[Prototype digital unit dedicated to radiography of the thorax].
Explore the source record for details and available documents.
Evaluation Studies as Topic↗
Biomedical subjects
G T Barnes
Publications and source records attributed to G T Barnes.
Dual-energy digital radiographic quantification of calcium in simulated pulmonary nodules.
The presence or absence of calcium in solitary pulmonary nodules may indicate whether a nodule is benign or malignant. Because current techniques for measuring the amount of calcium in these nodules are unsatisfactory, a study was carried out to assess the capability of dual-energy digital chest radiography to identify and quantify the calcium content of simulated pulmonary nodules of known calcium content. Measurements were carried out on 280 nodules of various sizes and calcium content that were placed within the lungs of a frozen human-chest phantom. A new calcium quantification technique that uses a parallelogram was developed to eliminate the problem of nodule superimposition over ribs. Nodules containing more than 35 mg of calcium per square centimeter (i.e., 7, 30, 60, and 110 mg of calcium for spherical nodules 0.5, 1.0, 1.5, and 2.0 cm in diameter) were measured with a high degree of accuracy and reasonable precision. Dual-energy digital radiography is a simple and accurate method of measuring the calcium content of solitary pulmonary nodules in humans.
Calcium↗
Metastatic calcification of the heart and lungs in end-stage renal disease: detection and quantification by dual-energy digital chest radiography.
Metastatic calcification of the lung and heart can cause severe cardiopulmonary compromise and death. Although it is found in most end-stage renal disease patients at autopsy, it is only rarely detected during life. Using a prototype dual-energy digital chest radiographic unit, we measured calcium content (mg/cm2) over the lung and heart in 32 hemodialysis patients. Pulmonary calcium content was significantly greater in these patients than in sex-matched control subjects (men, 230 +/- 43 [mean +/- standard error] vs 166 +/- 7, p less than .05; women, 168 +/- 19 vs 110 +/- 7.5, p less than .001). Abnormal values were detected by dual-energy radiography in 44% of patients (vs 9% of patients studied by conventional radiography). Cardiac calcium content was also significantly greater in the hemodialysis patients than in the control subjects (259 +/- 14 vs 184 +/- 8, p less than .05). Metastatic calcification was significantly correlated with elevated phosphate and calcium-phosphate product levels. Patients with significantly elevated pulmonary calcium content had evidence of restrictive lung disease by functional testing. There was an inverse correlation between elevated cardiac calcium content and ejection fraction. We conclude that dual-energy digital radiography allows premortem diagnosis of metastatic visceral calcification and is more sensitive than current techniques.
Adult↗
Mineral content of bone: measurement by energy subtraction digital chest radiography.
Several methods are presently available for measuring the mineral content of bone. Those in widespread use include dual-photon absorptiometry and quantitative CT. The feasibility of using dual-energy digital chest radiography for determination of the mineral content of posterior ribs on digital chest images was studied by using a prototype unit. The results showed a significant difference in the mineral density of the posterior ribs of control subjects and those of patients who had osteoporosis (251.1 +/- 36 mg Ca2+/cm2 of rib vs 158.8 +/- 48 mg Ca2+/cm2, p less than or equal to .01) and a close correlation with values obtained by dual-photon absorptiometry of the lumbar spine (r = .77). The results suggest that this technique can provide an accurate assessment of the presence or absence of osteoporosis.
Adult↗
Scanned projection digital radiography of the chest. A review of five years' experience.
Explore the source record for details and available documents.
Calcinosis↗
Effects of strong government measures against tobacco in Hong Kong.
The government of Hong Kong grasped the political nettle of control of tobacco in the early 1980s, since when a comprehensive policy of legislation, education, and publicity, together with large increases in taxation on tobacco products, has been introduced. This has led to almost all of the population of Hong Kong having knowledge of the harmful effects of tobacco and of antismoking measures taken by the government. From 1982 to 1984 the number of people who smoked daily fell appreciably from 888 300 to 744 500, a reduction of 16%, while the number of teenage smokers was halved (from 22 600 to 11 200). Government commitment is crucial in programmes against tobacco in developing countries; without it antismoking efforts are unlikely to be successful.
