[Subjective Contrast of Pulmonary Tissues in CsI-FPD Chest Radiography Using Model Phantom by Monte Carlo Simulation].

OBJECTIVE: Subject contrast of pulmonary tissues was investigated for five X-ray beams (70 kV without filter, 90 kV with 0.15 mm Cu filter, 90 kV with 0.2 mm Cu filter, 120 kV without filter, and 120 kV with 0.2 mm Cu filter) in CsI-FPD chest radiography using two types of model phantoms by Monte Carlo simulation. METHODS: A total of 72 million photons were entered to the model lung phantom (width, 300 mm; length, 300 mm; thickness, 200 mm; air space, 120 mm) and model mediastinum phantom (width, 300 mm; length, 300 mm; thickness, 200 mm; air space, 40 mm). Individual primary and secondary photon's process (absorption, scattering, and penetration) in the phantom and CsI-detector was recorded by Monte Carlo simulation. Subject contrast was calculated by entered and absorbed photon's number in the CsI-detector. RESULTS: Subject contrast pulmonary tissues were high to low energy X-ray beam; however, the ones of soft tissue and soft tissue overlaying bone had few differences for beam quality except 70 kV without filter. Moreover, the subject contrast by absorbed photons was higher compared to the one by entered photons in CsI. CONCLUSION: It was shown that the subject contrast study by Monte Carlo calculation can be replaced by the way of physical chest phantom, and that the subject contrast by absorbed photons and by injected photons in CsI was different. Furthermore, be verified that the subject contrast of soft tissue and soft tissue overlaying bone differs hardly.

[Study of X-ray Beam Quality and Contrast-to-Noise Ratio of Lung Nodules in Chest FPD Radiography: Monte Carlo Simulation Using Chest Model Phantom].

OBJECTIVES: Contrast-to-noise ratio (CNR) of four X-ray beams (90 kV with 0.15-mm Cu filter, 90 kV with 0.2-mm Cu filter, 120 kV without filter and 120 kV with 0.2-mm Cu filter) in CsI-flat panel detector (FPD) radiography for lung cancer diagnosis was investigated using Monte Carlo simulation. METHOD: Two billion photons were injected to the chest phantom model (width: 300 mm, length: 300 mm, thickness: 200 mm) with imitated lung nodules (10 mm diameter, CT value: +30 Hounsfield unit (HU), -375 HU, and -620 HU). Individual primary and secondary photon's process (absorption, scattering and penetration) in the phantom and CsI-detector was recorded by Monte Carlo simulation. CNR was calculated using primary and secondary absorbed photon's number in the CsI-detector. RESULTS: CNR of 90 kV X-ray beam with 0.15 mm and 0.2 mm Cu filters was higher to 120 kV X-ray beam because of higher primary object contrast and photon's contribution, and high photon's absorption to CsI. CONCLUSION: By Monte Carlo calculation, it was verified that 90 kV X-ray beam with 0.15 mm and 0.2 mm Cu filters yielded higher CNR to 120 kV X-ray beam.

[Optimal Beam Quality in Chest Radiography Using CsI-flat Panel Detector for Detection of Pulmonary Nodules].

OBJECTIVES: Optimal beam quality for detection of pulmonary nodules in digital chest radiography using CsI-flat panel detector (FPD) was investigated in consideration of image quality and patient dose. METHODS: The human chest phantom with inserted imitated nodules (diameter: 10 mm, CT value: +30 Hounsfield unit (HU), -375 HU, -620 HU) was used for the measurement of contrast-to-noise ratio (CNR) of imitated nodules by twenty beams arranged by five tube voltages and four filters. RESULTS: The CNR varies with X-ray tube voltage and added filter. CNR correlates weakly to the tube voltage, fairly to the effective energy in second-order polynomial and strongly to the quality index (effective energy divided X-ray tube voltage). In order to improve the CNR, the effective energy and the quality index are kept about 50 keV and more than 0.5, respectively, using an 80-100 kV beam with a copper filter. CONCLUSION: A 90 kV (2.5 mm Al inherent filtration) beam with a 0.15 mm copper filter and a 90 kV or 100 kV (2.5 mm Al inherent filtration) beam with a 0.2 mm copper filter are appropriate for chest radiography using CsI-FPD.

[Evaluation of 90 kV Beam with 0.15 mm Cu Filter in Chest Radiography Using CsI-flat Panel Detector].

PURPOSE: To compare the visibility of anatomic structure in chest radiography acquired with different beam quality (120 kV beam and 90 kV beam with 0.15 mmCu) using CsI-flat panel detector. METHOD: Pair image obtained by different beam quality of 100 person's chest radiographies which were taken periodical health examination were compared with the visibility of normal structures (pulmonary vessels) and abnormal opacities by two pulmonologists and four radiological technologists. Moreover, the spectrum of the two beam quality were calculated using Monte Carlo simulation. RESULT: Dominant observers gave high score significantly (p<0.01) to the 90 kV beam's image in spite of 20% less dose. Monte Carlo simulation showed that 90 kV beam with 0.15 mmCu were much absorbed primary photon than 120 kV beam to CsI detector, and less absorbed secondary photon. CONCLUSION: The visibility of anatomic structure and abnormal opacities in FPD chest radiography was improved by using the 90 kV beam with 0.15 mmCu than traditional 120 kV beam's chest radiography.

[Invention of Optical Sight in Mobile Radiography with Anti-scatter Grid].

