Radiographic Film Research Articles

Discussion on effect of observation circumstances for image in digital radiography

The discriminability of the IQI in the film radiography is affected by the observation circumstance and the luminance of film viewer. ISO17636-2 states that the images of digital radiograph shall be examined in a dimmed room. However, it does not describe requirements for the observation environment in digital radiography, despite the fact that the environment is similar to that of a normal professional PC and the display of the images can be easily adjusted. In this report, the influence of the observation environment in digital radiography was compared as the parameters the wire diameter and the WL value of a display adjustment value when the minimum wire diameter of the image quality indicator (IQI) was percepted, using images of welded steel at t25mm and t50mm. For welded steel of t25mm, differences due to SNRN values and differences due to the observation environment of light and dark room were compared. For t50mm, differences due to the presence or absence of the observation mask for the single wire of wire IQI which is places in front of the display, differences due to the resolution and brightness of the PC monitor, and differences when the WL was adjusted arbitrarily or fixed were compared. For the Digital Radiographic testing (RT-D), the basic spatial resolutions (SRb) were obtained by measuring the profile and applying of visual observation with the duplex wire type IQI. On the other hand, when observing the image of wire type IQI, the observation ways that one was obtain the perceptible image for all wires and another was to get the perceptible single wire image by using the observation mask for watching each wire were applied. Moreover, the influence of window width (WW) and window level (WL) adjustment on the discrimination of wire-type IQI was examined by quantifying it as WW/WL. As a result, it was confirmed that the discriminality in the dimmed room and the adjustment of WW and WL were effective. In addition, using the observation a mask showed that the perception of the adjacent wire image affected observer cognition in IQI discrimination during image observation. When using viewer software profiling, SRb measurements were not affected by the observation environment, but the visual observation was affected by the environment, and when observing images in the dimmed room with RT-D, it was found that adjusting WW and WL had a greater effect on discrimination for images with low SNRN and low contrast.

Effects of Parallax and Distortion in Total Ankle Arthroplasty.

Surgeons rely on intraoperative fluoroscopy to assist in placement of implant components during total ankle arthroplasty (TAA). Parallax alters the direction of an object when viewed from two different points, resulting in image distortion. The purpose of this study was to evaluate parallax/distortion in intraoperative fluoroscopic images during TAA. A retrospective review of all TAAs performed by two surgeons (R.W.M. and B.S.) from August 2019 to April 2023 were reviewed. Intraoperative fluoroscopic anteroposterior (AP) ankle views were evaluated for any obvious parallax image distortion. Cases with obvious parallax distortion were included for angular evaluation of AP intraoperative fluoroscopic and first postoperative plain films. The tibia was marked at 2-centimeter intervals to create zones from the proximal stem of the implant. The anatomical axis of the tibia (AAT) was drawn at the mid-diaphysis. The anatomic lateral distal tibial angle (aLDTA) and anatomic axis deviation (AAD) were measured for each zone. A total of 22 TAAs were performed during the study period. Four cases were excluded due to inadequate imaging, leaving a total of 18 TAAs for review. We found 6 of 18 (33.3%) cases had obvious parallax distortion. We found the average aLDTA was 90.9° (84°-101°). At the most proximal tibial zone, the average aLDTA was 94° (91°-101°). We found the average AAD was 4.7 (0.5-17.2) mm. The AAD ranged from 0.5 to 17.2 mm lateral to 0.8 to 8.2 mm medial. Postoperative plain film radiographs displayed a normal aLDTA and an AAT centered within the ankle joint. Parallax can distort the appearance of the tibia on fluoroscopic images. Deviation from the normal aLDTA and anatomical axis should be anticipated. Surgeons should be aware of the potential impact of parallax and ways to mitigate these effects.

