Digital Radiography Examination Research Articles

Alveolar bone loss and tooth loss contribute to increase in cancer mortality among older patients

BackgroundBoth cancer and periodontitis are more prevalent with age. Information on their relationship in older patients is limited. This study aims to examine whether periodontitis is associated with increased risk of cancer mortality with a ≥ 75-year age group cohort.MethodsA retrospective cohort study was conducted on 1146 patients who had digital radiographic examinations. Alveolar bone loss and loss of teeth were measured as indicators of periodontitis. Hazard ratio (HR) with 95% confidence interval (CI) were taken as the effect size to summarize the associations between periodontitis and risks of cancer mortality using the multivariate adjusted cox proportional hazards model and competing risk hazard model.ResultsTotally, 104 total cancer, 28 lip, oral cavity and pharynx (LOP) cancer, 39 digestive cancer and 13 respiratory cancer cases were documented over 10 years of follow-up. Total cancer (HR 1.27, 95% CI 1.06–1.53) displayed statistically significant associations with alveolar bone loss and tooth loss after adjusting for relevant confounding variables. We also observed borderline significant association between alveolar bone loss and LOP cancer (HR 1.45, 95% CI 0.99–2.12). The above associations were consistent with the results observed from the competing risk hazard models.ConclusionOur results indicate that older patients suffering from tooth loss or alveolar bone loss are at increased risks of cancer mortality, especially for total cancer and LOP cancer.

Entrance surface air kerma to patients during digital radiographic examinations in Tanzania.

The aim of this study was to determine the entrance surface air kerma (ESAK) in adult patients during digital radiography and to evaluate the optimisation potential in five common X-ray examinations in Tanzania. Based on a sample of 240-610 patients, ESAK was estimated using X-ray tube output measurements, patient information and backscatter factors. The results show that the mean ESAK values were higher or comparable to data from the literature. The diagnostic reference values of ESAK for digital radiography were 0.31 mGy (chest PA), 4 mGy (lumbar spine AP), 5.4 mGy (lumbar spine LAT), 3.8 mGy (abdomen AP) and 2.4 mGy (pelvis AP). For computed radiography, the mean ESAK ranges were 0.44-0.57 mGy (thoracic AP), 3.59-3.72 mGy (lumbar spine AP), 6.16-6.35 mGy (lumbar spine LAT), 3.89-3.44 mGy (abdominal AP) and 2.92-3.47 mGy (pelvic AP). In conclusion, high ESAK variations show the potential for optimising protection in digital radiology.

Estimating the risk of cancer incidence and radiation-induced cancer death of children patients undergoing digital radiology X-ray examinations

BackgroundIt is generally accepted that children are more sensitive to radiation than adults and have a higher relative risk of cancer. The longer life expectancy after exposure increases the risk of developing radiation-associated malignancies. PurposeThis study aims to estimate the risk of cancer incidence and radiation-induced cancer death of children patients undergoing digital radiology X-ray examinations. Material and methodsIn this study, data were collected retrospectively from 15 radiography rooms in the major radiology centers in Mazandaran province (Iran). The information of 12 common digital radiography examinations including pelvis (in the anteroposterior projection (AP)), skull (in the two lateral projection (LAT) and posteroanterior projection (PA)), abdomen (AP), cervical vertebra (AP and LAT), chest (PA and LAT), lumbar vertebra (AP and LAT), thoracic vertebra (AP and LAT) examinations which was recorded from 10 to 15 years old patients. The Entrance Surface Air Kerma (ESAK), Entrance Skin Dose (ESD), and Organ Effective Dose (ED) were measured. Finally, the risk of cancer incidence and Risk of Exposure-Induced cancer Death (REID) values were estimated for these patients. ResultsIn total, 1800 (983 females and 817 males) patients (10–15 years old) were included in this study. Across all procedures, the lowest ED belonged to the skull (PA) examination (10.40 μSv), and the highest ED belonged to the AP abdominal imaging technique (378.46 μSv). The highest ESD was related to the lumbar spine (LAT) projection (3.62 ± 1.38 mGy) and the least to the cervical vertebra (AP) view (0.97 ± 0.21). It was also shown that the differences in cancer incidence and radiation-induced cancer death values in male and female patients were not statistically significant. ConclusionThe result showed that ESDs are influenced by various factors that affect patients' dose distributions, so through the optimization of imaging parameters, image quality can be increased and the patient dose reduced. These actions will necessarily decrease the risk of cancer incidence and radiation-induced mortality risk. Further studies are recommended to assess the workplace environment and practical training in radiology institutions, along with the quality control tests of radiology devices.

