Evaluation of the measurement accuracy and uncertainty of a solid-state detector under diagnostic x-ray beam conditions.

OBJECTIVE: An accurate measurement of x-ray beams is expected to reduce the uncertainties associated with estimating radiation risk to patients in clinical settings. To perform assessment tasks based on the readings of a solid-state detector (SSD) using semiconductor technology, the characteristics of the detector should be elucidated. In this study, we evaluated the measurement accuracy of a new SSD under diagnostic x-ray beam conditions in terms of air kerma, tube voltage, and half-value layer (HVL). The performance of the SSD was then compared with those of reference instruments. METHODS: The tube voltage was varied within the range of 50-120 kV in steps of 10 kV and the thickness and materials of additional filters were concurrently changed (several combinations were tested). In addition, the dose rate and energy dependence of the SSD were also investigated. These effects were analyzed based on statistical significance tests. Furthermore, the expanded uncertainties in the series of measurements were meticulously calculated. RESULTS: The results showed average relative differences of -3.26 ± 1.33%, 0.44 ± 1.01%, and -2.60 ± 3.31% for air kerma, tube voltage, and HVL, respectively. Furthermore, air kerma did not exhibit any dependence on dose rate and energy, in contrast to tube voltage and HVL measurements. CONCLUSION: The measurement values of the SSD fall within the acceptable range of uncertainty, highlighting its measurement accuracy and reliability. Furthermore, based on the characteristics elucidated by this study, valuable insights are provided concerning the assurance of appropriate measurement values in clinical settings.

An image quality assessment index based on image features and keypoints for X-ray CT images.

Optimization tasks in diagnostic radiological imaging require objective quantitative metrics that correlate with the subjective perception of observers. However, although one such metric, the structural similarity index (SSIM), is popular, it has limitations across various aspects in its application to medical images. In this study, we introduce a novel image quality evaluation approach based on keypoints and their associated unique image feature values, focusing on developing a framework to address the need for robustness and interpretability that are lacking in conventional methodologies. The proposed index quantifies and visualizes the distance between feature vectors associated with keypoints, which varies depending on changes in the image quality. This metric was validated on images with varying noise levels and resolution characteristics, and its applicability and effectiveness were examined by evaluating images subjected to various affine transformations. In the verification of X-ray computed tomography imaging using a head phantom, the distances between feature descriptors for each keypoint increased as the image quality degraded, exhibiting a strong correlation with the changes in the SSIM. Notably, the proposed index outperformed conventional full-reference metrics in terms of robustness to various transformations which are without changes in the image quality. Overall, the results suggested that image analysis performed using the proposed framework could effectively visualize the corresponding feature points, potentially harnessing lost feature information owing to changes in the image quality. These findings demonstrate the feasibility of applying the novel index to analyze changes in the image quality. This method may overcome limitations inherent in conventional evaluation methodologies and contribute to medical image analysis in the broader domain.

Auto-evaluation of skull radiograph accuracy using unsupervised anomaly detection.

BACKGROUND: Radiography plays an important role in medical care, and accurate positioning is essential for providing optimal quality images. Radiographs with insufficient diagnostic value are rejected, and retakes are required. However, determining the suitability of retaking radiographs is a qualitative evaluation. OBJECTIVE: To evaluate skull radiograph accuracy automatically using an unsupervised learning-based autoencoder (AE) and a variational autoencoder (VAE). In this study, we eliminated visual qualitative evaluation and used unsupervised learning to identify skull radiography retakes from the quantitative evaluation. METHODS: Five skull phantoms were imaged on radiographs, and 1,680 images were acquired. These images correspond to two categories: normal images captured at appropriate positions and images captured at inappropriate positions. This study verified the discriminatory ability of skull radiographs using anomaly detection methods. RESULTS: The areas under the curves for AE and VAE were 0.7060 and 0.6707, respectively, in receiver operating characteristic analysis. Our proposed method showed a higher discrimination ability than those of previous studies which had an accuracy of 52%. CONCLUSIONS: Our findings suggest that the proposed method has high classification accuracy in determining the suitability of retaking skull radiographs. Automation of optimal image consideration, whether or not to retake radiographs, contributes to improving operational efficiency in busy X-ray imaging operations.

