Technical Phantom Research Articles

About the generalizability of deep learning based image quality assessment in mammography

One method of assessing the image quality of a mammography unit is to estimate a contrast-detail-curve (CDC) that is obtained from images of a technical phantom. It has been proposed to estimate this CDC by using an end-to-end neural network (NN) which only needs one image to determine the CDC. That approach, however, has been developed on the basis of images of one single mammography unit. In this work, we train NNs on synthetic images of contrast-detail phantoms for mammography and test the so-trained NNs on images that are obtained from real mammography units. The goal of this paper is to demonstrate that such a deep learning approach is capable to generalize to predict CDCs for various real mammography units. Our experiments cover various manufacturers and the proposed approach is shown to work across different NN architectures and preprocessing methods which highlights its generalizability.

Split electrodes for electrical-conductivity-based tissue discrimination.

This work presents a method to minimize the inadvertent cutting of tissues in surgeries involving bone drilling. We present electrical impedance measurements as an assistive technology to image-guided surgery to achieve online guidance. Proposed concept is to identify and localize the landmarks via impedance measurements and then use this information to superimpose the estimated drilling trajectory on the offline maps obtained by pre-operative imaging. To this end., we propose an asymmetric electrode geometry., split electrodes., capable of distinguishing impedance variations as a function of rotation angle. The feasibility of the proposed approach is verified with numerical analysis. A probe with stainless steel electrodes has been fabricated and tested with a technical phantom. Although the results are impacted by a non-ideality in the phantom., we could show that the variation of impedance as a function of rotation angle can be used to localize the regions with different impedivities. Clinical Relevance- Presented approach may be used to minimize the inadvertent cutting of tissues in surgeries involving bone drilling.

The regression detectability index RDI for mammography images of breast phantoms with calcification-like objects and anatomical background

Currently, quality assurance measurements in mammography are performed on unprocessed images. For diagnosis, however, radiologists are provided with processed images. This image processing is optimised for images of human anatomy and therefore does not always perform satisfactorily with technical phantoms. To overcome this problem, it may be possible to use anthropomorphic phantoms reflecting the anatomic structure of the human breast in place of technical phantoms when carrying out task-specific quality assessment using model observers. However, the use of model observers is hampered by the fact that a large number of images needs to be acquired. A recently published novel observer called the regression detectability index (RDI) needs significantly fewer images, but requires the background of the images to be flat. Therefore, to be able to apply the RDI to images of anthropomorphic phantoms, the anatomic background needs to be removed. For this, a procedure in which the anatomical structures are fitted by thin plate spline (TPS) interpolation has been developed. When the object to be detected is small, such as a calcification-like lesion, it is shown that the anatomic background can be removed successfully by subtracting the TPS interpolation, which makes the background-free image accessible to the RDI. We have compared the detectability obtained by the RDI with TPS background subtraction to results of the channelized Hotelling observer (CHO) and human observers. With the RDI, results for the detectability can be obtained using 75% fewer images compared to the CHO, while the same uncertainty of is achieved. Furthermore, the correlation of (RDI) with the results of human observers is at least as good as that of (CHO) with human observers.

Breast phantoms for 2D digital mammography with realistic anatomical structures and attenuation characteristics based on clinical images using 3D printing

The aim of this work was to develop a production process for breast phantoms for 2D digital mammography (DM) with realistic anatomical structures and attenuation characteristics based on clinical images using 3D printing.The presented production process is based on PolyJet 3D printing technology using a polypropylene like printing material. First, an attenuation calibration function for this material and the achievable lateral resolution of the printing process of about 200 µm was determined. Subsequently, to generate the digital 3D model of the breast phantom, the pixel intensities of the unprocessed clinical image that are related to the attenuation along the z-axis of the breast, were converted to corresponding phantom heights using the calibration function.To validate the process, an image of the 3D printed breast phantom was acquired on the full field digital mammography (FFDM) system used for calibration and compared with the clinical image in terms of anatomical structures and associated attenuation characteristics. The exposure parameters and image impression of the phantom were evaluated using five other FFDM systems of different manufacturers and types.Results demonstrated that the anatomical structures in the images and the attenuation characteristics of a female breast and the derived phantom agreed on the FFDM system used for calibration. The automatic exposure control segmentation, the automatically selected exposure parameters and the image postprocessing of the clinical and phantom image indicated a high level of conformity. As shown, the phantom is also suitable for other FFDM systems.In conclusion, an approach to produce anthropomorphic breast phantoms for DM offering realistic anatomical structures and attenuation characteristics based on clinical images was successfully developed. As shown, the phantom realistically simulated the original female breast. Therefore, it is expected that such phantoms are promising to support bridging the gap between physical-technical and diagnostic image quality assessment. In addition, they enable a variety of practical and scientific applications for which present technical phantoms are not suitable.

