Flat Panel Detector Research Articles

Short-term outcome of fragility fractures of the pelvis in the elderly treated with screw osteosynthesis and external fixator

BackgroundThe treatment of fragility fractures of the pelvis is rising challenge for orthopedic trauma surgeons. Operative treatment should allow immediate full weight bearing and early mobilisation but should also be as minimal invasive as possible. Sacroiliac (SI) or transsacral transiliac screws (TSTI) alone or depending on the fracture in combination with an external fixator meets both of these criteria.Material and methodsThe outcome of 121 operatively treated patients with fragility fractures of the pelvis were evaluated in this retrospective study. Depending on the type of fracture the patients were treated with navigated SI screw or TSTI screw alone or in combination with an external fixator. All patients were operated in supine position in a hybrid-OR, which consists of a fixed robotic 3D flatpanel detector (Artis zeego, Siemens Healthineers, Germany) and a navigation system (BrainLab Curve, BrainLab, Germany).Results37 patients were treated with either one or two SI screws and 57 with one TSTI screw. An additional external fixator was combined with SI screws in 17 patients and with TSTI screws in 10 patients. The preoperative pain score was significantly higher compared to the postoperative score (5.1 ± 2.5 vs 2.2 ± 1.9, p < 0.05). Follow-up at 6 month was possible for 106 patients which showed screw loosening in 16.3% of the SI Screws (n = 49) compared to only 5.2% of TSTI screws (n = 57). No screw loosening was seen in the combination of TSTI-screw and external fixator (n = 10). There were two septic and three aseptic pin loosenings of the external fixator. Overall only one patient needed revision surgery due to screw loosening and local irritation. Overall 75.2% (n = 91) of the patients could be released in their home or in a rehabilitation unit and only 14% (n = 17) were released to a nursing home due to immobility despite the operation. Non-surgical complications rate was 21.5%.ConclusionSI or TSTI screws with possible combination with an external fixator show early pain relief and allows most of the patients to keep their former level of independence. With an also low surgical complication rate, it proved to be a safe and reliable treatment for fragility fractures of the pelvis. Due the effective pain relief and the minimal invasive approach, early mobilisation is possible and might prevent typical non-surgical complications which are very common during conservative treatment.

Magnification-driven B-spline interpolation for cone-beam projection and backprojection.

Discretizing tomographic forward and backward operations is a crucial step in the design of model-based reconstruction algorithms. Standard projectors rely on linear interpolation, whose adjoint introduces discretization errors during backprojection. More advanced techniques are obtained through geometric footprint models that may present a high computational cost and an inner logic that is not suitable for implementation on massively parallel computing architectures. In this work, we take a fresh look at the discretization of resampling transforms and focus on the issue of magnification-induced local sampling variations by introducing a new magnification-driven interpolation approach for tomography. Starting from the existing literature on spline interpolation for magnification purposes, we provide a mathematical formulation for discretizing a one-dimensional homography. We then extend our approach to two-dimensional representations in order to account for the geometry of cone-beam computed tomography with a flat panel detector. Our new method relies on the decomposition of signals onto a space generated by nonuniform B-splines so as to capture the spatially varying magnification that locally affects sampling. We propose various degrees of approximations for a rapid implementation of the proposed approach. Our framework allows us to define a novel family of projector/backprojector pairs parameterized by the order of the employed B-splines. The state-of-the-art distance-driven interpolation appears to fit into this family thus providing new insight and computational layout for this scheme. The question of data resampling at the detector level is handled and integrated with reconstruction in a singleframework. Results on both synthetic data and real data using a quality assurance phantom, were performed to validate our approach. We show experimentally that our approximate implementations are associated with reduced complexity while achieving a near-optimal performance. In contrast with linear interpolation, B-splines guarantee full usage of all data samples, and thus the X-ray dose, leading to more uniform noise properties. In addition, higher-order B-splines allow analytical and iterative reconstruction to reach higher resolution. These benefits appear more significant when downsampling frames acquired by X-ray flat-panel detectors with small pixels. Magnification-driven B-spline interpolation is shown to provide high-accuracy projection operators with good-quality adjoints for iterative reconstruction. It equally applies to backprojection for analytical reconstruction and detector datadownsampling.

