Flat-panel Detector System Research Articles

Ventilatory impairment detection based on distribution of respiratory-induced changes in pixel values in dynamic chest radiography: a feasibility study

Decreased ventilation is observed on chest radiographs as small changes in X-ray translucency, and ventilatory impairments can therefore be detected by analyzing the distribution of respiratory-induced changes in pixel value. This study was performed to develop a ventilatory impairment detection method based on the distribution of respiratory-induced changes in pixel values. Sequential chest radiographs during respiration were obtained using a dynamic flat panel detector system. Respiratory-induced changes in pixel value were measured in each local area and then compared for symmetrical positions in both lungs, which were located at the same distance from the axis of the thorax at the same level. The right-left symmetry was assessed in 20 clinical cases (Abnormal, 14; Normal, 6). In normal controls, the distribution was symmetrical, and there were good correlations of the pixel value changes in both lungs at symmetrical positions (r = 0.66 ± 0.05). In contrast, abnormal cases did not show a symmetrical distribution of pixel value changes (r = 0.40 ± 0.23) due to ventilation abnormalities observed as reductions in pixel value changes. Ventilatory impairment could be detected as deviation from the right-left symmetry of respiratory-induced changes in pixel value. In particular, the present method could be useful for detecting unilateral abnormalities. However, to detect bilateral abnormalities, further studies are required to develop multilevel detection methods combined with several methods of pattern analysis.

Does a flat panel detector reduce the patient radiaton dose in interventional cardiology?

An internal audit has been performed to evaluate the patient radiation dose in the clinical use of X-ray cardiac flat panel detector (FPD) systems. Fluoroscopy and image acquisition (cine mode) programs are optimised for low-dose settings. The diagnostic and therapeutic interventional cardiac procedures are performed at 6 pulse s(-1) for fluoroscopy and 15 frames s(-1) for image acquisition. The FPD entrance dose is configured for 29 nGy pulse(-1) in the fluoroscopy mode and 0.10 microGy frame(-1) in the cine mode. From the data collected, the following local reference levels for coronary angiography and angioplasty have been obtained: kerma-area products 23 and 44 Gy cm(2), cumulative doses 376 and 776 mGy, fluoroscopy times 5 and 15.5 min and cine images 617 and 1163 images.

An X-ray Computed Tomography/Positron Emission Tomography System Designed Specifically for Breast Imaging

Mammography has served the population of women who are at-risk for breast cancer well over the past 30 years. While mammography has undergone a number of changes as digital detector technology has advanced, other modalities such as computed tomography have experienced technological sophistication over this same time frame as well. The advent of large field of view flat panel detector systems enable the development of breast CT and several other niche CT applications, which rely on cone beam geometry. The breast, it turns out, is well suited to cone beam CT imaging because the lack of bones reduces artifacts, and the natural tapering of the breast anteriorly reduces the x-ray path lengths through the breast at large cone angle, reducing cone beam artifacts as well. We are in the process of designing a third prototype system which will enable the use of breast CT for image guided interventional procedures. This system will have several copies fabricated so that several breast CT scanners can be used in a multi-institutional clinical trial to better understand the role that this technology can bring to breast imaging.

直接，間接変換方式の違いにおけるフラットパネルディテクタのノイズ特性の比較

Flat-panel detector (FPD) digital radiography systems have direct and indirect conversion systems, and the 2 conversion systems provide different imaging performances. We measured some imaging performances [input-output characteristic, presampled modulation transfer function (presampled MTF), noise power spectrum (NPS)] of direct and indirect FPD systems. Moreover, some image samples of the NPSs were visually evaluated by the pair comparison method. As a result, the presampled MTF of the direct FPD system was substantially higher than that of the indirect FPD system. The NPS of the direct FPD system had a high value for all spatial frequencies. In contrast, the NPS of the indirect FPD system had a lower value as the frequency became higher. The results of visual evaluations showed the same tendency as that found for NPSs. We elucidated the cause of the difference in NPSs in a simulation study, and we determined that the cause of the difference in the noise components of the direct and indirect FPD systems was closely related to the presampled MTF.

