Analysis of the trend of radiological diagnostic examination frequency and the related influencing factors / 中华放射医学与防护杂志

Objective:To investigate the trend of radiological diagnostic examination frequency and the related influencing factors in a general hospital in recent four years.Methods:The hospital information system and the radiology information system were used to collect the information on the numbers of the outpatients, the emergency patients, and the inpatients and the radiology examination information from 2019 to 2022. The examination frequency and proportion of various imaging equipment were counted by using the perspective table of data, and the examination items and the proportion of the radiological diagnostic examinations were calculated. The positive rates of the radiological examinations were measured from 2019 to 2022. The gender and age distribution of the patients were analyzed. Spearman correlation analysis was used to analyze the relationships between the numbers of the patients undergoing radiological examinations and the numbers of the outpatients, emergency patients and the inpatients.Results:The annual frequency of radiological diagnostic examinations from 2019 to 2022 were 307 306, 245 418, 317 250 and 325 625, respectively, with a total of 1 195 599. Among them, the proportions of CT, X-rays, bedside X-rays, bone density, gastrointestinal imaging and mammography were 59.74%, 38.04%, 1.39%, 0.42%, 0.21% and 0.19%, respectively. In each year, the proportion of CT in all radiological diagnostic examinations was 49.58%, 63.40%, 60.40% and 65.20%, respectively. The frequency of emergency CT and emergency chest CT was correlated with the number of emergency patients( r =0.63, 0.61, P<0.05), and the frequency of non-emergency CT was correlated with the number of outpatients and inpatients ( r =0.61, 0.66, P<0.05). The positive rates of the CT examinations were higher than 80% except the lowest of 79.95% in 2021. Conclusions:Radiological examinations especially CT examinations have increased significantly, and played an important role in the diagnosis of diseases. However, attention should be paid to the Justification of the CT examinations. Timely statistical analysis of radiological examination information can provide data supports and references for scientific management of radiological examinations.

Study on the effect of virtual grid on chest X-ray image quality / 中华放射学杂志

Objective:To explore the image quality and its evaluation method using virtual grid under different tube voltages in the clinical chest X-ray exam.Methods:According to the conditions of chest X-ray photography commonly used in clinical practice, the corresponding thickness of plexiglass (20 cm, including CDRAD phantom) was determined as the experimental object. With a fixed tube loading of 4 mAs and the tube voltage from 60 to 125 kV, the experimental object was imaged in three ways: physical grid, none grid and virtual grid. The common physical parameters (CNR, σ, C, SNR), texture analysis (Angular second moment, texture Contrast, Correlation, Inverse difference moment, Entropy) and CDRAD phantom score (IQF inv) were evaluated. Two-way ANOVA test was used for each group of common physical parameters, and further pairwise comparisons were made. At the same time, applying virtual grids on the obtained images with chest anthropomorphic model and texture indexing the images with and without virtual grids, then rank sum test of paired sample can be conducted. Results:There were differences in image quality among the three groups of grid mode( P<0.05), and the physical grid delivered the best image quality. The tube voltage had an impact on all image quality evaluation indexes ( P<0.05). The tube voltage was positively correlated with CNR, SNR, angular second moment, inverse difference moment and IQF inv ( P<0.05), and negatively correlated with σ, C, texture contrast and entropy ( P<0.05). There was no significant correlation between the tube voltage and Correlation ( P>0.05). The chest anthropomorphic model images were used to evaluate the virtual grids, and the texture indexes (Angle second moment, Contrast, Correlation, Inverse difference moment, Entropy) were statistically significant (P<0.05). Conclusions:The virtual grid can improve the image quality of chest X-ray photography, and the image texture analysis method can be a useful supplement to the image quality evaluation parameters.

The effect of CT detector width and signal acquisition positions on image quality / 中华放射学杂志

Objective:To evaluate the influence of different detector widths and signal acquisition positions of wide-detector CT in different scanning modes on CT number and noise, and to provide a basis for reasonable selection of scanning modes and related parameters in clinical practice.Methods:The body dose phantom was scanned by GE Revolution CT. The scan was performed with detector widths of 40, 80 and 160 mm in sequential scanning mode and with detector width/pitch combinations of 40 mm/0.516, 40 mm/0.984, 80 mm/0.508 and 80 mm/0.992 in spiral scanning mode. The phantom was placed at the central and peripheral of the selected detector widths, and the adjacent positions between two axial scans. The images of the phantom were evaluated subjectively and the CT numbers and SDs were measured. The differences between the measured values at different imaging parameters were compared. The multi-group Friedman test was used to compare CT numbers and SD under different scanning parameters in sequential scanning mode, and the Wilcoxon test was used to compare CT numbers and SD in spiral scanning mode.Results:There was no statistically significant difference in the geometric shapes of the phantom images obtained at any combination of parameters. In sequential scanning mode, the differences at different detector widths were statistically significant (χ 2=14.00, P=0.001) with CT numbers at 40 mm and 160 mm greater than CT numbers at 80 mm ( P<0.05). The differences at different signal acquisition positions were statistically significant (χ 2=12.04, P=0.002) with CT numbers at peripheral and adjacent greater than CT numbers at central ( P<0.05). In spiral scanning mode CT numbers at detector width at 80 mm were greater than CT numbers at 40 mm ( Z=-2.10, P=0.036). For SD, the differences at different detector widths were statistically significant in sequential scanning modes (χ 2=8.17, P=0.017) with SD at 160 mm greater than SD at 80 mm ( P<0.05). The differences at different signal acquisition positions were statistically significant (χ 2=13.50, P=0.001) with SD at peripheral greater than SD at central ( P<0.05). In spiral scanning mode SDs at pitches 0.984 and 0.992 were greater than SDs at 0.516 and 0.508 ( Z=-2.66, P=0.008). There were no significant differences among other groups. Conclusion:The selection of scanning mode, detector width and signal acquisition position of wide-detector CT will affect the image CT numbers and SDs.

