Impact of Image Enhancement on the Radiomics Stability of Diffusion-Weighted MRI Images of Cervical Cancer.

The diffusion-weighted imaging (DWI) technique is known for its capability to differentiate the diffusion of water molecules between cancerous and non-cancerous cervix tissues, which enhances the accuracy of detection. Despite the potential of DWI-MRI, its accuracy is limited by technical factors influencing in vivo data acquisition, thus impacting the quantification of radiomics features. This study aimed to measure the radiomics stability of manual and semi-automated segmentation on contrast limited adaptive histogram equalization (CLAHE)-enhanced DWI-MRI cervical images. Eighty diffusion-weighted MRI images were obtained from patients diagnosed with cervical cancer, and an active contour model was used to analyze the data. Radiomics analysis was conducted to extract the first statistical order, shape, and textural features with intraclass correlation coefficient (ICC) measurement. The results of the CLAHE segmentation approach showed a marked improvement when compared to the manual and semi-automated segmentation methods, with an ICC value of 0.990 ± 0.005 (p<0.05), compared to 0.864 ± 0.033 (p<0.05) and 0.554 ± 0.185 (p>0.05), respectively. The CLAHE segmentation displayed a higher level of robustness than the manual groups in terms of the features present in both categories. Thus, CLAHE segmentation is owing to its potential to generate radiomics features that are more durable and consistent.

Bibliometric Review of Optimization and Image Processing of Positron Emission Tomography (PET) Imaging System between 1981-2022.

BACKGROUND: PET scan stands as a valuable diagnostic tool in nuclear medicine, enabling the observation of metabolic and physiological changes at a molecular level. However, PET scans have a number of drawbacks, such as poor spatial resolution, noisy images, scattered radiation, artifacts, and radiation exposure. These challenges demonstrate the need for optimization in image processing techniques. OBJECTIVES: Our objective is to identify the evolving trends and impacts of publication in this field, as well as the most productive and influential countries, institutions, authors, themes, and articles. METHODS: A bibliometric study was conducted using a comprehensive query string such as "positron emission tomography" AND "image processing" AND optimization to retrieve 1,783 publications from 1981 to 2022 found in the Scopus database related to this field of study. RESULTS: The findings revealed that the most influential country, institution, and authors are from the USA, and the most prevalent theme is TOF PET image reconstruction. CONCLUSION: The increasing trend in publication in the field of optimization of image processing in PET scans would address the challenges in PET scan by reducing radiation exposure, faster scanning speed, as well as enhancing lesion identification.

Impact of age and breast thickness on mean glandular dose of standard digital mammography and digital breast tomosynthesis.

This study compares the mean glandular dose (MGD) across 2D, 3D projection and Contrast-Enhanced Digital Mammography (CEDM) mammographic techniques. The important metadata were extracted from the digital mammography console. 650 subjects were clustered based on projections, age and CBT. The MGD of 2D, 3D, and CEDM was positively correlated with CBT but inversely correlated with the age factor. This study indicate MGD of CEDM was 16% and 22% lower compared to 2D and 3D techniques, respectively.

Estimating Local Diagnostic Reference Levels for Mammography in Dubai.

As the total volume of mammograms in Dubai is increasing consistently, it is crucial to focus on the process of dose optimization by determining dose reference levels for such sensitive radiographic examinations as mammography. This work aimed to determine local diagnostic reference levels (DRLs) for mammography procedures in Dubai at different ranges of breast thickness. A total of 2599 anonymized mammograms were randomly retrieved from a central dose survey database. Mammographic cases for screening women aged from 40 to 69 years were included, while cases of breast implants and breast thickness outside the range of 20-100 mm were excluded. Mean, median, and 75 percentiles were obtained for the mean glandular dose (MGD) distribution of each mammography projection for all compressed breast thickness (CBT) ranges. The local DRLs for mammography in Dubai were found to be between 0.80 mGy and 0.82 mGy for the craniocaudal (CC) projection and between 0.89 mGy and 0.971.8 mGy for the mediolateral oblique (MLO) projection. Local DRLs were proposed according to different breast thicknesses, starting from 20 to 100 mm. All groups of CBT showed a slight difference in MGD values, with higher values in MLO views rather than CC views. The local DRLs in this study were lower than some other Middle Eastern countries and lower than the standard reference levels reported by the International Atomic Energy Agency (IAEA) at 3 mGy/view.