3D bone shape from CT-scans provides an objective measure of osteoarthritis severity: Data from the IMI-APPROACH study

Decisions regarding total knee arthroplasty are usually made using a patient's own assessment of pain and the structural disposition of the joint as seen on plain film radiographs. Pain severity can fluctuate, and radiographs can be misleading, with the apparent joint status affected by anatomical orientation. An important component of the surgical management of knee osteoarthritis (OA) is the timing of surgical intervention: knee arthroplasty performed too early in the course of the disease may increase the need for revision surgery.Femoral 3D bone shape (B-score) from MR images is an objective measure of OA severity and has been correlated with current and future risk of pain. We aimed to derive the B-score from CT images and compare it against the B-score derived from MR images.We used baseline and 24-month image data from the IMI-APPROACH 2-year prospective cohort study, comprising pairs of CT and MR images taken for each subject-timepoint. The femur was automatically segmented in both CT and MR modalities using an active appearance model, a machine-learning method, to measure the B-score. Linear regression was used to test for correlation between measures. Limits of agreement and bias were tested using Bland-Altman analysis.CT-MR pairs of the same knee were available from 424 participants (78 % women). B-scores from CT and MR were strongly correlated (CCC = 0.980) with negligible bias of 0.0106 (95 % CI: −0. 0281, +0.0493).The strong correlation and small B-score bias suggests that B-scores may be measured reliably using CT images. Since CT images are used in planning robot-assisted knee arthroplasty, with further study B-scores derived from CT surgical planning images could in principle provide a useful objective input to deciding the appropriateness, timing and type of knee arthroplasty.

Thorn-induced Injury of the Knee Mimicking Pigmented Villonodular Synovitis (PVNS): A Case Report

Background and Aims: Plain film radiography is the first imaging modality in the detection of most foreign bodies. However, it is not sensitive for detection of radiolucent objects such as organic material including plant thorns. Case report: Herein, we present the case of a 19-year-old male patient, presenting with an 8-month history of right knee pain and laxity, whose radiographic appearance mimicked that of pigmented villonodular synovitis (PVNS) but was found to have a retained neglected plant thorn in his knee. Upon ultrasound evaluation for image-guided biopsy to confirm the provisional diagnosis of PVNS, he was found to have a retained neglected plant thorn in his knee. Discussion: Plant thorn injuries can present as knee synovitis, as in our case, and should be kept in the differential diagnosis. An ultrasound-guided removal is possible and is a useful minimally invasive procedure.

ASTM International Subcommittee E07.02 on Reference Radiological Images: A brief history and update of recent work

Radiographic interpretation is a combination of art and science. The radiograph interpreter must be well versed in x-ray physics, conditions of the exposure, characteristics of the source and image detector, the design of the part, its specifications, and potential flaws. But there is also an art to interpretation that is gained over years of looking at many radiographs taken in many different conditions. As an aid to interpretation, reference radiographs have been developed and well accepted as means of identifying different types of indications and grading those indications for accept/reject decisions. Industrial radiography began in 1922 under the direction of HH Lester at the US Army Watertown Arsenal. The first radiography standards and reference radiographs appeared in the 1930s. ASTM International Committee E07 on Nondestructive Testing was formed out of Committee E04 on Metallography X-ray Methods subcommittee in 1938 when ASTM was the American Society for Testing Materials. An ASTM Subcommittee on Reference Radiographs was formed in 1950 and immediately adopted some of these first reference films as consensus standards. Since those first reference radiograph standards ASTM has developed both film and digital radiograph standards for 11 types of castings and 3 types of welds, several radiographic parameter demonstration films, a standard film for measuring film digitization performance, and films for evaluating visual acuity of radiograph interpreters. This paper discusses the history of reference films and the recent development of digital reference images, film digitizer performance film, and the visual acuity standard. The just-approved ASTM E3168 Standard Practice for Determining Low-Contrast Visual Acuity of Radiographic Interpreters is the first standard containing actual radiographic images of varying sharpness, contrast, and noise that can be used to evaluate interpreters and/or interpretation environments. This paper documents the initial statistical study performed on the visual acuity standard films.

