Comparative Evaluation of the Quality of Obturation Between Three Obturation Techniques in Primary Canines: An In Vitro Study.

Aims This study compares three obturation techniques (rotary lentulo spiral, handheld lentulo spiral, and pressure syringe) for the quality of two filling pastes (zinc oxide eugenol (ZOE) paste and Metapex (Meta Biomed Co., Ltd., Chungcheongbuk-do, Korea). Methods and materials Sixty extracted primary canines were instrumented and obturated by filling materials. The obturation techniques were divided into three groups according to different obturation techniques. Obturation quality was evaluated for length, density, and presence of voids by using digital radiography. Results This study showed that the handheld lentulo spiral technique using Metapex and ZOE exhibited more optimal fillings for obturation length. The highest density obturation was achieved using the syringe injection approach with Metapex and ZOE. The highest incidence of both external and internal voids was observed in the group using ZOE with the handheld lentulo spiral technique Conclusions Based on the findings of this study, for both filling materials, the handheld lentulo spiral technique had the greatest number of optimal lengths but there were also more voids.

Development of a correction coefficient for radiographic evaluation of the alveolar bone crest: a pilot study.

OBJECTIVES: To analyze the differences in cusp height on radiographs, establishing proportional relationships between cusp and alveolar bone crest (ABC) measurements. The goal of this study was to develop a correction coefficient by considering this proportion. MATERIALS AND METHODS: Twenty-one artificial teeth, molars and premolars, and bovine ribs were used. Interproximal radiographs were taken with the aid of a positioner. The vertical angles used were: 0°, + 5°, and + 10°, and processed using three spatial resolutions measured in line pairs per mm (lp/mm): 20, 25 and 40. The Perio filter was applied to each image, in addition to the original one. Combinations of angle, resolution, and filter were made. Eighteen images were analyzed by three specialists, resulting in 252 measurements for each evaluator, totaling 756 measurements. RESULTS: The overall variability of the measurements can be explained mainly by the variation in tooth anatomy. The 0° 25 lp/mm Perio filter method was the closest one to the actual clinical scenario for both cusps and ABC. The correction factor managed to explain 71.45% of the errors. CONCLUSIONS: The variation in vertical angulation interferes with cusp and ABC measurements, and the angulation at 0º and spatial resolution of 25 lp/mm showed better results. The use of correction coefficients allowed approaching actual measurement values. CLINICAL RELEVANCE: More accurate ABC height measurements are essential even in radiographic exams that do not meet the standard of excellence because the need to repeat radiographic exams is then eliminated.

ACPSEM position paper: recommendations for a digital general X-ray quality assurance program.

This guideline has been prepared by the ACPSEM to provide a standardised quality assurance program to be used within General X-ray imaging environments. The guideline includes the responsibilities of various multidisciplinary team members within medical imaging facilities. It must be noted that the listed tests and testing frequencies are not intended to replace or become regulatory requirements. Implementing a quality assurance program as outlined in this position paper is there to ensure best practice for imaging facilities by providing a framework to establish and monitor correct equipment performance. The current document has been produced through an extensive review of current international practices and local experience within the Australasian healthcare environment. Due to the constant evolution of digital radiographic equipment, there is no current consensus in international quality assurance guidelines as they continue to be adapted and updated. This document describes the current state of the use of digital General X-ray equipment in the Australasian environment and provides recommendations of test procedures that may be best suited for the current medical imaging climate in Australasia. Due to the everchanging developments in the medical imaging environment and the ability of new technologies to perform more complex tasks it is believed that in the future this document will be further reviewed in the hopes of producing a more globally agreed upon standard quality assurance program. Any such adjustments that are deemed to be necessary to Version 1.0 of this document will be provided in electronic format on the ACPSEM website with a notification to all parties involved in the use of digital General X-ray equipment. This guideline does not provide detailed methodologies for all the quality control tests recommended as it is it is expected that the professionals implementing aspects of this quality assurance program have the working knowledge and access to appropriate resources to develop testing methodologies appropriate for their local imaging environment.

