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D R Dance

Publications and source records attributed to D R Dance.

At least 19 recordsLinked to original sources

Breast dosimetry using high-resolution voxel phantoms.

A computer model of X-ray mammography has been developed, which uses quasi-realistic high-resolution voxel phantoms to simulate the breast. The phantoms have 400 microm voxels and simulate the three-dimensional distributions of adipose and fibro-glandular tissues, Cooper's ligaments, ducts and skin and allow the estimation of dose to individual tissues. Calculations of the incident air kerma to mean glandular dose conversion factor, g, were made using a Mo/Mo spectrum at 28 kV for eight phantoms in the thickness range 40-80 mm and of varying glandularity. The values differed from standard tabulations used for breast dosimetry by up to 43%, because of the different spatial distribution of glandular tissue within the breast. To study this further, additional voxel phantoms were constructed, which gave variations of between 9 and 59% compared with standard values. For accurate breast dosimetry, it is therefore very important to take the distribution of glandular tissues into account.

Breast↗

Monte Carlo simulation of a mammographic test phantom.

A test phantom, including a wide range of mammographic tissue equivalent materials and test details, was imaged on a digital mammographic system. In order to quantify the effect of scatter on the contrast obtained for the test details, calculations of the scatter-to-primary ratio (S/P) have been made using a Monte Carlo simulation of the digital mammographic imaging chain, grid and test phantom. The results show that the S/P values corresponding to the imaging conditions used were in the range 0.084-0.126. Calculated and measured pixel values in different regions of the image were compared as a validation of the model and showed excellent agreement. The results indicate the potential of Monte Carlo methods in the image quality-patient dose process optimisation, especially in the assessment of imaging conditions not available on standard mammographic units.

Adipose Tissue↗

Calculation of the properties of digital mammograms using a computer simulation.

A Monte Carlo computer model of mammography has been developed to study and optimise the performance of digital mammographic systems. The program uses high-resolution voxel phantoms to model the breast, which simulate the adipose and fibroglandular tissues, Cooper's ligaments, ducts and skin in three dimensions. The model calculates the dose to each tissue, and also the quantities such as energy imparted to image pixels, noise per image pixel and scatter-to-primary (S/P) ratios. It allows studies of the dependence of image properties on breast structure and on position within the image. The program has been calibrated by calculating and measuring the pixel values and noise for a digital mammographic system. The thicknesses of two components of this system were unknown, and were adjusted to obtain a good agreement between measurement and calculation. The utility of the program is demonstrated with the calculations of the variation of the S/P ratio with and without a grid, and of the image contrast across the image of a 50-mm-thick breast phantom.

Adipose Tissue↗

CT dosimetry: getting the best from the adult Cristy phantom.

The use of geometrical phantoms for computed tomography (CT) dosimetry can incur errors in the calculation of effective dose due to the anatomically incorrect organ shapes and distributions, and unrepresentative body dimensions. A Monte Carlo program that makes use of an anatomically correct voxel phantom has been developed to calculate effective doses in CT and to compare with conventional dosimetric techniques. The code was validated against the latter by matching the phantom dimensions and simulating whole-body irradiation; agreement to within 6% was found. Effective doses were calculated for brain, lung, abdomen and pelvis CT scans for voxel phantom sizes corresponding to those of standard-sized adult, a teenager and 10% greater than those of standard-sized adult. Errors incurred by using the conventional techniques are minimised if the scan range is set by matching the fractions of radiosensitive organs that are irradiated directly. Under these circumstances, the conventional techniques will underestimate the dose to a 15 y old by up to 22% while the dose to a large subject is overestimated by up to 11%.

Adolescent↗

Estimation of the peak entrance surface air kerma for patients undergoing computed tomography-guided procedures.

The purpose of this work was to develop a method for estimating the patient peak entrance surface air kerma from measurements using a pencil ionisation chamber on dosimetry phantoms exposed in a computed tomography (CT) scanner. The method described is especially relevant for CT fluoroscopy and CT perfusion procedures where the peak entrance surface air kerma is the risk-related quantity of primary concern. Pencil ionisation chamber measurements include scattered radiation, which is outside the primary radiation field, and that must be subtracted in order to derive the peak entrance surface air kerma. A Monte Carlo computer model has therefore been used to calculate correction factors, which may be applied to measurements of the CT dose index obtained using a pencil ionisation chamber in order to estimate the peak entrance surface air kerma. The calculations were made for beam widths of 5, 7, 10 and 20 mm, for seven positions of the phantom, and for the geometry of a GE HiSpeed CT/i scanner. The program was validated by comparing measurements and calculations of CTDI for various vertical positions of the phantom and by directly estimating the peak ESAK using the program. Both validations showed agreement within statistical uncertainties (standard deviation of 2.3% or less). For the GE machine, the correction factors vary by approximately 10% with slice width for a fixed phantom position, being largest for the 20 mm beam width, and at that beam width range from 0.87 when the phantom surface is at the isocentre to 1.23 when it is displaced vertically by 24 cm.