EVALUATION OF THE RELATIVE POSITION OF THE MANDIBULAR FORAMEN IN YEMENI CHILDREN AS A REFERENCE FOR INFERIOR ALVEOLAR NERVE BLOCK USING AN ORTHOPANTAMOGRAPH

Aim and objectives: A crucial component of managing a kid dentistry patient's behavior is pain control. For mandibular teeth, the most used local anesthetic method is inferior alveolar nerve block (IANB). So, an effective IANB anesthetic requires knowledge of the mandibular foramen's location. Using digital panoramic radiography pictures, the mandibular foramen's position in relation to the occlusal plane and the deepest point of the anterior border of the ramus was assessed in a sample of Yemeni children aged 4 to 12. Materials and Methods: This retrospective study consisted of 501 orthodontic charts that were analyzed and divided into three groups: Group 1: 4-6 years, Group 2: 7-9 years and Group 3: 10-12 years. The OPGS were traced directly on radiographic films and measurements were taken from the mandibular foramen to the occlusal level and to the deepest point of the anterior border of the ramus, respectively, on the right and left sides of the mandible. Data were analyzed and the mean and SD were determined and compared for different gender, age groups and side (right/left). Results: Male participants showed slightly higher mean distance values for MF-AB-Right compared to females (16.276±2.03 mm VS 15.952±1.82), but the contrast was not statistically significant. The study found significant differences in the mean MF distances of ABR between the 10-12 year age group and the 4-6 year age group (16.518±1.86 mm VS 15.487±1.95 mm), (p=0.0001). The mean OP-MF distances for the 10-12 year age group were also significant, with significant differences observed in the right side and left side. Conclusion: The results were similar for the total children, regardless of gender. The study suggests that the mandibular foramina position may vary among different age groups. For inferior alveolar nerve block, the needle should be inserted slightly below the OP in 4-6 years old girls and at the same level of OP in 7-9 years old girls, and 4-6 years old boys. Peer Review History: Received 23 March 2024; Revised 6 May 2024; Accepted 29 June; Available online 15 July 2024 Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, asia_abdullah65@yahoo.com Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Dr. Masoumeh Divar, Shiraz University, Shiraz, Iran, zhaledivar@gmail.com

Determination of voiding pressure in infants with normal lower urinary tracts: Exploring the possible effect of sacral development.

To investigate the association between sacral underdevelopment, as defined by subnormal sacral ratio (SR) measurements, with increased maximum detrusor voiding pressure (P det. Max) in infants. In this 2007-2015 retrospective cohort study, the medical records of all infants who underwent a pyeloplasty due to congenital ureteropelvic junction obstruction were added. Their P det. Max was evaluated through the suprapubic catheter utilized for urinary drainage intraoperatively, without imposing any additional risk of urethral catheterization on the infant. SR was calculated via the plain kidney, ureter, and bladder (KUB) radiography film obtained during the voiding cystourethrogram (VCUG) evaluation before the surgery. Participants were categorized into SR < 0.74 or SR ≥ 0.74. P det. Max was subsequently compared between these two groups. A total of 45 patients were included in our analysis. Twenty-eight (62.2%) patients had a (SR < 0.74), while 17 (37.8%) had a (SR ≥ 0.74). P det. Max was shown to be significantly higher in the SR < 0.74 compared to the SR ≥ 0.74 group (167.5 ± 60.8 vs. 55.7 ± 17.9 cmH2O, p < 0.001). After adjusting for age and sex, SR remained a significant contributor to P det. Max (p < 0.001). Physiologic detrusor sphincter dyscoordination (PDSD) rate was significantly higher in the SR < 0.74 versus SR ≥ 0.74 group (100.0% vs. 70.6%, respectively; p = 0.005). Lumbosacral underdevelopment, as indicated by subnormal sacral ratios, is associated with sphincter-detrusor dyscoordination, which causes PDSD and can ultimately result in higher P det. Max in infants.

Pelvic Fixation for Non-Ambulatory Patients with Neuromuscular Scoliosis Treated with Magnetically Controlled Growing Rods-A 4-Year Comparison of Two Different Fixation Methods.