Bedside diagnosis of silent aspiration using mobile dynamic digital radiography: a preliminary study.

PURPOSE: This study aimed to assess reliable options for bedside diagnosis of silent aspiration in the intensive care unit by examining the use of default grayscale images (DGI) obtained using a mobile, general-purpose, radiography system capable of dynamic digital radiography (M-DDR) and inverted grayscale images (IGI) of DGI. METHODS: This cohort study (exploratory and preliminary) involved 18 adult patients (mean age, 89.0 years) for whom a swallowing assessment request was received from their primary physicians. Fifty-six IGI videoclips were evaluated by three specialists using the penetration-aspiration scale (PAS), with the gold standard being the consensus reading of all three specialists. Another three speech-language pathologists (SLPs) assessed 56 DGI and IGI videoclips using the PAS. PAS scores 1 and 2 were classified as normal range, PAS scores 3-5 as pathological laryngeal penetration, and PAS scores 6-8 as aspiration. The correct rates with IGI and DGI were then determined, and the level of agreement of IGI and DGI evaluations was evaluated. RESULTS: The correct rate of all evaluators was 100% for normal range, 80-100% for pathological laryngeal penetration, and 83-100% for aspiration with IGI and 100% for normal range, 90% for pathological laryngeal penetration, and 83% for aspiration with DGI. The kappa coefficient for IGI and DGI showed almost complete agreement for abnormal conditions. CONCLUSION: Dynamic imaging of swallowing 2-5 ml of liquid using M-DDR performed for elderly patients at the bedside showed that aspiration assessments by SLPs obtained from DGI videos immediately after imaging are acceptable.

Evaluation of the performance of digital x-ray systems in pelvis radiography.

The aim of this study was to investigate the performance of eight digital radiography systems and to optimise the dose-image quality relationship for digital pelvis radiography. The study involved eight digital radiography systems used for general examinations at Vilnius University Hospital Santaros Klinikos. An anthropomorphic pelvic phantom (CIRS, US) was used to simulate a patient undergoing clinical pelvis radiography. Dose quantities entrance surface dose, dose area product (DAP) and exposure parameters (kVp, mA, mAs) were measured and the effects on the images were evaluated, considering physical contrast to noise ratio (CNR) and observer-based evaluations as image quality metrics. Increasing the tube voltage by 5 kVp from standard protocol led to a reduction in radiation dose (DAP) by 12%-20% with a slight impact on image quality (CNR decreases by 2%-10%). There was an inter-observer variability in image rating across different equipment (kappa value between 0 and 0.3); however, both observers agreed that increasing kVp up to 85-90 kV had no effect on perceived image quality. The results indicate that optimisation strategies should be tailored specifically for each x-ray system since significant performance differences and wide variations in radiation dose exist across various digital radiography systems used in clinical settings. The use of high kVp can be used for dose optimisation in digital pelvis radiography without compromising image diagnostic accuracy.

Reliability of impedance spectroscopy versus digital radiograph and ICDAS-II in occlusal caries detection: a prospective clinical trial.

The traditional methods in early caries detection had many limitations. So, this study aimed to evaluate the clinical performance of alternating current impedance spectroscopy ACIST in comparison with digital radiograph and ICDAS-II in detection of occlusal carious lesions. Occlusal surfaces of molar and premolar teeth from 40 adult participants were examined by two observers using three diagnostic methods: (1) international caries detection and assessment system (ICDAS-II) (2) digital radiograph (DR) and (3) Cariescan Pro device (ACIST). Agreement analysis and the difference in sensitivities and specificities were evaluated. The results showed an excellent agreement in the different groups. The difference from the visual tactile against ACIST scoring for enamel caries detection, was statistically significant (p = 0.012) and the agreement was moderate (k = 0.509). For dentinal caries the difference was not statistically significant (p > 0.05) and the agreement was similarly moderate (k < 0.6). The difference from the digital radiograph against ACIST scoring, for enamel caries, digital radiography had significantly higher sensitivity and specificity than ACIST (p < 0.001) while for dentinal caries detection and overall, ACIST had higher sensitivity and digital radiography had higher specificity and the difference was statistically significant (p < 0.001). Visual-tactile examination is a considered as feasible and valid technique for occlusal caries detection, digital radiography is superior to ACIST in diagnosing enamel caries, but it could underestimate the caries depth, ACIST is a reliable tool for detecting occlusal caries in dentin.

