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Biomedical subjects

C J Kotre

Publications and source records attributed to C J Kotre.

At least 19 recordsLinked to original sources
PubMed2006

Patient and staff radiation doses from early radiological examinations (1899-1902).

A source of data on radiographic and fluoroscopic examinations, including radiographic technique factors, was used in conjunction with information about cold-cathode X-ray apparatus to estimate patient and staff radiation doses for the years 1899 to 1902 at the Forth Banks Infirmary, Newcastle-upon-Tyne. Physical evidence from representative apparatus of the period was used with a beam spectral simulation program to characterize the X-ray beam, and information about the electrical supply waveform was produced by experimental operation of a contemporary induction coil. Results are given in terms of skin entrance dose, and these are compared with modern values. An estimate of the annual dose received by the radiographer known to have carried out all of the examinations within this period is also given.

England↗
PubMed2006

Reference levels in PTCA as a function of procedure complexity.

The multicentre assessment of a procedure complexity index (CI) for the introduction of reference levels (RLs) in percutaneous transluminal coronary angioplasties (PTCA) is presented here. PTCAs were investigated based on methodology proposed by Bernardi et al. Multiple linear stepwise regression analysis, including clinical, anatomical and technical factors, was performed to obtain fluoroscopy time predictors. Based on these regression coefficients, a scoring system was defined and CI obtained. CI was used to classify dose values into three groups: low, medium and high complexity procedures, since there was good correlation (r = 0.41; P < 0.001) between dose-area product (DAP) and CI. CI groups were determined by an ANOVA test, and the resulting DAP and fluoroscopy time third quartiles suggested as preliminary RLs in PTCA, as a function of procedure complexity. PTCA preliminary RLs for DAP are 54, 76 and 127 Gy cm2, and 12, 20 and 27 min for fluoroscopy time, for the three CI groups.

Analysis of Variance↗
PubMed2006

Development and application of programs to measure modulation transfer function, noise power spectrum and detective quantum efficiency.

This project aimed to produce programs to calculate the modulation transfer function (MTF), noise power spectrum (NPS) and detective quantum efficiency (DQE) of digital X-ray systems, given a suitable digital image. The MTF was calculated using the edge technique and the NPS was calculated from a flat field image. Both programs require a suitably edited DICOM image as input. The DQE was then calculated from the output of MTF and NPS programs. This required data external to the DQE program to estimate the number of quanta per mm2 in the beam which formed the NPS image. All three programs run independent of each other on a PC and require no special software to be installed. Results for MTF, NPS and DQE for a Philips AC3 CR system are presented. In addition, the results for MTF from a Siemens Duo CT scanner with a specially designed PTFE edge are also shown.

Algorithms↗
PubMed2006

Pilot study into optimisation of viewing conditions for electronically displayed images.

The increased use of soft-copy reporting introduces new concerns over the effect of viewing conditions on the observer's ability to report images. Owing to their lower luminance, electronic display screens may be more susceptible to poor viewing conditions than conventional viewing boxes and there is the potential for images to be displayed in locations not optimised for viewing radiographs. In the present work, the effects of sub-optimal viewing conditions on the observer's performance for images on an electronic display device are investigated. A test object was used to produce a computed radiography image containing a wide range of grey levels. The image was scored under quasi-ideal and sub-optimal conditions and the effect of changing the viewing conditions on the observer's performance determined. Basic photometric quantities were used to characterise the viewing conditions and the degradation in observer performance related to these quantities. The presence of structured reflection had a significant effect on the observer's ability to discern low-contrast objects. The study demonstrates the need for adequate viewing conditions especially when images are displayed on low luminance devices in sub-optimal conditions.

Humans↗
PubMed2006

Quantification of motion unsharpness in digital fluoroscopy.

