Image Quality Criteria Research Articles

Comparison of two Meglumine-Diatrizoate based bowel preparations for computed tomography colonography: Comparison of patient symptoms and bowel preparation quality

IntroductionTo investigate the impact of two Meglumine-Diatrizoate based bowel preparation regimes for computed tomography colonography (CTC) on the patient experience and image quality. Methods100 patients consumed Meglumine-Diatrizoate at 24 h and 12 h prior to the CTC examination. 50 patients followed regime 1 (50:50), 50 ml of Meglumine-Diatrizoate at both 24 and 12 h prior to the examination. 50 patients followed regime 2 (75:25), 75 ml of Meglumine-Diatrizoate at 24 h prior to the examination and 25 ml of Meglumine-Diatrizoate at 12 h prior to the examination. All patients completed a questionnaire to indicate the time of onset of adverse effects and when they were most severe. Five advanced practitioners assessed the image quality in a visual grading study. Visual grading characteristic (VGC) analysis was applied with regime 1 as the reference condition and regime 2 and test condition; test alpha was set at 0.05. ResultsImage quality was assessed with successful bowel cleansing as the scoring criteria for the visual grading study. The bowel cleansing as provided by the two Meglumine-Diatrizoate regimes was revealed not to be statistically different, with the area under the VGC curve and 95% confidence intervals 0.487 (0.287, 0.701), p = 0.887. Patients taking the 75:25 bowel preparation experienced a shorter median time to the onset of adverse effects. ConclusionThere was no observed difference in Image quality criteria score for the two Meglumine-Diatrizoate based bowel preparation with more predictable adverse effects of Meglumine-Diatrizoate with the 75:25 preparation. Implications for practiceProviding patients with a higher contrast burden 24 h prior to CTC may have a positive impact on the patient experience without compromising image quality.

Consensus about image quality assessment criteria of breast implants mammography using Delphi method with radiographers and radiologists

AimsTo identify image quality criteria that can be applied to assess breast implant (BI) mammograms according to radiologists and radiographers’ perspectives and to explore the level of agreement about criteria priority.MethodsA two-round Delphi method using a questionnaire was applied to identify the level of agreement between experts, asking them to rank each image criteria available for mammography according to 4 possible answers (1 = need to have, 2 = nice to have, 3 = not pertinent/appropriate, 4 = do not know). Criteria for craniocaudal (CC), mediolateral-oblique (MLO) and lateral (ML), with and without Eklund manoeuvre, were included. This process was repeated after removing the less relevant criteria.ResultsBetween first and second rounds, different results were obtained regarding the criteria to assess CC and MLO images. Details for anatomic areas were considered the most relevant by radiographers during the first round, while general criteria were prioritised during the second round. Radiologists focused more on analysis of the spread of the breast tissue, if the breast was aligned with detector’s centre and level of contrast. The analysis of implant flow, the BI anterior edge and the maximum retropulsion of BI when Eklund manoeuvre is performed were the specific aspects of BI imaging considered as relevant for assessment.ConclusionsThe importance of each criterion used to assess BI mammograms was not the same between radiographers and radiologists, suggesting the two groups of experts are looking for different requirements from the image. Further education and training is necessary to align strategies for assessing BI mammograms, and some criteria need to be adapted to reduce subjectivity.

Results of the clinical evaluation of the low-dose protocols of the digital linear tomography of the chest