Cystine and urate cystoliths in dogs are frequently visible on radiographs prior to surgical or nonsurgical removal.

OBJECTIVE: To investigate the frequency at which cystine and urate cystoliths (stones) are visible on radiographs prior to surgical or nonsurgical retrieval. METHODS: Records of client-owned dogs (n = 331) were analyzed between January 2019 and December 2023 for cystoliths submitted for stone analysis after surgical removal or nonsurgical retrieval. Records were analyzed for cystolith type; when cystine or urate stones were identified, records were analyzed for signalment, procedure, presence of mineral opaque cystoliths on pre-procedural radiographs, urine pH and crystalluria, history of previous cystoliths, prior prescription diet attempt, recurrence, and genetic, congenital and acquired comorbidities. Descriptive statistics were generated after data collection. RESULTS: 31 of 331 (9%) were cystine stones, 49 of 331 (15%) were urate, and 1 of 331 (0.3%) was a mix of urate and cystine. When radiographs were taken prior to stone removal, 24 of 28 (85%) of urate, 24 of 26 (92%) of cystine, and 1 of 1 (100%) of urate/cystine were visible on radiographs. CONCLUSIONS: Cystine and urate stones are visible on survey radiography at a high frequency in dogs. CLINICAL RELEVANCE: While cystine and urate stones have been historically designated as radiolucent, they are frequently radiopaque on radiographs. Radiopacity is commonly used as one of the criterion to determine whether a dissolution or prevention diet is an appropriate management technique, particularly when determination of the stone type has yet to be performed. As a result, these findings may prompt clinicians to investigate other patient-specific factors before a specific dietary recommendation is made.

Deep learning approach to femoral AVN detection in digital radiography: differentiating patients and pre-collapse stages.

OBJECTIVE: This study aimed to evaluate a new deep-learning model for diagnosing avascular necrosis of the femoral head (AVNFH) by analyzing pelvic anteroposterior digital radiography. METHODS: The study sample included 1167 hips. The radiographs were independently classified into 6 stages by a radiologist using their simultaneous MRIs. After that, the radiographs were given to train and test the deep learning models of the project including SVM and ANFIS layer using the Python programming language and TensorFlow library. In the last step, the test set of hip radiographs was provided to two independent radiologists with different work experiences to compare their diagnosis performance to the deep learning models' performance using the F1 score and Mcnemar test analysis. RESULTS: The performance of SVM for AVNFH detection (AUC = 82.88%) was slightly higher than less experienced radiologists (79.68%) and slightly lower than experienced radiologists (88.4%) without reaching significance (p-value > 0.05). Evaluation of the performance of SVM for pre-collapse AVNFH detection with an AUC of 73.58% showed significantly higher performance than less experienced radiologists (AUC = 60.70%, p-value < 0.001). On the other hand, no significant difference is noted between experienced radiologists and SVM for pre-collapse detection. ANFIS algorithm for AVNFH detection with an AUC of 86.60% showed significantly higher performance than less experienced radiologists (AUC = 79.68%, p-value = 0.04). Although reaching less performance compared to experienced radiologists statistically not significant (AUC = 88.40%, p-value = 0.20). CONCLUSIONS: Our study has shed light on the remarkable capabilities of SVM and ANFIS as diagnostic tools for AVNFH detection in radiography. Their ability to achieve high accuracy with remarkable efficiency makes them promising candidates for early detection and intervention, ultimately contributing to improved patient outcomes.

Patient dose and associated exposure parameters in pelvic x-ray examinations: dependence on radiographic system.