The objectives of this work were first to develop a convenient method to quantify persistence in digital fluoroscopy systems, then to quantify the effect of variable temporal averaging on the detection of moving low-contrast test details within digital fluoroscopic and pulsed fluoroscopic images. The results were analysed to clarify the relationship between the optimum persistence required to see the lowest contrast for circular test details for a range of diameters and their speed of movement. The optimum persistence values obtained are compared with the limited data available on speeds of movement of patient organs during fluoroscopy. It is tentatively concluded that for imaging the abdomen, the optimum imaging system persistence time constant is approximately 0.15 s. For the much greater speeds associated with cardiac motion, no additional frame averaging is necessary, i.e. just the persistence provided by the observer's visual system appears to be optimal for small objects.

Fluoroscopy↗
PubMed2006

The influence of patient size on patient doses in cardiology.

In cardiology and interventional radiology, areas that contribute large components to medical radiation exposure, a major source of variation in patient dose is the variation in complexity between cases for nominally identical procedures. In patient dose surveys, this variation tends to mask that due to patient size. The effect of applying a previously defined size correction to cardiology patient dose-area product (DAP) records was investigated. The correction method uses the experimentally determined relationship between patient diameter and DAP to derive a factor to convert DAP to that which would be expected had the patient been similar in size to ICRP Reference Man. The size correction was found to greatly reduce the residual correlation of DAP with patient weight. An implication of this finding is that data collection for the setting of diagnostic reference levels in cardiology can be performed for all patients rather than just 'standard-sized' patients.

Body Size↗
PubMed2006

Short communication: an investigation of search pattern extent in the threshold contrast detection task.

The threshold contrast-detail diameter test is used as a semi-quantitative measure of image quality in radiology. This observation task is called "signal known exactly/background known exactly" because the signals are usually low contrast disks in known positions, and the background is uniform except for noise fluctuations. The performance of the observer undertaking this task can to some extent be predicted from knowledge of the noise power in the image background, and adoption of the assumption that the noise is sampled through an aperture of the same area as the test feature being observed. In order to extend this approach to optimization of clinical images, the effect of the cluttered anatomical background on the detection task must be quantified. To study the effect on detection of nearby structure, a series of contrast-detail tests was carried out using a progressively restricted background area of Gaussian noise, and a range of object diameters. It was found that the observer's ability to detect low contrast objects is progressively reduced as the area of the search area is reduced, the difficulty of the task increasing rapidly as the diameter of the restricted search area falls to less than twice that of the target disk. The results suggest the presence of a search pattern that scales in proportion with the size of the test feature.

Algorithms↗
PubMed2006

Trends in image quality in high magnification digital specimen cabinet radiography.

Advances in microfocus X-ray tube design together with the availability of high resolution charge coupled device (CCD) detectors have led to the introduction of high magnification digital specimen cabinets for the examination of tissue samples. This paper explores the effect that the high magnification geometry permitted by such units has upon image quality in terms of phase contrast edge enhancement, spatial resolution and the appearance of test phantom images. Phase contrast effects and spatial resolution were studied using a previously established method (using edge profiles) and by computing the system spatial frequency response at various geometries. It was demonstrated that the magnitude of the phase contrast enhancement effect reaches a stable maximum at a magnification of x 4. It has also been shown that a continual increase in both the spatial resolution together with an improved signal to noise ratio occurs up to the maximum permissible magnification geometry, with effects of focal spot blur being negligible. In practice, the limited size of the digital detector and the difficulty of object alignment can constrain the use of the very high magnification option.

Phantoms, Imaging↗
PubMed2005

Short communication: A printed image quality test phantom for mammography.

This communication describes a novel design for a mammographic image quality test phantom, the final design of which was produced as a radiographer weekly quality assurance phantom for breast screening and symptomatic mammography. The phantom is based on low contrast test features which are built up by superimposing sheets of Mylar overhead projector transparency, on which the test features are printed using a standard LaserJet printer. The required radiation contrast at mammographic energies is produced by the approximately 50% by weight component of iron oxide (Fe(3)O(4)) present in the toner. An easily replicated design of mammographic image quality phantom based on LaserJet printed test features is described. Approximately 40 of these phantoms were constructed, and these have been used successfully for 5 years in both breast screening and symptomatic mammography. The phantom design offers a performance similar to much more expensive mammographic contrast-detail phantoms, but suffers from the disadvantage that high contrast resolution bar patterns cannot be produced using the standard printing process.

