Relationship between the visual evaluation of pathology visibility and the physical measure of low contrast detail detectability in neonatal chest radiography.

INTRODUCTION: The detectability of low contrast detail (LCD) is a method used to assess image quality (IQ) in neonatal radiography; however, there is a lack of data on the relationship between LCD detectability and visual IQ. The study aims at investigating the relationship between the LCD detectability and visual IQ and pathology visibility (PV). METHODS: Several acquisition parameters were employed to obtain a group of images from a neonatal Gammex chest phantom. Three observers applied relative visual grading analysis (VGA) for assessing the IQ and PV. A simulated pneumothorax visibility (PNV) and simulated hyaline membrane disease visibility (HMV) represented PV. Next, a CDRAD 2.0 phantom was radiographed utilising the same acquisition protocols, and several paired images were obtained. With the use of CDRAD analyser software, the detectability of LCD was assessed and expressed by an image quality figure inverse (IQFiinv) metric. The correlation between the IQFinv and each of IQ, PNV and HMV was examined. RESULTS: The physical measure (IQFinv) and the visual assessment of IQ were shown to be strongly correlated (r = 0.95; p < 0.001). Using Pearson's correlation, the IQFinv, PNV, and HMV were found to be strongly correlated (r = 0.94; p < 0.001) and (r = 0.92; p < 0.001), correspondingly. CONCLUSION: Results of the study show that physical measures of LCD detectability utilising the CDRAD 2.0 phantom is strongly corelated with visual IQ and PV (PNV and HMV) and can be used to evaluate IQ when undertaking neonatal chest radiography (CXR). IMPLICATIONS FOR PRACTICE: This study establishes the feasibility of utilising the physical measure (IQFinv) and the CDRAD 2.0 phantom in routine quality assurance and neonatal CXR optimisation studies.

Nutrient Status in Patients with Frequent Episodic Tension-Type Headache: A Case-Control Study.

OBJECTIVE: To investigate the relationship between frequent episodic tension-type headache (FE-TTH) and 25-hydroxyvitamin-D (25(OH)D), folate, vitamin B12, and magnesium. DESIGN-METHODS: A prospective case-control study involving adults with FETTH and age-sex matched healthy controls (HC) was performed. Individuals under the responsibility of the three provincial Health Centres of the prefecture of Trikala (Central Greece) were recruited during their regular check-up visits. The relationship between FETTH and serum levels of 25(OH)D, vitamin B12, folate, and magnesium was investigated (primary outcomes). Demographics, daily habits, somatometrics, psychometric and sleep quality measurements, laboratory indices, cardiovascular comorbidities and medications taken were also recorded and compared (secondary outcomes). Potential associations of the above-listed parameters with headache parameters (headache frequency, severity and analgesic consumption) were also examined (secondary outcomes). RESULTS: Between September and December 2020, 30 patients with FETTH and 30 HC were successfully recruited. Demographics, comorbidities, regular medications, smoking habits, alcohol and coffee consumption, body mass index measurements, markers of systemic inflammation, folate and vitamin B12 levels were similar between the two groups (P>0.05). Lower serum 25(OH)D was both univariately (P<0.001) and multivariately [OR= 0.72, 95%CI=(0.55, 0.94) per 1ng/ml increase] associated with FETTH, while serum magnesium was found lower in FETTH only according to the univariate approach (P=0.036). Higher levels of depression (P=0.050) and anxiety (P=0.020), as well as poor quality of sleep (P=0.008), were univariately associated with FETTH. Only the effect of anxiety remained significant following the multivariate logistic regression [OR=7.90, 95%CI=(1.00, 62.47)]. Headache parameters were not associated with any one of the assessed variables. DISCUSSION: Lower serum 25(OH)D was related to the presence of FETTH. This finding could imply a potential role for vitamin D in the pathophysiology of TTH.

Survey of monitor specification and viewing conditions in breast screening units in the North West of England.

INTRODUCTION: Monitor specification and viewing conditions are important factors affecting image assessment in mammography. This survey evaluates the different viewing conditions and monitor specifications that exist in acquisition and reporting rooms in UK breast screening units. METHODS: Static (n = 10) and mobile (n = 2) breast screening units were evaluated in North West England. Room illumination levels were measured in 3 locations for each room using a calibrated Lux meter and the specification of 122 monitors recorded. Room layout, wall colour, location and number of doors, windows and light sources were recorded. RESULTS: In reporting rooms, 90/91 of monitors had similar technical specifications and were compliant to guidelines. The ambient light levels ranged from 10 to 25.8 lux. The mean illuminance was 12.32 ± 4.6 lux. In acquisition rooms, great variances appeared in monitor specification and ambient light levels. The majority of monitors (24/34) had 3 megapixel (MB) optimum resolution but the ambient light level ranged from 10 to 1020 lux. The mean illuminance was 105.3 ± 178.8 lux. The mobile units were consistent with each other and compliant with guidelines. CONCLUSION: A lack of consistency and great variances appeared in terms of ambient light levels and monitor specifications in the image acquisition rooms. However, there was excellent consistency among the illumination measurements and the monitors' technical specifications in the reporting rooms. IMPLICATIONS FOR PRACTICE: This research demonstrates, for the first time, the need for further research and specialised guidelines for acquisition rooms.

A systematic review of viewing conditions and monitor specifications in mammography.

OBJECTIVES: The purpose of this systematic review was to establish the current status of recommended monitor specifications and viewing conditions in mammography for image acquisition and reporting rooms. A literature search was completed between August 2018 and March 2019 using ScienceDirect, PubMed, Web of Science and MEDLINE databases. An additional manual search was performed to identify relevant guidelines to support the review. Only articles and guidelines written in English were included. KEY FINDINGS: Results were selected according to the following criteria; articles detailing (i) monitor specification and, (ii) viewing conditions in mammography acquisition and reporting rooms. Twenty-one studies met the inclusion criteria. Six papers described monitor specifications, five described viewing conditions and ten guideline documents were identified from the UK, Europe and the US. Common outcomes were that monitors with 3 or 5 MP resolution seemed to be preferred and at the same time higher illumination levels (>15 lux) were found to decrease the luminance of the monitors and negatively impact the assessment of image quality. Contrary to this, the majority of guideline documents recommended illumination levels above 20 Lux. Finally, there is a lack of guidance for viewing conditions in acquisition rooms. CONCLUSION: This review did not reveal any strong evidence for the proposed room illumination levels in acquisition rooms. In reference to monitors specifications, there is preference for using higher resolution displays (3 and 5 MP) but again, the evidence is not strong. Moreover, variance exists in the guidelines and that promotes inconsistency in mammography departments. IMPLICATIONS FOR PRACTICE: This review highlights the lack of standardised guidelines and the need for further research on the viewing conditions and monitor specifications for the acquisition rooms in mammography.