Assessment and optimisation of digital radiography systems for clinical use

Digital imaging has long been available in radiology in the form of computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound. Initially the transition to general radiography was slow and fragmented but in the last 10-15 years in particular, huge investment by the manufacturers, greater and cheaper computing power, inexpensive digital storage and high bandwidth data transfer networks have lead to an enormous increase in the number of digital radiography systems in the UK. There are a number of competing digital radiography (DR) technologies, the most common are computer radiography (CR) systems followed by indirect digital radiography (IDR) systems. To ensure and maintain diagnostic quality and effectiveness in the radiology department appropriate methods are required to evaluate and optimise the performance of DR systems. Current semi-quantitative test object based methods routinely used to examine DR performance suffer known short comings, mainly due to the subjective nature of the test results and difficulty in maintaining a constant decision threshold among observers with time. Objective image quality based measurements of noise power spectra (NPS) and modulation transfer function (MTF) are the ‘gold standard’ for assessing image quality. Advantages these metrics afford are due to their objective nature, the comprehensive noise analysis they permit and in the fact that they have been reported to be relatively more sensitive to changes in detector performance. The advent of DR systems and access to digital image data has opened up new opportunities in applying such measurements to routine quality control and this project initially focuses on obtaining NPS and MTF results for 12 IDR systems in routine clinical use. Appropriate automatic exposure control (AEC) device calibration and a reproducible measurement method are key to optimising X-ray equipment for digital radiography. The uses of various parameters to calibrate AEC devices specifically for DR were explored in the next part of the project and calibration methods recommended. Practical advice on dosemeter selection, measurement technique and phantoms were also given. A model was developed as part of the project to simulate CNR to optimise beam quality for chest radiography with an IDR system. The values were simulated for a chest phantom and adjusted to describe the performance of the system by inputting data on phosphor sensitivity, the signal transfer function (STF), the scatter removal method and the automatic exposure control (AEC) responses. The simulated values showed good agreement with empirical data measured from images of the phantom and so provide validation of the calculation methodology. It was then possible to apply the calculation technique to imaging of tissues to investigate optimisation of exposure parameters. The behaviour of a range of imaging phosphors in terms of energy response and variation in CNR with tube potential and various filtration options were investigated. Optimum exposure factors were presented in terms of kV-mAs regulation curves and the large dose savings achieved using additional metal filters were emphasised. Optimum tube potentials for imaging a simulated lesion in patient equivalent thicknesses of water ranging from 5-40 cm thick for example were: 90-110kVp for CsI (IDR); 80-100kVp for Gd2O2S (screen /film); and 65-85kVp for BaFBrI. Plots of CNR values allowed useful conclusions regarding the expected clinical operation of the various DR phosphors. For example 80-90 kVp was appropriate for maintaining image quality over an entire chest radiograph in CR whereas higher tube potentials of 100-110 kVp were indicated for the CsI IDR system. Better image quality is achievable for pelvic radiographs at lower tube potentials for the majority of detectors however, for gadolinium oxysulphide 70-80 kVp gives the best image quality. The relative phosphor sensitivity and energy response with tube potential were also calculated for a range of DR phosphors. Caesium iodide image receptors were significantly more sensitive than the other systems. The percentage relative sensitivities of the image receptors averaged over the diagnostic kV range were used to provide a method of indicating what the likely clinically operational dose levels would be, for example results suggested 1.8 µGy for CsI (IDR); 2.8 µGy for Gd2O2S (Screen/film); and 3.8 µGy for BaFBrI (CR). The efficiency of scatter reduction methods for DR using a range of grids and air gaps were also reviewed. The performance of various scatter reduction methods: 17/70; 15/80; 8/40 Pb grids and 15 cm and 20 cm air gaps were evaluated in terms of the improvement in CNR they afford, using two different models. The first, simpler model assumed quantum noise only and a photon counting detector. The second model incorporated quantum noise and system noise for a specific CsI detector and assumed the detector was energy integrating. Both models allowed the same general conclusions and suggest improved performance for air gaps over grids for medium to low scatter factors and both models suggest the best choice of grid for digital systems is the 15/80 grid, achieving comparable or better performance than air gaps for high scatter factors. The development, analysis and discussion of AEC calibration, CNR value, phosphor energy response, and scatter reduction methods are then brought together to form a practical step by step recipe that may be followed to optimise digital technology for clinical use. Finally, CNR results suggest the addition of 0.2 mm of copper filtration will have a negligible effect on image quality in DR. A comprehensive study examining the effect of copper filtration on image quality was performed using receiver operator characteristic (ROC) methodology to include observer performance in the analysis. A total of 3,600 observations from 80 radiographs and 3 observers were analysed to provide a confidence interval of 95% in detecting differences in image quality. There was no statistical difference found when 0.2 mm copper filtration was used and the benefit of the dose saving promote it as a valuable optimisation tool