Proposed Institutional Diagnostic Reference Levels in Computed and Direct Digital Radiography Examinations in Two Teaching Hospitals

Background: The detectors of both computed radiography (CR) and direct digital radiography (DR) have a wide dynamic range that could tolerate high values of exposure factors without an adverse effect on image quality. Therefore, this study aims to assess patient radiation dose and proposes institutional diagnostic reference levels (DRLs) for two teaching hospitals in Ghana.Materials and Methods: CR and DR systems were utilized in this study from two teaching hospitals. The CR system was manufactured by Philips Medical Systems DMC GmbH, while the DR system was manufactured by General Electric. The entrance skin doses (ESDs) were calculated using the standard equation and the tube output measurements. Free-in-air kerma (μGy) was measured using a calibrated radiation dosimeter. The proposed institutional DRLs were estimated using 75<sup>th</sup> percentiles values of the estimated ESDs for nine radiographic projections.Results and Discussion: The calculated DRLs were 0.4, 1.6, 3.4, 0.5, 0.4, 1.1, 1.0, 1.2, and 1.7 mGy for chest posteroanterior (PA), lumbar spine anteroposterior (AP), lumbar spine lateral (LAT), cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively in CR system. In the DR system, the values were 0.3, 1.6, 3.1, 0.4, 0.3, 0.7, 0.6, 0.9, and 1.3 for chest PA, lumbar spine AP, lumbar spine LAT, cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively.Conclusion: Institutional DRLs in nine radiographic projections have been proposed for two teaching hospitals in Ghana for the first time. The proposed DRLs will serve as baseline data for establishing local DRLs in the hospitals and will be a valuable tool in optimizing patient doses.

Wheel-made pottery of the Przeworsk culture in the light of digital radiography examinations. Preliminary study of vessels from the microregion to the east of the lower Raba River

The article presents the results obtained by examining wheel-made pottery with the use of digital radiography. As exemplified by selected fragments, the possibilities offered by this method of studying the production techniques applied in Przeworsk culture ceramics are presented. Vessel sherds from the younger and late Roman period from workshops located in the microregion east of the lower Raba River (sites in Strzelce Małe and Bessów) were analysed. Analysis of X-radiography images offers some insight into the features of the primary forming techniques used and the structure of the clay fabric.

A Comparative Evaluation of Digital Radiography and Ultrasound Imaging to Detect Periapical Lesions in the Oral Cavity.

Purpose This study evaluates the efficacy of digital radiography and ultrasound (USG) for the distinction between periapical cysts and granulomas, determines the nature and extent of the periapical lesion, visualizes the lumen of the lesion, assesses its size, content, and vascularity. Material and Methods Thirty patients, ages 18 to 40, with well-defined periapical radiolucencies on maxillary or mandibular teeth, indicated for the extraction or periapical surgery, underwent digital radiography examination using the paralleling technique, followed by USG examination. A sonologist evaluated the lesions' size, echogenicity, and vascular content. The diagnosis was compared to histopathological examinations of tissues obtained through extraction or periapical surgery. Results The diagnostic value of USG compared to the histopathological diagnosis of the periapical cyst was greater than that of the radiographic diagnosis, with an ultrasonographic diagnostic sensitivity (SN) value of 60% and a radiographic diagnostic SN value of 40%, respectively. The diagnostic value of USG imaging against the histopathological diagnosis of periapical granuloma was slightly lower than that of digital radiography, with an SN value of 72.2% for USG and 83.33% for digital radiography. However, the specificity (SP) value and precision of USG imaging were superior to those of digital radiographic diagnosis. USG imaging and radiographic diagnosis had 58.33% and 50% SP values, respectively. In cases of periapical abscess, the diagnostic values of USG against histopathological diagnosis were lower than those of radiographic diagnosis, which had an SN value of 100%. Conclusion USG with color doppler is a more effective tool than digital radiography for diagnosing periapical lesions. The echo structure of the lesions and the presence of vascularity on USG with color doppler correlated with histopathology better than the radiological diagnosis.