In radiography with anti-scatter grid, it is important to make sure that the X-ray beam direct exactly perpendicular to the grid plane. However, it is so difficult to ensure in mobile radiography. An optical sight to ensure X-ray alignment in mobile radiography with anti-scatter grid was devised. The device measures the X-ray beam angle respect to the grid plane by utilizing collimator-lamp. Computed radiography of water phantom on inclined bedding with anti-scatter grid (6 : 1) were done by aid of devised optical sight 20 times. The result showed that the average alignment error of the radiographies by aid of devised optical sight was within 1°, and the maximum error was<2°.

[Improvement of the Radiographic Contrast in Off-center Radiography with Focused Grid].

In radiography with focused grid, it is important to agree the X-ray center on the grid center. Actually, radiography is often put the off-center alignment which disagrees the X-ray center to the grid center. This misalignment decreases radiographic contrast because of cutoff the primary X-rays. The grid-tilt technique which makes the grid tilt corresponding to the misalignment of the X-ray center and the grid center was investigated. Using solid state dosimeter and 10 cm water phantom, transited dose of focused grids (focal distance 120 cm, grid ratio 6:1 and 8:1) were measured at off-center. The transited dose at 6 cm off-center by conventional manner was lower 20% (6:1) and 30% (8:1) to center's one. While by grid-tilt technique, the transited dose at off-center was same to the center's one. Axial radiography of hip joint was applied by this technique.

[Wrapping of X-ray Cassette by a Plastic Bag in Portable Radiography: For Infection Prevention and Alleviation of Patient's Discomfort].

Portable radiography is available for the patient who is postoperative, severe condition and old. As they have weak immunity, it is important to prevent from hospital infection. Wrapping of 14×14 inch or 14×17 inch X-ray cassette by a plastic (polyethylene) bag a little bit bigger than the cassette was proposed for infection prevention in portable radiography. How to wrap the cassette easily was devised using the sheath of a polyester bag cutting at the bottom. In radiography with the grid, the plastic bag fastens the X-ray grid to the cassette substantially without any other means. In addition, the wrapped cassette, or the cassette with grid covered by the foamed plastic sheet alleviates patient's discomfort.

[Optimal beam quality for chest digital radiography].

To investigate the optimal beam quality for chest computed radiography (CR), we measured the radiographic contrast and evaluated the image quality of chest CR using various X-ray tube voltages. The contrast between lung and rib or heart increased on CR images obtained by lowering the tube voltage from 140 to 60 kV, but the degree of increase was less. Scattered radiation was reduced on CR images with a lower tube voltage. The Wiener spectrum of CR images with a low tube voltage showed a low value under identical conditions of amount of light stimulated emission. The quality of chest CR images obtained using a lower tube voltage (80 kV and 100 kV) was evaluated as being superior to those obtained with a higher tube voltage (120 kV and 140 kV). Considering the problem of tube loading and exposure in clinical applications, a tube voltage of 90 to 100 kV (0.1 mm copper filter backed by 0.5 mm aluminum) is recommended for chest CR.

[Development of unique supporting pad for performing chest radiography on patients in wheelchairs].

Chest radiography is a widely used X-ray inspection. The numbers of patients who use wheelchairs in everyday life has increased in Japan, and their need for radiography has also increased. A unique supporting pad that enables chest radiography for patients in wheelchairs has been developed. This supporting pad applies the force of the patient's weight and the frictional force to hold a cassette on. Performing chest radiography in the wheelchair using the supporting pad reduces the corporal burden of the patient in the wheelchair and the radiological technologist.

[Analysis of patient flow by radiology information system].

HIS (hospital information system) and PACS (picture archiving and communication system) have become widely popular in clinical offices, and use of RIS (radiology information system) in the department of radiology has spread, creating networking between HIS, PACS, and diagnostic systems. RIS receives patient data and order data from HIS and sends them to the diagnostic systems. On the other hand, the RIS sends the implementation record and accounting data to HIS. When receiving and transmitting of these data are done by the RIS, the event's time is recorded in the RIS as attendant data. This paper proposes a way to analyze patient flow from the records of the event's time. The method counts the number of the accepted examinations y(i) (i = 0, 1, ... N) and the completed examinations z(i) every divided time t from the RIS work list, and computes the following three characteristic values related to patient flow. Those values are average expended time T; T = ( Sigma z(i ) i t - Sigma y(i ) i t ) / Sigma y(i) ,number of exam queue q(i); q(i) = Sigma y(i) - Sigma z(i) , and dissolved time of queue w(i); w(i) = q(i ) ( t / z(i) ). The method analyzes patient flow of radiology using these characteristic values. It also performs a simulation of the flow in cases of equipment trouble.

[Radiation dose to the operator's hands during non-vascular radiology involving surgical technique-comparison between under-table method and over-table method].

In non-vascular interventional radiology (IVR) such as percutaneous transhepatic cholangio-drainage (PTCD) and nerve block, the operator's hands are irradiated in primary x-ray field. In Over-table tube fluoroscopy system, operator's hands inevitably are exposed excessively to intensive primary radiation, whereas in the Under-table tube fluoroscopy system, they are irradiated weakly by attenuated radiation through the patient's body. For this reason, the dose to the operator's hands in Under-table tube fluoroscopy is less than in Over-table tube fluoroscopy. This paper proposes general formulas for estimating the absorbed dose on the operator's hands in two types of fluoroscopy. The formulas include factors affecting the absorbed dose on the operator's hand; distance from source to the operator's hands, x-ray transmittance of the patient and patient's bed, and back-scatter factor of the patient. Absorbed dose to imitated operator's hand was measured and estimated by formulas in two types of fluoroscopy for various phantom thicknesses and two field sizes using an ionization chamber. The difference between estimated absorbed dose and measured absorbed dose was less than 10%.