Air↗

Monte Carlo simulations in CT for the study of the surface air kerma and energy imparted to phantoms of varying size and position.

A Monte Carlo computational model of CT has been developed and used to investigate the effect of various physical factors on the surface air kerma length product, the peak surface air kerma, the air kerma length product within a phantom and the energy imparted. The factors investigated were the bow-tie filter and the size, shape and position of a phantom which simulates the patient. The calculations show that the surface air kerma length product and the maximum surface air kerma are mainly dependent on phantom position and decrease along the vertical axis of the CT plane as the phantom surface moves away from the isocentre along this axis. As a result, measurements using standard body dosimetry phantoms may underestimate the skin dose for real patients. This result is specially important for CT fluoroscopic procedures: for an adult patient the peak skin dose can be 37% higher than that estimated with a standard measurement on the body AAPM (American Association of Physicists in Medicine) phantom. The results also show that the energy imparted to a phantom is mainly influenced by phantom size and is nearly independent of phantom position (within 3%) and shape (up to 5% variation). However, variations of up to 30% were found for the air kerma to regions within the AAPM body phantom when it is moved vertically. This highlights the importance of calculating doses to organs taking into account their size and position within the gantry.

Adult↗

Influence of the characteristic curve on the clinical image quality of lumbar spine and chest radiographs.

The "European Guidelines on Quality Criteria for Diagnostic Radiographic Images" do not address the choice of the film characteristic (H&D) curve, which is an important parameter for the description of a radiographic screen-film system. The image contrast of clinical lumbar spine and chest radiographs was altered by digital image processing techniques, simulating images with different H&D curves, both steeper and flatter than the original. The manipulated images were printed on film for evaluation. Seven experienced radiologists evaluated the clinical image quality by analysing the fulfilment of the European Image Criteria (ICS) and by visual grading analysis (VGA) of in total 224 lumbar spine and 360 chest images. A parallel study of the effect of the H&D curve has also been made using a theoretical model. The contrast (DeltaOD) of relevant anatomical details was calculated, using a Monte Carlo simulation-model of the complete imaging system including a 3D voxel phantom of a patient. Correlations between the calculated contrast and the radiologists' assessment by VGA were sought. The results of the radiologists' assessment show that the quality in selected regions of lumbar spine and chest images can be significantly improved by the use of films with a steeper H&D curve compared with the standard latitude film. Significant (p<0.05) correlations were found between the VGA results and the calculations of the contrast of transverse processes and trabecular details in the lumbar spine vertebrae, and with the contrast of blood vessels in the retrocardiac area of the chest.

Computer Simulation↗

X-ray refraction effects: application to the imaging of biological tissues.

The purpose of this study was to explore the potential of refraction contrast X-ray imaging of biological tissues. Images of dissected mouse lungs, heart, liver and legs were produced using the medical beamline at the Elettra Synchrotron at Trieste, Italy. The technique used was diffraction enhanced imaging. This utilizes a silicon crystal positioned between the tissue sample and the detector to separate refracted X-rays from transmitted and scattered radiation by Bragg diffraction. The contrast in the images produced is related to changes in the X-ray refractive index of the tissues, resulting in remarkable clarity compared with conventional X-ray images based on absorption effects. These changes were greatest at the boundaries between different tissues, giving a marked edge enhancement effect and three-dimensional appearance to the images. The technique provides a way of imaging a property of biological tissues not yet exploited, and further studies are planned to identify specific applications in medical imaging.

Animals↗

A study and optimization of lumbar spine X-ray imaging systems.

A Monte Carlo program has been developed that incorporates a voxel phantom of an adult patient in a model of the complete X-ray imaging system, including the anti-scatter grid and screen-film receptor. This allows the realistic estimation of patient dose and the corresponding image (optical density map) for a wide range of equipment configurations. This paper focuses on the application of the program to lumbar spine anteroposterior and lateral screen-film examinations. The program has been applied to study the variation of physical image quality measures and effective dose for changing system parameters such as tube voltage, grid design and screen-film system speed. These variations form the basis for optimization of these system parameters. In our approach to optimization, the best systems are those that can match (or come close to) the calculated image quality measure of systems preferred in a recent European clinical trial, but with lower patient dose. The largest dose savings found were 21% for a 400 speed class system with a grid having a strip density of 40 cm(-1) and a grid ratio of 16. A further dose saving of 13% was possible when a 600 speed class system was employed. The best systems found from the optimization correspond to those recommended by the European Commission guidelines on image quality criteria for diagnostic radiographic images.

