Added copper filtration in digital paediatric double-contrast colon examinations: effects on radiation dose and image quality

Paediatric double-contrast barium enema examinations are usually performed at high tube voltage, 102-105 kV. The aim of this study was to investigate how much the effective dose to the child could be reduced by increasing the X-ray energy further by adding copper filter in the beam, and if this dose reduction could be achieved without endangering image quality. Organ doses to an anthropomorphic phantom simulating a 1-year-old child was measured using thermoluminescence dosimetry for assessment of the effective dose and this value was compared with the energy imparted which was obtained from kerma-area product measurements. To verify that the image quality achieved with this added filtration was still diagnostically acceptable, the study included 15 patient examinations. Since the increased X-ray energy will most probably affect low-contrast objects, image quality was also evaluated with two different phantoms containing low-contrast objects. Effective dose for a complete examination can be decreased 44 % and energy imparted 77 % when a 0.3-mm copper filter is inserted in the beam at tube voltage 102 kV. The patient study did not show any significant deterioration of image quality, whereas phantom measurements of contrast-detail resolution and signal-to-noise ratio was marginally impaired by the added copper filtration. This technique is now in clinical practice for paediatric colon examinations.     

Mantle treatment. Absorbed dose measurements in patients compared with dose planning

In vivo dose measurements were performed in the hypopharnyx-oesophagus for 60 adult patients receiving mantle treatment with 60Co. The measurements of absorbed dose in more than 1 600 points were analysed and compared with dose plans for the same patients. For the technique used the mean difference between in vivo measured and planned absorbed dose is within +0.4 and -1.3 per cent with a standard error of the mean of 0.4 per cent.     

Radiation dose and image quality of double-loaded cassettes

Some U.S. hospitals double-load x-ray cassettes for certain procedures. Loading two films in the same cassette for portable emergency room (ER), intensive care unit (ICU), or operating room radiographs provides both the referring clinicians and the radiologists with immediate images. Our study demonstrates a cost increase of 15%, an increase in air kerma for a chest x ray from 0.12 to 0.35 mGy (12-35 mrad), slight differences in optical density, image contrast, and spatial resolution under double-loading conditions. Our study shows that double loading cassettes may improve patient care by economically expediting the communication of radiographic findings. The decision to double load portable ICU or ER cassettes must be based on a balance of factors.     

Nationwide survey of fluoroscopy: radiation dose and image quality

PURPOSE: To determine the average abdominal entrance air kerma, low-contrast sensitivity, and spatial resolution in upper gastrointestinal tract fluoroscopy in the United States. MATERIALS AND METHODS: A random sample of fluoroscopic facilities was selected to be surveyed for the Nationwide Evaluation of X-ray Trends program. Measurements were performed by using a newly developed fluoroscopic phantom. The surveys were conducted by state radiation control personnel. RESULTS: Average air kerma rates 1 cm above the tabletop, free in air, were 43 mGy/min (n = 340). The rate increased to 64 mGy/min when a 1.6-mm-thick copper filter, which simulated the use of barium contrast medium, was added to increase attenuation. The average entrance air kerma, free in air, for radiographs was 3.4 mGy, and an average of 12 radiographs were obtained per examination. Of 352 facilities surveyed, 306 (87%) were able to resolve wire mesh with 20 or more lines per inch. Of 339 facilities for which percentage contrast could be calculated, 192 (57%) had minimum percentage contrast values of 4% or more. CONCLUSION: Spatial resolution for fluoroscopy is adequate for most of the facilities surveyed, but a substantial proportion of facilities could not visualize low-contrast test objects, which strongly suggests image quality problems.     

Radiology in the neonatal intensive care unit: dose reduction and image quality

This paper describes a prospective study of the diagnostic radiation doses received in a neonatal intensive care unit (NICU) for a representative radiological technique used at our institution for a number of years and a "low dose" technique similar to that recommended by the Commission of the European Communities (CEC). A 400 speed film-screen combination was used in both techniques. A total of 363 anteroposterior (AP) chest and abdominal films of 77 neonates were accrued. For each radiograph, the entrance skin dose (FSD), energy imparted (EI) and mean whole body dose were determined. For a neonatal AP chest, there was an 18% reduction in the mean ESD per radiograph from 20.0 muGy for the representative technique to 16.4 muGy for the low dose technique (p < 0.0005). The reduction in the mean EI per radiograph values for the two techniques from 7.9 muJ to 7.1 muJ (10%) was statistically significant at the p < 0.017 level, after compensating for the difference in mean field dimensions between the two patient cohorts. The mean whole body dose per radiograph reduction from 4.4 to 3.5 muGy (20%) was statistically significant at the p < 0.0028 level. It was determined that the ESD and EI could be fitted by an exponential function in the equivalent patient diameter, a single parameter indicative of neonate size. Absolute excess childhood cancer mortality risk per film was estimated using risk factors derived for fetal exposures. A "worst case" absolute excess mortality risk per chest radiograph was estimated to be 1.40 x 10(-7) for the conventional technique and was further reduced to 1.11 x 10(-7) for the low dose technique. A blind comparison of patient-matched film pairs for each technique was performed by three radiologists using criteria similar to those specified by the CEC. No statistically significant difference in clinical image quality was found between the two techniques.     