Collateral aortic branches in the collared peccary (Pecari tajacu Linnaeus, 1758).

The determination of arterial vascular distribution patterns can contribute to more detailed knowledge on arterial systems. In this context, the aim of the present study was to describe the collateral aortic branches in the collared peccary, aiming to define a standard model for this species, providing information through comparative anatomy for analysis of some evolutionary aspects of the order Artiodactyla. Ten young male animals were employed. The vascular system was washed with a saline solution and then perfused with Neoprene 450 latex coloured with red or yellow pigment, followed by collateral aorta branch dissections and analyses. The contrasted digital radiography technique was applied to two animals, which were initially perfused with a barium sulphate solution (1 g/ml) and Neoprene 450 latex at a 1:3 ratio, and subsequently, the digital radiographic examination was performed. The aortic arch of the collared peccary emitted the brachiocephalic trunk and the left subclavian artery, while eight symmetric pairs of dorsal intercostal arteries originated from the thoracic aorta. The abdominal aorta, in turn, exhibited the celiac, cranial mesenteric, renal, caudal mesenteric, testicular, external iliac, internal iliac and sacral arteries as the collateral branches in all studied animals. Therefore, no relevant variations were observed regarding the arrangement of the arterial distribution of the aorta, thus suggesting a static standard model in the collared peccary.

A pilot study on deep learning-based grading of corners of vertebral bodies for assessment of radiographic progression in patients with ankylosing spondylitis.

Background:Radiographs are widely used to evaluate radiographic progression with modified stoke ankylosing spondylitis spinal score (mSASSS).Objective:This pilot study aimed to develop a deep learning model for grading the corners of the cervical and lumbar vertebral bodies for computer-aided detection of mSASSS in patients with ankylosing spondylitis (AS).Methods:Digital radiographic examination of the spine was performed using Discovery XR656 (GE Healthcare) and Digital Diagnost (Philips). The disk points were detected between the bodies using a key-point detection deep learning model from the image obtained in DICOM (digital imaging and communications in medicine) format from the cervical and lumbar spinal radiographs. After cropping the vertebral regions around the disk point, the lower and upper corners of the vertebral bodies were classified as grade 3 (total bony bridges) or grades 0, 1, or 2 (non-bridges). We trained a convolutional neural network model to predict the grades in the lower and upper corners of the vertebral bodies. The performance of the model was evaluated in a validation set, which was separate from the training set.Results:Among 1280 patients with AS for whom mSASSS data were available, 5,083 cervical and 5245 lumbar lateral radiographs were reviewed. The total number of corners where mSASSS was measured in the cervical and lumbar vertebrae, including the upper and lower corners, was 119,414. Among them, the number of corners in the training and validation sets was 110,088 and 9326, respectively. The mean accuracy, sensitivity, and specificity for mSASSS scoring in one corner of the vertebral body were 0.91604, 0.80288, and 0.94244, respectively.Conclusion:A high-performance deep learning model for grading the corners of the vertebral bodies was developed for the first time. This model must be improved and further validated to develop a computer-aided tool for assessing mSASSS in the future.

