Optimization of computed tomography protocols: limitations of a methodology employing a phantom with location-known opacities.

This study aimed to determine if phantom-based methodologies for optimization of hepatic lesion detection with computed tomography (CT) require randomization of lesion placement and inclusion of normal images. A phantom containing fixed opacities of varying size (diameters, 2.4, 4.8, and 9.5 mm) was scanned at various exposure and slice thickness settings. Two image sets were compared: All images in the first image set contained opacities with known location; the second image set contained images with opacities in random locations. Following Institutional Review Board approval, nine experienced observers scored opacity visualization using a 4-point confidence scale. Comparisons between image sets were performed using Spearman, Kappa, and Wilcoxon techniques. Observer scores demonstrated strong correlation between both approaches when all opacity sizes were combined (r = 0.92, p < 0.0001), for the 9.5 mm opacity (r = 0.96, p < 0.0001) and for the 2.4 mm opacity (r = 0.64, p < 0.05). There was no significant correlation for the 4.8 mm opacity. A significantly higher sensitivity score for the known compared with the unknown location was found for the 9.5 mm opacity and 4.8 mm opacity for a single slice thickness and exposure condition (p < 0.05). Phantom-based optimization of CT hepatic examinations requires randomized lesion location when investigating challenging conditions; however, a standard phantom with fixed lesion location is suitable for the optimization of routine liver protocols. The development of more sophisticated phantoms or methods than those currently available is indicated for the optimization of CT protocols for diagnostic tasks involving the detection of subtle change.

Diagnostic reference levels for mammography in BreastScreen Queensland.

Diagnostic reference levels assist in the optimisation of radiation exposure parameters within a medical imaging facility. As no Australian DRLs currently exist, radiation doses from mammography in BreastScreen Queensland are analysed. Program-based DRLs of 1.1 and 1.4 mGy are proposed for digital radiography and computed radiography mammography systems, respectively.

Suggested baseline ranges for performance testing of the Fujifilm FCR Capsula XL computed radiography system.

Due to the difficulty in obtaining expected baseline values from the supplier for the performance testing of the Fujifilm FCR Capsula XL computed radiography system, performance test results from the acceptance testing of 42 Capsula systems were reviewed. Guidance ranges are provided for nine system performance tests which can be applied to future testing of calibrated systems.

Results from a phantom based multi-centre paediatric computed tomography dose survey.

A computed tomography radiation dose survey was performed within our enterprise using three age-based paediatric phantoms representing a 1, 5 and 10 years old. Twenty-seven scanners were surveyed with volume computed tomography dose index and dose length product data collected for head, chest and abdomen-pelvis protocols at each age. Reconstruction method e.g. filtered back projection (FBP) or iterative (IR) was also recorded. About two-thirds of the 1 year old FBP chest scans exceeded the national Baby diagnostic reference level (DRL). A small number of scanners also exceeded the national Child DRL for the 1 and 5 years old phantoms. Only about half of the phantom protocols showed a difference of statistical significance between FBP and IR scanners. The results suggested the need for optimisation work at a number of sites. It was determined that the proposed local (i.e. enterprise-wide) DRLs are presented best in terms of weight or girth rather than age.