Performance characterization of a MVCT scanner using multislice thick, segmented cadmium tungstate‐photodiode detectors

Megavoltage computed tomography (MVCT) and megavoltage cone beam computed tomography (MVCBCT) can be used for visualizing anatomical structures prior to radiation therapy treatments to assist in patient setup and target localization. These systems are less susceptible to metal artifacts and provide better CT number linearity than conventional CT scanners. However, their contrast is limited by the properties of the megavoltage photons and the low detective quantum efficiency (DQE) of flat panel detector systems currently available. By using higher DQE, thick, segmented cadmium tungstate detectors, the authors can improve the low contrast detectability of a MVCT system. This in turn would permit greater soft tissue visualization for a given radiation dose, allowing MVCT to be used in more clinical situations. This article describes the evaluation of our prototype system that uses thick, segmented detectors. In order to create images using a dose that would be acceptable for day to day patient imaging, the authors evaluated their system using the low intensity bremsstrahlung component of a 6 MeV electron beam. The system was evaluated for its uniformity, high contrast resolution, low contrast detectability, signal to noise ratio, contrast to noise ratio, and CT number linearity. The prototype system was found to have a high contrast spatial resolution of about 5 line pairs per cm, and to be able to visualize a 15 mm 1.5% contrast target with 2 cGy of radiation dose delivered. SNR2 vs radiation dose and mean pixel value vs electron density curves were linear. This prototype system shows a large improvement in low contrast detectability over current MVCBCT systems.

Development of pulmonary blood flow evaluation method with a dynamic flat-panel detector: quantitative correlation analysis with findings on perfusion scan

Pulmonary blood flow is reflected in dynamic chest radiographs as changes in X-ray translucency, i.e., pixel values. Thus, decreased blood flow should be observed as a reduction of the variation of X-ray translucency. We performed the present study to investigate the feasibility of pulmonary blood flow evaluation with a dynamic flat-panel detector (FPD). Sequential chest radiographs of 14 subjects were obtained with a dynamic FPD system. The changes in pixel value in each local area were measured and mapped on the original image by use of a gray scale in which small and large changes were shown in white and black, respectively. The resulting images were compared to the findings in perfusion scans. The cross-correlation coefficients of the changes in pixel value and radioactivity counts in each local area were also computed. In all patients, pulmonary blood flow disorder was indicated as a reduction of changes in pixel values on the mapping image, and a correlation was observed between the distribution of changes in pixel value and those in radioactivity counts (0.7 <or= r, 3 cases; 0.4 <or= r < 0.7, 7 cases; 0.2 <or= r < 0.4, 4 cases). The results indicated that the distribution of changes in pixel value could provide a relative measure related to pulmonary blood flow. The present method is potentially useful for evaluating pulmonary blood flow as an additional examination in conventional chest radiography.

Three-Dimensional Intravenous Digital Subtraction Angiography Using Flat Panel Detector System in Vascular Mapping of the External Carotid Artery: A Comparison with 3-Dimensional Computed Tomography Angiography

Super-selective intra-arterial infusion chemotherapy for head and neck cancer via the superficial temporal artery is an established procedure. Three-dimensional computed tomography angiography (3D-CTA) has often been used to assess the arterial anatomy. However, 3D-CTA images are sometimes affected by severe metallic artifacts near the oral cavity region, due to the presence of metallic dental materials. This study has evaluated 3-dimensional intravenous digital subtraction angiography (3D-IV-DSA) using a flat panel detector (FPD) system in vascular mapping of the external carotid artery (ECA), in comparison with 3D-CTA. To clarify the vascular anatomy of ECA branches, 15 patients had undergone both 3D-IV-DSA and 3D-CTA. The angiographic images of the ECA were generated using a volume-rendering technique. The 15 patients were also divided into two groups according to the existence of adverse effects due to dental metallic artifacts on 3D-CTA.Images from 3D-IVDSA were statistically significantly superior to 3D-CTA (P < 0.05). In particular, when metallic artifacts affected 3DCTA images, 3D-IV-DSA was able to depict the ECA more clearly. These findings confirm the utility of 3D-IV-DSA, and the technique may be particularly suitable for patients with metallic dental materials. Keywords: 3D-IV-DSA, rotational angiography, 3D-CTA, metallic artifacts, intra-arterial infusion chemotherapy, head and, neck cancer

Pulmonary blood flow evaluation using a dynamic flat-panel detector: feasibility study with pulmonary diseases

Pulmonary ventilation and circulation dynamics are reflected on fluoroscopic images as changes in X-ray translucency. The purpose of this study was to investigate the feasibility of non-contrast functional imaging using a dynamic flat-panel detector (FPD). Dynamic chest radiographs of 20 subjects (abnormal, n = 12; normal, n = 8) were obtained using the FPD system. Image analysis was performed to get qualitative perfusion mapping image; first, focal pixel value was defined. Second, lung area was determined and pulmonary hilar areas were eliminated. Third, one cardiac cycle was determined in each of the cases. Finally, total changes in pixel values during one cardiac cycle were calculated and their distributions were visualized with mapping on the original image. They were compared with the findings of lung perfusion scintigraphy. In all normal controls, the total changes in pixel value in one cardiac cycle decreased from the hilar region to the peripheral region of the lung with left-right symmetric distribution. In contrast, in many abnormal cases, pulmonary blood flow disorder was indicated as a reduction of changes in pixel values on a mapping image. The findings of mapping image coincided with those of lung perfusion scintigraphy. Dynamic chest radiography using an FPD system with computer analysis is expected to be a new type of functional imaging, which provides pulmonary blood flow distribution additionally.