基于数字图像处理的带钢缺陷检测和度量

针对带钢表面麻点和裂纹缺陷,设计了一种缺陷检测和度量方法。首先对样本图像进行滤波、二值化、细化及去毛刺操作,在得到的二值图上进行麻点缺陷检测,骨架图上进行裂纹缺陷检测。最后,在缺陷区域进行统计分析,得到样本图像的麻点缺陷数量和面积,裂纹缺陷的数量、长度和方向等指标。测试结果表明,该方法可有效实现带钢缺陷的检测和度量。     

Prevention of crackle in double contrast examinations of the colon

In an attempt to determine the minimum dose of D-Thyroxine (D-T4) which will suppress pituitary TSH response to TRH, we have treated 6 euthyroid, hypercholesterolemic patients with graded doses of D-T4. TSH response was suppressed in 3 patients with 3 mg and in the remaining 3 patients with 4 mg D-T4 administered once daily. The mean TSH suppressive dose of 3.5 mg, as determined in this study, is considerably less than the 6 mg daily dose given to patients treated with D-T4 in the Coronary Drug Project. This suggests that the adverse effects observed with D-T4 treatment in the Coronary Drug Project may have been due to mild, undetected hyperthryroidism. D-T4 treatment in our patients was not associated with an increase in heart rate or ventricular ectopic beats as determined by Holter monitoring. However, bile samples obtained at the time of TSH suppression showed a significant increase in lithogenic index. In four patients, TSH suppressive doses of D-T4 were associated with a 12% decrease in mean cholesterol and a 17% decrease in mean LDL cholesterol concentrations.     

A comparison of patient dose for examinations of the upper gastrointestinal tract at 11 conventional and digital X-ray units in The Netherlands

The objective of this study was to derive the effective dose to patients from examinations of the upper gastrointestinal (GI) tract at 11 X-ray units in 10 Dutch hospitals. Entrance dose and entrance dose rate were measured at the surface of a homogeneous PMMA phantom and at the entrance surface of the image intensifier. Dose-area products (DAPs) were assessed during examinations of patients. The patients (334 females and 256 males) ages were 18-95 years (average 52 years). Effective dose was assessed from DAP using Monte Carlo computer calculations for male and female mathematical anthropomorphic phantoms. The DAPs measured during the survey showed substantial variations, i.e. an overall average value of 21 Gy cm2 and a range of average DAP per X-ray unit varying from 7 to 56 Gy cm2. Variations in the number of images (8-28) and the fluoroscopy time (1.7 min-7.0 min) were also large. A DAP to effective dose conversion factor of 0.32 mSv Gy cm-2 was derived for upper GI studies. The dose survey yielded an overall average effective dose of 6.7 mSv. At one location an examination involving as many as 28 projections was performed, whilst maintaining a DAP well below 15 Gy cm2 and an effective dose below 6 mSv. This was achieved using modern equipment (i.e. high frequency generator, digital spot films) with 0.2 mm additional copper filtration and a relatively high tube voltage. For examinations of the upper GI tract, the application of a reference value of 30 Gy cm2 for the DAP will ensure that, in general, the effective dose to individual patients will not exceed 15 mSv.     

The effect of phosphor persistence on image quality in digital x-ray scanning systems

A digital x-ray scanning system offers several advantages over conventional film-screen systems. However, there are sources of image degradation resulting from the scanning motion, such as motion blur due to the temporal response of the phosphor. This mechanism produces an asymmetrical blur, requiring the use of the complex optical transfer function (OTF) rather than the normal modulation transfer function (MTF) for correct characterization of image resolution. The luminescence response of eight phosphors was measured under pulsed x-ray excitation. A weighted exponential model was used to represent the primary luminescence. The dominant luminescence life-times ranged from 2.7 microseconds for Gd2O2S:Pr to 558 microseconds for Gd2O2S:Tb. The long term response was also measured, monitoring significant increases in a slow form of luminescence known as afterglow. Afterglow was modeled by an inverse power law equation. Afterglow was found to be strong in two of the phosphors studied (ZnCdS:Ag and YTaO4). In selecting a phosphor for a scanning system, it must satisfy several criteria, including a fast temporal response. Thus, a phosphor like Gd2O2S:Tb, which has a slow luminescence, but otherwise excellent imaging properties, may not be as useful as a more rapid phosphor like CsI:Tl.     