Analysis of osteoblast, osteoclast levels and radiographic patterns in the healing process of bone fractures (preliminary research)

Objectives: The healing process of a bone fracture goes through many phases. The hard callus phase was critical where the original structure was conducted. The hard callus growth depends on osteoblasts and osteoclasts active, and this condition can be analyzed on the radiograph. This study aimed to examine the analysis of bone fracture healing between osteoblasts and osteoclast numbers and radiographic patterns.
 Materials and Methods: The study used 12 male Wistar rats with an incomplete fracture in the right femur made by a dental tapered bur with 0.3 mm in length and 0.2 mm in depth. Digital radiographic examinations were carried out on days 0, 5, 10, 17, and 25 after fracturing in a lateral position. Furthermore, a radiographic analysis was performed using Image-J to obtain changes in the value of length and depth in the healing area. The research was conducted to find the radiopaque and radiolucent patterns and the number of osteoblasts and osteoclasts.
 Results: This study resulted in a change in the radiograph pattern. Callus formation resulted in fracture areas with a smaller distance from day 0 to day 25. The bone healing process begins with granulation tissue formation, followed by the gradual replacement of the connective tissue and bone. This process is comparable to the increase in osteoblasts up to day 25, which blocks bone resorption. Osteoclasts regulate bone resorption, and their number increases after 10 and 17 days to replace bone formation. Osteoclasts decline after 25 days because osteoblasts inhibit them, which control bone formation.
 Conclusion: The conclusions were obtained there are changes in the radiograph pattern. The radiopaque increased while the radiolucent decreased; the osteoclast pattern tended to be stable and lowered while the osteoblasts increased during the fracture healing process. The correlation of all the factors is very closely related.

Effects of Exposure Dose Reduction by Optimization of Automatic Exposure Control Factors in Digital Radiographic Examination of Paranasal Sinus

Effects of Exposure Dose Reduction by Optimization of Automatic Exposure Control Factors in Digital Radiographic Examination of Paranasal Sinus

Comparison of Laser Fluorescence and Digital Radiograph with International Caries Detection and Assessment System in Primary Teeth (In-vivo study)

Background: There has been an increased incidence of dental caries in children due to recent changes in lifestyle. More sensitive and reproducible diagnostic tools for precise caries detection in children are needed because of the complex occlusal anatomy. Aim: To compare the clinical performance and accuracy of international caries detection and assessment system-II (ICDAS II) versus DIAGNOdent pen and digital bitewing radiograph in the detection of occlusal caries in the primary teeth. Materials and Methods: Fifty children aged 6-11 years were assessed of both gender (29 girls and 21 boys) and 377 occlusal surface of primary teeth were examined by visual ICDAS II, DIAGNOdent pen and digital bitewing radiographic examination at D0 (non caries lesions), D1 (lesions limited to enamel) and D2 (lesions limited to dentin) thresholds. Results: Sensitivity at D0 for ICADS II was 14.23% and 95.95% for DIAGNOdent pen and 87.85% for digital bitewing, radiographs while specificity for both ICADS II and bitewing radiographs were 99.23% but 73.85% for DIAGNOdent pen. At D1, threshold sensitivity of ICADS II and digital bitewing radiographs were higher than DIAGNOdent pen but specificity for bitewing radiographs and DIAGNOdent pen 90.69% - 87.99%. were highly significant than ICADS II At D2, threshold specificity for all diagnostic methods was almost similar with better sensitivity for ICADS II and digital bitewing radiographs. Conclusion: This study showed that ICDAS II, Diagnodent pen, and bitewing radiography are effective for the detection of occlusal caries for primary molars. Digital bitewing radiography correlated stronger with ICDASII than Diagnodent pen and proved to be the best method to detect occlusal lesions within the dentin in primary molars while Diagnodent pen and bitewing radiography are better for detecting enamel caries lesion. In addition, the clinical performance of three diagnostic methods was insufficient to detect occlusal caries lesions separately. Consequently, it is advisable to use a combination of diagnostic methods, especially in unclear cases, as well as in cases of initial lesions and their monitoring.

ESTIMATION OF ENTRANCE SURFACE AIR KERMA IN DIGITAL RADIOGRAPHIC EXAMINATIONS.

