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Biomedical subjects

C Kimme-Smith

Publications and source records attributed to C Kimme-Smith.

63 records · Page 4Linked to original sources

Diagnostic effects of edge sharpening filtration and magnification on digitally subtracted renal images.

The improved appearance of digital radiographs filtered to improve local contrast and sharpen edges has not increased acceptance of these images by radiologists. Furthermore, many radiologists assert that correct diagnosis is not improved with these filtered images. This study was designed to test this assertion for digital subtraction angiograms (DSA) of renal images. Four experiments are described. First, phantom studies identified filters and their parameters thought likely to be acceptable and useful in diagnosing renal images formed by DSA. Second, these filters and parameters were then tested on medical images to assess their acceptance by radiologists. Third, display modes of windowing, positive/negative presentation, and magnification were varied for filtered and unfiltered images to assess preferences of radiologists. Fourth, filtered and unfiltered magnified images were used to test improved diagnosis. In the final experiment, 148 images from 33 renal studies (15 normal, 18 abnormal) were magnified, gray level windowed, and filtered. Diagnosis was not improved by the two edge sharpening filters tested.

Angiography↗

Focal spot size measurements with pinhole and slit for microfocus mammography units.

Many mammography units now have microfocal spots ranging in size from 0.09 to 0.4 mm for magnification radiography. On site measurements of these focal spots are not possible without invasive procedures if National Equipment Manufactures Association (NEMA) specifications are to be followed. This paper describes a method to perform such measurements expeditiously (1.5 h) and noninvasively. We describe how this method differs from NEMA test specifications, and report the test results of 22 units from ten manufacturers. Six of the focal spots were larger than the manufacturer's specifications which were based on current NEMA standards. Emphasis is placed on the need for verifiable standards for mammography x-ray systems.

Female↗

Medical pattern recognition pitfalls in a clinical setting: renal cell carcinoma survival prediction.

Three studies to predict renal cell carcinoma patient survival from tumor textures found in digitized early venous phase arteriograms were successful individually. However, when the three methods were compared, they were not consistent and no single method was clinically useful. The first study predicted 5 yr survival of 37 patients with 87% accuracy. The second study added 29 patients to the data base; the poor survival of the 21 patients who died within 5 yr of diagnosis was predicted with 80.9% accuracy. When 27 of these cases were redigitized with a laser scanner, average survival prediction accuracy was 78%. In these studies, digitization hardware, radiographic technique, normalization methods, window selection, and contrast medium distribution all contributed to differences in the statistics separating poor from good patient survival.

Angiography↗

A review of mammography test objects for the calibration of resolution, contrast, and exposure.

Mandated and voluntary accreditation and quality control programs for mammography require the use of standardized mammography test objects. We evaluated eleven commercially available test objects and three prototype test objects, comparing them with respect to their resolution targets, contrast targets, and the dose they required when imaged by the same automatic exposure meter. Ion chamber and/or thermoluminescent dosimeter measurements of exposure were made with each test object, while attenuation was measured for seven. Measurements of dosage using acrylic (5 test objects) and tissue equivalent epoxy (9 test objects) showed as much as a 400% variation in the radiation supplied by the same automatic exposure device when differences in thicknesses of test objects were normalized. Speck visibility was as dependent on the composition of the specks and of the surrounding material as on the size of the specks. Contrast targets were adequate in only three test objects. Optical density differences between images of a 4-cm-thick breast and of different test object materials, also 4 cm in thickness, exposed to the same radiation, imply that untested acrylic or epoxy resin materials should not used in the calibration of automatic exposure controls.

Evaluation Studies as Topic↗

Film-screen mammography x-ray tube anodes: molybdenum versus tungsten.