Technological differences between computed radiography (CR) and digital radiography (DR) systems can influence patient doses and exposure parameters in pelvic x-ray examinations. The presence of radiosensitive organs in the pelvic region underscores the need to optimize these parameters for both CR and DR systems. This prospective study aimed to compare the patient doses and exposure parameters for adult patients undergoing pelvic x-ray examinations using CR and DR systems, based on data from Sri Lanka. The study included data from 56 x-ray examinations, with 25 using CR and 31 using DR. Patient demographic characteristics and exposure parameters (kVp: kilovoltage peak, mAs: tube current-exposure time product) were recorded, and patient doses were measured in terms of the kerma-area product (PKA) using a PKA meter. Despite similar mean weight and body mass index (BMI), the CR systems showed significantly higher mean kVp (7.4%), mAs (16.4%), and PKA (29.7%) than the DR systems (CR - kVp: 73.2, mAs: 37.8, PKA: 2.29 Gy cm2; DR - kVp: 67.8, mAs: 31.6, PKA: 1.61 Gy cm2). The Mann-Whitney U test revealed statistically significant differences in PKA and kVp between the CR and DR systems (p < 0.05). Furthermore, even with lower patient weight and BMI, the mean mAs and PKA in this study were substantially higher than those reported in the literature for both CR and DR systems. These results suggest the need to optimize current mAs settings for the studied hospitals and introduce radiographic system-specific exposure parameters and reference dose levels for pelvic x-ray examinations in order to enhance patient protection.

Assessment of pulmonary function in COPD patients using dynamic digital radiography: A novel approach utilizing lung signal intensity changes during forced breathing.

Objectives: To investigate the association of lung signal intensity changes during forced breathing using dynamic digital radiography (DDR) with pulmonary function and disease severity in patients with chronic obstructive pulmonary disease (COPD). Methods: This retrospective study included 46 healthy subjects and 33 COPD patients who underwent posteroanterior chest DDR examination. We collected raw signal intensity and gray-scale image data. The lung contour was extracted on the gray-scale images using our previously developed automated lung field tracking system and calculated the average of signal intensity values within the extracted lung contour on gray-scale images. Lung signal intensity changes were quantified as SImax/SImin, representing the maximum ratio of the average signal intensity in the inspiratory phase to that in the expiratory phase. We investigated the correlation between SImax/SImin and pulmonary function parameters, and differences in SImax/SImin by disease severity. Results: SImax/SImin showed the highest correlation with VC (rs = 0.54, P < 0.0001), followed by FEV1 (rs = 0.44, P < 0.0001), both of which are key indicators of COPD pathophysiology. In a multivariate linear regression analysis adjusted for confounding factors, SImax/SImin was significantly lower in the severe COPD group compared to the normal group (P = 0.0004) and mild COPD group (P=0.0022), suggesting its potential usefulness in assessing COPD severity. Conclusion: This study suggests that the signal intensity changes of lung fields during forced breathing using DDR reflect the pathophysiology of COPD and can be a useful index in assessing pulmonary function in COPD patients, potentially improving COPD diagnosis and management.

Selective postmortem arterial angiography of head and neck using digital x-ray or computed tomography: A practical and rapid method to identify vascular injuries.

Identification of vascular injuries is crucial for complete postmortem evaluation and understanding of trauma deaths by the Medical Examiner. Some vascular injuries are difficult to evaluate due to challenging anatomic locations, especially in the head and neck. Documenting injuries of the facial and vertebral arteries is challenging and necessitates time-consuming dissections that can create artifacts and disfigurement. In busy medical examiner offices with a significant number of traumatic injuries, finding a creative solution to employ reliable postmortem angiography is desirable. At the Office of the Chief Medical Examiner for the State of Maryland (OCME), we created and effectively implemented a selective angiography procedure using traditional indwelling Foley catheters and water-soluble barium swallow contrast to evaluate arterial injuries using either digital radiography or computed tomography imaging modalities. This technique and imaging interpretation can be performed by a medical examiner or forensic pathology fellow after basic technical training and basic radiology training. This study outlines the technique, methods, and utilization of the procedure and describes the findings of six deaths due to vascular lesions from different injury mechanisms and disease processes and describes the ease of implementation on a broader scale in busy Medical Examiner's offices.

