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Sample records for tetrofosmin chest images

  1. Usefulness of technetium-99m tetrofosmin single-photon emission computed tomography for short-term risk stratification in patients with acute chest pain in the emergency room

    International Nuclear Information System (INIS)

    Kawahito, Michitomo; Kondo, Makoto; Abe, Yoshiteru

    2003-01-01

    High-risk patients with acute coronary syndrome are difficult to distinguish from low-risk patients with chest pain in the emergency room. Technetium-99 m ( 99m Tc) tetrofosmin single-photon emission computed tomography (SPECT) was investigated to exclude high-risk patients with chest pain in the emergency room. 99m Tc-tetrofosmin SPECT was evaluated using a four-point scoring system in 228 patients (144 men, 84 women, mean age 68±12 years) with chest pain. Negative was defined as the myocardial segments with a defect score (DS) of 99m Tc-tetrofosmin; no significance (NS)), 84.9% (NS) and 60.4% (p 99m Tc-tetrofosmin SPECT is a useful method to exclude high-risk patients among patients with chest pain in the emergency room. (author)

  2. Tetrofosmin in metastatic breast cancer

    International Nuclear Information System (INIS)

    Berghammer, P.; Obwegeser, R.; Ulm, M.; Wiltschke, C.; Kubista, E.; Sinzinger, H.; Zielinski, C.

    1997-01-01

    Tetrofosmin (1,2-bis[bis(2-ethoxyethyl)phosphino]ethan) is currently under investigation for its tumor seeking properties, encouraged by the incidental finding of a malignant breast-lesion on myocardial scintigraphy in 1995 (Rambaldi et al, Clin Nucl Med 1995) using tetrofosmin. Recent reports have confirmed tetrofosmins role in detecting primary tumors in breast cancer. To investigate whether tetrofosmin significantly helps detect metastatic lesions in such patients we performed tetrofosmin scintigraphy in 21 patients with metastatic breast cancer. Patients and methods: Median age of patients was 61 years. In one patient the primary site was unknown. All patients had at least one distant metastasis. 550 MBq of 99m-Tc-tetrofosmin was administered ten minutes before imaging was begun. After obtaining a planar image, a single photon emission computed tomography (SPECT) was done of every suspected distant lesion. CT-scans or MRI were used to confirm positive correlation with tetrofosmin scintigraphy. Results: Tetrofosmin scintigraphy correctly diagnosed metastatic disease in 71 % of patients with no false negative and two false positive results. In each of the two patients a mediastinal hot spot suggestive of malignancy was found, but none of those lesions could be proven using CT scans. Excluding patients with liver metastasis from the present analysis, 91 % of all metastasis would have been correctly diagnosed. The first patient in our department had a large metastasis in the upper mediastinum which could not be seen on regular chest films. In the patient in whom the primary site of cancer was unknown, tetrofosmin scintigraphy showed three consecutive nodules in the left mammary, gland in a coronary fashion. Magnetic resonance imaging then confirmed two single nodules of 0.8 cm in diameter. Conclusions: Evaluating 21 patients, the present study was performed to investigate tetrofosmins properties of detecting metastatic lesions in patients with breast cancer. A 91

  3. A comparative study of 99Tcm-tetrofosmin and 99Tcm-MIBI myocardial imaging

    International Nuclear Information System (INIS)

    Zhao Kui; Chen Peng; Zhang Furong; Shen Wenhua

    2001-01-01

    Objective: To evaluate the value of 99 Tc m -tetrofosmin myocardial imaging for detecting coronary artery disease. Methods: Twenty-seven patients underwent 99 Tc m -tetrofosmin SPECT, twenty-six patients underwent 99 Tc m -MIBI SPECT; coronary angiography was performed on patients included in both groups (≥50% luminal diameter stenosis was considered significant coronary stenosis). Results: 99 Tc m -tetrofosmin produced high quality myocardial images from 30 min to several hours postinjection, the outlines of myocardial perfusion images provided by 99 Tc m -tetrofosmin imaging were clearly discernible. One-day exercise/rest 99 Tc m -tetrofosmin myocardial perfusion imaging was feasible and had a high sensitivity for detection of coronary artery disease. Sensitivities of 99 Tc m -tetrofosmin SPECT and 99 Tc m -MIBI SPECT for detecting coronary artery disease were 90% and 94%, respectively. The 95% confidence limits of both sensitivities were 68.65% - 98.77% and 72.33% - 99.86%, respectively; the positive predictive values of both imaging agents were 90.0% and 89.5%, respectively, the 95% confidence limits of those were 68.38% - 98.77% and 72.33% - 99.86% respectively; the positive predictive values of both imaging agents were 90.0% and 89.5%, respectively, the 95% confidence limits of those were 68.38% - 98.77% and 66.38% - 98.70%, respectively; efficiencies of both imaging agents were 85.2% and 88.5%, respectively. The 95% confidence limits of both efficiencies were 65.81% - 95.78% and 69.44 - 98.70%, respectively. The specificity for both imaging agents was 71% and 75%. There was no significant difference among above results (P > 0.05). No ECG abnormalities were found following the injection of 99 Tc m -tetrofosmin SPECT. There were no drug-related effects on blood pressure, heart rate and body temperature. This experiment failed to provide the negative predictive value of the myocardial perfusion imaging with 99 Tc m -tetrofosmin because that few patients with

  4. Tc99m-Tetrofosmin and Thallium-201 SPECT imaging of pituitary tumors: Preliminary results

    International Nuclear Information System (INIS)

    Yarman, S.; Mudun, A.

    2002-01-01

    Aim: It has been reported that pituitary adenomas accumulate Thallium -201(Tl-201), Tc99m-sestamibi and In111-Octreotide. These agents maybe useful in the diagnosis and follow-up of pituitary adenomas. Tc99m-tetrofosmin also has been shown as an tumor seeking agent in various tumors. The aim of this study is to evaluate the accumulation of Tc99m-tetrofosmin in pituitary adenomas and compare the results to Tl-201 SPECT. Methods: We performed Tc99m-Tetrofosmin and Tl-201 SPECT imaging on 5 patients (pts) with pituitary tumors, 3 patients with acromegaly, 1 patient with macro prolactinoma, and 1 patient with nonfunctional tumor (1 female, 4 male, age range: 26-50). SPECT imaging of cranium were obtained 20 min after intravenous injection of 111 MBq Tl-201 and 555 MBq Tc99m-Tetrofosmin on different days with a dual head gamma camera. All but one patient had surgical therapy. One patient had medical treatment. One patient had post surgical imaging with both Tetrofosmin and Tl-201 and 2 pts had only with Thallium. Semiquantitative analysis were performed by calculating tumor to background ratio from the mean counts of the created ROI's. Results: All adenomas showed prominent uptake with both Thallium and Tetrofosmin. The mean tumor to background ratios were 2.3 (range: 1.2-4.29) with Thallium and 3.57 (range: 1.6-6.86) with Tetrofosmin. Post therapy images showed no significant uptake in pituitary region with both agents in 2 patients. Post therapy mean Thallium uptake ratio in 3 pts was 1.64. One patient with acromegaly showed no decrease in thallium uptake, but showed some decrease in tetrofosmin uptake. Conclusion: Although our patient number is limited, these preliminary results indicate that Tc99m-tetrofosmin has also strong affinity for pituitary adenomas as does Thallium, either the adenoma is functioning or non-functioning. It may have a potential value to evaluate the response to therapy

  5. Clinical efficacy of 99mTc-tetrofosmin myocardial scintigraphy

    International Nuclear Information System (INIS)

    Adachi, Itaru; Sugioka, Yasushi; Tanaka, Yasunori

    1993-01-01

    99m Tc-tetrofosmin is a lipophilic, cationic diphosphine which has been developed for myocardial imaging. We examined 9 patients with ischemic heart disease including 3 angina pectoris (AP), 4 old myocardial infarction (OMI), 1 AP with OMI and 1 syndrome X. One patient was examined before and after operation. Three hundred seventy MBq of 99m Tc-tetrofosmin was injected during exercise and 740 MBq at rest. And 74 MBq of 201 Tl myocardial exercise and redistribution scintigraphy was also performed to compare with 99m Tc-tetrofosmin myocardial scintigraphy. SPECT, multiple gated SPECT and anterior planar images were obtained in all cases. We calculated percent wall thickening (%WT) using multiple gated SPECT images. There was a decreased lung uptake in 99m Tc-tetrofosmin planar images compared to 201 Tl myocardial scintigraphy. Liver and Biliary system uptake in 99m Tc-tetrofosmin images was decreased with intake of milk. Segmental comparison of SPECT images showed an agreement in 9/10 of the segment between 201 Tl and 99m Tc-tetrofosmin. We could obtain excellent quality of multiple gated SPECT images in all patients. We could calculate percent wall thickening (%WT) in all patients. We conclude that 99m Tc-tetrofosmin myocardial scintigraphy should provide usefulness for detection of ischemic myocardium as same as 201 Tl myocardial scintigraphy, although the biologic characteristics of two agents were different. These data and excellent quality of multiple gated SPECT images suggest that 99m Tc-tetrofosmin is a new 99m Tc agent for evaluation of patients with ischemic heart disease. (author)

  6. Technetium-99m tetrofosmin imaging in thyroid diseases: comparison with Tc-99m-pertechnetate, thallium-201 and Tc-99m-methoxyisobutylisonitrile scans

    International Nuclear Information System (INIS)

    Klain, M.; Cuocolo, A.; Marzano, L.; Lombardi, G.; Salvatore, M.; Univ. di Napoli

    1996-01-01

    In this study, tetrofosmin whole-body scintigraphy was performed in 35 patients with evidence of thyroid diseases. All patients underwent laboratory evaluation of thyroid function as well as 99m Tc pertechnetate scan, thallium-201 99m Tc-methoxyisobutylisonitrile (MIBI) whole-body studies. Thyroid images were semi-quantitatively analysed by a 4-point score: 0=no significant uptake; 1=uptake increased but inferior to normal thyroid tissue; 2=uptake equal to normal thyroid tissue; 3=uptake superior to normal thyroid tissue. A total of 41 thyroid nodules were detected, of which 15 were goitre nodules, 13 adenomas and 13 malignant lesions. In goitre nodules, concordant results of tetrofosmin and pertechnetate uptake (score 1 or 0) were observed in the majority of lesions (87%). In function adenomas both tetrofosmin uptake and pertechnetate uptake were score 3. In non-function adenomas tetrofosmin uptake was score 3, while pertechnetate uptake was score 0. In six malignant lesions, tetrofosmin uptake was score 3, while pertechnetate uptake was score 0; in the other seven lesions, where a prevalence of goitre abnormalities was observed, results of tetrofosmin and pertechnetate uptake were similar (score 0 or 1). In (70%) patients with malignant nodules, whole-body tetrofosmin images showed increased abnormal uptake in a total of 28 extra-thyroid tumour sites, as subsequently confirmed by other techniques. When tetrofosmin images were compared to 201 Tl and 99m Tc-MIBI scans, concordant results were observed in all cases. In conclusion, tetrofosmin imaging may be particularly useful to characterize and stage patients with malignant thyroid nodules; it shows similar results to thallium but provides better image quality. Comparable findings were observed between tetrofosmin and MIBI studies. Thus, tetrofosmin may be an alternative to thallium and MIBI in the aforementioned patients. (orig.). With 4 figs., 3 tabs

  7. Quantitative comparison of technetium-99m tetrofosmin and thallium-201 images of the thyroid and abnormal parathyroid glands

    International Nuclear Information System (INIS)

    Giordano, A.; Meduri, G.; Calcagni, M.L.; Marozzi, P.; Ficola, U.; Vaccaro, A.; Rubini, G.; Attard, M.; Li Puma, M.; Ricci, R.; Corsello, S.

    1999-01-01

    The aim of the study was to quantitatively compare the scintigraphic images of the thyroid and abnormal parathyroid glands obtained with technetium-99m tetrofosmin and thallium-201 in patients with hyperparathyroidism. Forty-six patients with hyperparathyroidism underwent 201 Tl (74 MBq), 99m Tc-pertechnetate (74 MBq) and 99m Tc-tetrofosmin (555-740 MBq) scintigraphy in a single session. Image analysis included the computation of the thyroid/background ratio in the whole study population and the parathyroid/background ratio, parathyroid/thyroid ratio and diagnostic sensitivity in 17 patients who underwent parathyroid surgery. The pertechnetate subtraction technique was used. 201 Tl and 99m Tc-tetrofosmin showed a similar thyroid/background ratio (1.79±0.41 and 1.81±0.47, respectively, P=NS); however, 99m Tc-tetrofosmin showed a higher parathyroid/background ratio than 201 Tl (2.06±0.54 vs 1.79± 0.50, P=0.007). Despite the superior quality of 99m Tc-tetrofosmin images, both tracers showed identical sensitivity in detecting enlarged parathyroid glands in patients with primary hyperparathyroidism (89%) and in those with secondary hyperparathyroidism (50%). (orig.)

  8. Evaluation of myocardial viability with 99Tcm-tetrofosmin after nitrate administration: comparison with FDG PET imaging

    International Nuclear Information System (INIS)

    He Wei; Cuocolo, A.

    2007-01-01

    Objective: The purpose of this study was to assess the relationship between tetrofosmin uptake after nitrate administration and the metabolic activity assessed by 18 F-FDG PET in patients with ischemic left ventricular (LV) dysfunction. Methods: A baseline 99 Tc m -tetrofosmin SPECT at rest and a repeated study after sublingual administration of 10 mg isosorbide dinitrate within two days were undertaken in 36 patients with chronic myocardial infarction and LV dysfunction. All patients underwent metabolic PET imaging with 18 F-FDG in the following week. 99 Tc m -tetrofosmin uptake and metabolic activity in 13 segments of myocardium were measured in every patient. A 55% peak activity on tetrofosmin and 50% peak activity on FDG were used as the differential threshold in evaluating myocardial viability, and the uptakes compared with regional LV function assessed by echocardiography. Results: Fifty-three (40%) of the 131 akinetic or dyskinetic segments had reduced tracer uptake. Of those segments, 14 (26%) segments showed increased tetrofosmin uptake after nitrate intervention (>10% vs baseline), 39 (74%) segments remained no change. The sensitivity and specificity of baseline tetrofosmin SPECT for detecting preserved metabolic activity were 69% and 86%, respectively. After nitrate administration, the sensitivity increased to 81% (P 99 Tc m -tetrofosmin SPECT after nitrate administration may improve the identification of ischemic but still viable myocardium in patients with chronic ischemic LV dysfunction. (authors)

  9. Assessment of area at risk and efficacy of treatment in patients with acute coronary syndrome using 99Tc tetrofosmin imaging in humans

    International Nuclear Information System (INIS)

    Matsuo, Hitoshi; Watanabe, Sachiro; Nishida, Yoshio

    1993-01-01

    The determination of the myocardium at risk before intervention and the change in that region after intervention constitute a promising measurement tool for the assessment of acute therapy. A new 99m Tc labeled myocardial blood flow tracer, 99m Tc tetrofosmin, is expected to enable the evaluation of myocardium at risk because of the absence of redistribution. This preliminary study was performed in 9 patients with acute coronary syndrome (4 unstable angina and 5 acute myocardial infarction) to investigate whether recovery of perfusion by tetrofosmin imaging parallels mechanical improvement. Tetrofosmin imaging was performed acutely and 3-30 days later. Visual analysis of defect severity was assessed in both studies. Segments with improvement in perfusion were accompanied by significant wall motion recovery compared with normal and unimproved segments (ΔWMI: normal segments 0.40±0.67, improved segments 1.79±0.68, unimproved segments -0.15±0.16, p 99m Tc tetrofosmin imaging is a useful method for the assessment of the myocardial area at risk and the efficacy of acute therapy in acute myocardial infarction and unstable angina. (author)

  10. Early and delayed Tc-99m-tetrofosmin myocardial SPECT in patients with left bundle branch block

    International Nuclear Information System (INIS)

    Sugihara, Hiroki; Kinoshita, Noriyuki; Adachi, Yoshihiko

    1998-01-01

    To determine the utility of the myocardial tracer Tc-99m-tetrofosmin in the examination of patients with left bundle branch block (LBBB) and to investigate Tc-99m-tetrofosmin uptake and retention in the myocardium, early and delayed Tc-99m-tetrofosmin SPECT was performed in 10 patients having LBBB without coronary stenosis. After 740 MBq of Tc-99m-tetrofosmin injection in the resting state, the early and delayed SPECT imaging was done at 30 min and 180 min, respectively. Decreased Tc-99m-tetrofosmin uptake in the septal segments was observed in 4 patients (40%) at 30 min and in 9 (90%) at 180 min. Reverse redistribution was seen in 9 of 10 patients. In patients with LBBB, the septal-to-lateral uptake ratio was lower in the delayed images than in the early images (0.80±0.09 vs. 0.89±0.09, p<0.001). In patients with LBBB, the washout rate of Tc-99m-tetrofosmin was higher in the septal segments than in the lateral segments (28.3±4.3% vs. 22.8±3.3%, p<0.001). The SPECT data indicate that in LBBB without coronary stenosis, the uptake of Tc-99m-tetrofosmin is decreased in the septal wall, and that reverse redistribution occurs frequently. Our results contribute to the elucidation of both the cellular biokinetics of Tc-99m-tetrofosmin in the myocardium and the hemodynamics of the septum in LBBB, and indicate the possible clinical utility of Tc-99m-tetrofosmin. (author)

  11. Evaluation of thyroid nodules with technetium-99m tetrofosmin dual-phase scintigraphy

    International Nuclear Information System (INIS)

    Kresnik, E.; Gallowitsch, H.J.; Mikosch, P.; Molnar, M.; Pipam, W.; Gomez, I.; Lind, P.

    1997-01-01

    Technetium-99m tetrofosmin, a lipophilic cationic complex molecule, was introduced for myocardial imaging. In some biodistribution studies it has also been reported to accumulate in the thyroid gland. Our objectives were to determine which thyroid nodules retain tetrofosmin and whether preoperative evaluation of malignancy is possible. Tetrofosmin scintigraphy was performed in 57 patients with a cold thyroid nodule on previously performed pertechnetate scintigraphy. All patients had undergone ultrasonography and sonographically guided fine-needle aspiration biopsy. The tetrofosmin scintigrams were obtained 5 min (early image) and 1 h (late image) after intravenous injection of 370 MBq. Only nodules that showed clear tracer retention after 1 h in comparison with retention at 5 min were classified as TETRO positive. Nodules without late retention were classified as TETRO negative. All patients underwent surgery and the histological results were compared with the results of tetrofosmin scintigraphy. Ten out of 11 patients with thyroid carcinoma (two pT1, three pT2, five pT4) were TETRO negative. One patient with papillary carcinoma (pT2) was TETRO positive. The mean nodular to thyroid tissue (N/T) ratio for the late scan was 1.0±0.20. There were 21 patients with thyroid adenomas (seven follicular, seven microfollicular and seven oxyphilic); 15 of these patients were TETRO positive and six TETRO negative. The mean N/T ratio for the late images was 1.34±0.41. All patients with degenerative goitre (24 cases) and the one patient with Hashimoto's disease were TETRO negative after 1 h and the N/T ratio was 0.92±0.12 on the late scan. Our results indicate that 99m Tc-tetrofosmin scanning is of little value preoperatively in distinguishing thyroid carcinoma from other thyroid nodules. Tetrofosmin tends to demonstrate thyroid adenomas but does not have a routine role in the assessment of thyroid nodules. (orig.). With 2 figs., 4 tabs

  12. Tc-99m-tetrofosmin scintimammography: A prospective study in primary breast lesions

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    Lind, P. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology; Gallowitsch, H.J. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology; Kogler, D. [LKH Klagenfurt (Austria). Dept. of Radiology; Kresnik, E. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology; Mikosch, P. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology; Gomez, I. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology

    1996-12-01

    The purpose of our study was to evaluate prospectively the sensitivity, specificity, PPV and NPV of scintimammography with a new catonic complex Tc-99m-tetrofosmin. Methods: Fourtyeight patients in whom mammography and/or high resolution ultrasonography (10 MHz) revealed suspicious breast lesions were studied with Tc-99m-tetrofosmin scintimammography. In thirty four of them biopsy and/or surgery was performed for histological evaluation. After intravenous injection of 555 MBq Tc-99m-tetrofosmin dynamic images over three minutes planar images in anterior and lateral projections and SPECT imaging including 3-D-reconstruction (20 min. p.i.) were performed. Scintimammography was evaluated as negative, equivocal (+), probably (++) or definitely (+++) positive. Results: Scintimammography with Tc-99m-tetrofosmin was negative in 18 patients (17 t.n.; 1 f.n.) and positive in 16 patients (10 t.p., 6 f.p.). The false negative scintimammography was observed in a patient with infiltrating ductal carcinoma pT1, the false positive result in a patient with fibrocystic disease; all of the five fibroadenomas were also `false` positive. Sensitivity of Tc-99m-tetrofosmin scintimammography in this prospective study was 91%, specificity 74%, PPV 63% and NPV 94%. Scintimammographic results in patients with suspicious breast lesion show, that Tc-99m-tetrofosmin accumulates in breast cancer as well as in fibroadenoma. However the high NPV of 94% excludes breast cancer in suspicious mammographic lesions in a very high degree and therefore reduces the need of biopsy and/or surgery in most of these patients. Conclusion: Our first results show that scintimammography with Tc-99m-tetrofosmin might play a role as further diagnostic step before surgery for women in whom mammography and/or ultrasonography show suspicious lesions. [Deutsch] Ziel unserer prospektiven Studie war es, die Sensitivitaet, Spezifitaet sowie den positiven (PVW) und negativen Voraussagewert (NVW) der Mammoszintigraphie

  13. TC-99M tetrofosmin scintimammography in diagnosis of breast cancer patients

    International Nuclear Information System (INIS)

    Jaukovic, L.; Spaic, R.; Ajdinovic, B.

    2004-01-01

    99m Tc Tetrofosmin is a cationic complex developed for myocardial perfusion imaging, also used in diagnosis of patients with various malignancies. AIM of this study was to compare the diagnostic accuracy of 99m Tc-Tetrofosmin scintimammography (SMM) and X-ray mammography (MM) in detection of primary breast cancer. Method: Twenty eight female patients (mean age 52.4) with 30 breast lesions suspicious for malignancy were comprised in the study. In all patients were performed clinical investigation, MM, SMM and biopsy/surgery for final histopathologic diagnosis. Patients were injected by 555 MBq 99m Tc-Tetrofosmin intravenously, cubitaly, in the arm contralateral to the side of suspicious lesion. Seven minutes static scans or' at least 2.0 million counts were obtained. Planar images were acquired in left and right prone lateral view as well as in the supine position for an anterior view of chest and axilary region. SMM scans were interpreted visuely regarding the tracer' uptake in tumor and background tissue. SMM scans and mammograms of 30 lesions were compared to the definitive histopathologic (HP) using decision matrix and the results expressed as: sensitivity, specificity, accuracy, positive (PPV) and negative predictive value (NPV). HP analysis revealed 20 malignant and 10 benign lesions. Out of 23 patients with positive SMM scans 19 were related to breast cancer ( 15 invasive ductal, 1 invasive lobular, 1 papilllar, 1 colloid cancer and 1 cystosarcoma phyllodes-malignant type). Comparing the sensitivity in our group of patients, MM 'missed' four cancer lesions and SMM only one (1.0 cm invasive ductal carcinoma). Three of four false positive SMM results were obtained in patients with fibroadenomas bigger than 2.0 cm. Conclusion: SMM could play an important role as a part of the diagnostic protocol in patients with breast lesion suspicious for malignancy. This protocol is aimed to reduce the number of biopsies performed on benign lesions, and in the other hand to

  14. Technetium-99m-tetrofosmin in diagnosis of breast cancer and axillary lymph node involvement

    International Nuclear Information System (INIS)

    Jaukovic, Dj.; Ajdinovic, B.Z.; Jankovic, Z. D.; Strbac, M.

    2006-01-01

    The aim of this study was to evaluate the accuracy of breast cancer seeking agent Tc-99m-Tetrofosmin in the detection of breast malignancy and axillary lymph node metastases. Twenty-eight female patients (mean age 52.4) with 30 breast lesions suspected of malignancy were enrolled in the study. All the patients underwent clinical investigation, Tc-99m Tetrofosmin scintimammography (SMM), mammography (MM) and biopsy/surgery for final histopathologic diagnosis. Patients were injected intravenously with 555 MBq of Tc-99m Tetrofosmin, cubitally, in the contralateral arm to the side of suspicious lesion. Seven minute static scans or at least 2.0 million counts were obtained using single head gamma camera (Orbiter 75, Siemens). Planar images were acquired in left and right prone lateral view as well as in the supine position for an anterior view of chest and axillary region. SMM scans of 30 breast lesions were compared to the definitive histopathology findings (HP) using decision matrix. In the group of 23 patients with positive SMM scans 19 had breast malignancy: 15 infiltrating ductal cancer, three patients with one infiltrating lobular, one papillary, one colloidal cancer and one patient with cystosarcoma phyllodes-malignant type. SMM detected primary breast malignancy with 95% sensitivity, 60% specificity and 83% accuracy. Axillary dissection was performed in 19/20 with malignant disease. The number of lymph nodes extracted and HP evaluated varied from 4 to 23 per patient. Metastatic involvement was confirmed by HP in 9 out of 20 patients. SMM detected axillary metastases with 55% sensitivity and 80% accuracy. Our results showed that SMM might be useful as a complementary test to improve the sensitivity and specificity of conventional imaging modalities, although SMM in the staging of breast carcinoma was less reliable. Further studies to evaluate the role of SMM in metastatic node involvement are necessary. (author)

  15. Effect of Temperature and Mole Ratio on the Synthesis Yield of Rhenium-Tetrofosmin

    Directory of Open Access Journals (Sweden)

    Widyastuti

    2015-08-01

    Full Text Available Technetium-99m (99mTc tetrofosmin is widely used in nuclear medicine as a diagnostic agent for myocardial perfusion and as a tumor imaging agent. As a parenteral preparation it requires an evaluation of its pharmacokinetics and stability in-vivo. Since 99mTc has a short half-life and is only available in very low concentrations, it is impossible to characterize its chemical properties and presence in the body. Due to this reason, only technetium-99 (T1/2 = 5 × 105 years, which is available in macro quantities, or natural rhenium can be used for this purpose. In this study rhenium-188 (188Re tetrofosmin will be synthesized and applied, because non-radioactive Re can be easily obtained. Synthesis and radiochemical purity analysis of carrier-added 188Re-tetrofosmin were carried out as a model to study the in-vivo stability of technetium-99m tetrofosmin. Rhenium-188 was used as a tracer to identify the formation of rhenium tetrofosmin. Rhenium gluconate was synthesized first prior to the formation of rhenium tetrofosmin. The quality of labeling for both rhenium gluconate and rhenium tetrofosmin was analyzed using paper- and thin-layer chromatography, respectively. Rhenium gluconate can be synthesized with high labeling yield within 1 hour, whereas rhenium tetrofosmin was synthesized both in room temperature and in an elevated temperature with various tetrofosmin-to-rhenium mole ratios.The results showed that heating at 95oC led to a higher yield of more than 90% within 30 minutes. Rhenium tetrofosmin could be produced in high radiochemical purity using an excess of tetrofosmin with mole ratio of 2000. It is concluded that rhenium tetrofosmin could be synthesized through the formation of rhenium gluconate, and a higher yield could be obtained in a shorter time by heating process.

  16. Uji Stabilitas Kit Cair Tetrofosmin pada Berbagai Kondisi Penyimpanan

    Directory of Open Access Journals (Sweden)

    Yunilda Yunilda

    2016-09-01

    Full Text Available Tetrofosmin radiopharmaceutical compound that is being developed by PTRR BATAN for use as myocardial perfusion imaging agent and cancer diagnostic agent in nuclear medicine. The aim of this study is observe the stability of this liquid kits after stored in various condition to determine its expire date various condition. The stability test was done of 1 hour, 3 hours, 5 hours and 7 hours after labeling. The radiochemical was determined its radiochemical purity has to be ≥ 90 %. Analysis of radiochemical purity was carried out by separation method which using Sep-Pak C18 cartride. Storage condition of tetrofosmin kit was carried out at various temperatures as in the deep freezer (-800C, freezer (-180C, refrigerator (2-60C and cool box (2-60C. The result showed that the liquid tetrofosmin kits stored in deep freezer, freezer, refrigerator were stable up to 23 months, 8 weeks and 4 days respectively. Simulation of stability  test after stored in a cool box was done by observing the temperature of cool box, and the result showed that the temperature in the cool box was constant as in refrigerator for up to 24 hours. Tetrofosmin which has been labeled with technetium-99m can with stand up 7 hours. It is concluded that expiry date of liquid tetrofosmin kit related with storage temperature, the lower the temperature the longer the expiry date of the kits.

  17. Pediatric chest imaging. Chest imaging in infants and children. 2. rev. ed.

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    Lucaya, Javier [Vall d' Hebron Hospitals, Barcelona (Spain). Dept. of Pediatric Radiology and Inst. of Diagnostic Imaging; Hospital Quiron, Barcelona (Spain). Dept. of Radiology; Strife, Janet L. (eds.) [Cincinnati Univ. Coll. of Medicine, Cincinnati, OH (United States). Dept. of Radiology Cincinnati Children' s Hospital Medical Center

    2008-07-01

    Imaging of the pediatric chest continues to evolve rapidly. All chapters in this 2nd edition of Pediatric Chest Imaging have been extensively updated, with additional disease-specific information and numerous new illustrations. The book thus presents the state of the art in the diagnosis of pediatric chest disorders, highlighting the role played by advanced technology. As the conventional features of most of these disorders are extremely well known, special attention is devoted to the technical aspects of the modern imaging modalities, their indications, and the diagnostic information that they supply. Individual chapters focus on chest ultrasound, nuclear medicine imaging, high-resolution chest CT, helical CT, and pediatric cardiac CT and pediatric cardiacMRI. Others are directed towards specific disorders, including congenital malformations of the chest, chest tumors, pulmonary infection, trauma, the lung in systemic diseases, the pediatric airway, foreign bodies, the thymus, and the chest wall. Without exception, the authors of this book are internationally known specialists with great expertise in the field. This book will serve as a handy, superbly illustrated reference for all who routinely image children, as well as for those who need access to information on how best to image them. (orig.)

  18. Learning chest imaging

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    Pedrozo Pupo, John C. (ed.) [Magdalena Univ., Santa Maria (Colombia). Respire - Inst. for Respiratory Care

    2013-03-01

    Useful learning tool for practitioners and students. Overview of the imaging techniques used in chest radiology. Aid to the correct interpretation of chest X-ray images. Radiology of the thorax forms an indispensable element of the basic diagnostic process for many conditions and is of key importance in a variety of medical disciplines. This user-friendly book provides an overview of the imaging techniques used in chest radiology and presents numerous instructive case-based images with accompanying explanatory text. A wide range of clinical conditions and circumstances are covered with the aim of enabling the reader to confidently interpret chest images by correctly identifying structures of interest and the causes of abnormalities. This book, which will be an invaluable learning tool, forms part of the Learning Imaging series for medical students, residents, less experienced radiologists, and other medical staff. Learning Imaging is a unique case-based series for those in professional education in general and for physicians in prarticular.

  19. 99m-Tc tetrofosmin scintigraphy vs mammography in breast cancer detection

    International Nuclear Information System (INIS)

    Jaukovic, L.J.; Spaic, R.; Markovic, S.; Stankovic, N.; Dimitrijevic, S.; Strbac, M.

    2002-01-01

    99m-Tc tetrofosmin is a widely used radiotracer for breast cancer imaging. Routine mammography ,as a method for screening breast cancer patients, might be insufficient for diagnosis, especially in patients with dense breast. Aim: The aim of this study was to compare the results of mammography (MM) and scintimammography with 99m- Tc tetrofosmin (SMM) in detection of primary breast cancer. Method: Thirty patients with breast disease were included in study. All of them had clinical investigation, MM, SMM and surgical biopsy for final histological diagnosis. An amount of 600 MBq 99m- Tc tetrofosmin was injected intravenously in the arm opposite to the side of breast lesion. Ten minutes after injection planar breast 7-minutes scans were performed in supine (anterior) and prone (left and right lateral) position. Results: Out of 30 lesion breast cancer was histologically confirmed in 20 (15 ductal invasive, two lobular, one colloid, one papillar carcinoma and one case of cyst sarcoma phylodes- malignant type.) For MM sensitivity of 80%, specificity of 60% and accuracy of 76 % were obtained. At SMM 19/ 20 malignant lesions were detected. Only one false negative result was obtained in 1.0 cm lobular infiltrative cancer, although the smallest detectable lesion measured 0.6 cm. At pathohistology ten lesions presented benign. Four false positive results (two fibroadenomas, one lipogranuloma and one case of fibrocystic disease) were observed, six true negative results in four cases with fibrocystic disease and two fibroadenomas. The overall sensitivity of scintimammography was 95%, specificity 60% and accuracy 83%. Conclusion: We concluded that sensitivity of 99m-Tc tetrofosmin scintimammography in detection of breast cancer is superior to that of mammography. Our results suggest that 99m -Tc tetrofosmin is a suitable tumor seeking agent for breast cancer imaging

  20. Use of resting myocardial scintigraphy during chest pain to exclude diagnosis of acute myocardial infarction

    International Nuclear Information System (INIS)

    Barbirato, Gustavo Borges; Azevedo, Jader Cunha de; Felix, Renata Christian Martins; Correa, Patricia Lavatori; Volschan, Andre; Viegas, Monica; Pimenta, Lucia; Dohmann, Hans Fernando Rocha; Mesquita, Evandro Tinoco; Mesquita, Claudio Tinoco

    2009-01-01

    Background: Images of myocardial perfusion taken during an episode of chest pain have been used for patients in the emergency department. Objective: To evaluate the operating characteristics of 99m Tc-Tetrofosmin scintigraphy during an episode of chest pain to exclude the diagnosis of cute myocardial infarction. Methods: One hundred and eight patients admitted with chest pain, or up to four hours after the end of symptoms and non diagnostic electrocardiogram, underwent resting scintigraphy and measurement of troponin I concentrations. Patients with a history of myocardial infarction (MI) were not excluded (24 patients). Troponin I concentrations were determined at admission and 6 hours later. Nuclear physicians performed a blind analysis of the images, and myocardial infarction was confirmed whenever troponin I level increase was three times that of the control. Results: Resting perfusion image was abnormal in all 6 patients with MI. Only 1 patient had a normal image and increased troponin levels. Fifty-five patients had positive images without MI, and 46 patients had normal images and troponin levels. The prevalence of the disease was 6.5%. The sensitivity and specificity of the resting images during an episode of chest pain to diagnose MI was 85.7% and 45.5%, respectively. The negative predictive value was 97.7%. Conclusion: Patients undergoing chest pain protocol with SPECT showed an excellent negative predictive value to exclude diagnosis of myocardial infarction. These results suggest that resting perfusion image is an important tool at the chest pain unit. (author)

  1. The use of {sup 99m} Tc-tetrofosmin in the hyperparathyroidism caused by parathyroid adenoma; Utilidade do {sup 99m} Tc-tetrofosmin no hiperparatireoidismo causado por adenoma de paratireoide

    Energy Technology Data Exchange (ETDEWEB)

    Calegaro, Jose Ulisses Manzini; Queiroz, Danicia Lobao; Barra Sobrinho, Alaor; Duarte, Lidia Vania de Moura; Gomes, Enio de Freitas; Almeida, Mario Sergio Severino de; Barcelos, Grecyane Lopes; Malheiros, Alessandra Maria Tavares; Ulyssea, Rogerio [Hospital de Base do Distrito Federal, Brasilia, DF (Brazil)

    1998-12-01

    The aim of this study was to verify the clinical condition of our patients with parathyroid adenoma an to evaluate the diagnostic value of {sup 99} Tc-tetrofosmin in its preoperative location. The authors reported 6 cases (3 males) with ages between 17 and 63 years old, 4 with bone manifestations, one with repetitive urinary lithyasis and another with peptic ulcer and obesity, showing alternations in calcium metabolism and increased P T H. They were submitted to parathyroid scintigraphy after intravenous injection of {sup 99m} Tc-tetrofosmin (20 m Ci; 740 MBq), with obtention of sequential images (10, 60, 120 minutes) in a gamma-camera with large field of detection. THe scintigraphy showed preferential uptake of the tracer in the inferior right lobe (2 cases) and in the inferior left lobe (4 cases) of thyroid, with total location agreement in the surgery. The histological study was parathyroid adenoma in all cases. These results emphasize the clinical necessity of a more initial diagnosis of primary hyperparathyroidism and it is possible to day that the metabolism of tetrofosmin is quite similar to sestamibi. Tetrofosmin can be used in parathyroid scintigraphy routinely. (author) 25 refs., 3 figs.

  2. Diagnostic and prognostic value of {sup 99m}Tc-tetrofosmin scintigraphy in maxillofacial flaps

    Energy Technology Data Exchange (ETDEWEB)

    Aigner, Reingard M.; Sorantin, Erich [Department of Radiology, Division of Nuclear Medicine, Karl-Franzens University Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Schultes, Guenter [Department of Oral and Maxillofacial Surgery, Karl-Franzens University Graz (Austria)

    2003-02-01

    In oro-maxillofacial malignancies, new therapeutic approaches are placing changing demands on the diverse diagnostic modalities. In contradistinction to mandibular reconstruction of former years, the transplants (microvascular anastomosed pedicled flaps, ''flaps'') now consist of one or more arteries feeding a soft tissue component attached to a piece of bone suitably fitted to fill the defect. We addressed the diagnostic value of technetium-99m tetrofosmin scintigraphy in differentiating between viability and non-viability of the soft tissue portion of flaps in the immediate postoperative assessment. A total of 60 patients who had received flaps for reconstruction of the mandible after partial resection were investigated with {sup 99m}Tc-tetrofosmin 3-5 days after surgery. Scintigraphy consisted of (a) radionuclide angiography, (b) static planar imaging in four projections starting at 10 min post injection, and (c) single-photon emission tomography (SPET) performed immediately after the planar imaging. Normal perfusion associated with no defects throughout the soft tissue portion of the transplant was observed in 46/60 patients. This scintigraphic pattern was identical to viability and normal postoperative follow-up. Hypoperfusion and small defects on planar and SPET images indicated viability and uncomplicated postoperative healing in 6/60 patients, but non-viability/inadequate healing of the flap in 4/60 patients. Absence of perfusion combined with a large defect on static planar and SPET images definitively showed the non-viability of the flap (4/60 patients). It is concluded that {sup 99m}Tc-tetrofosmin scintigraphy is a sensitive diagnostic tool for the immediate postoperative assessment of the viability and the adequacy of implantation of the soft tissue portion of flaps. Therefore tetrofosmin scintigraphy is an important modality in order (a) to define the optimal therapeutic regimen in the immediate postoperative period and (b) to

  3. Detection of tumor recurrence using technetium99m-tetrofosmin brain SPECT in patients with previously irradiated brain tumors

    International Nuclear Information System (INIS)

    Llamas A; Reyes A; Uribe, L F; Martinez T

    2004-01-01

    Objective: to assess the clinical utility of brain SPECT with Tc-99m Tetrofosmin to differentiate between tumor recurrence and radionecrosis in patients with primary brain tumors previously treated with external beam radiotherapy. Materials and methods: thirteen patients with clinical or radiological suspicion of tumor recurrence were studied with brain SPECT using 20-mCi of Tc-99m Tetrofosmin. Obtained images were interpreted by consensus between two experienced observers and subsequently classified as positive or negative for tumor viability. Results were compared to those of conventional diagnostic imaging techniques. Diagnostic test values and 95% confidence intervals were quantified. Results: SPECT results included 7 true-positives, 5 true-negatives and 1 false negative result. Conclusions: Tc-99m Tetrofosmin brain SPECT night be a useful alternative to diagnose recurrent brain tumors, especially with non-conclusive clinical and radiological findings

  4. Imaging of chest wall infections

    International Nuclear Information System (INIS)

    Chelli Bouaziz, Mouna; Jelassi, Helmi; Chaabane, Skander; Ladeb, Mohamed Fethi; Ben Miled-Mrad, Khaoula

    2009-01-01

    A wide variety of infections can affect the chest wall including pyogenic, tuberculous, fungal, and some other unusual infections. These potentially life-threatening disorders are frequent especially among immunocompromised patients but often misdiagnosed by physical examination and radiographs. The purpose of this article is to describe the clinical and imaging features of these different chest wall infections according to the different imaging modalities with emphasis on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). The outcome of chest wall infection depends on early diagnosis, severity of the immunosuppression, offending organism, and extent of infection. Because clinical findings and laboratory tests may be not contributive in immunocompromised patients, imaging plays an important role in the early detection and precise assessment of the disease. US, CT, and MRI are all useful: bone destruction is more accurately detected with CT whereas soft tissue involvement are better visualized with US and MRI. CT and US are also used to guide percutaneous biopsy and drainage procedures. MR images are helpful in pre-operative planning of extensive chest wall infections. (orig.)