Analysis of the precision of modulation transfer function measurements with a circular edge: influence of object circularity.

Purpose: To measure the modulation transfer function (MTF) using a circular edge, we generate a synthesized edge spread function from multiple profiles radiating from the center, assuming that the circular object is perfectly round. Therefore, this study aimed to quantify the influence of the shape change of the circular edge on the measurement precision of the MTF. Approach: To examine this relationship, we generated simulated images with intentionally distorted circular edges and analyzed the correlation between circularity and the calculated MTF. This simulation was designed to replicate the MTF properties of an actual computed tomography image and was applied to isolate the effect of shape distortion on MTF measurements. MTF measurements were conducted on 11 different circularity images to determine the spatial frequencies at which the MTF values are 50% (f50) and 10% (f10), and the error rates to the true value were calculated. Results: Our findings revealed a correlation between circularity and the measured MTF value. Specifically, an 1% decrease in circularity from the perfect circle condition resulted in an approximately -35% change in f50. This decrease in MTF values was attributed to the presence of rectangular spatial blurring, which occurs when a distorted circular image is used to generate the synthetic edge profile. Conclusions: This study provided insights into the influence of the shape changes in the circular edge on MTF measurements. The present findings contribute to a better understanding of the evaluation results and measurement errors when describing the image quality characteristics modalities using the circular edge technique.

Simulation Analysis on the Performance of a Circular-Edge Technique in Measurements of the Modulation Transfer Function.

The modulation transfer function (MTF) plays an important role in characterizing medical imaging systems. For such characterization, the circular-edge technique has become a prevalent task-based methodology. When determining the MTF with complicated task-based measurements, error factors must be well understood to properly interpret the results. In this context, the aim of this work was to study the changes in measurement performance in the analysis of the MTF using a circular edge. To eliminate the systematic error related to the measurement and suitably manage the error factors, images were generated by Monte Carlo simulation. Further, a performance comparison with the conventional method was conducted; in addition, the influence of the edge size and contrast and the setting error of the center coordinates were investigated. The difference from the true value and the standard deviation relative to the average value were applied to the index as the accuracy and precision, respectively. The results demonstrated that the smaller the circular object used and the lower the contrast, the grater the deterioration in the measurement performance. Furthermore, this study clarified the underestimating of the MTF in proportion to the square of the distance with respect to the setting error of the center position, which is important for the synthesis of the edge profile. Evaluations in the backgrounds wherein there are multiple factors affecting the results are complex, and the system users must properly judge the validity of the characterization results. These findings provide meaningful insight in the context of MTF measurement techniques.

Properties of the SSIM metric in medical image assessment: correspondence between measurements and the spatial frequency spectrum.

In radiological imaging, the acquisition of the required diagnostic image quality under optimized conditions is important. Although techniques based on structural similarity (SSIM) have been investigated, concerns have been raised regarding their application to medical images. This study aims to clarify the properties of SSIM as an image quality index in medical images, focusing on digital radiography and verifying the correspondence between the evaluation results obtained by SSIM and the frequency spectrum. The analysis target was chest X-ray images of a human-body phantom. Various types of processing were applied to the images, and several regions of interest (ROIs) were used in local areas for analysis. The SSIM was measured using unprocessed data as a reference while changing the calculation parameters, and the spatial frequency spectrum of each local region was analyzed. Thus, a significant effect of ROI size was observed when calculating the SSIM. This indicates that larger the ROI size leads to SSIM values closer to 1 for all analysis conditions. In addition, a relationship between the size of the ROI in the analysis and the frequency components is demonstrated. It was shown that careful attention should be paid to the structures included in the ROI, and parameter settings should be reconsidered. Furthermore, when using SSIM to assess medical images, a multiscale SSIM method obtained by changing the ROI size would be useful.

Quantification of the Intrinsic T1 and T2 of Heschl's Gyri with MR Fingerprinting.