Contribution of radiation doses from medical X-ray examination to collective dose is significant. Unusually, high doses may increase the risk of stochastic effects of radiations. Therefore, radiation dose assessment was performed in 241 digital X-ray examinations in the study and was compared with published dose reference levels (DRLs). Entrance surface air kerma (ESAK) was calculated in chest PA, cervical AP/Lat, abdomen AP, lumbar AP/Lat and pelvis AP digital radiographic examinations (119 male and 122 female) following the International Atomic Energy Agency recommended protocol. Initially, 270 digital examinations were selected, reject analysis was performed and final 241 examinations were enrolled in the study for dose calculations. The exposure parameters and X-ray tube output were used for dose calculations. Effective doses were estimated with the help of conversion coefficients from ICRP 103. Median ESAK (mGy) and associated effective doses obtained were cervical spine AP (1.30mGy, 0.045mSv), cervical spine Lat (0.25mGy, 0.005mSv), chest PA (0.11mGy, 0.014mSv), abdomen AP (0.90mGy, 0.118mSv), lumbar spine AP (1.52mGy, 0.177mSv), lumbar spine Lat (7.76mGy, 0.209mSv) and pelvis AP (0.82mGy, 0.081mSv). Results were compared with the studies of UK, Oman, India and Canada. The calculated ESAK and effective dose values were less than or close to previously published literature except for cervical spine AP and lumbar spine Lat. The results reinforce the need for radiation protection optimization, improving examination techniques and appropriate use of automatic exposure control in digital radiography. ESAK values reported in this study could further contribute to establishing local DRLs, regional DRLs and national DRLs.

Estimating the cancer risk and mortalities induced by routine digital radiography examinations on patient of different ages in Mazandaran province

Estimating the cancer risk and mortalities induced by routine digital radiography examinations on patient of different ages in Mazandaran province

Lifetime attributable risk of cancer incidence and mortality in routine digital radiology procedures

PurposeDigital radiography has the potential to improve the practice of radiography but it also has the potential to significantly increase patient doses. Considering rapidly growing digital radiography in many centers, concerns rise about increasing the collective dose of the human population and following health effects. This study aimed to estimate organ and effective doses and calculate the lifetime attributable risk (LAR) of cancer incidence and mortality in digital radiography procedures in Iran. MethodsOrgan and effective doses of 12 routine digital radiography examinations including the skull, cervical spine, chest, thoracic spine, lumbar spine, pelvic and abdomen were estimated using PCXMC software based on Monte Carlo simulation method. Then, LARs of cancer incidence and mortality were estimated using the BEIR VII method. ResultsOrgan doses ranged from 0.01 to a maximum of 2.5 mGy while effective doses ranged from 0.01 to 0.7 mSv. Radiation risk showed dependence on the X-ray examination type and the patient's sex and age. In skull and cervical X-rays, the thyroid; in the chest and thoracic spine X-rays, the lung, and breast; and in the lumbar spine, pelvic and abdominal X-rays, the colon and bladder had the highest LAR of cancer incidence and mortality. Furthermore, younger patients and also females were at higher radiation risk. ConclusionThe lifetime attributable risk of cancer incidence and mortality due to radiation exposure is not trivial. Therefore efforts should be made to reduce patient doses while maintaining image quality.

Current Radiographic Practices and Radiation Dose Evaluation

To investigate the current radiographic practices in a public tertiary care teaching hospital in digital radiography set-up, the study aimed to calculate the entrance surface air kerma (ESAK), kerma area product (PKA), and effective doses in chest PA, and AP digital radiographic examinations. Chest radiography is the most common examination performed worldwide. Due to the frequency of these examinations, its contribution to the collective dose is considerable. Also, various international authorities have recommended guidelines for local dose surveys for radiation protection and optimization. IAEA recommended protocol was used to calculate the patient doses. The 3rd quartile values of ESAK and PKA obtained are 0.17 mGy and 0.27 Gycm2 for chest PA; 0.38mGy and 0.21 Gycm2 for chest AP. The estimated mean effective doses are 0.017 (ED from ESAK), 0.037 (ED from PKA) for chest PA and 0.041 (ED from ESAK), 0.028 (ED from PKA) for chest AP. The results obtained are compared with ESAK, PKA, and effective dose values of previously published literature. The estimated doses could be used as a baselines value for setting up of future local diagnostic reference levels (LDRLs) and for optimization of patient doses in diagnostic radiology.

