Computed radiography (CR) is considered a drop-in addition or replacement for traditional screen-film (SF) systems in
digital mammography. Unlike other technologies, CR has the advantage of being compatible with existing
mammography units. One of the challenges, however, is to properly configure the automatic exposure control (AEC) on
existing mammography units for CR use. Unlike analogue systems, the capture and display of digital CR images is
decoupled. The function of AEC is changed from ensuring proper and consistent optical density of the captured image
on film to balancing image quality with patient dose needed for CR.
One of the preferences when acquiring CR images under AEC is to use the same patient dose as SF systems. The
challenge is whether the existing AEC design and calibration
process-most of them proprietary from the X-ray systems
manufacturers and tailored specifically for SF response
properties-can be adapted for CR cassettes, in order to
compensate for their response and attenuation differences. This paper describes the methods for configuring the AEC of
three different mammography units models to match the patient dose used for CR with those that are used for a KODAK
MIN-R 2000 SF System. Based on phantom test results, these methods provide the dose level under AEC for the CR
systems to match with the dose of SF systems. These methods can be used in clinical environments that require the
acquisition of CR images under AEC at the same dose levels as those used for SF systems.
The image quality of three experimental computed radiography (CR) mammography systems was compared through the
measurement of commonly accepted image-quality metrics such as modulation transfer function (MTF) and detective
quantum efficiency (DQE). The design and configuration of the scanners in the three systems were different in that they
had different signal extraction strategies for each storage phosphor screen. Efforts were also made to improve the image
quality through changes in phosphor layers, phosphor particle morphology, particle size distribution, and phosphor
binder ratio. The effects on overall image quality as a result of these improvements were demonstrated on these systems.
It was found that there were significant variations in system MTF and DQE, depending on how the CR system was
configured. Higher system MTF does not always lead to higher DQE. Screen designs as well as scanning strategies
need to be taken into consideration in order to achieve image quality improvements for the application of
mammography.
As digital radiography (DR) systems are being increasingly adopted for clinical applications, automatic exposure control (AEC) has remained a critically important component. Unlike traditional screen/film systems, however, there does not currently exist a widely accepted AEC calibration criterion for DR systems. This is due mainly to the signal response characteristics and wide dynamic range of a DR detector, which are inherently different from those of a screen/film system. Consequently, the AEC cutoff dose and its dependence on the kVp selection (i.e., kVp compensation) should be calibrated differently for DR systems. In this paper, we have investigated three possible schemes to set up the AEC compensation based on a constant response of the detector in terms of the signal, receptor dose, or signal-to-noise-ratio (SNR) respectively. The results for each of the setup schemes were evaluated on four different DR detectors (Gd2O2S, CsI(Tl), a-Se, or BaFBrI as x-ray absorption material) based on the measured signal and noise response of the detector under the ISO beam conditions (ISO 6236-1). The results showed that all three setup schemes produced similar results for clinical beams above 70 kVp. Significant differences were observed only at lower kVp (≤60) beams. In addition, schemes of constant signal and constant SNR produced similar results with the only exception for the a-Se detector at low kVp (≤60) beam. These results indicate that the choice of the kVp schemes would be important only for low kVp exams.
Software scoring approaches provide an attractive alternative to human evaluation of CDMAM images from digital
mammography systems, particularly for annual quality control testing as recommended by the European Protocol for the
Quality Control of the Physical and Technical Aspects of Mammography Screening (EPQCM). Methods for correlating
CDCOM-based results with human observer performance have been proposed. A common feature of all methods is the
use of a small number (at most eight) of CDMAM images to evaluate the system. This study focuses on the potential
variability in the estimated system performance that is associated with these methods.
Sets of 36 CDMAM images were acquired under carefully controlled conditions from three different digital
mammography systems. The threshold visibility thickness (TVT) for each disk diameter was determined using
previously reported post-analysis methods from the CDCOM scorings for a randomly selected group of eight images for
one measurement trial. This random selection process was repeated 3000 times to estimate the variability in the
resulting TVT values for each disk diameter. The results from using different post-analysis methods, different random
selection strategies and different digital systems were compared. Additional variability of the 0.1 mm disk diameter was
explored by comparing the results from two different image data sets acquired under the same conditions from the same
system.
The magnitude and the type of error estimated for experimental data was explained through modeling. The modeled
results also suggest a limitation in the current phantom design for the 0.1 mm diameter disks. Through modeling, it was
also found that, because of the binomial statistic nature of the CDMAM test, the true variability of the test could be
underestimated by the commonly used method of random re-sampling.
Minimally invasive image-guided interventions require very high image resolution and quality, specifically over regions-of-interest (ROI) crucial to the procedure. An ROI high quality image allows limited patient radiation deposition while permitting rapid frame transfer rates. Considering current developments in direct conversion Flat Panel Detectors (FPD), advantages of such an imager for ROI angiography were investigated. The performance of an amorphous-selenium based FPD was simulated to evaluate improvements in MTF and DQE under various angiographic imaging conditions. The detector envisioned incorporates the smallest pixel size of 70 mm, reported to date, and a photoconductor thickness of 1000 mm to permit angiography. The MTF of the FPD is calculated to be 60% at the Nyquist frequency of 7.1 lp/mm compared to 6% for a previously reported CsI(Tl)-based ROI CCD camera. The DQE(0) of the FPD at 0.7 mR and 70 kVp is 74% while for the CCD camera is 70%. At 7.1 lp/mm, the FPD's DQE is 26% while for the CCD camera it is 12%. Images of an undeployed stent with 70 mm pixel mammography FPD prototype, compare favorably with images acquired with the CCD camera. Thus a practical direct flat-panel ROI detector with both improved performance and physical size is proposed.