PURPOSE: The human primary auditory cortex is located in the Heschl's gyrus (HG). To assess the intrinsic MR property in the gray matter of the HG (GM-HG) with T1 and T2 values using a commercially available MR fingerprinting (MRF) technique. METHODS: The subjects were 10 healthy volunteers (with 20 HGs; mean age, 31.5 years old; range, 25-53 years old). Coronal T1 and T2 maps were obtained with commercially available MRF using a 3-Tesla MR system. Two radiologists measured the T1 and T2 values of the GM-HG, the GM in the superior temporal gyrus (GM-STG), and the GM in the middle temporal gyrus (GM-MTG) by drawing a ROI on coronal maps. RESULTS: For both radiologists, the mean T1 and T2 values of the GM-HG were significantly lower than those in the GM-STG or GM-MTG (P < 0.01). The interobserver reliability using the intraclass correlation coefficients (ICC) (2,1) showed strong agreement for the measurement of the T1 and T2 values (ICCs =⃥ 0.80 and 0.78 for T1 and T2 values, respectively). CONCLUSION: The T1 and T2 values on MRF for the GM-HG were lower than those for the GM-STG and GM-MTG, likely reflecting a higher myelin content and iron deposition in the GM-HG. Quantitative measurements using the MRF can clarify cortical properties with high reliability, which may indicate that MRF mapping provides new insights into the structure of the human cortical GM.

Effectiveness of Cytological Diagnosis with Outer Cannula Washing Solution for Computed Tomography-Guided Needle Biopsy.

RATIONALE AND OBJECTIVES: We evaluated the availability of cytological diagnosis with outer cannula washing solution (C-OCWS) as a clinical diagnostic tool for computed tomography (CT)-guided needle biopsy. MATERIALS AND METHODS: We retrospectively assessed 109 consecutive patients (71 males, 38 females; median age 68 years), who underwent CT-guided needle biopsy. In all patients, the specimens sampled by the inner needle were used for histological diagnosis, and those taken from the outer cannula were rinsed with 0.9% saline solution: outer cannula washing solution for cytological diagnosis. The accuracy of C-OCWS in addition to histological diagnosis were compared with that of histological diagnosis alone. We used binary logistic regression analysis to determine the variables associated with diagnostic accuracy for malignancy and lesion characteristics. RESULTS: The C-OCWS method precisely diagnosed 7 (6.4%) malignant lesions (i.e., effective cases) in the 109 patients characterized as "negative for malignancy" via histological diagnosis alone. The accuracy of the combination of C-OCWS and histological diagnoses was significantly higher than that of histological diagnosis alone (0.95 vs. 0.89, respectively; p = 0.023). Multivariate logistic regression analysis showed that increasing only a marginal ratio (failure rate for proper position of biopsy needle within the tumor) was independently associated with a high rate of effective cases (p = 0.003). CONCLUSION: C-OCWS may be helpful for improving the quality of CT-guided needle biopsy, and is a simple method that may not necessarily increase the patients' physical burden.

Cerebral ventriculomegaly in myotonic dystrophy type 1: normal pressure hydrocephalus-like appearances on magnetic resonance imaging.

BACKGROUND: Cerebral ventriculomegaly is an abnormal feature characteristic of myotonic dystrophy type 1 (DM1). This retrospective study investigated the morphologic changes accompanied by ventriculomegaly in DM1 on brain MRI. METHODS: One hundred and twelve adult patients with DM1 and 50 sex- and age-matched controls were assessed. The imaging characteristics for evaluations included the z-Evans Index (ventriculomegaly), callosal angle (CA), enlarged perivascular spaces in the centrum semiovale (CS-EPVS), temporo-polar white matter lesion (WML) on 3D fluid-attenuated inversion recovery (FLAIR), disproportionately enlarged subarachnoid-space hydrocephalus (DESH), and pathological brain atrophy. The "z-Evans Index" was defined as the maximum z-axial length of the frontal horns to the maximum cranial z-axial length. To determine the imaging characteristics and genetic information (CTG repeat numbers) that were associated with the z-Evans Index, we used binominal logistic regression analyses. RESULTS: The z-Evans Index was significantly larger in the patients than in the controls (0.30 ± 0.05 vs. 0.24 ± 0.02; p < 0.01). The z-Evans Index was independently associated with the callosal angle (p < 0.01) and pathological brain atrophy (p < 0.01) but not with age, gender, CTG repeat numbers, or CS-EPVS. Of the 34 patients older than 49 years, 7 (20.6%) were considered to have DESH. CONCLUSIONS: Our MRI study revealed a normal pressure hydrocephalus (NPH)-like appearance as a morphologic finding accompanied by ventriculomegaly in DM1 that tends to occur in elderly patients.