High levels of tuberculosis morbidity in the Russian Federation lead to the extensive use of X-ray diagnostics for the tuberculosis screening and assessment of the effectiveness of treatment. Digital radiography and computed tomography are traditionally used for the diagnostics of tuberculosis. These methods are associated with significant drawbacks: low specificity for radiography, high costs per examination, significant patient doses, and limited availability for computed tomography. As an additional method for the assessment of the effectiveness of the tuberculosis treatment it is possible to use linear tomography performed on the digital X-ray units. The aim of the current study was to evaluate the possibility of utilization of the digital linear tomography for the control of the effectiveness of tuberculosis treatment in a dedicated antitubercular medical facility. The study was divided in two stages. The first stage was aimed at the assessment of the diagnostic image quality of the digital linear tomograms obtained using the previously developed low-dose imaging protocols. Image quality assessment was performed using an anthropomorphic chest phantom and dedicated imitators of the lung lesions. Image quality was assessed by the experts (radiologists) based on the developed image quality criteria. Results of the first stage of the study indicate that all low-dose protocols allow obtaining images with at least acceptable image quality. Hence it was possible to propose low-dose protocols for clinical evaluations. The second stage of the study was performed as a prospective cohort survey aimed at the evaluation of the structure of X-ray examinations, patient doses and clinical image quality of the digital linear tomograms in antitubercular early treatment center. The cohort survey included two patient samples, uniform by age and gender composition, anthropometric characteristics and structure of diagnosis. One of the samples was imaged using standard (vendor) digital linear protocols, other – using the proposed low-dose protocols. Dose data collection (measurement of dose-area product and subsequent calculation of effective dose) and expert image quality assessment was performed for each patient. The results of the second stage of the study indicate that the use of the low-dose protocols allow reducing the patient effective doses per examination up to a factor of 6–8 (0.56 – 5.9 mSv for standard protocols; 0.2 – 1.15 mSv for low-dose protocols) due to the reduction in tube current-time product (126 mean mAs and 11 mean mAs, respectively). The dose reduction is accompanied by the reduction in the image quality of the linear tomograms (from “excellent” or “good” for standard protocols to “acceptable” for low-dose protocols). However, that dose not hinder the conclusion decision and identification of pathologies. Results of the study indicate that digital linear tomography can be used for the evaluation of the dynamics of the pathological process in the lungs with the previously defined localization of the pathology. The presented low-dose protocols were implemented into radiological practice of the antitubercular early treatment center. Currently, the proposed low-dose protocols are under evaluation for the large-scale study on the base of general practice hospitals

Patient radiation dose and image quality in plain radiography: An assessment of three common procedures in ten hospitals

This study aimed to assess the main factors affecting radiographic image quality in selected routine radiography procedures, to establish guidelines for maintaining the expected quality, while keeping the patient radiation doses as low as possible.Entrance surface air kerma (ESAK) for 811 patients undergoing chest, abdomen and pelvis x-ray procedures in ten X-ray departments were assessed using the European Image Criteria method. Basic quality control (QC) tests were performed to check the compliance of x-ray machines with the international standards. The mean percentage and range of good quality images were 71.3 (56–86.1) for chest posterior anterior (PA), 76.1 (65–91) for abdomen anterior posterior (AP) and 70.7 (35.7–92.6) for pelvis anteroposterior (AP). The corresponding ESAK (mGy) were 0.5 ± 0.3, 3.7 ± 1.7 and 3.6 ± 1.6 per procedure, respectively. These image quality findings reveal wide inter and intra-hospital variations. The ESAK values for patients undergoing abdominal and pelvic X-ray procedures showed comparable values in relation to the international diagnostic reference levels (DRLs), while they were twice as high for chest X-ray procedures. Improper image processing, exposure factor errors, and suboptimal patient communication and instructions prior to examination were the main factors commonly responsible for inadequate quality radiographs. The radiation dose variations are according to variable patient demographic data across the hospitals and type of examination, besides the variations of the applied technical parameters for each given examination. The film reject rates are higher in most hospital compared to the World Health Organization (WHO) recommended value. Establishment of image quality criteria will improve the department productivity and will reduce the reject rate.