Ｆｌａｔｐａｎｅｌｄｅｔｅｃｔｏｒ（ＦＰＤ）装置を使用した小児ディジタル胸部撮影における最適ヒストグラム解析の検討

Optical density of the lung area in pediatric digital chest radiography using an indirect flat panel detector (FPD) system were changed enormously by the influence of such factors as the size of lung area, gas of retroperitoneum, and so on. Our purpose in this study was to improve the stability of lung density on output images by means of optimizing histogram analysis. Chest images of a lung phantom were taken at various X-ray tube voltages and processed using a half-type region of interest (ROI) for the lung area. The shape of the histogram obtained by two different calculation methods including frequency distribution and cumulative relative frequency were compared, and digital chest images of 110 clinical cases in our hospital were classified into three age-groups (under 6 years old, over 6 years old and under 13 years old, and over 13 years old) and their histograms were analyzed. In conclusion, it was important that to analyze the histograms of age-groups, a cumulative relative frequency histogram should be used because the influence of X-ray tube voltage was lower than the frequency distribution histogram, and stabilized lung density under 6 years old could be obtained if the value of the imaging parameter for lung density from default was 90% to 85% or 80% because the distribution of lung area and its center value were significantly lower than in those over 13 years old.

動画対応フラットパネルディテクタによる肺機能画像診断法：肺シンチグラフィ所見との比較

Pulmonary ventilation and circulation dynamics are reflected on dynamic chest radiographs as changes in X-ray translucency,i.e., pixel values. The present study was performed to develop a pulmonary functional evaluation method based on the changes in pixel value, and to investigate the clinical usefulness of our method. Sequential chest radiographs of 20 subjects (abnormal,n=12; normal,n=8) during respiration were obtained with a dynamic flat-panel detector (FPD) system. The average pixel value in each local area was measured tracking the same area. To facilitate visual evaluation, the results were mapped on the original image using a grayscale in which small changes were shown in black and large changes were shown in white. In our clinical evaluation in comparison with a pulmonary scintigraphy, pulmonary ventilation disorder was indicated as a reduction of changes in pixel values. In many patients, there was a correlation between our result and a pulmonary scintigraphy (0.7<r, 4 cases; 0.4<r<or=0.7, 6 cases; 0.2<r<or=0.4, 1 case; 0<r<or=0.2, 1 case). The present method with real-time computer analysis is expected to be a rapid and simple method for evaluating pulmonary function and as an additional examination in conventional chest radiography.

Specific Issue Related Flat Panel Detector System

Specific Issue Related Flat Panel Detector System

アモルファスセレンを用いた直接変換型ＦＰＤ装置における残像現象の測定

The purpose of this study was to evaluate the residual effect generated by the amorphous selenium flat panel detector system (a-Se FPD). A residual effect occurs as a result of the addition of delayed electrons by previous X-ray irradiation joining the signal and change in detector sensitivity caused by hole-electron recombination or trapped electrons in a-Se. To evaluate the effect of previous radiation exposure, we irradiated a-Se FPD that were half-shielded by a 3 mm thick lead plate. A residual effect was generated in irradiated areas, with the unirradiated areas serving as reference points. Next, we removed the lead plate and took a new image using uniform irradiation. The difference in pixel value between irradiated and nonirradiated areas was measured using a variety of time intervals between each exposure. Through a comparison of pixel values from images taken over various time intervals, we discovered our system needs 20 hours to return to a normal state and become capable of producing a residual-free image.

Does digital flat detector technology tip the scale towards better image quality or reduced patient dose in interventional cardiology?