Background/Objectives: This study aims to analyze the efficacy and safety of the two pelvic fixation systems, S-hooks (SH) and lumbar-sacral-alar-iliac (SAI) screws, when used in association with magnetically controlled growing rods (MCGRs) in non-ambulatory children with severe neuromuscular scoliosis (NMS). Methods: Forty-one patients were retrospectively examined and subdivided corresponding to ilium hook fixation or SAI screws. The major curve correction (%) and pelvic obliquity (PO) correction (%) were assessed utilizing scoliosis plain film radiographs over time. Complications and unplanned return to the operating room (UPROR) were recorded. Patient-specific pre- and postoperative values were included in a backward stepwise regression model to assess UPROR. Results: Mean age at index intervention was 9.4 years. Preoperative main curve was 81° and PO was 22°. 21 and 20 patients were categorized into the SH and SAI subgroups, respectively. Initial curve correction was significantly better in the SAI subgroup (63 vs. 42% in the SH, p = 0.045), while PO correction was equally good. Curve and PO correction were maintained throughout the follow-up period of 55 months. UPROR rate was 38% in the SH subgroup, and 5% in the SAI subgroup (p = 0.010). Regression analysis identified postoperative curve correction as predictive value for UPROR (p = 0.006). Conclusions: SAI screw fixation has a low UPROR rate and achieves superior curve correction. S-hooks are a viable option to correct PO and NMS in children with high operative risk to reduce operative time, but revision surgery is not uncommon.

Radiochromic film EBT3 calibration for linear accelerator in 10 MV

Radiochromic film is used to applications in dosimetry have become increasingly significant for studies on radiotherapy. Due to sensitivity to exposure to ionizing radiation, radiochromic films are commonly used to obtain dose distribution maps and for calibration curves. The calibration curves in the radiochromic films can be use radiochromic films as a dosimetry method and then seek the generation of images with lower dose deposition and higher diagnostic quality. When ionizing radiation interacts with matter it generates energy deposition. Radiation dosimetry is important for medical applications of ionizing radiation due to the increasing demand for diagnostic radiology and radiotherapy. The film is a dose measurement method that records the energy deposition by the darkening of its emulsion. Radiochromic films have a little visible light sensitivity and respond better to ionizing radiation exposure. The aim of this study is to obtain the resulting calibration curve by the irradiation of radiochromic film strips, making it possible to relate the darkening of the film with the absorbed dose, to measure doses in experiments with X-ray beam of 10 MeV in Linear Accelerator. The objective of this study is to obtain the calibration curves of the radiographic film for exposure with X-ray beam in Linear Accelerator scanner for realize measures of typical doses found in radiotherapy. It was used Gafchromic EBT Radiochromic Film, which shows little sensitivity to visible light and a response in the range of 0.1 to 10 Gy for X-ray beam. In the experiments, a Solid Water Phantom, with a 30x30x2.0 cm³. The strips were scanned and processed using the ImageJ software to obtain the intensity values resulting from the absorbed radiation by grayscale. The darkening responses on film strips according to the doses were observed and they allowed obtaining the corresponding numeric values to the darkening for each specific dose value. From the numerical values of darkening, a calibration curve was obtained.

Computed chest radiography for total body irradiation: image quality and clinical feasibility

Objective. In myeloablative total body irradiation (TBI), lung shielding blocks are used to reduce the dose to the lungs and hence decrease the risk of radiation pneumonitis. Some centers are still using mega-Volt (MV) imaging with dedicated silver halide-based films during simulation and treatment for lung delineation and position verification. However, the availability of these films has recently become an issue. This study examines the clinical performance of a computed radiography (CR) solution in comparison to radiographic films and potential improvement of image quality by filtering and post-processing. Approach. We compared BaFBrI-based CR plates to radiographic films. First, images of an aluminum block were analyzed to assess filter impact on scatter reduction. Secondly, a dedicated image quality phantom was used to assess signal linearity, signal-to-noise ratio (SNR), contrast and spatial resolution. Ultimately, a clinical performance study involving two impartial observers was conducted on an anthropomorphic chest phantom, employing visual grading analysis (VGA). Various filter materials and positions as well as post-processing were examined, and the workflow between CR and film was compared. Main results. CR images exhibited high SNR and linearity but demonstrated lower spatial and contrast resolution when compared to film. However, filtering improved contrast resolution and SNR, while positioning filters inside the cassette additionally enhanced sharpness. Image processing improved VGA scores, while additional filtering also resulted in higher spine visibility scores. CR shortened TBI simulation by over 10 minutes for one patient, alongside a dose reduction by order of 0.1 Gy. Significance. This study highlights potential advantages of shifting from conventional radiographic film to CR for TBI. Overall, CR with the incorporation of processing and filtering proves to be suitable for TBI chest imaging. When compared to radiographic film, CR offers advantages such as reduced simulation time and dose delivery, re-usability of image plates and digital workflow integration.