DETERMINATION OF DIAGNOSTIC REFERENCE LEVEL IN ROUTINE EXAMINATIONS OF DIGITAL RADIOGRAPHY IN MAZANDARAN PROVINCE.

The main purpose of this study was to determine the diagnostic reference level (DRL) for routine digital radiography examinations in Mazandaran province. Thirteen digital radiographic examinations at 18 high-patient-load radiography centres were investigated. The indirect dosimetry method was performed based on the IAEA report. Average entrance skin dose (ESD) and the third quartile of ESD as the DRL were evaluated from the measurement made by a semiconductor dosemeter. DRL for the examinations of digital radiography was obtained as: Skull (postero-anterior [PA]): 2.2, skull (lateral [LAT]): 2.4, cervical spine (antero-posterior [AP]): 1.6, cervical spine (LAT): 1.7, thoracic spine (AP): 3.6, thoracic spine (LAT): 9.9, lumbar spine (AP): 5.3, lumbar spine (LAT): 11.8, chest (PA): 1.4, chest (LAT): 2.1, abdomen (AP): 4.3, pelvis (AP): 3.2 and hip (AP): 2.1mGy. Although DRL was not higher compared with the international organisations' levels, it can be reduced by adequate training of radiographers.

Variation of Pediatric Doses Undergoing Digital and Computed Radiography Examination in Addis Ababa, Ethiopia.

Various researchers who carried out national and international surveys have reported wide variations in patient dose arising from specific X-ray examinations. Thus, assessment of radiation dose is an essential part in the optimization process. The aim of this study was to compare the entrance surface doses delivered to pediatric patients undergoing digital and computed radiography X-ray examination. A cross-sectional study was conducted on 389 pediatric X-ray projections less than 15 years of age on eight X-ray machines in Addis Ababa in February 2009 E.C. The tube output of the X-ray machines in air was measured using RaySafe XI dosimeters. Then, entrance surface dose was estimated for common x-ray examinations like chest, skull, extremities and pelvis using established relation between X-ray tube output and radiographic parameters. These data were analyzed statistically using computer (Excel and SPSS method). The third quartile estimated ESDs in mGy for both computed and digital radiography examinations of chest (AP) for age (0-1 year) were 0.24 and 0.15, (1-5 year) 0.3 and 0.16. For the age group (5-10 year), it was 1.97 and 0.26 and for the (10-15 year) group, 0.56 and 0.18 respectively. These values were higher than those of the United Nations Scientific Committee's on the Effects of Atomic Radiation's established dose reference levels (in mGy for age (0-1 year) 0.02, (1-5 year) 0.03, (5-10 year) 0.04, and (10-15 year) 0.05 respectively). The wider dose variation between computed and digital radiography shows that there is a pressing need to minimize the detriment caused by unnecessary computed radiography.

Evaluation of Transfer Learning with Deep Convolutional Neural Networks for Screening Osteoporosis in Dental Panoramic Radiographs

Dental panoramic radiographs (DPRs) provide information required to potentially evaluate bone density changes through a textural and morphological feature analysis on a mandible. This study aims to evaluate the discriminating performance of deep convolutional neural networks (CNNs), employed with various transfer learning strategies, on the classification of specific features of osteoporosis in DPRs. For objective labeling, we collected a dataset containing 680 images from different patients who underwent both skeletal bone mineral density and digital panoramic radiographic examinations at the Korea University Ansan Hospital between 2009 and 2018. Four study groups were used to evaluate the impact of various transfer learning strategies on deep CNN models as follows: a basic CNN model with three convolutional layers (CNN3), visual geometry group deep CNN model (VGG-16), transfer learning model from VGG-16 (VGG-16_TF), and fine-tuning with the transfer learning model (VGG-16_TF_FT). The best performing model achieved an overall area under the receiver operating characteristic of 0.858. In this study, transfer learning and fine-tuning improved the performance of a deep CNN for screening osteoporosis in DPR images. In addition, using the gradient-weighted class activation mapping technique, a visual interpretation of the best performing deep CNN model indicated that the model relied on image features in the lower left and right border of the mandibular. This result suggests that deep learning-based assessment of DPR images could be useful and reliable in the automated screening of osteoporosis patients.