As dynamic flat-panel detectors (FD) are introduced in interventional cardiology (IC), the relation between patient dose and image quality (IQ) needs to be reconsidered for this type of image receptor. On one hand this study investigates IQ of a FD system by means of a threshold contrast-detail analysis and compares it to an image intensifier (II) system on a similar X-ray setup. On the other hand patient dose for coronary angiography (CA) procedures on both systems is compared by Dose-Area Product (DAP)-registration of a patient population. The comparative IQ study was performed for a range of entrance dose rates (EDR) covering the fluoroscopy and cinegraphy working mode. In addition the IQ investigation was extended to a similar study under automatic brightness control (ABC). As well the systematic study of IQ as a function of EDR as the study performed under ABC point to a better IQ for FD in cinegraphy mode and no difference between both systems in fluoroscopy mode. The patient population study resulted in mean DAP values of 31 Gy cm 2 (II system) and 33 Gy cm 2 (FD system) ( p = 0.68) for CA procedures. As well total DAP as contributions of fluoroscopy and cinegraphy on both systems are not significantly different. To conclude, we could state that profit was taken from the intrinsic better performance of the FD for cinegraphy mode in producing higher quality images in this mode but without any effect on patient dose for CA procedures.

Development of functional chest imaging with a dynamic flat-panel detector (FPD)

Dynamic FPD permits the acquisition of distortion-free radiographs with a large field of view and high image quality. In the present study, we investigated the feasibility of functional imaging for evaluating the pulmonary sequential blood distribution with an FPD, based on changes in pixel values during cardiac pumping. Dynamic chest radiographs of seven normal subjects were obtained in the expiratory phase by use of an FPD system. We measured the average pixel value in each region of interest that was located manually in the heart and lung areas. Subsequently, inter-frame differences and differences from a minimum-intensity projection image, which was created from one cardiac cycle, were calculated. These difference values were then superimposed on dynamic chest radiographs in the form of a color display, and sequential blood distribution images and a blood distribution map were created. The results were compared to typical data on normal cardiac physiology. The clinical effectiveness of our method was evaluated in a patient who had abnormal pulmonary blood flow. In normal cases, there was a strong correlation between the cardiac cycle and changes in pixel value. Sequential blood distribution images showed a normal pattern at determined by the physiology of pulmonary blood flow, with a symmetric distribution and no blood flow defects throughout the entire lung region. These findings indicated that pulmonary blood flow was reflected on dynamic chest radiographs. In an abnormal case, a defect in blood flow was shown as defective in color in a blood distribution map. The present method has the potential for evaluation of local blood flow as an optional application in general chest radiography.

Acceptance testing and QA of interventional cardiology systems

Interventional cardiology (IC) is a rapidly growing field of medical specialisation. Such procedures are complex and may subject patients and operators to higher levels of risk than those encountered in general radiology. Acceptance testing and quality assurance (QA) of radiological equipment, including IC equipment, is a requirement of the EU Medical Exposures Directive (MED) (97/43/EURATOM). In addition, the MED identifies interventional radiology as an area of special concern. This study presents the results of a survey of 17 IC systems (including several flat panel detector systems) in Irish hospitals. The results of the survey indicate large differences in patient doses between manufacturers for equivalent levels of measured image quality. In addition, all systems were found to have failed one or more acceptance tests, with 60% of systems demonstrating significant problems at acceptance testing. The results of the survey demonstrate the importance of acceptance testing and QA in IC. The results also provide baseline data, which may be used in the development of future QA guidelines.

Quality control measurements for fluoroscopy systems in eight countries participating in the SENTINEL EU coordination action

Quality control (QC) is becoming increasingly important in relation to the introduction of digital medical imaging systems using X rays. It was, therefore, decided to organise and perform a trial on image quality and physical measurements. The SENTINEL toolkit for QC measurements of fluoroscopy systems containing equipment and instructions for their use in the assessment of dose and image quality circulated among participants in the trial. The participants reported on their results. In the present contribution, the impact of the trial on the selected protocols is presented. The Medical Physics and Bioengineering protocol appeared to be useful for QC, and also for digital systems. The protocol needs an additional section, or an addition to each section, to state compliance with the requirements. The circular cross-sections of the Leeds test objects need adaptation for rectangular flat panel detector (FPD) systems. Only one participant was able to perform the monitor test using MoniQA. This is due to the fact that assistance is required from the suppliers of the X-ray systems. This problem needs to be solved to apply MoniQA in practice.

Participation Report in the RSNA2006

PURPOSE/AIM OF THE EXHIBIT: The purpose of this exhibit is: 1. To explain "resampling", an image data processing, performed by the digital radiographic system based on flat panel detector (FPD). 2. To show the influence of "resampling" on the basic imaging properties. 3. To present accurate measurement methods of the basic imaging properties of the FPD system. 1. The relationship between the matrix sizes of the output image and the image data acquired on FPD that automatically changes depending on a selected image size (FOV). 2. The explanation of the image data processing of "resampling". 3. The evaluation results of the basic imaging properties of the FPD system using two types of DICOM image to which "resampling" was performed: characteristic curves, presampled MTFs, noise power spectra, detective quantum efficiencies. CONCLUSION/SUMMARY: The major points of the exhibit are as follows: 1. The influence of "resampling" should not be disregarded in the evaluation of the basic imaging properties of the flat panel detector system. 2. It is necessary for the basic imaging properties to be measured by using DICOM image to which no "resampling" is performed.

