Technical characterization of five x-ray detectors for paediatric radiography applications.

Physical image quality of five x-ray detectors used in the paediatric imaging department is characterized with the aim of establishing the range/scope of imaging performance provided by these detectors for neonatal imaging. Two computed radiography (CR) detectors (MD4.0 powder imaging plate (PIP) and HD5.0 needle imaging plate (NIP), Agfa HealthCare NV, B-2640 Mortsel, Belgium) and three flat panel detectors (FPD) (the Agfa DX-D35C and DX-D45C and the DRX-2530C (Carestream Health Inc., Rochester, NY 14608, USA)) were assessed. Physical image quality was characterized using the detector metrics given by the International Electrotechnical Commission (IEC 62220-1) to measure modulation transfer function (MTF), the noise power spectrum (NPS) and the detective quantum efficiency (DQE) using the IEC-specified beam qualities of RQA3 and RQA5. The DQE was evaluated at the normal operating detector air kerma (DAK) level, defined at 2.5 µGy for all detectors, and at factors of 1/3.2 and 3.2 times the normal level. MTF curves for the different detectors were similar at both RQA3 and RQA5 energies; the average spatial frequency for the 50% point (MTF0.5) at RQA3 was 1.26 mm-1, with a range from 1.20 mm-1 to 1.37 mm-1. The DQE of the NIP CR compared to the PIP CR was notably greater and similar to that for the FPD devices. At RQA3, average DQE for the FPD and NIP (at 0.5 mm-1; 2.5 µGy) was 0.57 compared to 0.26 for the PIP CR. At the RQA5 energy, the DRX-2530C and the DX-D45C had the highest DQE (~0.6 at 0.5 mm-1; 2.5 µGy). Noise separation analysis using the polynomial model showed higher electronic noise for the DX-D35C and DRX-2530C detectors; this explains the reduced DQE seen at 0.7 µGy/image. The NIP CR detector offers notably improved DQE performance compared to the PIP CR system and a value similar to the DQE for FPD devices at the RQA3 energy.

Staphylococcus saprophyticus bacteremia after ESWL in an immunocompetent woman.

Staphylococcus saprophyticus is a well-known cause of uncomplicated urinary tract infections, especially in young and sexually active women. Presence in blood cultures is rare and often attributed to contamination. When bacteremia is significant, it occurs mostly in patients with hematologic malignancies and is predominantly catheter-related. However, we describe a case of significant bacteremia with S. saprophyticus associated with urinary tract infection after extracorporeal shock wave lithotripsy of an ureterolithiasis in an otherwise healthy patient.