Applicant Perception and Content Exploration of the 2024 podiatric Residency Interview Process

Considerable resources are dedicated on an annual basis to the podiatric medicine and surgery residency interview by both students and programs. Despite this, relatively little is known about student perception of the process, nor the format and content of interview. The objective of this investigation was to study and organize experiences of fourth-year podiatric medical students following the 2024 Centralized Residency Interview Program (CRIP) process. An anonymous and voluntary survey was developed and made available to fourth year podiatric medical students. It was relatively common for there to be academic, social/personal, case work-up, and rapid-fire academic question components to the interview. It was also very common to be provided with the opportunity to ask programs questions. It was relatively uncommon for there to be ethical/moral questions, personality/psychologic assessments, logic assessments, and hands-on demonstrations. The most common hands-on demonstrations were suturing, hand ties and performance of fixation principles. Relatively high yield academic topics included plain film radiography interpretation, rearfoot/ankle osseous trauma, diabetic foot infection, advanced imaging interpretation, and fixation constructs/principles. When evaluating programs, students placed high value on surgical volume, surgical variety, relative resident autonomy, program location, exposure to outpatient clinics, salary, future connections as a program alumnus, unique off-service rotations, exposure to business management/coding/billing, scope of practice, exposure to inpatient management, resident salary, and who the senior co-residents would be. The results of this investigation provide unique information for both medical students and residency programs with respect to the perception, format and content of the podiatric residency interview process.

Tablet-based Augmented reality and 3D printed templates in fully guided Microtia Reconstruction: a clinical workflow

BackgroundMicrotia is a congenital malformation of the auricle that affects approximately 4 of every 10,000 live newborns. Radiographic film paper is traditionally employed to bidimensionally trace the structures of the contralateral healthy ear in a quasi-artistic manner. Anatomical points provide linear and angular measurements. However, this technique proves time-consuming, subjectivity-rich, and greatly dependent on surgeon expertise. Hence, it’s susceptible to shape errors and misplacement.MethodsWe present an innovative clinical workflow that combines 3D printing and augmented reality (AR) to increase objectivity and reproducibility of these procedures. Specifically, we introduce patient-specific 3D cutting templates and remodeling molds to carve and construct the cartilaginous framework that will conform the new ear. Moreover, we developed an in-house AR application compatible with any commercial Android tablet. It precisely guides the positioning of the new ear during surgery, ensuring symmetrical alignment with the healthy one and avoiding time-consuming intraoperative linear or angular measurements. Our solution was evaluated in one case, first with controlled experiments in a simulation scenario and finally during surgery.ResultsOverall, the ears placed in the simulation scenario had a mean absolute deviation of 2.2 ± 1.7 mm with respect to the reference plan. During the surgical intervention, the reconstructed ear was 3.1 mm longer and 1.3 mm wider with respect to the ideal plan and had a positioning error of 2.7 ± 2.4 mm relative to the contralateral side. Note that in this case, additional morphometric variations were induced from inflammation and other issues intended to be addressed in a subsequent stage of surgery, which are independent of our proposed solution.ConclusionsIn this work we propose an innovative workflow that combines 3D printing and AR to improve ear reconstruction and positioning in microtia correction procedures. Our implementation in the surgical workflow showed good accuracy, empowering surgeons to attain consistent and objective outcomes.