直接変換型ＦＰＤを搭載したディジタルＸ線透視撮影システムの基本的な画質特性の比較

The purpose of this study was to evaluate the basic imaging properties of the two latest digital radiographic X-ray systems, namely, the DynaDirect Winscope 6000 (abbr. as System A, Toshiba Medical Systems) and the Sonialvision Safire Multi (abbr. as System B, Shimadzu Corp.). These systems were based on a direct-conversion flat panel detector (FPD) of amorphous selenium. The basic imaging properties of the two systems were evaluated by measuring characteristic curves, presampled modulation transfer functions (MTFs), and noise power spectra (NPS) using DICOM images to which no resampling was performed with a matrix size of 2048x2048. In addition, noise equivalent quanta (NEQ) and detective quantum efficiency (DQE) calculated from the result of the basic imaging properties were evaluated. The characteristic curves of the two systems showed quite high linearity. The MTFs of the two systems indicated high-resolution properties, as is well known to be an advantage of the direct conversion FPD system. However, the NPS of System A showed better performance than System B under the same exposures. Therefore, the DQE of System A was higher than that of System B at all spatial frequencies.

Usefulness of Cone-Beam Volume CT with Flat Panel Detectors in Conjunction with Catheter Angiography for Transcatheter Arterial Embolization

To assess the usefulness of cone-beam volume computed tomography (CT) (cone-beam CT) with use of flat panel detectors of the direct conversion type in conjunction with conventional digital subtraction angiography (DSA) in the diagnosis and treatment of patients with hepatocellular carcinoma (HCC). Forty-nine consecutive patients (52 suspicious lesions) were prospectively examined. All patients underwent intraarterial rotational angiography with a flat panel detector system, and the cone-beam CT scans were reconstructed from the volume data set. The authors evaluated the diagnostic quality of cone-beam CT for the transcatheter arterial chemoembolization (TACE) procedure. The diagnostic quality of conventional DSA plus cone-beam CT with regard to tumor staining was superior to that of DSA alone. Cone-beam CT showed tumor staining in five lesions that were difficult to diagnose with confidence on the basis of the DSA findings alone. The extent of contrast medium perfusion was sufficiently visualized on all cone-beam CT scans at the tip of the catheter positioned in either the segmental or subsegmental hepatic arteries. In 42 of the 52 lesions (81%), cone-beam CT provided additional useful information for therapeutic decision making or TACE compared with DSA. Intraarterial cone-beam CT with a flat panel detector can provide clinically acceptable image quality in the assessment of HCC, thereby improving the detection of tumor staining due to HCC and the visualization of the extent of contrast medium perfusion.

Development of a cardiac evaluation method using a dynamic flat-panel detector (FPD) system: a feasibility study using a cardiac motion phantom

The purpose of this study is to investigate the feasibility of cardiac evaluation with a dynamic flat-panel detector (FPD), based on changes in pixel values during cardiac pumping. To investigate the feasibility of cardiac evaluation with a dynamic flat-panel detector (FPD), based on changes in pixel values during cardiac pumping. Sequential radiographs of a cardiac motion phantom and water-equivalent material step were obtained with an FPD system. Various combinations of cardiac output and heart rate were evaluated with and without contrast medium. The ventricular area and summation of pixel values in the ventricles were measured. The ejection fraction (EF) was calculated based on the rate of changes and then compared to EF obtained from computed tomography images. In addition, slight changes in pixel values were visualized by use of inter-frame subtraction and color-mapping. The result of a clinical case was examined according to cardiac physiology. There were strong correlations between EF and our results. There was no significant difference between the findings with and without contrast medium. When the heart rate was greater than 60 bpm, EF obtained with our method were underestimated. It is necessary for a patient to be examined at an imaging rate between 7.5 and 10 fps at least. In addition, a +/-1.2% change in pixel value was equivalent to a +/-10 mm change in the thickness of water. Color-mapping images were supported by cardiac physiology. Evaluating changes in pixel values on dynamic chest radiography with FPD has the potential to demonstrate cardiac function without contrast medium. Inter-frame subtraction and color-mapping are very useful for interpreting changes in pixel value as velocities of blood flow.