 0 – 20 lux. Conclusion: The results support the view that while it is advisable to keep the viewing angle to a minimum, it may be advisable also to adjust the room illuminance and monitor background luminance to specific levels which may be best suited for a particular AMLCD display.

Contrast-detail analysis of three flat panel detectors for digital radiography

In this paper we performed a contrast detail analysis of three commercially available flat panel detectors, two based on the indirect detection mechanism (GE Revolution XQ/i, system A, and Trixell/Philips Pixium 4600, system B) and one based on the direct detection mechanism (Hologic DirectRay DR 1000, system C). The experiment was conducted using standard x-ray radiation quality and a widely used contrast-detail phantom. Images were evaluated using a four alternative forced choice paradigm on a diagnostic-quality softcopy monitor. At the low and intermediate exposures, systems A and B gave equivalent performances. At the high dose levels, system A performed better than system B in the entire range of target sizes, even though the pixel size of system A was about 40% larger than that of system B. At all the dose levels, the performances of the system C (direct system) were lower than those of system A and B (indirect systems). Theoretical analyses based on the Perception Statistical Model gave similar predicted SNRT values corresponding to an observer efficiency of about 0.08 for systems A and B and 0.05 for system C.

A comparison of low contrast performance for amorphous Silicon/caesium iodide direct radiography with a computed radiography: A contrast detail phantom study

A range of digital image acquisition devices exists in diagnostic radiology. This study compares contrast performance of two such systems: an amorphous Silicon/caesium iodide (a-Si:CsI) based flat panel (DR) digital chest radiography system and a computed radiography (CR) system. Images of a contrast detail resolution phantom were acquired at a range of radiation doses. Three observers assessed all hardcopy images using a four-alternative forced choice observer perception technique. Contrast detail performance was calculated and low contrast performance quantified. The DR system demonstrated significantly better low contrast performance and potential dose savings of up to 75% compared to the CR system. Threshold levels of contrast detail resolution were defined and levels of under- and over-exposure, compared to the threshold level, were highlighted. Both systems were noise limited at lower exposures and latitude limited at higher exposures. The results demonstrate that the DR system should perform better than the CR system under typical clinical conditions relevant to chest radiography particularly for the detection of low contrast details such as lung metastases or pneumothoraces.

Image quality performance of liquid crystal display systems: Influence of display resolution, magnification and window settings on contrast-detail detection

The aim of this study was to investigate the combined effects of liquid crystal display (LCD) resolution, image magnification and window/level adjustment on the low-contrast performance in soft-copy image interpretation in digital radiography and digital mammography. In addition, the effect of a new LCD noise reduction mechanism on the low-contrast detectability was studied. Digital radiographs and mammograms of two dedicated contrast-detail phantoms (CDRAD 2.0 and CDMAM 3.4) were scored on five LCD devices with varying resolutions (1–3- and 5-megapixel) and one dedicated 5-megapixel cathode ray tube monitor. Two 5-megapixel LCDs were included. The first one was a standard 5-megapixel LCD and the second had a new (Per Pixel Uniformity) noise reduction mechanism. A multi-variate analysis of variance revealed a significant influence of LCD resolution, image magnification and window/level adjustment on the image quality performance assessed with both the CDRAD 2.0 and the CDMAM 3.4 phantoms. The interactive adjustment of brightness and contrast of digital images did not affect the reading time, whereas magnification to full resolution resulted in a significantly slower soft-copy interpretation. For digital radiography applications, a 3-megapixel LCD is comparable with a 5-megapixel CRT monitor in terms of low-contrast performance as well as in reading time. The use of a 2-megapixel LCD is only warranted when radiographs are analysed in full resolution and when using the interactive window/level adjustment. In digital mammography, a 5-megapixel monitor should be the first choice. In addition, the new PPU noise reduction system in the 5-megapixel LCD devices provides significantly better results for mammography reading as compared to a standard 5-magapixel LCD or CRT. If a 3-megapixel LCD is used in mammography setting, a very time-consuming magnification of the digital mammograms would be necessary.