Two-Phase Neural Combinatorial Optimization with Reinforcement Learning for Agile Satellite Scheduling

The agile Earth observing satellite (AEOS) scheduling problem consists of scheduling a set of image acquisitions and selecting the start time of each acquisition, satisfying the constraints and maximizing the gain. With the development of satellite technologies and higher requirements of users, the AEOS scheduling problem has to consider constraints and criteria that vary with the run-time on-orbit state, such as the transition time constraint and image quality criteria. These requirements increase the difficulty to model the problem. In this paper, a two-phase neural combinatorial optimization method with reinforcement learning is proposed for the AEOS scheduling problem. First, a neural combinatorial optimization with the reinforcement learning method is proposed to select a set of possible acquisitions and provide a permutation of them. Second, with the selected acquisition sequence, a reinforcement learning algorithm based on deep deterministic policy gradient is proposed to select the start time of each acquisition under the time constraints. The experimental results with artificial instances show that the proposed method is a viable candidate for the highly combinatorial AEOS scheduling problem; furthermore, it has the ability to cope with the run-time assessment, like the transition time calculation and the image quality evaluation.

Multi Criteria Decision Making for the Multi-Satellite Image Acquisition Scheduling Problem.

The multi-satellite image acquisition scheduling problem is traditionally seen as a complex optimization problem containing a generic objective function that represents the priority structure of the satellite operator. However, the majority of literature neglect the collective and contemporary effect of factors associated with the operational goal in the objective function, i.e., uncertainty in cloud cover, customer priority, image quality criteria, etc. Consequently, the focus of the article is to integrate a real-time scoring approach of imaging attempts that considers these aspects. This is accomplished in a multi-satellite planning environment, through the utilization of the multi-criteria decision making (MCDM) models, Elimination and Choice Expressing Reality (ELECTRE-III) and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), and the formulation of a binary linear programming model. The two scoring approaches belong to different model classes of MCDM, respectively an outranking approach and a distance to ideal point approach, and they are compared with a naive approach. Numerical experiments are conducted to validate the models and illustrate the importance of criteria neglected in previous studies. The results demonstrate the customized behaviour allowed by MCDM methods, especially the ELECTRE-III approach.

Locally advanced rectal cancer: 3D diffusion-prepared stimulated-echo turbo spin-echo versus 2D diffusion-weighted echo-planar imaging

BackgroundDiffusion-weighted imaging (DWI) has shown great value in rectal cancer imaging. However, traditional DWI with echo-planar imaging (DW-EPI) often suffers from geometrical distortions. We applied a three-dimensional diffusion-prepared stimulated-echo turbo spin-echo sequence (DPsti-TSE), allowing geometrically undistorted rectal DWI. We compared DPsti-TSE with DW-EPI for locally advanced rectal cancer DWI.MethodsFor 33 prior-to-treatment patients, DWI images of the rectum were acquired with DPsti-TSE and DW-EPI at 3 T using b-values of 200 and 1000 s/mm2. Two radiologists conducted a blinded scoring of the images considering nine aspects of image quality and anatomical quality. Tumour apparent diffusion coefficient (ADC) and distortions were compared quantitatively.ResultsDPsti-TSE scored significantly better than DW-EPI in rectum distortion (p = 0.005) and signal pileup (p = 0.001). DPsti-TSE had better tumour Dice similarity coefficient compared to DW-EPI (0.84 versus 0.80, p = 0.010). Tumour ADC values were higher for DPsti-TSE compared to DW-EPI (1.47 versus 0.86 × 10-3 mm2/s, p < 0.001). Radiologists scored DPsti-TSE significantly lower than DW-EPI on aspects of overall image quality (p = 0.001), sharpness (p < 0.001), quality of fat suppression (p < 0.001), tumour visibility (p = 0.009), tumour conspicuity (p = 0.010) and rectum wall visibility (p = 0.005).ConclusionsDPsti-TSE provided geometrically less distorted rectal cancer diffusion-weighted images. However, the image quality of DW-EPI over DPsti-TSE was referred on the basis of several image quality criteria. A significant bias in tumour ADC values from DPsti-TSE was present. Further improvements of DPsti-TSE are needed until it can replace DW-EPI.

Peer Review Tool for General Radiography Technologists Improves Image Quality.