Assessment of Uncertainty Depending on Various Conditions in Modulation Transfer Function Calculation Using the Edge Method.

In medical X-ray imaging, to perform optimal operations, it is essential for the user to understand whether a required image quality level which depends on a diagnostic task can be achieved with the imaging system used. This study focuses on the effects of noise on the modulation transfer function (MTF) using the edge method, the most widely used to evaluate the task dependence property. The purpose is to verify the uncertainty of the MTF value at each spatial frequency and examine the conditions under which the accuracy is ensured. By using a Monte Carlo simulation, edge images with various contrast-to-noise ratio (CNR) are acquired. MTFs are then calculated with different edge spread function (ESF) lengths. The uncertainties for each spatial frequency are estimated based on the independent MTF calculations obtained from the five edge data. The uncertainty of the MTF is inversely proportional to the CNR. In the frequency range up to the Nyquist frequency, the uncertainty in five calculations is <0.01 when the CNR is more than 60. In addition, it is observed that the uncertainty increases as the ESF length increases. This relationship depends on the frequency range, but it is proportional to the 0.3-0.5 power of the ESF length. The results in which the uncertainty is most likely to be large in the MTF calculation are clearly shown. Therefore, it is expected to provide an important barometer and useful insights for a proper image quality measurement.

Characterization of anti-scatter grids via a modulation transfer function improvement factor using an edge device.

In optimizing the imaging conditions, changes in image quality due to scattered radiation are important evaluation targets. This study focuses on the evaluation of the image quality improvement characteristics obtained using anti-scatter grids in digital x-ray imaging, and proposes a frequency-dependent modulation transfer function (MTF) improvement factor,MIFG(u),as a new evaluation index. Accordingly, the purpose of this study is to clarify the validity and the usefulness of this proposed index in the performance evaluation of grids. The proposedMIFG(u)method is applied to evaluate several types of grids with different grid densities and ratios, and the characteristics of grids exhibiting different performances are examined. The proposed index is calculated based on the MTF measurement by using an edge test device. The results show thatMIFG(u)changed according to grid type and scatter conditions. In particular, a remarkable difference was observed in the high scatter condition compared with the low condition.MIFG(u)in the vertical direction with regards to the absorbing strips shows a peak at 0.2-0.5 cycles/mm and be a constant value from approximately 1 cycle/mm; whileMIFG(u)in the parallel direction is a constant value with respect to changes in spatial frequency. It is shown thatMIFG(u)could be used to accurately describe the characteristics of a grid under different imaging conditions. We believe that the use of the proposed index could expand the options for optimizing imaging conditions when using grids.

High-signal venous sinuses on MR angiography: discrimination between reversal of venous flow and arteriovenous shunting using arterial spin labeling.