Dosisvariation mit einem direkten Selen-Flachbilddetektor - Eine Studie zur Dosisreduktion bis an die Grenzen der diagnostischen Verwertbarkeit

To evaluate the diagnostic quality and minimum required dose to obtain acceptable images for diagnostic purposes in the field of musculoskeletal radiology. A critical comparison of the image quality produced by a novel flat panel detector and the conventional screen/film system using a contrast-detail phantom was performed in phase I. Images from both systems were obtained with the same dose and displayed with similar contrast and density. In phase II images of significant anatomical structures in cadaver extremities obtained using the digital detector system and the standard film/screen system were critically evaluated. After a successive reduction in the X-ray dose for 84 patients in phase III, eight independent radiologists compared the image quality of the screen/film system to that of the novel flat panel detector. Phases I and II revealed a difference in the image quality achieved by the standard screen/film system and the digital detector system to the advantage of the digital detector system. In 77 of 84 patients (91.7 %), phase III showed equal image quality after a 50 % reduction in the X-ray dose. In 3 cases (3.6 %) the image quality and the level of contrast were better. No unified statement could be made for 4 patients (4.7 %). Digital imaging of skeletal disorders using the novel flat panel detector makes it possible to reduce the X-ray dose by 50 % with equal or even better image quality.

Data analysis from a multi-centre, comparative study of angiographic examinations leading to practical guidelines for the optimisation of patient doses

In this study, patient doses were analysed against exposure parameters and procedure protocol. Patient doses were measured in seven hospitals for a standard diagnostic vascular examination. Image quality was assessed using the contrast-detail phantom from Nijmegen (CD-DISC 2.0). A link between dose and image quality was investigated. Image quality strongly depends on the preset dose level. The higher the dose level, the better the image quality, but also the higher the patient dose. However, no clear correlation was found between total dose-area product (DAP) or effective dose and image quality. A large range in patient dose was found: DAP (22-130 Gy cm2) and effective dose (3.9-16.8 mSv). A difference in number of frames was also found in the different centres, owing to different frame rates (3-2-1 frames per second) and use of oblique projections. Differences in doses and exposure settings offer the possibility of optimising patient doses in angiography and interventional radiology.

Investigation of possible methods for equipment self-tests in digital radiology

Quality control in digital radiology can be time-consuming. Equipment self-tests may significantly decrease staff workload. The two most essential parameters for radiology systems are image quality and patient dose. Concerning patient dose, information on the dose-area product (DAP) values generally forms the basis for assessment of patient dose. DAP-values can be measured using a transmission ionisation chamber or calculated from equipment settings. In the present study, various image quality parameters were derived using a contrast-detail (C-D) phantom. The investigation included a computer-aided assessment of C-D images, which produced various parameters, and also parameters based upon scoring by human observers. In addition, another parameter was calculated from modulation transfer function (MTF) measurements. The automatically calculated parameters showed good correlation with human readings, although the number of X-ray systems studied is still limited. We propose a combined evaluation of DAP and automatically calculated C-D or MTF parameters for equipment self-tests.

Analysis of image quality in digital chest imaging

An evaluation of the image quality of an amorphous silicon flat-panel detector system and a computed radiology system compared with a screen-film system was performed by means of contrast-detail phantom images. Hard and soft copy images were evaluated. Although patient dose at clinical settings was strongly decreased with the amorphous silicon system, the low-contrast visibility with this system was still significantly better than with the screen-film system. For the computed radiology system, low-contrast visibility was comparable to the screen-film system. Best results were obtained by soft copy reading at full resolution with adaptation of contrast and brightness. Changing tube voltage (102-133 kV), or additional filtration, did not significantly affect image quality. However, low-contrast visibility improved significantly with increasing exposure. It was clearly demonstrated that, in chest imaging, the amorphous silicon system has superior imaging characteristics compared to the screen-film and the computed radiology system.