Computer Peripherals↗
PubMed2004

Mammographic image restoration using maximum entropy deconvolution.

An image restoration approach based on a Bayesian maximum entropy method (MEM) has been applied to a radiological image deconvolution problem, that of reduction of geometric blurring in magnification mammography. The aim of the work is to demonstrate an improvement in image spatial resolution in realistic noisy radiological images with no associated penalty in terms of reduction in the signal-to-noise ratio perceived by the observer. Images of the TORMAM mammographic image quality phantom were recorded using the standard magnification settings of 1.8 magnification/fine focus and also at 1.8 magnification/broad focus and 3.0 magnification/fine focus; the latter two arrangements would normally give rise to unacceptable geometric blurring. Measured point-spread functions were used in conjunction with the MEM image processing to de-blur these images. The results are presented as comparative images of phantom test features and as observer scores for the raw and processed images. Visualization of high resolution features and the total image scores for the test phantom were improved by the application of the MEM processing. It is argued that this successful demonstration of image de-blurring in noisy radiological images offers the possibility of weakening the link between focal spot size and geometric blurring in radiology, thus opening up new approaches to system optimization.

Algorithms↗
PubMed2004

Assessment of the effects of pixel loss on image quality in direct digital radiography.

Modern digital radiographic 'flat panel' detectors can exhibit a progressive form of image degradation arising from non-functioning pixels. The effect of these 'dead pixels' on the quantitive image quality measures of modulation transfer function (MTF), noise power spectrum (NPS) and detective quantum efficiency (DQE) is investigated by a simulated degradation of images obtained from an Hologic EPEX system. The effects on the semi-quantitive measures obtained from contrast threshold test objects and resolution gratings are also investigated. Results suggest that the contrast-detail tests often employed in quality assurance measures are not sufficient to reveal the presence of dead pixels until well beyond the recommended replacement point for the flat panel detector. However, measurements of spatial resolution using a line pairs phantom were found to be more sensitive to pixel loss. Measurement of the MTF, NPS and DQE can reveal small changes in image quality with increasing pixel loss, with a distinctive pattern in the trend of the NPS.

Algorithms↗
PubMed2004

Application of low dose rate pulsed fluoroscopy in cardiac pacing and electrophysiology: patient dose and image quality implications.

The performance of a low dose rate pulsed fluoroscopy option and its successful application to cardiac pacing and electrophysiology is reported. Low dose rate 6.25 frames per second pulsed fluoroscopy was made available in two catheter laboratories at a specialist cardiac centre in February 2003, and was adopted as the standard imaging technique for cardiac pacing procedures. The image quality was found to be considerably poorer than conventional modern units, being very similar to that which would have been accepted as adequate performance 20 years ago, but at less than one-tenth of the dose rate. No problems with the clinical acceptance of this imaging mode for cardiac pacing and electrophysiology have been reported. The already low median patient dose-area product for pacing at this cardiac centre was further reduced by 50% with the introduction of this fluoroscopy option.

Attitude of Health Personnel↗
PubMed2004

Optimization of variable temporal averaging in digital fluoroscopy.

In modern X-ray fluoroscopy systems, the amount of temporal averaging (i.e. persistence) applied to the image is often user selectable. The objective of this work is to quantify the effect of variable temporal averaging on the detection of low contrast test objects moving at a range of known speeds within the digital fluoroscopic image. An image intensifier system with a short-persistence television camera was used to record image sequences of a moving threshold contrast-detail diameter test object onto broadcast-standard U-matic videotape. The image sequences were replayed through an image processing system allowing different amounts of temporal averaging to be applied. The test images were scored by an experienced observer. The temporal averaging time constants produced by the added image processing were measured using a method based on noise correlation. Results are presented showing the trends of threshold contrast with test detail diameter and movement speed. The optimum value of temporal averaging time constant is presented as a function of detail diameter for a range of speeds. By comparison with the limited information available in the literature on organ movement, it is tentatively concluded that for the organ movement speeds expected in the abdomen, the optimum imaging system persistence time constant should be approximately 0.15 s. For the much greater speeds associated with cardiac motion no additional frame averaging, i.e. just the persistence provided by the observer's visual system, appears to be optimal.