Experimental comparison of noise and resolution for 2k and 4k storage phosphor radiography systems

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134792/1/mp8656.pd

Determining The Detective Quantum Efficiency (DQE) Of X-Ray Detectors In Clinical Environments

According to Health Canada, dental and medical radiography accounts for more than 90% of total man-made radiation dose to the general population. Ensuring patients receive the health benefits of diagnostic x-ray imaging without use of higher radiation exposures requires knowledge and understanding of the detective quantum efficiency (DQE). Currently, the DQE is not measured in clinics because it requires specialized instrumentation and specific DQE-expertise to perform an accurate analysis. In this regard, the goals of this thesis were to: 1) address the limitations of measuring the DQE in clinical environments that affects the accuracy of the measurement; 2) develop and validate an automated method of measuring the DQE that is compliant with current regulatory standards to relieve experimental burden on the end-user. It is shown that the DQE can be measured with confidence using the automated method despite the limitations present in clinical environments. This work provides the opportunity for the clinical end-user who may not be familiar with the DQE-measurement process to accurately measure the DQE of clinical x-ray detectors, and provides the opportunity for the DQE to be a primary metric for quality assurance and control practices in the clinical environment

Apodized-Aperture Pixel Design X-Ray Detector for Improvement of Detective Quantum Efficiency at High Spatial Frequencies

The detective quantum efficiency (DQE) is a characteristic of x-ray imaging systems describing how well a system can produce high signal-to-noise ratio images compared to an ideal detector. In medical radiography, increases in DQE result directly in increases in image SNR for a given x-ray exposure, and improved SNR has been shown to improve breast cancer detection rates in screening programs. Typically, modern x-ray detectors have DQE values about 0.6 to 0.7 at low spatial frequencies and 0.2 to 0.3 or less at high spatial frequencies. We describe a method to improve the high frequency DQE by developing a novel apodized-aperture pixel (AAP) design that can be implemented with detectors having very small elements. We show theoretically that the high-frequency DQE can be doubled using this approach. Experimental validation shows an increase from 0.2 to 0.4 at the sampling cut-off frequency (2.5 cycles/mm) for a laboratory CMOS/CsI detector. It is predicted the high-frequency DQE of a Se-based detector for mammography could be increased from 0.35 to 0.7. Such increases would improve visualization of small objects and fine detail in x-ray imaging by a factor of two

Design, development and characterization of a novel neutron and X-ray combined computed tomography system

Visualizing the three dimensional structure of objects (e.g. nuclear fuel, nuclear materials, explosives and bio materials) and phenomena (e.g. particle tracking) can be very important in nondestructive testing applications. Computed tomography systems are indispensable tools for these types of applications because they provide a versatile non-destructive technique for analysis. A novel neutron and X-ray combined computed tomography (NXCT) system has been designed and developed at the Missouri University of Science & Technology. The neutron and X-ray combined computed tomography system holds much promise for non-destructive material detection and analysis where multiple materials having similar atomic number and differing thermal cross section or vice versa may be present within an object, exclusive neutron or X-ray analysis may exhibit shortcomings in distinguishing interfaces. However, fusing neutron image and X-ray image offers the strengths of both and may provide a superior method of analysis. In addition, a feasible design of a sample positioning system which allows the user to remotely and automatically manipulate the objects makes the NXCT system viable for commercial applications. Moreover, characterization of the newly developed digital imaging system is imperative to the performance evaluation, as well as for describing the associated parameters. The performance of a combined neutron/X-ray digital imaging system was evaluated in terms of modulation transfer function (MTF), noise power spectrum (NPS) and detective quantum efficiency (DQE). This dissertation is a complete overview of the design of the NXCT system, operation, algorithms, performance evaluation and results --Abstract, page iii