CT Reconstruction Algorithm and Low Contrast Detectability of Phantom Study: A Systematic Review and Meta-Analysis.

BACKGROUND: For almost three decades, computed tomography (CT) has been extensively used in medical diagnosis, which led researchers to conduct linking of CT dose exposure with image quality. METHODS: In this study, a systematic review and a meta-analysis study were conducted on CT phantom for resolution study especially based on the low contrast detectability (LCD). Furthermore, the association between the CT parameter such as tube voltage and the type of reconstruction algorithm, the amount of phantom scanning affecting the image quality and the exposure dose were also investigated in this study. We utilize PubMed, ScienceDirect, Google Scholar and Scopus databases to search related published articles from the year 2011 until 2020. The notable keywords comprise "computed tomography", "CT phantom", and "low contrast detectability". Of 52 articles, 20 articles are within the inclusion criteria in this systematic review. RESULTS: The dichotomous outcomes were chosen to represent the results in terms of risk ratio as per meta-analysis study. Notably, the noise in iterative reconstruction (IR) reduced by 24%, 33% and 36% with the use of smooth, medium and sharp filters, respectively. Furthermore, adaptive iterative dose reduction (AIDR 3D) improved image quality and the visibility of smaller less dense objects compared to filtered back-projection. Most of the researchers used 120 kVp tube voltage to scan phantom for quality assurance study. CONCLUSION: Hence, optimizing primary factors such as tube potential reduces the dose exposure significantly, and the optimized IR technique could substantially reduce the radiation dose while maintaining the image quality.

Microstructure and Superconducting Properties of Bi-2223 Synthesized via Co-Precipitation Method: Effects of Graphene Nanoparticle Addition.

The effects of graphene addition on the phase formation and superconducting properties of (Bi1.6Pb0.4)Sr2Ca2Cu3O10 (Bi-2223) ceramics synthesized using the co-precipitation method were systematically investigated. Series samples of Bi-2223 were added with different weight percentages (x = 0.0, 0.3, 0.5 and 1.0 wt.%) of graphene nanoparticles. The samples' phase formations and crystal structures were characterized via X-ray diffraction (XRD), while the superconducting critical temperatures, Tc, were investigated using alternating current susceptibility (ACS). The XRD showed that a high-Tc phase, Bi-2223, and a small low-Tc phase, Bi-2212, dominated the samples. The volume fraction of the Bi-2223 phase increased for the sample with x = 0.3 wt.% and 0.5 wt.% of graphene and slightly reduced at x = 1.0 wt.%. The ACS showed that the onset critical temperature, Tc-onset, phase lock-in temperature, Tcj, and coupling peak temperature, TP, decreased when graphene was added to the samples. The susceptibility-temperature (χ'-T) and (χ″-T) curves of each sample, where χ' and χ″ are the real and imaginary parts of the susceptibility, respectively, were obtained. The critical temperature of the pure sample was also measured.

Local Diagnostic Reference Levels for Full-Field Digital Mammography and Digital Breast Tomosynthesis in a Tertiary Hospital in Malaysia.

A set of national diagnostic reference levels (DRLs) was established in Malaysia for a range of breast thicknesses in 2013, but no updates for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT). Due to the increasing number of DBTs used and concern over radiation exposure, this study aimed to explore and establish local diagnostic reference levels for FFDM and DBT in Malaysia health facilities at different compressed breast thickness (CBT) ranges. The CBT, kilovoltage peak (kVp), Entrance surface dose (ESD), and average glandular dose (AGD) were retrospectively extracted from the mammography Digital Imaging and Communications in Medicine (DICOM) header. The 75th and 95th percentile values were obtained for the AGD distribution of each mammography projection for three sets of CBT range. The difference in AGD values between FFDM and DBT at three CBT ranges was determined. The DRLs for FFDM were 1.13 mGy, 1.52 mGy, and 2.87 mGy, while DBT were 1.18 mGy, 1.88 mGy, and 2.78 mGy at CBT ranges of 20−39 mm, 40−59 mm, and 60−99 mm, respectively. The AGD of DBT was significantly higher than FFDM for both mammographic views (p < 0.005). All three CBT groups showed a significant difference in AGD values for FFDM and DBT (p < 0.005). The local DRLs from this study were lower than the national DRLs, with the AGD of FFDM significantly lower than DBT.