  5. Reverse redistribution phenomenon on rest 99mTc-tetrofosmin myocardial single photon emission computed tomography involves impaired left ventricular contraction in patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Kurokawa, Kazuyuki; Ohte, Nobuyuki; Miyabe, Hiromichi; Akita, Sachie; Yajima, Kazuhiro; Hayano, Junichiro; Kimura, Genjiro

    2003-01-01

    The purpose of this study was to investigate the clinical significance of the reverse redistribution (RR) phenomenon on technetium-99m ( 99m Tc)-tetrofosmin myocardial single photon emission computed tomography (SPECT) performed at rest. Twenty-five patients underwent myocardial SPECT 3 weeks after the onset of acute myocardial infarction. Myocardial images were acquired at 40 min (early) and 4 h (delayed) after the injection of 740 MBq of 99m Tc-tetrofosmin. The regional myocardial uptake of the tracer in 26 segments of the left ventricular (LV) wall was visually scored from 0 (no activity) to 3 (normal activity), and then the RR was defined as a decrease of more than 1 point in the activity score on the delayed image compared with that on the early image. Regions with an activity score of 3 on both the early and delayed images were defined as normal, and those with a score of 0 or 1 on the early image were considered to have a fixed defect. The regional myocardial 99m Tc-tetrofosmin uptake and washout rate were also quantitatively assessed in each region. In addition, exercise stress electrocardiograph-gated SPECT with 99m Tc-tetrofosmin was performed within 1 week of the rest study, and the percent count increase (%CI) during myocardial contraction in each corresponding region was studied. RR was observed in 18 of the 25 patients. The regional washout rate of 99m Tc-tetrofosmin was significantly higher in the RR regions (45.0±3.8%) than in either the normal regions (36.4±4.1%, p 99m Tc-tetrofosmin SPECT have severely impaired LV wall contraction after exercise. (author)

  6. Differential diagnosis of MRI detected intra cranial space occupying lesions (ICSOLS)-role of 99MTC tetrofosmin cerebral spect

    International Nuclear Information System (INIS)

    Padmal, S.; Sundaram, P.S.; Kumar, S.

    2004-01-01

    Discriminating the correct etiology of Intra Cranial Space Occupying Lesions (ICSOLs) detected by MRI is of paramount importance in deciding the right therapeutic approach. Functional imaging like 99m Tc Tetrofosmin cerebral SPECT (C SPECT) can be used to differentiate malignant from other benign cerebral pathologies. Objective: Our aim was to assess the efficacy of C SPECT in differentiating various etiologies (i.e. Infective / Inflammatory, Neoplastic and Post Radiotherapy changes) of MRI detected ICSOLs. We also aimed to assess the incremental value of quantitative uptake ratios in identifying the exact nature of ICSOLs. Method: 26 Patients (M:F=20:6), age range 28-76 yrs, mean 42±7 yrs were evaluated by 99mTc Tetrofosmin cerebral SPECT. 14/26 patients were HIV positive cases while remaining 12 were treated patients of intracerebral malignancies. All these patients had one or more discrete MRI detected ICSOLs. 6/4 patients with HIV and 4/12 patients in the non HIV group showed more than 1 discrete ICSOLs. 20 mci of 99mTc Tetrofosmin was injected IV .15 min (early) and 2 hrs (delayed) post injection C SPECT images were acquired on a dual head variable angle Gamma camera. After reconstruction, transverse, coronal and sagittal images were co- registered with DICOM online available MRI images using aco- registration software. Focal Tetrofosmin uptake in MRI detected ICSOL was interpreted as abnormal. Tetrofosmin uptake index (Ix) was calculated in early and delayed images as ratio of counts in lesion to that of contra lateral region. A value of more than 1.3 was considered to be abnormal. Persistent Ix of more than 1.3 in initial and delayed images were considered to be malignant while Ix of more or less than 1.3 in initial but less than 1.3 in delayed images was considered to be benign in both groups. Results: In HIV group (14 pts), 4 patients showed an Ix of less than 1.3 in both early and delayed images and 7 patients showed an Ix of more than 1.3 in early but

  7. Pediatric digital chest imaging.

    Science.gov (United States)

    Tarver, R D; Cohen, M; Broderick, N J; Conces, D J

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  8. Pediatric digital chest imaging

    International Nuclear Information System (INIS)

    Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr.

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology

  9. Myocardial imaging with 99mTc-Tetrofosmin: Influence of post-stress acquisition time, regional radiotracer uptake, and wall motion abnormalities on the clinical result.

    Science.gov (United States)

    Giorgetti, Assuero; Kusch, Annette; Casagranda, Mirta; Tagliavia, Irene D'Aragona; Marzullo, Paolo

    2010-04-01

    We previously demonstrated that early (15', T1) post-stress myocardial imaging with Tetrofosmin could be more accurate than standard acquisitions (45', T2) in identifying coronary artery disease. To clarify this phenomenon, 120 subjects (age 61 +/- 10 years) with both T1 and T2 scans were divided into Group 1 (53/120 pts) with more ischemia at T1 vs T2 imaging (T1-T2SDS > or = 3); Group 2 (67/120 pts) with similar results (T1-T2SDS statistic and semiquantitative wall motion/thickening values were obtained. Analysis of T1 and T2 post-stress myocardial counts demonstrated a significant Tetrofosmin wash-out rate that was higher in Group 1 control nonischemic regions (15 +/- 8% vs 13.6 +/- 9.6%, P stress wall thickening (T1-T2) was lower in Group 1 ischemic regions (-4.5 +/- 9.15% vs -1.90 +/- 7.0%, P stress acquisition time because of ischemic-induced regional wall thickening abnormalities and the existence of a differential radiotracer myocardial wash-out.

  10. Usefulness of Ga-67 citrate whole body imaging, chest spot imaging, and chest SPECT in sarcoidosis

    International Nuclear Information System (INIS)

    Ueno, Kyoichi; Nishi, Koichi; Namura, Masanobu; Kawashima, Yoshio; Kurumaya, Hiroshi

    1999-01-01

    To assess the sensitivity, and the relative role of Ga-67 whole body, chest spot imaging, and chest SPECT, we retrospectively studied 34 cases of sarcoidosis (24 biopsy proven, 10 clinically diagnosed) with Ga-67 (111 MBq), and compared the results of lung (25 cases), muscle (25 cases), skin (3 cases), and myocardial (2 cases) biopsies. Ga-67 chest SPECT (single photon emission CT) were done in 17 cases with Siemens MultiSPECT3. Ga-67 planar imaging visualized only 2 of 12 (16.7%) lung biopsy-positive cases, 5 of 12 (41.6%) muscle biopsy-positive cases, 2 of 3 (66.7%) skin biopsy-positive cases. However, Ga-67 imaging revealed the lesions in 1 of 9 (11.1%) of muscle biopsy-negative cases, in 2 of 3 (66.7%) of skin biopsy-negative cases, and in 1 of 2 myocardial biopsy-negative cases. Ga-67 chest SPECT visualized 14 hilar lymphadenopathy (LN), 3 supraclavicular LN, and 1 myocardial sarcoidosis. Although both SPECT, and planar spot imaging detected the lesions equally, the former showed them more clearly. Compared with various biopsies, the sensitivity of Ga-67 imaging was not so high. However, Ga-67 imaging is non-invasive, easy to perform the whole body imaging, and can detect the activity of the lesions. Ga-67 SPECT showed clear imaging of the hilar, mediastinal LN, and potentially fatal myocardial sarcoidosis. (author)

  11. Role of 99mTc-Tetrofosmin scintimammography in diagnosis of breast cancer patients

    International Nuclear Information System (INIS)

    Jaukovic, L.J.; Spaic, R.

    2004-01-01

    Full text: 99mTc Tetrofosmin is a cationic complex developed for myocardial perfusion imaging, also used in diagnosis of patients with various malignancies. The aim of this study was to compare the diagnostic accuracy of 99mTc Tetrofosmin scintimammography (SMM) in detection of primary breast cancer with that of X-ray mammography (MM). Eighty-five patients with suspicious mammographic and/or sonographic findings were referred to our department for SMM. Out of these, 28 female patients (mean age 52.4 years) with 30 breast lesions suspicious for malignancy were included in the study. All the 28 patients underwent, MM, SMM and biopsy/surgery for final histological diagnosis. 555 MBq of 99mTc Tetrofosmin was injected intravenously in the arm contra lateral to the side of suspicious lesion. Seven minutes static scans of at least two million counts were obtained using a large field of view gamma camera coupled with a low energy high-resolution collimator. Planar left lateral and right lateral images were acquired in prone position. An anterior image of chest and axillary region in the supine position with the hands raised above the head was also acquired. SMM scans were interpreted visually vis-a-vis the tracer uptake in tumor and background tissue, as well as the homogeneity of tracer distribution. SMM scans and mammograms of 30 lesions were compared with the definitive histopathological findings using decision matrix and the results were expressed as: sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV). Increased tracer uptake on SMM was noticed in 23 lesions with 19/20 proved to be malignant. The smallest lesion measured only 0.6 cm (infiltrating ductal arcinoma) the biggest one was 5.0 cm in diameter (Cystosarcoma phylode-malignant type). Infiltrating lesions with central necrosis showed diffuse inhomogeneously intense tracer uptake on SMM. In one patient SMM scan presented multifocality of disease while MM showed

  12. Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction

    International Nuclear Information System (INIS)

    Park, Soon Ah; Kim, Dae Weung; Kim, Chang Guhn; Jeong, Jin Won; Kim, Nam Ho; Yun, Kyeong Ho

    2009-01-01

    This study was performed to investigate the clinical significance of reverse redistribution (RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography (SPECT) in patients with acute myocardial infarction after revascularization. A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography (CAG) were performed 9 months later. On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments (31%) and in 43 patients (64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR (p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR (p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium

  13. Accumulation of Tc-99m-MIBI and Tc-99m-tetrofosmin in tumor cells. Uptake and washout studies

    International Nuclear Information System (INIS)

    Rodrigues, M.; Aghajanian, A.A.; Sinzinger, H.; Kalinowska, W.; Zielinski, C.

    2002-01-01

    Tc-99m-tetrofosmin seem to be promising for the in-vivo imaging and characterization of tumors with high cellular metabolic activity, such as cells rich in mitochondria or enhanced mitochondrial activity

  14. Nuclear imaging of the chest

    International Nuclear Information System (INIS)

    Bahk, Y.W.

    1998-01-01

    This book provides up-to-the minute information on the diagnostic nuclear imaging of chest disorders. The authors have endeavored to integrate and consolidate the many different subspecialities in order to enable a holistic understanding of chest diseases from the nuclear medicine standpoint. Highlights of the book include in addition to the cardiac scan the description of aerosol lung imaging in COPD and other important pulmonary diseases and the updates on breast and lung cancer imaging, as well as imaging of the bony thorax and esophagus. It is required reading not only for nuclear medicine practitioners and researchers but also for all interested radiologists, traumatologists, pulmonologists, oncologists and cardiologists. (orig.)

  15. Quantitative exercise technetium-99m tetrofosmin myocardial tomography for the identification and localization of coronary artery disease

    International Nuclear Information System (INIS)

    Sullo, P.; Cuocolo, A.; Nicolai, E.; Cardei, S.; Nappi, A.; Squame, F.; Covelli, E.M.; Pace, L.; Salvatore, M.

    1996-01-01

    The aim of this study was to evaluate the accuracy of quantitative 1-day exercise-rest technetium-99m tetrofosmin tomography in the identification of patients with coronary artery disease (CAD) and in the detection of individual stenosed coronary vessels. Sixty-one patients with suspected CAD who underwent coronary angiography and 13 normal volunteers were studied. All patients were submitted to two i.v. injections of 99m Tc-tetrofosmin, one at peak exercise (370 MBq) and the other (1110 MBq) at rest 3 h after exercise (images 15-30 min after injection for both studies). All patients with CAD (≥50% luminal stenosis) (n=50) had an abnormal 99m Tc-tetrofosmin tomogram. Only one patient without significant coronary narrowing showed abnormal findings. Overall senstivity, specificity and diagnostic accuracy in the detection of individual stenosed vissels were 77%, 93% and 85%, respectively. Sensitivity and diagnostic accuracy in the identification of individuals stenosed coronary vessels were significantly higher (P 75%). (orig.)

  16. New chromatographic systems for the quality control determination of 99Tcm-tetrofosmin

    International Nuclear Information System (INIS)

    Penglis, S.; Tsopelas, C.

    1999-01-01

    Full text: The manufacturer's method for assessing the radiochemical purity (RCP) of 99 Tc m -tetrofosmin requires the use of a volatile solvent system on silica gel impregnated thin layer chromatography strips, and is a time-consuming procedure (> 15 minutes). A rapid quality control procedure for this product has already been proposed which utilizes miniature Whatman 1 paper strips with ethyl acetate as the mobile phase, where 99 Tc m -tetrofosmin appears at the solvent front (R f 0.9). In our laboratory, this procedure was found to be unreliable, prompting us to develop two new and improved methods to successfully determine the % RCP of 99 Tc m -tetrofosmin. These include: (1) an Amprep anion exchange cartridge with absolute ethanol as the mobile phase; and (2) a miniature Whatman 17 strip with ethyl acetate:acetone [1:9] as the mobile phase. 99 Tc m -tetrofosmin elutes with the solvent, and 99 Tc m O 2 plus 99 Tc m O 4 -remain on the cartridge for the cartridge method. 99 Tc m -tetrofosmin moves with the solvent front (Rf 0.8) and the other 99 Tc m -impurities remain at the origin for the Whatman paper method. The % RCP of 99 Tc m -tetrofosmin (n = 8) by the manufacturer's method was 96.5 ± 1.5%, as compared to the cartridge method (98.0 ± 0.9%) and Whatman paper method (97.3 ± 0.9%) at 0-2 h post-reconstitution. The quality control determinations gave a result in 3 or 5 min for the cartridge or Whatman paper methods respectively. These methods can be used successfully in a dose calibrator for counting, particularly if the total counts are > 1.5 MBq. These new methods were found to be highly reproducible, convenient and rapid for the routine analysis of 99 Tc m -tetrofosmin preparations

  17. Discordant results in Tc-99m tetrofosmin and Tc-99m sestamibi parathyroid scintigraphies; Resultados discordantes em cintilografias das paratireoides realizadas com tetrofosmin-99mTc e com sestamibi-99mTc

    Energy Technology Data Exchange (ETDEWEB)

    Duarte, Paulo Schiavom; Domingues, Fernanda C.; Santi Costa, Michele; Brandao, Cynthia; Oliveira, Marco A.C. de; Vieira, Jose G.H. [Fleury - Centro de Medicina Diagnostica, Sao Paulo, SP (Brazil)]. E-mail: paulo.duarte@fleury.com.br

    2007-10-15

    Parathyroid scintigraphies have been used to detect pathological parathyroid glands either before as well as after the parathyroid resection surgery in patients with hyperparathyroidism. One of the most utilized techniques to perform the studies is the double-phase images with Tc-99m sestamibi, which has been shown to be very accurate in the localization of enlarged parathyroid glands. Similar to Tc-99m sestamibi, Tc-99m tetrofosmin is a radiopharmaceutical initially developed to perform myocardial perfusion study that has been used to perform parathyroid scintigraphies. Although most of the papers suggest that the overall sensitivities of both radiopharmaceuticals are similar, there are some papers questioning the accuracy of Tc-99m tetrofosmin to detect abnormal parathyroid glands. In the present article, we report a case with discordant results by both methods. (author)

  18. Regional variance of visually lossless threshold in compressed chest CT images: Lung versus mediastinum and chest wall

    International Nuclear Information System (INIS)

    Kim, Tae Jung; Lee, Kyoung Ho; Kim, Bohyoung; Kim, Kil Joong; Chun, Eun Ju; Bajpai, Vasundhara; Kim, Young Hoon; Hahn, Seokyung; Lee, Kyung Won

    2009-01-01

    Objective: To estimate the visually lossless threshold (VLT) for the Joint Photographic Experts Group (JPEG) 2000 compression of chest CT images and to demonstrate the variance of the VLT between the lung and mediastinum/chest wall. Subjects and methods: Eighty images were compressed reversibly (as negative control) and irreversibly to 5:1, 10:1, 15:1 and 20:1. Five radiologists determined if the compressed images were distinguishable from their originals in the lung and mediastinum/chest wall. Exact tests for paired proportions were used to compare the readers' responses between the reversible and irreversible compressions and between the lung and mediastinum/chest wall. Results: At reversible, 5:1, 10:1, 15:1, and 20:1 compressions, 0%, 0%, 3-49% (p < .004, for three readers), 69-99% (p < .001, for all readers), and 100% of the 80 image pairs were distinguishable in the lung, respectively; and 0%, 0%, 74-100% (p < .001, for all readers), 100%, and 100% were distinguishable in the mediastinum/chest wall, respectively. The image pairs were less frequently distinguishable in the lung than in the mediastinum/chest wall at 10:1 (p < .001, for all readers) and 15:1 (p < .001, for two readers). In 321 image comparisons, the image pairs were indistinguishable in the lung but distinguishable in the mediastinum/chest wall, whereas there was no instance of the opposite. Conclusion: For JPEG2000 compression of chest CT images, the VLT is between 5:1 and 10:1. The lung is more tolerant to the compression than the mediastinum/chest wall.

  19. Regional variance of visually lossless threshold in compressed chest CT images: Lung versus mediastinum and chest wall

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Jung [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Lee, Kyoung Ho [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)], E-mail: kholee@snubhrad.snu.ac.kr; Kim, Bohyoung; Kim, Kil Joong; Chun, Eun Ju; Bajpai, Vasundhara; Kim, Young Hoon [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Hahn, Seokyung [Medical Research Collaborating Center, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Seoul National University College of Medicine (Korea, Republic of); Lee, Kyung Won [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)

    2009-03-15

    Objective: To estimate the visually lossless threshold (VLT) for the Joint Photographic Experts Group (JPEG) 2000 compression of chest CT images and to demonstrate the variance of the VLT between the lung and mediastinum/chest wall. Subjects and methods: Eighty images were compressed reversibly (as negative control) and irreversibly to 5:1, 10:1, 15:1 and 20:1. Five radiologists determined if the compressed images were distinguishable from their originals in the lung and mediastinum/chest wall. Exact tests for paired proportions were used to compare the readers' responses between the reversible and irreversible compressions and between the lung and mediastinum/chest wall. Results: At reversible, 5:1, 10:1, 15:1, and 20:1 compressions, 0%, 0%, 3-49% (p < .004, for three readers), 69-99% (p < .001, for all readers), and 100% of the 80 image pairs were distinguishable in the lung, respectively; and 0%, 0%, 74-100% (p < .001, for all readers), 100%, and 100% were distinguishable in the mediastinum/chest wall, respectively. The image pairs were less frequently distinguishable in the lung than in the mediastinum/chest wall at 10:1 (p < .001, for all readers) and 15:1 (p < .001, for two readers). In 321 image comparisons, the image pairs were indistinguishable in the lung but distinguishable in the mediastinum/chest wall, whereas there was no instance of the opposite. Conclusion: For JPEG2000 compression of chest CT images, the VLT is between 5:1 and 10:1. The lung is more tolerant to the compression than the mediastinum/chest wall.

  20. [Imaging of pleural diseases: evaluation of imaging methods based on chest radiography].

    Science.gov (United States)

    Poyraz, Necdet; Kalkan, Havva; Ödev, Kemal; Ceran, Sami

    2017-03-01

    The most commonly employed radiologic method in diagnosis of pleural diseases is conventional chest radiograph. The commonest chest- X-Ray findings are the presence of pleural effusion and thickening. Small pleural effusions are not readily identified on posteroanterior chest radiograph. However, lateral decubitus chest radiograph and chest ultrasonography may show small pleural effusions. These are more efficient methods than posteroanterior chest radiograph in the erect position for demonstrating small amounts of free pleural effusions. Chest ultrasonograph may be able to help in distinguishing the pleural pathologies from parenchymal lesions. On chest radiograph pleural effusions or pleural thickening may obscure the visibility of the underlying disease or parenchymal abnormality. Thus, computed tomography (CT) may provide additional information of determining the extent and severity of pleural disease and may help to differentiate malign pleural lesions from the benign ones. Moreover, CT may provide the differentiation of parenchmal abnormalities from pleural pathologies. CT (coronal and sagittal reformatted images) that also show invasion of chest wall, mediastinum and diaphragm, as well as enlarged hilar or mediastinal lymph nodes. Standart non-invasive imaging techniques may be supplemented with magnetic resonans imaging (MRI).

  1. Chest trauma in children: current imaging guidelines and techniques.

    LENUS (Irish Health Repository)

    Moore, Michael A

    2011-09-01

    Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailored to the specific patient. Chest radiography remains the most important imaging modality for initial triage. The decision to perform a chest computed tomography scan should be based on the nature of the trauma, the child\\'s clinical condition, and the initial radiographic findings, taking the age-related pretest probabilities of serious injury into account. The principles of as low as reasonably achievable and Image Gently should be followed. The epidemiology and pathophysiology, imaging techniques, characteristic findings, and evidence-based algorithms for pediatric chest trauma are discussed.

  2. Dose and perceived image quality in chest radiography

    International Nuclear Information System (INIS)

    Veldkamp, Wouter J.H.; Kroft, Lucia J.M.; Geleijns, Jacob

    2009-01-01

    Chest radiography is the most commonly performed diagnostic X-ray examination. The radiation dose to the patient for this examination is relatively low but because of its frequent use, the contribution to the collective dose is considerable. Consequently, optimization of dose and image quality offers a challenging area of research. In this article studies on dose reduction, different detector technologies, optimization of image acquisition and new technical developments in image acquisition and post processing will be reviewed. Studies indicate that dose reduction in PA chest images to at least 50% of commonly applied dose levels does not affect diagnosis in the lung fields; however, dose reduction in the mediastinum, upper abdomen and retrocardiac areas appears to directly deteriorate diagnosis. In addition to patient dose, also the design of the various digital detectors seems to have an effect on image quality. With respect to image acquisition, studies showed that using a lower tube voltage improves visibility of anatomical structures and lesions in digital chest radiographs but also increases the disturbing appearance of ribs. New techniques that are currently being evaluated are dual energy, tomosynthesis, temporal subtraction and rib suppression. These technologies may improve diagnostic chest X-ray further. They may for example reduce the negative influence of over projection of ribs, referred to as anatomic noise. In chest X-ray this type of noise may be the dominating factor in the detection of nodules. In conclusion, optimization and new developments will enlarge the value of chest X-ray as a mainstay in the diagnosis of chest diseases.

  3. Image processing in digital chest radiography

    International Nuclear Information System (INIS)

    Manninen, H.; Partanen, K.; Lehtovirta, J.; Matsi, P.; Soimakallio, S.

    1992-01-01

    The usefulness of digital image processing of chest radiographs was evaluated in a clinical study. In 54 patients, chest radiographs in the posteroanterior projection were obtained by both 14 inch digital image intensifier equipment and the conventional screen-film technique. The digital radiographs (512x512 image format) viewed on a 625 line monitor were processed in 3 different ways: 1.standard display; 2.digital edge enhancement for the standard display; 3.inverse intensity display. The radiographs were interpreted independently by 3 radiologists. Diagnoses were confirmed by CT, follow-up radiographs and clinical records. Chest abnormalities of the films analyzed included 21 primary lung tumors, 44 pulmonary nodules, 16 cases with mediastinal disease, 17 with pneumonia /atelectasis. Interstitial lung disease, pleural plaques, and pulmonary emphysema were found in 30, 18 and 19 cases respectively. Sensitivity of conventional radiography when averaged overall findings was better than that of digital techniques (P<0.001). Differences in diagnostic accuracy measured by sensitivity and specificity between the 3 digital display modes were small. Standard image display showed better sensitivity for pulmonary nodules (0.74 vs 0.66; P<0.05) but poorer specificity for pulmonary emphysema (0.85 vs 0.93; P<0.05) compared with inverse intensity display. It is concluded that when using 512x512 image format, the routine use of digital edge enhancement and tone reversal at digital chest radiographs is not warranted. (author). 12 refs.; 4 figs.; 2 tabs

  4. MR imaging in tumor invasion of the chest wall

    International Nuclear Information System (INIS)

    Bittner, R.C.; Lang, P.; Schorner, W.; Sander, B.; Weiss, T.; Loddenkemper, R.; Kaiser, D.; Felix, R.

    1989-01-01

    The authors have used MR imaging to study 22 patients who had intrathoracic, pleura-related malignancies and whose CT findings had suggested chest wall invasion. ECG-gated T1- and T2-weighted spin-echo sequences were used in all patients. Additionally, in 10 patients an ungated, multisection, gradient-echo sequence was used, which was repeated after intravenous administration of Gd-DTPA in five patients. Surgery confirmed chest wall invasion in 19 patients. CT showed tumor invasion only in 14 of these 19 patients. MR imaging showed high-signal-intensity lesion within chest wall and pleura in T2-weighted and Gd-DTPA-enhanced T1-weighted images as the typical pattern of chest wall invasion in all 19 patients. Two of the three patients with pleural inflammation and without chest wall invasion had high-signal-intensity pleural lesions, but none of these lesions were within the chest wall

  5. The role of scintimammography with 99m-Tc-Tetrofosmin in breast cancer detection

    International Nuclear Information System (INIS)

    Vonorta, K.; Stefanakos, N.; Anagnostopoulos, K.; Michailidou, E.; Prassopoulos, V.; Baltas, D.; Giatas, A.; Keramopoulos, A.; Papageorgiou, S.

    2002-01-01

    Aim: It is already known that breast cancer is the most common malignancy of women. Breast mammography, although it is of a great importance as a screening test, it has some limitations, especially in women with dense breast tissue, or in those who underwent partial mastectomy and post-surgical scars are present. This resulted in the necessity of the use of other complementary imaging procedures, such as ultrasonography, magnetic resonance imaging and scintimammography with technetium-99m labeled agents (Methyl-Isobutyl-Isonitrile: MIBI) or monoclonal antibodies. In the present study the contribution of scintimammography with 99m- Tc- Tetrofosmin in the diagnosis of breast cancer and/or local relapses is investigated. Material-Methods: 91 women aged 22-72 years old with strong clinical and/or mammographic suspicion of breast cancer and/or local relapse after mastectomy (92 lesions) were investigated. All patients underwent scintimammography with 99m-Tc-Tetrofosmin (dose: 20mCi) before surgery and/or biopsy. An intravenous injection was performed at the contralateral site of that of the suspected or palpable lesion. Imaging was performed 10 minutes post-injection. Patients were at a prone position and lateral and views of the breasts and axillary areas were performed (10 minutes per view, matrix size 128x128, high resolution collimator).Anterior views of the breasts and axillary areas were performed with the patients placed in at supine position. Results: The overall Sensitivity was 85,7%, Specificity was 87,9%, Positive Predictive Value was 81,9%, Negative Predictive Value was 90,7% and Diagnostic Accuracy was 85,3%.Three out of three local relapses were detected,as well as one out of one bilateral involvement. In a case of negative breast scan and positive findings at the axillary area, histology revealed a lymphoma. Conclusions: Scintimammography with 99m-Tc-Tetrofosmin is a valuable method in the detection of primary breast cancer or the early diagnosis of local

  6. 99mTc-Tetrofosmin scintimammography in suspected breast cancer patients: comparison with 99mTc-MIBI

    International Nuclear Information System (INIS)

    Kim, Seong Jang; Kim, In Ju; Kim, Yong Ki; Bae, Young Tae

    2000-01-01

    The aim of this study was to investigate the diagnostic role of 99m Tc-Tetrofosmin in detection of breast cancer and compared with that of 99m Tc-MIBI. Forty-eight patients with a clinically palpable mass or abnormal mammographic or ultrasonographic findings had 99m Tc-MIBI and 99m Tc-Tetrofosmin scintimammographies after intravenous injection of 925 MBq of radiopharmaceuticals. The scintimammographs were correlated with histopathologic findings. Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The numbers of true positive, true negative, false positive, and false negative cases of 99m Tc-MIBI scintimammography were 29, 10, 5, and 4 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of 99m Tc-MIBI scintimammographies were 87.8%, 66.7%, 85.3%, and 71.4% respectively. The numbers of true positive, true negative, false positive, and false negative cases of 99m Tc-Tetrofosmin were 31, 10, 5, and 2 respectively. The sensitivity, specificity, positive predictive value, negative predictive value of 99m Tc-Tetrofosmin were 93.9%, 66.7%, 86.1%, and 73.3% respectively. One patient was false negative in both 99m Tc-Tetrofosmin scintimammographies and its size was 0.5cm. 99m Tc-Tetrofosmin and 99m Tc-MIBI were non-invasive and useful in detection of breast cancer and 99m Tc-Tetrofosmin was comparable to the 99m Tc-MIBI in detection of primary breast cancer.=20

  7. Influence of MR imaging in radiation therapy of chest lymphoma

    International Nuclear Information System (INIS)

    Carlsen, S.E.; Hoppe, R.; Bergin, C.J.

    1991-01-01

    This paper evaluates the influence of MR detection of additional sites of chest lymphoma on radiation therapy. Chest MR images and CT scans of 56 patients with new or recurrent mediastinal lymphoma obtained within 1 month of each other were retrospectively reviewed. MR images included T1- and T2-weighted SE and STIR sequences. Images were assessed for pleural and extrapleural disease. Radiation portals of patients with pleural or chest wall disease were reevaluated and compared with portals originally designed with CT. MR imaging demonstrated chest wall disease in 15 patients (21 sites). Ten patients also had pleural disease (13 sites). CT identified chest wall disease in four of these patients (five sites) and pleural disease in three patients (five sites). Seven of the 15 patients with chest wall disease were treated with radiation therapy alone. Two of the seven patients had significant modification of radiation portals based on MR findings. Retrospectively, therapy would have been altered in an additional two patients in whom pleural disease was identified at MR. The increased sensitivity of MR in detecting chest wall or pleural disease has important implications for treatment planning in chest wall lymphoma

  8. Comparison of the uptakes of Tc-99m MIBI and Tc-99m tetrofosmin in A549, an MRP-expressing cancer cell, in vitro and in vivo

    International Nuclear Information System (INIS)

    Yoo, Jeong Ah; Jeong, Shin Young; Seo, Myung Rang; Bae, Jin Ho; Ahn, Byeong Cheol; Lee, Kyu Bo; Lee, Jae Tae; Choi, Sang Woon; Lee, Byung Ho

    2003-01-01

    240 min) were progressively higher by the time up to 240 min with CsA. These results indicate that MIBI and tetrofosmin are suitable tracers for imaging MRP-mediated drug resistance in A549 tumors. MIBI may be a better tracer than tetrofosmin for evaluating MRP reversal effect of modulators

  9. Comparative study between rib imaging of DR dual energy subtraction technology and chest imaging

    International Nuclear Information System (INIS)

    Yu Jianming; Lei Ziqiao; Kong Xiangchuang

    2006-01-01

    Objective: To investigate the application value of DR dual energy subtraction technology in rib lesions. Methods: 200 patients were performed with chest DR dual energy subtraction, comparing the rib imaging between DR of thorax and chest imaging using ROC analysis. Results: Among the total of 200 patients, there are 50 cases of rib calcification, 7 cases of rib destruction, 22 cases of rib fracture. The calcification, destruction and fracture were displayed respectively by ribs below diaphragm and rib markings. The analytic parameter of rib imaging of DR dual energy subtraction Az is 0.9367, while that of rib imaging of chest Az is 0.6830. Conclusion: DR dual energy subtraction technology is superior to chest imaging in the displaying of rib lesion and ribs below diaphragm. (authors)

  10. Detecting Myocardial Ischemia With 99mTechnetium-Tetrofosmin Myocardial Perfusion Imaging in Ischemic Stroke.

    Science.gov (United States)

    Giannopoulos, Sotirios; Markoula, Sofia; Sioka, Chrissa; Zouroudi, Sofia; Spiliotopoulou, Maria; Naka, Katerina K; Michalis, Lampros K; Fotopoulos, Andreas; Kyritsis, Athanassios P

    2017-10-01

    To assess the myocardial status in patients with stroke, employing myocardial perfusion imaging (MPI) with 99m Technetium-tetrofosmin ( 99m Tc-TF)-single-photon emission computed tomography (SPECT). Fifty-two patients with ischemic stroke were subjected to 99m Tc-TF-SPECT MPI within 1 month after stroke occurrence. None of the patients had any history or symptoms of coronary artery disease or other heart disease. Myocardial perfusion imaging was evaluated visually using a 17-segment polar map. Myocardial ischemia (MIS) was defined as present when the summed stress score (SSS) was >4; MIS was defined as mild when SSS was 4 to 8, and moderate/severe with SSS ≥9. Patients with SSS >4 were compared to patients with SSS SSS >9 were compared to patients with SSS SSS, with the oldest age exhibiting the highest SSS ( P = .01). The association of age with SSS remained statistically significant in the multivariate analysis ( P = .04). The study suggested that more than half of patients with stroke without a history of cardiac disease have MIS. Although most of them have mild MIS, we suggest a thorough cardiological evaluation in this group of patients for future prevention of severe myocardial outcome.

  11. Diagnostic image quality of video-digitized chest images

    International Nuclear Information System (INIS)

    Winter, L.H.; Butler, R.B.; Becking, W.B.; Warnars, G.A.O.; Haar Romeny, B. ter; Ottes, F.P.; Valk, J.-P.J. de

    1989-01-01

    The diagnostic accuracy obtained with the Philips picture archiving and communications subsystem was investigated by means of an observer performance study using receiver operating characteristic (ROC) analysis. The image qualities of conventional films and video digitized images were compared. The scanner had a 1024 x 1024 x 8 bit memory. The digitized images were displayed on a 60 Hz interlaced display monitor 1024 lines. Posteroanterior (AP) roetgenograms of a chest phantom with superimposed simulated interstitial pattern disease (IPD) were produced; there were 28 normal and 40 abnormal films. Normal films were produced by the chest phantom alone. Abnormal films were taken of the chest phantom with varying degrees of superimposed simulated intersitial disease (PND) for an observer performance study, because the results of a simulated interstitial pattern disease study are less likely to be influenced by perceptual capabilities. The conventional films and the video digitized images were viewed by five experienced observers during four separate sessions. Conventional films were presented on a viewing box, the digital images were displayed on the monitor described above. The presence of simulated intersitial disease was indicated on a 5-point ROC certainty scale by each observer. We analyzed the differences between ROC curves derived from correlated data statistically. The mean time required to evaluate 68 digitized images is approximately four times the mean time needed to read the convential films. The diagnostic quality of the video digitized images was significantly lower (at the 5% level) than that of the conventional films (median area under the curve (AUC) of 0.71 and 0.94, respectively). (author). 25 refs.; 2 figs.; 4 tabs

  12. Relationship between lung-to-heart uptake ratio of technetium-99m-tetrofosmin during exercise myocardial single photon emission computed tomographic imaging and the number of diseased coronary arteries in patients with effort angina pectoris without myocardial infarction

    International Nuclear Information System (INIS)

    Okajima, Toshiya; Ueshima, Kenji; Nishiyama, Osamu; Ogawa, Muneyoshi; Ohuchi, Mami; Saitoh, Masahiko; Hiramori, Katsuhiko

    2004-01-01

    Increased lung uptake of thallium-201 in exercise myocardial perfusion imaging is a reliable marker of multivessel disease in patients with ischemic heart disease. This study investigated whether the lung-to-heart uptake ratio with technetium-99m ( 99m Tc)-tetrofosmin also provides valuable information to detect patients with multivessel disease. Fifty-three consecutive patients (35 men, 18 women, mean age 66±11 years; single-vessel disease: 29, double-vessel disease: 16, triple-vessel disease: 8) with stable effort angina pectoris without prior myocardial infarction and 17 control subjects (12 men, 5 women, mean age 62±9 years) underwent exercise myocardial perfusion imaging with 99m Tc-tetrofosmin and coronary angiography in January 2000 to December 2002. The lung-to-heart uptake ratio was calculated on an anterior projection before reconstruction of the exercise single photon emission computed tomographic images. The mean lung-to-heart uptake ratio was 0.34±0.04, 0.38±0.07, 0.41±0.05, and 0.46±0.09, in patients with normal coronary, single-vessel disease, double-vessel disease, and triple-vessel disease, respectively. Significantly higher lung-to-heart uptake ratio was associated with more diseased vessels (p 99m Tc-tetrofosmin can provide clinically useful information to detect multivessel disease in patients with ischemic heart disease. (author)

  13. Selective chest imaging for blunt trauma patients: The national emergency X-ray utilization studies (NEXUS-chest algorithm).

    Science.gov (United States)

    Rodriguez, Robert M; Hendey, Gregory W; Mower, William R

    2017-01-01

    Chest imaging plays a prominent role in blunt trauma patient evaluation, but indiscriminate imaging is expensive, may delay care, and unnecessarily exposes patients to potentially harmful ionizing radiation. To improve diagnostic chest imaging utilization, we conducted 3 prospective multicenter studies over 12years to derive and validate decision instruments (DIs) to guide the use of chest x-ray (CXR) and chest computed tomography (CT). The first DI, NEXUS Chest x-ray, consists of seven criteria (Age >60years; rapid deceleration mechanism; chest pain; intoxication; altered mental status; distracting painful injury; and chest wall tenderness) and exhibits a sensitivity of 99.0% (95% confidence interval [CI] 98.2-99.4%) and a specificity of 13.3% (95% CI, 12.6%-14.0%) for detecting clinically significant injuries. We developed two NEXUS Chest CT DIs, which are both highly reliable in detecting clinically major injuries (sensitivity of 99.2%; 95% CI 95.4-100%). Designed primarily to focus on detecting major injuries, the NEXUS Chest CT-Major DI consists of six criteria (abnormal CXR; distracting injury; chest wall tenderness; sternal tenderness; thoracic spine tenderness; and scapular tenderness) and exhibits higher specificity (37.9%; 95% CI 35.8-40.1%). Designed to reliability detect both major and minor injuries (sensitivity 95.4%; 95% CI 93.6-96.9%) with resulting lower specificity (25.5%; 95% CI 23.5-27.5%), the NEXUS CT-All rule consists of seven elements (the six NEXUS CT-Major criteria plus rapid deceleration mechanism). The purpose of this review is to synthesize the three DIs into a novel, cohesive summary algorithm with practical implementation recommendations to guide selective chest imaging in adult blunt trauma patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Comparative uptake of Tc-99m sestamibi and Tc-99m tetrofosmin in cancer cells and tissue expressing P-Glycoprotein or multidrug resistance associated protein

    International Nuclear Information System (INIS)

    Cho, Jung Ah; Lee, Jae Tae; Yoo, Jung Ah

    2005-01-01

    increases in tumoral uptake were not significantly different between MIBI and tetrofosmin for both tumors. MIBI seems to be a better tracer than tetrofosmin for evaluating MDR reversal effect of the modulators in vitro, but these differences were not evident in vivo tumoral uptake. Both MIBI and tetrofosmin seem to be suitable tracers for imaging Pgp-and MRP=mediated drug resistance in tumors

  15. Comparative uptake of Tc-99m sestamibi and Tc-99m tetrofosmin in cancer cells and tissue expressing P-Glycoprotein or multidrug resistance associated protein

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jung Ah; Lee, Jae Tae; Yoo, Jung Ah [School of Medicine, Kyungpook National University, Daegu (Korea, Republic of)] (and others)

    2005-02-15

    240 min with CsA. But increases in tumoral uptake were not significantly different between MIBI and tetrofosmin for both tumors. MIBI seems to be a better tracer than tetrofosmin for evaluating MDR reversal effect of the modulators in vitro, but these differences were not evident in vivo tumoral uptake. Both MIBI and tetrofosmin seem to be suitable tracers for imaging Pgp-and MRP=mediated drug resistance in tumors.

  16. Impaired exercise-related myocardial uptake of technetium-99m-tetrofosmin in relation to coronary narrowing and diabetic state

    International Nuclear Information System (INIS)

    Sasao, Hisataka; Nakata, Tomoaki; Tsuchihashi, Kazufumi; Wakabayashi, Takeru; Nakahara, Norifumi; Doi, Atsushi; Hashimoto, Akiyoshi; Kobayashi, Hiroshi; Shimamoto, Kazuaki

    2001-01-01

    Despite the diagnostic efficacy of stress myocardial perfusion imaging, the correlation between the actual perfusion tracer activity and diseased state of a coronary artery has not been studied in detail. We estimated exercise-related perfusion augmentation in relation to disease states of a coronary artery in diabetic and non-diabetic patients by a newly developed quantitative technetium (Tc)-99m-tetrofosmin myocardial imaging technique. Tc-99m-tetrofosmin tomographic imaging with an exercise-rest protocol was performed in 26 stable coronary patients and in 8 age-matched controls. Percent increase (%IR) in myocardial count during symptom-limited submaximal exercise-stress was calculated in 16 non-infarcted polar map segments and in each coronary territory by a subtraction technique with corrections for physical decay and injected tracer doses, and the results were compared with those of angiographically quantified coronary diameter stenosis (%DS). Percent IR and peak heart rate during exercise showed a positive linear correlation both in coronary territories with significant stenosis (%DS≥75%) and in control or non-stenotic (%DS<75%) territories. The regression line in stenotic regions was, however, significantly (p<0.01) shifted downward compared to that in non-stenotic regions. Percent IR in stenotic regions showed a significant inverse correlation with %DS. Coronary stenosis of 75% or more was identified by a %IR cutoff value of 40% with 77% sensitivity, 70% specificity, and an accuracy of 72%. In coronary territories with a %DS of less than 75%, %IR in diabetic patients was significantly lower (46±15%) than that in non-diabetic patients (61±25%). Thus, blunted exercise-related augmentation of myocardial uptake of Tc-99m-tetrofosmin correlates with the severity of coronary narrowing and diabetic state. (author)

  17. Neonatal chest image quality addressed through training to enhance radiographer awareness

    Directory of Open Access Journals (Sweden)

    Hesta Friedrich-Nel

    2018-03-01

    Full Text Available Background: Diagnostic radiographers working in the neonatal intensive care unit primarily aim to produce an image of optimal quality using optimal exposure techniques without repeating exposures, to keep neonatal radiation dose to a minimum.   Objectives: The aim of the study was to determine whether radiographers were producing optimal quality chest images and, if not, whether additional training could contribute to reaching this goal in the Free State Province of South Africa.   Methods: Neonatal chest image quality was determined in the Neonatal Intensive Care Unit by using a checklist based on and compiled from published guidelines to evaluate the quality of 450 randomly-selected images. Thereafter, a training programme was designed, based on the evaluation criteria of the checklist and image quality areas identified. The training also referred to positioning techniques that should be applied to ensure optimal image quality. After presentation of the training, 450 newly-produced neonatal chest images were evaluated. These images were selected through purposive sampling as this evaluation only included images of participating radiographers who completed the training.   Results: Image quality that showed significant improvement included a reduction in electrocardiogram lines superimposed on chest anatomy, a tendency to centre closer to thoracic vertebra four, and visible four-sided collimation on images. Image quality areas with no significant enhancement were the absence of lead markers and radiation shielding.   Conclusion: The study has shown that a training programme has the potential to improve neonatal chest image quality.