Accuracy and feasibility of a dedicated image guidance solution for endoscopic lateral skull base surgery

We aimed to design, build and validate a surgical navigation system which fulfills the accuracy requirements for surgical procedures on the ear and the lateral skull base, and which integrates with the endoscopic workflow and operating room setup. The navigation system consists of portable tablet computer (iPad Pro, Apple Computer, USA) and an optical tracking system (Cambar B1, Axios3D, Germany), both connected via a wireless Bluetooth link and attached directly to the OR table. Active optical tracking references are rigidly fixed to both the patient and surgical tools. Software to support image import, registration and 2D/3D visualization has been developed. Two models were used for targeting accuracy assessment: a technical phantom model and an ex vivo temporal bone model. Additionally, workflow integration and usability of the navigation system during endoscopic lateral skull base procedures was investigated in ex vivo experiments on 12 sides of cadaver head specimens. The accuracy experiments revealed a target registration error in the technical phantom model of 0.20 ± 0.10mm (n = 36) and during the ex vivo assessment of 0.28 ± 0.10mm (n = 21). Navigation was successfully carried out in n = 36 procedures (infracochlear, suprageniculate and transpromontorial approach), with navigated instruments usable without interference with the endoscope. The system aided in the successful and accurate identification of vital anatomical structures. Useful surgical navigation is, to a large extent, a result of sufficiently accurate tracking technology. We have demonstrated sufficient accuracy and a potentially suitable integration for surgical application within endoscopic lateral skull base procedures.

A MONTE-CARLO SIMULATION FRAMEWORK FOR JOINT OPTIMISATION OF IMAGE QUALITY AND PATIENT DOSE IN DIGITAL PAEDIATRIC RADIOGRAPHY.

In paediatric radiography, according to the as low as reasonably achievable (ALARA) principle, the imaging task should be performed with the lowest possible radiation dose. This paper describes a Monte-Carlo simulation framework for dose optimisation of imaging parameters in digital paediatric radiography. Patient models with high spatial resolution and organ segmentation enable the simultaneous evaluation of image quality and patient dose on the same simulated radiographic examination. The accuracy of the image simulation is analysed by comparing simulated and acquired images of technical phantoms. As a first application example, the framework is applied to optimise tube voltage and pre-filtration in newborn chest radiography. At equal patient dose, the highest CNR is obtained with low-kV settings in combination with copper filtration.

Comparison of image quality and radiation dose between an image-intensifier system and a newer-generation flat-panel detector system — technical phantom measurements and evaluation of clinical imaging in children

Many image-intensifier fluoroscopy systems have been replaced by flat-panel detectors in recent years. To compare the level of contrast, image resolution and radiation dose between an image-intensifier and a newer-generation flat-panel detector system in a pediatric radiology unit. We compared two systems — a conventional image intensifier and a newer-generation flat-panel system. We measured image quality and radiation dose using a technical phantom. Additionally, we retrospectively compared age-matched fluoroscopic pediatric voiding cystourethrography (n = 15) and upper gastrointestinal investigations (n = 25). In phantom studies image contrast was equal while image resolution was higher and mean radiation dose lower using the flat-panel system (P < 0.0001). In pediatric investigations, mean dose area product was significantly reduced on the flat-panel system for upper gastrointestinal investigation (45 ± 38 μGy*m2 vs. 11 ± 9 μGy*m2; P < 0.0001) and for voiding cystourethrography (18 ± 20 μGy*m2 vs. 10 ± 12 μGy*m2; P = 0.04). The newer flat-panel system performs at lower dose levels with equal to better image quality and therefore seems to be the more suitable technique for pediatric fluoroscopy in comparison to image-intensifier systems.