Dynamic chest radiography: clinical validation of ventilation and perfusion metrics derived from changes in radiographic lung density compared to nuclear medicine imaging.

Dynamic chest radiography (DCR) is a type of non-contrast-enhanced functional lung imaging with a dynamic flat-panel detector (FPD). This study aimed to assess the clinical significance of ventilation and perfusion metrics derived from changes in radiographic lung density on DCR in comparison to nuclear medicine imaging-derived metrics. DCR images of 42 lung cancer patients were sequentially obtained during respiration using a dynamic FPD imaging system. For each subdivided lung region, the maximum change in the averaged pixel value (Δmax), i.e., lung density, due to respiration and cardiac function was calculated, and the percentage of Δmax relative to the total of all lung regions (Δmax%) was computed for ventilation and perfusion, respectively. The Δmax% was compared to the accumulation of radioactive agents such as Tc-99m gas and Tc-99m macro-aggregated albumin (radioactive agents%) on ventilation and perfusion scans in the subdivided lung regions, by Spearman's correlation coefficient (r) and the Dice similarity coefficients (DSC). To facilitate visual evaluation, Δmax% was visualized as a color scaling, where larger Δmax values were indicated by higher color intensities. We found a moderate correlation between Δmax% and radioactive agents% on ventilation and perfusion scans, with perfusion metrics (r=0.57, P<0.001) showing a higher correlation than ventilation metrics (r=0.53, P<0.001). We also found a good or strong correlation (r≥0.5) in 80.9% (34/42) of patients for perfusion metrics (r=0.60±0.16) and in 52.4% (22/42) of patients for ventilation metrics (r=0.53±0.16). DSC indicated a moderate correlation for both metrics. Decreased pulmonary function was observed in the form of reduced color intensities on color-mapping images. DCR-derived ventilation and perfusion metrics correlated reasonably well with nuclear medicine imaging findings in lung subdivisions, suggesting that DCR could provide useful information on pulmonary function without the use of radioactive contrast agents.

High-sensitivity high-resolution X-ray imaging with soft-sintered metal halide perovskites

To realize the potential of artificial intelligence in medical imaging, improvements in imaging capabilities are required, as well as advances in computing power and algorithms. Hybrid inorganic–organic metal halide perovskites, such as methylammonium lead triiodide (MAPbI3), offer strong X-ray absorption, high carrier mobilities (µ) and long carrier lifetimes (τ), and they are promising materials for use in X-ray imaging. However, their incorporation into pixelated sensing arrays remains challenging. Here we show that X-ray flat-panel detector arrays based on microcrystalline MAPbI3 can be created using a two-step manufacturing process. Our approach is based on the mechanical soft sintering of a freestanding absorber layer and the subsequent integration of this layer on a pixelated backplane. Freestanding microcrystalline MAPbI3 wafers exhibit a sensitivity of 9,300 µC Gyair–1 cm–2 with a μτ product of 4 × 10–4 cm2 V–1, and the resulting X-ray imaging detector, which has 508 pixels per inch, combines a high spatial resolution of 6 line pairs per millimetre with a low detection limit of 0.22 nGyair per frame.

Local diagnostic reference levels for routine chest X-ray examinations at a public sector hospital in central South Africa.