Cervical dilation: accuracy of visual and digital examinations

OBJECTIVE: To determine the accuracy of visually versus digitally determined cervical dilation. METHODS: We studied 64 pregnant women with rupture of the amniotic membranes. One of two residents performed a speculum examination, estimated the dilation and effacement visually, and noted whether fetal parts or amniotic membranes were present. The same examiner then determined digitally the cervical dilation and effacement and station of the presenting part. RESULTS: There was a statistically significant correlation between visually and digitally determined cervical dilation (r = 0.78, P < .001). CONCLUSION: Visual estimation of cervical dilation correlates well with digital examination.     

Radiation dose and image quality in spiral computed tomography: multicentre evaluation at six institutions

The purpose of this study was to evaluate the correlation of radiation dose with image quality in spiral CT. Seven clinical protocols were measured in six different radiological departments provided with four different types of high specification spiral CT scanners. Central and surface absorbed doses were measured in acrylic. The practical CT dose index (PCTDI) was calculated for seven clinical examination protocols and one standardized protocol using identical parameters on four different spiral CT scanners with a dedicated ionization chamber inserted into PMMA phantoms. For low contrast measurements, a cylindrical three-dimensional (3D) phantom (different sized spheres of defined contrast) was used. Image noise was measured with a cylindrical water phantom and high contrast resolution with a Perspex hole phantom. Image quality phantoms were scanned using the parameters of the clinical protocols. Images were randomized, blinded and read by six radiologists (one from each institution). PCTDI values for four different scanners varied up to a factor between 1.5 (centre) and 2.2 (surface) for the standardized protocol. A greater degree of variation was observed for seven clinical examination protocols of the six radiological departments. For example, PCTDI varied up to a factor between 1.7 (cerebrum protocol) and 8.3 (abdomen paediatric protocol). Low contrast resolution correlates closely with dose. An improvement in detection from 8 mm to 4 mm sized spheres needs approximately a ten-fold increase in dose. Noise shows a moderate correlation with PCTDI. High contrast resolution of clinical protocols is independent of PCTDI within a certain range. Differences in modern CT scanner technology seem to be of less importance for radiation exposure than selection of protocol parameters in different radiological institutes. Future discussion on guidelines regarding optimal (patient adapted) tube current for clinical protocols is desirable.     

Analysis of bone loss with aging and menopause--using digital image processing

To study bone loss relationships to aging and menopause, cross-sectional bone mass measurements by digital image processing (DIP method), and menopause information collected by questionnaire, were analyzed on 291 women who live in Tsukude village. The results are as follows. 1) The mean DIP values (sigma GS/D, MCI) by age-stratified groups decrease with age after menopause. The rate of bone loss in sigma GS/D is almost constant, but in MCI it increases with aging. 2) In 30-year old and 40-year old age groups, the frequency distribution of DIP values is symmetrical and bell-shaped. But after the fifties the distribution is asymmetrical, with the mode of distribution deviated toward low bone mass. The change of mode with aging is larger than that of mean. This fact suggests that change of mean bone mass substantially underestimates actual bone loss from aging. 3) The change of the mean DIP values stratified by years elapsed since menopause is not especially large at start of menopause but becomes almost constant after menopause. DIP values reflect the bone loss from the aging rather than from menopause, and are beneficial to the study of bone loss in elderly women.     

Features of construction and use of digital X-ray apparatuses for lung examinations

Comparative analysis for different antibodies' binding sites at the proteins samples, which were isolated from control and morphologically abnormal coniferous plants tissues have been investigated. Monoclonal antibodies against cytoskeletal proteins (actin, alpha- and beta tubulin), hsp 70 and against phosphotyrosine were used. It was detected that investigated biochemical features reflect morphological similarities between different plant species. Some differences between cytoskeleton proteins content in control and abnormal tissues have been also indicated. It is assumed that abnormal morphogenesis may be determined by low-level chronic irradiation during plants growth and development.     

Some aspects of surgical techniques in diffuse polyposis of the colon

Data on morphological and biochemical properties of the postoperative extravasate are reported in 102 patients in different terms postoperatively. There is a reduced number of erythrocytes, amount of hemoglobin and thrombocytes in the extravasate. The number of leucocytes in the latter corresponds to their amount in peripheral blood. Free hemoglobin ranged from 6 to 125 mg%, and its concentration depends on traumatism and duration of surgery. There is no fibrinogen in the extravasate and a decreased fibrinolytic activity. Bacterial contamination of the extravasate is dependent on the character of a surgical procedure. The extravasate sterility is supported by its apyrogenic and nontoxic action on rabbits and mice. Determination of the amount of leucocytes, sugar, alpha-2 and beta golbulins in the extravasate 18 hours following the operation is of a diagnostic value for early recognition of inflammation in the pleural cavity.     