Effect of neck CT arteriovenous simultaneous enhancement methods on image quality and radiation dose / 中华放射学杂志

Objective:To investigate the feasibility of simultaneous arteriovenous enhancement of neck CT with two-stage injection of contrast agent and its effect on image quality and radiation dose.Methods:A total of 30 patients undergoing neck CT enhancement scan due to space-occupying lesions in Beijing Tongren Hospital, Capital Medical University from February to April 2022 were prospectively included as the experimental group. The neck CT enhancement scan was performed with two-stage injection of contrast agent and arteriovenous simultaneous enhancement. The dosage of contrast agent was calculated according to the patient′s body weight, and the method of two-stage injection was adopted. The dosage of contrast agent in the first stage was 0.7 ml/kg, with normal saline in the middle stage, and the second stage (began at 35 s) was 0.3 ml/kg. A total of 30 patients with gender and age matching with the experimental group from December 2021 to January 2022 were retrospectively collected as the control group. The control group was treated with the traditional arterial phase and venous phase scanning method with the dosage of 1.0 ml/kg contrast agent. The arterial phase was scanned at the 30 s and the venous phase was scanned at the 60 s. The CT values of bilateral carotid arteries and jugular veins in the experimental group were measured, the CT values of bilateral carotid arteries in the arterial phase were measured in the control group, and the CT values of bilateral carotid arteries and jugular veins in the venous phase were measured. Carotid artery enhancement score was performed for images of experimental group and control group in arterial and venous phase, and jugular vein and lesion enhancement score was performed for images of experimental group and control group in venous phase. The effective dose was calculated for both groups. The difference of carotid artery CT values between images was compared by one-way analysis of variance, and LSD method was used for pairwise comparison. The CT values of jugular vein were compared using independent sample t test. Kruskal-Wallis test was used to compare carotid artery enhancement scores, and Nemenyi method was used for pairwise comparison. Jugular vein and lesion enhancement scores and effective dose were compared by Mann-Whitney U test. Results:The CT value of carotid artery of experimental group [left (276±24) HU, right (273±25) HU] was lower than that of control group in arterial phase [left (329±33) HU, right (327±32) HU], and higher than that in the venous phase [left (147±15) HU, right (148±16) HU]. All the differences were statistically significant ( P<0.001). The CT value of jugular vein of experimental group [left (206±18) HU, right (203±19)] was higher than that of control group in the venous phase [left (154±15) HU, right (151±15)], the difference was statistically significant ( t=11.88, 11.76, both P<0.001). There was no significant difference in carotid artery enhancement score between experimental group and control group in arterial phase ( P=0.624), but the carotid artery enhancement score of the experimental group was higher than that of the control group in the venous phase, and the difference was statistically significant ( P<0.001). The scores of jugular vein and lesion enhancement in experimental group were higher than those of control group in venous phase, and the difference was statistically significant ( Z=5.01, P<0.001). The effective dose of the experimental group [2.41(2.04, 2.72) mSv] was decreased by 52.2% compared with the control group [5.04(4.18, 5.44) mSv], and the difference was statistically significant ( Z=-6.24, P<0.001). Conclusions:The neck CT enhanced scan with two-stage injection of contrast agent and arteriovenous simultaneous enhancement method can obtain comprehensive images of arterial and venous phases, and realize simultaneous enhancement of carotid artery, jugular vein and lesions, and reduce radiation dose.