Adult↗

Schemes for the optimization of chest radiography using a computer model of the patient and x-ray imaging system.

A computer program has been developed to model chest radiography. It incorporates a voxel phantom of an adult and includes antiscatter grid, radiographic screen, and film. Image quality is quantified by calculating the contrast (deltaOD) and the ideal observer signal-to-noise ratio (SNR(I)) for a number of relevant anatomical details at various positions in the anatomy. Detector noise and system unsharpness are modeled and their influence on image quality is considered. A measure of useful dynamic range is computed and defined as the fraction of the image that is reproduced at an optical density such that the film gradient exceeds a preset value. The effective dose is used as a measure of the radiation risk for the patient. A novel approach to patient dose and image quality optimization has been developed and implemented. It is based on a reference system acknowledged to yield acceptable image quality in a clinical trial. Two optimizations schemes have been studied, the first including the contrast of vessels as measure of image quality and the second scheme using also the signal-to-noise ratio of calcifications. Both schemes make use of our measure of useful dynamic range as a key quantity. A large variety of imaging conditions was simulated by varying the tube voltage, antiscatter device, screen-film system, and maximum optical density in the computed image. It was found that the optical density is crucial in screen-film chest radiography. Significant dose savings (30%-50%) can be accomplished without sacrificing image quality by using low-atomic-number grids with a low grid ratio or an air gap and more sensitive screen-film system. Dose-efficient configurations proposed by the model agree well with the example of good radiographic technique suggested by the European Commission.

Dose-Response Relationship, Radiation↗

Demonstration of correlations between clinical and physical image quality measures in chest and lumbar spine screen-film radiography.

The ability to predict clinical image quality from physical measures is useful for optimization in diagnostic radiology. In this work, clinical and physical assessments of image quality are compared and correlations between the two are derived. Clinical assessment has been made by a group of expert radiologists who evaluated fulfillment of the European image criteria for chest and lumbar spine radiography using two scoring methods: image criteria score (ICS) and visual grading analysis score (VGAS). Physical image quality measures were calculated using a Monte Carlo simulation model of the complete imaging system. This model includes a voxelized male anatomy and was used to calculate contrast and signal-to-noise ratio of various important anatomical details and measures of dynamic range. Correlations between the physical image quality measures on the one hand and the ICS and VGAS on the other were sought. 16 chest and 4 lumbar spine imaging system configurations were compared in frontal projection. A statistically significant correlation with clinical image quality was found in chest posteroanterior radiography for the contrast of blood vessels in the retrocardiac area and a measure of useful dynamic range. In lumbar spine anteroposterior radiography, a similar significant correlation with clinical image quality was found between the contrast and signal-to-noise ratio of the trabecular structures in the L1-L5 vertebrae. The significant correlation shows that clinical image quality can, at least in some cases, be predicted from appropriate measures of physical image quality.

Computer Simulation↗

Analysis of surface dose variation in CT procedures.

An experimental and theoretical study has been made of the variations in air kerma-length product (AKLP) at the surface of a phantom exposed in a CT scanner, using clinical parameters. For the theoretical part, a computer simulation was developed, based on a simple analytical model, requiring information generic to the scanner model. The effects of patient size, position within the gantry plane and beam-shaping filter type were studied using three different elliptical phantoms. A dose reduction technique based on a sinusoidal tube current modulation system was also investigated. The surface AKLP was shown to be independent of phantom size (within experimental error) but decreases as the surface moves vertically away from the isocentre. The major contributor to this variation is the beam-shaping filter. A maximum difference of 19% between the values of surface AKLP was calculated for the two beam-shaping filters available. When the tube current modulation system was used, the maximum surface dose reduction was 18%. A maximum difference of 2% was found between measurements and computer simulations. It is therefore possible to predict the behaviour of AKLP using the analytical model. As the dose measured on the surface of a patient is simply related to AKLP, the model can be applied to data obtained from patient surface dose surveys and can be helpful in interpreting the sources of variation in the latter.

Computer Simulation↗

Breast cancer diagnosis using scattered X-rays.