Lower extremity angiography: improved image quality and outflow vessel detection with bilaterally antegrade selective digital subtraction angiography. A blinded prospective intraindividual comparison with aortic flush digital subtraction angiography

RATIONALE AND OBJECTIVES: To introduce routine bilaterally antegrade selective stationary digital subtraction angiography (DSA), and prospectively compare it with unselective stationary DSA in the detection of calf arteries and assess additional time and complication rate. METHODS: Twenty-five patients received one unselective and two separate antegrade selective studies of each calf. Images were evaluated for image quality, number of depicted run-off vessels, and potential crural bypass recipient arteries. RESULTS: Bilaterally antegrade selective DSA was significantly superior in image quality and motion artifacts (P < 0.01). The number of adequately depicted run-off arteries per calf increased from 79% (2.37 of 3) to 96% (2.89 of 3) for legs with advanced peripheral vascular disease (PVD). Seventy-nine instead of 62 potential bypass recipients were identified (P = 0.002). Mean procedure time needed for selective catheterizations was 7 minutes. No adverse events were seen. CONCLUSIONS: Bilaterally antegrade selective DSA clearly is superior to aortic run-off DSA depicting tibial arteries. It requires comparatively small additional effort. Outflow vessel detection essentially is independent of advanced PVD.     

ROC-analysis of detection performance by analogue and digital plain film systems in chest radiography

We have previously reported that a microcarrier-attached human hepatoma (Hep G2) cell line responds to hydrodynamic shear upon transfer to an agitated, clean, autoclaved spinner flask with a transient increase in cytochrome P450IA1 (CYPIA1) activity. Physiological changes induced by hydrodynamic stress could be problematic in the scaleup of microcarrier cultures. A better understanding of how stress alters cell physiology may assist in reactor scaleup. The induction of CYPIA1 activity was dependent on the agitation level of the cultures, and the level of CYPIA1 induction was comparable to that obtained with exposure to approximately 0.1 nM TCDD (2, 3, 7, 8-tetrachlorodibenzo-p-dioxin). It has been well documented that hydrodynamic shear stress can cause alterations in the metabolism of phospholipid membrane-bound arachidonic acid (AA) in adherent cells in a parallel plate system. The present study was carried out to determine if either AA or a metabolite of AA was involved in the induction of CYPIA1 activity in the microcarrier cultures of Hep G2 cells. Addition of exogenous AA followed by initiation of the stress resulted in an increase in the level of CYPIA1 activity. Pretreatment of the cultures with quinacrine, an inhibitor of phospholipase A2, reduced the stress-induced CYPIA1 activity. Furthermore, addition of propranolol, an inhibitor of phosphatidic acid phosphohydrolase, resulted in an increase in the response in addition to sustaining the induced enzyme activity. Pretreatment with the cyclooxygenase inhibitor, indomethacin, or the lipoxygenase inhibitor, caffeic acid, had no effect on the response, suggesting that the cyclooxygenase and lipoxygenase pathways were not involved in generating AA metabolites that alter CYPIA1 activity. The agent, nordihydroguaiaretic acid, blocks the monooxygenase pathway and blocks CYPIA1 activity increases. These observations suggest a possible mechanism where the stress on the cells induces phospholipase D, resulting in the formation of phosphatidic acid which then activates phospholipase A2, resulting in the release of AA. Further, these results are consistent with a mechanism in which the metabolism of AA, most likely through the monooxygenase pathway, results in a metabolite that by a yet unknown mechanism induced CYPIA1.     

利用数字图像处理技术在线检测烧结台车料层厚度

针对烧结台车料层厚度检测维护困难和检测数据受环境影响大的问题,攀钢集团攀枝花钢钒有限公司炼铁厂开发了视频烧结台车料层厚度检测系统。系统根据监视的烧结台车布料视频图像,运用数字图像处理技术计算测量臂角度,通过测量臂与料层厚度的转换关系间接得到料层厚度。在实际生产中,采用此种非接触检测方法测量料层厚度得到了很好的应用效果。     

Image quality and dose in spiral computed tomography

Image quality and dose produced by a spiral CT with various pitch values were investigated on the basis of test-object images and measurements of CT dose indexes. No major difference in image quality or dose was observed when comparing sequential and spiral mode acquisition with a pitch of one. Increase in pitch value produces a loss of contrast which leads to a loss of detectability. Nevertheless, in realistic protocols the image quality in the transverse plane remains acceptable up to pitch values of 1.3-1.6.