  18. 1024 matrix image reconstruction: usefulness in high resolution chest CT

    International Nuclear Information System (INIS)

    Jeong, Sun Young; Chung, Myung Jin; Chong, Se Min; Sung, Yon Mi; Lee, Kyung Soo

    2006-01-01

    We tried to evaluate whether high resolution chest CT with a 1,024 matrix has a significant advantage in image quality compared to a 512 matrix. Each set of 512 and 1024 matrix high resolution chest CT scans with both 0.625 mm and 1.25 mm slice thickness were obtained from 26 patients. Seventy locations that contained twenty-four low density lesions without sharp boundary such as emphysema, and forty-six sharp linear densities such as linear fibrosis were selected; these were randomly displayed on a five mega pixel LCD monitor. All the images were masked for information concerning the matrix size and slice thickness. Two chest radiologists scored the image quality of each ar rowed lesion as follows: (1) undistinguishable, (2) poorly distinguishable, (3) fairly distinguishable, (4) well visible and (5) excellently visible. The scores were compared from the aspects of matrix size, slice thickness and the different observers by using ANOVA tests. The average and standard deviation of image quality were 3.09 (± .92) for the 0.625 mm x 512 matrix, 3.16 (± .84) for the 0.625 mm x 1024 matrix, 2.49 (± 1.02) for the 1.25 mm x 512 matrix, and 2.35 (± 1.02) for the 1.25 mm x 1024 matrix, respectively. The image quality on both matrices of the high resolution chest CT scans with a 0.625 mm slice thickness was significantly better than that on the 1.25 mm slice thickness (ρ < 0.001). However, the image quality on the 1024 matrix high resolution chest CT scans was not significantly different from that on the 512 matrix high resolution chest CT scans (ρ = 0.678). The interobserver variation between the two observers was not significant (ρ = 0.691). We think that 1024 matrix image reconstruction for high resolution chest CT may not be clinical useful

  19. Quality of intensive care chest imaging

    International Nuclear Information System (INIS)

    Adam, G.; Wein, B.; Keulers, P.; Stargardt, A.; Guenther, R.W.

    1989-01-01

    The authors have evaluated the image quality of a stimulable phosphorous plate system in intensive care chest radiography. Four radiologists examined 308 chest radiographs (200 conventional, 108 digital) according to the following criteria: visibility of catheters, tubes (artificial objects), bronchi, central and peripheral vessels, diaphragm, trachea, and retrocardial lung parenchyma. Detectability of these structures was classified as good, poor, or impossible to see. In addition, optical density was measured in the region of liver, heart, and lung. Results were evaluated by Student and υ test

  20. Digital training platform for interpreting radiographic images of the chest.

    Science.gov (United States)

    McLaughlin, L; Woznitza, N; Cairns, A; McFadden, S L; Bond, R; Hughes, C M; Elsayed, A; Finlay, D; McConnell, J

    2018-05-01

    Time delays and errors exist which lead to delays in patient care and misdiagnosis. Reporting clinicians follow guidance to form their own search strategy. However, little research has tested these training guides. With the use of eye tracking technology and expert input we developed a digital training platform to be used in chest image interpretation learning. Two sections of a digital training platform were planned and developed; A) a search strategy training tool to assist reporters during their interpretation of images, and B) an educational tool to communicate the search strategies of expert viewers to trainees by using eye tracking technology. A digital training platform for use in chest image interpretation was created based on evidence within the literature, expert input and two search strategies previously used in clinical practice. Images and diagrams, aiding translation of the platform content, were incorporated where possible. The platform is structured to allow the chest image interpretation process to be clear, concise and methodical. A search strategy was incorporated within the tool to investigate its use, with the possibility that it could be recommended as an evidence based approach for use by reporting clinicians. Eye tracking, a checklist and voice recordings have been combined to form a multi-dimensional learning tool, which has never been used in chest image interpretation learning before. The training platform for use in chest image interpretation learning has been designed, created and digitised. Future work will establish the efficacy of the developed approaches. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  1. Radiological imaging of the neonatal chest. 2. rev. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Donoghue, Veronica (ed.) [Children' s University Hospital, Dublin (Ireland). Dept. of Radiology; National Maternity Hospital, Dublin (Ireland)

    2008-07-01

    This second, revised edition of Radiological Imaging of the Neonatal Chest provides a comprehensive and up-to-date discussion of the subject. It is written primarily from the point of view of the paediatric radiologist but will be of particular interest to all antenatal ultrasonographers, neonatologists, paediatric cardiologists, paediatricians and paediatric surgeons. It includes an update on clinical management and appraises the advantages of the various techniques available to image the newborn chest. There is particular emphasis on the impact of recent therapeutic advances on imaging findings. Extensive consideration is given to both antenatal and postnatal imaging of congenital chest malformations, as well as to controversies regarding the postnatal management of asymptomatic infants with these anomalies. There are dedicated chapters on upper airway problems, infection and congenital heart disease, with special emphasis on the current role of magnetic resonance imaging, computed tomography and interventional therapy. There is also a chapter devoted to computed radiography and digital radiography. This book contains important information for all those involved in caring for the neonate. (orig.)

  2. Improvement of the clinical use of computed radiography for mobile chest imaging: Image quality and patient dose

    Science.gov (United States)

    Rill, Lynn Neitzey

    Chest radiography is technically difficult because of the wide variation of tissue attenuations in the chest and limitations of screen-film systems. Mobile chest radiography, performed bedside on hospital inpatients, presents additional difficulties due to geometrical and equipment limitations inherent to mobile x-ray procedures and the severity of illness in patients. Computed radiography (CR) offers a new approach for mobile chest radiography by utilizing a photostimulable phosphor. Photostimulable phosphors are more efficient in absorbing lower-energy x-rays than standard intensifying screens and overcome some image quality limitations of mobile chest imaging, particularly because of the inherent latitude. This study evaluated changes in imaging parameters for CR to take advantage of differences between CR and screen-film radiography. Two chest phantoms, made of acrylic and aluminum, simulated x-ray attenuation for average-sized and large- sized adult chests. The phantoms contained regions representing the lungs, heart and subdiaphragm. Acrylic and aluminum disks (1.9 cm diameter) were positioned in the chest regions to make signal-to-noise ratio (SNR) measurements for different combinations of imaging parameters. Disk thicknesses (contrast) were determined from disk visibility. Effective dose to the phantom was also measured for technique combinations. The results indicated that using an anti-scatter grid and lowering x- ray tube potential improved the SNR significantly; however, the dose to the phantom also increased. An evaluation was performed to examine the clinical applicability of the observed improvements in SNR. Parameter adjustments that improved phantom SNRs by more than 50% resulted in perceived image quality improvements in the lung region of clinical mobile chest radiographs. Parameters that produced smaller improvements in SNR had no apparent effect on clinical image quality. Based on this study, it is recommended that a 3:1 grid be used for

  3. Short TI inversion-recovery MR imaging of chest wall malignancies

    International Nuclear Information System (INIS)

    Dubinsky, T.J.; Porter, B.A.; Olson, D.O.

    1987-01-01

    Short-T1 inversion-recovery (STIR) sequences have greater constant, less motion sensitivity, and require shorter imaging times than conventional T2-weighted spin-echo (SE) sequences and are therefore particularly useful for staging chest wall malignancies. MR studies of 49 patients with possible chest wall malignancies were reviewed. Images were produced at 0.15 T with a variety of SE sequences. Forty-five also had STIR (repetition time, 1,400 - 2,100; echo time, 36 or 40; inversion time, 100 or 125). MR studies indicated chest wall involvement in 39 of 49 patients; 12 had obvious rib encasement, the most definitive finding. IN 13, lesions detected on STIR were either not visible or seen only in retrospect on T1 SE images. In five of five, STIR was clearly superior to T2 SE for delineation of tumor margins. The authors have discontinued using T2 SE sequences for chest neoplasms in favor of the higher contrast and sensitivity of STIR

  4. Testing the radiochemical purity of a radiopharmaceutical: study of 99mTc-Tetrofosmin (Myoview)

    International Nuclear Information System (INIS)

    Moati, F.; Quartarone, C.; Jourdain, J.R.; Rizzo, N.; Dumont, A.; De Beco, V.; Ait Ben Ali, S.; Lours, S.; Piketty, M.L.; Izembart, M.; Goudou, C.; Lemercier, V.; Schlageter, M.H.; Moretti, J.L.; Progent, A.

    1997-01-01

    The goal of this study is to optimize the testing method of radiochemical purity (RCP) of 99m Tc-Tetrofosmin proposed by the Amersham Company: thin-layer chromatography (TLC); ITLC-SG support, migration on 15 Cm; acetone-dichloromethane mobile phase, (35/65, v/v), This technique allows separating the reduced-Tc (Rf = 0), the TcO 4 - (Rf = 1), and in intermediary position (0.2 99m Tc-Tetrofosmin. The results of RCP depend on working conditions, particularly, on the volume of deposit (10 to 20 μl, expected). If the deposited is too small, the 99m Tc-Tetrofosmin does not migrate. With a volume of 20 μl, the separation is weak and the peak width is un-resolvable. The results obtained correspond to the following operational conditions: migration on 8 cm; deposit of 8 to 10 μl; no drying. In these conditions the peak of 99m Tc-Tetrofosmin is well singled out: migration Rf of 0.375 to 0.625. These results have been obtained by the analysis of radio-chromatographic peak. Every strip has been cut cm by cm and the activity was measured by a gamma counter. Repeatability of the method on a series of 8 tests is good: average RCP 93.22%, mean value = 93.24%. The reproducibility was realized by measuring directly by the activity-meter the activity corresponding to 3 identifiable peaks: Reduced Tc (Rf 4 - (Rf 99m Tc-Tetrofosmin (0.25 < Rf < 0.75). On the 21 effectuated tests the inter-test RCP reproducibility was good: average value = 95.24%, CV = 2.07%, mean value 95.3%). In conclusion, the miniaturization improves the separation by Myoview (0.25 < Rf < 0.75), diminishes the migration time by a factor 4 and lowers the reactive cost of testing by 50%

  5. Dynamic chest radiography: flat-panel detector (FPD) based functional X-ray imaging.

    Science.gov (United States)

    Tanaka, Rie

    2016-07-01

    Dynamic chest radiography is a flat-panel detector (FPD)-based functional X-ray imaging, which is performed as an additional examination in chest radiography. The large field of view (FOV) of FPDs permits real-time observation of the entire lungs and simultaneous right-and-left evaluation of diaphragm kinetics. Most importantly, dynamic chest radiography provides pulmonary ventilation and circulation findings as slight changes in pixel value even without the use of contrast media; the interpretation is challenging and crucial for a better understanding of pulmonary function. The basic concept was proposed in the 1980s; however, it was not realized until the 2010s because of technical limitations. Dynamic FPDs and advanced digital image processing played a key role for clinical application of dynamic chest radiography. Pulmonary ventilation and circulation can be quantified and visualized for the diagnosis of pulmonary diseases. Dynamic chest radiography can be deployed as a simple and rapid means of functional imaging in both routine and emergency medicine. Here, we focus on the evaluation of pulmonary ventilation and circulation. This review article describes the basic mechanism of imaging findings according to pulmonary/circulation physiology, followed by imaging procedures, analysis method, and diagnostic performance of dynamic chest radiography.

  6. [Optimization of digital chest radiography image post-processing in diagnosis of pneumoconiosis].

    Science.gov (United States)

    Sheng, Bing-yong; Mao, Ling; Zhou, Shao-wei; Shi, Jin

    2013-11-01

    To establish the optimal image post-processing parameters for digital chest radiography as preliminary research for introducing digital radiography (DR) to pneumoconiosis diagnosis in China. A total of 204 pneumoconiosis patients and 31 dust-exposed workers were enrolled as the subjects in this research. Film-screen radiography (FSR) and DR images were taken for all subjects. DR films were printed after raw images were processed and parameters were altered using DR workstation (GE Healthcare, U.S.A.). Image gradations, lung textures, and the imaging of thoracic vertebra were evaluated by pneumoconiosis experts, and the optimal post-processing parameters were selected. Optical density was measured for both DR films and FSR films. For the DR machine used in this research, the contrast adjustment (CA) and brightness adjustment (BA) were the main parameters that determine the brightness and gray levels of images. The optimal ranges for CA and BA were 115%∼120% and 160%∼165%, respectively. The quality of DR chest films would be optimized when tissue contrast was adjusted to a maximum of 0.15, edge to a minimum of 1, and both noise reduction and tissue equalization to0.The failure rate of chest DR (0.4%) was significantly lower than that of chest FSR (17%) (P image post-processing on DR machine purchased from GE Healthcare, the DR chest films can meet all requirements for the quality of chest X-ray films in the Chinese diagnostic criteria for pneumoconiosis.

  7. Analysis of chest image performance in patients with acute chlorine poisoning

    International Nuclear Information System (INIS)

    Liu Liangqing; Zheng Jiangang; Yang Keyu; Wu Honglin; Tang Qingfang; Wu Huiming

    2012-01-01

    Objective: To explore chest image features of patients with acute chlorine poisoning and their clinical values. Methods: A retrospective analysis was performed by chest image features of 117 patients with acute chlorine poisoning. All the patients were classified according to Chinese management of occupational acute chlorine poisoning diagnosis standard. Results: Sixty-five patients presented with stimulus response, and normal or both lungs had a little more white on their chest images. Thirty-one cases presented with minor poisoning, and without or the texture of both lungs was increased, and grew hazy and coarse.seventeen cases were moderate, and small sample vague shadows or single or multiple limitations lamellar shadow. Four cases were serious,and two lungs had extensive and density homogeneous consolidation shadow. Conclusions: It would make the diagnosis and assessment of chlorine poisoning more easier based on the combination of chest image features, the clear history of acute chlorine poisoning and relevant clinical performance. (authors)

  8. Single isotope dual-phase scintigraphy with 99mTc-MIBI and 99mTc-tetrofosmin combined with SPECT technique in patients with secondary hyperparathyroidism

    International Nuclear Information System (INIS)

    Botushanova, A.; Yaneva, M.; Botushanov, N.

    2015-01-01

    Full text: Preoperative parathyroid scintigraphy is highly beneficial when used for minimally invasive parathyroidectomy. The aim is to examine the diagnostic value of single isotope dual-phase scintigraphy with 99mTc-MIBI and 99mTc-etrofosmin combined with SPECT technique in preoperative localization of hyperplastic parathyroid glands in patients with secondary hyperparathyroidism. The study included 15 patients aged 37 to 73 years (8 women and 7 men) with proven secondary hyperparathyroidism with increased serum calcium and parathyroid hormone. All patients were on chroniodialysis and treatment with Calcitriol. The examination was done with two-headed SPECT gamma camera SIMBIA by protocol for single isotope dual-phase scintigraphy and SPECT technique. 740 MBq 99mTc-MIBI were applied intravenously in 6 of the patients, and in 9 patients were administered 740 MBq 99mTc-tetrofosmin. The scintigraphy with 99mTc-MIBI visualized a focus of residual activity in 4 patients, and in 2 we received negative scintigraphy. The scintigraphy with 99mTc-tetrofosmin combined with SPECT showed an area of hyperfixation in both phases on SPECT images in 1 patient. In 2 patients hyperfixating areas suspicious for abnormal parathyroid glands were registered only in the early SPECT images. In 6 patients the scintigraphic results were negative. Negative scintigraphic results can be explained with the ability to suppress the uptake of 99mTc-MIBI and 99mTc - tetrofosmin by the parathyroid cells as a result of taking Calcitriol. Scintigraphy with 99mTc-MIBI and 99mTc-tetrofosmin did not show high sensitivity in identifying the hyperplastic parathyroid glands, although it was capable to distinguish patients with nodular hyperplasia of those with diffuse hyperplasia

  9. Automated image quality assessment for chest CT scans.

    Science.gov (United States)

    Reeves, Anthony P; Xie, Yiting; Liu, Shuang

    2018-02-01

    Medical image quality needs to be maintained at standards sufficient for effective clinical reading. Automated computer analytic methods may be applied to medical images for quality assessment. For chest CT scans in a lung cancer screening context, an automated quality assessment method is presented that characterizes image noise and image intensity calibration. This is achieved by image measurements in three automatically segmented homogeneous regions of the scan: external air, trachea lumen air, and descending aorta blood. Profiles of CT scanner behavior are also computed. The method has been evaluated on both phantom and real low-dose chest CT scans and results show that repeatable noise and calibration measures may be realized by automated computer algorithms. Noise and calibration profiles show relevant differences between different scanners and protocols. Automated image quality assessment may be useful for quality control for lung cancer screening and may enable performance improvements to automated computer analysis methods. © 2017 American Association of Physicists in Medicine.

  10. Imaging of chest trauma: radiological patterns of injury and diagnostic algorithms

    International Nuclear Information System (INIS)

    Lomoschitz, Fritz M.; Eisenhuber, Edith; Linnau, Ken F.; Peloschek, Philipp; Schoder, Maria; Bankier, Alexander A.

    2003-01-01

    In patients after chest trauma, imaging plays a key role for both, the primary diagnostic work-up, and the secondary assessment of potential treatment. Despite its well-known limitations, the anteroposterior chest radiograph remains the starting point of the imaging work-up. Adjunctive imaging with computed tomography, that recently is increasingly often performed on multidetector computed tomography units, adds essential information not readily available on the conventional radiograph. This allows better definition of trauma-associated thoracic injuries not only in acute traumatic aortic injury, but also in pulmonary, tracheobronchial, cardiac, diaphragmal, and thoracic skeletal injuries. This article reviews common radiographic findings in patients after chest trauma, shows typical imaging features resulting from thoracic injury, presents imaging algorithms, and recalls to the reader less common but clinically relevant entities encountered in patients after thoracic trauma

  11. Angular relational signature-based chest radiograph image view classification.

    Science.gov (United States)

    Santosh, K C; Wendling, Laurent

    2018-01-22

    In a computer-aided diagnosis (CAD) system, especially for chest radiograph or chest X-ray (CXR) screening, CXR image view information is required. Automatically separating CXR image view, frontal and lateral can ease subsequent CXR screening process, since the techniques may not equally work for both views. We present a novel technique to classify frontal and lateral CXR images, where we introduce angular relational signature through force histogram to extract features and apply three different state-of-the-art classifiers: multi-layer perceptron, random forest, and support vector machine to make a decision. We validated our fully automatic technique on a set of 8100 images hosted by the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH), and achieved an accuracy close to 100%. Our method outperforms the state-of-the-art methods in terms of processing time (less than or close to 2 s for the whole test data) while the accuracies can be compared, and therefore, it justifies its practicality. Graphical Abstract Interpreting chest X-ray (CXR) through the angular relational signature.

  12. Testing the radiochemical purity of a radiopharmaceutical: study of {sup 99m}Tc-Tetrofosmin (Myoview); Controle de la purete radiochimique d`un radiopharmaceutique: etude du {sup 99m}Tc-Tetrofosmin (Myoview)

    Energy Technology Data Exchange (ETDEWEB)

    Moati, F.; Quartarone, C.; Jourdain, J.R.; Rizzo, N.; Dumont, A.; De Beco, V.; Ait Ben Ali, S.; Lours, S.; Piketty, M.L.; Izembart, M.; Goudou, C.; Lemercier, V.; Schlageter, M.H.; Moretti, J.L.; Progent, A. [Groupe de travail `Radiopharmaceutiques - Ile de France` (France)

    1997-12-31

    The goal of this study is to optimize the testing method of radiochemical purity (RCP) of {sup 99m}Tc-Tetrofosmin proposed by the Amersham Company: thin-layer chromatography (TLC); ITLC-SG support, migration on 15 Cm; acetone-dichloromethane mobile phase, (35/65, v/v), This technique allows separating the reduced-Tc (Rf = 0), the TcO{sub 4}{sup -} (Rf = 1), and in intermediary position (0.2Tetrofosmin. The results of RCP depend on working conditions, particularly, on the volume of deposit (10 to 20 {mu}l, expected). If the deposited is too small, the {sup 99m}Tc-Tetrofosmin does not migrate. With a volume of 20 {mu}l, the separation is weak and the peak width is un-resolvable. The results obtained correspond to the following operational conditions: migration on 8 cm; deposit of 8 to 10 {mu}l; no drying. In these conditions the peak of {sup 99m}Tc-Tetrofosmin is well singled out: migration Rf of 0.375 to 0.625. These results have been obtained by the analysis of radio-chromatographic peak. Every strip has been cut cm by cm and the activity was measured by a gamma counter. Repeatability of the method on a series of 8 tests is good: average RCP 93.22%, mean value = 93.24%. The reproducibility was realized by measuring directly by the activity-meter the activity corresponding to 3 identifiable peaks: Reduced Tc (Rf < 0.25), TcO{sub 4}{sup -} (Rf < 0.75), and {sup 99m}Tc-Tetrofosmin (0.25 < Rf < 0.75). On the 21 effectuated tests the inter-test RCP reproducibility was good: average value = 95.24%, CV = 2.07%, mean value 95.3%. In conclusion, the miniaturization improves the separation by Myoview (0.25 < Rf < 0.75), diminishes the migration time by a factor 4 and lowers the reactive cost of testing by 50%

  13. Image quality in conventional chest radiography. Evaluation using the postprocessing tool Diamond View

    International Nuclear Information System (INIS)

    Niemann, Tilo; Reisinger, Clemens; Rau, Philipp; Schwarz, Jochen; Ruis-Lopez, Laura; Bongartz, Georg

    2010-01-01

    The objective of this work was to evaluate the influence of the postprocessing tool Diamond View (Siemens AG Medical Solutions, Germany) on image quality in conventional chest radiography. Evaluation of image quality remains a challenge in conventional radiography. Based on the European Commission quality criteria we evaluated the improvement of image quality when applying the new postprocessing tool Diamond View (Siemens AG Medical solutions, Germany) to conventional chest radiographs. Three different readers prospectively evaluated 102 digital image pairs of chest radiographs. Statistical analysis was performed with a p value <0.05 considered as significant. Images were evaluated on basis of the modified imaging Quality Criteria by the Commission of the European Communities. Each of the 11 image quality criteria was evaluated separately using a five point classification. Statistical analysis showed an overall tendency for improved image quality for Diamond View (DV) for all criteria. Significant differences could be found in most of the criteria. In conclusion DV improves image quality in conventional chest radiographs.

  14. Double-phase Tc-99m tetrofosmin parathyroid scan in hyperparathyroidism: comparison with ultrasonography

    International Nuclear Information System (INIS)

    Kim, In Soo; Kim, Sang Yoon; Zeon, Seok Kil; Won, Kyoung Sook

    2004-01-01

    This study was performed to evaluate the utility of double-phase Tc-99m Tetrofosmin(TF) parathyroid scan in the detection of pathologic lesions of primary hyperparathyroidism, and comparison with the ultrasonography(US). The double phase TF parathyroid scan of the anterior neck including upper mediastinum with 800 MBq TF were acquired at ten minutes (early phase) and at two hours (delayed phase) after radiopharmaceutical injection, in 24 consecutive patients under the clinical impression of primary hyperparathyroidism and hypercalcaemia. The images were evaluated for abnormal focal areas of increased tracer localization in the anterior neck and superior mediastinum in early phase, and visualization of parathyroid gland radioactivity after wash-out of the thyroid gland radioactivity in delayed phase. US of the anterior neck including upper mediastinum was performed by a diagnostic radiologist in 24 consecutive patients, within one week before or after the scan. The findings of double phase TF parathyroid scan and US were compared with the pathologic results. Ten of 24 patients were surgically explored and pathologic results showed eight adenomas and two hyperplasia. The double phase TF parathyroid scan showed positive findings in seven patients of eight adenomas and one patient of two hyperplasia patients. US image showed positive findings in six patients of eight adenomas and no positive findings of two hyperplasia. The sensitivity of the double phase TF scan for detection of the causes of the primary hyperparathyroidism was 80% and US was 60%. The double phase Tc-99m Tetrofosmin parathyroid scan showed higher sensitivity in detection of the pathologic lesions of primary hyperparathyroidism than ultrasonography

  15. Imaging of fetal chest masses

    Energy Technology Data Exchange (ETDEWEB)

    Barth, Richard A. [Lucile Packard Children' s Hospital, Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2012-01-15

    Prenatal imaging with high-resolution US and rapid acquisition MRI plays a key role in the accurate diagnosis of congenital chest masses. Imaging has enhanced our understanding of the natural history of fetal lung masses, allowing for accurate prediction of outcome, parental counseling, and planning of pregnancy and newborn management. This paper will focus on congenital bronchopulmonary malformations, which account for the vast majority of primary lung masses in the fetus. In addition, anomalies that mimic masses and less common causes of lung masses will be discussed. (orig.)

  16. Correlation of the clinical and physical image quality in chest radiography for average adults with a computed radiography imaging system.

    Science.gov (United States)

    Moore, C S; Wood, T J; Beavis, A W; Saunderson, J R

    2013-07-01

    The purpose of this study was to examine the correlation between the quality of visually graded patient (clinical) chest images and a quantitative assessment of chest phantom (physical) images acquired with a computed radiography (CR) imaging system. The results of a previously published study, in which four experienced image evaluators graded computer-simulated postero-anterior chest images using a visual grading analysis scoring (VGAS) scheme, were used for the clinical image quality measurement. Contrast-to-noise ratio (CNR) and effective dose efficiency (eDE) were used as physical image quality metrics measured in a uniform chest phantom. Although optimal values of these physical metrics for chest radiography were not derived in this work, their correlation with VGAS in images acquired without an antiscatter grid across the diagnostic range of X-ray tube voltages was determined using Pearson's correlation coefficient. Clinical and physical image quality metrics increased with decreasing tube voltage. Statistically significant correlations between VGAS and CNR (R=0.87, pchest CR images acquired without an antiscatter grid. A statistically significant correlation has been found between the clinical and physical image quality in CR chest imaging. The results support the value of using CNR and eDE in the evaluation of quality in clinical thorax radiography.

  17. Evaluation and comparison of signal to noise ratio according to histogram equalization of heart shadow on chest image

    International Nuclear Information System (INIS)

    Kim, Ki Won; Lee, Eul Kyu; Jeong, Hoi Woun; Kang, Byung Sam; Kim, Hyun Soo; Min, Jung Whan; Son, Jin Hyun

    2017-01-01

    The purpose of this study was to measure signal to noise ratio (SNR) according to change of equalization from region of interest (ROI) of heart shadow in chest image. We examined images of chest image of 87 patients in a University-affiliated hospital, Seoul, Korea. Chest images of each patient were calculated by using Image. We have analysis socio-demographical variables, SNR according to images, 95% confidence according to SNR of difference in a mean of SNR. Differences of SNR among change of equalization were tested by SPSS Statistics21 ANOVA test for there was statistical significance 95%(p < 0.05). In SNR results, with the quality of distributions in the order of original chest image, original chest image heart shadow and equalization chest image, equalization chest image heart shadow(p < 0.001). In conclusion, this study would be that quantitative evaluation of heart shadow on chest image can be used as an adjunct to the histogram equalization chest image

  18. Evaluation and comparison of signal to noise ratio according to histogram equalization of heart shadow on chest image

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Won [Dept. of Radiology, Kyung Hee University Hospital at Gang-dong, Seoul (Korea, Republic of); Lee, Eul Kyu [Inje Paik University Hospital at Jeo-dong, Seoul (Korea, Republic of); Jeong, Hoi Woun [The Baekseok Culture University, Cheonan (Korea, Republic of); Kang, Byung Sam; Kim, Hyun Soo; Min, Jung Whan; Son, Jin Hyun [The Shingu University, Seongnam (Korea, Republic of)

    2017-06-15

    The purpose of this study was to measure signal to noise ratio (SNR) according to change of equalization from region of interest (ROI) of heart shadow in chest image. We examined images of chest image of 87 patients in a University-affiliated hospital, Seoul, Korea. Chest images of each patient were calculated by using Image. We have analysis socio-demographical variables, SNR according to images, 95% confidence according to SNR of difference in a mean of SNR. Differences of SNR among change of equalization were tested by SPSS Statistics21 ANOVA test for there was statistical significance 95%(p < 0.05). In SNR results, with the quality of distributions in the order of original chest image, original chest image heart shadow and equalization chest image, equalization chest image heart shadow(p < 0.001). In conclusion, this study would be that quantitative evaluation of heart shadow on chest image can be used as an adjunct to the histogram equalization chest image.

  19. Scintigraphic study of palpable breast nodes with {sup 99m} Tc-tetrofosmin; Estudo cintilografico de nodulos palpaveis da mama com {sup 99m} Tc - tetrofosmin

    Energy Technology Data Exchange (ETDEWEB)

    Pellini, Marcos Pinto; Fonseca, Lea Mirian Barbosa da [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Amarante Junior, Jose Luiz de Medeiros [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear; Fabricio, Maria Ines Menescal [Universidade Federal, Rio de Janeiro, RJ (Brazil). Inst. de Ginecologia

    1998-12-01

    In Brazil, breast carcinoma has the greater incidence among women. In 1996, about 31,210 new cases were diagnosed. The purpose of this study is to determine if {sup 99m} technetium-tetrofosmin preferentially concentrates within malignant palpable breast nodes, distinguishing them from the benign lumps. Fifth-four consecutive and unsolicited women, mean age 47.5 +- 10.7 years, with palpable nodes in breast, underwent breast scintigraphy with {sup 99m} technetium-tetrofosmin and excisional biopsy or fine needle puncture within interval eight weeks. Histopathologic studies demonstrated 13 cysts, 1 cyst with local inflammation, 11 fibroadenoma, 2 fibrodysplasias, 3 fibroadenomas with high cellularity, 1 fibrocystic change with local inflammation, 23 invasive intraductal carcinomas and 1 invasive lobular carcinoma. The nodes ranged from 10 to 100 mm in greater diameter. The scintigraphic study yielded 30 true-negative cases, 24 true-positives, no false-negative and 1 false-positive. This case was a fibrocystic lump with local inflammation. Two patients had metastases in axillary lymph nodes, well detected in scintigraphy. The statistic analysis showed: sensitivity, 100%; specificity, 96.8%; accuracy, 98.2%; negative predictive value, 100%; positive predictive value, 96.0%. Nonparametric tests of Fisher and Chi-square rejected the antithesis at a confidence interval of 99.9% (p < 0.001). We concluded that {sup 99m} technetium-tetrofosmin preferentially concentrates in malignant palpable breast nodes and can help to distinguish them from the benign tumors with with very high accuracy. (author)

  20. Single photon emission computed tomography of technetium-99m tetrofosmin myocardial perfusion imaging in patients with systemic lupus erythematosus-A preliminary report

    International Nuclear Information System (INIS)

    Lin, Jen-Jhy; Hsu, Hsiu-Bao; Sun, Shung-Shung; Kao, Chia-Hung; Ho, Shung-Tai

    2003-01-01

    The purpose of this study was to evaluate the utility of single-photon emission computed tomography (SPECT) of technetium-99m tetrofosmin (Tc-99m TF) myocardial perfusion imaging to detect myocardial involvement in patients with systemic lupus erythematosus (SLE). Three groups of subjects-group 1: 25 SLE female patients with non-specific cardiac symptoms and signs, group 2: 25 female SLE patients without any cardiac symptoms and signs, and group 3: 25 female healthy controls-were evaluated by comparing rest and dipyridamole-stress Tc-99m TF myocardial perfusion SPECT. Tc-99m TF myocardial perfusion SPECT revealed perfusion defects in 88% and 40% of the cases in groups 1 and 2, respectively. However, no cases in group 3 demonstrated myocardial perfusion defects. Tc-99m TF myocardial perfusion SPECT is a useful noninvasive imaging modality to detect cardiac involvement in SLE patients with or without cardiac symptoms and signs. (author)

  1. Sensitivity and Specificity of Dual-Isotope 99mTc-Tetrofosmin and 123I Sodium Iodide Single Photon Emission Computed Tomography (SPECT) in Hyperparathyroidism.

    Science.gov (United States)

    Sommerauer, Michael; Graf, Carmen; Schäfer, Niklaus; Huber, Gerhard; Schneider, Paul; Wüthrich, Rudolf; Schmid, Christoph; Steinert, Hans

    2015-01-01

    Despite recommendations for 99mTc-tetrofosmin dual tracer imaging for hyperparathyroidism in current guidelines, no report was published on dual-isotope 99mTc-tetrofosmin and 123I sodium iodide single-photon-emission-computed-tomography (SPECT). We evaluated diagnostic accuracy and the impact of preoperative SPECT on the surgical procedures and disease outcomes. Analysis of 70 consecutive patients with primary hyperparathyroidism and 20 consecutive patients with tertiary hyperparathyroidism. Imaging findings were correlated with surgical results. Concomitant thyroid disease, pre- and postoperative laboratory measurements, histopathological results, type and duration of surgery were assessed. In primary hyperparathyroidism, SPECT had a sensitivity of 80% and a positive predictive value of 93% in patient-based analysis. Specificity was 99% in lesion-based analysis. Patients with positive SPECT elicit higher levels of parathyroid hormone and higher weight of resected parathyroids than SPECT-negative patients. Duration of parathyroid surgery was on average, approximately 40 minutes shorter in SPECT-positive than in SPECT-negative patients (89 ± 46 vs. 129 ± 41 minutes, p = 0.006); 86% of SPECT-positive and 50% of SPECT-negative patients had minimal invasive surgery (p = 0.021). SPECT had lower sensitivity (60%) in patients with tertiary hyperparathyroidism; however, 90% of these patients had multiple lesions and all of these patients had bilateral lesions. Dual-isotope SPECT with 99mTc-tetrofosmin and 123I sodium iodide has a high diagnostic value in patients with primary hyperparathyroidism and allows for saving of operation time. Higher levels of parathyroid hormone and higher glandular weight facilitated detection of parathyroid lesion. Diagnostic accuracy of preoperative imaging was lower in patients with tertiary hyperparathyroidism.

  2. Studies on image quality and dose exposure in chest radiography in children

    International Nuclear Information System (INIS)

    Schumacher, R.

    1985-01-01

    Chest radiography accounts for almost 50% of all radiographies in radiological departments for children, thus clearly dominating X-ray performances. The indications for examination in children are frequent infections of the upper airways, congenital cardiac defects, and controls in oncological patients. By contrast, indications for radioscopy of the chest organs which figure greatly in adult age and are often required concurrently with every chest radiography, are rather rare in the patient group of a paediatric X-ray department with their rate of c. 0.5% related to chest radiography. Chest radiographs and phantom radiographs were produced using different techniques and were compared by means of subjective and objective image quality parameters. Concurrently, thermoluminescence dosimetry was used to perform dose measurements of the small gonadal dose occurring in patients in chest radiographies. The study aimed at finding a chest radiography technique appropriate for use in paediatric radiology while considering both image quality parameters and the radiation dose required for producing pictures. (orig./DG) [de

  3. 99mTc-MIBI, 99mTc-tetrofosmin and 99mTc-Q12 in vitro and in vivo

    International Nuclear Information System (INIS)

    Bernard, Bert F.; Krenning, Eric P.; Breeman, Wout A. P.; Ensing, Geert; Benjamins, Harry; Bakker, Willem H.; Visser, Theo J.; Jong, Marion de

    1998-01-01

    The aim of this study was to compare uptake of 99m Tc-MIBI, 99m Tc-tetrofosmin and 99m Tc-Q12 in vitro and biodistribution in vivo in rats. In vitro, uptake decreased in the order MIBI→tetrofosmin→Q12. Uptake of MIBI and tetrofosmin, but not of Q12, in cultured tumor cells was dependent on the plasma membrane and mitochondrial potential. In vivo, heart uptake of all three compounds was high and stable. Tumor uptake decreased in the order MIBI→Q12→tetrofosmin and the tumor/blood ratio in the order MIBI→tetrofosmin→Q12

  4. Improved detection of focal pneumonia by chest radiography with bone suppression imaging

    International Nuclear Information System (INIS)

    Li, Feng; Engelmann, Roger; Pesce, Lorenzo; Armato, Samuel G.; MacMahon, Heber

    2012-01-01

    To evaluate radiologists' ability to detect focal pneumonia by use of standard chest radiographs alone compared with standard plus bone-suppressed chest radiographs. Standard chest radiographs in 36 patients with 46 focal airspace opacities due to pneumonia (10 patients had bilateral opacities) and 20 patients without focal opacities were included in an observer study. A bone suppression image processing system was applied to the 56 radiographs to create corresponding bone suppression images. In the observer study, eight observers, including six attending radiologists and two radiology residents, indicated their confidence level regarding the presence of a focal opacity compatible with pneumonia for each lung, first by use of standard images, then with the addition of bone suppression images. Receiver operating characteristic (ROC) analysis was used to evaluate the observers' performance. The mean value of the area under the ROC curve (AUC) for eight observers was significantly improved from 0.844 with use of standard images alone to 0.880 with standard plus bone suppression images (P < 0.001) based on 46 positive lungs and 66 negative lungs. Use of bone suppression images improved radiologists' performance for detection of focal pneumonia on chest radiographs. (orig.)

  5. Improved detection of focal pneumonia by chest radiography with bone suppression imaging

    Energy Technology Data Exchange (ETDEWEB)

    Li, Feng; Engelmann, Roger; Pesce, Lorenzo; Armato, Samuel G.; MacMahon, Heber [University of Chicago, Department of Radiology, MC-2026, Chicago, IL (United States)

    2012-12-15

    To evaluate radiologists' ability to detect focal pneumonia by use of standard chest radiographs alone compared with standard plus bone-suppressed chest radiographs. Standard chest radiographs in 36 patients with 46 focal airspace opacities due to pneumonia (10 patients had bilateral opacities) and 20 patients without focal opacities were included in an observer study. A bone suppression image processing system was applied to the 56 radiographs to create corresponding bone suppression images. In the observer study, eight observers, including six attending radiologists and two radiology residents, indicated their confidence level regarding the presence of a focal opacity compatible with pneumonia for each lung, first by use of standard images, then with the addition of bone suppression images. Receiver operating characteristic (ROC) analysis was used to evaluate the observers' performance. The mean value of the area under the ROC curve (AUC) for eight observers was significantly improved from 0.844 with use of standard images alone to 0.880 with standard plus bone suppression images (P < 0.001) based on 46 positive lungs and 66 negative lungs. Use of bone suppression images improved radiologists' performance for detection of focal pneumonia on chest radiographs. (orig.)

  6. Cu filtration for dose reduction in neonatal chest imaging

    International Nuclear Information System (INIS)

    Smans, K.; Struelens, L.; Smet, M.; Bosmans, H.; Vanhavere, F.

    2010-01-01

    As neonatal chest images are frequently acquired to investigate the life-threatening lung diseases in prematurely born children, their optimisation in terms of X-ray exposure is required. The aim of this study was to investigate whether such dose-optimisation studies could be performed using a Monte Carlo computer model. More specifically, a Monte Carlo computer model was used to investigate the influence of Cu filtration on image quality and dose in neonatal chest imaging. Monte Carlo simulations were performed with the MCNPX code and used with voxel models representing prematurely born babies (590 and 1910 g). Physical image quality was derived from simulated images in terms of the signal difference-to-noise ratio and signal-to-noise ratio (SNR). To verify the simulation results, measurements were performed using the Gammex 610 Neonatal Chest Phantom, which represents a 1-2 kg neonate. A figure of merit was used to assist in evaluating the optimum balance between the image quality and the patient dose. The results show that the Monte Carlo computer model to investigate dose and image quality works well and can be used in dose-optimisation studies for real clinical practices. Furthermore, working at a specific constant incident air kerma (K a,I ), additional filtration proved to increase SNR with 30%, whereas working at a specific constant detector dose, extra Cu filtration reduces the lung dose with 25%. Optimum balance between patient dose and image quality is found to be 60 kVp (using extra filtration). (authors)

  7. Scintigraphic study of palpable breast nodes with 99m Tc-tetrofosmin

    International Nuclear Information System (INIS)

    Pellini, Marcos Pinto; Fonseca, Lea Mirian Barbosa da; Amarante Junior, Jose Luiz de Medeiros; Fabricio, Maria Ines Menescal

    1998-01-01

    In Brazil, breast carcinoma has the greater incidence among women. In 1996, about 31,210 new cases were diagnosed. The purpose of this study is to determine if 99m technetium-tetrofosmin preferentially concentrates within malignant palpable breast nodes, distinguishing them from the benign lumps. Fifth-four consecutive and unsolicited women, mean age 47.5 +- 10.7 years, with palpable nodes in breast, underwent breast scintigraphy with 99m technetium-tetrofosmin and excisional biopsy or fine needle puncture within interval eight weeks. Histopathologic studies demonstrated 13 cysts, 1 cyst with local inflammation, 11 fibroadenoma, 2 fibrodysplasias, 3 fibroadenomas with high cellularity, 1 fibrocystic change with local inflammation, 23 invasive intraductal carcinomas and 1 invasive lobular carcinoma. The nodes ranged from 10 to 100 mm in greater diameter. The scintigraphic study yielded 30 true-negative cases, 24 true-positives, no false-negative and 1 false-positive. This case was a fibrocystic lump with local inflammation. Two patients had metastases in axillary lymph nodes, well detected in scintigraphy. The statistic analysis showed: sensitivity, 100%; specificity, 96.8%; accuracy, 98.2%; negative predictive value, 100%; positive predictive value, 96.0%. Nonparametric tests of Fisher and Chi-square rejected the antithesis at a confidence interval of 99.9% (p 99m technetium-tetrofosmin preferentially concentrates in malignant palpable breast nodes and can help to distinguish them from the benign tumors with with very high accuracy. (author)

  8. Computed and conventional chest radiography: a comparison of image quality and radiation dose

    International Nuclear Information System (INIS)

    Ramli, K.; Abdullah, B.J.J.; Ng, K-H.; Hussain, A.F.; Mahmud, R.