BackgroundDose optimisation is a radiation protection guideline recommended by the International Commission on Radiological Protection (ICRP) for adherence to the ‘as low as reasonably achievable’ (ALARA) principle. Diagnostic reference levels (DRLs) are used to optimise patients’ radiation protection for diagnostic and interventional procedures and are particularly useful for frequently performed examinations such as chest X-rays.AimTo establish the local diagnostic reference levels (LDRLs) for routine chest X-rays.SettingPublic sector hospital, Northern Cape province, South Africa.MethodsSixty patients referred for chest X-rays fulfilling the inclusion criteria participated in this study. Patients were ≥ 18 years of age and weighed between 60 kg and 80 kg. Consent for participation was obtained. The entrance skin air kerma (ESAK) was measured by using the indirect method recommended by the International Atomic Energy Agency (IAEA). Statistical software (SAS version 9.2) was used to determine the LDRLs for chest X-rays in three different rooms. In two rooms, computed radiography (CR) was used and the other one was a digital radiography (DR) unit. The LDRL values at the research site were compared with various published international values.ResultsLDRLs for chest X-rays were established. The CR LDRL value for the posteroanterior (PA) chest projection was higher than the DR (flat panel detector [FPD]) LDRL value. The LDRLs of the PA chest projections were 0.3 mGy for CR and 0.2 mGy for DR. The lateral (LAT) chest projection LDRL value was 0.8 mGy for both CR and DR (FPD) projections. The resultant LDRL between rooms at the research site was 0.3 mGy for PA 0.3 mGy and 0.8 mGy for LAT chest projections.ConclusionThe LDRLs for chest X-rays established at this research site were lower than internationally reported DRLs. We recommend that LDRLs for routine chest X-rays should be repeated every 3 years, according to the ICRP.ContributionCurrently, no established or published DRL values prescribed by the Directorate of Radiation Control (DRC) are available in South Africa. The LDRLs established for routine chest X-ray examinations at this research site can serve as a guideline for the establishment of DRL values for other anatomical regions at the research site and other radiology departments in the country.

Extended imaging volume in cone-beam x-ray tomography using the weighted simultaneous iterative reconstruction technique

An issue in computerized x-ray tomography is the limited size of available detectors relative to objects of interest. A solution was provided in the past two decades by positioning the detector in a lateral offset position, increasing the effective field of view (FOV) and thus the diameter of the reconstructed volume. However, this introduced artifacts in the obtained reconstructions, caused by projection truncation and data redundancy. These issues can be addressed by incorporating an additional data weighting step in the reconstruction algorithms, known as redundancy weighting. In this work, we present an implementation of redundancy weighting in the widely-used simultaneous iterative reconstruction technique (SIRT), yielding the weighted SIRT (W-SIRT) method. The new technique is validated using geometric phantoms and a rabbit specimen, by performing both simulation studies as well as physical experiments. The experiments are carried out in a highly flexible stereoscopic x-ray system equipped with x-ray image intensifiers (XRIIs). The simulations showed that higher values of contrast-to-noise ratio could be obtained using the W-SIRT approach as compared to a weighted implementation of the simultaneous algebraic reconstruction technique (SART). The convergence rate of the W-SIRT was accelerated by including a relaxation parameter in the W-SIRT algorithm, creating the aW-SIRT algorithm. This allowed to obtain the same results as the W-SIRT algorithm, but at half the number of iterations, yielding a much shorter computation time. The aW-SIRT algorithm has proven to perform well for both large as well as small regions of overlap, outperforming the pre-convolutional Feldkamp–David–Kress algorithm for small overlap regions (or large detector offsets). The experiments confirmed the results of the simulations. Using the aW-SIRT algorithm, the effective FOV was increased by >75%, only limited by experimental constraints. Although an XRII is used in this work, the method readily applies to flat-panel detectors as well.

Fast and effective single-scan dual-energy cone-beam CT reconstruction and decomposition denoising based on dual-energy vectorization.