A new high spatial resolution micro-angiographic camera will enable routine viewing within a region of interest of detailed vascular structure unable to be seen with current full field of view (FOV) angiographic detectors. Such details include perforator vessels, vessel contractility or compliance, and condition and location of 50 micron or smaller stent wires. Although the basic CsI(Tl) phosphor-optical taper-CCD design of the new ROI micro-angiographic camera is essentially the same as that of the pre-clinical prototype, many of the physical parameters are much improved. The FOV is 5 cm X 5 cm vs. the previous 1 cm X 1 cm; the phosphor thickness is 350 - 400 micron vs. the previous 100 micron; the taper ratio is now 1.8 rather than 3.0 (2.8X improvement in light collection). The pixel size is either 25 or 50 micron. Additionally, detector noise may now be carefully considered in the camera design as may mechanical supporting mechanisms, methods to synchronize image acquisition with exposure and the effects of other physical factors such as exposure parameters, tube loading, focal spot size and geometric unsharpness. It is expected that this new capability should allow improved treatments and further development of smaller interventional devices and catheter delivery systems.
The x-ray flat-panel detector (FPD) will be a key component of the coming generation of x-ray imaging systems. FPD systems applicable to both fluoroscopy and radiography especially, will be the prime candidate to replace current image intensifier x-ray (IIXR-TV) systems. Nevertheless, IIXR-TV systems which have recently been improved by the addition of CCD cameras, have established themselves over time by offering good image quality which in most cases clinicians appear to be satisfied with. It will thus take a substantial improvement in image quality combined with a new ease of use due to reduced physical size for new FPDs to replace those systems that have evolved over many decades. Our group has been developing a selenium-based FPD which has superior spatial resolution characteristics. The purpose of this research is to elucidate the FPD's potential to replace IIXR-TV systems by offering improved image quality. Detailed measurements of physical characteristics were made and extensive in vivo animal studies were conducted. It can be concluded that the FPD's demonstrated superior image quality appears to have the potential to improve clinical performance.
An improved approach to the current fixed sampling area design of automatic brightness control (ABC) systems installed in most fluoroscopy units is described. Using a binary image to define the sampling and non-sampling areas, the digital image data and statistical information within the sampling area of the image can be extracted in real time for feedback control of the ABC system. The operator can select the binary image so the sampling area in that binary image matches the feature of interest wherever it is in the field of view. This design allows greater control and flexibility in the selection of sampling area for ABC systems in digital fluoroscopy, and therefore overcomes the problems inherent in current fixed sampling area systems. It is applicable to current image intensifiers and new flat panel detectors.
By changing the design paradigm for radiographic detectors to optimize imaging of a region of interest (ROI) for endovascular interventions, a new class of micro-angiographic detectors is proposed. Such ROI imagers optimized for high spatial resolution over a fraction of the conventional FOV accept compromises in x-ray absorption so that the desired high frequency DQE is achieved. A prototype demonstration system based upon a CsI(Tl) phosphor coupled by a fiber taper to a CCD is compared with an image-intensifier-based digital angiographic (DA) system for imaging typical neuro-vascular pathologies (stenoses, aneurysms, arterio-venous malformations (AVMs) and a variety of stents with wire diameter down to 50 micrometer. Although the zero frequency DQE of the DA unit exceeded that of the prototype with its thin phosphor layer, the prototype excelled in the desired frequency range of 3 - 10 lp/mm. Using an artery block phantom, the smallest 1 mm diameter stenoses and aneurysms were clearly visualized only with the prototype. For imaging stents, details of wires and struts were only visible with the prototype. ROI images of an AVM pig rete model showed more detailed angio-architecture compared to blurred-appearing DA images. It is expected that future such ROI cameras should allow improved clinical interventions.
An automatic ROI tracking system for the application of ROI fluoroscopy is designed. The methods for processing in real- time, generating binary masks, equalization of the display and the scheme for the image analysis to track ROI size are described. The initial results of the system tested on a torso phantom are reported and discussed. The system results in the appearance of an almost completely equalized real-time image and the method can be incorporated into x-ray fluoroscopy units with minimum modification. With the technology, ROI fluoroscopy can be applied to interventional or diagnostic procedures for practical patient dose reduction.
Detailed cerebrovascular blood flow can be more accurately determined radiographically from the new droplet tracking method previously introduced by the authors than from standard soluble contrast techniques. For example, arteriovenous malformation (AVM) transit times which are crucial for proper glue embolization treatments, were shown to be about half when using droplets compared to those measured using soluble contrast techniques. In this work, factors such as x-ray pulse duration, frame rate, system spatial resolution (focal spot size), droplet size, droplet and system contrast parameters, and system noise are considered in relation to their affect on the accurate determination of droplet location and velocity.
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