    2005-01-01

    The aim of this study was to compare the image quality and entrance skin dose (ESD) for film-screen and computed chest radiography. Analysis of the image quality and dose on chest radiography was carried out on a conventional X-ray unit using film-screen, storage phosphor plates and selenium drum direct chest radiography. For each receptor, ESD was measured in 60 patients using thermoluminescent dosemeters. Images were printed on 35 x 43 cm films. Image quality was assessed subjectively by evaluation of anatomic features and estimation of the image quality, following the guidelines established by the protocols of the Commission of the European Communities. There was no statistically significant difference noted between the computed and conventional images (Wilcoxon rank sum test, P>0.05). Imaging of the mediastinum and peripheral lung structures were better visualized with the storage phosphor and selenium drum technique than with the film-screen combination. The patients' mean ESD for chest radiography using the storage phosphor, film-screen combination and selenium drum was 0.20, 0.20 and 0.25 mGy, respectively, with no statistically significant difference with P > 0.05 (χ 2 tests) Copyright (2005) Blackwell Publishing Asia Pty Ltd

  9. [Development of image quality assurance support system using image recognition technology in radiography in lacked images of chest and abdomen].

    Science.gov (United States)

    Shibuya, Toru; Kato, Kyouichi; Eshima, Hidekazu; Sumi, Shinichirou; Kubo, Tadashi; Ishida, Hideki; Nakazawa, Yasuo

    2012-01-01

    In order to provide a precise radiography for diagnosis, it is required that we avoid radiography with defects by having enough evaluation. Conventionally, evaluation was performed only by observation of a radiological technologist (RT). The evaluation support system was developed for providing a high quality assurance without depending on RT observation only. The evaluation support system, called as the Image Quality Assurance Support System (IQASS), is characterized in that "image recognition technology" for the purpose of diagnostic radiography of chest and abdomen areas. The technique of the system used in this study. Of the 259 samples of posterior-anterior (AP) chest, lateral chest, and upright abdominal x-rays, the sensitivity and specificity was 93.1% and 91.8% in the chest AP, 93.3% and 93.6% in the chest lateral, and 95.0% and 93.8% in the upright abdominal x-rays. In the light of these results, it is suggested that AIQAS could be applied to practical usage for the RT.

  10. A dual-view digital tomosynthesis imaging technique for improved chest imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhong, Yuncheng; Lai, Chao-Jen; Wang, Tianpeng; Shaw, Chris C., E-mail: cshaw@mdanderson.org [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77054 (United States)

    2015-09-15

    Purpose: Digital tomosynthesis (DTS) has been shown to be useful for reducing the overlapping of abnormalities with anatomical structures at various depth levels along the posterior–anterior (PA) direction in chest radiography. However, DTS provides crude three-dimensional (3D) images that have poor resolution in the lateral view and can only be displayed with reasonable quality in the PA view. Furthermore, the spillover of high-contrast objects from off-fulcrum planes generates artifacts that may impede the diagnostic use of the DTS images. In this paper, the authors describe and demonstrate the use of a dual-view DTS technique to improve the accuracy of the reconstructed volume image data for more accurate rendition of the anatomy and slice images with improved resolution and reduced artifacts, thus allowing the 3D image data to be viewed in views other than the PA view. Methods: With the dual-view DTS technique, limited angle scans are performed and projection images are acquired in two orthogonal views: PA and lateral. The dual-view projection data are used together to reconstruct 3D images using the maximum likelihood expectation maximization iterative algorithm. In this study, projection images were simulated or experimentally acquired over 360° using the scanning geometry for cone beam computed tomography (CBCT). While all projections were used to reconstruct CBCT images, selected projections were extracted and used to reconstruct single- and dual-view DTS images for comparison with the CBCT images. For realistic demonstration and comparison, a digital chest phantom derived from clinical CT images was used for the simulation study. An anthropomorphic chest phantom was imaged for the experimental study. The resultant dual-view DTS images were visually compared with the single-view DTS images and CBCT images for the presence of image artifacts and accuracy of CT numbers and anatomy and quantitatively compared with root-mean-square-deviation (RMSD) values

  11. Super-resolution convolutional neural network for the improvement of the image quality of magnified images in chest radiographs

    Science.gov (United States)

    Umehara, Kensuke; Ota, Junko; Ishimaru, Naoki; Ohno, Shunsuke; Okamoto, Kentaro; Suzuki, Takanori; Shirai, Naoki; Ishida, Takayuki

    2017-02-01

    Single image super-resolution (SR) method can generate a high-resolution (HR) image from a low-resolution (LR) image by enhancing image resolution. In medical imaging, HR images are expected to have a potential to provide a more accurate diagnosis with the practical application of HR displays. In recent years, the super-resolution convolutional neural network (SRCNN), which is one of the state-of-the-art deep learning based SR methods, has proposed in computer vision. In this study, we applied and evaluated the SRCNN scheme to improve the image quality of magnified images in chest radiographs. For evaluation, a total of 247 chest X-rays were sampled from the JSRT database. The 247 chest X-rays were divided into 93 training cases with non-nodules and 152 test cases with lung nodules. The SRCNN was trained using the training dataset. With the trained SRCNN, the HR image was reconstructed from the LR one. We compared the image quality of the SRCNN and conventional image interpolation methods, nearest neighbor, bilinear and bicubic interpolations. For quantitative evaluation, we measured two image quality metrics, peak signal-to-noise ratio (PSNR) and structural similarity (SSIM). In the SRCNN scheme, PSNR and SSIM were significantly higher than those of three interpolation methods (pmethods without any obvious artifacts. These preliminary results indicate that the SRCNN scheme significantly outperforms conventional interpolation algorithms for enhancing image resolution and that the use of the SRCNN can yield substantial improvement of the image quality of magnified images in chest radiographs.

  12. Routine chest and abdominal high-pitch CT: An alternative low dose protocol with preserved image quality

    International Nuclear Information System (INIS)

    Amacker, Nadja A.; Mader, Caecilia; Alkadhi, Hatem; Leschka, Sebastian; Frauenfelder, Thomas

    2012-01-01

    Objective: To investigate the radiation dose and image quality of the high-pitch dual source computer tomography (DSCT) for routine chest and abdominal scans. Methods: 130 consecutive patients (62 female, 68 male, median age 55 years) were included. All patients underwent 128-slice high-pitch DSCT (chest n = 99; abdomen n = 84) at a pitch of 3.2. Two observers independently rated image quality using a 4-point score (1: excellent to 4: non-diagnostic). Image noise was measured and operational radiation dose quantities were recorded. An additional group of 132 patients (chest, n = 80; abdomen n = 52) scanned with standard-pitch CT matched for age, gender, and body mass index (BMI) served as control group. Results: Interobserver agreement for image quality rating was good (k = 0.74). Subjective image quality of high-pitch CT was diagnostic in all patients (median score chest; 2, median score abdomen: 2). Image noise of high-pitch CT was comparable to standard-pitch for the chest (p = 0.32) but increased in the abdomen (p < 0.0001). For high-pitch CT radiation dose was 4.4 ± 0.9 mSv (chest) and 6.5 ± 1.2 mSv (abdomen). These values were significantly lower compared to standard-pitch CT (chest: 5.5 ± 1.2 mSv; abdomen: 11.3 ± 3.8 mSv). Conclusion: Based on the technical background high-pitch dual source CT may serve as an alternative scan mode for low radiation dose routine chest and abdominal CT.

  13. Myocardial impairment detected by late gadolinium enhancement in hypertrophic cardiomyopathy: comparison with 99mTc-MIBI/tetrofosmin and 123I-BMIPP SPECT.

    Science.gov (United States)

    Hashimura, Hiromi; Kiso, Keisuke; Yamada, Naoaki; Kono, Atsushi; Morita, Yoshiaki; Fukushima, Kazuto; Higashi, Masahiro; Noguchi, Teruo; Ishibashi-Ueda, Hatsue; Naito, Hiroaki; Sugimura, Kazuro

    2013-06-17

    Myocardial fibrosis is considered to be an important factor in myocardial dysfunction and sudden cardiac death in hypertrophic cardiomyopathy (HCM). The purpose of this study was to compare myocardial fibrosis detected by late gadolinium enhancement (LGE) on cardiac MRI with myocardial perfusion and fatty acid metabolism assessed by single photon emission computed tomography in HCM. We retrospectively evaluated 20 consecutive HCM patients (female, 7; mean age, 53.4 years) who underwent LGE, technetium-99m methoxyisobutylisonitrile/tetrofosmin (99mTc-MIBI/tetrofosmin), and iodine-123 beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP) imaging. We calculated the myocardium-to-lumen signal ratio (M/L) for LGE in 17 segments based on the American Heart Association statement. Scoring of 99mTc-MIBI/tetrofosmin (PI) and 123I-BMIPP (BM) was performed for each segment using a 5-point scale (0, normal; 4, highly decreased). Nineteen of 20 patients (95%) and 153 of 340 segments (45%) showed LGE. M/Ls were 0.42±0.16, 0.55±0.17, and 0.65±0.24 in PI0/BM0, PI0/BM1-4 and PI1-4/BM1-4, respectively. All M/Ls were significantly higher than that of a normal control (0.34±0.14) (pacid metabolism, and is more strongly associated with disorders of fatty acid metabolism than with perfusion abnormalities. M/L may be a useful indicator of disease severity.

  14. Image quality of a Konica Regius 336 digital system in chest radiography

    International Nuclear Information System (INIS)

    Ostinelli, A.; Frigerio, M.; Monti, A.F.; Gelosa, S.; Tognoli, P.; Perniola, N.; Gozzi, G.

    2000-01-01

    Digital radiographic systems permit to optimize execution, depiction and storage of radiological images. Since a Regius 336 digital system (Konica Corp. Tokyo, Japan) devoted to chest radiography Department of S. Anna Hospital in Como, Italy, it was investigated its performance relative to image quality. Konica Regius 336 is a computed radiography system made of a phosphorescence detector plate which is scanned with an infrared semiconductor laser beam. The radiographic image obtained from the detector is subjected to image processing, which allows a stable output and the nonlinear curve typical of conventional radiographic systems. Image quality was assessed based on the following parameters: dose, contrast, noise and spatial resolution. As reference, it was assessed the same parameters on a Cronex 88 analogic chest-changer (DuPont Pharma, North Billerica, Mass, USA). The Regius 336 air kerma values were always higher than the analogic ones (about 10%), both with and without a chest phantom; noise was also greater than in analogic images, sometimes even doubled. The optical densities of a step wedge and the spatial resolution of the digital chest-changer are independent of the X-ray tube voltage consequent to broader optical latitude. Inversely, the analogic images of the wedges show great optical density variability as a function of the X-ray tube voltage (in a range of 2). The modulation transfer functions of the two systems have the same trend. The performance of the Konica Regius 336 is nearly equivalent to that of an analogic system. The main advantages of the digital system are a standard output, lower consumption of radiographic films, higher productiveness and better image quality standard level [it

  15. Performance evaluation of image denoising developed using convolutional denoising autoencoders in chest radiography

    Science.gov (United States)

    Lee, Donghoon; Choi, Sunghoon; Kim, Hee-Joung

    2018-03-01

    When processing medical images, image denoising is an important pre-processing step. Various image denoising algorithms have been developed in the past few decades. Recently, image denoising using the deep learning method has shown excellent performance compared to conventional image denoising algorithms. In this study, we introduce an image denoising technique based on a convolutional denoising autoencoder (CDAE) and evaluate clinical applications by comparing existing image denoising algorithms. We train the proposed CDAE model using 3000 chest radiograms training data. To evaluate the performance of the developed CDAE model, we compare it with conventional denoising algorithms including median filter, total variation (TV) minimization, and non-local mean (NLM) algorithms. Furthermore, to verify the clinical effectiveness of the developed denoising model with CDAE, we investigate the performance of the developed denoising algorithm on chest radiograms acquired from real patients. The results demonstrate that the proposed denoising algorithm developed using CDAE achieves a superior noise-reduction effect in chest radiograms compared to TV minimization and NLM algorithms, which are state-of-the-art algorithms for image noise reduction. For example, the peak signal-to-noise ratio and structure similarity index measure of CDAE were at least 10% higher compared to conventional denoising algorithms. In conclusion, the image denoising algorithm developed using CDAE effectively eliminated noise without loss of information on anatomical structures in chest radiograms. It is expected that the proposed denoising algorithm developed using CDAE will be effective for medical images with microscopic anatomical structures, such as terminal bronchioles.

  16. Dose-image quality study in digital chest radiography using Monte Carlo simulation

    International Nuclear Information System (INIS)

    Correa, S.C.A.; Souza, E.M.; Silva, A.X.; Lopes, R.T.; Yoriyaz, H.

    2008-01-01

    One of the main preoccupations of diagnostic radiology is to guarantee a good image-sparing dose to the patient. In the present study, Monte Carlo simulations, with MCNPX code, coupled with an adult voxel female model (FAX) were performed to investigate how image quality and dose in digital chest radiography vary with tube voltage (80-150 kV) using air-gap technique and a computed radiography system. Calculated quantities were normalized to a fixed value of entrance skin exposure (ESE) of 0.0136 R. The results of the present analysis show that the image quality for chest radiography with imaging plate is improved and the dose reduced at lower tube voltage

  17. A study on the digital image transfer application mass chest X-ray system up-grade

    International Nuclear Information System (INIS)

    Kim, Sun Chil; Park, Jong Sam; Lee, Jon Il

    2003-01-01

    By converting movable indirect mass chest X-ray devices for vehicles into digital systems and upgrading it to share information with the hospital's medical image information system, excellencies have been confirmed as a result of installing and running this type of system and are listed hereinafter. Upgrading analog systems, such as indirect mass chest X-ray devices dependent on printed film, to digital systems allows them to be run and managed much more efficiently, contributing to the increase in the stability and the efficiency of the system. Unlike existing images, communication based on DICOM standards allow images to be compatible with the hospital's outer and inner network PACS systems, extending the scope of the radiation departments information system. Assuming chest-exclusive indirect mass chest X-rays, a linked development of CAD (Computer Aided Diagnosis, Detector) becomes possible. By applying wireless Internet, Web-PACS for movable indirect mass chest X-ray devices for vehicles will become possible. Research in these fields must continue and if the superior image quality and convenience of digital systems are confirmed, I believe that the conversion of systems still dependent on analog images to modernized digital systems is a must

  18. Evaluation of the image quality of chest CT scans: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Martins N, P. I.; Prata M, A., E-mail: priscillainglid@gmail.com [Centro Federal de Educacao Tecnologica de Minas Gerais, Centro de Engenharia Biomedica, Av. Amazonas 5253, 30421-169 Nova Suica, Belo Horizonte, Minas Gerais (Brazil)

    2016-10-15

    Computed tomography (CT) is considered one of the most important methods of medical imaging employed nowadays, due to its non-invasiveness and the high quality of the images it is able to generate. However, the diagnostic radiation dose received by an individual over the year often exceeds the dose received on account of background radiation. Therefore, it is important to know and to control the dose distribution in the patient by varying the image acquisition parameters. The aim of this study is to evaluate the variation of the image quality of chest CT scans performed by two phantoms. In this paper, a cylindrical Polymethyl Methacrylate (PMMA) chest phantom was used and a second PMMA phantom has been developed with the same volume but an oblong shape, based on the actual dimensions of a male human thorax, in the axillary region. Ten-centimeter scans of the central area of each phantom were performed by a 16-channel Toshiba CT scanner, model Alexion. The scanning protocol employed was the radiology service protocol for chest scans. The noise survey was conducted within the image of the center slice, in five regions: one central and four peripheral areas close to the edge of the object (anterior, posterior, left and right). The recorded values showed that the oblong phantom, with a shape that is more similar to the actual human chest, has a considerably smaller noise, especially in the anterior, posterior and central regions. (Author)

  19. Evaluation of the image quality of chest CT scans: a phantom study

    International Nuclear Information System (INIS)

    Martins N, P. I.; Prata M, A.

    2016-10-01

    Computed tomography (CT) is considered one of the most important methods of medical imaging employed nowadays, due to its non-invasiveness and the high quality of the images it is able to generate. However, the diagnostic radiation dose received by an individual over the year often exceeds the dose received on account of background radiation. Therefore, it is important to know and to control the dose distribution in the patient by varying the image acquisition parameters. The aim of this study is to evaluate the variation of the image quality of chest CT scans performed by two phantoms. In this paper, a cylindrical Polymethyl Methacrylate (PMMA) chest phantom was used and a second PMMA phantom has been developed with the same volume but an oblong shape, based on the actual dimensions of a male human thorax, in the axillary region. Ten-centimeter scans of the central area of each phantom were performed by a 16-channel Toshiba CT scanner, model Alexion. The scanning protocol employed was the radiology service protocol for chest scans. The noise survey was conducted within the image of the center slice, in five regions: one central and four peripheral areas close to the edge of the object (anterior, posterior, left and right). The recorded values showed that the oblong phantom, with a shape that is more similar to the actual human chest, has a considerably smaller noise, especially in the anterior, posterior and central regions. (Author)

  20. Cross-sectional imaging with CT and/or MRI of pediatric chest tumors

    International Nuclear Information System (INIS)

    Wyttenbach, R.; Vock, P.; Tschaeppeler, H.

    1998-01-01

    The purpose of this study was to provide an overview of the spectrum of pediatric chest masses, to present the results of cross-sectional imaging with CT and/or MRI, and to define diagnostic criteria to limit differential diagnosis. Seventy-eight children with thoracic mass lesions were retrospectively evaluated using CT (72 patients) and/or MR imaging (12 patients). All masses were evaluated for tissue characteristics (attenuation values or signal intensity, enhancement, and calcification) and were differentiated according to age, gender, location, and etiology. Twenty-eight of 38 (74 %) mediastinal masses were malignant (neuroblastoma, malignant lymphoma). Thirty of 38 (79 %) pulmonary masses were metastatic in origin, all with an already known primary tumor (osteosarcoma, Wilms tumor). With one exception, all remaining pulmonary lesions were benign. Seventeen of 21 (81 %) chest wall lesions were malignant (Ewing sarcoma, primitive neuroectodermal tumor). The majority of mediastinal and chest wall tumors in children is malignant. Lung lesions are usually benign, unless a known extrapulmonary tumor suggests pulmonary metastases. Cross-sectional imaging with CT and/or MRI allows narrowing of the differential diagnosis of pediatric chest masses substantially by defining the origin and tissue characteristics. Magnetic resonance imaging is preferred for posterior mediastinal lesions, whereas CT should be used for pulmonary lesions. For the residual locations both modalities are complementary. (orig.)

  1. Value of the asymmetric film-screen system InSight HC in chest imaging

    International Nuclear Information System (INIS)

    Haeussler, M.D.; Lenzen, H.; Reckels, C.; Peters, P.E.

    1994-01-01

    The asymmetric film-screen system InSight HC represents a development to optimize chest imaging. The purpose of the study was to compare the exposure range and the image quality of this new system with a conventional film-screen system. The optical density of images in both techniques was measured and the image quality of 100 chest images from 50 intensive-care patients was evaluated. 4 observers graded the image quality of organic, non-organic and pathological structures. Statistical evaluation was performed by interobserver analysis. The asymmetric film-screen system shows a larger exposure range and a superior image quality in the mediastinal field. The image quality in the peripheral field must be judged critically and improved especially because of the poor recognizability of pneumothoraces. (orig.) [de

  2. An investigation of automatic exposure control calibration for chest imaging with a computed radiography system

    International Nuclear Information System (INIS)

    Moore, C S; Wood, T J; Beavis, A W; Saunderson, J R; Avery, G; Balcam, S; Needler, L

    2014-01-01

    The purpose of this study was to examine the use of three physical image quality metrics in the calibration of an automatic exposure control (AEC) device for chest radiography with a computed radiography (CR) imaging system. The metrics assessed were signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQ m ), all measured using a uniform chest phantom. Subsequent calibration curves were derived to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated chest images with correct detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated chest images contained clinically realistic projected anatomy and anatomical noise and were scored by experienced image evaluators. Constant DDI and CNR curves do not appear to provide optimized performance across the diagnostic energy range. Conversely, constant eNEQ m  and SNR do appear to provide optimized performance, with the latter being the preferred calibration metric given as it is easier to measure in practice. Medical physicists may use the SNR image quality metric described here when setting up and optimizing AEC devices for chest radiography CR systems with a degree of confidence that resulting clinical image quality will be adequate for the required clinical task. However, this must be done with close cooperation of expert image evaluators, to ensure appropriate levels of detector air kerma. (paper)

  3. An investigation of automatic exposure control calibration for chest imaging with a computed radiography system.

    Science.gov (United States)

    Moore, C S; Wood, T J; Avery, G; Balcam, S; Needler, L; Beavis, A W; Saunderson, J R

    2014-05-07

    The purpose of this study was to examine the use of three physical image quality metrics in the calibration of an automatic exposure control (AEC) device for chest radiography with a computed radiography (CR) imaging system. The metrics assessed were signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm), all measured using a uniform chest phantom. Subsequent calibration curves were derived to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated chest images with correct detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated chest images contained clinically realistic projected anatomy and anatomical noise and were scored by experienced image evaluators. Constant DDI and CNR curves do not appear to provide optimized performance across the diagnostic energy range. Conversely, constant eNEQm and SNR do appear to provide optimized performance, with the latter being the preferred calibration metric given as it is easier to measure in practice. Medical physicists may use the SNR image quality metric described here when setting up and optimizing AEC devices for chest radiography CR systems with a degree of confidence that resulting clinical image quality will be adequate for the required clinical task. However, this must be done with close cooperation of expert image evaluators, to ensure appropriate levels of detector air kerma.

  4. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    Prosch, H.; Negrin, L.

    2014-01-01

    Blunt chest trauma is associated with high morbidity and mortality. Consequently, all patients should be evaluated radiologically after blunt chest trauma to allow timely and appropriate treatment. Conventional chest radiographs and computed tomography (CT) are proven modalities with which to evaluate patients after blunt chest trauma. Over the last several years extended focused assessment with sonography for trauma (eFAST) has gained increasing importance for the initial assessment of seriously injured patients. In the acute phase of severely injured patients eFAST examinations are helpful to exclude pneumothorax, hemothorax and hemopericardium. Chest radiographs may also be used to diagnose a pneumothorax or hemothorax; however, the sensitivity is limited and CT is the diagnostic modality of choice to evaluate severely injured patients. (orig.) [de

  5. Chest X-Ray

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, ... d like to talk with you about chest radiography also known as chest x-rays. Chest x- ...

  6. Large-field image intensifiers versus conventional chest radiography: ROC study with simulated interstitial disease

    International Nuclear Information System (INIS)

    Winter, L.H.L.; Chakraborty, D.P.; Waes, P.F.G.M.

    1988-01-01

    Two image intensifier tubes have recently been introduced whose large imaging area makes them suitable for chest imaging (Phillips Pulmodiagnost TLX slit II and Siemens TX 57 large entrance field II). Both modalities present a 10 x 10-cm hard copy image to the radiologist. A receiver operating characteristic (ROC) curve study with simulated interstitial disease was performed to compare the image quality of these image intensifiers with conventional chest images. The relative ranking in terms of decreasing ROC areas was Siemens, conventional, and Philips. Compared with conventional imaging, none of the differences in ROC curve area were statistically significant at the 5% level

  7. Chest X-Ray

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, ... you about chest radiography also known as chest x-rays. Chest x-rays are the most commonly performed ...

  8. Imaging recognition of inhibition of multidrug resistance in human breast cancer xenografts using 99mTc-labeled sestamibi and tetrofosmin

    International Nuclear Information System (INIS)

    Liu Zhonglin; Stevenson, Gail D.; Barrett, Harrison H.; Furenlid, Lars R.; Wilson, Donald W.; Kastis, George A.; Bettan, Michael; Woolfenden, James M.

    2005-01-01

    Background: 99m Tc-sestamibi (MIBI) and 99m Tc-tetrofosmin (TF) are avid transport substrates recognized by the multidrug resistance (MDR) P-glycoprotein (Pgp). This study was designed to compare the properties of MIBI and TF in assessing the inhibition of Pgp by PSC833 in severe combined immunodeficient mice bearing MCF7 human breast tumors using SPECT imaging. Methods: Animals with drug-sensitive (MCF/WT) and drug-resistant (MCF7/AdrR) tumors were treated by PSC833 and by carrier vehicle 1 h before imaging, respectively. Dynamic images were acquired for 30 min after intravenous injection of MIBI/TF using a SPECT system, FastSPECT. The biodistribution of MIBI and TF was determined at the end of the imaging session. Results: MCF7/WT in the absence and presence of PSC833 could be visualized by MIBI and TF imaging within 5 min and remained detectable for 30 min postinjection. MCF7/AdrR could be visualized only 2-5 min without PSC833 treatment but could be detected for 30 min with PSC833, very similar to MCF7/WT. MCF7/AdrR without PSC833 showed significantly greater radioactive washout than MCF7/WT and MCF7/AdrR with PSC833 treatment. PSC833 increased the accumulation (%ID/g) in MCF7/AdrR 3.0-fold (1.62±0.15 vs. 0.55±0.05, P<.05) for TF and 1.9-fold (1.21±0.04 vs. 0.64±0.05, P<.05) for MIBI but did not affect MCF7/WT. Conclusions: The feasibility of MIBI and TF for assessment of MDR expression and inhibition was demonstrated in mice through FastSPECT imaging. The results indicate that TF may be at least comparable with MIBI in recognizing Pgp expression and modulation

  9. 99Tcm-tetrofosmin myocardial perfusion imaging for diagnosis of coronary heart disease

    International Nuclear Information System (INIS)

    Zhang Lele; Tian Wei; Shao Guoqiang; Zhang Hang; You Wei; Meng Qingle; Yang Rui; Cao Yan; Wang Xiaowen; Wang Feng

    2012-01-01

    Objective: To assess the clinical value of 99 Tc m -tetrofosmin (TF) MPI for diagnosis of CHD. Methods: A total of 73 patients (46 males,27 females; age: (61.16 ± 12.95) y) were included in this study. 99 Tc m -TF MPI and CAG were performed in all patients. Two-day protocol of MPI was used in this study, with rest MPI performed on the first day and stress (exercise stress or adenosine stress) imaging on the next day. CAG was performed within one week after MPI and served as the gold standard in diagnosis of CHD. Stenosis over 50% of the lumen was considered positive. The diagnostic efficacy of 99 Tc m -TF MPI was evaluated based on the results of CAG. Results: Among the 73 patients,43 patients were CAG positive, 27 cases with single vessel disease, 10 patients with double vessel disease and 6 patients with triple vessel disease. There were 37 patients with abnormality in MPI and 36 patients with normal MPI. Out of 43 patients with positive CAG, there were 32 cases diagnosed with myocardial ischemia and 11 with normal results in MPI. Among the 65 diseased vessels,there were 33 involved in LAD, 16 LCX and 16 RCA. The sensitivity,specificity, positive predictive value,negative predictive value and accuracy of MPI for detection of CHD were 74.4% (32/43), 83.3% (25/30), 86.5% (32/37), 69.4% (25/36) and 78.1% (57/73), respectively. The sensitivities for detection of single vessel disease, double vessel disease and triple vessel disease were 66.7% (18/27), 80.0% (8/10) and 5/6, respectively. The sensitivity and specificity of MPI for detection of coronary disease in all 219 vessels were 67.7% (44/65) and 89.0% (137/154), respectively. Conclusion: 99 Tc m -TF MPI, with convenient preparation and reliable properties of the tracer, may provide an alternative modality for accurate detection of CHD. (authors)

  10. Chest imaging in aids - radiological findings with pathologic correlation: review article

    International Nuclear Information System (INIS)

    Qazi, A.S.

    1999-01-01

    Majority of life threatening illnesses in AIDS begin as pulmonary infections and a radiologist must always seriously consider the possibility of HIV infection and its manifestation when confronting an abnormal chest study in a young adult. Chest radiography may be normal in up to 15% of patients with proven pulmonary involvement or the radiographic picture may be confusing due to atypical appearances of opportunistic infections in immuno-compromised host, compounded further by concomitant appearance of neoplastic complications like Kaposi AIDS relate lymphoma. Cases with normal chest radiograph but high degree of suspicion of chest disease need to be evaluated by CT scan which has been found to be superior to chest radiography in identifying patient with and without chest disease and in the differential diagnosis of pulmonary complications in patients with AIDS. Radio nuclear scans and MRI have some role only in selected few cases. Combining imaging features with clinical presentation, CD4 lymphocyte count, previous treatment and underlying risk group can narrow down differential diagnosis, expedite treatment and may be helpful in preventing complications. (author)

  11. Effect of collateral circulation on myocardial protection in patients with acute myocardial infarction. Comparison of technetium-99m-tetrofosmin myocardial single photon emission computed tomography and coronary angiography

    International Nuclear Information System (INIS)

    Yoshida, Michi; Kondo, Makoto; Abe, Yoshiteru; Kubota, Tomoyuki; Matsuoka, Ryota; Araki, Makoto; Tanio, Hitoshi; Doyama, Kiyoshi

    2006-01-01

    Evaluation of myocardial blood flow from collateral vessels into the infarct area has been estimated by coronary angiography. In patients with acute myocardial infarction with Thrombolysis in Myocardial Infarction (TIMI) 0 flow, myocardial tracer uptake on single photon emission computed tomography (SPECT) images can predict the collateral blood flow in the infarct area if technetium (Tc)-99m-tetrofosmin was administered before recanalization. The present study investigated whether collateral blood flow evaluated by myocardial scintigraphy is a good predictor of myocardial salvage in patients with acute myocardial infarction. The study group consisted of 30 patients (mean age 65±14 years, 23 males, 7 females) with first acute myocardial infarction and coronary angiography evidence of total occlusion (TIMI 0) within 12 hr after the onset. All patients had one vessel disease related to infarction and TIMI 3 flow after percutaneous coronary intervention (PCI). Tc-99m-tetrofosmin was injected intravenously before the PCI. The regional severity score index (RSSI) was obtained from SPECT using the 17 segment method with the four-point scoring system. Myocardial viability was evaluated by the RSSI obtained from thallium-glucose-insulin infusion SPECT after 1 week and regional wall motion score index obtained from echocardiography during the chronic phase. The patients were divided into two groups according to the angiographic collateral finding. There were no differences in RSSI on thallium-glucose-insulin SPECT and regional wall motion score between the good collateral group (n=8) and poor collateral group (n=22). Myocardial Tc-99m-tetrofosmin RSSI was similar in these groups. On the other hand, the patients were divided according to Tc-99m-tetrofosmin scintigraphic evaluation before PCI. RSSI on thallium-glucose-insulin SPECT was significantly greater (0.7±0.5 vs 1.5±0.4, p<0.01) and regional wall motion score was significantly less (1.46±0.50 vs 2.08±0.78, p<0

  12. Application of Super-Resolution Convolutional Neural Network for Enhancing Image Resolution in Chest CT.

    Science.gov (United States)

    Umehara, Kensuke; Ota, Junko; Ishida, Takayuki

    2017-10-18

    In this study, the super-resolution convolutional neural network (SRCNN) scheme, which is the emerging deep-learning-based super-resolution method for enhancing image resolution in chest CT images, was applied and evaluated using the post-processing approach. For evaluation, 89 chest CT cases were sampled from The Cancer Imaging Archive. The 89 CT cases were divided randomly into 45 training cases and 44 external test cases. The SRCNN was trained using the training dataset. With the trained SRCNN, a high-resolution image was reconstructed from a low-resolution image, which was down-sampled from an original test image. For quantitative evaluation, two image quality metrics were measured and compared to those of the conventional linear interpolation methods. The image restoration quality of the SRCNN scheme was significantly higher than that of the linear interpolation methods (p < 0.001 or p < 0.05). The high-resolution image reconstructed by the SRCNN scheme was highly restored and comparable to the original reference image, in particular, for a ×2 magnification. These results indicate that the SRCNN scheme significantly outperforms the linear interpolation methods for enhancing image resolution in chest CT images. The results also suggest that SRCNN may become a potential solution for generating high-resolution CT images from standard CT images.

  13. Chest magnetic resonance imaging: a protocol suggestion

    Directory of Open Access Journals (Sweden)

    Bruno Hochhegger

    2015-12-01

    Full Text Available Abstract In the recent years, with the development of ultrafast sequences, magnetic resonance imaging (MRI has been established as a valuable diagnostic modality in body imaging. Because of improvements in speed and image quality, MRI is now ready for routine clinical use also in the study of pulmonary diseases. The main advantage of MRI of the lungs is its unique combination of morphological and functional assessment in a single imaging session. In this article, the authors review most technical aspects and suggest a protocol for performing chest MRI. The authors also describe the three major clinical indications for MRI of the lungs: staging of lung tumors; evaluation of pulmonary vascular diseases; and investigation of pulmonary abnormalities in patients who should not be exposed to radiation.

  14. Cardiac CT for the assessment of chest pain: Imaging techniques and clinical results

    International Nuclear Information System (INIS)

    Becker, Hans-Christoph; Johnson, Thorsten

    2012-01-01

    Immediate and efficient risk stratification and management of patients with acute chest pain in the emergency department is challenging. Traditional management of these patients includes serial ECG, laboratory tests and further on radionuclide perfusion imaging or ECG treadmill testing. Due to the advances of multi-detector CT technology, dedicated coronary CT angiography provides the potential to rapidly and reliably diagnose or exclude acute coronary artery disease. Life-threatening causes of chest pain, such as aortic dissection and pulmonary embolism can simultaneously be assessed with a single scan, sometimes referred to as “triple rule out” scan. With appropriate patient selection, cardiac CT can accurately diagnose heart disease or other sources of chest pain, markedly decrease health care costs, and reliably predict clinical outcomes. This article reviews imaging techniques and clinical results for CT been used to evaluate patients with chest pain entering the emergency department.

  15. Assessment of Takotsubo (ampulla) cardiomyopathy using 99mTc-tetrofosmin myocardial SPECT. Comparison with acute coronary syndrome

    International Nuclear Information System (INIS)

    Ito, Kazuki; Katoh, Shuji

    2003-01-01

    We assessed Takotsubo (ampulla) cardiomyopathy compared with acute coronary syndrome (ACS) using two-dimensional echocardiography and 99m Tc-tetrofosmin myocardial SPECT. We examined 10 patients with Takotsubo cardiomyopathy and 16 with ACS at the time of emergency admission (acute phase), at three to nine days after the attack (subacute phase) and at one month after the attack (chronic phase). The left ventricle was divided into nine regions on echocardiograms and SPECT images, and the degree of abnormalities in each region was scored in five grades from normal (0) to severely abnormal (4). Coronary angiography revealed total or subtotal occlusion in patients with ACS but no stenotic legions in those with Takotsubo cardiomyopathy. The amount of ST segment elevation (mm) was 7.9±3.4 in patients with Takotsubo cardiomyopathy and 7.3±3.7 in those with ACS (N.S.). Abnormal wall motion scores on echocardiograms were 13.8±4.4, 4.4±3.8 and 1.8±2.3 during the acute, subacute and chronic phases in patients with Takotsubo cardiomyopathy, and 13.9±4.0, 11.7±3.7, 7.6±4.2, respectively in patients with ACS. The value of MB fraction of creatine phosphokinase (IU/l) was 34±23 in patients with Takotsubo cardiomyopathy and 326±98 in those with ACS (p 99m Tc-tetrofosmin myocardial SPECT were 11.4±3.2, 3.2±3.3 and 0.7±1.1 during the acute, subacute and chronic phases respectively, in patients with Takotsubo cardiomyopathy, and 15.8±4.1, 13.5±4.4, 8.2±4.4, respectively, in those with ACS. The numbers of myocardial segments that did not uptake 99m Tc-tetrofosmin during the acute phase were 0.5±0.8 and 3.6±2.8 in patients with Takotsubo cardiomyopathy and ACS, respectively. Impaired coronary microcirculation might be a causative mechanism of Takotsubo cardiomyopathy. (author)

  16. Correlation between the signal-to-noise ratio improvement factor (KSNR) and clinical image quality for chest imaging with a computed radiography system

    International Nuclear Information System (INIS)

    Moore, C S; Wood, T J; Saunderson, J R; Beavis, A W

    2015-01-01

    This work assessed the appropriateness of the signal-to-noise ratio improvement factor (K SNR ) as a metric for the optimisation of computed radiography (CR) of the chest. The results of a previous study in which four experienced image evaluators graded computer simulated chest images using a visual grading analysis scoring (VGAS) scheme to quantify the benefit of using an anti-scatter grid were used for the clinical image quality measurement (number of simulated patients  =  80). The K SNR was used to calculate the improvement in physical image quality measured in a physical chest phantom. K SNR correlation with VGAS was assessed as a function of chest region (lung, spine and diaphragm/retrodiaphragm), and as a function of x-ray tube voltage in a given chest region. The correlation of the latter was determined by the Pearson correlation coefficient. VGAS and K SNR image quality metrics demonstrated no correlation in the lung region but did show correlation in the spine and diaphragm/retrodiaphragmatic regions. However, there was no correlation as a function of tube voltage in any region; a Pearson correlation coefficient (R) of  −0.93 (p  =  0.015) was found for lung, a coefficient (R) of  −0.95 (p  =  0.46) was found for spine, and a coefficient (R) of  −0.85 (p  =  0.015) was found for diaphragm. All demonstrate strong negative correlations indicating conflicting results, i.e. K SNR increases with tube voltage but VGAS decreases. Medical physicists should use the K SNR metric with caution when assessing any potential improvement in clinical chest image quality when introducing an anti-scatter grid for CR imaging, especially in the lung region. This metric may also be a limited descriptor of clinical chest image quality as a function of tube voltage when a grid is used routinely. (paper)

  17. Clinical usefulness of delayed exercise images on 99mTc-tetrofosmin myocardial SPECT in the diagnosis of vasospastic angina pectoris

    International Nuclear Information System (INIS)

    Ito, Kazuki; Zen, Kan; Hikosaka, Takatou; Adachi, Yoshihiko; Yoneyama, Satoshi; Katoh, Shuuji; Sugihara, Hiroki; Nakamura, Tomoki; Azuma, Akihiro

    2000-01-01

    This study was designed to evaluate the clinical usefulness of delayed exercise images in 99m Tc-tetrofosmin (TF) myocardial SPECT in the diagnosis of vasospastic angina pectoris. We studied 30 patients with vasospastic angina, 10 of 30 patients (group A) had both effort and rest angina, 20 of 30 patients (group B) had rest angina. A 370 MBq of TF was intravenously injected at peak exercise, and initial (EX-I) and delayed exercise (EX-D) images were obtained at 30 min and 180 min after the injection. An additional 740 MBq of TF was intravenously reinjected after EX-D image acquisition, and rest images were obtained 30 min after the reinjection. The left ventricular wall was divided into 9 segments. Regional myocardial uptakes of TF were scored by 4-point defect score (0=normal, 1=mildly reduced, 2=moderately reduced, and 3=severely reduced). Total defect score (TDS) was calculated from the sum of defect scores in 9 segments. Reverse redistribution (RR) was defined as increase of more than 2 in TDS on EX-D images. In group A, 4 of 10 cases (40%) showed decreased uptake on EX-I images, 6 of 10 cases (60%) revealed RR on EX-D images, and none of the patients showed decreased uptake on rest images. In group B, no one showed decreased uptake on EX-I and rest images, 11 of 20 cases (55%) revealed RR on EX-D images. The mean±SD of TDS were 2.9±3.4, 5.1±4.5, 0.5±0.5 on EX-I, EX-D, rest images in group A, and serially 0.4±0.5, 3.3±3.6, 0.4±0.5 in group B. Regional wall motion abnormality was reduced in regions with RR. RR on EX-D images may reflect ischemic damaged but viable myocardium in vasospastic angina. The clinical usefulness of exercise-rest TF imaging in detection of organic coronary artery disease has been well established. Therefore, exercise-rest TF imaging with additional delayed exercise image could evaluate not only organic coronary artery disease but also coronary artery vasospasm. (author)

  18. Reducing the absorbed dose in analogue radiography of infant chest images by improving the image quality, using image processing techniques

    International Nuclear Information System (INIS)

    Karimian, A.; Yazdani, S.; Askari, M. A.