Scale-based landmark for internal organs assessments of common carp (Cyprinus carpio) during digital radiography and ultrasonography imaging.

Medical imaging techniques such as digital radiography and ultrasonography are non-invasive and provide precise results for examining internal organs and structures within fish. Their effectiveness can be further enhanced by using body parts like scales as markers for the organs beneath them. This study utilized the number of scales as landmarks in digital radiography and ultrasonography to non-invasively evaluate the muscles, bones, and images of internal and reproductive organs of common carp (Cyprinus carpio). Digital radiography was performed in the dorsoventral and lateral views of the fish, whereas ultrasonography was conducted in longitudinal and transverse views on sequence scale numbers with brightness and colour Doppler-modes. Digital radiography of the common carp revealed the whole-body morphology, including the bony parts from the head, pectoral fins, dorsal fins, pelvic fins, anal fins, and vertebrae to the tail that appeared radiopaque. Internal organs were also observed, with the swim bladder and heart appeared radiolucent, while the intestines, liver, testes, and ovaries appeared radiopaque. Ultrasonography in brightness mode displayed the digestive organs, reproductive organs, and muscle thickness. Additionally, colour Doppler mode demonstrated blood flow within the heart's ventricle.

Fast digitally reconstructed radiograph generation using particle-based statistical shape and intensity model.

Purpose: Statistical shape and intensity models (SSIMs) and digitally reconstructed radiographs (DRRs) were introduced for non-rigid 2D-3D registration and skeletal geometry/density reconstruction studies. The computation of DRRs takes most of the time during registration or reconstruction. The goal of this study is to propose a particle-based method for composing an SSIM and a DRR image generation scheme and analyze the quality of the images compared with previous DRR generation methods. Approach: Particle-based SSIMs consist of densely scattered particles on the surface and inside of an object, with each particle having an intensity value. Generating the DRR resembles ray tracing, which counts the particles that are binned with each ray and calculates the radiation attenuation. The distance between adjacent particles was considered to be the radiologic path during attenuation integration, and the mean linear attenuation coefficient of the two particles was multiplied. The proposed method was compared with the DRR of CT projection. The mean squared error and peak signal-to-noise ratio (PSNR) were calculated between the DRR images from the proposed method and those of existing methods of projecting tetrahedral-based SSIMs or computed tomography (CT) images to verify the accuracy of the proposed scheme. Results: The suggested method was about 600 times faster than the tetrahedral-based SSIM without using the hardware acceleration technique. The PSNR was 37.59 dB, and the root mean squared error of the normalized pixel intensities was 0.0136. Conclusions: The proposed SSIM and DRR generation procedure showed high temporal performance while maintaining image quality, and particle-based SSIM is a feasible form for representing a 3D volume and generating the DRR images.

[Examination of Optimal Frequency Processing in X-ray Images for Occult Femoral Neck Fractures].

PURPOSE: Osteosclerotic images are known as an image appearance of occult femoral neck fractures in X-ray images. The aim of this study is to investigate frequency enhancement processing that improves the visibility of the osteosclerotic image. METHODS: We acquired three sclerotic bone images with different thicknesses, and self-made bone equivalent phantoms were set up on a pelvic phantom. The frequency processing type and high-density enhancement coefficients were applied to the X-ray images taken at RF-A(1.0, 2.0), C(2.0, 4.0), D(1.0), and H(2.0, 4.0). For the physical index, we compared the difference in signal values between the sclerotic and background normal bone. We evaluated the preference using Scheffé's paired comparison methods for the visual index. RESULTS: For the physical index, RF-C(4.0) had the most significant signal value difference for all 3 bone stiffness images. For the visual index, RF-C(4.0) showed the highest preference. CONCLUSION: Using frequency-enhanced processing, RF-C(4.0) was suggested to improve the visibility of the osteosclerosis image.