Preliminary imaging study on the distribution of female Volumetric Breast Density / 中华放射医学与防护杂志

Objective:To describe the distribution of volumetric breast density(VBD) in different ages of Chinese women based on X-ray mammograms.Methods:Based on mammographic images of 1 140 patients from January 2010 to December 2016 in a hospital in Beijing, the VBD of women was assessed by Volpara 1.5.1 and graded according to breast imaging reporting and data system published by American College of Radiology. The patients were divided into two groups according to the median age, and the two independent samples t-test was used to compare them. The patients were also divided into four groups according to age ( <40 years, 40-49 years, 50-59 years, ≥ 60 years), and the breast thickness, breast volume, glandular volume, and VBD were compared using a One-way ANOVA analysis. Results:The median age was 50 years. The compressed breast thickness and breast volume in patients over 50 years were significantly higher than those in patients below 50 years ( t= -8.99, -7.92, P<0.001), while glandular volume and VBD were significantly lower than those below 50 years ( t= 8.11, 18.49, P<0.001). The compressed breast thickness, breast volume, glandular volume, and VBD were statistically significant different among four groups ( F=27.10, 22.34, 25.70, 122.03, P<0.001). Patients over 60 years had the lowest VBD ( t=-12.56, -15.27, -4.57, P<0.001). VBD was negatively correlated with ages ( r=0.47, P<0.001). Conclusions:The compressed breast thickness and breast volume increased with ages, while the glandular volume and VBD decreased with ages.

Study of the application of low tube potemtial scanning in dacryocystography CT / 中华放射医学与防护杂志

Objective:To investigate the feasibility of the application of low tube potential scanning in dacryocystography CT.Methods:The mixture of iohexol and saline with the ration of 1∶3 as the dacryocyst was set on the nose wing of the head-neck phantom. The phantom was scanned at 80, 100, 120, 140 kV with appropriate mAs to set the volume CT dose index(CTDI vol)at 10, 15, 20, 25, 30, 35 or 40 mGy. All the images were objectively evaluated to find out the optimal scanning parameters of 80 kV/240 mAs with the same contrast-to-noise ratio(CNR)of conventional scanning condition of 120 kV/180 mAs. A total of 62 patients who conducted dacryocystography CT in Beijing Tongren Hospital from November 2019 to July 2020 were prospectively selected. They were randomly divided equally into conventional scanning group with 120 kV/180 mAs and low tube potential group with 80 kV/240 mAs. The CT number, noise (SD) and contrast-to-noise ratio (CNR) of the two groups were measured as the objective evaluation indicators of image quality. The subjective evaluation was performed by two senior radiologists using a double-blind method and a 5-scale system evaluation. Results:For the phantom study, the CNR was positively correlated with CTDI vol under the same tube potential ( r=0.985, 0.965, 0.971, 0.972, P < 0.05). With the same CNR, the radiation dose decreased with lower tube potential. Under the conventional scanning parameters of 120 kV/180 mAs, the CNR was 27.8. At the same CNR, the optimal scanning parameters were 80 kV/240 mAs. For the clinical study, the CTDI vol of conventional scanning group and low tube potential group were 31.2 and 12.8 mGy respectively, 59% decreased in low tube potential group. There were statistically significant differences in CT number of dacryocyst area, CT number of orbital fat area and noise between the two groups ( t=-3.476, 2.601, -5.704, P < 0.05). There was no statistically significante difference in CNR between 2 groups( P>0.05). Two observers had a good consistency ( Kappa >0.75). There was no statistically significante difference in subjective rating between 2 groups( P>0.05). Conclusions:Low tube potential scanning could obtain satisfactory image quality in dacryocystography CT at much lower radiation dose.

Influence of CT scanning mode on the variability of radiation dose measurements of superficial organs / 中华放射医学与防护杂志

Objective:To investigate the uncertainty of the dose measurements of superficial organs and the image noise in CT scanning.Methods:GE Revolution CT was used to perform 20 repeated scans on the isolated skull specimen in sequential and helical mode. The chest phantom was scanned for 45 times with the pitch 1.0 and the collimation 80 mm for two scanners (GE Revolution CT, Philips Brilliance iCT) and 40 mm for the Siemens Somatom Definition Flash CT. The volume CT dose index (CTDI vol) was maintained during the above scannings. A dosimeter was used to measure the dose at the position of the right eye lens of the specimen and the center of right breast of the chest phantom. The position of dosimeter sensor remained unchanged. The standard deviation of CT values (image noise) in the air region of cross-sectional images at the center of the sensor reconstructed with lung/soft tissue algorithms were measured. The mean values ( Av), standard deviations ( SD), coefficients of variation ( CV) and relative ranges ( RR) of the dosimetric values and the standard deviations of CT values of 3, 5, 10, 20, 30 and 45 scans were calculated. Pearson and Spearman correlation analysis were used to evaluate the correlation between the dosimetric values and the standard deviations of CT values. Results:The measured dosimetric values of the skull specimen were almost unchanged in the sequential scannings. The relative range of dose in helical mode was 10.67%. The relative ranges of the measured values of the three CT scanners for 45 scans reached 43.83%, 25.31%, and 14.32%. The standard deviations of CT values of the lung/soft tissue images varied greatly and the differences were not completely related to the dosimetric values.Conclusions:The dosimetric values of superficial organs were stable in the sequential scanning mode. The dose measurements of superficial organs and the image noise changed greatly in helical scanning mode.