New Developed DR Detector Performs Radiographs of Hand, Pelvic and Premature Chest Anatomies at a Lower Radiation Dose and/or a Higher Image Quality

A newly developed Digital Radiography (DR) detector has smaller pixel size and higher fill factor than earlier detector models. These technical advantages should theoretically lead to higher sensitivity and higher spatial resolution, thus making dose reduction possible without scarifying image quality compared to previous DR detector versions. To examine whether the newly developed Canon CXDI-70C DR detector provides an improved image quality and/or allows for dose reductions in hand and pelvic bone examinations as well as premature chest examinations, compared to the previous (CXDI-55C) DR detector version. A total of 450 images of a technical Contrast-Detail phantom were imaged on a DR system employing various kVp and mAs settings, providing an objective image quality assessment. In addition, 450 images of anthropomorphic phantoms were taken and analyzed by three specialized radiologists using Visual Grading Analysis (VGA). The results from the technical phantom studies showed that the image quality expressed as IQFINV values was on average approximately 45% higher with the CXDI-70C detector compared to the CXDI-55C detector. Consistently, the VGA results from the anatomical phantom studies indicated that by using the CXDI-70C detector, diagnostic image quality could be maintained at a dose reduction of in average 30%, depending on anatomy and kVp level. This indicates that the CXDI-70C detector is significantly more sensitive than the previous model, and supports a better clinical image quality. By using the newly developed DR detector a significant dose reduction is possible while maintaining image quality.

Digital radiography: optimization of image quality and dose using multi-frequency software

New developments in processing of digital radiographs (DR), including multi-frequency processing (MFP), allow optimization of image quality and radiation dose. This is particularly promising in children as they are believed to be more sensitive to ionizing radiation than adults. To examine whether the use of MFP software reduces the radiation dose without compromising quality at DR of the femur in 5-year-old-equivalent anthropomorphic and technical phantoms. A total of 110 images of an anthropomorphic phantom were imaged on a DR system (Canon DR with CXDI-50 C detector and MLT[S] software) and analyzed by three pediatric radiologists using Visual Grading Analysis. In addition, 3,500 images taken of a technical contrast-detail phantom (CDRAD 2.0) provide an objective image-quality assessment. Optimal image-quality was maintained at a dose reduction of 61% with MLT(S) optimized images. Even for images of diagnostic quality, MLT(S) provided a dose reduction of 88% as compared to the reference image. Software impact on image quality was found significant for dose (mAs), dynamic range dark region and frequency band. By optimizing image processing parameters, a significant dose reduction is possible without significant loss of image quality.

A Norwegian Survey of Image Quality, Doses and Film Processing in Mammography, with Reference to Two Technical Phantoms

The performance of 45 mammography units in Norway has been compared by means of two commercial phantoms, a Nordic phantom and another used as a part of the American College of Radiology accreditation system (ACR). Three images of both phantoms were obtained from each unit, and corresponding dose measurements and sensitometric tests were performed. The results were evaluated according to Nordic recommendations and the phantom image quality criteria set by ACR. Large variations were found, although glandular doses were all kept below 2 mGy. The contrast and sensitivity of the film were shown to influence the image contrast and the dose considerably. Image quality criteria based on image quality parameters that can be assessed with technical phantoms are discussed. These should he separately linked to grid and non-grid techniques, and might be used as references for future quality control programmes based on these phantoms.

Experience with a multichannel system for biomagnetic study

The components of the biomagnetic multichannel system Krenikon are described. The combination of biomagnetically yielded localizations with anatomic images gained from MR or CT is discussed as well as the enhancement of the signal-to-noise ratio by using a correlation technique. The overall localization accuracy is tested with technical phantoms. With volunteers measurements of auditory, visual and somatosensory evoked fields are performed to evaluate the system performance in vivo. The data acquisition time typically is 2-10 min which is tolerable both for the patient and the clinical staff. Electric potentials even with invasive electrodes can be recorded simultaneously with the magnetic fields. MEG gives important information for the presurgical diagnosis of epileptic patients and for the understanding of the epilepsy genesis. With MCG, centres of biologic excitation such as ventricular ectopies or accessory bundles in WPW syndrome have been successfully localized.