Determination of relative dose of ionizing radiation in the thyroid gland using a panoramic device with different protocols.

The use of panoramic radiography (PR) is a complementary examination to aid in the diagnosis of cases in paediatric dentistry. The lack of specific protocols for these devices, however, can result in high doses of radiation, affecting critical organs such as the thyroid. To evaluate the discrepancies in ionizing radiation received by the thyroid during PR examinations using anthropomorphic paediatric simulators built from computed tomography images. Two anthropomorphic paediatric phantoms were printed and used, representing children aged 6 and 11 years, with an opening in the thyroid region for the insertion of dosimetric radiographic films. The simulators were subjected to different pre-existing protocols in the PR devices. The radiographic films were processed and analysed using a luxmeter. The radiation dose to the thyroid was higher in the 6-year-old phantom than in the 11-year-old phantom, for given exposure factors. In addition, there was an increase in dose in children's protocols compared with small adult protocols. Therefore, companies that develop PR equipment must develop child protocols for separate age groups that will consequently reduce the radiation dose in children, especially in their critical organs.

Renal colic

Renal colic accounts for 5-10% of all emergency department visits, making it acommon condition in acute medicine. The typical clinical presentation is an early indication of urolithiasis. Diagnostic measures include laboratory tests, ultrasound, and low-dose noncontrast computed tomography (CT) scans. Kidney, ureter, bladder (KUB) plain film radiography has been widely replaced by low-dose noncontrast CT with similar radiation dosage. In special patient groups such as children or pregnant women, ionizing radiation should be avoided if possible. General measures involve pain management (non-steroidal anti-inflammatory agents, opioids) and empirical antibiotic treatment for suspected bacterial infection. Depending on the location/size of the stone, pharmacological stone expulsion therapy may be considered. In cases of obstructive pyelonephritis or acute renal insufficiency, early urinary drainage (JJ stent/nephrostomy) is recommended. Definitive stone removal may be performed primarily in some cases (rather small and rather distal ureterolithiasis). It is common to schedule stone removal as asecondary intervention.

Efficacy of a radiographic film holder adapter in generating radiographs of dental implants with improved geometric accuracy and sharpness

Some radiographic film holders produce radiographs with geometric distortion that may interfere with diagnosis. However, whether the distortion can be corrected by adjusting the design of the radiographic film holder is unclear. The purpose of the study was to develop an adapter for a radiographic film holder model aiming to generate radiographs with greater sharpness and a more accurate geometric representation of dental implants. The 2-piece adapter was designed using the SketchUp software program and was 3-dimensionally (3D) printed. Implants with internal conical connections were installed in 19 maxillary prototypes in the central incisor region. Five dentists obtained 285 digital periapical radiographs with 3 different radiographic film holders: standard Cone Indicator, Rinn XCP, and adapted Cone Indicator. They then evaluated the radiographic sharpness of the implants threads and their dimensions using the ImageJ software program. The data were analyzed using the Friedman test with the Durbin-Conover post hoc test and MANOVA with the Tukey post hoc test (α=.05). On the mesial surface of the implants, the threads were sharper for the adapted than for the standard Cone Indicator radiographic film holder (P<.05). The adapted Cone Indicator showed a smaller difference between the radiographic and actual implant diameters compared with the Rinn XCP and standard Cone Indicator radiographic film holders (P<.05). The developed adapter provided radiographs of dental implants with improved sharpness and geometric accuracy.