Adolescent↗
Digital and conventional chest imaging: a modified ROC study of observer performance using simulated nodules.
A modified receiver operating characteristic (ROC) study was performed in which five readers were asked to locate multiple nodules on images of an anthropomorphic phantom obtained with a prototype digital radiographic chest unit and with a conventional chest unit. Results indicate that when nodules were projected over the lungs, a significantly greater number (significant at the 5% level) were identified on conventional radiographs, whereas for nodules projected over the mediastinum, the digital images were notably superior (difference significant at the 2% level). An error analysis of the multiple nodule problem and pseudo-ROC curves are presented. The modified ROC study does not suffer from the positional ambiguity inherent in most ROC studies and is efficient in acquiring data.
Analog-Digital Conversion↗
Simulated pulmonary nodules: detection with dual-energy digital versus conventional radiography.
Performance of a prototype dual-energy digital chest radiography unit in detecting calcified and noncalcified simulated pulmonary nodules was compared with that of a highly optimized, conventional system. Nodules ranging in size (0.5, 1.0, and 1.6 cm), in number (five to 11), and in calcium content (0-25 mg) were superimposed over the lungs of a frozen, unembalmed, human chest phantom. For each technique, six observers examined 50 posteroanterior projections with different randomized nodule locations. Detection consisted of locating and assigning a level of confidence to each perceived nodular opacity. The resulting plots of the true-positive fraction versus the mean number of false-positive calls per projection indicate that for both calcified and noncalcified nodules, the digital unit performed significantly better (P less than .01).
Cadaver↗
Calcification in pulmonary nodules: detection with dual-energy digital radiography.
The authors undertook a clinical study to determine the accuracy of dual-energy digital radiography in revealing nodule calcification because calcification in a pulmonary nodule almost excludes the possibility of malignancy. Over a 6-month period, 61 patients with pulmonary nodules (less than or equal to 3 cm) or masses (greater than 3 cm) were examined on a prototype scanned projection unit using a dual-energy detector. In 49 of 61 patients, nodules were noncalcified, and in 12, they were calcified. In 57 patients, the benignancy or malignancy of nodules was established beyond reasonable doubt by pathologic confirmation in 38 and by strong inference in 19 (four patients with noncalcified solitary pulmonary nodules either refused further investigation or surgery or their follow-up was too short to permit exclusion of malignancy). Dual-energy radiography was found to be highly accurate in assessing the presence or absence of calcification in pulmonary nodules and thus in determining their benignancy or possible malignancy.
Adult↗
Potential value of digital radiography. Preliminary observations on the use of dual-energy subtraction in the evaluation of pulmonary nodules.
The radiographic demonstration of calcification in a solitary pulmonary nodule renders the possibility of malignancy extremely unlikely, although rare exceptions have been reported. Conventional roentgenograms and tomograms sometimes provide inconclusive evidence although CT can be highly accurate in both identifying and quantifying calcium content. An alternative method is dual-energy subtraction utilizing scanned projection digital radiography. Forty-one patients with solitary (occasionally multiple) pulmonary nodules were examined with the technique, employing second-generation fan-beam equipment: 28 nodules or masses were noncalcified and 13 calcified. Of the former, 20 were pathologically proved, 16 being malignant and 4 benign (2 granulomas, 2 bronchiectasis); in 3 of the remaining 8, a presumptive diagnosis was reasonably certain (1 granuloma, 2 metastases), while in 5 the diagnosis was not made. In 8 of the 13 calcified lesions, the diagnosis can reasonably be regarded as confirmed as granulomas; 5 are being followed up with that presumptive diagnosis.
Adult↗
Digital chest radiography: performance evaluation of a prototype unit.
Measurements of the physical performance of a prototype digital chest unit (DCU) are presented. The parameters evaluated were entrance skin exposure, system exposure response and dynamic range, system modulation transfer function (MTF), image noise levels, detective quantum efficiency (DQE) of the detector, and scatter suppression efficiency. Compared with conventional chest imaging systems, the unit has markedly greater exposure latitude, limited spatial resolution, a lower detector DQE, and virtually scatter-free images. Routine clinical exposure levels are comparable with the 1982 national average.