A study to evaluate the efficacy of intra oral periapical radiographs (IOPA) in the diagnosis of osteoporosis in postmenopausal women, as compared to ultrasonography of calcaneus

Introduction: The risk factors for the development of osteoporosis include ageing, menopause, insufficient consumption of food containing calcium, familial education and decreased physical activity. Dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound are among the techniques developed to identify individuals with osteoporosis and serve as the gold standard. These methods are very expensive and hence there is a need to develop alternative methods to diagnose osteoporosis in postmenopausal women. Objectives: 1. To evaluate digital IOPAs in post-menopausal women for changes in the trabecular pattern, to assess osteoporosis in postmenopausal women by comparing with USG-calcaneus; 2. To assess the changes in the serum calcium levels in osteoporosis in postmenopausal women by comparing with USG-calcaneus. Materials and Methods: 100 patients were divided into 2 groups (pre and post-menopausal women.) Each patient underwent digital radiographic examination of premolar molar region of the mandible on the right side using bisecting angle technique and the density measurements i.e. grey values were measured and trabecular patterns were assessed in these radiographs. 2 ml of blood sample was taken from antecubital vein by venipuncture method and serum calcium was estimated. USG - Calcaneus Estimation was done and the speed of sound in m/sec for every patient was also noted. Results: It was found that 46% of patients in the postmenopausal group had a sparse trabecular pattern, while only 2% in the premenopausal group showed similar findings. Significantly higher numbers of patients with sparse trabeculation were observed in the postmenopausal group (p < 0>p-value 0.0009). (54%). No significant differences in the mean levels of serum calcium were observed between the postmenopausal and premenopausal groups. Conclusion: Intra oral periapical radiographs (IOPA) seem to be a promising tool in screening post-menopausal women for osteoporosis. The indices used in th

Evaluation of the dose reduction capabilities in digital radiography of the chest using contrast-detail phantom

Assessment of the quality of the images obtained using optimized (low-dose) protocols is the inherent part of the optimization in X-ray diagnostics. To perform the objective quantitative image quality assessment one can use dedicated test-objects, including several components for the simultaneous measurement of the different physical image characteristics (contrast and spatial resolution). The use of such test objects allows estimating and assessing the relations between the patient dose, parameter of the X-ray examination and image quality. That is especially important for the optimization of the digital radiographic examinations performed with automated exposure control. The aim of the current study was to evaluate the possibilities of the patient dose reduction using “contrast-detail” test-object for the digital radiography of the chest in posterior-anterior projection performed with automated exposure control. The study was performed in St-Petersburg Mariinsky hospital on a digital X-ray unit “ARC-Electron” with a flat-panel detector. The combination of a test-object and a tissue-equivalent phantom were imaged on a range of chest X-ray protocols: on a 60–150 kV tube voltage range with automated exposure control; and using fixed 90 kV tube voltage on a range of 2–100 mAs tube current-exposure time product. Dose-area product (cGy×cm2) was measured for each exposure; effective dose (mSv) was estimated for each exposure based on dose-area product. A dedicated software was developed for the automated image quality assessment. The results of the study indicate that the use of a high tube voltage (140–150 kV) with current automated exposure control settings would lead to 60% and 95% reduction of the dose-area product and effective dose, respectively, compared to the standard protocol. The adjustment of the current automated exposure control settings with the reduction of the tube current-exposure time product from 11,2 mAs to the 4,2 mAs for the tube voltage of 90 kV would lead to the reduction of both the dose-area product and effective dose up to a factor of three, compared to the standard protocol. For both scenarios image quality characteristics decreased by less than 15%. The proposed low-dose protocols are under the clinical approbation at Mariinsky hospital. The proposed method of image quality assessment and development of low-dose protocols is recommended for inclusion in the quality assurance program for the radiography examinations.