Flat-panel detector (FPD) based dual-energy cone-beam computed tomography (DE-CBCT) is a promising imaging technique for dedicated clinical applications. In this paper, we proposed a fully analytical method for fast and effective single-scan DE-CBCT image reconstruction and decomposition. A rotatable Mo filter was inserted between an x-ray source and imaged object to alternately produce low and high-energy x-ray spectra. First, filtered-backprojection (FBP) method was applied on down-sampled projections to reconstruct low and high-energy images. Then, the two images were converted into a vectorized form represented with an amplitude and an argument image. Using amplitude image as a guide, a joint bilateral filter was applied to denoise the argument image. Then, high-quality dual-energy images were recovered from the amplitude image and the denoised argument image. Finally, the recovered dual-energy images were further used for low-noise material decomposition and electron density synthesis. Imaging was conducted on a Catphan® 600 phantom and an anthropomorphic head phantom. The proposed method was evaluated via comparison with the traditional two-scan method and a commonly used filtering method (HYPR-LR). On the Catphan® 600 phantom, the proposed method successfully reduced streaking artifacts and preserved spatial resolution and noise-power-spectrum (NPS) pattern. In the electron density image, the proposed method increased contrast-to-noise ratio (CNR) by more than 2.5 times and achieved <1.2% error for electron density values. On the anthropomorphic head phantom, the proposed method greatly improved the soft-tissue contrast and the fine detail differentiation ability. In the selected ROIs on different human tissues, the differences between the CT number obtained by the proposed method and that by the two-scan method were less than 4HU. In the material images, the proposed method suppressed noise by over 75.5% compared with two-scan results, and by over 40.4% compared with HYPR-LR results. Implementation of the whole algorithm took 44.5s for volumetric imaging, including projection preprocessing, FBP reconstruction, joint bilateral filtering, and material decomposition. Using down-sampled projections in single-scan DE-CBCT, the proposed method could effectively and efficiently produce high-quality DE-CBCT images and low-noise material decomposition images. This method demonstrated superior performance on spatial resolution enhancement, NPS preservation, noise reduction, and electron density accuracy, indicating better prospect in material differentiation and dose calculation.

Single-pass metal artifact reduction using a dual-layer flat panel detector.

Metal artifact remains a challenge in cone-beam CT images. Many image domain-based segmentation methods have been proposed for metal artifact reduction (MAR), which require two-pass reconstruction. Such methods first segment metal from a first-pass reconstruction and then forward-project the metal mask to identify them in projections. These methods work well in general but are limited when the metal is outside the scan field-of-view (FOV) or when the metal is moving during the scan. In the former, even reconstructing with a larger FOV does not guarantee a good estimate of metal location in the projections; and in the latter, the metal location in each projection is difficult to identify due to motion. Single-pass methods that detect metal in single-energy projections have also been developed, but often have imperfect metal detection that leads to residual artifacts. In this work, we develop a MAR method using a dual-layer (DL) flat panel detector, which improves performance for single-pass reconstruction. In this work, we directly detect metal objects in projections using dual-energy (DE) imaging that generates material-specific images (e.g., soft tissue and bone), where the metal stands out in bone images when nonuniform soft tissue background is removed. Metal is detected via simple thresholding, and entropy filtration is further applied to remove false-positive detections. A DL detector provides DE images with superior temporal and spatial registration and was used to perform the task. Scatter correction was first performed on DE raw projections to improve the accuracy of material decomposition. One phantom mimicking a liver biopsy setup and a cadaver head were used to evaluate the metal reduction performance of the proposed method and compared with that of a standard two-pass reconstruction, a previously published sinogram-based method using a Markov random field (MRF) model, and a single-pass projection-domain method using single-energy imaging. The phantom has a liver steering setup placed in a hollow chest phantom, with embedded metal and a biopsy needle crossing the phantom boundary. The cadaver head has dental fillings and a metal tag attached to its surface. The identified metal regions in each projection were corrected by interpolation using surrounding pixels, and the images were reconstructed using filtered backprojection. Our current approach removes metal from the projections, which is robust to FOV truncation during imaging acquisition. In case of FOV truncation, the method outperformed the two-pass reconstruction method. The proposed method using DE renders better accuracy in metal segmentation than the MRF method and single-energy method, which were prone to false-positive errors that cause additional streaks. For the liver steering phantom, the average spatial nonuniformity was reduced from 0.127 in uncorrected images to 0.086 using a standard two-pass reconstruction and to 0.077 using the proposed method. For the cadaver head, the average standard deviation within selected soft tissue regions ( ) was reduced from 209.1 HU in uncorrected images to 69.1 HU using a standard two-pass reconstruction and to 46.8 HU using our proposed method. The proposed method reduced the processing time by 31% as compared with the two-pass method. We proposed a MAR method that directly detects metal in the projection domain using DE imaging, which is robust to truncation and superior to that of single-energy imaging. The method requires only a single-pass reconstruction that substantially reduces processing time compared with the standard two-pass metal reduction method.