    2011-01-01

    Radiographic inspection is one of the most widely employed techniques for medical testing methods. Because of poor contrast and high un-sharpness of radiographic image quality in films, converting radiographs to a digital format and using further digital image processing is the best method of enhancing the image quality and assisting the interpreter in their evaluation. In this research work, radiographic films of 70 infant chest images with different sizes of defects were selected. To digitise the chest images and employ image processing the two algorithms (i) spatial domain and (ii) frequency domain techniques were used. The MATLAB environment was selected for processing in the digital format. Our results showed that by using these two techniques, the defects with small dimensions are detectable. Therefore, these suggested techniques may help medical specialists to diagnose the defects in the primary stages and help to prevent more repeat X-ray examination of paediatric patients. (authors)

  19. Chocolate intake may reduce liver count in 99m-Tc-tetrofosmin myocardial SPECT

    International Nuclear Information System (INIS)

    Tsunekawa, Akikazu; Yasuda, Eisuke; Okuda, Seiji

    2005-01-01

    The accumulation of 99m-Tc-Tetrofosmin (TF) in the liver and intestine may often interfere the image quality of myocardial TF SPECT. Although milk intake before acquisition is recommended to reduce its accumulation by enhancing biliary excretion of TF, some patients cannot accept milk. To elucidate the efficacy of chocolate intake as a substitute for milk, we investigated 72 patients with coronary heart disease who underwent TF SPECT (stress imaging; n=36, rest imaging; n=36). Following injection of TF, the patients were randomly treated either with milk (n=24), or chocolate (n=24). The images were acquired before treatment, at 15 min, at 30 min, and 45 min after treatment. The ratio of liver to heart count (LHR) was calculated and was compared between the two groups. LHR in the stress imaging was not significantly different between the milk-treated and chocolate-treated groups: 1.86 vs 1.87 before treatment, 1.39 vs 1.39 at 30 min, and 1.02 vs 1.03 at 45 min. LHR in the rest imaging was also the same between the two groups: 1.43 vs 1.42 before treatment, 1.22 vs 1.21 at 15 min, and 0.95 vs. 0.95 at 30 min. Chocolate intake may be equally effective to milk intake in reducing the liver accumulation of TF. (author)

  20. Chest MRI

    Science.gov (United States)

    ... resonance imaging - chest; NMR - chest; MRI of the thorax; Thoracic MRI Patient Instructions ... Gotway MB, Panse PM, Gruden JF, Elicker BM. Thoracic radiology. In: Broaddus VC, Mason RJ, Ernst JD, et ...

  1. Imaging of chest disease due to intravenous heroin abuse

    International Nuclear Information System (INIS)

    Lian Xuhui; Chen Zhong; Ye Wenqin

    2002-01-01

    Objective: To study the imaging findings of the chest disease due to intravenous heroin abuse. Methods: Twenty-five cases of clinically confirmed chest disease due to intravenous heroin abuse were retrospectively analyzed. 25 cases had conventional X-ray film, 6 cases had CT scanning, and 6 cases had echocardiography scanning. Results: On X-ray and CT, the following signs were found: lung making manifold (n = 5), small patchy shadow (n = 15), pneumatocele (n = 16), small cavity (n = 16), small node (n = 7), pleural effusion (n = 8 ), pneumothorax (n = 2), hydropneumothorax (n = 6), pulmonary edema (n = 2), megacardia (n = 11), multiple-shaped lesion (n = 20). On echocardiography, tricuspid vegetation (n = 4) and tricuspid insufficiency (n = 4) were found. Conclusion: The X-ray and CT manifestations of chest inflammation due to intravenous heroin abuse are multiple. The multiple small cavities and pneumatoceles sign are of some value in the diagnosis of lung inflammation due to intravenous heroin abuse among young patients

  2. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    Wicky, S.; Wintermark, M.; Schnyder, P.; Capasso, P.; Denys, A.

    2000-01-01

    In western European countries most blunt chest traumas are associated with motor vehicle and sport-related accidents. In Switzerland, 39 of 10,000 inhabitants were involved and severely injured in road accidents in 1998. Fifty two percent of them suffered from blunt chest trauma. According to the Swiss Federal Office of Statistics, traumas represented in men the fourth major cause of death (4 %) after cardiovascular disease (38 %), cancer (28 %), and respiratory disease (7 %) in 1998. The outcome of chest trauma patients is determined mainly by the severity of the lesions, the prompt appropriate treatment delivered on the scene of the accident, the time needed to transport the patient to a trauma center, and the immediate recognition of the lesions by a trained emergency team. Other determining factors include age as well as coexisting cardiac, pulmonary, and renal diseases. Our purpose was to review the wide spectrum of pathologies related to blunt chest trauma involving the chest wall, pleura, lungs, trachea and bronchi, aorta, aortic arch vessels, and diaphragm. A particular focus on the diagnostic impact of CT is demonstrated. (orig.)

  3. Evaluation of Image Quality in Low Tube-Voltage Chest CT Scan

    International Nuclear Information System (INIS)

    Kim, Hyun Ju; Cho, Jae Hwan; Park, Cheol Soo

    2010-01-01

    The patients who visited this department for pulmonary disease and need CT scans for Follow-up to observe change of CT value, evaluation of image quality and decrease of radiation dose as change of kVp. Subjects were the patients of 20 persons visited this department for pulmonary disease and Somatom Sensation 16(Semens, Enlarge, Germany) was used. Measurement of CT value as change of kVp was done by setting up ROI diameter of 1cm at the height of thyroid, aortic arch, right pulmonary artery in arterial phase image using 100 kVp, measuring 3 times, and recorded the average. CT value of phantom was measured by scanning phantoms which means contrast media diluted by normal saline by various ratio with tube voltage of 80 kVp, 100 kVp, 120 kVp, 140 kVp and recorded the average of 3 CT values of center of phantom image. In analysing radiation dose, CTDIVOL values of the latest arterial phase image of 120 kVp and as this research set that of 100 kVp were analyzed comparatively. 2 observers graded quality of chest images by 5 degrees (Unacceptable, Suboptimal, Adequate, Good, Excellent). CT value of chest image increased at 100 kVp by 14.06%∼27.26% in each ROI than 120 kVp. CT value of phantom increased as tube voltage lowered at various concentration of contrast media. CTDIVOL decreased at 100 kVp(5.00 mGy) by 36% than 120 kVp(7.80 mGy) in radiation dose analysis. here were 0 Unacceptable, 1 Suboptimal, 3 Adequate, 10 Good, 6 Excellent in totally 20 persons. Chest CT scanning with low kilo-voltage for patients who need CT scan repeatedly can bring images valuable for diagnose, and decrease radiation dose against patients

  4. Chest tuberculosis: Radiological review and imaging recommendations

    International Nuclear Information System (INIS)

    Bhalla, Ashu Seith; Goyal, Ankur; Guleria, Randeep; Gupta, Arun Kumar

    2015-01-01

    Chest tuberculosis (CTB) is a widespread problem, especially in our country where it is one of the leading causes of mortality. The article reviews the imaging findings in CTB on various modalities. We also attempt to categorize the findings into those definitive for active TB, indeterminate for disease activity, and those indicating healed TB. Though various radiological modalities are widely used in evaluation of such patients, no imaging guidelines exist for the use of these modalities in diagnosis and follow-up. Consequently, imaging is not optimally utilized and patients are often unnecessarily subjected to repeated CT examinations, which is undesirable. Based on the available literature and our experience, we propose certain recommendations delineating the role of imaging in the diagnosis and follow-up of such patients. The authors recognize that this is an evolving field and there may be future revisions depending on emergence of new evidence

  5. Evaluation of the distortions of the digital chest image caused by the data compression

    International Nuclear Information System (INIS)

    Ando, Yutaka; Kunieda, Etsuo; Ogawa, Koichi; Tukamoto, Nobuhiro; Hashimoto, Shozo; Aoki, Makoto; Kurotani, Kenichi.

    1988-01-01

    The image data compression methods using orthogonal transforms (Discrete cosine transform, Discrete fourier transform, Hadamard transform, Haar transform, Slant transform) were analyzed. From the points of the error and the speed of the data conversion, the discrete cosine transform method (DCT) is superior to the other methods. The block quantization by the DCT for the digital chest image was used. The quality of data compressed and reconstructed images by the score analysis and the ROC curve analysis was examined. The chest image with the esophageal cancer and metastatic lung tumors was evaluated at the 17 checkpoints (the tumor, the vascular markings, the border of the heart and ribs, the mediastinal structures and et al). By our score analysis, the satisfactory ratio of the data compression is 1/5 and 1/10. The ROC analysis using normal chest images superimposed by the artificial coin lesions was made. The ROC curve of the 1/5 compressed ratio is almost as same as the original one. To summarize our study, the image data compression method using the DCT is thought to be useful for the clinical use and the 1/5 compression ratio is a tolerable ratio. (author)

  6. Evaluation of the distortions of the digital chest image caused by the data compression

    Energy Technology Data Exchange (ETDEWEB)

    Ando, Yutaka; Kunieda, Etsuo; Ogawa, Koichi; Tukamoto, Nobuhiro; Hashimoto, Shozo; Aoki, Makoto; Kurotani, Kenichi

    1988-08-01

    The image data compression methods using orthogonal transforms (Discrete cosine transform, Discrete fourier transform, Hadamard transform, Haar transform, Slant transform) were analyzed. From the points of the error and the speed of the data conversion, the discrete cosine transform method (DCT) is superior to the other methods. The block quantization by the DCT for the digital chest image was used. The quality of data compressed and reconstructed images by the score analysis and the ROC curve analysis was examined. The chest image with the esophageal cancer and metastatic lung tumors was evaluated at the 17 checkpoints (the tumor, the vascular markings, the border of the heart and ribs, the mediastinal structures and et al). By our score analysis, the satisfactory ratio of the data compression is 1/5 and 1/10. The ROC analysis using normal chest images superimposed by the artificial coin lesions was made. The ROC curve of the 1/5 compressed ratio is almost as same as the original one. To summarize our study, the image data compression method using the DCT is thought to be useful for the clinical use and the 1/5 compression ratio is a tolerable ratio.

  7. Correlation of contrast-detail analysis and clinical image quality assessment in chest radiography with a human cadaver study.

    Science.gov (United States)

    De Crop, An; Bacher, Klaus; Van Hoof, Tom; Smeets, Peter V; Smet, Barbara S; Vergauwen, Merel; Kiendys, Urszula; Duyck, Philippe; Verstraete, Koenraad; D'Herde, Katharina; Thierens, Hubert

    2012-01-01

    To determine the correlation between the clinical and physical image quality of chest images by using cadavers embalmed with the Thiel technique and a contrast-detail phantom. The use of human cadavers fulfilled the requirements of the institutional ethics committee. Clinical image quality was assessed by using three human cadavers embalmed with the Thiel technique, which results in excellent preservation of the flexibility and plasticity of organs and tissues. As a result, lungs can be inflated during image acquisition to simulate the pulmonary anatomy seen on a chest radiograph. Both contrast-detail phantom images and chest images of the Thiel-embalmed bodies were acquired with an amorphous silicon flat-panel detector. Tube voltage (70, 81, 90, 100, 113, 125 kVp), copper filtration (0.1, 0.2, 0.3 mm Cu), and exposure settings (200, 280, 400, 560, 800 speed class) were altered to simulate different quality levels. Four experienced radiologists assessed the image quality by using a visual grading analysis (VGA) technique based on European Quality Criteria for Chest Radiology. The phantom images were scored manually and automatically with use of dedicated software, both resulting in an inverse image quality figure (IQF). Spearman rank correlations between inverse IQFs and VGA scores were calculated. A statistically significant correlation (r = 0.80, P chest radiography. © RSNA, 2011.

  8. Application of Deconvolution Algorithm of Point Spread Function in Improving Image Quality: An Observer Preference Study on Chest Radiography.

    Science.gov (United States)

    Chae, Kum Ju; Goo, Jin Mo; Ahn, Su Yeon; Yoo, Jin Young; Yoon, Soon Ho

    2018-01-01

    To evaluate the preference of observers for image quality of chest radiography using the deconvolution algorithm of point spread function (PSF) (TRUVIEW ART algorithm, DRTECH Corp.) compared with that of original chest radiography for visualization of anatomic regions of the chest. Prospectively enrolled 50 pairs of posteroanterior chest radiographs collected with standard protocol and with additional TRUVIEW ART algorithm were compared by four chest radiologists. This algorithm corrects scattered signals generated by a scintillator. Readers independently evaluated the visibility of 10 anatomical regions and overall image quality with a 5-point scale of preference. The significance of the differences in reader's preference was tested with a Wilcoxon's signed rank test. All four readers preferred the images applied with the algorithm to those without algorithm for all 10 anatomical regions (mean, 3.6; range, 3.2-4.0; p chest anatomical structures applied with the deconvolution algorithm of PSF was superior to the original chest radiography.

  9. Radiological diagnosis of chest wall tuberculosis: CT versus chest radiograph

    International Nuclear Information System (INIS)

    Liu Fugeng; Pan Jishu; Chen Qihang; Zhou Cheng; Yu Jingying; Tang Dairong

    2006-01-01

    Objective: To evaluate the role of CT or Chest radiograph in diagnosis of chest wall tuberculosis. Methods: The study population included 21 patients with chest wall tuberculosis confirmed by operation or biopsy. Chest radiograph and plain CT were performed in all eases, while enhanced CT in 9 cases, and all images were reviewed by 2 radiologists. Results: Single soft tissue mass of the chest wall was detected in all cases on CT, but not on chest radiograph(χ 2 =42.000, P 2 =4.421, P<0.05). Conclusion: CT, especially enhanced CT scan is the first choice in the diagnosis of chest wall tuberculosis. (authors)

  10. Objective quantification of pulmonary effects in X-ray chest images

    International Nuclear Information System (INIS)

    Oliveira, Marcela de; Giacomini, Guilherme; Alvarez, Matheus; Pereira, Paulo M.C.; Ribeiro, Sergio M.; Pina, Diana R. de

    2016-01-01

    Tuberculosis (TB) is an infectious lung disease of great concern worldwide. Even after treatment, TB leaves pulmonary sequelae that compromise the quality of life of patients. The exam of diagnostic imaging done more frequently is the X-ray chest. The evaluation of pulmonary involvement of these patients is performed visually by the radiologist. The detection and quantification aided by computer systems are of great importance for the more accurate assessment of pulmonary involvement. The objective of this study was to evaluate computationally the reduction of lung damage in X-ray of chest in patients treated with two different medication regimens. (author)

  11. Intelligent retrieval of chest X-ray image database using sketches

    International Nuclear Information System (INIS)

    Hasegawa, Jun-ichi; Okada, Noritake; Toriwaki, Jun-ichiro

    1988-01-01

    This paper presents further experiments on intelligent retrieval in our chest X-ray image database system using 'sketches'. First, in the previous sketch extraction procedure, vertical-location-invariant thresholding and shape-oriented smoothing are newly developed to improve the precision of lung borders and rib images in each sketch, respectively. Then, two new ways for image retrieval using sketches; (1) image-description retrieval and (2) pattern-matching retrieval, are proposed. In each retrieval way, a procedure for understanding picture queries input through a sketch is described in detail. (author)

  12. Adaptive wiener filter based on Gaussian mixture distribution model for denoising chest X-ray CT image

    International Nuclear Information System (INIS)

    Tabuchi, Motohiro; Yamane, Nobumoto; Morikawa, Yoshitaka

    2008-01-01

    In recent decades, X-ray CT imaging has become more important as a result of its high-resolution performance. However, it is well known that the X-ray dose is insufficient in the techniques that use low-dose imaging in health screening or thin-slice imaging in work-up. Therefore, the degradation of CT images caused by the streak artifact frequently becomes problematic. In this study, we applied a Wiener filter (WF) using the universal Gaussian mixture distribution model (UNI-GMM) as a statistical model to remove streak artifact. In designing the WF, it is necessary to estimate the statistical model and the precise co-variances of the original image. In the proposed method, we obtained a variety of chest X-ray CT images using a phantom simulating a chest organ, and we estimated the statistical information using the images for training. The results of simulation showed that it is possible to fit the UNI-GMM to the chest X-ray CT images and reduce the specific noise. (author)

  13. Chest tube insertion - series (image)

    Science.gov (United States)

    Chest tubes are inserted to drain blood, fluid, or air and allow full expansion of the lungs. The tube is placed in the pleural space. The area where the tube will be inserted is numbed (local anesthesia). The patient may also be sedated. The chest ...

  14. Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and99mTc-tetrofosmin: Method and validation

    OpenAIRE

    Shrestha, U; Sciammarella, M; Alhassen, F; Yeghiazarians, Y; Ellin, J; Verdin, E; Boyle, A; Seo, Y; Botvinick, EH; Gullberg, GT

    2017-01-01

    © 2015, American Society of Nuclear Cardiology. Background: The objective of this study was to measure myocardial blood flow (MBF) in humans using 99m Tc-tetrofosmin and dynamic single-photon emission computed tomography (SPECT). Methods: Dynamic SPECT using 99m Tc-tetrofosmin and dynamic positron emission tomography (PET) was performed on a group of 16 patients. The SPECT data were reconstructed using a 4D-spatiotemporal iterative reconstruction method. The data corresponding to 9 patients w...

  15. Comparison of uptake of 99mTc-MIBI, 99mTc-tetrofosmin and 99mT-Q12 into human breast cancer cell lines

    International Nuclear Information System (INIS)

    Yong, M. de; Bernard, B.F.; Breeman, W.A.P.; Ensing, G.; Benjamins, H.; Bakker, W.H.; Visser, T.J.; Krenning, E.P.

    1996-01-01

    Technetium-99m hexakis-2-methoxyisobutyl-isonitrile (MIBI), 99m Tc-tetrofosmin and 99m Tc-Q12 were all introduced for myocardial imaging but found additional applications as they are taken up by different tumours, enabling imaging of these lesions in patients. The aim of this study was to compare the uptake characteristics of these compounds in vitro in the human adenocarcinoma breast cell lines MCF-7 and ZR-75. It was shown that 99m Tc-MIBI had the highest cellular uptake (15.9%±0.5% dose/mg protein after 60 min in MCF-7, and 14.2%±0.4% dose/mg protein in ZR-75), followed by 99m Tc-tetrofosmin (6.8%±0.6% dose/mg protein in MCF-7, and 8.2%±0.2% dose/mg protein in ZR-75) and 99m TC-Q12 (3.2%±0.1% dose/mg protein in MCF-7, and 3.5%±0.3% dose/mg protein in ZR-75 cells). For all three compounds tenfold differences in specific activity did not influence total cell-associated radioactivity. Uptake of 99m Tc-MIBI and 99m Tc-tetrofosmin was obviously lower at 4 C than at 37 C, whereas 99m Tc-Q12 uptake showed only slight temperature dependence. When uptake was compared in cells grown to different cell densities (1 mg/ml cellular protein versus 0.3 mg/ml), no differences in uptake were detected when uptake was corrected for the amount of cellular protein present in the dishes. Furthermore, for all compounds it was shown that cellular radioactivity decreased rapidly after washing. Apart from the differences in cellular uptake of the three compounds after 60 min, no differences in residual cellular radioactivity after washing were found between the different compounds when expressed as a percentage of their 60-min uptake, suggesting that the efflux process of the radiolabelled compounds was similar. The differences in cell-associated activity after 60 min were thus presumably caused by differences in uptake. (orig./MG)

  16. Dual-source computed tomography in patients with acute chest pain: feasibility and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Schertler, Thomas; Scheffel, Hans; Frauenfelder, Thomas; Desbiolles, Lotus; Leschka, Sebastian; Stolzmann, Paul; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Department of Medical Radiology, Institute of Diagnostic Radiology, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Department of Biostatistics, Zurich (Switzerland); Flohr, Thomas G. [Computed Tomography CTE PA, Siemens Medical Solutions, Forchheim (Germany)

    2007-12-15

    The aim of this study was to determine the feasibility and image quality of dual-source computed tomography angiography (DSCTA) in patients with acute chest pain for the assessment of the lung, thoracic aorta, and for pulmonary and coronary arteries. Sixty consecutive patients (32 female, 28 male, mean age 58.1{+-}16.3 years) with acute chest pain underwent contrast-enhanced electrocardiography-gated DSCTA without prior beta-blocker administration. Vessel attenuation of different thoracic vascular territories was measured, and image quality was semi-quantitatively analyzed by two independent readers. Image quality of the thoracic aorta was diagnostic in all 60 patients, image quality of pulmonary arteries was diagnostic in 59, and image quality of coronary arteries was diagnostic in 58 patients. Pairwise intraindividual comparisons of attenuation values were small and ranged between 1{+-}6 HU comparing right and left coronary artery and 56{+-}9 HU comparing the pulmonary trunk and left ventricle. Mean attenuation was 291{+-}65 HU in the ascending aorta, 334{+-}93 HU in the pulmonary trunk, and 285{+-}66 HU and 268{+-}67 HU in the right and left coronary artery, respectively. DSCTA is feasible and provides diagnostic image quality of the thoracic aorta, pulmonary and coronary arteries in patients with acute chest pain. (orig.)

  17. Dual-source computed tomography in patients with acute chest pain: feasibility and image quality

    International Nuclear Information System (INIS)

    Schertler, Thomas; Scheffel, Hans; Frauenfelder, Thomas; Desbiolles, Lotus; Leschka, Sebastian; Stolzmann, Paul; Marincek, Borut; Alkadhi, Hatem; Seifert, Burkhardt; Flohr, Thomas G.

    2007-01-01

    The aim of this study was to determine the feasibility and image quality of dual-source computed tomography angiography (DSCTA) in patients with acute chest pain for the assessment of the lung, thoracic aorta, and for pulmonary and coronary arteries. Sixty consecutive patients (32 female, 28 male, mean age 58.1±16.3 years) with acute chest pain underwent contrast-enhanced electrocardiography-gated DSCTA without prior beta-blocker administration. Vessel attenuation of different thoracic vascular territories was measured, and image quality was semi-quantitatively analyzed by two independent readers. Image quality of the thoracic aorta was diagnostic in all 60 patients, image quality of pulmonary arteries was diagnostic in 59, and image quality of coronary arteries was diagnostic in 58 patients. Pairwise intraindividual comparisons of attenuation values were small and ranged between 1±6 HU comparing right and left coronary artery and 56±9 HU comparing the pulmonary trunk and left ventricle. Mean attenuation was 291±65 HU in the ascending aorta, 334±93 HU in the pulmonary trunk, and 285±66 HU and 268±67 HU in the right and left coronary artery, respectively. DSCTA is feasible and provides diagnostic image quality of the thoracic aorta, pulmonary and coronary arteries in patients with acute chest pain. (orig.)

  18. Diagnostic Yield of Recommendations for Chest CT Examination Prompted by Outpatient Chest Radiographic Findings

    Science.gov (United States)

    Harvey, H. Benjamin; Gilman, Matthew D.; Wu, Carol C.; Cushing, Matthew S.; Halpern, Elkan F.; Zhao, Jing; Pandharipande, Pari V.; Shepard, Jo-Anne O.

    2015-01-01

    Purpose To evaluate the diagnostic yield of recommended chest computed tomography (CT) prompted by abnormalities detected on outpatient chest radiographic images. Materials and Methods This HIPAA-compliant study had institutional review board approval; informed consent was waived. Reports of all outpatient chest radiographic examinations performed at a large academic center during 2008 (n = 29 138) were queried to identify studies that included a recommendation for a chest CT imaging. The radiology information system was queried for these patients to determine if a chest CT examination was obtained within 1 year of the index radiographic examination that contained the recommendation. For chest CT examinations obtained within 1 year of the index chest radiographic examination and that met inclusion criteria, chest CT images were reviewed to determine if there was an abnormality that corresponded to the chest radiographic finding that prompted the recommendation. All corresponding abnormalities were categorized as clinically relevant or not clinically relevant, based on whether further work-up or treatment was warranted. Groups were compared by using t test and Fisher exact test with a Bonferroni correction applied for multiple comparisons. Results There were 4.5% (1316 of 29138 [95% confidence interval {CI}: 4.3%, 4.8%]) of outpatient chest radiographic examinations that contained a recommendation for chest CT examination, and increasing patient age (P recommendation for chest CT examination. Of patients within this subset who met inclusion criteria, 65.4% (691 of 1057 [95% CI: 62.4%, 68.2%) underwent a chest CT examination within the year after the index chest radiographic examination. Clinically relevant corresponding abnormalities were present on chest CT images in 41.4% (286 of 691 [95% CI: 37.7%, 45.2%]) of cases, nonclinically relevant corresponding abnormalities in 20.6% (142 of 691 [95% CI: 17.6%, 23.8%]) of cases, and no corresponding abnormalities in 38

  19. Usefulness of combination post-stress dysfunction and perfusion imaging in technetium-99m-tetrofosmin myocardial scintigraphy

    International Nuclear Information System (INIS)

    Yamazaki, Yoko; Imai, Kamon; Konaka, Ryohei; Nakajima, Takatomo; Goto, Sayaka; Horie, Toshinobu; Saito, Satoshi; Ozawa, Yukio; Kanmatsuse, Katsuo

    2001-01-01

    Myocardial perfusion imaging has lower sensitivity for the diagnosis of coronary artery disease in patients with three-vessel disease. The presence of post-stress dysfunction of the left ventricle, evaluated by electrocardiography (ECG) gated single photon emission computed tomography (SPECT) with a quantitative gated SPECT program, was investigated in patients with coronary artery disease, and also whether combining post-stress dysfunction and myocardial perfusion imaging improved the diagnosis of coronary artery disease. ECG gated technetium-99m-tetrofosmin SPECT was performed using a one day, stress and rest, protocol in 139 patients. SPECT and coronary angiography were performed within 1 month. The coronary artery disease group consisted of 89 patients: 43 with one-vessel disease (1VD), 28 with two-vessel disease (2VD), and 18 with three-vessel disease (3VD). The group with zero-vessel disease (0VD) consisted of 50 patients. According to post-stress and rest ejection fraction (EF) and end-systolic volume (ESV), post-stress dysfunction is defined as follows: rest EF - post-stress EF≥5% and post-stress ESV - rest ESV≥5ml. In the coronary artery disease group, post-stress ESV was larger than rest ESV (37.8±26.4, 34.0±24.2 ml, p<0.001), and post-stress EF was lower than rest EF (61.5±11.1%, 64.2±10.8%, p<0.001). In the 0VD group, ESV and EF were the same for post-stress and rest (25.7±20.8, 26.2±21.6 ml, NS; 70.4±9.5%, 70.0±9.6%, NS). Post-stress dysfunction was 6.0% in the 0VD group and 30.3% in the coronary artery disease group (p<0.001). Furthermore, post-stress dysfunction in the 2VD (35.7%) and 3VD (38.9%) groups was higher than that in the 0VD group (p<0.01, p<0.01). Sensitivity of coronary artery disease diagnosis by myocardial perfusion imaging was 75%. The combination of post-stress dysfunction and myocardial perfusion imaging improved sensitivity from 75% to 82% (p<0.05), but reduced the specificity from 92% to 86% (p=0.08). Post

  20. Conversion to use of digital chest images for surveillance of coal workers' pneumoconiosis (black lung).

    Science.gov (United States)

    Levine, Betty A; Ingeholm, Mary Lou; Prior, Fred; Mun, Seong K; Freedman, Matthew; Weissman, David; Attfield, Michael; Wolfe, Anita; Petsonk, Edward

    2009-01-01

    To protect the health of active U.S. underground coal miners, the National Institute for Occupational Safety and Health (NIOSH) has a mandate to carry out surveillance for coal workers' pneumoconiosis, commonly known as Black Lung (PHS 2001). This is accomplished by reviewing chest x-ray films obtained from miners at approximately 5-year intervals in approved x-ray acquisition facilities around the country. Currently, digital chest images are not accepted. Because most chest x-rays are now obtained in digital format, NIOSH is redesigning the surveillance program to accept and manage digital x-rays. This paper highlights the functional and security requirements for a digital image management system for a surveillance program. It also identifies the operational differences between a digital imaging surveillance network and a clinical Picture Archiving Communication Systems (PACS) or teleradiology system.

  1. Incremental value of combined 99MTc tetrofosmin parathyroid scintigraphy, rapid intra operative PTH assays and minimally invasive radio-guided surgery (MIRS) in optimizing parathyroidectomies

    International Nuclear Information System (INIS)

    Padma, S.; Kumar, S.; Babu, T.; Kumar, H.; Nair, V.; Nair, G.K.

    2004-01-01

    Objective: Aim of our study was to evaluate incremental diagnostic value of 99mTc Tetrofosmin parathyroid SPECT (TPSPECT), rapid intra operative quick parathyroid hormone measurement (QPTH) combined with radio guidance provided by scintillation probe (Minimally Invasive Radio guided Surgery MIRS) in parathyroid surgeries. While TPSPECT is an established investigation in preoperative workup of hyperparathyroidism patients , MIRS is a relatively new concept in Indian subcontinent. Methods: 29 pts (M: F = 18: 11), age range 16- 65 yrs (mean 41+ 9 yrs) having clinical and biochemical hyperparathyroidism underwent TPSPECT between Jan 02 -04, using 20 mci IV 99mTc Tetrofosmin. Pts with familial hyperparathyroidism , previous nodular goiters and previous neck irradiation were excluded from study. Scintigraphy comprised of immediate, delayed planar and SPECT imaging of neck and chest. Imagewise abnormal, persistent tracer uptake was considered positive for adenoma and diffuse uptake for hyperplasia. 26 pts underwent exploration (22 adenomas and 4 hyperplasias).18 pts had benefit of intraoperative QPTH. A select group (after Dec 2003) i.e. 9 pts got the assistance of radioguided probing. Peroperatively NM physician used cordless handheld gamma probe (Gamma Finder, World of Medicine, Germany) in neck and mediastinum to detect parathyroid adenoma / hyperplasias. A five fold increase in radioactive counts perceived by probe when compared to background was considered positive for parathyroid adenoma / hyperplasia. If PTH levels fell from baseline by at least 50%, the surgery was concluded as complete. Results: In all 22 pts suspected to have primary hyperparathyroidism TPSPECT identified adenomas (100 % sensitivity). While planar imaging had a sensitivity of 90.1% (20/22 pts), SPECT identified the adenoma in all pts. Interestingly only 3/22 pts had ectopic glands while 5 had more than one adenomas. The most commonly involved gland was left inferior. In secondary

  2. {sup 201}Tl, {sup 99m}Tc-MIBI, {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin: relative retention and clearance kinetics in retrogradely perfused guinea pig hearts

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, Wolfgang M.; Moka, Detlef E-mail: detlef.moka@uni-koeln.de; Brockmann, Holger A.; Schomaecker, Klaus; Schicha, Harald

    2002-02-01

    Myocellular kinetics of {sup 201}Tl, {sup 99m}Tc-MIBI, {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin were investigated using retrogradely-perfused guinea-pig hearts. Relative retention decreased in the order {sup 99m}Tc-MIBI {yields}{yields} implies {sup 99m}Tc-tetrofosmin {yields}{yields} implies {sup 99m}Tc-furifosmin. {sup 201}Tl and {sup 99m}Tc-MIBI exhibited bi- (t1,t2), {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin triexponential (t1,t2,t3) time-activity-curves. Latest-phase elimination-half-life increased from {sup 201}Tl (t2) {yields}{yields} implies {sup 99m}Tc-MIBI (t2) {yields}{yields} implies {sup 99m}Tc-tetrofosmin (t3) {yields}{yields} implies {sup 99m}Tc-furifosmin (t3), showing a significant increase in deteriorating myocardium for all tracers but {sup 99m}Tc-furifosmin. Delayed elimination in deteriorating myocardium explains at least partly the redistribution phenomenon of {sup 201}Tl, and suggests a similar phenomenon for {sup 99m}Tc-MIBI and {sup 99m}Tc-tetrofosmin.

  3. Evaluation of pneumonia in children: comparison of MRI with fast imaging sequences at 1.5T with chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Yikilmaz, Ali; Koc, Ali; Coskun, Abdulhakim (Dept. of Radiology, Erciyes Medical School, Kayseri (Turkey)); Ozturk, Mustafa K (Dept. of Pediatric Infectious Diseases, Erciyes Medical School, Kayseri (Turkey)); Mulkern, Robert V; Lee, Edward Y (Dept. of Radiology and Dept. of Medicine, Pulmonary Div., Children' s Hospital Boston and Harvard Medical School, Boston (United States)), email: Edward.lee@childrens.harvard.edu

    2011-10-15

    Background Although there has been a study aimed at magnetic resonance imaging (MRI) evaluation of pneumonia in children at a low magnetic field (0.2T), there is no study which assessed the efficacy of MRI, particularly with fast imaging sequences at 1.5T, for evaluating pneumonia in children. Purpose To investigate the efficacy of chest MRI with fast imaging sequences at 1.5T for evaluating pneumonia in children by comparing MRI findings with those of chest radiographs. Material and Methods This was an Institutional Review Board-approved, HIPPA-compliant prospective study of 40 consecutive pediatric patients (24 boys, 16 girls; mean age 7.3 years +- 6.6 years) with pneumonia, who underwent PA and lateral chest radiographs followed by MRI within 24 h. All MRI studies were obtained in axial and coronal planes with two different fast imaging sequences: T1-weighted FFE (Fast Field Echo) (TR/TE: 83/4.6) and T2-weighted B-FFE M2D (Balanced Fast Field Echo Multiple 2D Dimensional) (TR/TE: 3.2/1.6). Two experienced pediatric radiologists reviewed each chest radiograph and MRI for the presence of consolidation, necrosis/abscess, bronchiectasis, and pleural effusion. Chest radiograph and MRI findings were compared with Kappa statistics. Results All consolidation, lung necrosis/abscess, bronchiectasis, and pleural effusion detected with chest radiographs were also detected with MRI. There was statistically substantial agreement between chest radiographs and MRI in detecting consolidation (k = 0.78) and bronchiectasis (k = 0.72) in children with pneumonia. The agreement between chest radiographs and MRI was moderate for detecting necrosis/abscess (k = 0.49) and fair for detecting pleural effusion (k = 0.30). Conclusion MRI with fast imaging sequences is comparable to chest radiographs for evaluating underlying pulmonary consolidation, bronchiectasis, necrosis/abscess, and pleural effusion often associated with pneumonia in children

  4. Bone images from dual-energy subtraction chest radiography in the detection of rib fractures

    Energy Technology Data Exchange (ETDEWEB)

    Szucs-Farkas, Zsolt, E-mail: zsolt.szuecs@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Lautenschlager, Katrin, E-mail: katrin@students.unibe.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Flach, Patricia M., E-mail: patricia.flach@irm.unibe.ch [Institute of Forensic Medicine, University of Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Ott, Daniel, E-mail: daniel.ott@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Strautz, Tamara, E-mail: tamara.strautz@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Vock, Peter, E-mail: peter.vock@insel.ch [Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland); Ruder, Thomas D., E-mail: thomas.ruder@irm.unibe.ch [Institute of Forensic Medicine, University of Bern, Freiburgstrasse 4, Bern CH-3010 (Switzerland)

    2011-08-15

    Objective: To assess the sensitivity and image quality of chest radiography (CXR) with or without dual-energy subtracted (ES) bone images in the detection of rib fractures. Materials and methods: In this retrospective study, 39 patients with 204 rib fractures and 24 subjects with no fractures were examined with a single exposure dual-energy subtraction digital radiography system. Three blinded readers first evaluated the non-subtracted posteroanterior and lateral chest radiographs alone, and 3 months later they evaluated the non-subtracted images together with the subtracted posteroanterior bone images. The locations of rib fractures were registered with confidence levels on a 3-grade scale. Image quality was rated on a 5-point scale. Marks by readers were compared with fracture localizations in CT as a standard of reference. Results: The sensivity for fracture detection using both methods was very similar (34.3% with standard CXR and 33.5% with ES-CXR, p = 0.92). At the patient level, both sensitivity (71.8%) and specificity (92.9%) with or without ES were identical. Diagnostic confidence was not significantly different (2.61 with CXR and 2.75 with ES-CXR, p = 0.063). Image quality with ES was rated higher than that on standard CXR (4.08 vs. 3.74, p < 0.001). Conclusions: Despite a better image quality, adding ES bone images to standard radiographs of the chest does not provide better sensitivity or improved diagnostic confidence in the detection of rib fractures.

  5. Regionally adaptive histogram equalization of the chest

    International Nuclear Information System (INIS)

    Sherrier, R.H.; Johnson, G.A.

    1986-01-01

    Advances in digital chest radiography have resulted in the acquisition of high-quality digital images of the human chest. With these advances, there arises a genuine need for image processing algorithms, specific to chest images. The author has implemented the technique of histogram equalization, noting the problems encountered when it is adapted to chest images. These problems have been successfully solved with a regionally adaptive histogram equalization method. Histograms are calculated locally and then modified according to both the mean pixel value of a given region and certain characteristics of the cumulative distribution function. The method allows certain regions of the chest radiograph to be enhanced differentially

  6. Usefulness of computerized method for lung nodule detection on digital chest radiographs using similar subtraction images from different patients

    International Nuclear Information System (INIS)

    Aoki, Takatoshi; Oda, Nobuhiro; Yamashita, Yoshiko; Yamamoto, Keiji; Korogi, Yukunori

    2012-01-01

    Purpose: The purpose of this study is to evaluate the usefulness of a novel computerized method to select automatically the similar chest radiograph for image subtraction in the patients who have no previous chest radiographs and to assist the radiologists’ interpretation by presenting the “similar subtraction image” from different patients. Materials and methods: Institutional review board approval was obtained, and the requirement for informed patient consent was waived. A large database of approximately 15,000 normal chest radiographs was used for searching similar images of different patients. One hundred images of candidates were selected according to two clinical parameters and similarity of the lung field in the target image. We used the correlation value of chest region in the 100 images for searching the most similar image. The similar subtraction images were obtained by subtracting the similar image selected from the target image. Thirty cases with lung nodules and 30 cases without lung nodules were used for an observer performance test. Four attending radiologists and four radiology residents participated in this observer performance test. Results: The AUC for all radiologists increased significantly from 0.925 to 0.974 with the CAD (P = .004). When the computer output images were available, the average AUC for the residents was more improved (0.960 vs. 0.890) than for the attending radiologists (0.987 vs. 0.960). Conclusion: The novel computerized method for lung nodule detection using similar subtraction images from different patients would be useful to detect lung nodules on digital chest radiographs, especially for less experienced readers.

  7. Dynamic Chest Image Analysis: Model-Based Perfusion Analysis in Dynamic Pulmonary Imaging

    Directory of Open Access Journals (Sweden)

    Kiuru Aaro

    2003-01-01

    Full Text Available The "Dynamic Chest Image Analysis" project aims to develop model-based computer analysis and visualization methods for showing focal and general abnormalities of lung ventilation and perfusion based on a sequence of digital chest fluoroscopy frames collected with the dynamic pulmonary imaging technique. We have proposed and evaluated a multiresolutional method with an explicit ventilation model for ventilation analysis. This paper presents a new model-based method for pulmonary perfusion analysis. According to perfusion properties, we first devise a novel mathematical function to form a perfusion model. A simple yet accurate approach is further introduced to extract cardiac systolic and diastolic phases from the heart, so that this cardiac information may be utilized to accelerate the perfusion analysis and improve its sensitivity in detecting pulmonary perfusion abnormalities. This makes perfusion analysis not only fast but also robust in computation; consequently, perfusion analysis becomes computationally feasible without using contrast media. Our clinical case studies with 52 patients show that this technique is effective for pulmonary embolism even without using contrast media, demonstrating consistent correlations with computed tomography (CT and nuclear medicine (NM studies. This fluoroscopical examination takes only about 2 seconds for perfusion study with only low radiation dose to patient, involving no preparation, no radioactive isotopes, and no contrast media.

  8. Nodule detection in digital chest radiography: Summary of the radius chest trial

    International Nuclear Information System (INIS)

    Haakansson, M.; Baath, M.; Boerjesson, S.; Kheddache, S.; Grahn, A.; Ruschin, M.; Tingberg, A.; Mattson, S.; Maansson, L. G.

    2005-01-01

    As a part of the Europe-wide research project 'Unification of physical and clinical requirements for medical X-ray imaging' - governed by the Radiological Imaging Unification Strategies (RADIUS) Group - a major image quality trial was conducted by members of the group. The RADIUS chest trial aimed at thoroughly examining various aspects of nodule detection in digital chest radiography, such as the effects of nodule location, system noise, anatomical noise, and anatomical background. The main findings of the RADIUS chest trial concerning the detection of a lung nodule with a size in the order of 10 mm can be summarised as: (1) the detectability of the nodule is largely dependent on its location in the chest, (2) the system noise has a minor impact on the detectability at the dose levels used today, (3) the disturbance of the anatomical noise is larger than that of the system noise but smaller than that of the anatomical background and (4) the anatomical background acts as noise to a large extent and is the major image component affecting the detectability of the nodule. (authors)

  9. New developments in ultrasonic imaging of the chest and other body organs

    International Nuclear Information System (INIS)

    Campbell, G.W.; Anderson, A.L.

    1978-01-01

    The ultrasonic imaging system described herein was developed to measure chest-wall thickness and the percentage of fat in the chest and around other body organs. The system uses pulse-echo techniques to transmit and detect sound waves reflected from the interfaces of body organs and adjacent tissue. A computer draws these interfaces on color scans, and a code is used to exponentially average data from several points on each scan to find the average thicknesses of the chest wall and fat layers. These average thicknesses are then used to adjust x-ray calibration factors for plutonium lung counters. The correction factor for three subjects measured for fat content ranging from 12.6 to 22.2% was 18 to 41%. The ultrasonic system also defines the shape and position of the kidneys and liver so we are able to more accurately place detectors on the body during in-vivo radiation measurements. We have also developed a technique for displaying the interfaces from a series of ultrasonic chest scans to produce a topographical map that enables us to better understand the shape and contour of the lung and chest-wall interface

  10. Phantom development for radiographic image optimization of chest, skull and pelvis examination for nonstandard patient

    International Nuclear Information System (INIS)

    Pina, D.R.; Duarte, S.B.; Ghilardi Netto, T.; Morceli, J.