Mechanical and Imaging Properties of a Clinical-Grade Kidney Phantom Based on Polydimethylsiloxane and Elastomer.

Medical imaging phantoms are considered critical in mimicking the properties of human tissue for calibration, training, surgical planning, and simulation purposes. Hence, the stability and accuracy of the imaging phantom play a significant role in diagnostic imaging. This study aimed to evaluate the influence of hydrogen silicone (HS) and water (H2O) on the compression strength, radiation attenuation properties, and computed tomography (CT) number of the blended Polydimethylsiloxane (PDMS) samples, and to verify the best material to simulate kidney tissue. Four samples with different compositions were studied, including samples S1, S2, S3, and S4, which consisted of PDMS 100%, HS/PDMS 20:80, H2O/PDMS 20:80, and HS/H2O/PDMS 20:40:40, respectively. The stability of the samples was assessed using compression testing, and the attenuation properties of sample S2 were evaluated. The effective atomic number of S2 showed a similar pattern to the human kidney tissue at 1.50 × 10-1 to 1 MeV. With the use of a 120 kVp X-ray beam, the CT number quantified for S2, as well measured 40 HU, and had the highest contrast-to-noise ratio (CNR) value. Therefore, the S2 sample formulation exhibited the potential to mimic the human kidney, as it has a similar dynamic and is higher in terms of stability as a medical phantom.

Stability and Reproducibility of Radiomic Features Based Various Segmentation Technique on MR Images of Hepatocellular Carcinoma (HCC).

Hepatocellular carcinoma (HCC) is considered as a complex liver disease and ranked as the eighth-highest mortality rate with a prevalence of 2.4% in Malaysia. Magnetic resonance imaging (MRI) has been acknowledged for its advantages, a gold technique for diagnosing HCC, and yet the false-negative diagnosis from the examinations is inevitable. In this study, 30 MR images from patients diagnosed with HCC is used to evaluate the robustness of semi-automatic segmentation using the flood fill algorithm for quantitative features extraction. The relevant features were extracted from the segmented MR images of HCC. Four types of features extraction were used for this study, which are tumour intensity, shape feature, textural feature and wavelet feature. A total of 662 radiomic features were extracted from manual and semi-automatic segmentation and compared using intra-class relation coefficient (ICC). Radiomic features extracted using semi-automatic segmentation utilized flood filling algorithm from 3D-slicer had significantly higher reproducibility (average ICC = 0.952 ± 0.009, p < 0.05) compared with features extracted from manual segmentation (average ICC = 0.897 ± 0.011, p > 0.05). Moreover, features extracted from semi-automatic segmentation were more robust compared to manual segmentation. This study shows that semi-automatic segmentation from 3D-Slicer is a better alternative to the manual segmentation, as they can produce more robust and reproducible radiomic features.

Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia.

Pediatrics are more vulnerable to radiation and are prone to dose compared to adults, requiring more attention to computed tomography (CT) optimization. Hence, diagnostic reference levels (DRLs) have been implemented as part of optimization process in order to monitor CT dose and diagnostic quality. The noise index has recently been endorsed to be included as a part of CT optimization in the DRLs report. In this study, we have therefore set local DRLs for pediatric CT examination with a noise index as an indicator of image quality. One thousand one hundred and ninety-two (1192) paediatric patients undergoing CT brain, CT thorax and CT chest-abdomen-pelvis (CAP) examinations were analyzed retrospectively and categorized into four age groups; group 1 (0-1 year), group 2 (1-5 years), group 3 (5-10 years) and group 4 (10-15 years). For each group, data such as the volume-weighted CT dose index (CTDIvol), dose-length product (DLP) and the effective dose (E) were calculated and DRLs for each age group set at 50th percentile were determined. Both CT dose and image noise values between age groups have differed significantly with p-value < 0.05. The highest CTDIvol and DLP values in all age groups with the lowest noise index value reported in the 10-15 age group were found in CT brain examination. In conclusion, there was a significant variation in doses and noise intensity among children of different ages, and the need to change specific parameters to fit the clinical requirement.