A retrospective comparison of organ dose and effective dose in percutaneous vertebroplasty performed under CT guidance or using a fixed C-arm with a flat-panel detector.

To compare the organ-dose and effective-dose (E) delivered to the patient during percutaneous vertebroplasty (PVP) of one thoracic or lumbar vertebra performed under CT guidance or using a fixed C-arm. Consecutive adult patients undergoing PVP of one vertebra under CT-guidance, with optimized protocol and training of physicians, or using a fixed C-arm were retrospectively included from January 2016 to June 2017. Organ-doses were computed on 16 organs using CT Expo 2.4 software for the CT procedures and PCXMC 2.0 for the fixed C-arm procedures. E was also computed with both software. Dosimetric values per anatomic locations for all procedures were compared using the paired Mann-Whitney-Wilcoxon test. In total, 73 patients were analysed (27 men and 46 women, mean age 78±10years) among whom 35 (48%) underwent PVP under CT guidance and 38 (52%) PVP using a fixed C-arm. The median E was 11.31 [6.54; 15.82] mSv for all PVPs performed under CT guidance and 5.58 [3.33; 8.71] mSv for fixed C-arm and the differences was significant (p<0.001). For lumbar PVP, the organ doses of stomach, liver and colon were significantly higher with CT-scan than with the fixed C-arm: 97% (p=0.02); 21% (p=0.099) and 375% (p=0.002), respectively. For thoracic PVP, the lung organ dose was significantly higher with CT-scan than with the fixed C-arm (127%; p<0.001) and the oesophagus organ doses were not significantly different (p = 0.626). This study showed that the E and the organ dose on directly exposed organs were both higher for PVP performed under CT-guidance than with the fixed C-arm.

Digital reference images when evaluating the quality of castings from aluminum and magnesium alloys

Reference X-ray images of defects in castings and welded joints have been used for many years in X-ray radiation inspection. With the transition to digital technologies, and the use of flat-panel detectors instead of radiographic film, the problem arose of creating reference digital images. Comparison of the digital image of the reference sample with the digital image of the test object can be carried out using software, which completely or partially excludes the subjective assessment of the operator, makes it possible to view doubtful areas of the image with magnification and without loss of contrast, automatically show the size of the defect, its intensity distribution by volume of the casting. All this makes the control more objective and productive. The reference images in the detector’s memory do not undergo the aging and degradation typical of X-ray images, and there is no need to replicate them.

Correction to: Lung cancer screening by single-shot dual-energy subtraction using flat-panel detector

Correction to: Lung cancer screening by single-shot dual-energy subtraction using flat-panel detector

A new stationary grid, with grid lines aligned to pixel lines with submicron‐order precision, to suppress grid artifacts

We have developed a new stationary grid named a pixel-aligned grid (PA grid), in which the grid lines are aligned to the pixel lines with submicron-order precision. Further, we have evaluated its performance relative to that of a conventional grid combined with grid-line removal (GLR) processing. A flat-panel detector system of an indirect type, with a pixel pitch of 150μm, was employed. Four PA grids having a grid ratio of 6:1 associated with abdominal bedside radiography, with the grid-line pitch (GP) varied around the target value of 150μm, were produced. Blank images were obtained with four PA grids for measuring the period and amplitude of the grid artifact. In performance evaluation, acrylic and anthropomorphic abdominal phantom images were used with the PA grid, a conventional grid (40 lines/cm, grid ratio 6:1), and no grids. The grid artifacts were evaluated by power spectrum (PS) analysis. Also, the signal-to-noise ratio (SNR) improvement factor (KSNR ) was measured. Grid artifacts were hardly recognizable with PA grids with GP errors of 0.3μm and 0.6μm because of the prolonged grid artifact periods. The measured artifact amplitudes of these PA grids were less than 0.6%. Furthermore, the PA grids did not produce notable frequency peaks in PS. In contrast, the conventional grid without GLR processing produced two conspicuous peaks. With GLR processing, notable reductions in PS were observed around the two peak frequencies, which caused blurring in bone structures. For the acrylic thickness of 20cm, the KSNR s for the PA grid were around 1.4, suggesting some SNR improvement in abdominal bedside radiography. The present study has demonstrated that PA grids with their grid-line pitches close to the pixel-line pitch within errors of 0.6μm produce grid artifact-free images without any signal losses. Thus, the proposed PA grid will prove to be effective and useful in various clinical applications.