Algorithms↗
PubMed2003

Is patient size important in dose determination and optimization in cardiology?

Patient dose determination and optimization have become more topical in recent years with the implementation of the Medical Exposures Directive into national legislation, the Ionising Radiation (Medical Exposure) Regulations. This legislation incorporates a requirement for new equipment to provide a means of displaying a measure of patient exposure and introduces the concept of diagnostic reference levels. It is normally assumed that patient dose is governed largely by patient size; however, in cardiology, where procedures are often very complex, the significance of patient size is less well understood. This study considers over 9000 cardiology procedures, undertaken throughout the north of England, and investigates the relationship between patient size and dose. It uses simple linear regression to calculate both correlation coefficients and significance levels for data sorted by both room and individual clinician for the four most common examinations, left ventrical and/or coronary angiography, single vessel stent insertion and single vessel angioplasty. This paper concludes that the correlation between patient size and dose is weak for the procedures considered. It also illustrates the use of an existing method for removing the effect of patient size from dose survey data. This allows typical doses and, therefore, reference levels to be defined for the purposes of dose optimization.

Body Constitution↗
PubMed2003

Software for the estimation of foetal radiation dose to patients and staff in diagnostic radiology.

Occasionally, it is clinically necessary to perform a radiological examination(s) on a woman who is known to be pregnant or an examination is performed on a woman who subsequently discovers that she was pregnant at the time. In radiological examinations, especially of the lower abdomen and pelvis area, the foetus is directly irradiated. It is therefore important to be able to determine the absorbed dose to the foetus in diagnostic radiology for pregnant patients as well as the foetal dose from occupational exposure of the pregnant worker. The determination of the absorbed dose to the unborn child in diagnostic radiology is of interest as a basis for risk estimates from medical exposure of the pregnant patient and occupational exposure of the pregnant worker. In this paper we describe a simple computer program, FetDose, which calculates the dose to the foetus from both medical and occupational exposures of the pregnant woman. It also calculates the risks of in utero exposure, compares calculated doses with published data in the literature and provides information on the natural spontaneous risks. The program will be a useful tool for the medical and paramedical personnel who are involved with foetal dose (and hence risks) calculations and counselling of pregnant women who may be concerned about in utero exposure of their foetuses.

Algorithms↗
PubMed2003

A method for the systematic selection of technique factors in paediatric CT.

A method for the systematic selection of paediatric CT technique factors is described. The approach is based on the assumption that the level of image noise acceptable for a given adult CT image is also acceptable for the equivalent paediatric examination. A simple exponential attenuation model is proposed. Effective linear attenuation coefficients were initially established from a series of phantom measurements simulating head, chest and abdomen examinations at 120 kVp, then extended for a range of tube potentials and beam qualities using a beam spectral model. Application of the method is demonstrated using phantoms representing head, chest and abdomen sections for neonate and ages 1 year, 5 years, 10 years, 15 years and adult.

Adolescent↗
PubMed2003

Analysis of benefit:risk ratio and mortality reduction for the UK Breast Screening Programme.

A quantitative analysis has been performed to predict the benefit:risk ratio and associated mortality reduction for the UK National Health Service Breast Screening Programme. The analysis is based on the results of an established biological simulation method coupled with dosimetric information and population statistics applicable to the UK breast screening programme. As well as the general breast screening population, the benefit:risk ratios for specific subgroups of women thought to be at higher risk are estimated. The effects of alterations in screening strategy are also investigated. The results indicate favourable benefit:risk ratios and mortality reductions for all women in the programme, with a breast cancer mortality reduction of approximately 9% over the whole UK female population, equivalent to a breast cancer mortality reduction in the region of 25% for the age range 55-69 years.

Age Factors↗