Quality improvement is vital to ensure health-care providers meet optimal patient care standards. Within our jurisdiction, accreditation requires image peer review as part of the quality assurance program. We propose a method to improve quality assurance in radiography by implementing a novel software-based peer review system for radiography technologists. This is a retrospective study. A peer review tool was developed in Microsoft Excel and Visual Basic. The tool has 14 image quality criteria, which were selected based on national and international criteria, each containing standardized answers ensuring a common scoring regime. The tool provides data analysis and storage of all peer reviews performed. Radiography supervisors utilized the tool to evaluate image quality of various body parts at 28 hospitals. The tool enabled each Medical Imaging Department to objectively score images at their own hospital. Approximately 2% of all radiographs were randomly chosen for peer review. Additionally, the tool allowed for regional analysis based on hospital, body part, and quality criterion. Initial findings exposed equipment-related issues such as worn imaging plates, artifacts, and poor exposures, which prompted increased preventative maintenance. Other documented issues included foreign objects, inadequate collimation and centering, and inconsistent usage of lead markers. After identifying quality assurance-related issues, hospitals implemented education, resulting in improved overall image quality scores in subsequent audits. The peer review tool helped identify and correct various issues affecting image quality and ensures our program meets required accreditation standards. Furthermore, staff found utilizing the tool to identify areas for improvement improved collaboration, ongoing education, and support between staff.

Comparison of propagation-based CT using synchrotron radiation and conventional cone-beam CT for breast imaging.

To evaluate and compare the image quality of propagation-based phase-contrast computed tomography (PB-CT) using synchrotron radiation and conventional cone-beam breast computed tomography (CBBCT) based on various radiological image quality criteria. Eight excised breast tissue samples of various sizes and containing different lesion types were scanned using PB-CT at a synchrotron facility and using CBBCT at a university-affiliated breast imaging centre. PB-CT scans were performed at two different mean glandular dose (MGD) levels: standard (5.8 mGy) and low (1.5 mGy), for comparison with CBBCT scans at the standard MGD (5.8 mGy). Image quality assessment was carried out using six quality criteria and six independent medical imaging experts in a reading room with mammography workstations. The interobserver agreement between readers was evaluated using intraclass correlation coefficient (ICC), and image quality was compared between the two breast imaging modalities using the area under the visual grading characteristic curve (AUCVGC). Interobserver agreement between the readers showed moderate reliability for five image criteria (ICC: ranging from 0.488 to 0.633) and low reliability for one criterion (image noise) (ICC 0.307). For five image quality criteria (overall quality, perceptible contrast, lesion sharpness, normal tissue interfaces, and calcification visibility), both standard-dose PB-CT images (AUCVGC 0.958 to 1, p ≤ .05) and low dose PB-CT images (AUCVGC 0.785 to 0.834, p ≤ .05) were of significantly higher image quality than standard-dose CBBCT images. Synchrotron-based PB-CT can achieve a significantly higher radiological image quality at a substantially lower radiation dose compared with conventional CBBCT. • PB-CT using synchrotron radiation results in higher image quality than conventional CBBCT for breast imaging. • PB-CT using synchrotron radiation requires a lower radiation dose than conventional CBBCT for breast imaging. • PB-CT can help clinicians diagnose patients with breast cancer.

Study of breast implants mammography examinations for identification of suitable image quality criteria