PURPOSE: It is sometimes difficult to differentiate between high signals originating from a reverse flow on magnetic resonance angiography (MRA) and occult arteriovenous shunting. We attempted to determine whether arterial spin labeling (ASL) can be used to discriminate reversal of venous flow from arteriovenous shunting for high-signal venous sinuses on MR angiography. METHODS: Two radiologists evaluated the signals of the venous sinus on MRA and ASL obtained from 364 cases without arteriovenous shunting. In addition, the findings on MRA were compared with those on ASL in an additional 13 patients who had dural arteriovenous fistula (DAVF). RESULTS: In the 364 cases (728 sides) without arteriovenous shunting, a high signal due to reverse flow in the cavernous sinuses (CS) was observed on 99 sides (13.6%) on MRA and none on ASL. Of these cases, a high signal in the sigmoid sinus, transverse sinus, and internal jugular vein was seen on 3, 3, and 8 sides, respectively. All of these venous sinuses showed a high signal from the reverse flow on MRA images. CONCLUSION: ASL is a simple and useful MR imaging sequence for differentiating between reversal of venous flow and CS DAVF. In the sigmoid and transverse sinus, ASL showed false-positives due to the reverse flow from the jugular vein, which may be a limitation of which radiologists should be aware.

Visualization of blurring process due to analog components in a digital radiography system using a simple method.

To obtain useful medical X-ray images for diagnosis, it is necessary to accurately evaluate the characteristics and fully understand the features of the system to determine the imaging target and conditions. This study describes the performance of a digital radiography (DR) system in detail and proposes a method for characterizing the blurring process due to the presence of analog components in an imaging system. Our method does not involve any specialized technique, such as a simulation that requires long computing time on a high-performance computer. The method is based on the concept of the modulation transfer function (MTF). The functions that corresponded to the MTF of the analog components of the system when the Fourier transform was performed were examined. Indirect conversion type flat-panel detectors (FPD) in the general radiography energy range and direct conversion type FPD in the mammography were used for verification. A Gaussian function and Lorentz function were synthesized for modelling the blurring process of the indirect type FPDs. The spreads and shapes of the modeled functions depended on the systems. For the direct conversion type FPD, a combination of a Lorentz function with a narrow width and an impulse function characterized the results. Furthermore, based on the structure of each detector and the signal transfer process, the visualized results were considered reliable. The results of these experiments will aid in the detailed understanding of the image quality characteristics of the DR system by the feasible approach.

The effects of scattered radiation from a semitransparent edge on MTF measurement: verification of several factors by Monte Carlo simulation.

Accurate evaluation of image quality not only characterizes system performance but also allows quantitative understanding of various image quality factors and the resulting image quality changes. The presampled modulation transfer function (MTF) can be useful in determining system resolution characteristics and response reduction caused by certain image quality factors. Although many studies have been conducted to accurately measure the MTF, there is still ample room for investigation of factors that affect the measured MTF for a task-based assessment using a semitransparent edge. In this study, we focus on the effects of scattered radiation from the edge on MTF measurement. The edge enhancement effect confirmed by a previous study is verified using Monte Carlo simulation; influences on the MTF due to air gaps and scattered radiation from objects are investigated. This effect by scattered radiation from an edge is also confirmed in our simulation. The results show that as air gaps change, the effect on the MTF also changes; that is, as air gaps increase, the MTF peak shifts to lower spatial frequencies. When scatter is introduced by adding an object, the MTF obtained using a semitransparent edge in the low spatial frequency is higher than that of the opaque edges for RQA9. Thus, when using such an edge, the X-ray energy should be set such that the K absorption edge of the edge material is not exceeded. Further the experimental geometry, such as air gaps, and the effect of low spatial frequency due to scattered radiation should be considered.

EXPOSURE DOSE INDEX BASED ON NOISE FACTOR ANALYSIS IN DIGITAL MAMMOGRAPHY: VERIFICATION USING DIRECT-TYPE FLAT-PANEL DETECTOR SYSTEM.

In this study, the development of a reasonable index of optimized exposure dose is attempted. Using a direct-type flat-panel system, noise factors contained in the image are analyzed based on the relative standard deviation method, and it is verified that the proposed index conforms with the appropriate standards regarding minimum exposure dose. The findings indicate that Poisson noise is dominant in the general clinical dose range; this noise fraction formed 90% of the total noise in the system considered in this study. Considering the results of previous surveys, it is estimated that the point at which the content rate of the Poisson noise starts to decrease can be considered as the lower limit, below which the dose cannot be reduced further without compromising on image quality. As the 'index' obtained by this method can be easily measured, it is useful as a quantitative indicator for dose determination and optimization.