Comparison of spectra and mean glandular dose (MGD) with tube voltage used in digital mammography for simulated, metrological and clinical cases

Mammography has a crucial role in breast cancer detection. The National Cancer Institute (INCA) estimates that 29.7% of the cancer cases in Brazil are related specifically to the breast. It is necessary to evaluate the mean glandular dose with a new solid-state detector in a digital radiography system, utilizing PMMA phantoms and spacers for different thicknesses. The Selenia Dimensions (Hologic, Bedford) direct radiography (DR) system can perform full-field digital mammographies through digital detectors. This system uses new technologies, such as the digital breast tomosynthesis system (DBT), and employs a sequence of projections acquired over the breast, resulting in images with low contrast. The estimation of breast dose is an important part of mammographic quality control for x-ray mammography. Nevertheless, there are currently no standard protocols for the dosimetry of breast imaging in 3D. Additionally, a x-ray spectra function is crucial to measure a considerable output in x-ray spectrometry. The purpose of this work was to assess the mean glandular dose (MGD) and the spectra in slabs of polymethyl methacrylate (PMMA) and breast equivalent thickness through digital mammography using four experiments: a Hologic Selenia Dimensions mammograph with a solid-state detector; a spectrometer (only for the spectra, in this case); a clinical COMET x-ray tube with a solid-state detector; and the MCNPX code. References recommend that the real environments that work well with digital mammography are in the following tube voltages: 25 kVp; 26 kVp; 28 kVp; 31 kVp and 33 kVp. Taking into account several thicknesses of PMMA, the results of both the MGD in metrological, clinical and simulated cases were in accordance with the references, from 30 mm of PMMA. All the spectra for all cases have indicated good agreement with the references.

High-resolution model-based material decomposition in dual-layer flat-panel CBCT.

Spectral CT uses energy-dependent measurements that enable material discrimination in addition to reconstruction of structural information. Flat-panel detectors (FPDs) have been widely used in dedicated and interventional systems to deliver high spatial resolution, volumetric cone-beam CT (CBCT) in compact and OR-friendly designs. In this work, we derive a model-based method that facilitates high-resolution material decomposition in a spectral CBCT system equipped with a prototype dual-layer FPD. Through high-fidelity modeling of multilayer detector, we seek to avoid resolution loss that is present in more traditional processing and decomposition approaches. A physical model for spectral measurements in dual-layer flat-panel CBCT is developed including layer-dependent differences in system geometry, spectral sensitivities, and detector blur (e.g., due to varied scintillator thicknesses). This forward model is integrated into a model-based material decomposition (MBMD) method based on minimization of a penalized weighted least-squared (PWLS) objective function. The noise and resolution performance of this approach was compared with traditional projection-domain decomposition (PDD) and image-domain decomposition (IDD) approaches as well as one-step MBMD with lower-fidelity models that use approximated geometry, projection interpolation, or an idealized system geometry without system blur model. Physical studies using high-resolution three-dimensional (3D)-printed water-iodine phantoms were conducted to demonstrate the high-resolution imaging performance of the compared decomposition methods in iodine basis images and synthetic monoenergetic images. Physical experiments demonstrate that the MBMD methods incorporating an accurate geometry model can yield higher spatial resolution iodine basis images and synthetic monoenergetic images than PDD and IDD results at the same noise level. MBMD with blur modeling can further improve the spatial-resolution compared with the decomposition results obtained with IDD, PDD, and MBMD methods with lower-fidelity models. Using the MBMD without or with blur model can increase the absolute modulation at 1.75 lp/mm by 10% and 22% compared with IDD at the same noise level. The proposed model-based material decomposition method for a dual-layer flat-panel CBCT system has demonstrated an ability to extend high-resolution performance through sophisticated detector modeling including the layer-dependent blur. The proposed work has the potential to not only facilitate high-resolution spectral CT in interventional and dedicated CBCT systems, but may also provide the opportunity to evaluate different flat-panel design trade-offs including multilayer FPDs with mismatched geometries, scintillator thicknesses, and spectral sensitivities.