    2009-01-01

    The construction of the adapted patient equivalent phantom (APEP) to simulate the X-ray scattering and absorption by chest, skull and pelvis of nonstandard patient in conventional radiographic equipment is presented. This APEP system is associated to the pre-existing realistic-analytic phantom (RAP) [Pina, D.R., Duarte, S.B., Ghilardi Netto, T., Trad, C. S., Brochi, M.A.C., Oliveira, S.C. de, 2004. Optimization of standard patient radiographic images for chest, skull and pelvis exams in conventional X-ray equipment. Phys. Med. Biol. 49, N215-N226] forming the coupled phantom (RAP-APEP), which is used to establish an optimization process of radiographic images of chest, skull and pelvis for nonstandard patients. A chart of the optimized radiographic technique is established covering a wide range of nonstandard patient thickness, and offering a dose reduction in comparison with those techniques currently used. Different validation processes were applied to confirm the improving of the radiographic image quality when techniques of the established chart are used

  11. High-resolution magnetic resonance imaging (HR-MRI) of the pleura and chest wall: Normal findings and pathological changes

    International Nuclear Information System (INIS)

    Bittner, R.C.; Schnoy, N.; Schoenfeld, N.; Grassot, A.; Loddenkemper, R.; Lode, H.; Kaiser, D.; Krumhaar, D.; Felix, R.

    1995-01-01

    To determine the value of high-resolution MRI in pleural and chest wall diseases, the normal and pathologic costal pleura and adjacent chest wall between paravertebral and the axillar region were examined with contrast enhanced high-resolution T 1 -weighted MRI images using a surface coil. Normal anatomy was evaluated in 5 healthy volunteers and a normal specimen of the thoracic wall, and correlation was made with corresponding HR-CT and histologic sections. CT-proved focal and diffuse changes of the pleura and the chest wall in 36 patients underwent HR-MRI, and visual comparison of MRI and CT was done retrospectively. Especially sagittal T 1 -weighted HR-MRI images allowed accurate delineation of the peripleural fat layer (PFL) and the innermost intercostal muscle (IIM), which served as landmarks of the intact inner chest wall. PFL and IIM were well delineated in 3/4 patients with tuberculous pleuritis, and in all 7 patients with non-specific pleuritis, as opposed to impairment of the PFL and/or the IIM, which was detected in 15/18 malignancies as a pattern of malignant chest wall involvement. In one case of tuberculous pleural empyema with edema of the inner chest wall HR-MRI produced false positive diagnosis of malignant disease. HR-MRI images improved non-invasive evaluation of pleural and chest wall diseases, and allowed for differentiation of bengin and malignant changes. (orig./MG) [de

  12. Evaluation of automatic image quality assessment in chest CT - A human cadaver study.

    Science.gov (United States)

    Franck, Caro; De Crop, An; De Roo, Bieke; Smeets, Peter; Vergauwen, Merel; Dewaele, Tom; Van Borsel, Mathias; Achten, Eric; Van Hoof, Tom; Bacher, Klaus

    2017-04-01

    The evaluation of clinical image quality (IQ) is important to optimize CT protocols and to keep patient doses as low as reasonably achievable. Considering the significant amount of effort needed for human observer studies, automatic IQ tools are a promising alternative. The purpose of this study was to evaluate automatic IQ assessment in chest CT using Thiel embalmed cadavers. Chest CT's of Thiel embalmed cadavers were acquired at different exposures. Clinical IQ was determined by performing a visual grading analysis. Physical-technical IQ (noise, contrast-to-noise and contrast-detail) was assessed in a Catphan phantom. Soft and sharp reconstructions were made with filtered back projection and two strengths of iterative reconstruction. In addition to the classical IQ metrics, an automatic algorithm was used to calculate image quality scores (IQs). To be able to compare datasets reconstructed with different kernels, the IQs values were normalized. Good correlations were found between IQs and the measured physical-technical image quality: noise (ρ=-1.00), contrast-to-noise (ρ=1.00) and contrast-detail (ρ=0.96). The correlation coefficients between IQs and the observed clinical image quality of soft and sharp reconstructions were 0.88 and 0.93, respectively. The automatic scoring algorithm is a promising tool for the evaluation of thoracic CT scans in daily clinical practice. It allows monitoring of the image quality of a chest protocol over time, without human intervention. Different reconstruction kernels can be compared after normalization of the IQs. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. Chest CT using spectral filtration: radiation dose, image quality, and spectrum of clinical utility

    Energy Technology Data Exchange (ETDEWEB)

    Braun, Franziska M.; Johnson, Thorsten R.C.; Sommer, Wieland H.; Thierfelder, Kolja M.; Meinel, Felix G. [University Hospital Munich, Institute for Clinical Radiology, Munich (Germany)

    2015-06-01

    To determine the radiation dose, image quality, and clinical utility of non-enhanced chest CT with spectral filtration. We retrospectively analysed 25 non-contrast chest CT examinations acquired with spectral filtration (tin-filtered Sn100 kVp spectrum) compared to 25 examinations acquired without spectral filtration (120 kV). Radiation metrics were compared. Image noise was measured. Contrast-to-noise-ratio (CNR) and figure-of-merit (FOM) were calculated. Diagnostic confidence for the assessment of various thoracic pathologies was rated by two independent readers. Effective chest diameters were comparable between groups (P = 0.613). In spectral filtration CT, median CTDI{sub vol}, DLP, and size-specific dose estimate (SSDE) were reduced (0.46 vs. 4.3 mGy, 16 vs. 141 mGy*cm, and 0.65 vs. 5.9 mGy, all P < 0.001). Spectral filtration CT had higher image noise (21.3 vs. 13.2 HU, P < 0.001) and lower CNR (47.2 vs. 75.3, P < 0.001), but was more dose-efficient (FOM 10,659 vs. 2,231/mSv, P < 0.001). Diagnostic confidence for parenchymal lung disease and osseous pathologies was lower with spectral filtration CT, but no significant difference was found for pleural pathologies, pulmonary nodules, or pneumonia. Non-contrast chest CT using spectral filtration appears to be sufficient for the assessment of a considerable spectrum of thoracic pathologies, while providing superior dose efficiency, allowing for substantial radiation dose reduction. (orig.)

  14. Comparative assessment of 18F-fluorodeoxyglucose PET and 99mTc-tetrofosmin SPECT for the prediction of functional recovery in patients with reperfused acute myocardial infarction

    International Nuclear Information System (INIS)

    Shirasaki, Haruhisa; Nakano, Akira; Uzui, Hiroyasu; Ueda, Takanori; Lee, Jong-Dae; Yonekura, Yoshiharu; Okazawa, Hidehiko

    2006-01-01

    Purpose: Although preserved glucose metabolism is considered to be a marker of myocardial viability in the chronic stage, it has not been fully elucidated whether this is also true with regard to reperfused acute myocardial infarction (AMI). The aim of this study was to compare the diagnostic performance of 99m Tc-tetrofosmin SPECT and 18 F-fluorodeoxyglucose (FDG) PET for the prediction of functional recovery in reperfused AMI.Methods: The study population comprised 28 patients. Both tetrofosmin SPECT and FDG PET were performed in all 28 patients at ca. 2 weeks and in 23 at 6 months. The tetrofosmin and FDG findings in infarct-related segments were compared with the regional wall motion score assessed by left ventriculography over 6 months to determine the predictive value for functional recovery. Of 120 infarct-related segments, 83 had preserved flow (tetrofosmin uptake ≥50%) and 81 had preserved glucose metabolism (FDG uptake ≥40%). The sensitivity and specificity of tetrofosmin SPECT for the prediction of functional recovery tended to be superior to those of FDG PET (90.0% and 72.5% vs 85.0% and 67.5%, respectively). Thirteen segments with preserved flow and decreased glucose metabolism demonstrated marked recovery of contractile function from 2.5±1.0 to 1.4±1.4 (p<0.01), with restoration of glucose metabolism at 6 months. In contrast, 11 segments with decreased flow and preserved glucose metabolism demonstrated incomplete functional improvement from 3.0±0.8 to 2.2±1.2. In the subacute phase, preserved myocardial blood flow is more reliable than glucose metabolism in predicting functional recovery in reperfused myocardium. (orig.)

  15. Chest tomosynthesis: technical and clinical perspectives.

    Science.gov (United States)

    Johnsson, Ase Allansdotter; Vikgren, Jenny; Bath, Magnus

    2014-02-01

    The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Dual-energy chest imaging with the variable compensation technique

    International Nuclear Information System (INIS)

    Dobbins, J.T.; Powell, A.O.

    1988-01-01

    The authors reported on a new imaging algorithm, termed the variable compensation (VC) technique, that combines the signal-to-noise ratio (S/N) advantages of x-ray beam compensation with the ability to adjust retrospectively the amount of displayed image equalization. The VC technique acquires a compensated image of the patient and also an image of the modulated beam profile incident on the patient. A fraction of the beam profile image is then subtracted from the compensated image. A limitation of traditional dual-energy techniques is the significant S/N degradation in poorly penetrated regions. Their new VC technique permits improvement in image S/N before formation of the dual-energy image pair. Specifically, the authors subtract 100% of the beam image from the compensated image for both the high- and low-energy images and produce a pair of images that appear similar to the normal high- and low-energy pair, except for improved S/N in the mediastinum due to the beam compensator. S/N measurements in tissue-canceled chest phantom images show the improved S/N visualization of calcified squares in the mediastinum with our technique

  17. Improved detection of fill-in using sublingual nitroglycerin in technetium-99m tetrofosmin exercise/rest single photon emission computed tomography one day protocol for old myocardial infarction

    International Nuclear Information System (INIS)

    Miyanaga, Hajime; Kunieda, Yasufumi; Oguni, Atsuhiko; Kamitani, Tadaaki; Kawasaki, Shingo; Takahashi, Toru

    1999-01-01

    Twenty-one patients with old myocardial infarction underwent repeated 99m Tc-tetrofosmin ( 99m Tc) exercise/rest same day protocols with and without the administration of sublingual nitroglycerin (NTG) 5 min before the second injection of 99m Tc for rest SPECT. Twelve of these patients also underwent ordinary exercise/redistribution 201 Tl SPECT. The control study protocol images showed decreased uptake of 99m Tc on exercise in 157 of 420 segments and the presence of fill-in at rest in 58 segments. Images obtained with administration of NTG showed decreased uptake of 99m Tc on exercise in 163 of 420 segments and fill-in in 74 segments at rest. The frequency of fill-in was greater in the NTG protocol than in the control protocol. The segments were scored as different grades according to 99m Tc uptake between 2 protocols. Fill-in was only present or more remarkable in 31 segments in the NTG protocol than in the control protocol. Fill-in was only present or more remarkable in 10 segments in the control protocol than in the NTG protocol. In the NTG protocol, the mean defect score of the exercise images, calculated from the bull's eye image automatically, was higher than that of the rest images. The mean severity score of the exercise images, also calculated from the bull's eye image automatically, was likewise higher than that of the rest images, whereas the mean severity score of the stress images and rest images in the control protocol was not significantly different. Moreover, the mean defect score and severity score of the rest images from the NTG protocol were significantly lower than those obtained from the control protocol. Sublingual NTG administration before the injection of 99m Tc-tetrofosmin at the rest study in the one day exercise/rest studies enhanced fill-in, so may enhance the detection of viable myocardium, allowing more informed decisions regarding cardiac revascularization in patients with chronic coronary artery disease. (K.H.)

  18. Improvement in visibility of simulated lung nodules on computed radiography (CR) chest images by use of temporal subtraction technique

    International Nuclear Information System (INIS)

    Oda, Nobuhiro; Fujimoto, Keiji; Murakami, Seiichi; Katsuragawa, Shigehiko; Doi, Kunio; Nakata, Hajime

    1999-01-01

    A temporal subtraction image obtained by subtraction of a previous image from a current one can enhance interval change on chest images. In this study, we compared the visibility of simulated lung nodules on CR images with and without temporal subtraction. Chest phantom images without and with simulated nodules were obtained as previous and current images, respectively, by a CR system. Then, subtraction images were produced with an iterative image warping technique. Twelve simulated nodules were attached on various locations of the chest phantom. The diameter of nodules having a CT number of 47 ranged from 3 mm to 10 mm. Seven radiologists subjectively evaluated the visibility of simulated nodules on CR images with and without temporal subtraction using a three-point rating scale (0: invisible, +1: questionable, +2:visible). The minimum diameter of simulated nodules visible at a frequency greater than 50% was 4 mm on the CR images with temporal subtraction and 6 mm on those without. Our results indicated that the subtraction images clearly improved the visibility of simulated nodules. (author)

  19. A comparison between 99Tcm-tetrofosmin and 99Tcm-MIBI myocardial perfusion imaging in detection of silent myocardial ischemia

    International Nuclear Information System (INIS)

    Fu Wei; Tang Yi; Liu Xuemei; Fan Yan; Liu Tao

    2012-01-01

    Objective: To compare 99 Tc m -tetrofosmin (TF) and 99 Tc m -MIBI adenosine stress/resting MPI in detection of silent myocardial ischemia (SMI). Methods: According to the WHO diagnostic criteria for coronary heart disease (CHD), 306 SMI patients were classified to three groups as type Ⅰ (n=122), type Ⅱ (n=112) and type Ⅲ (n=72). The subjects of each type were randomly divided into 2 subgroups; one subgroup underwent adenosine stress/rest MPI with 99 Tc m -MIBI and another subgroup with 99 Tc m -TF. The clinical diagnosis of CHD was proven with electrocardiogram (46 cases), dynamic electrocardiogram (219 cases) or CAG (41 cases). Comparison factors between the two tracers included image quality and diagnostic efficacy. The image quality was graded into three classes:excellent, good and moderate. χ 2 test and analysis of variance were used to analyze data. Results: The sensitivities of detecting myocardial ischemia with 99 Tc m -MIBI MPI and 99 Tc m -TF MPI in group type Ⅰ were 57.38% (35/61) vs 60.66% (37/61) (χ 2 =0.136, P>0.05); in group type Ⅱ 69.64% (39/56) vs 64.29% (36/56) (χ 2 =0.363, P>0.05) and in group type Ⅲ 83.33% (30/36) vs 88.89% (32/36) (χ 2 =0.465, P>0.05), respectively. There was no significant difference between the sensitivities of the two imaging modalities in all three types of SMI patients.In image quality grading, 99 Tc m -MIBI and 99 Tc m -TF demonstrated excellent images with 41.18% (63/153) vs 48.37% (74/153) (χ 2 =1.599, P=0.206), good with 45.10% (69/153) vs 34.64% (53/153) (χ 2 =3.489, P=0.062) and moderate with 13.72% (21/153) vs 16.99%(26/153) (χ 2 =0.628, P=0.428). There was no unqualified image with either modality. 99 Tc m -TF displayed quicker radioactivity clearance in liver and lungs. Thereby there was less interference or pitfalls present in the ventricle base or interior wall that may result from higher liver radioactivity retention. The waiting time between the tracer injection and imaging was at least 1 h

  20. Two K versus 4 K storage phosphor chest radiography: detection performance and image quality

    International Nuclear Information System (INIS)

    Koelblinger, Claus; Weber, Michael; Sailer, Johannes; Cartes-Zumelzu, Fabiola; Prokop, Mathias; Schaefer-Prokop, Cornelia

    2007-01-01

    The purpose of this study was to evaluate the effect of matrix size (4-K versus 2-K) in digital storage phosphor chest radiographs on image quality and on the detection of CT-proven thoracic abnormalities. In 85 patients who underwent a CT of the thorax, we obtained two additional posteroanterior storage phosphor chest radiographs, one with a matrix size of 3,520 x 4,280 (=4-K) and the other with a matrix size of 1,760 x 2,140 (=2-K). Acquisition, processing and presentation parameters were identical for all radiographs. Two radiologists evaluated the presence of mediastinal, pleural, and pulmonary abnormalities on hard copies of the radiographs, applying ROC analysis. In addition, four radiologists were asked to subjectively rank differences in image quality and to assess the demarcation of anatomic landmarks comparing the images in a blinded side-by-side manner. These data were analyzed using a two-sided binomial test with a significance level of P<0.05. Both tests, the ROC analysis of the detection performance and the binomial test of the subjective quality ratings, did not reveal significant differences between the two matrix sizes. Compared to 2-K radiographs, 4-K storage phosphor chest radiographs do not provide superior detection performance or image quality when evaluated in identical hard copy formats. (orig.)

  1. Optimisation of radiation dose and image quality in mobile neonatal chest radiography.

    Science.gov (United States)

    Hinojos-Armendáriz, V I; Mejía-Rosales, S J; Franco-Cabrera, M C

    2018-05-01

    To optimise the radiation dose and image quality for chest radiography in the neonatal intensive care unit (NICU) by increasing the mean beam energy. Two techniques for the acquisition of NICU AP chest X-ray images were compared for image quality and radiation dose. 73 images were acquired using a standard technique (56 kV, 3.2 mAs and no additional filtration) and 90 images with a new technique (62 kV, 2 mAs and 2 mm Al filtration). The entrance surface air kerma (ESAK) was measured using a phantom and compared between the techniques and against established diagnostic reference levels (DRL). Images were evaluated using seven image quality criteria independently by three radiologists. Images quality and radiation dose were compared statistically between the standard and new techniques. The maximum ESAK for the new technique was 40.20 μGy, 43.7% of the ESAK of the standard technique. Statistical evaluation demonstrated no significant differences in image quality between the two acquisition techniques. Based on the techniques and acquisition factors investigated within this study, it is possible to lower the radiation dose without any significant effects on image quality by adding filtration (2 mm Al) and increasing the tube potential. Such steps are relatively simple to undertake and as such, other departments should consider testing and implementing this dose reduction strategy within clinical practice where appropriate. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  2. Development and validation of a psychometric scale for assessing PA chest image quality: A pilot study

    International Nuclear Information System (INIS)

    Mraity, H.; England, A.; Akhtar, I.; Aslam, A.; De Lange, R.; Momoniat, H.; Nicoulaz, S.; Ribeiro, A.; Mazhir, S.; Hogg, P.

    2014-01-01

    Purpose: To develop and validate a psychometric scale for assessing image quality perception for chest X-ray images. Methods: Bandura's theory was used to guide scale development. A review of the literature was undertaken to identify items/factors which could be used to evaluate image quality using a perceptual approach. A draft scale was then created (22 items) and presented to a focus group (student and qualified radiographers). Within the focus group the draft scale was discussed and modified. A series of seven postero-anterior chest images were generated using a phantom with a range of image qualities. Image quality perception was confirmed for the seven images using signal-to-noise ratio (SNR 17.2–36.5). Participants (student and qualified radiographers and radiology trainees) were then invited to independently score each of the seven images using the draft image quality perception scale. Cronbach alpha was used to test interval reliability. Results: Fifty three participants used the scale to grade image quality perception on each of the seven images. Aggregated mean scale score increased with increasing SNR from 42.1 to 87.7 (r = 0.98, P < 0.001). For each of the 22 individual scale items there was clear differentiation of low, mid and high quality images. A Cronbach alpha coefficient of >0.7 was obtained across each of the seven images. Conclusion: This study represents the first development of a chest image quality perception scale based on Bandura's theory. There was excellent correlation between the image quality perception scores derived using the scale and the SNR. Further research will involve a more detailed item and factor analysis

  3. Movement analysis of chest MR image under rest breath using realignment of SPM

    International Nuclear Information System (INIS)

    Kitamura, Shigemi; Usui, Shuji; Horiguchi, Takayoshi; Akiyama, Mitoshi

    2007-01-01

    Analyses of diaphragm and chest wall motion are good indicators to evaluate clinical status and pulmonary function before and after surgery for respiratory disease. Noninvasive MR images using fast gradient recalled echo techniques recently have received a great deal of attention for their assessment of inspiratory motion. However, it is laborious to analyze a large number of dynamic MR images. Therefore, we performed movement analyses of chest two-dimensional (2D) MR images by using the public domain software statistical parametric mapping (SPM) Realignment sub-routine, which is commonly used for the motion correction of brain functional MRI analyses. First, dynamic 2D MR images of a glue-stick phantom were measured as a simple reciprocal movement model and were numerically analyzed by the SPM Realignment. The resulting translation to each axis coincided with the measured values. Then the dynamic images of normal volunteers under free breathing were analyzed by the same method, and we found that the inspiratory motions were quantitatively shown as the translation to each axis. These results revealed that the SPM Realignment is a useful tool for screening the magnitude and characteristics of inspiratory motion. (author)

  4. Semi-automated measurements of heart-to-mediastinum ratio on 123I-MIBG myocardial scintigrams by using image fusion method with chest X-ray images

    Science.gov (United States)

    Kawai, Ryosuke; Hara, Takeshi; Katafuchi, Tetsuro; Ishihara, Tadahiko; Zhou, Xiangrong; Muramatsu, Chisako; Abe, Yoshiteru; Fujita, Hiroshi

    2015-03-01

    MIBG (iodine-123-meta-iodobenzylguanidine) is a radioactive medicine that is used to help diagnose not only myocardial diseases but also Parkinson's diseases (PD) and dementia with Lewy Bodies (DLB). The difficulty of the segmentation around the myocardium often reduces the consistency of measurement results. One of the most common measurement methods is the ratio of the uptake values of the heart to mediastinum (H/M). This ratio will be a stable independent of the operators when the uptake value in the myocardium region is clearly higher than that in background, however, it will be unreliable indices when the myocardium region is unclear because of the low uptake values. This study aims to develop a new measurement method by using the image fusion of three modalities of MIBG scintigrams, 201-Tl scintigrams, and chest radiograms, to increase the reliability of the H/M measurement results. Our automated method consists of the following steps: (1) construct left ventricular (LV) map from 201-Tl myocardium image database, (2) determine heart region in chest radiograms, (3) determine mediastinum region in chest radiograms, (4) perform image fusion of chest radiograms and MIBG scintigrams, and 5) perform H/M measurements on MIBG scintigrams by using the locations of heart and mediastinum determined on the chest radiograms. We collected 165 cases with 201-Tl scintigrams and chest radiograms to construct the LV map. Another 65 cases with MIBG scintigrams and chest radiograms were also collected for the measurements. Four radiological technologists (RTs) manually measured the H/M in the MIBG images. We compared the four RTs' results with our computer outputs by using Pearson's correlation, the Bland-Altman method, and the equivalency test method. As a result, the correlations of the H/M between four the RTs and the computer were 0.85 to 0.88. We confirmed systematic errors between the four RTs and the computer as well as among the four RTs. The variation range of the H

  5. Value of a Computer-aided Detection System Based on Chest Tomosynthesis Imaging for the Detection of Pulmonary Nodules.

    Science.gov (United States)

    Yamada, Yoshitake; Shiomi, Eisuke; Hashimoto, Masahiro; Abe, Takayuki; Matsusako, Masaki; Saida, Yukihisa; Ogawa, Kenji

    2018-04-01

    Purpose To assess the value of a computer-aided detection (CAD) system for the detection of pulmonary nodules on chest tomosynthesis images. Materials and Methods Fifty patients with and 50 without pulmonary nodules underwent both chest tomosynthesis and multidetector computed tomography (CT) on the same day. Fifteen observers (five interns and residents, five chest radiologists, and five abdominal radiologists) independently evaluated tomosynthesis images of 100 patients for the presence of pulmonary nodules in a blinded and randomized manner, first without CAD, then with the inclusion of CAD marks. Multidetector CT images served as the reference standard. Free-response receiver operating characteristic analysis was used for the statistical analysis. Results The pooled diagnostic performance of 15 observers was significantly better with CAD than without CAD (figure of merit [FOM], 0.74 vs 0.71, respectively; P = .02). The average true-positive fraction and false-positive rate per all cases with CAD were 0.56 and 0.26, respectively, whereas those without CAD were 0.47 and 0.20, respectively. Subanalysis showed that the diagnostic performance of interns and residents was significantly better with CAD than without CAD (FOM, 0.70 vs 0.62, respectively; P = .001), whereas for chest radiologists and abdominal radiologists, the FOM with CAD values were greater but not significantly: 0.80 versus 0.78 (P = .38) and 0.74 versus 0.73 (P = .65), respectively. Conclusion CAD significantly improved diagnostic performance in the detection of pulmonary nodules on chest tomosynthesis images for interns and residents, but provided minimal benefit for chest radiologists and abdominal radiologists. © RSNA, 2017 Online supplemental material is available for this article.

  6. MRI of the Chest

    Medline Plus

    Full Text Available ... are the limitations of MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging ( ... heart, valves, great vessels, etc.). top of page What are some common uses of the procedure? MR ...

  7. Chest CT in children: anesthesia and atelectasis

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Gawande, Rakhee [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Krane, Elliot J. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA (United States); Holmes, Tyson H. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Robinson, Terry E. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary Biology, Stanford, CA (United States)

    2014-02-15

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  8. Chest CT in children: anesthesia and atelectasis

    International Nuclear Information System (INIS)

    Newman, Beverley; Gawande, Rakhee; Krane, Elliot J.; Holmes, Tyson H.; Robinson, Terry E.

    2014-01-01

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  9. A method for smoothing segmented lung boundary in chest CT images

    Science.gov (United States)

    Yim, Yeny; Hong, Helen

    2007-03-01

    To segment low density lung regions in chest CT images, most of methods use the difference in gray-level value of pixels. However, radiodense pulmonary vessels and pleural nodules that contact with the surrounding anatomy are often excluded from the segmentation result. To smooth lung boundary segmented by gray-level processing in chest CT images, we propose a new method using scan line search. Our method consists of three main steps. First, lung boundary is extracted by our automatic segmentation method. Second, segmented lung contour is smoothed in each axial CT slice. We propose a scan line search to track the points on lung contour and find rapidly changing curvature efficiently. Finally, to provide consistent appearance between lung contours in adjacent axial slices, 2D closing in coronal plane is applied within pre-defined subvolume. Our method has been applied for performance evaluation with the aspects of visual inspection, accuracy and processing time. The results of our method show that the smoothness of lung contour was considerably increased by compensating for pulmonary vessels and pleural nodules.

  10. Sci-Fri AM: Imaging - 09: Serial estimation of cross-talk for correction in dual-isotope imaging with dynamic tracers.

    Science.gov (United States)

    Wells, R G; Lockwood, J; Wei, L; Duan, D; Fernando, P; Bensimon, C; Ruddy, T D

    2012-07-01

    The recent radioisotope shortage has led to interest in non-Tc99m-based tracers. We have developed a novel I-123-labelled myocardial perfusion imaging tracer. We compare the I123-tracer to the clinical standard of Tc99m tetrofosmin in vivo in a rat model using a small-animal SPECT/CT camera. SPECT distinguishes different isotopes based on the different energies of the emitted gamma rays and thus allows simultaneous comparison of two tracer distributions in the same animal. Dual-isotope imaging is complicated by cross-talk between the energy windows of the isotopes. Standard energy-window-based correction methods are difficult to employ because of the proximity in energy of Tc99m (140keV) and I123 (159keV). Imaging the second tracer's energy window prior to its injection provides an estimate of the cross-talk. However, this estimate is only accurate if the tracer distribution is static. We use serial imaging prior to the introduction of the second tracer to estimate the dynamics of the first tracer and interpolate the cross-talk images to provide a more accurate correction. We used rat models of myocardial disease (n=3). I123 tracer was injected and imaged for one hour at 20min intervals. The Tc99m tetrofosmin was then injected and 30min later, a dual-isotope image was obtained. The impact of this approach is assessed by comparing the differences in the Tc99m-tetrofosmin image using this method with correction by simple correction for physical decay. The interpolative approach improves the accuracy of the correction by 2%-5% and thereby enhances the comparison of the two tracers. © 2012 American Association of Physicists in Medicine.

  11. Single-energy pediatric chest computed tomography with spectral filtration at 100 kVp: effects on radiation parameters and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Bodelle, Boris; Fischbach, Constanze; Booz, Christian; Yel, Ibrahim; Frellesen, Claudia; Kaup, Moritz; Beeres, Martin; Vogl, Thomas J.; Scholtz, Jan-Erik [Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany)

    2017-06-15

    Most of the applied radiation dose at CT is in the lower photon energy range, which is of limited diagnostic importance. To investigate image quality and effects on radiation parameters of 100-kVp spectral filtration single-energy chest CT using a tin-filter at third-generation dual-source CT in comparison to standard 100-kVp chest CT. Thirty-three children referred for a non-contrast chest CT performed on a third-generation dual-source CT scanner were examined at 100 kVp with a dedicated tin filter with a tube current-time product resulting in standard protocol dose. We compared resulting images with images from children examined using standard single-source chest CT at 100 kVp. We assessed objective and subjective image quality and compared radiation dose parameters. Radiation dose was comparable for children 5 years old and younger, and it was moderately decreased for older children when using spectral filtration (P=0.006). Effective tube current increased significantly (P=0.0001) with spectral filtration, up to a factor of 10. Signal-to-noise ratio and image noise were similar for both examination techniques (P≥0.06). Subjective image quality showed no significant differences (P≥0.2). Using 100-kVp spectral filtration chest CT in children by means of a tube-based tin-filter on a third-generation dual-source CT scanner increases effective tube current up to a factor of 10 to provide similar image quality at equivalent dose compared to standard single-source CT without spectral filtration. (orig.)

  12. Single-energy pediatric chest computed tomography with spectral filtration at 100 kVp: effects on radiation parameters and image quality

    International Nuclear Information System (INIS)

    Bodelle, Boris; Fischbach, Constanze; Booz, Christian; Yel, Ibrahim; Frellesen, Claudia; Kaup, Moritz; Beeres, Martin; Vogl, Thomas J.; Scholtz, Jan-Erik

    2017-01-01

    Most of the applied radiation dose at CT is in the lower photon energy range, which is of limited diagnostic importance. To investigate image quality and effects on radiation parameters of 100-kVp spectral filtration single-energy chest CT using a tin-filter at third-generation dual-source CT in comparison to standard 100-kVp chest CT. Thirty-three children referred for a non-contrast chest CT performed on a third-generation dual-source CT scanner were examined at 100 kVp with a dedicated tin filter with a tube current-time product resulting in standard protocol dose. We compared resulting images with images from children examined using standard single-source chest CT at 100 kVp. We assessed objective and subjective image quality and compared radiation dose parameters. Radiation dose was comparable for children 5 years old and younger, and it was moderately decreased for older children when using spectral filtration (P=0.006). Effective tube current increased significantly (P=0.0001) with spectral filtration, up to a factor of 10. Signal-to-noise ratio and image noise were similar for both examination techniques (P≥0.06). Subjective image quality showed no significant differences (P≥0.2). Using 100-kVp spectral filtration chest CT in children by means of a tube-based tin-filter on a third-generation dual-source CT scanner increases effective tube current up to a factor of 10 to provide similar image quality at equivalent dose compared to standard single-source CT without spectral filtration. (orig.)

  13. Application of off-line image processing for optimization in chest computed radiography using a low cost system.

    Science.gov (United States)

    Muhogora, Wilbroad E; Msaki, Peter; Padovani, Renato

    2015-03-08

     The objective of this study was to improve the visibility of anatomical details by applying off-line postimage processing in chest computed radiography (CR). Four spatial domain-based external image processing techniques were developed by using MATLAB software version 7.0.0.19920 (R14) and image processing tools. The developed techniques were implemented to sample images and their visual appearances confirmed by two consultant radiologists to be clinically adequate. The techniques were then applied to 200 chest clinical images and randomized with other 100 images previously processed online. These 300 images were presented to three experienced radiologists for image quality assessment using standard quality criteria. The mean and ranges of the average scores for three radiologists were characterized for each of the developed technique and imaging system. The Mann-Whitney U-test was used to test the difference of details visibility between the images processed using each of the developed techniques and the corresponding images processed using default algorithms. The results show that the visibility of anatomical features improved significantly (0.005 ≤ p ≤ 0.02) with combinations of intensity values adjustment and/or spatial linear filtering techniques for images acquired using 60 ≤ kVp ≤ 70. However, there was no improvement for images acquired using 102 ≤ kVp ≤ 107 (0.127 ≤ p ≤ 0.48). In conclusion, the use of external image processing for optimization can be effective in chest CR, but should be implemented in consultations with the radiologists.

  14. Localized Energy-Based Normalization of Medical Images: Application to Chest Radiography.

    Science.gov (United States)

    Philipsen, R H H M; Maduskar, P; Hogeweg, L; Melendez, J; Sánchez, C I; van Ginneken, B

    2015-09-01

    Automated quantitative analysis systems for medical images often lack the capability to successfully process images from multiple sources. Normalization of such images prior to further analysis is a possible solution to this limitation. This work presents a general method to normalize medical images and thoroughly investigates its effectiveness for chest radiography (CXR). The method starts with an energy decomposition of the image in different bands. Next, each band's localized energy is scaled to a reference value and the image is reconstructed. We investigate iterative and local application of this technique. The normalization is applied iteratively to the lung fields on six datasets from different sources, each comprising 50 normal CXRs and 50 abnormal CXRs. The method is evaluated in three supervised computer-aided detection tasks related to CXR analysis and compared to two reference normalization methods. In the first task, automatic lung segmentation, the average Jaccard overlap significantly increased from 0.72±0.30 and 0.87±0.11 for both reference methods to with normalization. The second experiment was aimed at segmentation of the clavicles. The reference methods had an average Jaccard index of 0.57±0.26 and 0.53±0.26; with normalization this significantly increased to . The third experiment was detection of tuberculosis related abnormalities in the lung fields. The average area under the Receiver Operating Curve increased significantly from 0.72±0.14 and 0.79±0.06 using the reference methods to with normalization. We conclude that the normalization can be successfully applied in chest radiography and makes supervised systems more generally applicable to data from different sources.

  15. Muscular sarcoidosis involving the chest and abdominal walls: case report with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seunghyun; Lee, In Sook; Song, You Seon [Pusan National University Hospital, Biomedical Research Institute, Department of Radiology, Busan (Korea, Republic of); Pusan National University School of Medicine, Busan (Korea, Republic of); Mok, Jeongha [Pusan National University Hospital, Biomedical Research Institute, Department of Internal Medicine, Busan (Korea, Republic of); Choi, Kyung-Un [Pusan National University Hospital, Biomedical Research Institute, Department of Pathology, Busan (Korea, Republic of)

    2018-03-15

    Sarcoidosis is an inflammatory disorder that is characterized by the presence of noncaseating granulomas in tissues, involving many organs and tissues. Extra-pulmonary, especially muscular sarcoidosis is a rare condition. The most common location of the muscular sarcoidosis is known to be the proximal muscles of the extremities; however, there have been no cases of diffuse involvement of the chest and abdominal wall muscles. Here, we report a rare muscular sarcoidosis with infiltrative pattern in the chest and abdominal wall muscles and describe the MR imaging findings that were mistaken as lymphoma at initial diagnosis. Although our case did not show characteristic MR findings of muscular sarcoidosis, clinicians or radiologists who are aware of these imaging features can perform early systemic survey for sarcoidosis. Also muscle biopsy is very important to confirm the sarcoidosis and distinguish it from other tumors. (orig.)

  16. Muscular sarcoidosis involving the chest and abdominal walls: case report with MR imaging

    International Nuclear Information System (INIS)

    Lee, Seunghyun; Lee, In Sook; Song, You Seon; Mok, Jeongha; Choi, Kyung-Un

    2018-01-01

    Sarcoidosis is an inflammatory disorder that is characterized by the presence of noncaseating granulomas in tissues, involving many organs and tissues. Extra-pulmonary, especially muscular sarcoidosis is a rare condition. The most common location of the muscular sarcoidosis is known to be the proximal muscles of the extremities; however, there have been no cases of diffuse involvement of the chest and abdominal wall muscles. Here, we report a rare muscular sarcoidosis with infiltrative pattern in the chest and abdominal wall muscles and describe the MR imaging findings that were mistaken as lymphoma at initial diagnosis. Although our case did not show characteristic MR findings of muscular sarcoidosis, clinicians or radiologists who are aware of these imaging features can perform early systemic survey for sarcoidosis. Also muscle biopsy is very important to confirm the sarcoidosis and distinguish it from other tumors. (orig.)

  17. Fundamental imaging characteristics of a slot-scan digital chest radiographic system

    International Nuclear Information System (INIS)

    Samei, Ehsan; Saunders, Robert S.; Lo, Joseph Y.; Dobbins, James T. III; Jesneck, Jonathan L.; Floyd, Carey E.; Ravin, Carl E.

    2004-01-01

    Our purpose in this study was to evaluate the fundamental image quality characteristics of a new slot-scan digital chest radiography system (ThoraScan, Delft Imaging Systems/Nucletron, Veenendaal, The Netherlands). The linearity of the system was measured over a wide exposure range at 90, 117, and 140 kVp with added Al filtration. System uniformity and reproducibility were established with an analysis of images from repeated exposures. The modulation transfer function (MTF) was evaluated using an established edge method. The noise power spectrum (NPS) and the detective quantum efficiency (DQE) of the system were evaluated at the three kilo-voltages over a range of exposures. Scatter fraction (SF) measurements were made using a posterior beam stop method and a geometrical chest phantom. The system demonstrated excellent linearity, but some structured nonuniformities. The 0.1 MTF values occurred between 3.3-3.5 mm -1 . The DQE(0.15) and DQE(2.5) were 0.21 and 0.07 at 90 kVp, 0.18 and 0.05 at 117 kVp, and 0.16 and 0.03 at 140 kVp, respectively. The system exhibited remarkably lower SFs compared to conventional full-field systems with anti-scatter grid, measuring 0.13 in the lungs and 0.43 in the mediastinum. The findings indicated that the slot-scan design provides marked scatter reduction leading to high effective DQE (DQE eff ) of the system and reduced patient dose required to achieve high image quality

  18. Evaluation of a Noise Reduction Procedure for Chest Radiography

    Science.gov (United States)

    Fukui, Ryohei; Ishii, Rie; Kodani, Kazuhiko; Kanasaki, Yoshiko; Suyama, Hisashi; Watanabe, Masanari; Nakamoto, Masaki; Fukuoka, Yasushi

    2013-01-01

    Background The aim of this study was to evaluate the usefulness of noise reduction procedure (NRP), a function in the new image processing for chest radiography. Methods A CXDI-50G Portable Digital Radiography System (Canon) was used for X-ray detection. Image noise was analyzed with a noise power spectrum (NPS) and a burger phantom was used for evaluation of density resolution. The usefulness of NRP was evaluated by chest phantom images and clinical chest radiography. We employed the Bureau of Radiological Health Method for scoring chest images while carrying out our observations. Results NPS through the use of NRP was improved compared with conventional image processing (CIP). The results in image quality showed high-density resolution through the use of NRP, so that chest radiography examination can be performed with a low dose of radiation. Scores were significantly higher than for CIP. Conclusion In this study, use of NRP led to a high evaluation in these so we are able to confirm the usefulness of NRP for clinical chest radiography. PMID:24574577

  19. Evaluation of image quality when using grid during child chest x-ray examination

    Energy Technology Data Exchange (ETDEWEB)

    Jeung Seung Hun [Dept. of Radiology, SeoSan JungAng General Hospital, Seosan (Korea, Republic of); Han, Beom Hul [Dept. of Radiological Science, SeoNam University, Gwangju (Korea, Republic of); Jung, Hong Ryang [Dept. of Radiological Science, Hanseo University, (Korea, Republic of)

    2017-09-15

    Since in case of children, they are sensitive to the radiation compared to the adult and the potential exposure damage lasts longer, the exposure dose should be managed better than for the adult. Therefore, this study was conducted to observe the change in the chest x-ray image by the use of grid, which eliminates the scattering rays but increases the exposure dose during the child chest x-ray examination. As a research method, SNR, CNR and V. Vuichi were measured at 100 cm and 180 cm with the grid varying the kVp to 70, 90 and 110. In addition, SNR, CNR and V. Vuichi were measured fixing 100 cm and 180cm without grid and varying the dose to 6, 8 and 10 mAs. In the results of measuring them by fixing kVp, SNR, VNR and V. Vuichi were represented high when FID is 100cm. And in the results of meaduring them varying mAs, SNR, VNR and V. Vuichi were represented high when FID is 100cm. Currently in our country, the chest x-ray examination is performed at 180 cm. However, as the image is measured high when FID is 100 cm, in case of child, FID is deemed to be 100 cm.

  20. Evaluation of image quality when using grid during child chest x-ray examination

    International Nuclear Information System (INIS)

    Jeung Seung Hun; Han, Beom Hul; Jung, Hong Ryang

    2017-01-01

    Since in case of children, they are sensitive to the radiation compared to the adult and the potential exposure damage lasts longer, the exposure dose should be managed better than for the adult. Therefore, this study was conducted to observe the change in the chest x-ray image by the use of grid, which eliminates the scattering rays but increases the exposure dose during the child chest x-ray examination. As a research method, SNR, CNR and V. Vuichi were measured at 100 cm and 180 cm with the grid varying the kVp to 70, 90 and 110. In addition, SNR, CNR and V. Vuichi were measured fixing 100 cm and 180cm without grid and varying the dose to 6, 8 and 10 mAs. In the results of measuring them by fixing kVp, SNR, VNR and V. Vuichi were represented high when FID is 100cm. And in the results of meaduring them varying mAs, SNR, VNR and V. Vuichi were represented high when FID is 100cm. Currently in our country, the chest x-ray examination is performed at 180 cm. However, as the image is measured high when FID is 100 cm, in case of child, FID is deemed to be 100 cm

  1. Cine magnetic resonance imaging, computed tomography and ultrasonography in the evaluation of chest wall invasion of lung cancer

    International Nuclear Information System (INIS)

    Yokozaki, Michiya; Nawano, Shigeru; Nagai, Kanji; Moriyama, Noriyuki; Kodama, Tetsuro; Nishiwaki, Yutaka.