PurposeTo characterise the mammography technique used in breast cancer screening programmes for breast implants (BI) and to identify if the image quality (IQ) criteria available in literature are applicable to BI imaging.MethodsThe study was conducted in two phases: literature review to find IQ criteria used in mammography combining keywords in several sources; and assessment of 1207 BI mammograms using the criteria that was identified previously to see if they were achieved or not. An observation grid was used to collect information about positioning, beam energy, compression force, and exposure mode. Descriptive statistics and Student’s t test and χ2 test were performed according to the nature of the variables.ResultsForty-seven out of 2188 documents were included in the analysis, with 13 items identified to assess the quality of positioning, 4 for sharpness, 3 for artefacts, and 2 for exposure parameters. After applying the criteria to BI mammograms, retroglandular fat was not included in 37.3% of the images. The “Pectoral-Nipple-Line” criterion was achieved in 35% of MLO/ML images. The placement of the implant (subpectoral/subglandular) or performing the Eklund had significant influence on the visible anatomy (p = < 0.005), alongside whether the breast was aligned to the detector’s centre.ConclusionsSome of the criteria used to assess standard mammograms were not applicable to BI due to implant overlap. The alignment of the image with the detector’s centre seems to have an impact on the amount of visible tissue. Further studies are necessary to define the appropriate protocol, technique, and suitable quality criteria to assess BI mammograms.

Assessment of image quality of plain abdominal radiographs at a northwestern Nigeria tertiary hospital

Background: Image quality has a significant effect on the accuracy of radiographic diagnosis, and without optimal image quality many vital information might be missed and that will affect patient management negatively. This work is aimed at assessing the image quality of plain abdominal radiographs, which is one of the most frequent emergency radiographic examinations done, using the radiographic technical parameters and the guidelines of image quality criteria set by the European Commission (EC) as the measuring criteria for the development of quality assurance program. Materials and Methods: A prospective survey of anteroposterior erect and supine plain abdominal radiographs of adult patients produced at Ahmadu Bello University Teaching Hospital from August 2019 to October 2019 was conducted assessing its quality based on the radiographic technical parameters and the guideline set by the EC for assessing image quality using a data capture sheet. Results: Plain abdominal radiographs of 92 adults comprising, 55.4% male, 44.6% female, 42.4% erect, and 57.6% supine, were evaluated. The finding of the study revealed that image quality criteria on radiographic technical parameters were optimal in 2%, suboptimal in 50%, and poor in 48%. The image quality based on the EC guideline result shows that only 3% of the reviewed plain abdominal radiograph were optimum, 63.0% were suboptimal, and 34% were poor. Furthermore, the study proves that gender has no significant effect (P = 0.985) on the image quality based on radiographic technical parameter, whereas image quality based on the EC guideline is significantly influenced by gender (P = 0.023). Conclusion: The quality of plain abdominal radiographs produced at this center during this period was abysmal; hence, rigorous quality control programs, familiarization of the radiographers with the guidelines for assessing image quality, and total replacement of obsolete equipment need to be instituted.

Assessment of Level of Collimation for Pediatric Plain Chest Radiographs in a Teaching Hospital in Kano, Northwestern Nigeria

Collimation of x-ray beam is an important factor in optimization; good collimation will both minimize the radiation dose to the patient and improve image quality because the amount of scattered radiation will increase as if a large volume of tissue is irradiated. This study aimed to assess the level of collimation for pediatric plain chest radiographs in Aminu Kano Teaching Hospital as an optimization tool. A retrospective audit was conducted on pediatric plain chest radiographs from May 2016 to May 2019 in Aminu Kano Teaching Hospital (Kano, Nigeria) using a simple random sampling technique. Data were collected and recorded using self-developed data capture sheet based on the European Guidelines on quality criteria for diagnostic radiographic images in pediatrics which captures the gender, age, projection, collimation (4 ways, 3 ways, 2 ways, 1 way, no and under collimation). The results showed that the most predominant age group exposed in the study was within 0 to 1 year representing 31.7% (n=76). Also gender distribution showed that more male were exposed than female, representing 55% (n=132). Out of 240 plain chest radiographs, about 77.0% (n=175), showed inadequate collimation. In conclusion,the study revealed poor collimation practice in pediatric plain chest radiographs.