Multi-centre digital radiography reject analysis for different clinical room use types: The establishment of local reject reference levels for public hospital departments.

INTRODUCTION: Reject analysis in digital radiography helps guide the training of staff to reduce patient radiation dose and improve department efficiency. The purpose of this study was to perform a multi-centre, vendor agnostic reject analysis across different room usage types, and to provide benchmarks for comparison. METHODS: Retrospective reject and exposure log data were collected via USB from fixed general X-ray systems across multiple Australian sites, for collation and analysis. The overall reject rate, local reject reference level, absolute and relative reject rates for body part categories, reject rates by room usage types and the reject rate for each reason of rejection were calculated. RESULTS: Data were collected from 44 X-ray systems, across 11 hospitals. A total of 2,031,713 acquired images and 172,495 rejected images were included. The median reject rate was 9.1%. The local reject reference level (LRRL), set as the 75th percentile of all reject rates, was 10.6%. Median reject rates by room type were emergency (7.4%), inpatients + outpatients (9.6%), outpatients (9.2%), and hybrid (10.1%). The highest absolute reject rates by body part were chest (2.1%) and knee (1.4%). The highest relative rates by body part were knee (18.1%) and pelvis (17.2%). The most frequent reasons for image rejection were patient positioning (76%) and patient motion (7.5%). CONCLUSIONS: The results compare well with previously published data. The range of reject rates highlights the need to analyse typical reject rates in different ways. With analysis feedback to participating sites and the implementation of standardised reject reasons, future analysis should monitor whether reject rates reduce.

Validation of artificial intelligence application for dental caries diagnosis on intraoral bitewing and periapical radiographs.

OBJECTIVES: This study aimed to assess the reliability of AI-based system that assists the healthcare processes in the diagnosis of caries on intraoral radiographs. METHODS: The proximal surfaces of the 323 selected teeth on the intraoral radiographs were evaluated by two independent observers using an AI-based (Diagnocat) system. The presence or absence of carious lesions was recorded during Phase 1. After 4 months, the AI-aided human observers evaluated the same radiographs (Phase 2), and the advanced convolutional neural network (CNN) reassessed the radiographic data (Phase 3). Subsequently, data reflecting human disagreements were excluded (Phase 4). For each phase, the Cohen and Fleiss kappa values, as well as the sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of Diagnocat, were calculated. RESULTS: During the four phases, the range of Cohen kappa values between the human observers and Diagnocat were κ=0.66-1, κ=0.58-0.7, and κ=0.49-0.7. The Fleiss kappa values were κ=0.57-0.8. The sensitivity, specificity and diagnostic accuracy values ranged between 0.51-0.76, 0.88-0.97 and 0.76-0.86, respectively. CONCLUSIONS: The Diagnocat CNN supports the evaluation of intraoral radiographs for caries diagnosis, as determined by consensus between human and AI system observers. CLINICAL SIGNIFICANCE: Our study may aid in the understanding of deep learning-based systems developed for dental imaging modalities for dentists and contribute to expanding the body of results in the field of AI-supported dental radiology..

A deep-learning-based scatter correction with water equivalent path length map for digital radiography.

We proposed a new deep learning (DL) model for accurate scatter correction in digital radiography. The proposed network featured a pixel-wise water equivalent path length (WEPL) map of subjects with diverse sizes and 3D inner structures. The proposed U-Net model comprises two concatenated modules: one for generating a WEPL map and the other for predicting scatter using the WEPL map as auxiliary information. First, 3D CT images were used as numerical phantoms for training and validation, generating observed and scattered images by Monte Carlo simulation, and WEPL maps using Siddon's algorithm. Then, we optimised the model without overfitting. Next, we validated the proposed model's performance by comparing it with other DL models. The proposed model obtained scatter-corrected images with a peak signal-to-noise ratio of 44.24 ± 2.89 dB and a structural similarity index measure of 0.9987 ± 0.0004, which were higher than other DL models. Finally, scatter fractions (SFs) were compared with other DL models using an actual phantom to confirm practicality. Among DL models, the proposed model showed the smallest deviation from measured SF values. Furthermore, using an actual radiograph containing an acrylic object, the contrast-to-noise ratio (CNR) of the proposed model and the anti-scatter grid were compared. The CNR of the images corrected using the proposed model are 16% and 82% higher than those of the raw and grid-applied images, respectively. The advantage of the proposed method is that no actual radiography system is required for collecting training dataset, as the dataset is created from CT images using Monte Carlo simulation.