    1997-01-01

    To assess the usefulness of cine-magnetic resonance imaging (cine-MRI) in the evaluation of chest wall invasion, we compared the results of cine-MRI with those of computed tomography (CT) and ultrasonography (US). Eleven patients were examined who had no pain and who were difficult to diagnose by routine examinations. MRI was performed with a Magnetom SP/4000, 1.5T unit (Siemens, Germany). For cine imaging, continuous turbo-FLUSH (ultra fast low angle shot) images were obtained at an orthogonal section to the chest wall during slow deep breathing. A CT scan was performed using a TCT 900S or Super Helix (Toshiba, Japan) at 1 cm intervals, with section thicknesses of 1 cm throughout the entire chest. US was performed with a model SSA-270A (Toshiba, Japan) with 7.5-MHz linear array scanners (PLF-705S; Toshiba, Japan). Sensitivity, specificity and accuracy were 67%, 75% and 73% for cine MRI, 67%, 63% and 64% for CT, 33%, 75% and 64% for US, respectively. These results indicate that cine MRI is potentially useful for the diagnosis of chest wall invasion of lung cancer. (author)

  2. Imaging of occupational and environmental disorders of the chest

    International Nuclear Information System (INIS)

    Gevenois, P.A.; Vuyst, P. de

    2006-01-01

    The spectrum of occupational and environmental diseases has changed markedly in recent years. New industrial processes have led to the production and use of a wide range of chemicals, metals, and alloys, an increasing number of which have been reported to cause interstitial lung disease in exposed workers. Thus, while the workforce in coal mining and asbestos handling has decreased, new groups of workers are at risk of exposure to agents potentially responsible for pneumoconiosis. This well-illustrated book, written by internationally acclaimed experts, provides a comprehensive approach to modern imaging of environmental and occupational diseases of the chest. The first part of the book addresses the basic knowledge required to understand imaging in this context, while the second focuses on the imaging results achieved in a variety of specific disorders. There is particular emphasis on thin-section computed tomography since this technique facilitates the detection of early subclinical abnormalities. (orig.)

  3. Technetium-99m tetrofosmin rest/stress myocardial SPET with a same-day 2-hour protocol: comparison with coronary angiography. A Spanish-Portuguese multicentre clinical trial

    International Nuclear Information System (INIS)

    Montz, R.; Perez-Castejon, M.J.; Jurado, J.A.; Martin-Comin, J.; Esplugues, E.; Salgado, L.; Ventosa, A.; Cantinho, G.; Sa, E.P.; Fonseca, A.T.; Vieira, M.R.; Ortiz-Berrocal, J.; Magrina, J.; Ortega, D.; Puente, C.; Ferrer, A.I.; Pedrosa, J.; Latre, J.M.; Carreras, J.L.

    1996-01-01

    Technetium-99m tetrofosmin (Myoview) has unique properties for myocardial perfusion imaging very early after injection of the tracer. We used a very short same-day rest/stress protocol, to be performed within 2 h and evaluated its diagnostic accuracy. The study included 144 patients from seven Spanish and four Portuguese centres with a diagnosis of uncomplicated coronary artery disease (CAD); 78 patients (54%) had no history of prior myocardial infarction. Patients were injected with ≤300 MBq 99m Tc-tetrofosmin at rest and ≤900 MBq approximately 1 h later at peak exercise. Single-photon emission tomographic (SPET) acquisitions were initiated within 5-30 min post injection. The results were compared with those of coronary angiography (CA). The data of 142 patients were completely evaluable (two with non-evaluable images were excluded). The quality of rest images was excellent or good in 86%, regionally problematic in 7%, poor but well interpretable in 5% and non-evaluable in 2%. The overall sensitivity for the detection of CAD was 93%, the specificity 38% and the accuracy 85%. The localization of defects by SPET in relation the perfusion territories of stenosed vessels (≥=50%) was achieved with a sensitivity of 64% for the left anterior descending artery, 49% for the left circumflex artery and 86% for the right coronary artery, and an accuracy of 71%, 72% and 73% respectively. Concordance of SPET and CA was 62% for single-vessel disease and 68% for multivessel disease. In conclusion, this Spanish-Portuguese multicentre clinical trial confirmed, in a considerable number of patients who underwent coronary angiography, the feasibility of 99m Tc terofosmin (Myoview) rest/stress myocardial SPET using a very short protocol (2 h). (orig.)

  4. MRI of the Chest

    Medline Plus

    Full Text Available ... chest is performed to: assess abnormal masses, including cancer of the lungs or other tissues, which either cannot be assessed ... in diagnosing a broad range of conditions, including cancer, heart and ... tissues, except for lung abnormalities where Chest CT is a preferred imaging ...

  5. Homogeneous Canine Chest Phantom Construction: A Tool for Image Quality Optimization.

    Directory of Open Access Journals (Sweden)

    Ana Luiza Menegatti Pavan

    Full Text Available Digital radiographic imaging is increasing in veterinary practice. The use of radiation demands responsibility to maintain high image quality. Low doses are necessary because workers are requested to restrain the animal. Optimizing digital systems is necessary to avoid unnecessary exposure, causing the phenomenon known as dose creep. Homogeneous phantoms are widely used to optimize image quality and dose. We developed an automatic computational methodology to classify and quantify tissues (i.e., lung tissue, adipose tissue, muscle tissue, and bone in canine chest computed tomography exams. The thickness of each tissue was converted to simulator materials (i.e., Lucite, aluminum, and air. Dogs were separated into groups of 20 animals each according to weight. Mean weights were 6.5 ± 2.0 kg, 15.0 ± 5.0 kg, 32.0 ± 5.5 kg, and 50.0 ± 12.0 kg, for the small, medium, large, and giant groups, respectively. The one-way analysis of variance revealed significant differences in all simulator material thicknesses (p < 0.05 quantified between groups. As a result, four phantoms were constructed for dorsoventral and lateral views. In conclusion, the present methodology allows the development of phantoms of the canine chest and possibly other body regions and/or animals. The proposed phantom is a practical tool that may be employed in future work to optimize veterinary X-ray procedures.

  6. Analysis of image quality according to BMI of digital chest radiography: Focusing on bureau of radiological health evaluation

    International Nuclear Information System (INIS)

    Jin, Seong Jin; Im, In Chul; Cho, Ji Hwan

    2017-01-01

    Visual evaluation of chest radiograph images is the most practical and effective method. This study compared the Body Mass Index, waist circumference, and mAs with chest radiographs of 351 women. The Bureau of Radiological Health method was used to evaluate the image quality of chest X-ray images by anatomical and physical methods. The average age of the subjects was 30.17±4.73 and the average waist circumference was 66.91±4.67 cm. The mean Body Mass Index value was 20.21±2.23, the mean value of mAs was 3.04±0.78, and the mean value of Bureau of Radiological Health was 79.83±8.45. When the Body Mass Index value increased, waist circumference and mAs mean value increased. The mean value of Body Mass Index was statistically significant(p<0.05) in Group 4 compared to Groups 1 and 2, with increasing Body Mass Index. Exposure control of the automatic exposure control system is considered to be well performed according to body thickness or Body Mass Index at the time of chest radiography. As the Body Mass Index increases, the thickness of the body increases and the breast thickness of the woman also increases. Therefore, it is considered that the exposure amount is changed by the automatic exposure control device to affect the image quality

  7. Analysis of image quality according to BMI of digital chest radiography: Focusing on bureau of radiological health evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Seong Jin [Gammaknife center, Inje University Haeundae Paik Hospital, Busan (Korea, Republic of); Im, In Chul [Dept. of Radiological Science, Dongeui University, Busan (Korea, Republic of); Cho, Ji Hwan [Dept. of Health Care Clinic, Inje University Busan Paik Hospital, Busan (Korea, Republic of)

    2017-03-15

    Visual evaluation of chest radiograph images is the most practical and effective method. This study compared the Body Mass Index, waist circumference, and mAs with chest radiographs of 351 women. The Bureau of Radiological Health method was used to evaluate the image quality of chest X-ray images by anatomical and physical methods. The average age of the subjects was 30.17±4.73 and the average waist circumference was 66.91±4.67 cm. The mean Body Mass Index value was 20.21±2.23, the mean value of mAs was 3.04±0.78, and the mean value of Bureau of Radiological Health was 79.83±8.45. When the Body Mass Index value increased, waist circumference and mAs mean value increased. The mean value of Body Mass Index was statistically significant(p<0.05) in Group 4 compared to Groups 1 and 2, with increasing Body Mass Index. Exposure control of the automatic exposure control system is considered to be well performed according to body thickness or Body Mass Index at the time of chest radiography. As the Body Mass Index increases, the thickness of the body increases and the breast thickness of the woman also increases. Therefore, it is considered that the exposure amount is changed by the automatic exposure control device to affect the image quality.

  8. Bone images from dual-energy subtraction chest radiography in the detection of rib fractures.

    Science.gov (United States)

    Szucs-Farkas, Zsolt; Lautenschlager, Katrin; Flach, Patricia M; Ott, Daniel; Strautz, Tamara; Vock, Peter; Ruder, Thomas D

    2011-08-01

    To assess the sensitivity and image quality of chest radiography (CXR) with or without dual-energy subtracted (ES) bone images in the detection of rib fractures. In this retrospective study, 39 patients with 204 rib fractures and 24 subjects with no fractures were examined with a single exposure dual-energy subtraction digital radiography system. Three blinded readers first evaluated the non-subtracted posteroanterior and lateral chest radiographs alone, and 3 months later they evaluated the non-subtracted images together with the subtracted posteroanterior bone images. The locations of rib fractures were registered with confidence levels on a 3-grade scale. Image quality was rated on a 5-point scale. Marks by readers were compared with fracture localizations in CT as a standard of reference. The sensivity for fracture detection using both methods was very similar (34.3% with standard CXR and 33.5% with ES-CXR, p=0.92). At the patient level, both sensitivity (71.8%) and specificity (92.9%) with or without ES were identical. Diagnostic confidence was not significantly different (2.61 with CXR and 2.75 with ES-CXR, p=0.063). Image quality with ES was rated higher than that on standard CXR (4.08 vs. 3.74, prib fractures. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Automated computerized scheme for distinction between benign and malignant solitary pulmonary nodules on chest images

    International Nuclear Information System (INIS)

    Aoyama, Masahito; Li Qiang; Katsuragawa, Shigehiko; MacMahon, Heber; Doi, Kunio

    2002-01-01

    A novel automated computerized scheme has been developed to assist radiologists for their distinction between benign and malignant solitary pulmonary nodules on chest images. Our database consisted of 55 chest radiographs (33 primary lung cancers and 22 benign nodules). In this method, the location of a nodule was indicated first by a radiologist. The difference image with a nodule was produced by use of filters and then represented in a polar coordinate system. The nodule was segmented automatically by analysis of contour lines of the gray-level distribution based on the polar-coordinate representation. Two clinical parameters (age and sex) and 75 image features were determined from the outline, the image, and histogram analysis for inside and outside regions of the segmented nodule. Linear discriminant analysis (LDA) and knowledge about benign and malignant nodules were used to select initial feature combinations. Many combinations for subgroups of 77 features were evaluated as input to artificial neural networks (ANNs). The performance of ANNs with the selected 7 features by use of the round-robin test showed Az=0.872, which was greater than Az=0.854 obtained previously with the manual method (P=0.53). The performance of LDA (Az=0.886) was slightly improved compared to that of ANNs (P=0.59) and was greater than that of the manual method (Az=0.854) reported previously (P=0.40). The high level of its performance indicates the potential usefulness of this automated computerized scheme in assisting radiologists as a second opinion for distinction between benign and malignant solitary pulmonary nodules on chest images

  10. Chest X-Ray

    Medline Plus

    Full Text Available ... An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Chest X-ray ... posted: How to Obtain and Share Your Medical Images Movement Disorders Video: The Basketball Game: An MRI ...

  11. The role of CT in assessing chest pain

    International Nuclear Information System (INIS)

    Capsa, R.

    2012-01-01

    Full text: Objective: Thoracic pain represents the common feature of a wide range of diseases of different causes. Usually, chest pain requires a fast workup, in order to eliminate potentially hazardous underlying conditions. The objective of the paper consists of presenting the role of computerized tomography (CT) in assessing the different causes and conditions related to chest pain. Materials and methods: The educational presentation relies on current literature data and mostly on images obtained from patients admitted in the various clinics and departments of our hospital, suffering from chest pain as admittance condition or as a symptom appeared during the hospital stay. Results: There are various radiological and imaging options for assessing a patient with chest pain, with reference to the underlying condition, type of pain onset (acute or chronic), specific indications and contraindications. From all these, CT is considered one of the most useful imaging options, in terms of diagnosis accuracy, fast workup, cost and availability. This paper focuses on the role of CT, presenting the most important diseases and conditions related to potential occurrence of chest pain and the most specific CT signs and findings usually reported in this setting. Furthermore, the presentation separates acute and chronic conditions, presenting the actual imaging protocols employed in this circumstances. Finally, there are considerations regarding CT rule-out protocols used in patients with acute chest pain in emergency conditions. Conclusions: Fast and accurate diagnosis is crucial for patient outcome, often life-saving, but currently there is no single algorithm in the imaging assessment of chest pain, while choosing the best imaging option relies mainly on history, clinical and laboratory data. CT is one of the most important imaging options available in patients with both acute and chronic chest pain. CT rule-out techniques have still to establish their clear role in a

  12. Digital chest radiography with an amorphous silicon flat-panel-detector versus a storage-phosphor system: comparison of soft-copy images

    International Nuclear Information System (INIS)

    Lee, Hyun Ju; Im, Jung Gi; Goo, Jin Mo; Lee, Chang Hyun

    2006-01-01

    We compared the soft-copy images produced by an amorphous silicon flat-panel-detector system with the images produced by a storage-phosphor radiography system for their ability to visualize anatomic regions of the chest. Two chest radiologists independently analyzed 234 posteroanterior chest radiographs obtained from 78 patients on high-resolution liquid crystal display monitors (2560 x 2048 x 8 bits). In each patient, one radiograph was obtained with a storage-phosphor system, and two radiographs were obtained via amorphous silicon flat-panel-detector radiography with and without spatial frequency filtering. After randomizing the 234 images, the interpreters rated the visibility and radiographic quality of 11 different anatomic regions. Each image was ranked on a five-point scale (1 = not visualized, 2 = poor visualization, 3 = fair visualization, 4 = good visualization, and 5 = excellent visualization). The statistical difference between each system was determined using the Wilcoxon's signed rank test. The visibility of three anatomic regions (hilum, heart border and ribs), as determined by the chest radiologist with 14 years experience (ρ < 0.05) and the visibility of the thoracic spine, as determined by the chest radiologist with 8 years experience (ρ = 0.036), on the amorphous silicon flat-panel-detector radiography prior to spatial frequency filtering were significantly superior to that on the storage-phosphor radiography. The visibility of 11 anatomic regions, as determined by the chest radiologist with 14 years experience (ρ < 0.0001) and the visibility of five anatomic regions (unobscured lung, rib, proximal airway, thoracic spine and overall appearance), as determined by the chest radiologist with 8 years experience (ρ < 0.05), on the amorphous silicon flat-panel-detector radiography after spatial frequency filtering were significantly superior to that on the storage-phosphor radiography. The amorphous silicon flat-panel-detector system depicted the

  13. Persistent chest pain following oral dipyridamole for thallium 201 myocardial imaging

    International Nuclear Information System (INIS)

    Kwai, A.H.; Jacobson, A.F.; McIntyre, K.M.; Williams, W.H.; Tow, D.E.

    1990-01-01

    A patient was admitted to the hospital with acute chest pain. After acute myocardial infarction was ruled out, he underwent a stress thallium 201 scintigraphy using oral dipyridamole and developed persistent angina with sedimentation time segement elevation. This complication has not been reported previously. It is recommended that appropriate intervention be available if severe ischemia develops following administration of dipyridamole for diagnostic imaging. (orig.)

  14. Automatic anatomically selective image enhancement in digital chest radiography

    International Nuclear Information System (INIS)

    Sezan, M.I.; Minerbo, G.N.; Schaetzing, R.

    1989-01-01

    The authors develop a technique for automatic anatomically selective enhancement of digital chest radiographs. Anatomically selective enhancement is motivated by the desire to simultaneously meet the different enhancement requirements of the lung field and the mediastinum. A recent peak detection algorithm and a set of rules are applied to the image histogram to determine automatically a gray-level threshold between the lung field and mediastinum. The gray-level threshold facilitates anatomically selective gray-scale modification and/or unsharp masking. Further, in an attempt to suppress possible white-band or black-band artifacts due to unsharp masking at sharp edges, local-contrast adaptivity is incorporated into anatomically selective unsharp masking by designing an anatomy-sensitive emphasis parameter which varies asymmetrically with positive and negative values of the local image contrast

  15. MRI of the Chest

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic resonance imaging (MRI) ... clearer and more detailed than with other imaging methods. This detail makes MRI an invaluable tool in ...

  16. Design and Development of a New Multi-Projection X-Ray System for Chest Imaging

    Science.gov (United States)

    Chawla, Amarpreet S.; Boyce, Sarah; Washington, Lacey; McAdams, H. Page; Samei, Ehsan

    2009-02-01

    Overlapping anatomical structures may confound the detection of abnormal pathology, including lung nodules, in conventional single-projection chest radiography. To minimize this fundamental limiting factor, a dedicated digital multi-projection system for chest imaging was recently developed at the Radiology Department of Duke University. We are reporting the design of the multi-projection imaging system and its initial performance in an ongoing clinical trial. The system is capable of acquiring multiple full-field projections of the same patient along both the horizontal and vertical axes at variable speeds and acquisition frame rates. These images acquired in rapid succession from slightly different angles about the posterior-anterior (PA) orientation can be correlated to minimize the influence of overlying anatomy. The developed system has been tested for repeatability and motion blur artifacts to investigate its robustness for clinical trials. Excellent geometrical consistency was found in the tube motion, with positional errors for clinical settings within 1%. The effect of tube-motion on the image quality measured in terms of impact on the modulation transfer function (MTF) was found to be minimal. The system was deemed clinic-ready and a clinical trial was subsequently launched. The flexibility of image acquisition built into the system provides a unique opportunity to easily modify it for different clinical applications, including tomosynthesis, correlation imaging (CI), and stereoscopic imaging.

  17. Improving screen-film chest radiography

    International Nuclear Information System (INIS)

    Shaikh, N.; Baker, R.A.

    1996-01-01

    Traditionally symmetric screens and double emulsion symmetric films with medium to wide latitutde are used for radiography of the chest. Beacuse of mismatch of transmitted exposure through the chest with limited latitude of the film, most of the dense areas of the chest are underexposed. Kodak's recent innovation of a unique asymmetry screen-film system (InSight) alleviates this problem. Our phantom measurement indicates that the InSight system offers wider recording range, and the flexible grid permits more positional latitude than conventional grids. Our five-year extensive clinical experience indicates that dense anatomic structures, such as mediastinum, retrocardiac and subdiaphragmatic, are more visible in the InSight system than in the conventional symmetric system. Similarly, a substantial improvement in image quality in portable chest imaging is realized by use of flexible grids because of scatter rejection and invisible grid lines. (author)

  18. Nodule detection in digital chest radiography: Part of image background acting as pure noise

    International Nuclear Information System (INIS)

    Baath, M.; Haakansson, M.; Boerjesson, S.; Kheddache, S.; Grahn, A.; Bochud, F. O.; Verdun, F. R.; Maansson, L. G.

    2005-01-01

    There are several factors that influence the radiologist's ability to detect a specific structure/lesion in a radiograph. Three factors that are commonly known to be of major importance are the signal itself, the system noise and the projected anatomy. The aim of this study was to determine to what extent the image background acts as pure noise for the detection of subtle lung nodules in five different regions of the chest. A receiver operating characteristic (ROC) study with five observers was conducted on two different sets of images, clinical chest X-ray images and images with a similar power spectrum as the clinical images but with a random phase spectrum, resulting in an image background containing pure noise. Simulated designer nodules with a full-width-at-fifth-maximum of 10 mm but with varying contrasts were added to the images. As a measure of the part of the image background that acts as pure noise, the ratio between the contrast needed to obtain an area under the ROC curve of 0.80 in the clinical images to that in the random-phase images was used. The ratio ranged from 0.40 (in the lateral pulmonary regions) to 0.83 (in the hilar regions) indicating that there was a large difference between different regions regarding to what extent the image background acted as pure noise; and that in the hilar regions the image background almost completely acted as pure noise for the detection of 10 mm nodules. (authors)

  19. Digital tomosynthesis of the chest: A literature review

    International Nuclear Information System (INIS)

    Molk, N.; Seeram, E.

    2015-01-01

    Digital tomosynthesis is a relatively novel imaging modality using limited angle tomography to provide 3D imaging. The purpose of this review is to compare the sensitivity of digital tomosynthesis of the chest and plain film chest imaging in accurately identifying pulmonary nodules and to compare the effective dose between standard chest examinations using digital tomosynthesis and CT. A review of current literature has shown that small scale studies found digital tomosynthesis to be three times more effective in identifying pulmonary nodules compared to conventional radiography and at lower doses compared with routine chest CT examinations. This indicates that tomosynthesis could potentially be a beneficial imaging modality and could be used in a number of ways to detect and monitor pulmonary nodules for cancer. However with limited research, large-scale studies would need to be performed to confirm its benefits and identify where it is best used in the clinical setting. - Highlights: • The detection of pulmonary nodules is compared between tomosynthesis and plain film. • The effective dose of digital chest tomosynthesis and chest CT are compared. • The place of digital tomosynthesis of the chest in the clinical setting is explored. • Three times more pulmonary nodules are seen with tomosynthesis. • The effective dose of tomosynthesis is significantly lower than CT

  20. [Development of a digital chest phantom for studies on energy subtraction techniques].

    Science.gov (United States)

    Hayashi, Norio; Taniguchi, Anna; Noto, Kimiya; Shimosegawa, Masayuki; Ogura, Toshihiro; Doi, Kunio

    2014-03-01

    Digital chest phantoms continue to play a significant role in optimizing imaging parameters for chest X-ray examinations. The purpose of this study was to develop a digital chest phantom for studies on energy subtraction techniques under ideal conditions without image noise. Computed tomography (CT) images from the LIDC (Lung Image Database Consortium) were employed to develop a digital chest phantom. The method consisted of the following four steps: 1) segmentation of the lung and bone regions on CT images; 2) creation of simulated nodules; 3) transformation to attenuation coefficient maps from the segmented images; and 4) projection from attenuation coefficient maps. To evaluate the usefulness of digital chest phantoms, we determined the contrast of the simulated nodules in projection images of the digital chest phantom using high and low X-ray energies, soft tissue images obtained by energy subtraction, and "gold standard" images of the soft tissues. Using our method, the lung and bone regions were segmented on the original CT images. The contrast of simulated nodules in soft tissue images obtained by energy subtraction closely matched that obtained using the gold standard images. We thus conclude that it is possible to carry out simulation studies based on energy subtraction techniques using the created digital chest phantoms. Our method is potentially useful for performing simulation studies for optimizing the imaging parameters in chest X-ray examinations.

  1. Pulmonary nodule size evaluation with chest tomosynthesis.

    Science.gov (United States)

    Johnsson, Åse A; Fagman, Erika; Vikgren, Jenny; Fisichella, Valeria A; Boijsen, Marianne; Flinck, Agneta; Kheddache, Susanne; Svalkvist, Angelica; Båth, Magnus

    2012-10-01

    To evaluate intra- and interobserver variability, as well as agreement for nodule size measurements on chest tomosynthesis and computed tomographic (CT) images. The Regional Ethical Review Board approved this study, and all participants gave written informed consent. Thirty-six segmented nodules in 20 patients were included in the study. Eight observers measured the left-to-right, inferior-to-superior, and longest nodule diameters on chest tomosynthesis and CT images. Intra- and interobserver repeatability, as well as agreement between measurements on chest tomosynthesis and CT images, were assessed as recommended by Bland and Altman. The difference between the mean manual and the segmented diameter was -2.2 and -2.3 mm for left-to-right and -2.6 and -2.2 mm for the inferior-to-superior diameter for measurements on chest tomosynthesis and CT images, respectively. Intraobserver 95% limits of agreement (LOA) for the longest diameter ranged from a lower limit of -1.1 mm and an upper limit of 1.0 mm to -1.8 and 1.8 mm for chest tomosynthesis and from -0.6 and 0.9 mm to -3.1 and 2.2 mm for axial CT. Interobserver 95% LOA ranged from -1.3 and 1.5 mm to -2.0 and 2.1 mm for chest tomosynthesis and from -1.8 and 1.1 mm to -2.2 and 3.1 mm for axial CT. The 95% LOA concerning the mean of the observers' measurements of the longest diameter at chest tomosynthesis and axial CT were ±2.1 mm (mean measurement error, 0 mm). For the different observers, the 95% LOA between the modalities ranged from -2.2 and 1.6 mm to -3.2 and 2.8 mm. Measurements on chest tomosynthesis and CT images are comparable, because there is no evident bias between the modalities and the repeatability is similar. The LOA between measurements for the two modalities raise concern if measurements from chest tomosynthesis and CT were to be used interchangeably. © RSNA, 2012.

  2. Radiation Dose Reduction of Chest CT with Iterative Reconstruction in Image Space - Part I: Studies on Image Quality Using Dual Source CT

    International Nuclear Information System (INIS)

    Hwang, Hye Jeon; Seo, Joon Beom; Lee, Jin Seong; Song, Jae Woo; Lee, Hyun Joo; Lim, Chae Hun; Kim, Song Soo

    2012-01-01

    To determine whether the image quality (IQ) is improved with iterative reconstruction in image space (IRIS), and whether IRIS can be used for radiation reduction in chest CT. Standard dose chest CT (SDCT) in 50 patients and low dose chest CT (LDCT) in another 50 patients were performed, using a dual-source CT, with 120 kVp and same reference mAs (50 mAs for SDCT and 25 mAs for LDCT) employed to both tubes by modifying a dual-energy scan mode. Full-dose data were obtained by combining the data from both tubes and half-dose data were separated from a single tube. These were reconstructed by using a filtered back projection (FBP) and IRIS: full-dose FBP (F-FBP); full-dose IRIS (F-IRIS); half-dose FBP (H-FBP) and half-dose IRIS (H-IRIS). Objective noise was measured. The subjective IQ was evaluated by radiologists for the followings: noise, contrast and sharpness of mediastinum and lung. Objective noise was significantly lower in H-IRIS than in F-FBP (p < 0.01). In both SDCT and LDCT, the IQ scores were highest in F-IRIS, followed by F-FBP, H-IRIS and H-FBP, except those for sharpness of mediastinum, which tended to be higher in FBP. When comparing CT images between the same dose and different reconstruction (F-IRIS/F-FBP and H-IRIS/H-FBP) algorithms, scores tended to be higher in IRIS than in FBP, being more distinct in half-dose images. However, despite the use of IRIS, the scores were lower in H-IRIS than in F-FBP. IRIS generally helps improve the IQ, being more distinct at the reduced radiation. However, reduced radiation by half results in IQ decrease even when using IRIS in chest CT.

  3. Adsorption of technetium-99m tetrofosmin and technetium-99m furifosmin on plastic syringes

    International Nuclear Information System (INIS)

    Bartosch, R.; Granegger, S.; Sinzinger, H.

    1998-01-01

    Some groups have reported that adsorption of radiopharmaceuticals on disposable plastic syringes can reach levels of almost 50%. This high loss of radioactivity stimulated us to carry out similar studies. Our measurements were done in combination with patient studies. Therefore, we used 2-ml syringes, all of the same brand. The radioactivity in the syringe was measured immediately before and after injection. a total of 500-600 MBq technetium-99m labelled tetrofosmin or technetium-99m furifosmin was administered to 48 patients using four different injection techniques (n = 6 for each technique with each tracer): with needles, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer; with butterflies, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer. Neither in syringes nor in needles or butterflies did more than 7% of the initial radioactivity remain. The entire residual activity in syringe plus needle or syringe plus butterfly together never exceeded the 9% limit. Furthermore, in a pilot study we measured the remaining radioactivity in the vial; here, too, we found no more than 14% of total radioactivity. These findings indicate that total retention of radioactivity during elution and application of 99m Tc-tetrofosmin and 99m Tc-furifosmin with material used in our setting does not approach relevant amounts. (orig.)

  4. MRI of the Chest

    Medline Plus

    Full Text Available ... of which shows a thin slice of the body. The images can then be studied from different angles by ... bear denotes child-specific content. Related Articles and Media MR ... Images related to Magnetic Resonance Imaging (MRI) - Chest Sponsored ...

  5. Early appearance of SARS on chest CT scan

    International Nuclear Information System (INIS)

    Cheng Xiaoguang; Feng Suchen; Xia Guoguang; Zhao Tao; Gu Xiang; Qu Hui

    2003-01-01

    Objective: To evaluate the early appearance of SARS on chest CT scan and its role in the early diagnosis. Methods: Forty cases of SARS in keeping with the criteria of the Ministry of Health had chest CT scans within 7 days of onset of symptoms, and CR chest X-ray films were available as well. These chest X-rays and CT images were retrospectively reviewed to determine if there were any abnormalities on the images. The lesions on the chest CT images were then further analyzed in terms of the number, location, size, and density. Results: Positive abnormalities on chest CT scans were revealed in all 40 SARS cases. Positive findings on CR chest films were showed in only 25 cases, equivocal in 6, and normal in 9 cases. The main abnormalities seen on CT and X-rays were pulmonary infiltrations varied markedly in severity. 70 % cases had 1 or 2 lesions on chest CT scan, 30 % cases had 3 or more lesions. The lesions seen on chest CT scan tended to be ground-glass opacification, sometimes with consolidation which was very faint and inhomogeneous, easily missed on chest X-rays. Typically the lesions were located in the periphery of the lung, or both central and peripheral lung, but very rare in a pure central location. They were commonly in the shape of patch or ball. Conclusions: Chest CT scan is much more sensitive in detecting the lesions of the lung in SARS. The early appearance of SARS on chest CT scan is characteristic but non-specific, indicating that chest CT scan plays a very important role in the early diagnosis and differential diagnosis of SARS

  6. Computed radiography versus mobile direct radiography for bedside chest radiographs: impact of dose on image quality and reader agreement

    NARCIS (Netherlands)

    de Boo, D. W.; Weber, M.; Deurloo, E. E.; Streekstra, G. J.; Freling, N. J.; Dongelmans, D. A.; Schaefer-Prokop, C. M.

    2011-01-01

    To asses the image quality and potential for dose reduction of mobile direct detector (DR) chest radiography as compared with computed radiography (CR) for intensive care unit (ICU) chest radiographs (CXR). Three groups of age-, weight- and disease-matched ICU patients (n=114 patients; 50 CXR per

  7. Small lung cancers: improved detection by use of bone suppression imaging--comparison with dual-energy subtraction chest radiography.

    Science.gov (United States)

    Li, Feng; Engelmann, Roger; Pesce, Lorenzo L; Doi, Kunio; Metz, Charles E; Macmahon, Heber

    2011-12-01

    To determine whether use of bone suppression (BS) imaging, used together with a standard radiograph, could improve radiologists' performance for detection of small lung cancers compared with use of standard chest radiographs alone and whether BS imaging would provide accuracy equivalent to that of dual-energy subtraction (DES) radiography. Institutional review board approval was obtained. The requirement for informed consent was waived. The study was HIPAA compliant. Standard and DES chest radiographs of 50 patients with 55 confirmed primary nodular cancers (mean diameter, 20 mm) as well as 30 patients without cancers were included in the observer study. A new BS imaging processing system that can suppress the conspicuity of bones was applied to the standard radiographs to create corresponding BS images. Ten observers, including six experienced radiologists and four radiology residents, indicated their confidence levels regarding the presence or absence of a lung cancer for each lung, first by using a standard image, then a BS image, and finally DES soft-tissue and bone images. Receiver operating characteristic (ROC) analysis was used to evaluate observer performance. The average area under the ROC curve (AUC) for all observers was significantly improved from 0.807 to 0.867 with BS imaging and to 0.916 with DES (both P chest radiographs. Further improvements can be achieved by use of DES radiography but with the requirement for special equipment and a potential small increase in radiation dose. © RSNA, 2011.

  8. An investigation on comprehensive evaluation and standard of image quality of high voltage chest radiograph

    International Nuclear Information System (INIS)

    Yan Shulin; Li Shuopeng; Zhao Bo; Niu Yantao

    1998-01-01

    Purpose: Based on clinical diagnostic demand, patient irradiation dose and imaging technical parameters, to establish a comprehensive evaluation method and standard in chest radiograph. Methods: (1) From 10 normal chest radiographs, the authors selected the evaluation area on thoracic PA (posteroanterior) radiographs and set up standard for diagnostic demand; (2) Using chest CT scans of 20 males and 20 females, the authors calculated the ratio of lung field to mediastinum; (3) Selecting 100 chest films using 125 kVp, the authors measured the standard density values of each evaluation area; (4) Body surface irradiation doses of 478 normal adults were measured. Results: (1) Based on diagnostic demand, the authors confirmed 7 evaluation areas and 4 physical evaluation factors. At the same time, evaluation standards were obtained; (2) Comprehensive evaluation methods were established; (3) Standard height, weight and body surface irradiation dose of Chinese normal adults were investigated preliminarily. Conclusion: Based on the concept of comprehensive evaluation, investigation on the evaluation methods and standard in chest PA radiograph was carried out which might be taken as the foundation for future approach on nation-wide basis

  9. Clinical image: Hydatid disease of the chest wall

    Energy Technology Data Exchange (ETDEWEB)

    Graham, R.J.; Berlin, J.W.; Ghahremani, G.G. [Northwestern Univ., Evanston, IL (United States)

    1996-05-01

    Hydatid disease is rarely encountered among the population of the United States, but it affects several million people in sheep-raising regions of the world. Human infestation with Echinococcus granulosus begins following ingestion of its ova, which are excreted into the contaminated water during the usual dog-sheep cycle. Hydatid cysts will then develop most frequently in the liver (75% of cases) and lungs (15%) of the human host. Skeletal involvement has been reported to occur in only 0.5-4.0% of patients in the endemic areas. Because of the rarity and perplexing imaging features of hydatid disease involving the chest wall, we wish herein to present a case evaluated recently at our institution. 5 refs., 1 fig.

  10. Potential clinical impact of advanced imaging and computer-aided diagnosis in chest radiology: importance of radiologist's role and successful observer study.

    Science.gov (United States)

    Li, Feng

    2015-07-01

    This review paper is based on our research experience in the past 30 years. The importance of radiologists' role is discussed in the development or evaluation of new medical images and of computer-aided detection (CAD) schemes in chest radiology. The four main topics include (1) introducing what diseases can be included in a research database for different imaging techniques or CAD systems and what imaging database can be built by radiologists, (2) understanding how radiologists' subjective judgment can be combined with technical objective features to improve CAD performance, (3) sharing our experience in the design of successful observer performance studies, and (4) finally, discussing whether the new images and CAD systems can improve radiologists' diagnostic ability in chest radiology. In conclusion, advanced imaging techniques and detection/classification of CAD systems have a potential clinical impact on improvement of radiologists' diagnostic ability, for both the detection and the differential diagnosis of various lung diseases, in chest radiology.

  11. Radiological diagnostic in acute chest pain

    International Nuclear Information System (INIS)

    Kawel, Nadine; Bremerich, Jens

    2010-01-01

    Acute chest pain is one of the main symptoms leading to a consultation of the emergency department. Main task of the initial diagnostic is the confirmation or exclusion of a potentially life threatening cause. Conventional chest X-ray and computed tomography are the most significant techniques. Due to limited availability and long examination times magnetic resonance tomography rather plays a limited role in routine clinical workup. In the following paper we will systematically review the radiological diagnostic of the acute life threatening causes of chest pain. Imaging modalities, technical aspects and image interpretation will be discussed. (orig.)

  12. Aspergillosis - chest x-ray (image)

    Science.gov (United States)

    ... usually occurs in immunocompromised individuals. Here, a chest x-ray shows that the fungus has invaded the lung ... are usually seen as black areas on an x-ray. The cloudiness on the left side of this ...

  13. Acceptable levels of digital image compression in chest radiology

    International Nuclear Information System (INIS)

    Smith, I.

    2000-01-01

    The introduction of picture archival and communications systems (PACS) and teleradiology has prompted an examination of techniques that optimize the storage capacity and speed of digital storage and distribution networks. The general acceptance of the move to replace conventional screen-film capture with computed radiography (CR) is an indication that clinicians within the radiology community are willing to accept images that have been 'compressed'. The question to be answered, therefore, is what level of compression is acceptable. The purpose of the present study is to provide an assessment of the ability of a group of imaging professionals to determine whether an image has been compressed. To undertake this study a single mobile chest image, selected for the presence of some subtle pathology in the form of a number of septal lines in both costphrenic angles, was compressed to levels of 10:1, 20:1 and 30:1. These images were randomly ordered and shown to the observers for interpretation. Analysis of the responses indicates that in general it was not possible to distinguish the original image from its compressed counterparts. Furthermore, a preference appeared to be shown for images that have undergone low levels of compression. This preference can most likely be attributed to the 'de-noising' effect of the compression algorithm at low levels. Copyright (1999) Blackwell Science Pty. Ltd

  14. Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 11: Quantification of chest wall motion during deep inspiration breast hold treatments using cine EPID images and a physics based algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Alpuche Aviles, Jorge E.; VanBeek, Timothy [CancerCare Manitoba, Winnipeg (Canada); Sasaki, David; Rivest, Ryan; Akra, Mohamed [CancerCare Manitoba, Winnipeg (Canada); University of Manitoba, Winnipeg (Canada)

    2016-08-15

    Purpose: This work presents an algorithm used to quantify intra-fraction motion for patients treated using deep inspiration breath hold (DIBH). The algorithm quantifies the position of the chest wall in breast tangent fields using electronic portal images. Methods: The algorithm assumes that image profiles, taken along a direction perpendicular to the medial border of the field, follow a monotonically and smooth decreasing function. This assumption is invalid in the presence of lung and can be used to calculate chest wall position. The algorithm was validated by determining the position of the chest wall for varying field edge positions in portal images of a thoracic phantom. The algorithm was used to quantify intra-fraction motion in cine images for 7 patients treated with DIBH. Results: Phantom results show that changes in the distance between chest wall and field edge were accurate within 0.1 mm on average. For a fixed field edge, the algorithm calculates the position of the chest wall with a 0.2 mm standard deviation. Intra-fraction motion for DIBH patients was within 1 mm 91.4% of the time and within 1.5 mm 97.9% of the time. The maximum intra-fraction motion was 3.0 mm. Conclusions: A physics based algorithm was developed and can be used to quantify the position of chest wall irradiated in tangent portal images with an accuracy of 0.1 mm and precision of 0.6 mm. Intra-fraction motion for patients treated with DIBH at our clinic is less than 3 mm.

  15. New Methods for Imaging Evaluation of Chest Wall Deformities

    Directory of Open Access Journals (Sweden)

    Ana Lain

    2017-12-01

    Full Text Available AimThe purpose of this study is to describe the development of an external 3-dimensional (3D scanner as a noninvasive method for imaging chest wall deformities. It allows objective assessment, reconstruction of the area of interest, and evaluation of the severity of the deformity by using external indexes.External 3D scanning systemThe OrtenBodyOne scanner (Orten, Lyon, France uses depth sensors to scan the entire 3D external body surface of a patient. The depth sensors combine structured light with two classic computer vision techniques: depth from focus and depth from stereo. The data acquired are processed and analyzed using the Orten-Clinic software.Materials and methodsTo investigate the performance of the device, a preliminary prospective study (January 2015–March 2016 was carried out in patients attending our hospital chest wall deformities unit. In total, 100 patients (children and young adults with pectus excavatum or pectus carinatum, treated by surgery or non-operative methods were included. In patients undergoing non-operative treatment, external 3D scanning was performed monthly until complete correction was achieved. In surgically treated patients, scanning was done before and after surgical correction. In 42 patients, computed tomography (CT was additionally performed and correlations between the Haller index calculated by CT and the external Haller index using external scanning were investigated using a Student’s test (r = 0.83.ConclusionExternal scanning is an effective, objective, radiation-free means to diagnose and follow-up patients with chest wall deformities. Externally measured indexes can be used to evaluate the severity of these conditions and the treatment outcomes.

  16. Adenocarcinoma - chest x-ray (image)

    Science.gov (United States)

    This chest x-ray shows adenocarcinoma of the lung. There is a rounded light spot in the right upper lung (left side ... density. Diseases that may cause this type of x-ray result would be tuberculous or fungal granuloma, and ...

  17. Evaluation of chest tomosynthesis for the detection of pulmonary nodules: effect of clinical experience and comparison with chest radiography

    Science.gov (United States)

    Zachrisson, Sara; Vikgren, Jenny; Svalkvist, Angelica; Johnsson, Åse A.; Boijsen, Marianne; Flinck, Agneta; Månsson, Lars Gunnar; Kheddache, Susanne; Båth, Magnus

    2009-02-01

    Chest tomosynthesis refers to the technique of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest. In this study, a comparison of chest tomosynthesis and chest radiography in the detection of pulmonary nodules was performed and the effect of clinical experience of chest tomosynthesis was evaluated. Three senior thoracic radiologists, with more than ten years of experience of chest radiology and 6 months of clinical experience of chest tomosynthesis, acted as observers in a jackknife free-response receiver operating characteristics (JAFROC-1) study, performed on 42 patients with and 47 patients without pulmonary nodules examined with both chest tomosynthesis and chest radiography. MDCT was used as reference and the total number of nodules found using MDCT was 131. To investigate the effect of additional clinical experience of chest tomosynthesis, a second reading session of the tomosynthesis images was performed one year after the initial one. The JAFROC-1 figure of merit (FOM) was used as the principal measure of detectability. In comparison with chest radiography, chest tomosynthesis performed significantly better with regard to detectability. The observer-averaged JAFROC-1 FOM was 0.61 for tomosynthesis and 0.40 for radiography, giving a statistically significant difference between the techniques of 0.21 (p<0.0001). The observer-averaged JAFROC-1 FOM of the second reading of the tomosynthesis cases was not significantly higher than that of the first reading, indicating no improvement in detectability due to additional clinical experience of tomosynthesis.