Misdiagnosis or Missed Diagnosis - Hallux Sesamoid Fractures among Active-Duty Females in the United States Air Force: A Case Series

Background: Female service members tend to have a higher level of foot injuries than males. The United States Army spent $103 million in 2017 on fractures in toes and feet. Fractures of the tibial and fibular sesamoids are problem that often can be nonspecific, mainly related to pain at the plantar aspect of the first metatarsal head without an obvious traumatic event. Anatomic variation in these sesamoids exist after ossification which results in the possibility of multipartite sesamoids. Of the multipartite sesamoids, bipartite sesamoids are the relatively common and tripartite sesamoids are quite rare. The overall prevalence of bipartite sesamoids is presumed to be between 7 and 30%, with a majority occurring bilaterally. Methods: We completed a case series on three female active-duty Airmen. All three patients were active with their pain beginning following activity. All three were subsequently misdiagnosed, resulting in at least 6 months of pain prior to diagnosis and treatment. Results: Plain film radiography and subsequent imaging confirmed the diagnosis of a tibial or fibular sesamoid fracture. Following conservative treatment all three patients made a full recovery as confirmed by imaging and self-reported pain levels and they were able to return to full activity. Conclusion: Providers should keep a sesamoid fracture in the differential diagnosis when evaluating active female patients with pain in the area around the base of the great toe, especially in women in the military and others that may do higher levels of physical activity compared to the average patient. While the diagnosis of sesamoid fractures can be challenging, it is standard practice to obtain multiple views if using plain film radiography. Magnetic resonance imaging, weightbearing computed tomography and bone scans can be useful confirmatory studies.

STUDY OF GEOMETRIC UNSHARPNESS PHENOMENON IN WELDED PLATES USING INDUSTRIAL RADIOGRAPHY METHOD

The purpose of this document is to elucidate the methodology employed in analyzing the impact of unsharpness resulting from an X-ray generator on the assessment of steel welded joints. The presence of unsharpness significantly affects the accuracy of welded joint inspections conducted through industrial radiographic techniques, distorting actual measurements of potential discontinuities within the weld. To address this issue, a series of welded joint testing specimens were fabricated using a Shielded Metal Arc Welding (SMAW) process. Each specimen was intentionally designed to contain simulated discontinuities whose dimensions adhered to the acceptance or rejection criteria outlined in the API 1104 standard. Subsequently, radiographic testing was conducted on each specimen, and the dimensions of the simulated discontinuities captured on the radiographic films were measured using the "ISee!" software, as recommended by the ASTM E1165 standard. Upon comparison of the actual and theoretical measurements, it was observed that the maximum unsharpness along the X-axis was recorded in specimens featuring elongated slag inclusions (ESI), with a value of 0.1948 mm. Conversely, the maximum unsharpness along the Y-axis was attributed to individual porosities (P), with a recorded value of 0.1041 mm.

Assessment of Radiographic Film Quality in Some Selected Hospitals in Benue State

The essence of diagnostic radiology is to obtain a high quality image with low radiation dose to patient. Since radiology is aimed in producing images which provide adequate information for the clinical purpose with minimum radiation dose to the patient, we seek to assess the high image qualities that are produced in the darkroom. The processing time and the temperature, at which these films were processed, stored and also evaluated, were carried out in the darkroom. Agfa films were used throughout the procedure in four different hospitals, H-1, H-2, H-3 and H-4 and the processing chemicals were observed for the period of a month. Therefore, in H-1, the average temperature was found to be 29oC, average temperature was 26oC in H-2; in H-3, average temperature was 30oC and the average temperature in H-4 was found to be 29oC which all fall above the standard temperature limit (25oC) as recommended by National Council on Radiation Protection (NCRP). From the experimental proceedings in the darkroom, the distance from safelight to workbench, it shows that H-1 and H-2 do not conform to the standard while H-3 and H-4 are in conformity. The result obtained from darkroom fog test shows that, the Optical Density Difference (ODD) for H-1, H-2, H-3 and H-4 was found to be 0.16, 0.07, 0.18 and 0.35 respectively, which were all found to be above the ICRP standard limit (0.05). This implies that, most hospitals in Makurdi operates below the set darkroom practices as recommended by NCRP and ICRP which affects the quality of image as a result of high temperature, poor concentration in processing chemicals and some effect of fogging in the darkroom which needs to be checked.

The unintentional effect of unicompartmental knee arthroplasty on extraarticular deformity and of high tibial osteotomy on intraarticular deformity for the treatment of anteromedial osteoarthritis.