A study for tube current exposure time products and image quality in digital mammography / 中华放射学杂志

Objective:To investigate the relationship between current-exposure time products (mAs) and image quality in digital mammography.Methods:The CDMAM phantom of 2 to 7 cm thickness were exposed by manual exposure modes using Mo-Rh anode-filer combinations. The exposure parameters were set as follows: (2 cm, 27 kVp, 10 to 90 mAs); (3 cm, 29 kVp, 20 to 120 mAs); (4 cm, 29 kVp, 20 to 200 mAs); (5 cm, 30 kVp, 40 to 220 mAs); (6 cm, 31 kVp, 40 to 260 mAs); (7 cm, 32 kVp, 80 to 280 mAs). The image quality figure (IQF), contrast to noise ratio (CNR), figure of merit (FOM) and the average glandular dose (AGD) were obtained from images. The optimum filtration and kVp for each breast thickness was found from the calculated FOMs. The optimum mAs for each breast thickness were found from the calculated FOMs and IQFs. And the Pearson correlation analysis was used to analyze the correlations among AGD, CNR and IQF.Results:With the increase of mAs, the average glandular dose were linearly increased, and the FOM first increased and then decreased or changed slowly. The AGD, CNR and IQF were significantly correlated when the compression thickness was less than 7 cm ( r all>0.87, P<0.05). The optimized exposure parameters were list as follows (2 cm,27 kVp,20 to 30 mAs);(3 cm,29 kVp,30 to 50 mAs); (4 cm,29 kVp,80 to 100 mAs); (5 cm, 30 kVp, 80 to 120 mAs); (6 cm, 31 kVp, 100 to 140 mAs); (7 cm, 32 kVp, 80 to 120 mAs). Conclusion:The optimum range of mAs can be confirmed with different breast compression thickness and the setting of automatic exposure parameters should be chosen in clinical practice.

A study for tube current exposure time products and image quality in digital mammography / 中华放射学杂志

Objective@#To investigate the relationship between current-exposure time products (mAs) and image quality in digital mammography.@*Methods@#The CDMAM phantom of 2 to 7 cm thickness were exposed by manual exposure modes using Mo-Rh anode-filer combinations. The exposure parameters were set as follows: (2 cm, 27 kVp, 10 to 90 mAs); (3 cm, 29 kVp, 20 to 120 mAs); (4 cm, 29 kVp, 20 to 200 mAs); (5 cm, 30 kVp, 40 to 220 mAs); (6 cm, 31 kVp, 40 to 260 mAs); (7 cm, 32 kVp, 80 to 280 mAs). The image quality figure (IQF), contrast to noise ratio (CNR), figure of merit (FOM) and the average glandular dose (AGD) were obtained from images. The optimum filtration and kVp for each breast thickness was found from the calculated FOMs. The optimum mAs for each breast thickness were found from the calculated FOMs and IQFs. And the Pearson correlation analysis was used to analyze the correlations among AGD, CNR and IQF.@*Results@#With the increase of mAs, the average glandular dose were linearly increased, and the FOM first increased and then decreased or changed slowly. The AGD, CNR and IQF were significantly correlated when the compression thickness was less than 7 cm (r all>0.87, P<0.05). The optimized exposure parameters were list as follows (2 cm,27 kVp,20 to 30 mAs);(3 cm,29 kVp,30 to 50 mAs); (4 cm,29 kVp,80 to 100 mAs); (5 cm, 30 kVp, 80 to 120 mAs); (6 cm, 31 kVp, 100 to 140 mAs); (7 cm, 32 kVp, 80 to 120 mAs).@*Conclusion@#The optimum range of mAs can be confirmed with different breast compression thickness and the setting of automatic exposure parameters should be chosen in clinical practice.

A study on the application of organ dose modulation technique to reduce breast radiation dose in chest CT imaging / 中华放射学杂志

