Effective dose in diagnostic radiology as a function of x-ray beam filtration for a constant exit dose and constant film density.

Individual organ absorbed dose and total effective dose for nine common radiographic projections were investigated as a function of half-value-layer, HVL, and total equivalent filtration for the following cases: (1) with the patient exit dose held constant and (2) with the film density held constant. As expected, the absorbed dose to organs proximal to the x-ray beam entry point tracked with skin dose as a function of HVL, whereas organ dose distal to the x-ray beam entry point was almost independent of HVL. Dose to organs near mid-line showed an intermediate HVL dependence. For the nine radiographic projections, increasing the total filtration from 1.5 to 4.0 mm Al while holding the kVp fixed resulted in mean decreases in the effective dose of 17% for the case of a constant exit dose, and 25% for a constant film density with a "400 speed" rare-earth screen-film system. The decreases in the mean skin entrance doses were 38% and 45%, respectively. With the screen-film system, the average effective dose decreased at 16% per mm of added Al between 1.5 and 2.5 mm Al total filtration, and at 7% per mm between 2.5 and 4.0 mm. These results partially support the NCRP Report No. 102 recommendation that the minimum filtration be 2.5 mm Al for general diagnostic x-ray tubes. They also suggest, using the linear no-threshold radiation risk model, that further significant reductions in stochastic risk to the U.S. population can be achieved by raising the minimum beyond 2.5 mm. Experience over a 12 year period in our tertiary care teaching hospital indicates that adding 1-1.5 mm Al filtration beyond the 2.5 mm minimum does not pose a problem in terms of additional tube loading or reduction in image quality. However, these issues need to be more formally addressed.

Spatial resolution measurements for passive microwave radiometry using a tissue-equivalent phantom.

A tissue-equivalent "hot" line source phantom is described for assessing spatial resolution in passive microwave radiometry systems. LSFs were measured for two rectangular waveguide antennas connected to a 4.7-GHz radiometer. The normalized LSFs and corresponding modulation transfer functions were found to be independent of line source temperature, but dependent upon antenna size, orientation, and line source depth.

Diagnostic ionizing radiation exposure in premature patients.

OBJECTIVE: Concern regarding the magnitude and consequences of diagnostic radiation exposure in premature infants in neonatal intensive care units (NICUs) has increased as survival of premature infants has improved. Radiation exposure is not often rigorously monitored in NICU patients. The purpose of this observational study was to quantify the amount of ionizing radiation exposure in infants <33 weeks gestational age and to identify the indications for diagnostic imaging. STUDY DESIGN: We conducted a retrospective review of 215 premature infants who were <33 weeks gestation and who received central venous line (CVL) placement during their NICU stay during the period from 2006 to 2011. Absorbed ionizing radiation was estimated using the method of Puch-Kapst and colleagues (2009) and compared with recommended radiation exposure limits. All infants were 29.2±2.3 weeks (mean±s.d.) and 1262±433 g birth weight. RESULT: Subjects received 15±15 radiographs (4.4±2.9 for CVL placement, 5.7±9.8 for gastrointestinal (GI) evaluations and 5.2±9.3 for respiratory indications). Eleven infants (5.1%) received more than the maximum recommended radiation from radiographs (>1000 µSv). Inclusion of fluoroscopic procedures increased to 26 the number of infants (12.1%) who received more than the maximum recommended 1000 µSv. CONCLUSION: Ionizing radiation exposure that exceeded the recommended maximum in premature infants at high risk for long-term sequelae occurred in 12.1% of infants who were <33 weeks gestation and who were cared for in our NICU over the past 5 years. CVL placement accounted for 22% of this radiation exposure. GI evaluations accounted for the greatest amount of ionizing radiation exposure. We suggest that the increased use of other imaging strategies may reduce total ionizing radiation exposure in this vulnerable population.

Evaluation of a commercial mammography image-enhancement system.

A commercial mammography image-enhancement system manufactured by Damon Corporation (Needham, MA) is evaluated. Using a dedicated computer, the system implements a real-time video local adaptive image processing algorithm based on the Wallis equation. Radiographs of a mammographic QA phantom (Nuclear Associates Model 76-001-4) containing five groups of simulated breast microcalcifications ranging in diameter from 0.12 to 0.35 mm were viewed by four investigators under three viewing conditions: on a light box with the unaided eye, on the image enhancer in magnified "bypass" (unenhanced) mode, and on the enhancer using all features for optimum enhancement. A mammogram was then overlaid on the radiographs, and the composite images were viewed under the same three conditions. Using the enhancer, as compared to using a light box alone, average increases of 1.4 and 1.1 microcalcifications per radiograph were observed for the phantom and phantom-with-mammogram radiographs, respectively. High-contrast resolution and spatial distortion were also measured.