P889 3D guided CT assessment to define the right pulmonary vein on standard apical 4-chamber view

Abstract Introduction Pulmonary vein(PV) assessment is an integral component of the transthoracic echocardiogram(TTE) examination; typically assessed in the apical four-chamber view(A4Ch). There is disagreement in current textbooks and literature regarding which specific right pulmonary vein is visualised on A4Ch; as either the right superior(RSPV) or right inferior PV(RIPV). Given the high reliability of cardiac CT for PV assessment, we aimed to characterize right PV anatomy on A4Ch by utilizing multi-modality comparison of echocardiography and a 3D-guided A4Ch on CT. Methods Retrospective analysis was performed on consecutive patients with TTE demonstrating PV flow(by colour or pulse-wave Doppler) and cardiac CT within 30days; studies not meeting image quality criteria excluded. To simulate the A4Ch on CT, multi-planar reconstruction was used to create an image plane including right PV ostia and LV apex. This image was rotated along the long-axis to achieve an A4Ch with both ventricles and atria, tricuspid and mitral valves in view without LVOT or aorta. This was attempted for right superior, inferior and middle(RMPV, if present) PV’s. Results 50 patients were analysed: mean age 66yrs, 48% female, mean LA volume(indexed) 43.5ml/m². A4Ch was feasible in 100%(n = 50) of CT simulations using the RIPV, only 24%(n = 12) were feasible using RSPV with all excluded cases due to LVOT/aorta persistently in view. RMPV was present in 6 cases with feasible A4ch in 67%. Conclusion This study demonstrates that the right PV on A4Ch is highly likely to be the RIPV due to the RSPV being anatomically impossible in the significant majority of cases. Abstract P889 Figure. CT multiplanar reconstruction of A4Ch

ФАКТОРЫ, КРИТЕРИИ И ТРЕБОВАНИЯ К ИЗОБРАЗИТЕЛЬНОМУ КАЧЕСТВУ МАТЕРИАЛОВ АЭРОФОТОСЪЕМКИ, ПОЛУЧАЕМОЙ ДЛЯ ЦЕЛЕЙ КАРТОГРАФИРОВАНИЯ

Fine image quality assessment of aerial imagery, obtained for mapping purposes, is a relevant problem today. The purpose of this article is development the criteria system of fine image quality assessment of aerial topographic imagery and set requirements to them. The article discusses a set of factors that determine the fine image quality - natural surveying conditions, its technical and technological conditions and parameters. The article carries out the analysis of how these factors influence on aerial imagery and shows the main defects of images caused by them – such as blurring, haze, loss of information in highlights and shadows, high random noise, color disbalance. The article defines the ways for identifying these defects and assessing their influence on the fine quality of aerial imagery both visual and automatic methods. It is shown that image fine quality assessment must be carried out in terms of structural and gradation (photographic) characteristics. It is also shown that, in addition to the above characteristics, fine quality of aerial images can be influenced by random factors, the appearance of which cannot be predicted. Defects caused by these factors are revealed by operator’s visual inspection. The requirements for several fine image quality criteria, which allow to establish this research phase, are given.

Automatic sensitivity control in television systems

This paper discusses a way to resolve the contradiction between a tendency to maximize the optical-signal intensity range of objects and the limited dynamic range of photodetectors. Methods of controlling the sensitivity of television systems are analyzed, taking into account how they affect the spatial, temporal, noise, and other image-quality criteria. Diagrams from automatic-control theory are adapted to sensitivity-control systems, and a flowchart is proposed for an automatic sensitivity-control system that uses five methods with a specified sequence of priorities. A method is proposed that makes it possible to expand the working illuminance range in Pregius-series photodetectors (Sony) to 200&#x00A0;dB&#x2014;i.e., by more than 40&#x00A0;dB&#x2014;by controlling the accumulation time and the analog and digital amplification in combination.