Small-angle X-ray diffraction data has been collected from 99 ;core-cut' breast tissue specimens representing a number of different pathologies. Data in the range 75-1390 A have been compared with controls from patients with no breast disease. Bessel functions and Bragg maxima resulting from the fibrillar structure of collagen have been identified. The Bragg maxima indexed onto a 649 A lattice. Systematic differences in the intensities and D-spacings between the collagen of malignant, benign and normal tissue groups have been clearly demonstrated and quantified. These differences appear to be due to a significantly lower structural order within the malignant tissues. Possible explanations for this are discussed and the potential for utilizing this observation in cancer diagnosis is considered.

Journal Article↗

Conversion factors for the estimation of effective dose in paediatric cardiac angiography.

Conversion factors, which relate the kerma-area product to effective dose, have been estimated for paediatric cardiac x-ray angiography. Monte Carlo techniques have been used to calculate the conversion factors for a wide range of projection angles for children of five ages and for adults. Correction factors are provided so that the conversion factors can be adjusted for different tube potentials and filtrations.

Adolescent↗

Additional factors for the estimation of mean glandular breast dose using the UK mammography dosimetry protocol.

The UK and European protocols for mammographic dosimetry use conversion factors that relate incident air kerma to the mean glandular dose (MGD) within the breast. The conversion factors currently used were obtained by computer simulation of a model breast with a composition of 50% adipose and 50% glandular tissues by weight (50% glandularity). Relative conversion factors have been calculated which allow the extension of the protocols to breasts of varying glandularity and for a wider range of mammographic x-ray spectra. The data have also been extended to breasts of a compressed thickness of 11 cm. To facilitate the calculation of MGD in patient surveys, typical breast glandularities are tabulated for women in the age ranges 40-49 and 50-64 years, and for breasts in the thickness range 2-11 cm. In addition, tables of equivalent thickness of polymethyl methacrylate have been provided to allow the simulation for dosimetric purposes of typical breasts of various thicknesses.

Adipose Tissue↗

Influence of anode/filter material and tube potential on contrast, signal-to-noise ratio and average absorbed dose in mammography: a Monte Carlo study.

The comparative performance of mammographic X-ray systems that use different anode/filter combinations has been assessed for screen-film and digital imaging. Monte Carlo techniques have been used to calculate average glandular dose as well as contrast and signal-to-noise ratio for imaging two test details. Five anode/filter combinations have been studied to establish the potential for dose saving or image quality improvement. For screen-film mammography, it was found that little benefit is gained by changing from a standard 28 kV molybdenum/molybdenum spectrum for breasts up to 6 cm thick. For thicker breasts, where the tube potential for the standard technique might be increased, 20% improvement in contrast can be achieved without dose penalty using molybdenum/rhodium or rhodium/rhodium spectra, whereas dose savings of more than 50% can be attained whilst maintaining contrast using tungsten/rhodium or rhodium/aluminium spectra. In digital mammography, a molybdenum/molybdenum spectrum delivers the lowest dose for a 2 cm breast, but gives the highest dose for thicker breasts. Tungsten/rhodium or rhodium/aluminium spectra provide the lowest doses at greater thicknesses. It is concluded that for screen-film mammography, molybdenum/molybdenum is the spectrum of choice for all but the thickest or most glandular breasts. In digital mammography, an alternative spectrum is preferable for breasts thicker than 2 cm.

Aluminum↗

Breast dosimetry.

The estimation of the absorbed dose to the breast is an important part of the quality control of the mammographic examination. Knowledge of breast dose is essential for the design and performance assessment of mammographic imaging systems. This review gives a historical introduction to the measurement of breast dose. The mean glandular dose (MGD) is introduced as an appropriate measure of breast dose. MGD can be estimated from measurements of the incident air kerma at the surface of the breast and the application of an appropriate conversion factor. Methods of calculating and measuring this conversion factor are described and the results discussed. The incident air kerma itself may be measured for patients or for a test phantom simulating the breast. In each case the dose may be determined using TLD measurements, or known exposure parameters and measurements of tube output. The methodology appropriate to each case is considered and the results from sample surveys of breast dose are presented. Finally the various national protocols for breast dosimetry are compared.

Breast↗

Use of the concept of energy imparted in diagnostic radiology.

The concept of energy imparted by ionizing radiation to the matter in a volume is analyzed and methods to determine the energy imparted epsilon to the patient are reviewed, in particular, determinations based on measurements of the air kerma integrated over beam area [the kerma-area-product (KAP)] and calculations needed to derive conversion factors epsilon/KAP. The energy imparted to the image receptor, epsilon rec, including the statistical aspects of the concept, and the effect of epsilon rec on image quality and patient dose are also analysed. Finally, use of the energy imparted to the patient as a risk indicator is discussed.

Humans↗