Objective:To investigate the effect of organ dose modulation (ODM) technique on reducing the breast radiation dose in chest CT scanning.Methods:In the phantom test, the PBU-2 adult chest module was used. The clinical chest scan protocol was used and three sets of scans performed on the chest module： (1) ODM off group, ODM was not used; (2) ODM part group, ODM was applied only in the breast region； (3) ODM all group, ODM was applied in the whole scan scope. Other scan parameters were same for the three groups, with smart mA applied. The volume CT dose index (CTDI vol) was recorded for all three groups. A long rod ionization chamber was placed in a fixed position in front of the right breast area to measure the breast skin dose (D). The contrast noise ratio (CNR) and the figure of merit (FOM) were measured respectively. In clinical research, 72 female patients who underwent chest CT scanning in Beijing Tongren Hospital Capital Medical University from August to November 2018 were retrospectively recruited. According to the application of ODM, the patients were divided into ODM off group (without ODM, 36 cases) and ODM part group (ODM applied in the breast region, 36 cases). The CTDI vol and the dose length product (DLP) were recorded. CNR, noise of images were measured and calculated, respectively. The image quality was evaluated by subjective evaluation scores. The one way ANOVA analysis was used in comparing the difference of CNR among the 3 groups in module test. As for clinical cases, the independent samples t test was used to compare the difference in CTDI vol, DLP, CNR and the noise between two groups; and the rank-sum test was used for comparison in image quality subjective evaluation. Results:In module test, the radiation dose was highest in ODM off group, and lowest in ODM all group. The CTDI vol were (6.90±0.02), (6.26±0.02) and (5.99±0.02) mGy, and the D values were (9.17±1.01), (8.01±0.92) and (7.58±0.87) mGy for ODM off group, ODM part group and ODM all group respectively. The CNR values of images with soft tissue algorithm reconstruction were highest in ODM off group and lowest in ODM all group, while no statistically significant difference was displayed ( P>0.05). The CNR values of the images with lung algorithm reconstruction showed the same trend, with statistically significant difference among the three groups ( F=154.732, P=0.006). The FOM of the lung and soft tissue algorithm images was maximized when the ODM was partially applied. As for clinical cases, compared with ODM off group, the dose of ODM part group showed significantly decreased, with CTDI vol decreased by 16.12% ( t=2.604, P=0.011), and the DLP decreased by 16.85% ( t=3.293, P=0.002). No significant difference was found in CNR, noise and subjective score by two doctors between two groups ( P>0.05). Conclusion:The application of ODM in chest CT imaging can reduce the radiation dose of breast with simultaneously maintaining the image quality.

A phantom study on the effects of detector coverage and pitch combined with organ dose modulation techniques on radiation dose and image quality in chest CT / 中华放射学杂志

Objective To explore the effects of detector width and pitch on radiation dose and image quality when using organ dose modulation (ODM) technology in a wide?area detector CT scanning. Methods Based on the clinical chest scan protocol,3 sets of scans of the chest phantom were performed using any combination of two detector width (40 mm and 80 mm) and pitch (0.500,1.000 and 1.375) with the same parameters:1 Do not use ODM technology (ODM off),2 open ODM (ODM part) 240 mm from scan start layer to breast area,3 open ODM (ODM all) in full 320 mm scan range. A long rod ionization chamber was placed in the fixed position in front of the right breast area. The scanning parameters of each group were measured 7 times, and the volume computed tomography dose index (CTDIvol) and breast skin dose measurement values D were recorded and the mean was calculated and recorded as Dav. The coronal 5 mm thick images of lung and soft tissue algorithms were reformed. It was divided into three parts in the Z?axis direction, and the contrast?to?noise ratio (CNR) and figure of merit (FOM) were measured separately. Independent sample t test was used for CTDI and breast skin doses D and CNR at both detector widths. ANOVA was used for dose and CNR of three sets of pitch (0.500, 1.000, and 1.375) and the three ODM techniques. Result The FOM factor was the largest when using an 80 mm detector with a pitch of 0.992 and partially turning on the ODM. The radiation dose of the three ODM groups decreased in turn, and the effect of ODM on CTDIvol (P=0.019) and breast skin dose (P=0.002) was statistically significant. The width of the detector increased and the dose was increased. The width of the detector was statistically significant for CTDIvol (t=-2.723, P=0.015). There was no statistically significant effect on the breast skin dose (t=-0.908, P=0.377). The effects of the pitch were not statistically significant for CTDIvol (P=0.254) and breast dose (P=0.146). The CNR of the three ODM groups decreased in turn, and the effect of ODM on the soft tissue image CNR was not statistically significant (P=0.146). The CNR of lung algorithm image (P=0.030) had significant effects. The multiple comparisons:only ODM all was significantly different from ODM off (P=0.009). With the increase of detector width,the values of CNR increased,the values of CNR (t=-4.128,P=0.001) of lung images were significantly affected. The effects on the soft tissue images were not statistically significant (P=0.187). There was no statistically significant difference in the effect of pitch on the CNR (P=0.660) of the lung images. The effects of the pitch on the values of CNR of soft tissue images (F=11.756,P=0.001) were statistically significant. By multiple comparisons, the difference of CNR between 0.500 (P=0.000) and 1.375 (P=0.013) was statistically significant compared with that when the pitch was 1.000. There was no significant difference among the three ODM modes (P>0.05) on the values of CNR of upper and middle parts of lung and soft tissue arithmetic images. The differences of CNR between ODM all and the other two groups were statistically significant (P<0.05) on the bottom part of images. Conclusion The changes of detector width and pitch will affect the organs dose modulation technique, and then affect the radiation dose and image quality. When using 80 mm detector with the pitch of 0.992 and partially turning on ODM in chest CT scan,achieving the optimized benefits of quality and dose.