Equipment Design↗
Detector for dual-energy digital radiography.
A detection scheme is described that allows one to accomplish dual-energy scanned projection digital radiography without switching the x-ray tube voltage. The method employs a high/low atomic number detector sandwich that simultaneously separates the x-ray beam transmitted by the patient into low and high energy components. To test the method, the response of a scanning linear array of energy-sensitive detectors was simulated, and bone and soft tissue images of an anthropomorphic chest phantom were obtained at 140 kVp. These were compared with similar images obtained by switching the x-ray tube voltage from 80 kVp to a heavily filtered 140 kVp. For comparable entrance skin exposures, the dual-energy detector images required a lower tube load and resulted in higher noise levels. The latter is attributable to the fact that the separation in energy between the high and low energy components is smaller with the dual-energy detector than with the voltage switching technique, and to misregistration problems associated with the simulation methodology. A detector design is also discussed that would result in improved energy separation and lower noise levels. In view of this possibility and the tube loading advantage, the method looks promising for digital scanned projection radiography.
Humans↗
Digital subtraction angiography apparatus.
An inexpensive digital subtraction angiography (DSA) apparatus that can perform live subtraction, processed subtraction, and road mapping is described. The apparatus can be used in any standard x-ray room with fluoroscopic capability, with a simple connection to the existing TV chain. It is especially useful in therapeutic neuroangiography.
Angiography↗
Mammography phototimer technique chart.
A phototimer technique chart for mammography is presented along with the methodology used to design it. The chart is based on accurate measurement of breast thickness and helps overcome the inability of the phototimer to track as breast thickness varies. In clinical practice, the chart results in the consistent attainment of optimally exposed films and decreased number of retakes.
Female↗
Segmented-field radiography in scoliosis.
A method of scoliosis imaging using segmented fields is presented. The method is advantageous for patients requiring serial radiographic monitoring, as it results in markedly reduced radiation doses to critical organs, particularly the breast. Absorbed dose to the breast was measured to be 8.8 mrad (88 microGy) for a full-field examination and 0.051 mrad (5.1 microGy) for the segmented-field study. The segmented-field technique also results in improved image quality. Experience with 53 studies in 23 patients is reported.
Adolescent↗
Self-masking subtraction tomosynthesis.
The authors tested the image quality and dose savings of self-masking subtraction tomosynthesis (SST), which combines digital tomosynthesis with subtraction of a blurred self-mask. High-quality images of the inner ear of a head phantom were obtained at moderate dose savings. Although they were taken with linear motion, they did not exhibit the streaking due to off-fulcrum objects that is characteristic of conventional linear tomography. SST could reduce patient dose by a factor of at least 12 in examinations of the inner ear, and the mechanical aspects can be implemented with moderate modifications of existing instrumentation.
Computers↗
Digital radiography of the chest: clinical experience with a prototype unit.
A prototype digital unit dedicated to chest radiography was used to examine 50 selected patients for a comparison study of the capability of digital images and conventional chest radiographs to reveal normal anatomic structures and a variety of pathologic states. The images in both modes were submitted for interpretation to seven experienced radiologists and a standardized questionnaire completed for each. Visibility of seven anatomic structures in the mediastinum was consistently better on the digital images than on the conventional radiographs. With minor exceptions, pathologic states were equally well seen in the two systems. Despite the less familiar viewing format of the digital images, the mean confidence levels achieved were higher than for those on the conventional radiographs; this difference was statistically significant both for normal anatomic structures (p = 0.001) and pathologic states (p = 0.01). The advantages and disadvantages of the digital technique are discussed.
Adult↗
Digital radiography of the chest: design features and considerations for a prototype unit.
The general features of a prototype digital chest unit are described along with the rationale for the choice of design factors employed. It is shown that the scanning-slit, linear-detector-array approach employed can, with available x-ray tube technology, achieve a spatial resolution of 1 cy/mm and detector radiation levels comparable with those obtained with conventional screen-film systems. Also discussed are the unit's exposure latitude and its ability virtually to eliminate scatter.
Computers↗