Evaluation of the effects of postprocessing settings in digital bitewing radiographs on proximal caries detection.

OBJECTIVE: Radiographs are an integral part of detecting proximal caries. The aim of this study was to evaluate the effect of contrast, brightness, noise, sharpness, and γ adjustment of digital intraoral radiographs on the diagnosis of proximal caries. MATERIALS AND METHODS: In this in vitro study, 40 extracted teeth including 20 premolars and 20 molars with enamel lesions (white spot or dentin discoloration seen through the enamel) were mounted together in groups of eight inside the skull. Bitewing radiographic images of each dental group were obtained by a photostimulable phosphor plate sensor with exposure conditions of 8 mA, 70 kV, and 0.2 s. The images were reconstructed by the built-in software and examined by two oral and maxillofacial radiologists in various settings of contrast, brightness, sharpness, noise, and γ. The teeth were then cut mesiodistally and the presence or absence of caries was confirmed by an oral and maxillofacial pathologist using a stereomicroscope. The data were then analyzed using the κ agreement coefficient, sensitivity, specificity, and accuracy (α = .05). RESULTS: Adjustment of brightness and contrast led to higher diagnostic performance with an accuracy of 82.5% and 83.8 (for observers 1 and 2, respectively) and 82.5% (for both observers), respectively. Noise adjustment was the least helpful approach for diagnosis of proximal dental caries among other adjustments, with an accuracy of 78.8% and 77.5% for observers 1 and 2, respectively. CONCLUSION: Brightness and contrast setting was more efficient in improving the diagnostic potential of bitewing radiographs compared to other adjustments.

Impact of intelligent virtual and AI-based automated collimation functionalities on the efficiency of radiographic acquisitions.

INTRODUCTION: Intelligent virtual and AI-based collimation functionalities have the potential to enable an efficient workflow for radiographers, but the specific impact on clinical routines is still unknown. This study analyzes primarily the influence of intelligent collimation functionalities on the examination time and the number of needed interactions with the radiography system. METHODS: An observational study was conducted on the use of three camera-based intelligent features at five clinical sites in Europe and the USA: AI-based auto thorax collimation (ATC), smart virtual ortho (SVO) collimation for stitched long-leg and full-spine examinations, and virtual collimation (VC) at the radiography system workstation. Two people conducted semi-structured observations during routine examinations to collect data with the functionalities either activated or deactivated. RESULTS: Median exam duration was 31 vs. 45 s (p < 0.0001) for 95 thorax examinations with ATC and 94 without ATC. For stitched orthopedic examinations, 34 were performed with SVO and 40 without SVO, and the median exam duration was 62 vs. 82 s (p < 0.0001). The median time for setting the ortho range - i.e., the time between setting the upper and the lower limits of the collimation field - was 7 vs. 16 s for 39 examinations with SVO and 43 without SVO (p < 0.0001). In 109 thorax examinations with ATC and 112 without ATC, the median number of system interactions was 1 vs. 2 (p < 0.0001). VC was used to collimate in 2.4% and to check the collimation field in 68.5% of 292 observed chest and other examinations. CONCLUSION: ATC and SVO enable the radiographer to save time during chest or stitched examinations. Additionally, ATC reduces machine interactions during chest examinations. IMPLICATIONS FOR PRACTICE: System and artificial intelligence can support the radiographer during the image acquisition by providing a more efficient workflow.