A phantom study of the effects of tube voltage combined with organ dose modulation on radiation dose and image quality in chest CT / 中华放射医学与防护杂志

Objective To investigate the effects of different tube voltages on the dose of superficial radiation-sensitive organs and image quality when using organ dose modulation( ODM) in chest CT. Methods Based on clinical chest CT protocol with the sameother parameters, chest phantom was scanned using 140, 120, 100, and 80 kv ( 100 kV was the recommended by the CT system) without ODM ( ODM off ) or with ODM from the starting layer to the breast area ( ODM part ) . A long rod ionization chamber was placed iat a fixed position in front of the right breast area. The scans were repeated for 7 times with each group of scanning parameters and dose values were measured for each scanning, the CTDIvol and breast skin dose measurements( D) were recorded. Coronal images of 5 mm thickness for the lung and soft tissue algorithms were reformatted. The images were divided into 8 parts along the z axis direction, the contrast noise ratios( CNR) for every region were measured. For CTDIvol , D, CNR for different ODM and tube voltage scanning modes, two factor non-repeat test ANOVA was performed. LSD method was used for comparison among groups. Results The CTDIvol was lowest at 80 kV, and the breast skin dose measurement was lowest at 100 kV, CTDIvol decreased in turn from140 to 80 kV ( F=105. 5795, P<0. 05) . The breast skin dose measurement decreased in turn from140 to 100 kV, but increased instead at 80 kV. The difference was statistically significant(F=27. 736, P<0. 05). Compared with ODM off , the CTDIvol and D for ODM part both declined and the differences were statistically significant ( F=39. 732, 81. 961, P<0. 05). The CNRs of the lung and soft tissue images decreased at every tube voltage(F=12. 809, 11. 261, P<0. 05 ) . The CNRs decreased from140 to 100 kV, but there was no statistical difference( P>0. 05) , and the difference was significant at 80 kV( P<0. 05) . Compared with ODM off, the CNRs of lung and soft tissue algorithm images with ODM part decreased, withnot statistically significant differences ( P>0. 05 ) . Conclusions In clinical practice, with the tube voltage not less than the recommended(100 kV), the optimal reduction of breast radiation dose can be achieved by reducing kV and using ODM on the premise of resonable image quality.

A study for the optimization of tube voltage and filter in digital mammography / 中华放射学杂志

Objective To investigate the image quality and average glandular dose from different breast compression thickness, and to provide recommendations for filtration material and tube voltage in digital mammography. Methods The CDMAM phantom of 2 to 7 cm thickness were exposed by manual exposure modes(proper mAs, 21 to 39 kVp range) using Mo/Mo and Mo/Rh anode/filer combinations at full-field digital mammography. The image quality figure (IQF), contrast to noise ratio (CNR), figure of merit (FOM) and the average glandular dose (AGD) were obtained from images. The optimum filtration and kVp for each breast thickness were found from the calculated FOMs. And the paired sample rank sum test was used to analyze the difference of AGD, CNR, IQF and FOM for Mo and Rh filters. Results For both Mo and Rh as used filter, under the compression of 2 to 7 cm thickness and the fixed mAs, with the increasing of tube voltage, AGD, CNR and IQF will gradually increase as following:AGD had the significant increasing while CNR and IQF gradually increasing to balance. Under different compression thickness, the AGD for Mo and Rh were statistically different (P<0.05). When the compression thickness were 2 and 3 cm, CNR for Mo was higher than Rh, with the statistically significant difference (P<0.05) while the IQF for Mo and Rh with no statistical significance (P>0.05). When the compression thickness was 4 cm, CNR for Mo and Rh were with no statistical significance (P<0.05) while IQF for Mo was higher than Rh, with statistically significant difference (P<0.05). When the compression thickness were 5 to 7 cm, CNR for Mo was lower than Rh, but only under the thickness of 6 cm with statistically significant difference (P<0.05), while there was no statistical significance (P>0.05) under the thickness of 5 cm and 7 cm; the IQF for Mo and Rh with no statistical significance (P>0.05). The FOM in each thickness for Mo and Rh filtration had statistical significance (P<0.05), and FOMRh>FOMMo. For different compression thickness, the suitable matching of tube voltage and filter material were Rh filtration, 2 cm and 27 kVp, 3 cm and 29 kVp, 4 cm and 29 kVp, 5 cm and 30 kVp, 6 cm and 31 kVp, 7 cm and 32 kVp. Conclusion Considering both image quality and radiation dose, Rh filtration is the optimum selection material and there is a corresponding optimal energy response in all kinds of thickness.