Radiation exposure in stent-grafting of abdominal aortic aneurysms

In recent years, endovascular stent-grafting of abdominal aortic aneurysms has become more and more common. The radiation dose associated with these procedures is not well documented however. The aim of the present study was to estimate the radiation exposure and to simulate the effects of a switch from C-arm radiographic equipment to a dedicated angiographic suite. Dose-area product (DAP) was recorded for 24 aortic stent-grafting procedures. Based on these data, entrance surface dose (ESD) and effective dose were calculated. A simulation of doses at various settings was also performed using a humanoid Alderson phantom. The image quality was evaluated with a CDRAD contrast-detail phantom. The mean DAP was 72.3 Gy cm(2) at 28 min fluoroscopy time with a mean ESD of 0.39 Gy and a mean effective dose of 10.5 mSv. If the procedures had been performed in an angiographic suite, all dose values would be much higher with a mean ESD of 2.9 Gy with 16 patients exceeding 2 Gy, which is considered to be a threshold for possible skin injury. The image quality for fluoroscopy was superior for the C-arm whilst the angiographic unit gave better acquisition images. Using a C-arm unit resulted in doses similar to percutaneous coronary intervention (PCI). If the same patients had been treated using dedicated angiographic equipment, the risk of skin injury would be much higher. It is thus important to be aware of the dose output of the equipment that is used.

A printed image quality test phantom for mammography

This communication describes a novel design for a mammographic image quality test phantom, the final design of which was produced as a radiographer weekly quality assurance phantom for breast screening and symptomatic mammography. The phantom is based on low contrast test features which are built up by superimposing sheets of Mylar overhead projector transparency, on which the test features are printed using a standard LaserJet printer. The required radiation contrast at mammographic energies is produced by the approximately 50% by weight component of iron oxide (Fe(3)O(4)) present in the toner. An easily replicated design of mammographic image quality phantom based on LaserJet printed test features is described. Approximately 40 of these phantoms were constructed, and these have been used successfully for 5 years in both breast screening and symptomatic mammography. The phantom design offers a performance similar to much more expensive mammographic contrast-detail phantoms, but suffers from the disadvantage that high contrast resolution bar patterns cannot be produced using the standard printing process.

Optimization of tube potential–filter combinations for film-screen mammography: A contrast detail phantom study

This study evaluated how tube potential–filter combinations [with a molybdenum (Mo) anode and either an Mo or a rhodium (Rh) filter] influence image quality and radiation dose to breasts of different thicknesses in film-screen mammography using a new mammography phantom (CDMAM Phantom Type 3.4). A 28-kVp/Mo tube potential–filter combination is recommended for a breast (phantom) thickness of 40 mm or less, 28 kVp/Rh for a breast (phantom) thickness of 60 mm or less, and 30 kVp/Rh for a breast (phantom) thickness greater than 60 mm.

Despeckling of medical ultrasound images using data and rate adaptive lossy compression

A novel technique for despeckling the medical ultrasound images using lossy compression is presented. The logarithm of the input image is first transformed to the multiscale wavelet domain. It is then shown that the subband coefficients of the log-transformed ultrasound image can be successfully modeled using the generalized Laplacian distribution. Based on this modeling, a simple adaptation of the zero-zone and reconstruction levels of the uniform threshold quantizer is proposed in order to achieve simultaneous despeckling and quantization. This adaptation is based on: (1) an estimate of the corrupting speckle noise level in the image; (2) the estimated statistics of the noise-free subband coefficients; and (3) the required compression rate. The Laplacian distribution is considered as a special case of the generalized Laplacian distribution and its efficacy is demonstrated for the problem under consideration. Context-based classification is also applied to the noisy coefficients to enhance the performance of the subband coder. Simulation results using a contrast detail phantom image and several real ultrasound images are presented. To validate the performance of the proposed scheme, comparison with two two-stage schemes, wherein the speckled image is first filtered and then compressed using the state-of-the-art JPEG2000 encoder, is presented. Experimental results show that the proposed scheme works better, both in terms of the signal to noise ratio and the visual quality.

TU‐FF‐A3‐04: Impact of Room Illuminance On Black Level Luminance and Contrast Detection for Off‐Axis Viewing On High Resolution Normal and High‐Bright Flat Panel Displays