A new focus evaluation operator based on max–min filter and its application in high quality multi-focus image fusion

Multi-focus image fusion plays an important role in the field of image recognition and analysis. However, current focus evaluation operators are complex and inefficiency. In this paper, a new focus evaluation operator based on max–min filter is proposed. In new focus measure, we use max–min filter with the help of average filter and median filter (MMAM) to evaluate the focus degree of source images. This evaluation algorithm can well measure the sharpness of different regions of the image, and the selected clear region will be more useful for human visual or machine perception. The experiment proved that MMAM can perform better than sum-of-modified-Laplacian in most of cases. Later, MMAM is used to fused multi-focus image by combined structure-driven fused regions and depth information of blurred images. Experimental results demonstrate that the proposed algorithm outperforms the state-of-the-art fusion algorithms on image quality and objective fusion criteria. This paper firstly proposes the concept and computational processing of MMAM, which provides a new research direction and innovative idea for multi-focus image fusion base on filter, and MMAM can embedded into state-of-the-art fusion algorithm to achieve high quality multi-focus image fusion.

Image quality and pathology assessment in CT Urography: when is the low-dose series sufficient?

BackgroundOur aim was to compare CT images from native, nephrographic and excretory phases using image quality criteria as well as the detection of positive pathological findings in CT Urography, to explore if the radiation burden to the younger group of patients or patients with negative outcomes can be reduced.MethodsThis is a retrospective study of 40 patients who underwent a CT Urography examination on a 192-slice dual source scanner. Image quality was assessed for four specific renal image criteria from the European guidelines, together with pathological assessment in three categories: renal, other abdominal, and incidental findings without clinical significance. Each phase was assessed individually by three radiologists with varying experience using a graded scale. Certainty scores were derived based on the graded assessments. Statistical analysis was performed using visual grading regression (VGR). The limit for significance was set at p = 0.05.ResultsFor visual reproduction of the renal parenchyma and renal arteries, the image quality was judged better for the nephrogram phase (p < 0.001), whereas renal pelvis/calyces and proximal ureters were better reproduced in the excretory phase compared to the native phase (p < 0.001). Similarly, significantly higher certainty scores were obtained in the nephrogram phase for renal parenchyma and renal arteries, but in the excretory phase for renal pelvis/calyxes and proximal ureters. Assessment of pathology in the three categories showed no statistically significant differences between the three phases. Certainty scores for assessment of pathology, however, showed a significantly higher certainty for renal pathology when comparing the native phase to nephrogram and excretory phase and a significantly higher score for nephrographic phase but only for incidental findings.ConclusionVisualisation of renal anatomy was as expected with each post-contrast phase showing favourable scores compared to the native phase. No statistically significant differences in the assessment of pathology were found between the three phases. The low-dose CT (LDCT) seems to be sufficient in differentiating between normal and pathological examinations. To reduce the radiation burden in certain patient groups, the LDCT could be considered a suitable alternative as a first line imaging method. However, radiologists should be aware of its limitations.

Ethiodized poppyseed oil versus ioversol for image quality and adverse events in hysterosalpingography: a prospective cohort study

BackgroundThis study aimed to investigate the image quality and adverse events (AEs) of ethiodized poppyseed oil (EPO) compared with ioversol as contrast agents in hysterosalpingography (HSG).MethodsTwo hundred twenty-eight patients underwent HSG were consecutively recruited in this prospective cohort study, and were accordingly divided into EPO group (N = 165) and ioversol group (N = 63). The quality of image was assessed according to the European Guidelines on quality criteria for diagnostic radiographic images. AEs during, within 2 h and at 1-month post-HSG were recorded.ResultsEPO displayed elevated image quality compared with ioversol including the total image quality score (P < 0.001), the cervical canal display score (P < 0.001), shape and outline of uterus score (P < 0.01), cervical mucosa or folds score (P < 0.001), oviduct isthmus score (P < 0.001), ampulla and fimbriae of oviduct score (P < 0.001) and celiac diffuse image score (P < 0.001). Multivariate linear regression displayed that EPO (P < 0.001) was an independent predictive factor for increased total image quality score. AEs were similar between EPO group and ioversol group during and within 2 h post-HSG (all P > 0.05). However, at 1-month post-HSG, the number of patients had unchanged and faded menstrual blood color decreased but the proportion of patients with deepened menstrual color increased in EPO group compared with ioversol group (P = 0.007). In addition, the number of patients had iodine residue in uterine cavity was elevated in EPO group compared with ioversol group (P < 0.001).ConclusionEPO is more efficient in image quality and equally tolerant compared to ioversol as contrast agents in HSG.