Correlation of objective image quality and working length measurements in different CBCT machines: An ex vivo study

To investigate potential correlations between objective CBCT image parameters and accuracy in endodontic working length determination ex vivo. Contrast-to-noise ratio (CNR) and spatial resolution (SR) as fundamental objective image parameters were examined using specific phantoms in seven different CBCT machines. Seven experienced observers were instructed and calibrated. The order of the CBCTs was randomized for each observer and observation. To assess intra-operator reproducibility, the procedure was repeated within six weeks with a randomized order of CBCT images. Multivariate analysis (MANOVA) did not reveal any influence of the combined image quality factors CNR and SR on measurement accuracy. Inter-operator reproducibility as assessed between the two observations was poor, with a mean intra-class correlation (ICC) of 0.48 (95%-CI 0.38, 0.59) for observation No. 1. and 0.40 (95%-CI 0.30, 0.51) for observation No. 2. Intra-operator reproducibility pooled over all observers between both observations was only moderate, with a mean ICC of 0.58 (95%-CI 0.52 to 0.64). Within the limitations of the study, objective image quality measures and exposure parameters seem not to have a significant influence on accuracy in determining endodontic root canal lengths in CBCT scans. The main factor of variance is the observer

Theoretical and Experimental Evaluation of Spatial Resolution in a Variable Resolution X-Ray Computed Tomography Scanner

A variable resolution x-ray (VRX) computed tomography (CT) scanner can image objects of various sizes with greatly improved spatial resolution. The scanner employs an angulated discrete detector and achieves the resolution boost by matching the detector angulation to the scanner field of view (FOV) determined by the size of an object being imaged. A comprehensive evaluation of spatial resolution in an experimental version of the VRX CT scanner is presented in this dissertation. Two components of this resolution were evaluated – the pre-reconstruction spatial resolution, described by the detector presampling modulation transfer function (MTF), and the post-reconstruction spatial resolution, given by the scanner reconstruction MTF. The detector presampling MTF was modeled by the Monte Carlo simulation and measured by the moving-slit method. The modeled results showed the increase in the maximum cutoff frequency (in the detector plane) from 1.53 to 53.64 cycles per mm (cy/mm) as the scanner FOV decreased from 32 to 1 cm. The measured results supported the modeling, except for the small FOVs (below 8 cm), where the MTF could not be measured up to the cutoff frequency due to the focal-spot limitation. The scanner reconstruction MTF was measured by the special-phantom method. The measured results demonstrated the increase in the average cutoff frequency (in the object plane) from 2.44 to 4.13 cy/mm as the scanner FOV decreased from 16 to 8 cm. The MTF could not be measured at the FOVs other than 8 and 16 cm, due to the calibration-reconstruction inaccuracies and, again, the focal-spot limitation. Overall, the evaluation confirmed the potential value of the VRX CT scanner and produced results important for its further development

Non-blind deconvolution with an alternating direction method of multipliers (ADMM) after noise reduction in nondestructive testing

Abstract: To ensure the quality of material, nondestructive testing is necessary, and radiography testing is the nondestructive technique most commonly used today. For inspection, the quality of a radiographic image is critical, and there are many image artifacts that can reduce inspection accuracies such as noise or blurring. The deterioration in spatial resolution caused by blur in both the X-ray imaging itself and the noise reduction process are particular problems. To tackle them, we implemented a non-blind deconvolution method that employs the alternating direction method of multipliers (ADMM) after noise reduction. Experimental results confirm that the proposed algorithm effectively restores edge sharpness. The 50% modulation transfer function of the restored image of a slit-camera was about 3.54 line-pairs per mm, which is about 2.5 times higher than that of the denoised image. Moreover, the edge preservation index values are about 0.82, 0.54, and 0.75 for the restored, denoised, and acquired images, respectively. Consequentially, the proposed method has the potential to increase inspection efficiency in industrial applications.ope