Purpose: Flat panel display image quality is known to be highly dependent on viewing angle. The contribution of room illuminance to black level luminance is well understood for CRTs, but, is not clearly understood for flat panel displays. We have investigated the effect of room illuminance and off axis viewing on displayed image quality. Two high resolution 9.2 megapixel flat panels were evaluated under various room illuminance levels and viewing angles — a standard IBM T221. Method and Materials: Black level luminance was measured at 0, ±15, ±30 and ±45 degrees with room illuminance levels of 0, 2, 5, 10 and 50 lux. Luminance was measured with a Minolta LA‐100a spot meter and illuminance levels were measured with an International Light Luminance Meter IL 1400a. The luminance target (3% of total display area) was centered on the display. Reader studies using a computer generated contrast detail phantom were conducted at each viewing angle and room illuminance level. Five readers read the target images. Specular reflections were minimized for all measurements and reader observations. Results: Minimization of specular reflections in the viewing room minimized the change in measured black level luminance. As room illuminance levels increased and viewing angles became more acute black level luminance increased. Reader results are presented as k‐values and a correlation with room illuminance and black level luminance is demonstrated. The optimal viewing condition was shown to be 0 degrees with a room illuminance of 2 lux. Substantial degradation of measured k‐value and black level luminance occurred at other viewing conditions. Conclusion: Visual perception of small targets is substantially impacted by both viewing angle and room illuminance. The results of these measurements help to explain the observed variations in 5 and 50 lux data presented at the Pittsburgh AAPM meeting.

Priorities in optimisation of medical X-ray imaging—a contribution to the debate

A simplistic approach to optimising medical imaging is to use the lowest effective dose to the patient that does not jeopardise a correct diagnosis. With limited resources and over 1000 different types of X-ray examinations, it is not always easy to set the right priorities and to decide how to perform the optimisation. Recent research shows that the 'Rose model' for the detection of specific structures does not hold for realistic backgrounds. A reasonable conclusion regarding methods for optimisation is therefore not to use contrast-detail phantoms. Phantoms producing clinically realistic background images or real clinical images-modified with respect to quantum noise levels-are preferred. The images should be evaluated using visual grading or receiver operating characteristic methods. The quality of many common X-ray investigations, performed with projection techniques, is not limited by quantum noise. For these, the radiation dose to the patient can be lowered without seriously affecting the outcome of the detection task. For computed tomography (CT) investigations, the obscuring effect of anatomical structures and anatomical noise is less pronounced than in projection techniques. For CT, true optimisation in terms of a trade-off between radiation dose and image quality is therefore more likely to be effective. Both the number of CT examinations performed per year and the effective dose per examination are increasing owing to the technical advances in CT--jointly leading to a steady increase in the collective dose from CT examinations. Moreover, the smaller influence of the anatomical background in CT gives a high correlation between detection tasks and radiation dose. Thus, a reasonable view to take on which examinations to optimise is to give priority to CT examinations. The recommended distribution of a full working week for optimisation, based on the relative lifetime risk of lethal cancer from diagnostic X rays and the total collective dose from CT, is to use three out of five days to optimise CT examinations, of which one day should be devoted to paediatric CT.

Varied tube potential with constant effective dose at lumbar spine radiography using a flat-panel digital detector

The purpose of the study was to evaluate the image quality at different tube potential (kV) settings using anteroposterior lumbar spine radiography as a model. An Alderson phantom was used with a flat-panel detector. The tube potential varied between 48 and 125 kV while the tube charge (mAs) was adjusted to keep an effective dose of 0.11 mSv. Image quality was assessed with a visual grading analysis and with a CDRAD contrast-detail phantom together with a computer program. The VGA showed inferior image quality for the higher kV settings, > or =96 kVwith similar results for the contrast-detail phantom. When keeping the effective dose fixed, it seems beneficial to reduce kV to get the best image quality despite the fact that the mAs is not as high as with automatic exposure. However, this cannot be done with automatic exposure, which is set for a constant detector dose.

Reducing dose in urography while maintaining image quality—a comparison of storage phosphor plates and a flat-panel detector

The introduction of new flat-panel detector technology often forces us to accept too high dose levels as proposed by the manufacturers. We need a tool to compare the image quality of a new system with the accepted standard. The aim of this study was to obtain a comparable image quality for two systems-storage phosphor plates and a flat-panel system using intravenous urography (IVU) as a clinical model. The image quality figure was calculated using a contrast-detail phantom (CDRAD) for the two evaluated systems. This allowed us to set a dose for the flat-panel system that gave equivalent image quality to the storage phosphor plates. This reduced detector dose was used in an evaluation of clinical images to find out if the dose reduction from the phantom study indeed resulted in images of equal clinical image quality. The image quality was assessed using image criteria of the European guidelines for IVU with visual grading analysis. Equivalent image quality in image pairs was achieved at 30% of the dose. The CDRAD contrast-detail phantom makes it possible to find dose levels that give equal image quality using different imaging systems.