[Influence of interest region and interest value settings on exposure index-analysis using chest clinical images].

With the digitization of general radiography, there are some concerns about an increase in radiation exposure doses. Therefore, the exposure index (EI) as a new dose index was proposed in 2008 by IEC. However, the settings for the interest region and the interest value in the clinical image do not show concrete prescribed values. Therefore, we inspected the distribution of EI by changing the interest region and the interest value for a standing-position chest radiograph image in students' medical examinations. EI50f, which is generally used, fluctuated between 41 and 136. In addition, as the area of the interest region became smaller, EI increased and the variation index increased. For the interest value, 50% (EI50h) was smaller than 85% (EI85h), and the variation index was also smaller. EI was not the absolute value in the clinical image, and immediate display of the deviation index (DI) with target exposure index (EIT) was effective of the adequacy of the radiography condition.

[Usefulness of a grid using fiber interspace material].

We had the opportunity to employ an anti-scatter grid, which uses fiber as the interspace material. The X-ray transmission rate of fiber is higher than aluminum, so we predicted that the use of a fiber grid would reduce radiation exposure. The purpose of this study was to evaluate the usefulness of the fiber grid. The physical characteristics and influence of focus-grid decentering were compared between the fiber grid and three kinds of antiscatter grids that use aluminum as the interspace material (Al grid). The contrast improvement factor and selectivity of the fiber grid was higher than the Al grid, and the Bucky factor of the fiber grid was lower. The interspace material and grid ratio also influenced focus-grid decentering. The results of this study suggest the potential for reduction of radiation exposure by the use of a fiber grid.

[Study of appropriate dosing in consideration of image quality and patient dose on the digital radiography].

Recently about 90% of radiographs have been taken by the digital radiographic system in Japan, but the exposure dose of the patients are about ten-times different among the systems. We understood it by a surveytaken in 2007. We studied the visual evaluation with varying exposure doses using the image phantom of the lumber AP, lumber lateral and hip AP. Additionally we measured quantum efficiency (DQE) of the digital systems. We also studied the exposure index (EI) of IEC standard to see whether it is able to be the sensitivity index among the digital systems. DQE in 1.0 cycle/mm of CR, FPD (GOS), FPD (CsI, a-Se) became 0.2-0.25, 0.3, 0.5, respectively. Our results display that the dose reduction is relative to DQE. The visual evaluation results also show that dose reduction is possible among the systems. From these results, we are able to reduce the exposure dose of the patients at the clinical site. We also suggest that we manage the exposure dose using the E.I of the IEC standard.

[Characteristic evaluation and clinical usefulness of dose area product meter at radiography].

Philips DigitalDiagnost, a digital radiographic system mounting flat panel detector (FPD), can display dose area data (DiDi dose) calculated by examination parameters. We evaluated its fundamental characteristics and compared the values of DiDi dose andactual measured data obtained by the area dose product meter (PD-4100L). Tendency of varied values of mAs, X-ray tube values and exposure area from both the area dose product meter and the DiDi dose were coincided. Further, in clinical images of chest PA 100 cases, chest lateral 50 cases and abdomen stand 25 cases, the determination coefficient was overly high as R(2)=0.99. Based on these results, it is clear that the DiDi dose can be treated the same as the area dose product meter. Under increasing of patient X-ray exposure dose is a concern in digital general radiography, this research indicates that maximum values of histogram obtained by DiDi dose contributes dose awareness for radiographer.

Prevalence, factors, and clinical impact of self-expanding stent fractures following iliac artery stenting.

PURPOSE: To evaluate the prevalence, factors, and clinical impact of self-expanding stent fracture following iliac artery stenting. MATERIALS AND METHODS: A review of the endovascular registry database for our department showed 353 patients with occlusive diseases of the iliac artery who underwent stenting between 1997 and 2007. While clinical data and images were retrospectively reviewed for all patients, 165 patients who underwent self-expanding stenting and plain radiograph with >or=6-months follow-up were analyzed. Mean follow-up was 43 months for 305 stents (elgiloy, n = 83; nitinol, n = 222) implanted in 216 iliac arteries. The mean duration until the last imaging study was 38 months. Items concerning prevalence of stent fracture, factors associated with fracture, and outcomes for patients with stent fracture were analyzed. RESULTS: Stent fracture was detected in 11 of 216 iliac arteries (5.1%). In stent-based analysis, 11 of 305 stents (3.6%) showed stent fracture, classified as type I in 2 stents, type II in 3 stents, type III in 4 stents, type IV in 1 stent, and type V in 1 stent. Stent fracture was detected in 11 of 222 nitinol stents (5.0%), but no Elgiloy stents. Cox proportional hazards regression model indicated stenting for chronic occlusion as a risk factor associated with nitinol stent fracture (hazard ratio [HR] = 6.09, P = 0.008, 95% confidence interval [CI] 1.59-23.3). Cumulative primary patency rates in iliac arteries with and without fractured stents were 90% and 91% at 8 years (P = .80), respectively. CONCLUSION: Fracture of self-expanding stents is rare in iliac arteries, but stenting for chronic occlusion represents a risk factor for fracture. Fractures of stents placed in iliac arteries rarely affect patency.