An evaluation of the effect of tube potential on clinical image quality using direct digital detectors for pelvis and lumbar spine radiographs.

INTRODUCTION: High kVp techniques, 15% or 10-kVp rules, are well-known dose reduction methods. Traditionally, the use of high tube potential (i.e. increased kVp) is associated with decreased radiographic contrast and overall image quality. Recent studies suggest contrast and image quality are not heavily reliant on kVp with digital systems. This study aims to assess the effects of the high tube potential technique on clinical radiographic image quality when using digital systems, to validate high kVp as a dose saving technique. METHODS: A selection of comparable pelvis and lumbar spine radiographs were collected from the hospital's picture archiving and communication system (PACS), with technical factors recorded. All clinical radiographs were assessed by 5 senior radiographers using a 15-point visual grading analysis (VGA) rubric. RESULTS: For 40 AP pelvis radiographs and 40 lateral lumbar spine radiographs, reduction in the dose area product (DAP) with higher kVp is seen. Average pelvis DAP at 75 kVp = 14.06 mGy.cm2 ; 85 kVp = 7.47 mGy.cm2 . Average lumbar spine DAP at 80 kVp = 15.76 mGy.cm2 ; 90 kVp = 14.83 mGy.cm2 . Image quality and contrast scores showed no statistically significant difference between the high and low kVp groups (z = 0.06 and 0.12, respectively). Average pelvis VGA score at 75 kVp = 11.26; 85 kVp = 12.55. Average lumbar spine VGA score at 80 kVp = 9.23; 90 kVp = 10.64. CONCLUSIONS: The high tube potential techniques allowed for reduced patient radiation doses whilst showing no degradation of diagnostic image quality in a clinical setting. This study successfully validates the high kVp technique as a useful tool for reducing patient radiation doses whilst maintaining high diagnostic image quality for digital pelvis and lumbar spine radiography.

A novel computer-based method for the measurement of the lipid "load" in the coronary vessels of rabbits.

INTRODUCTION: This study reports the development of a new, accurate and reproducible method which combines histological and computer techniques for the determination of fatty load in cholesterol-fed rabbits. METHODS: New Zealand male rabbits were randomly divided into three groups. The animals in group 1 (control) received neither cholesterol nor drugs. Those in group 2 received a 2% cholesterol diet for 30 days, followed by a normal diet for 45 days. In addition during the latter period (day 31 to day 75) animals received 200 g of chopped carrots each morning. The rabbits in group 3 followed the same dietary regime as those in group 2 except that 8.36 mg of simvastatin and 1.76 g cholestyramine were mixed with their carrots. On the 76th day, the animals were sacrificed and their blood and hearts were collected. Histological sections (15 microm thick) of hearts were cut at 90 degrees to the long axis using a motorized freezing microtome. Every tenth section was mounted on a glass slide and stained with Oil Red O. A total of hundred slides prepared from each heart were scanned into a computer and the area stained by Oil Red O was measured, giving a measure of the total fatty "load" in each heart. RESULTS: There was a highly significant increase in the coronary fatty deposits in the hearts of the animals fed with cholesterol rich diet (group 2) as compared to the control rabbits in group 1. Treatment of rabbits with simvastatin plus cholestyramine (group 3) significantly reduced the coronary lipids load. DISCUSSION: The combination of histological and computer-based techniques used in this study provides an accurate and reproducible method for the quantitation of fatty deposits in rabbit coronary vessels. This report is based on the measurement of coronary lipid depositions rather than aortic lesions. It also overcomes the shortcoming of the majority of the earlier published methods which are generally limited to the measurement of fatty plaques in only few major coronary vessels, totally neglecting the many small distributive vessels which are often responsible for cardiac ischemic disease.