Improvement in diagnostic quality of structural and angiographic MRI of the brain using motion correction with interleaved, volumetric navigators.

IntroductionSubject movements lead to severe artifacts in magnetic resonance (MR) brain imaging. In this study we evaluate the diagnostic image quality in T1-weighted, T2-weighted, and time-of-flight angiographic MR sequences when using a flexible, navigator-based prospective motion correction system (iMOCO).MethodsFive healthy volunteers were scanned during different movement scenarios with and without (+/-) iMOCO activated. An experienced neuroradiologist graded images for image quality criteria (grey-white-matter discrimination, basal ganglia, and small structure and vessel delineation), and general image quality on a four-grade scale.ResultsIn scans with deliberate motion, there was a significant improvement in the image quality with iMOCO compared to the scans without iMOCO in both general image impression (T1 p<0.01, T2 p<0.01, TOF p = 0.03) and in anatomical grading (T1 p<0.01, T2 p<0.01, TOF p = 0.01). Subjective image quality was considered non-diagnostic in 91% of the scans with motion -iMOCO, but only in 4% of the scans with motion +iMOCO. iMOCO performed best in the T1-weighted sequence and least well in the angiography sequence. iMOCO was not shown to have any negative effect on diagnostic image quality, as no significant difference in diagnostic quality was seen between scans -iMOCO and +iMOCO with no deliberate movement.ConclusionThe evaluation showed that iMOCO enables substantial improvements in image quality in scans affected by subject movement, recovering important diagnostic information in an otherwise unusable scan.

European guidelines on quality criteria for diagnostic radiographic images of the lumbar spine \u2013 an intra- and inter-observer reproducibility study

BackgroundThe Commission of the European Communities has published guidelines to be used as a gold standard for quality assessment of diagnostic radiographic images. Image quality and radiation dose must be monitored and optimally balanced for diagnostic purposes on patients. The objective of the current study was to assess intra- and inter-observer reproducibility in less experienced observers using the proposed European Guidelines on Quality Criteria for Diagnostic Radiographic Images in a quality assessment of lumbar spine radiographs in primary chiropractic practice in Denmark.MethodsTwo observers initially evaluated lumbar spine radiographs randomly selected from fifty chiropractic clinics, all connected to the national PACS server (KirPACS) in Denmark. All evaluations were performed twice by both observers using a four-week interval and for compliance with the European Quality Criteria for Diagnostic Radiographic Images. Inter- and intra-observer reproducibility was calculated using kappa statistics. In the interpretation of the kappa coefficient, the standards for strength of agreement reported by Landis and Koch were followed.ResultsThe strength of the inter-observer agreement of general image quality at baseline ranged from moderate agreement (k = 0.47) to substantial agreement (k = 0.68). After four weeks, the inter-observer agreement still ranged from moderate agreement (k = 0.59) to substantial agreement (k = 0.71), but with increased agreement for both kappa coefficients. In relation to intra-observer agreement of general image quality, the strength for observer A ranged from moderate (k = 0.58) to substantial (k = 0.72) and the strength for observer B overall was substantial (k = 0.63–0.75).ConclusionThe European Guidelines on Quality Criteria for Diagnostic Radiographic Images are considered a gold-standard and used in a method for quality assurance within the Danish chiropractic profession. The inter-rater and intra-rater agreements in this study, using the CEC-criteria, were found mostly acceptable. With appropriate attention to clear understanding of the individual criteria and sufficient training, this method is found to be reliable, even using less experienced observers, to carry out Diagnostic Radiographic Image Quality-assurance in primary care settings.