Effect of x-ray energy on the radiological image quality in propagation-based phase-contrast computed tomography of the breast.

Purpose: Breast cancer is the most common cancer in women in developing and developed countries and is responsible for 15% of women's cancer deaths worldwide. Conventional absorption-based breast imaging techniques lack sufficient contrast for comprehensive diagnosis. Propagation-based phase-contrast computed tomography (PB-CT) is a developing technique that exploits a more contrast-sensitive property of x-rays: x-ray refraction. X-ray absorption, refraction, and contrast-to-noise in the corresponding images depend on the x-ray energy used, for the same/fixed radiation dose. The aim of this paper is to explore the relationship between x-ray energy and radiological image quality in PB-CT imaging. Approach: Thirty-nine mastectomy samples were scanned at the imaging and medical beamline at the Australian Synchrotron. Samples were scanned at various x-ray energies of 26, 28, 30, 32, 34, and 60keV using a Hamamatsu Flat Panel detector at the same object-to-detector distance of 6m and mean glandular dose of 4mGy. A total of 132 image sets were produced for analysis. Seven observers rated PB-CT images against absorption-based CT (AB-CT) images of the same samples on a five-point scale. A visual grading characteristics (VGC) study was used to determine the difference in image quality. Results: PB-CT images produced at 28, 30, 32, and 34keV x-ray energies demonstrated statistically significant higher image quality than reference AB-CT images. The optimum x-ray energy, 30keV, displayed the largest area under the curve of 0.754 ( ). This was followed by 32keV ( , ), 34keV ( , ), and 28keV ( , ). Conclusions: An optimum energy range (around 30keV) in the PB-CT technique allows for higher image quality at a dose comparable to conventional mammographic techniques. This results in improved radiological image quality compared with conventional techniques, which may ultimately lead to higher diagnostic efficacy and a reduction in breast cancer mortalities.

Forensic age estimation based on magnetic resonance imaging of the proximal humeral epiphysis in Chinese living individuals.

Forensic age estimation in living individuals is mainly based on radiological features, but direct radiography and computed tomography lead to a rise in ethical concerns due to radiation exposure. Thus, the contribution of magnetic resonance imaging (MRI) to age estimation of living individuals is a subject of ongoing research. In the current study, MRIs of shoulder were retrospectively collected from a modern Chinese Han population and data from 835 individuals (599 males and 236 females) in the age group 12 to 30years were obtained. A staging technique based on (Schmidt et al. Int J Legal Med 121(4):321-324, 2007) and (Kellinghaus et al. Int J Legal Med 124(4):321-325, 2010) was used and all images were evaluated with T1-wieghted turbo spin echo (T1-TSE) sequence and T2-weighed fat suppression (T2-FS) sequence. One-sided images were assessed because data from both sides were considered coincidental, as no significant differences were found (P > 0.05). Two MRI sequences were evaluated separately and subsequently compared. Regression models and supportive vector classification (SVC) models were established accordingly. The intraobserver and interobserver agreement levels were good. Compared with T1-TSE sequence, the R2 values of T2-FS sequence were generally higher, while the mean absolute deviation (MAD) values were slightly lower. For T2-FS sequence, the MAD value was 1.49years in males and 2.19years in females. With two MRI sequences incorporated, the SVC model obtained with 85.7% correctly classified minors and 96.2% correctly classified adults in males, while 83.3% and 98.0% respectively in females. In conclusion, T2-FS sequence may slightly outperform the T1-TSE sequence in shoulder MRI analysis for age estimation, while shoulder MRIs could be a reliable prediction indicator for the 18-year threshold and two MRI sequences incorporated are encouraged.