Gridless screen-film mammography at 23 kVp with a W anode (inherent filtration: 0.1 mm A1, added filtration: 0.025 mm Mo) can achieve contrast identical to that achieved with gridless film-screen mammography at 27 kVp with a Mo anode (inherent filtration: 1.0 mm Be, added filtration: 0.025-mm Mo). However, W-anode film-screen mammograms obtained at 23 kVp require more radiation than Mo-anode film-screen mammograms obtained at 27 kVp. The lack of contrast of W-anode film-screen images produced at the same kVp as Mo-anode images was verified clinically and with a low contrast test object imaged over a range of densities. A step wedge test object was then used to match contrast between Mo- and W-anode gridless film-screen images at various kVp. The low contrast test object images verified the contrast equivalence of images obtained at 23 kVp for a W anode and 27 kVp for a Mo anode. A comparison of the two kVp for different anode materials was tested clinically on ten patients. The clinical and low contrast test object experiments were reviewed by three radiologists specializing in mammography.

Electrodes↗

Mammography screen-film selection: individual facility testing technique.

Variations in tube output, film processing, and radiologist's preferences affect the screen-film combination that is appropriate for any particular mammographic facility. A technique to test a variety of screen-film combinations for screening mammography is described. Films are selected for testing because of their densitometric characteristics. Dose and clinical reliability are established with phantoms before the screen-film combinations are used to image consecutive patients having bilateral examinations. The mammograms selected for evaluation are those with similar optical density ranges, and which also may be compared to available previous mammograms or which have unusual mammographic findings. All radiologists reading mammograms at a facility independently score the selected cases. Scores of "unacceptable," "acceptable," or "outstanding" are assigned to four basic imaging characteristics: sharpness, contrast, visibility of skin line, and noise. Interobserver variations by this method require normalization, unlike ROC analysis which is not applicable for this data because of the absence of proved pathologic diagnoses. The testing of 5 films and two screens using 42 patient examinations required 2 h of time from each radiologist. It took 7 h of the physicist's time to pretest the 5 films, select the 42 acceptable examinations for testing by the radiologists, and summarize the data.

Female↗

Testing mammography equipment: evolution over a 4-year period.

The results of quality control (QC) tests on 70 mammography units in Southern California from 1986 to 1990 are reported. Thirteen facilities, selected because they housed all of the mammography units in three communities involved in a National Institutes of Health research project, had their units tested twice at an interval of 1 year. Fourteen self-selected units were also tested twice at intervals ranging from 1-3 years. Forty-three self-selected units in 31 additional facilities had testing only once. All 70 units underwent measurement of focal spot size or resolution, tube output, half-value layer (HVL), automatic exposure control (AEC) accuracy, relative kVp accuracy, mean glandular dose, and imaging of several test objects. The test results for the units tested once showed no significant differences compared to those tested twice. For the latter, once the units were tested and determined to be acceptable, retesting showed differences only in overall film optical density, dose, and AEC performance.

Ambulatory Care Facilities↗

Recommendations on performance characteristics of diagnostic exposure meters: report of AAPM Diagnostic X-Ray Imaging Task Group No. 6.

Task Group 6 of the Diagnostic X-Ray Imaging Committee of the American Association of Physicists in Medicine (AAPM) was appointed to develop performance standards for diagnostic x-ray exposure meters. The recommendations as approved by the Diagnostic X-Ray Imaging Committee and the Science Council of the AAPM are delineated in this report and provide specifications on meter precision, calibration accuracy, calibration reference points, linearity, energy dependence, exposure rate dependence, leakage, amplification gain settings, directional dependence, the stem effect, constancy checks, and calibration intervals. The report summarizes recommendations for meters used in mammography, general purpose radiography including special procedures, computed tomography, and radiation safety surveys for x-ray radiography.

Child↗

Mammography focal spot measurement with a star pattern: techniques to avoid inaccuracies.

The increased emphasis on mammography acceptance testing and quality control make the star pattern test an essential component of the procedure for diagnosing poor resolution due to large focal spots. In this paper procedures for calculating magnification and the correct angle of the star pattern to use are described. The preferred placement of the star pattern in the field and proper exposure technique is also discussed.

Biophysical Phenomena↗