Unicompartmental Knee Arthroplasty (UKA) and High Tibial Osteotomy (HTO) are two valid options in the treatment of Anteromedial Osteoarthritis (AMOA) of the knee with UKA being mainly performed in cases of Intraarticular deformity (IA) and HTO in cases of Extraarticular deformity (EA). The exact unintentional effect of UKA on EA deformity and HTO on IA deformity is still not well understood. The aim of this study was to assess this unintentional effect of UKA on EA and HTO on IA deformities respectively. This a single-center retrospective study in which 50 patients who underwent UKA and 50 patients who underwent medial opening wedge HTO (MWOHTO) for the treatment of AMOA were included. Overall, 35 males and 15 females underwent HTO with a mean age of 44.3 ± 11.2 years while the mean age of the UKA group was 71.8 ± 7.9 years in 23 males and 27 females. The radiological effect of UKA and HTO on each of the following angles: Hip-Knee-Ankle angle (HKA), Medial Proximal Tibial Angle (MPTA), mechanical Lateral Distal Femoral Angle (mLDFA) and Joint Line Convergence Angle (JLCA) on long film radiographs both pre- and postoperatively was measured. The postoperative values were compared to the preoperative values to detect the expected and unintended effects of each technique on IA and EA deformities. In the HTO group, the MPTA has changed significantly as expected from 83.1 ± 4.5 preoperatively to 88.9 ± 3.9 postoperatively (p value < 0.001) correcting the existing preoperative EA varus without overcorrection. Similarly in the UKA group, the JLCA has also changed significantly as expected to correct the IA varus from 3.8 ± 1.7 preoperatively to 0.9 ± 1 postoperatively (p value < 0.001). On the other hand, the JLCA was unintentionally changed in the HTO group from 2.6 ± 2.1 preoperatively to 1.6 ± 2.4 postoperatively (p value = 0.03) partly correcting the IA varus deformity. Similarly, the MPTA showed a significant change that occurred inadvertently in the UKA group from 84.8 ± 2.1 to 86.3 ± 1.6 postoperatively (p value < 0.001). This unintentional increase in the MPTA also partly corrected the preexisting EA varus deformity. The mLDFA did not show a significant change neither in the HTO group (p value = 0.96) nor in the UKA group (p value = 0.94). In addition to intraarticular varus correction, UKA can partly correct the extraarticular varus deformity in AMOA even when resurfacing is exclusively attempted. Additionally, intraarticular deformity can be also partially managed by HTO along with the extraarticular varus correction even without performing overcorrection.

Advancing Cochlear Implant Programming: X-ray Guided Anatomy-Based Fitting.

Anatomy-based fitting (ABF) is a new research area in the field of cochlear implants (CIs). Despite the reported benefits and acceptable levels of ABF among CI recipients, some limitations remain, like the postoperative computed tomography (CT) scan, which is preferred for confirming electrode array insertion. This study aimed to investigate the feasibility of using plain film radiography (X-ray) for postoperative electrode detection and for building ABF as an alternative to CT. A total of 53 ears with CI were studied. All cases had routine post-insertion X-rays in the cochlear view and additionally underwent postoperative CT. The insertion angles and center frequencies measured by two independent observers were compared for each imaging modality. The angular insertion depth and center frequencies resulting from the X-ray and CT scans were then compared. No significant differences were observed between the X-ray- and CT-measured angles for the electrode contacts. Radiographic measurements between the two readers showed an almost perfect (≥0.8) or substantial (0.71) intraclass correlation coefficient along the electrode contacts. X-ray images showed a mean difference of 4.7 degrees from CT. The mean semitone deviation of the central frequency between the CT and X-ray images was 0.6. X-ray imaging provides a valid and easy-to-perform alternative to CT imaging, with less radiation exposure and lower costs. The radiographs showed excellent concordance with the CT-measured angular insertion depth and consequently with the central frequency for most electrode contacts. Therefore, plain X-ray could be a viable alternative in building ABF for the CI recipients.