Comparative Analysis of the Diagnostic Capabilities of a Computer Radiography System and a Portable Flat-Panel Detector for Mammography

For screening and diagnostic examinations of the mammary glands, it is recommended to use both digital mammographic systems and a system for digitizing images. There are two modifications for digitalization of images, a computer radiography system for mammography and a portable flat-panel detector. The article provides a comparative analysis of the diagnostic capabilities of a computer radiography system and a portable flat-panel detector.

Digital Mammography Device for Mobile Mammography Complex

The results of the development of a mammographic unit with a digital flat-panel detector designed for for installation in a mobile medical X-ray room are presented.The mammographic unit with a digital flat-panel detector is designed for screening and other specialized mammographic examinations, provides the ability to perform full-format raster (using a screening raster) mammography, X-ray of the armpits.

Accuracy of screw stabilization of the dorsal pelvic ring using a hybrid operating room: 5 Year experience in a level 1 trauma center

IntroductionAccuracy for screw placement in the dorsal pelvic ring can be enhanced using intraoperative 3D navigation. Advances in intraoperative imaging lead to benefits for pelvic surgery. New c-arms are equipped with flat panel detectors, which have a larger detector and assure higher image quality with accompanying dose reduction. A hybrid OR is defined by a fixed imaging system in an operating room providing the benefit of the surgical environment in combination with advanced intraoperative imaging. Aim of our investigation was to analyze the accuracy of navigated sacroiliac (SI) and transsacral transiliac (TSTI) screws in the dorsal pelvic ring, which were implanted with a hybrid OR in the first five years of use. Material and methodsAll percutaneous SI or TSTI screws implanted in the hybrid OR using intraoperative navigation in the first 5 years of utilization (between June 2012 to June 2017) were included. Intraoperative 3D-scans and postoperative computed tomography were examined for screw perforation. Results210 SI and TSTI screws were implanted in 187 patients using intraoperative navigation in the hybrid-OR. 90.6 % of SI screws showed no cortical perforation. 6,3 % had a grade 1, 2.4 % a grade 2 and 0.8 % a grade 3 perforation. In 80.7 % of TSTI screws no perforation and in 13.3 % a grade 1 perforation was detected. 3.6 % showed a grade 2 and 2.4 % a grade 3 perforation. No significant difference between both screw types regarding the grade of cortical perforation could be seen. No significant relation between perforation rate and year of operation could be detected. ConclusionIntraoperative navigation in a hybrid OR ensures a high accuracy for SI screws. Due to the large field of view and high image quality TSTI screws can be safely implanted in S1 and S2. Utilization of a hybrid-OR is accompanied with a steep learning curve.

Lung cancer screening by single-shot dual-energy subtraction using flat-panel detector

PurposeThe purpose of this study was to evaluate the usefulness of single-shot dual-energy subtraction (DES) method using a flat-panel detector for lung cancer screeningMaterials and methodsThe subjects were 13,315 residents (5801 males and 7514 females) aged 50 years or older (50–97 years, with an intermediate value of 68 years) who underwent lung cancer screening for a period of 1 year and 6 months from January 2019 to June 2020. We investigated whether the number of lung cancers detected, the detection rate, and the rate of required scrutiny changed, when DES images were added to the judgment based on conventional chest radiography.ResultsWhen DES images were added, the number and percentage of cancer detection increased from 16 (0.12%) to 23 (0.17%) (P < 0.05). Five of the newly detected 7 lung cancers were in the early stages of resectable cancer. The rate of participants requiring scrutiny increased slightly from 1.1 to 1.3%.ConclusionDES method improved the detection of lung cancer in screening. The increase in the percentage of participants requiring scrutiny was negligible.