Influence of additional filter on image quality and radiation dose in chest digital radiography / 中华放射学杂志

Objective To investigate the influence of additional filter on image quality and radiation dose in chest digital radiography (DR). Methods The adult chest phantom was exposed under the different additional filter by 0, 1.0 mm Al,1.0 mm Al+0.1 mm Cu,1.0 mm Al+0.2 mm Cu while the kV was 110 kV and the AEC parameter selection were -4,-2, 0, 2, and 4 respectively. Image quality was evaluated by the relative noise and the contrast-to-noise ratio (CNR). The radiation dose was evaluated by the entrance skin dose (ESD) and the effective dose. Linear regression analysis was used to analyze the relationship between the ESD and the effective dose, and the correlation between the image quality and the effective dose was analyzed by Pearson correlation analysis. Results The ESD were (0.023 ± 0.004), (0.034 ± 0.007),(0.045 ± 0.009),(0.056 ± 0.010),(0.067 ± 0.012)mGy and the effective dose were(6.15 ± 0.09)×10-3,(9.02±0.15)×10-3,(11.94±0.16)×10-3,(14.89±0.09)×10-3,(17.80±0.12)×10-3 mSv when the AEC parameter selection were -4,-2, 0, 2, and 4 respectively. The effective dose was linearly positively correlated with the ESD and the regression coefficient were(r=1.000, P<0.01)under different additional filter. The ESD decreased with the additional filter increased under the same AEC, and the maximum could be reduced by 34%. The relative noise was decreased with the effective dose increased and there was a negative correlation between the two and the Pearson correlation coefficient were(r=-0.970,-0.966,-0.971,-0.971;P<0.01)under different additional filter. The CNR was increased with more effective dose and there was a positive correlation between the two and the Pearson correlation coefficient were (r=0.952, 0.947, 0.908, 0.944;P<0.05)under different additional filter. The relative noise decreased with the additional filter increased under the same AEC, and the maximum could be decreased by 13%. The CNR values increased with the additional filter under the same AEC, and the maximum could be increased by 4%. Conclusions The use of additional filter in chest digital radiography can reduce the ESD and improve the quality of the image to some extent, but the effective dose change is not significant.

A phantom study of the influence of tube voltage on image quality and radiation dose in DR chest radiography / 中华放射医学与防护杂志

Objective To investigate the influence of tube voltage on image quality and radiation dosage to subjects in chest digital radiography (DR).Methods An adult chest phantom was exposed in the range of 80-130 kV with the interval of 10 kV and the automatic exposure control (AEC) setting was selected from-4 to 4.The entrance skin dose (ESD) of the phantom was measured,and the relative noise,contrast-to-noise ratio (CNR) and the effective dose of each exposure was calculated.Results The ESD was (0.062 9 ±0.027 4) mGy,and the effective dose was (0.012 7 ±0.004 5) mSv.The effective dose increased linearly with the ESD,and there was a positive correlation (r =0.912,P ＜ 0.01).When the tube voltage was held constant,the relative noise decreased as the effective dose increased (r =-0.967,-0.969,-0.968,-0.969,-0.968,-0.970,P ＜ 0.01).The CNR increased with the effective dose increasing under the same tube voltage(r =0.987,0.987,0.986,0.987,0.988,0.989,P ＜0.01).The ESD and effective dose decreased as the kV values increased under the same AEC,and the degree of decrease could be up to 50％ and 20％.The relative noise decreased as the kV values increased under the same AEC,and the degree of decrease could be up to 23％.The CNR values increased up to 8％.Conclusions The use of higher kVp in chest digital radiography can reduce the radiation dose to some extent

Radiation dose reduction to the lens of eye with bismuth shielding in head and neck MSCT / 中华放射医学与防护杂志

Objective To explore the effects on image quality and dose reduction to the lens when using bismuth shielding in head and neck MSCT.Methods The standard phantom and the cadaveric head with none,1,2 and 3 layers of bismuth shielding were scanned with protocols of brain,temporal bone and paranasal sinuses using a 16-MDCT scanner.The organ dose to the lens in each scanning was measured with thermoluminescence dosimeters(TLD).The above scanning with sinus protocol was repeated with a sponge with thickness of 5,10,15 and 20 mm placed between the shielding and phantom/head.The CT attenuation of phantom with the distance of 2,4,6 and 8 cm to shielding were measured.The image quality was subjectively evaluated by 2 physicians.Results The organ doses of the lens with protocols of brain,temporal bone and sinuses were 24.31,27.60 and 20.01 mGy,respectively.The doses were decreased significantly when using bismuth shielding.With the increase of the shield gap,the degree of dose reduction was reduced,but the increasing degree of CT attenuation significantly reduced.Using 2-layer and 3-layer bismuth shield in brain and temporal bone CT scan,the radiation doses were reduced by 47.1％ and 59.1％,respectively while maintaining the diagnostic image quality.Using 1-layer shield without gap and 2-layer shield with 1.5 cm gap in sinus CT,the radiation doses were reduced by 31.5％ and 34.5％,respectively.Conclusions Reasonable usage of bismuth shielding can effectively reduce the radiation dose to the lens of eye in head and neck MSCT.