Establishment of CTPA Local Diagnostic Reference Levels with Noise Magnitude as a Quality Indicator in a Tertiary Care Hospital.

This study aimed to establish the local diagnostic reference levels (LDRLs) of computed tomography pulmonary angiography (CTPA) examinations based on body size with regard to noise magnitude as a quality indicator. The records of 127 patients (55 males and 72 females) who had undergone CTPAs using a 128-slice CT scanner were retrieved. The dose information, scanning acquisition parameters, and patient demographics were recorded in standardized forms. The body size of patients was categorized into three groups based on their anteroposterior body length: P1 (14-19 cm), P2 (19-24 cm), and P3 (24-31 cm), and the radiation dose exposure was statistically compared. The image noise was determined quantitatively by measuring the standard deviation of the region of interest (ROI) at five different arteries-the ascending and descending aorta, pulmonary trunk, and the left and right main pulmonary arteries. We observed that the LDRL values were significantly different between body sizes (p < 0.05), and the median values of the CT dose index volume (CTDIvol) for P1, P2, and P3 were 6.13, 8.3, and 21.40 mGy, respectively. It was noted that the noise reference values were 23.78, 24.26, and 23.97 HU for P1, P2, and P3, respectively, which were not significantly different from each other (p > 0.05). The CTDIvol of 9 mGy and dose length product (DLP) of 329 mGy∙cm in this study were lower than those reported by other studies conducted elsewhere. This study successfully established the LDRLs of a local healthcare institution with the inclusion of the noise magnitude, which is comparable with other established references.

Association of Radiation Doses and Cancer Risks from CT Pulmonary Angiography Examinations in Relation to Body Diameter.

In this study, we aimed to estimate the probability of cancer risk induced by CT pulmonary angiography (CTPA) examinations concerning effective body diameter. One hundred patients who underwent CTPA examinations were recruited as subjects from a single institution in Kuala Lumpur. Subjects were categorized based on their effective diameter size, where 19-25, 25-28, and >28 cm categorized as Groups 1, 2, and 3, respectively. The mean value of the body diameter of the subjects was 26.82 ± 3.12 cm, with no significant differences found between male and female subjects. The risk of cancer in breast, lung, and liver organs was 0.009%, 0.007%, and 0.005% respectively. The volume-weighted CT dose index (CTDIvol) was underestimated, whereas the size-specific dose estimates (SSDEs) provided a more accurate description of the radiation dose and the risk of cancer. CTPA examinations are considered safe but it is essential to implement a protocol optimized following the As Low as Reasonably Achievable (ALARA) principle.

Effect of miscentering and low-dose protocols on contrast resolution in computed tomography head examination.

BACKGROUND: Unoptimized protocols, including a miscentered position, might affect the outcome of diagnostic in CT examinations. In this study, we investigate the effects of miscentering position during CT head examination on the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). METHOD: We simulate the CT head examination using a water phantom with a standard protocol (120 kVp/180 mAs) and a low dose protocol (100 kVp/142 mAs). The table height was adjusted to simulate miscentering by 5 cm from the isocenter, where the height was miscentered superiorly (MCS) at 109, 114, 119, and 124 cm, and miscentered inferiorly (MCI) at 99, 94, 89, and 84 cm. Seven circular regions of interest were used, with one drawn at the center, four at the peripheral area of the phantom, and two at the background area of the image. RESULTS: For the standard protocol, the mean CNR decreased uniformly as table height increased and significantly differed (p < 0.05) at +20 cm for MCS (435.70 ± 9.39) and -20 cm for MCI (438.91 ± 10.94) from the isocenter. Similarly, significant reductions (p < 0.05) were also noted for SNR for MCS (at +20 cm) and MCI (at -20 cm). For the low dose protocol, both CNR and SNR were significantly reduced (p < 0.05) at table heights of +20 and -20 cm from the isocenter. CONCLUSION: Miscentering is proven to significantly affect the image quality in both low and standard dose protocols for head CT procedure. This study implies that accurate patient centering is one of the approaches that can improve CT optimization practice.