The influence of bismuth shielding on image quality and radiation dose to eye lens in sinus multi-detector CT / 中华放射学杂志

Objective To explore the influence on image quality and the reduction of radiation dose to eye lens when using bismuth shielding in sinus MDCT.Methods The standard water phantom was scanned using clinical scanning protocols of sinus in 16-MDCT,and the images were acquired with none,1 layer,2 layers and 3 layers of bismuth shielding severally.Using the above protocol,the cadaveric head was scanned with no shield,1,2 and 3 layers of bismuth shielding material covered on both eyes,and the organ dose to eye lens in each scanning was measured with thermoluminescence dosimeter (TLD).The sponge with the thick of 0.5,1.0,1.5,2.0 cm was placed between the shielding material and the surface of subjects separately and the radiation doses to eye lens was measured with sinus scanning conditions in the same way.The CT values of phantom with the distances of 2.0,4.0,6.0 and 8.0 cm to shield material were measured.The influence of bismuth artifacts on anatomic structures was evaluated as well.Results The organ doses to the eye lens in the sinus clinical CT were 20.0 mGy.Doses decreased significantly to 13.7,10.9 and 9.4 mGy separately when using 3 types of bismuth shielding thickness.With different thicknesses of shielding material,the greater the shield gap,the smaller the degree of reduction of organ dose,but the increasment of CT value was significantly reduced.Using 1-layer shield no gap and 2-layer shield with 1.5 cm gap in sinus MDCT,the radiation doses were reduced to 13.7 and 13.1 mGy with the reduction rates of 31.5％ and 34.5％ respectively.Conclusion The reasonable bismuth shielding can effectively reduce the radiation dose to eye lens in sinus CT on the premise of ensuring image-diagnostic quality.

Research of using image noise characteristic to evaluation image quality in digital mammography / 中华放射学杂志

ObjectiveTo find the proper way of assessing the image noise characteristic through the analysis of noise characteristic in the digital mammographic images.MethodsThe CDMAM phantom was firstly exposed with different filter materials and tube voltages in the range of 23 to 35 kVp at a fixed tube current 90 mAs,then exposed with different filter materials and tube current in the range of 20 to 200 mAs at a fixed tube voltage 29 kVp.The parameters such as background standard deviation,joint standard deviation,subtracted standard deviation and relative standard deviation were calculated and measured from both 60 pixels of signal disc and background beside of the disk for all the images.The IQFinvs were calculated for the achieved images.Non-parametric rank sum tests were used to compare the difference of the background standard deviation,joint standard deviation and subtracted standard deviation,t test was used to compare the IQFinvs between Mo and Rh filers in each group.ResultsWith the same exposure parameters in the test above,the maximum value was the background standard deviation,while the subtracted standard deviation was the minimum,and the value of joint standard deviation was in the middle. With other parameters unchanged,the values of three kind of standard deviation increased with the increasing of tube voltage or tube current,while the differences between them getting more significant.Under the condition of 90 mAs and Mo filter material,background standard deviation,joint standard deviation,subtracted standard deviation were 10.91,10.34 and 9.87,the results were 11.24,10.57 and 9.96 while Rh filter material was used,significant difference was found ( x2 =26.0,P ＜ 0.01 ). Under the condition of 29 kVp and Mo filter material,background standard deviation,joint standard deviation,subtracted standard deviation were 12.30,11.61 and 11.05,the results were 12.29,11.58 and 10.87 while Rh filter material was used,significant difference was found( x2 =20.0,P ＜ 0.01 ).The IQFinvs were 149.14 ± 23.87 and 139.16 ± 23.14 under the condition of 90 mAs and Mo filter material ( t =9.129,P ＜ 0.01 ).The IQFinvs were 149.75 ±34.85 and 145.2 ±34.64 while the parameters were 29 kVp and Rh filter material(t =1.304,P ＞0.05 ).The value of relative standard deviation decreased with the increasing of tube voltage or tube current,and the image quality got better with the decreasing of relative standard deviation.ConclusionRelative standard deviation is suitable not only for the expression of the digital mammographic images,but also for the evaluation of the image quality.

Study of exercise heart rate variability based on correlation dimension / 生物医学工程学杂志

This paper is mainly devoted to the relationship between the correlation dimension (CD) of exercise heart rate variability (EHRV) and the status of cardiovascular function. Hypertensive patients and healthy people were enrolled in two contrast groups. Dynamic electrocardiograph (ECG) in step exercise was recorded. EHRV was extracted by wavelet transform. The CDs in the whole course of exercise and in three stages of exercise were calculated, the three stages being named rest-before-exercise, during-exercise, and after-exercise. SPSS software was used for statistical analysis. The results revealed all the CDs showed significant difference between two groups except that in the stage of during exercise. By discrimination analysis, the average correct rate was 92.2%. It indicated that the CD in stress status probably could be an effective non-linear parameter for assessing cardiovascular function status.