  18. Chest sonography. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Mathis, Gebhard (ed.)

    2008-07-01

    Chest sonography is an established procedure in the stepwise imaging diagnosis of pulmonary and pleural disease. It is the method of choice to distinguish between solid and liquid lesions and allows the investigator to make an unequivocal diagnosis without exposing the patient to costly and stressful procedures. This book presents the state of the art in chest investigation by means of ultrasonography. A number of excellent illustrations and the compact text provide concise and easy-to-assimilate information about the diagnostic procedure. Basic elements such as indications, investigation techniques and image artifacts are detailed in separate chapters. (orig.)

  19. Chest sonography. 2. ed.

    International Nuclear Information System (INIS)

    Mathis, Gebhard

    2008-01-01

    Chest sonography is an established procedure in the stepwise imaging diagnosis of pulmonary and pleural disease. It is the method of choice to distinguish between solid and liquid lesions and allows the investigator to make an unequivocal diagnosis without exposing the patient to costly and stressful procedures. This book presents the state of the art in chest investigation by means of ultrasonography. A number of excellent illustrations and the compact text provide concise and easy-to-assimilate information about the diagnostic procedure. Basic elements such as indications, investigation techniques and image artifacts are detailed in separate chapters. (orig.)

  20. Evaluation of image quality and radiation dose by adaptive statistical iterative reconstruction technique level for chest CT examination.

    Science.gov (United States)

    Hong, Sun Suk; Lee, Jong-Woong; Seo, Jeong Beom; Jung, Jae-Eun; Choi, Jiwon; Kweon, Dae Cheol

    2013-12-01

    The purpose of this research is to determine the adaptive statistical iterative reconstruction (ASIR) level that enables optimal image quality and dose reduction in the chest computed tomography (CT) protocol with ASIR. A chest phantom with 0-50 % ASIR levels was scanned and then noise power spectrum (NPS), signal and noise and the degree of distortion of peak signal-to-noise ratio (PSNR) and the root-mean-square error (RMSE) were measured. In addition, the objectivity of the experiment was measured using the American College of Radiology (ACR) phantom. Moreover, on a qualitative basis, five lesions' resolution, latitude and distortion degree of chest phantom and their compiled statistics were evaluated. The NPS value decreased as the frequency increased. The lowest noise and deviation were at the 20 % ASIR level, mean 126.15 ± 22.21. As a result of the degree of distortion, signal-to-noise ratio and PSNR at 20 % ASIR level were at the highest value as 31.0 and 41.52. However, maximum absolute error and RMSE showed the lowest deviation value as 11.2 and 16. In the ACR phantom study, all ASIR levels were within acceptable allowance of guidelines. The 20 % ASIR level performed best in qualitative evaluation at five lesions of chest phantom as resolution score 4.3, latitude 3.47 and the degree of distortion 4.25. The 20 % ASIR level was proved to be the best in all experiments, noise, distortion evaluation using ImageJ and qualitative evaluation of five lesions of a chest phantom. Therefore, optimal images as well as reduce radiation dose would be acquired when 20 % ASIR level in thoracic CT is applied.

  1. Magnetic resonance imaging of the chest: current and new applications, with an emphasis on pulmonology

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcel Koenigkam; Mauad, Fernando Marum, E-mail: marcelk46@yahoo.com.b [Universidade de Sao Paulo (HC/FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas; Elias Junior, Jorge; Muglia, Valdair Francisco [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Secao de Radiologia

    2011-03-15

    The objective of the present review study was to present the principal applications of magnetic resonance imaging (MRI) of the chest, including the description of new techniques. Over the past decade, this method has evolved considerably because of the development of new equipment, including the simultaneous interconnection of phased-array multiple radiofrequency receiver coils and remote control of the table movement, in addition to faster techniques of image acquisition, such as parallel imaging and partial Fourier acquisitions, as well as the introduction of new contrast agents. All of these advances have allowed MRI to gain ground in the study of various pathologies of the chest, including lung diseases. Currently, MRI is considered the modality of choice for the evaluation of lesions in the mediastinum and in the chest wall, as well as of superior sulcus tumors. However, it can also facilitate the diagnosis of lung, pleural, and cardiac diseases, as well as of those related to the pulmonary vasculature. Pulmonary MRI angiography can be used in order to evaluate various pulmonary vascular diseases, and it has played an ever greater role in the study of thromboembolism. Because cardiac MRI allows morphological and functional assessment in the same test, it has also become part of the clinical routine in the evaluation of various cardiac diseases. Finally, the role of MRI has been extended to the identification and characterization of pulmonary nodules, the evaluation of airway diseases, and the characterization of pleural effusion. (author)

  2. MRI of the Chest

    Medline Plus

    Full Text Available ... a risk, depending on their nature and the strength of the MRI magnet. Many implanted devices will ... abnormalities where Chest CT is a preferred imaging test. MR imaging can assess blood flow without risking ...

  3. MRI of the Chest

    Medline Plus

    Full Text Available ... etc.). top of page What are some common uses of the procedure? MR imaging of the chest ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  4. Image quality in children with low-radiation chest CT using adaptive statistical iterative reconstruction and model-based iterative reconstruction.

    Directory of Open Access Journals (Sweden)

    Jihang Sun

    Full Text Available OBJECTIVE: To evaluate noise reduction and image quality improvement in low-radiation dose chest CT images in children using adaptive statistical iterative reconstruction (ASIR and a full model-based iterative reconstruction (MBIR algorithm. METHODS: Forty-five children (age ranging from 28 days to 6 years, median of 1.8 years who received low-dose chest CT scans were included. Age-dependent noise index (NI was used for acquisition. Images were retrospectively reconstructed using three methods: MBIR, 60% of ASIR and 40% of conventional filtered back-projection (FBP, and FBP. The subjective quality of the images was independently evaluated by two radiologists. Objective noises in the left ventricle (LV, muscle, fat, descending aorta and lung field at the layer with the largest cross-section area of LV were measured, with the region of interest about one fourth to half of the area of descending aorta. Optimized signal-to-noise ratio (SNR was calculated. RESULT: In terms of subjective quality, MBIR images were significantly better than ASIR and FBP in image noise and visibility of tiny structures, but blurred edges were observed. In terms of objective noise, MBIR and ASIR reconstruction decreased the image noise by 55.2% and 31.8%, respectively, for LV compared with FBP. Similarly, MBIR and ASIR reconstruction increased the SNR by 124.0% and 46.2%, respectively, compared with FBP. CONCLUSION: Compared with FBP and ASIR, overall image quality and noise reduction were significantly improved by MBIR. MBIR image could reconstruct eligible chest CT images in children with lower radiation dose.

  5. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    International Nuclear Information System (INIS)

    Mahmoud, Mohamed; Towe, Christopher; Fleck, Robert J.

    2015-01-01

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  6. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    Energy Technology Data Exchange (ETDEWEB)

    Mahmoud, Mohamed [Cincinnati Children' s Hospital Medical Center, Department of Anesthesiology, Cincinnati, OH (United States); Towe, Christopher [Cincinnati Children' s Hospital Medical Center, Department of Pulmonary Medicine, Cincinnati, OH (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2015-07-15

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  7. Adsorption of technetium-99m tetrofosmin and technetium-99m furifosmin on plastic syringes

    Energy Technology Data Exchange (ETDEWEB)

    Bartosch, R.; Granegger, S.; Sinzinger, H. [Department of Nuclear Medicine, University of Vienna (Austria)

    1998-09-01

    Some groups have reported that adsorption of radiopharmaceuticals on disposable plastic syringes can reach levels of almost 50%. This high loss of radioactivity stimulated us to carry out similar studies. Our measurements were done in combination with patient studies. Therefore, we used 2-ml syringes, all of the same brand. The radioactivity in the syringe was measured immediately before and after injection. a total of 500-600 MBq technetium-99m labelled tetrofosmin or technetium-99m furifosmin was administered to 48 patients using four different injection techniques (n = 6 for each technique with each tracer): with needles, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer; with butterflies, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer. Neither in syringes nor in needles or butterflies did more than 7% of the initial radioactivity remain. The entire residual activity in syringe plus needle or syringe plus butterfly together never exceeded the 9% limit. Furthermore, in a pilot study we measured the remaining radioactivity in the vial; here, too, we found no more than 14% of total radioactivity. These findings indicate that total retention of radioactivity during elution and application of {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin with material used in our setting does not approach relevant amounts. (orig.) With 4 figs., 1 tab., 7 refs.

  8. Study of two novel large-field-of-view image intensifiers versus conventional chest radiography with use of FROC methods and simulated pulmonary nodules

    International Nuclear Information System (INIS)

    Winter, L.H.L.; Chakraborty, D.P.; Van Waes, P.F.G.M.; Puylaert, C.B.A.J.

    1989-01-01

    Two novel large-field-of-view image intensifier (LFOV 1.1) tubes have been introduced whose image area makes them suitable for chest imaging. Both modalities present a 100-mm hard-copy image to the radiologist. A pulmonary nodule performance experiment was done to compare the diagnostic accuracy of these tubes with conventional full-size chest images. The data were analyzed with the maximum-likelihood FROCFIT program. The relative ranking in terms of decreasing A1 values was TLX, Siemens 43-cm mode, conventional radiography, and Siemens 57-cm mode

  9. MRI of the Chest

    Medline Plus

    Full Text Available ... body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various ... seen by other imaging modalities, such as chest x-ray or CT. A special form of MRI called ...

  10. Chest wall segmentation in automated 3D breast ultrasound scans.

    Science.gov (United States)

    Tan, Tao; Platel, Bram; Mann, Ritse M; Huisman, Henkjan; Karssemeijer, Nico

    2013-12-01

    In this paper, we present an automatic method to segment the chest wall in automated 3D breast ultrasound images. Determining the location of the chest wall in automated 3D breast ultrasound images is necessary in computer-aided detection systems to remove automatically detected cancer candidates beyond the chest wall and it can be of great help for inter- and intra-modal image registration. We show that the visible part of the chest wall in an automated 3D breast ultrasound image can be accurately modeled by a cylinder. We fit the surface of our cylinder model to a set of automatically detected rib-surface points. The detection of the rib-surface points is done by a classifier using features representing local image intensity patterns and presence of rib shadows. Due to attenuation of the ultrasound signal, a clear shadow is visible behind the ribs. Evaluation of our segmentation method is done by computing the distance of manually annotated rib points to the surface of the automatically detected chest wall. We examined the performance on images obtained with the two most common 3D breast ultrasound devices in the market. In a dataset of 142 images, the average mean distance of the annotated points to the segmented chest wall was 5.59 ± 3.08 mm. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Influence of 'optical illusion' on the detectability of pneumothorax in diagnosis for chest CT images. Substantiation by visual psychological simulation images

    International Nuclear Information System (INIS)

    Henmi, Shuichi

    2008-01-01

    Some cases have been reported in which an optical illusion of lightness perception influences the detectability in diagnosis of low-density hematoma in head CT images in addition to the visual impression of the photographic density of the brain. Therefore, in this study, the author attempted to compare the detectability in diagnosis for chest images with pneumothorax using visual subjective evaluation, and investigated the influence of optical illusion on that detectability in diagnosis. Results indicated that in the window setting of lung, on such an occasion when the low-absorption free space with pneumothorax forms a crescent or the reduced lung borders on the chest-wall, an optical illusion in which the visual impression on the difference of the film contrast between the lung and the low-absorption free space with pneumothorax was psychologically emphasized when contrast was observed. In all cases the detectability in diagnosis for original images with the white thorax and mediastinum was superior to virtual images. Further, in case of the virtual double window setting of lung, thorax, and mediastinum, under the influence of the difference in the radiological anatomy of thorax and mediastinum as a result of the grouping theories of lightness computation, an optical illusion different from the original images was observed. (author)

  12. Evaluation of the impact of organ-specific dose reduction on image quality in pediatric chest computed tomography

    International Nuclear Information System (INIS)

    Boos, Johannes; Kroepil, Patric; Klee, Dirk; Heusch, Philipp; Schimmoeller, Lars; Schaper, Joerg; Antoch, Gerald; Lanzman, Rotem S.

    2014-01-01

    Organ-specific dose reduction significantly reduces the radiation exposure of radiosensitive organs. The purpose of this study was to assess the impact of a novel organ-specific dose reduction algorithm on image quality of pediatric chest CT. We included 28 children (mean age 10.9 ± 4.8 years, range 3-18 years) who had contrast-enhanced chest CT on a 128-row scanner. CT was performed at 100 kV using automated tube current modulation and a novel organ-specific dose-reduction algorithm (XCare trademark; Siemens, Forchheim, Germany). Seven children had a previous chest CT performed on a 64-row scanner at 100 kV without organ-specific dose reduction. Subjective image quality was assessed using a five-point scale (1-not diagnostic; 5-excellent). Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were assessed in the descending aorta. Overall mean subjective image quality was 4.1 ± 0.6. In the subgroup of the seven children examined both with and without organ-specific dose reduction, subjective image quality was comparable (score 4.4 ± 0.5 with organ-specific dose reduction vs. 4.4 ± 0.7 without it; P > 0.05). There was no significant difference in mean signal-to-noise ratio and contrast-to-noise ratio with organ-specific dose reduction (38.3 ± 10.1 and 28.5 ± 8.7, respectively) and without the reduction (35.5 ± 8.5 and 26.5 ± 7.8, respectively) (P > 0.05). Volume computed tomography dose index (CTDI vol ) and size-specific dose estimates did not differ significantly between acquisitions with the organ-specific dose reduction (1.7 ± 0.8 mGy) and without the reduction (1.7 ± 0.8 mGy) (P > 0.05). Organ-specific dose reduction does not have an impact on image quality of pediatric chest CT and can therefore be used in clinical practice to reduce radiation dose of radiosensitive organs such as breast and thyroid gland. (orig.)

  13. MRI of the Chest

    Medline Plus

    Full Text Available ... internal body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various ... seen by other imaging modalities, such as chest x-ray or CT. A special form of MRI called ...

  14. Dual-source CT in chest pain diagnosis

    International Nuclear Information System (INIS)

    Johnson, Thorsten R.C.; Nikolaou, K.; Fink, C.; Rist, C.; Reiser, M.F.; Becker, C.R.; Becker, A.; Knez, A.

    2007-01-01

    With the depiction of pulmonary arteries, coronary arteries, and the aorta, CT angiography of the chest offers a comprehensive diagnostic work-up of unclear chest pain. The aim of this study was to assess the diagnostic accuracy of dual-source CT in this patient group. A total of 47 patients suffering from unclear chest pain were examined with a Siemens Somatom Definition. Volume and flow of contrast media (Ultravist, Schering) were adapted to the body weight. The examinations were evaluated with regard to image quality and contrast opacification and to the diagnostic accuracy with reference to the final clinical diagnosis. Adequate contrast opacification was achieved in all examinations. The depiction of the coronary arteries was diagnostic in all cases. The cause of chest pain could be identified in 41 cases. Among the diagnoses were coronary and myocardial pathologies, valvular disease, aortic aneurysms and dissections, pulmonary embolism, and pneumonic consolidation. DSCT angiography of the chest offers a very good image quality even at high heart rates so that a high diagnostic accuracy is achieved in patients with acute chest pain. (orig.) [de

  15. Enterogastroesophageal reflux detected on 99m-technetium sestamibi cardiac imaging as a cause of chest pain

    International Nuclear Information System (INIS)

    Erdogan, Zeynep; Silov, Güler; Özdal, Aysegül; Turhal, Özgül

    2013-01-01

    Myocardial perfusion imaging (MPI) with technetium-99m sestamibi ( 99m Tc MIBI) is considered a diagnostic technique that is widely used for the investigation of suspected coronary artery disease. Incidental inspection of an extracardiac activity is indirect, but important marker, which can identify a potentially treatable non-coronary cause for chest pain that may mimic cardiac symptoms. Here, we present an illustrative case in which significant enterogastroesophageal reflux of 99m Tc MIBI occurred during the cardiac imaging following prompt hepatobiliary clearance. Because, there was normal myocardial perfusion on MPI, presence of gastroesophageal reflux (GER) on GER scintigraphy and detection of mild inflammation with pathologically confirmed hyperplastic polyp by endoscopy, in view of the above findings we concluded that the probable cause of chest pain was reflux. (author)

  16. Survey of image quality and radiographic technique of pediatric chest examinations performed in Latin America

    International Nuclear Information System (INIS)

    Khoury, H.; Mora, P.; Defaz, M.Y.; Blanco, S.; Leyton, F.; Benavente, T.; Ortiz Lopez, P.; Ramirez, R.

    2008-01-01

    This work presents the results of a survey of entrance surface air kerma values (K e ), image quality and radiographic exposure parameters used in pediatric chest examinations performed in Latin America. This study is part of the activities of the IAEA Regional Project RLA/9/057 whose objective is to optimize the radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy. The survey was performed in nine hospitals in Argentina (1), Brazil (4), Chile (1), Costa Rica (1), Peru (1) and Ecuador (1). The study group consisted of 462 pediatric patients (Group I- from two days to one year, Group II- from four to six years of age) undergoing chest PA/AP examinations. At the time of the examination the exposure parameters (kVp, mAs, focal-spot-to-film distance, etc.) and patient information (gender, height, weight and age) were recorded. The radiographic image quality was evaluated by the local radiologist based on the European Guidelines on Quality Criteria for Diagnostic Radiographic Images in Pediatrics. The results showed that the exposure parameters used on newborn patients were in the majority outside the 60-65kV range recommended by the European Guidelines for a good radiographic practice. In the case of examinations of patients with age between 4 to 6 years, 80% were performed with a peak tube voltage within the 60-80 kV range, as recommended by the European Guidelines. It was found that none of countries fully comply with the European Guidelines on Quality Criteria and those criteria No. 2 and No. 3 (reproduction of the chest without rotation) received the lowest scores. Probably this occurs because there are no proper patient immobilization devices. The Ke values, for both patient groups, showed a wide dispersion, ranged from 10 μGy to 160μGy for the newborn patients and from 20μGy to 240μGy for infant patients. It is possible to conclude that, in the participating Latin American countries on this project

  17. Two K versus 4 K storage phosphor chest radiography: detection performance and image quality

    NARCIS (Netherlands)

    Koelblinger, Claus; Prokop, Mathias; Weber, Michael; Sailer, Johannes; Cartes-Zumelzu, Fabiola; Schaefer-Prokop, Cornelia

    2007-01-01

    The purpose of this study was to evaluate the effect of matrix size (4-K versus 2-K) in digital storage phosphor chest radiographs on image quality and on the detection of CT-proven thoracic abnormalities. In 85 patients who underwent a CT of the thorax, we obtained two additional posteroanterior

  18. Assessment of noise reduction potential and image quality improvement of a new generation adaptive statistical iterative reconstruction (ASIR-V) in chest CT.

    Science.gov (United States)

    Tang, Hui; Yu, Nan; Jia, Yongjun; Yu, Yong; Duan, Haifeng; Han, Dong; Ma, Guangming; Ren, Chenglong; He, Taiping

    2018-01-01

    To evaluate the image quality improvement and noise reduction in routine dose, non-enhanced chest CT imaging by using a new generation adaptive statistical iterative reconstruction (ASIR-V) in comparison with ASIR algorithm. 30 patients who underwent routine dose, non-enhanced chest CT using GE Discovery CT750HU (GE Healthcare, Waukesha, WI) were included. The scan parameters included tube voltage of 120 kVp, automatic tube current modulation to obtain a noise index of 14HU, rotation speed of 0.6 s, pitch of 1.375:1 and slice thickness of 5 mm. After scanning, all scans were reconstructed with the recommended level of 40%ASIR for comparison purpose and different percentages of ASIR-V from 10% to 100% in a 10% increment. The CT attenuation values and SD of the subcutaneous fat, back muscle and descending aorta were measured at the level of tracheal carina of all reconstructed images. The signal-to-noise ratio (SNR) was calculated with SD representing image noise. The subjective image quality was independently evaluated by two experienced radiologists. For all ASIR-V images, the objective image noise (SD) of fat, muscle and aorta decreased and SNR increased along with increasing ASIR-V percentage. The SD of 30% ASIR-V to 100% ASIR-V was significantly lower than that of 40% ASIR (p ASIR-V reconstructions had good diagnostic acceptability. However, the 50% ASIR-V to 70% ASIR-V series showed significantly superior visibility of small structures when compared with the 40% ASIR and ASIR-V of other percentages (p ASIR-V was the best series of all ASIR-V images, with a highest subjective image quality. The image sharpness was significantly decreased in images reconstructed by 80% ASIR-V and higher. In routine dose, non-enhanced chest CT, ASIR-V shows greater potential in reducing image noise and artefacts and maintaining image sharpness when compared to the recommended level of 40%ASIR algorithm. Combining both the objective and subjective evaluation of images, non

  19. MRI of the Chest

    Medline Plus

    Full Text Available ... transplant, it will be necessary to perform a blood test to determine whether the kidneys are functioning adequately. ... abnormalities where Chest CT is a preferred imaging test. MR imaging can assess blood flow without risking the side effects of conventional ( ...

  20. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning.

    Science.gov (United States)

    van Ginneken, Bram

    2017-03-01

    Half a century ago, the term "computer-aided diagnosis" (CAD) was introduced in the scientific literature. Pulmonary imaging, with chest radiography and computed tomography, has always been one of the focus areas in this field. In this study, I describe how machine learning became the dominant technology for tackling CAD in the lungs, generally producing better results than do classical rule-based approaches, and how the field is now rapidly changing: in the last few years, we have seen how even better results can be obtained with deep learning. The key differences among rule-based processing, machine learning, and deep learning are summarized and illustrated for various applications of CAD in the chest.

  1. Radiation dose and image quality in pediatric chest CT: effects of iterative reconstruction in normal weight and overweight children

    International Nuclear Information System (INIS)

    Yoon, Haesung; Kim, Myung-Joon; Shin, Hyun Joo; Kim, Hyun Gi; Lee, Mi-Jung; Yoon, Choon-Sik; Choi, Jiin

    2015-01-01

    New CT reconstruction techniques may help reduce the burden of ionizing radiation. To quantify radiation dose reduction when performing pediatric chest CT using a low-dose protocol and 50% adaptive statistical iterative reconstruction (ASIR) compared with age/gender-matched chest CT using a conventional dose protocol and reconstructed with filtered back projection (control group) and to determine its effect on image quality in normal weight and overweight children. We retrospectively reviewed 40 pediatric chest CT (M:F = 21:19; range: 0.1-17 years) in both groups. Radiation dose was compared between the two groups using paired Student's t-test. Image quality including noise, sharpness, artifacts and diagnostic acceptability was subjectively assessed by three pediatric radiologists using a four-point scale (superior, average, suboptimal, unacceptable). Eight children in the ASIR group and seven in the control group were overweight. All radiation dose parameters were significantly lower in the ASIR group (P < 0.01) with a greater than 57% dose reduction in overweight children. Image noise was higher in the ASIR group in both normal weight and overweight children. Only one scan in the ASIR group (1/40, 2.5%) was rated as diagnostically suboptimal and there was no unacceptable study. In both normal weight and overweight children, the ASIR technique is associated with a greater than 57% mean dose reduction, without significantly impacting diagnostic image quality in pediatric chest CT examinations. However, CT scans in overweight children may have a greater noise level, even when using the ASIR technique. (orig.)

  2. Radiation dose and image quality in pediatric chest CT: effects of iterative reconstruction in normal weight and overweight children

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Haesung; Kim, Myung-Joon; Shin, Hyun Joo; Kim, Hyun Gi; Lee, Mi-Jung [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Seoul (Korea, Republic of); Yoon, Choon-Sik [Yonsei University College of Medicine, Department of Radiology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Choi, Jiin [Yonsei University College of Medicine, Biostatistics Collaboration Unit, Seoul (Korea, Republic of)

    2015-03-01

    New CT reconstruction techniques may help reduce the burden of ionizing radiation. To quantify radiation dose reduction when performing pediatric chest CT using a low-dose protocol and 50% adaptive statistical iterative reconstruction (ASIR) compared with age/gender-matched chest CT using a conventional dose protocol and reconstructed with filtered back projection (control group) and to determine its effect on image quality in normal weight and overweight children. We retrospectively reviewed 40 pediatric chest CT (M:F = 21:19; range: 0.1-17 years) in both groups. Radiation dose was compared between the two groups using paired Student's t-test. Image quality including noise, sharpness, artifacts and diagnostic acceptability was subjectively assessed by three pediatric radiologists using a four-point scale (superior, average, suboptimal, unacceptable). Eight children in the ASIR group and seven in the control group were overweight. All radiation dose parameters were significantly lower in the ASIR group (P < 0.01) with a greater than 57% dose reduction in overweight children. Image noise was higher in the ASIR group in both normal weight and overweight children. Only one scan in the ASIR group (1/40, 2.5%) was rated as diagnostically suboptimal and there was no unacceptable study. In both normal weight and overweight children, the ASIR technique is associated with a greater than 57% mean dose reduction, without significantly impacting diagnostic image quality in pediatric chest CT examinations. However, CT scans in overweight children may have a greater noise level, even when using the ASIR technique. (orig.)

  3. Chest X-Ray (Chest Radiography)

    Science.gov (United States)

    ... Resources Professions Site Index A-Z X-ray (Radiography) - Chest Chest x-ray uses a very small dose ... Radiography? What is a Chest X-ray (Chest Radiography)? The chest x-ray is the most commonly performed diagnostic ...

  4. Myocardial uptake characteristics of three 99mTc-labeled tracers for myocardial perfusion imaging one hour after rest injection

    International Nuclear Information System (INIS)

    Manka-Waluch, A.; Palmedo, H.; Reinhardt, M.J.; Joe, A.Y.; Manka, C.; Guhlke, S.; Biersack, H.J.; Bucerius, J.

    2006-01-01

    99m Tc-tetrofosmin and 99m Tc-sestamibi are approved tracers for myocardial perfusion studies. Recently, a 99m Tc-methoxyisobutylisonitrile (MIBI) preparation from a different manufacturer ( 99m Tc-cardiospect-MIBI) has been introduced to the market. Therefore, the aim of this study was the evaluation of 99m Tc-tetrofosmin as well as of two different 99m Tc-labeled MIBI tracers with regard to differences in imaging quality under resting conditions. Sixty patients (mean age 63.8 years±1.25) with known or suspected coronary artery disease but without evidence of rest-ischemia were included. Twenty patients in each group were examined by a two-day-rest-stress protocol using the three 99m Tc-labeled tracers. Visual analysis of all images was performed by two experienced physicians blinded with regard to the applied tracer. Regions of interest (ROI) were defined over the heart, lung and whole body only in the rest imaging in order to calculate heart-to-lung, lung-to-whole body-, and heart-to-whole body-ratios. The heart-to-lung ratio was statistically significant higher for 99 m T c-cardiospect-MIBI as compared to 99m Tc-sestamibi as well as to 99m Tc-tetrofosmin. Furthermore, a significantly higher heart-to-lung ratio was found for 99m Tc-sestamibi as compared to 99m Tc-tetrofosmin. The heart-to-whole body-ratio and the lung-to-whole body-ratio were equivalent between all tracers. Visual analysis revealed only slight differences regarding image quality between all tracers. ROI analysis surprisingly revealed a significant higher myocardial uptake and consequently a higher heart-to-lung ratio for 99m Tc-cardiospect-MIBI. Whether this leads to a better visual image quality has to be evaluated in future studies with larger study populations as well as semiquantitative segmental analysis of the myocardial perfusion images. (author)

  5. Digital radiography of the chest

    International Nuclear Information System (INIS)

    Sakurai, Kenji; Hachiya, Junichi; Korenaga, Tateo; Nitatori, Toshiaki; Miyasaka, Yasuo; Furuya, Yoshiro

    1984-01-01

    Initial clinical experience in digital chest radiography utilizing photostimulable phosphor and scanning laser stimulated luminescence was reported. Image quality of conventional film/screen radiography and digital radiography was compared in 30 normal cases. Reflecting wide dynamic range of the system, improved image quality was confirmed in all 30 cases, particularly in visibility of various mediastinal structures and pulmonary vessels. High sensor sensitivity of the system enabled digital radiography to reduce radiation dose requirement significantly. Diagnostically acceptable chest images were obtained with approximately 1/5 of routine dose for conventional radiography without significant image quality degradation. Some artifact created by digital processing were mostly overcome by a routine use of simultaneous display of two different types of image processing and therefore was not an actual drawback from diagnostic standpoint. Further technical advancement of the system to be seen for digital storage, retrieval and tranceference of images. (author)

  6. Comparison of clinical and physical measures of image quality in chest and pelvis computed radiography at different tube voltages

    International Nuclear Information System (INIS)

    Sandborg, Michael; Tingberg, Anders; Ullman, Gustaf; Dance, David R.; Alm Carlsson, Gudrun

    2006-01-01

    The aim of this work was to study the dependence of image quality in digital chest and pelvis radiography on tube voltage, and to explore correlations between clinical and physical measures of image quality. The effect on image quality of tube voltage in these two examinations was assessed using two methods. The first method relies on radiologists' observations of images of an anthropomorphic phantom, and the second method was based on computer modeling of the imaging system using an anthropomorphic voxel phantom. The tube voltage was varied within a broad range (50-150 kV), including those values typically used with screen-film radiography. The tube charge was altered so that the same effective dose was achieved for each projection. Two x-ray units were employed using a computed radiography (CR) image detector with standard tube filtration and antiscatter device. Clinical image quality was assessed by a group of radiologists using a visual grading analysis (VGA) technique based on the revised CEC image criteria. Physical image quality was derived from a Monte Carlo computer model in terms of the signal-to-noise ratio, SNR, of anatomical structures corresponding to the image criteria. Both the VGAS (visual grading analysis score) and SNR decrease with increasing tube voltage in both chest PA and pelvis AP examinations, indicating superior performance if lower tube voltages are employed. Hence, a positive correlation between clinical and physical measures of image quality was found. The pros and cons of using lower tube voltages with CR digital radiography than typically used in analog screen-film radiography are discussed, as well as the relevance of using VGAS and quantum-noise SNR as measures of image quality in pelvis and chest radiography

  7. Effects of optimization and image processing in digital chest radiography

    International Nuclear Information System (INIS)

    Kheddache, S.; Maansson, L.G.; Angelhed, J.E.; Denbratt, L.; Gottfridsson, B.; Schlossman, D.

    1991-01-01

    A digital system for chest radiography based on a large image intensifier was compared to a conventional film-screen system. The digital system was optimized with regard to spatial and contrast resolution and dose. The images were digitally processed for contrast and edge enhancement. A simulated pneumothorax and two and two simulated nodules were positioned over the lungs and the mediastinum of an anthro-pomorphic phantom. Observer performance was evaluated with Receiver Operating Characteristic (ROC) analysis. Five observers assessed the processed digital images and the conventional full-size radiographs. The time spent viewing the full-size radiographs and the digital images was recorded. For the simulated pneumothorax, the results showed perfect performance for the full-size radiographs and detectability was high also for the processed digital images. No significant differences in the detectability of the simulated nodules was seen between the two imaging systems. The results for the digital images showed a significantly improved detectability for the nodules in the mediastinum as compared to a previous ROC study where no optimization and image processing was available. No significant difference in detectability was seen between the former and the present ROC study for small nodules in the lung. No difference was seen in the time spent assessing the conventional full-size radiographs and the digital images. The study indicates that processed digital images produced by a large image intensifier are equal in image quality to conventional full-size radiographs for low-contrast objects such as nodules. (author). 38 refs.; 4 figs.; 1 tab

  8. Radiation doses and image quality in pediatric chest X-ray for the diagnosis of pneumonia in selected Latin American countries

    International Nuclear Information System (INIS)

    Jimenez, P.; Fleitas, I.; Cotelo, E.; Estevan, M.

    2008-01-01

    Full text: Pneumonia and acute lower respiratory infections in general, is the leading cause of child death in developing countries. According to the World Health Organization (WHO), 4 millions of children die annually due to this disease. Despite the growing use of vaccination as an alternate approach to reduce mortality, the increasing antimicrobial resistance and the high costs of vaccines remain important obstacles in the global struggle against the disease. The usual treatment strategy begins with a clinical examination of the patient followed by the prescription of a chest X-ray. Radiography would appear as the best available method for diagnosing pneumonia only if radiologists (and other health professionals such as pediatricians) knew how to interpret the images showed in the radiographs, and these meeting the standards of quality (anatomic structures, image contrast and optical density, and patient dose among other factors). On the other hand, special attention should be paid on patient doses due to children's specific radiosensitivity, repeated and extended use of chest x-ray in all Radiology Departments, and high rejection rate due to both equipment malfunction and to human skills shortcomings. Patient doses of chest X-ray performed to children less than 5 years old in PAHO Sentinel Hospitals for surveillance of bacterial pneumonias in various Latin American countries were estimated using technical parameters and equipment specifications. Image quality was compared to WHO criteria for chest X-rays quality. Results showing differences in patient doses translates on one hand the impact of specific characteristics of the radiological equipment, including equipment limitations and performance of the radiographs and on the other various and divers levels of health professionals skills and training on image quality interpretation and dose optimization. The study concludes that professionals' training and education on chest radiographs image quality constitutes

  9. Digital radiography of the chest: state of the art

    International Nuclear Information System (INIS)

    Souto, M.; Malagari, K.S.; Tucker, D.; Tahoces, P.G.; Correa, J.; Benakis, V.S.; Roussos, C.; Strigaris, K.A.; Vidal, J.J.; Barnes, G.T.; Fraser, R.G.

    1994-01-01

    Digital image acquisition possesses a number of advantages over conventional systems in radiographic examination of the chest, the most important of which is its greater dynamic range. In addition, once digital images are acquired, they can be processed by computer in ways that cannot be rivalled by conventional analog techniques. Finally, digital images can be stored, retrieved and transmitted to local or remote sites. Here the status of the different digital systems employed in chest radiology and commonly used image processing techniques are reviewed. Also discussed are the current clinical applications of integrating digital chest radiography with a picture archiving and communication system (PACS) along with the difficulties typically encountered. Studies with a variety of digital techniques have been carried out on several fronts. Computed radiography based on photostimulable phosphor (CR) has replaced screen-film imaging in certain applications (i.e. bedside imaging). However, CR has limitations, namely its poor X-ray utilisation efficiency at high X-ray tube voltages and sensitivity to scatter; therefore, it is not ideal for all applications. Recently, a dedicated digital chest unit with excellent X-ray utilisation efficiency at high X-ray tube potentials has been introduced. On the basis of the state-of-the-art capabilities and research during the past decade, recommendations are made regarding the most desirable equipment specifications for dedicated and bedside digital chest radiography. (orig.)

  10. Acute chest pain: The role of MR imaging and MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hunold, Peter, E-mail: peter.hunold@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany); Bischoff, Peter, E-mail: peter.bischoff@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany); Barkhausen, Jörg, E-mail: joerg.barkhausen@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany); Vogt, Florian M., E-mail: florian.vogt@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany)

    2012-12-15

    MR imaging (MRI) and MR angiography (MRA) have gained a high level of diagnostic accuracy in cardiovascular disease. MRI in cardiac disease has been established as the non-invasive standard of reference in many pathologies. However, in acute chest pain the situation is somewhat special since many of the patients presenting in the emergency department suffer from potentially life-threatening disease including acute coronary syndrome, pulmonary embolism, and acute aortic syndrome. Those patients need a fast and definitive evaluation under continuous monitoring of vital parameters. Due to those requirements MRI seems to be less suitable compared to X-ray coronary angiography and multislice computed tomography angiography (CTA). However, MRI allows for a comprehensive assessment of all clinically stable patients providing unique information on the cardiovascular system including ischemia, inflammation and function. Furthermore, MRI and MRA are considered the method of choice in patients with contraindications to CTA and for regular follow-up in known aortic disease. This review addresses specific features of MRI and MRA for different cardiovascular conditions presenting with acute chest pain.

  11. Nodule detection in digital chest radiography: Introduction to the radius chest trial

    International Nuclear Information System (INIS)

    Baath, M.; Haakansson, M.; Boerjesson, S.; Kheddache, S.; Grahn, A.; Ruschin, M.; Tingberg, A.; Mattsson, S.; Maansson, L. G.

    2005-01-01

    Most digital radiographic systems of today have wide latitude and are hence able to provide images with a small constraint on dose level. This opens up for an unprejudiced dose optimisation. However, in order to succeed in the optimisation task, good knowledge of the imaging and detection processes is needed. As a part of the European-wide research project 'unification of physical and clinical requirements for medical X-ray imaging - governed by the Radiological Imaging Unification Strategies (RADIUS) Group - a major image quality trial was conducted by members of the group. The RADIUS chest trial was focused on the detection of lung nodules in digital chest radiography with the aims of determining to what extent (1) the detection of a nodule is dependent on its location, (2) the system noise disturbs the detection of lung nodules, (3) the anatomical noise disturbs the detection of lung nodules and (4) the image background and anatomical background act as pure noise for the detection of lung nodules. The purpose of the present paper is to give an introduction to the trial and describe the framework and set-up of the investigation. (authors)

  12. The methods for detecting multiple small nodules from 3D chest X-ray CT images

    International Nuclear Information System (INIS)

    Hayase, Yosuke; Mekada, Yoshito; Mori, Kensaku; Toriwaki, Jun-ichiro; Natori, Hiroshi

    2004-01-01

    This paper describes a method for detecting small nodules, whose CT values and diameters are more than -600 Hounsfield unit (H.U.) and 2 mm, from three-dimensional chest X-ray CT images. The proposed method roughly consists of two submodules: initial detection of nodule candidates by discriminating between nodule regions and other regions such as blood vessels or bronchi using a shape feature computed from distance values inside the regions and reduction of false positive (FP) regions by using a minimum directional difference filter called minimum directional difference filter (Min-DD) changing its radius suit to the size of the initial candidates. The performance of the proposed method was evaluated by using seven cases of chest X-ray CT images including six abnormal cases where multiple lung cancers are observed. The experimental results for nodules (361 regions in total) showed that sensitivity and FP regions are 71% and 7.4 regions in average per case. (author)

  13. Tuberculosis, advanced - chest x-rays (image)

    Science.gov (United States)

    Tuberculosis is an infectious disease that causes inflammation, the formation of tubercules and other growths within tissue, ... death. These chest x-rays show advanced pulmonary tuberculosis. There are multiple light areas (opacities) of varying ...

  14. A review of 99mTc labeled myocardial imaging agents for tumor-positive imaging

    International Nuclear Information System (INIS)

    Xing Shian; Zhang Yongxue; An Rui

    2002-01-01

    The tumor-positive imaging with high sensitivity and specificity was useful in primary tumor and recurrences and metastases. The 99m Tc labeled myocardial imaging agents are easily available and stable and the radiochemical purity is high. 99m Tc is the preferred choice in routine works because its physical properties. The preparation, quality control, mechanism of accumulation and the clinical use of 99m Tc-sestamibi, 99m Tc-tetrofosmin, 99m Tc-furifosmin, and 99m Tc-N-NOET were reviewed

  15. Temporal subtraction of dual-energy chest radiographs

    International Nuclear Information System (INIS)

    Armato, Samuel G. III; Doshi, Devang J.; Engelmann, Roger; Caligiuri, Philip; MacMahon, Heber

    2006-01-01

    Temporal subtraction and dual-energy imaging are two enhanced radiography techniques that are receiving increased attention in chest radiography. Temporal subtraction is an image processing technique that facilitates the visualization of pathologic change across serial chest radiographic images acquired from the same patient; dual-energy imaging exploits the differential relative attenuation of x-ray photons exhibited by soft-tissue and bony structures at different x-ray energies to generate a pair of images that accentuate those structures. Although temporal subtraction images provide a powerful mechanism for enhancing visualization of subtle change, misregistration artifacts in these images can mimic or obscure abnormalities. The purpose of this study was to evaluate whether dual-energy imaging could improve the quality of temporal subtraction images. Temporal subtraction images were generated from 100 pairs of temporally sequential standard radiographic chest images and from the corresponding 100 pairs of dual-energy, soft-tissue radiographic images. The registration accuracy demonstrated in the resulting temporal subtraction images was evaluated subjectively by two radiologists. The registration accuracy of the soft-tissue-based temporal subtraction images was rated superior to that of the conventional temporal subtraction images. Registration accuracy also was evaluated objectively through an automated method, which achieved an area-under-the-ROC-curve value of 0.92 in the distinction between temporal subtraction images that demonstrated clinically acceptable and clinically unacceptable registration accuracy. By combining dual-energy soft-tissue images with temporal subtraction, misregistration artifacts can be reduced and superior image quality can be obtained

  16. Should the lateral chest radiograph be routinely performed?

    International Nuclear Information System (INIS)

    Osman, Fatuma; Williams, Imelda

    2014-01-01

    Background: The chest x-ray is one of the most common plain film radiographic examinations performed. Inclusion of the lateral chest radiograph varies internationally and nationally across radiology departments and states in Australia. Search strategy: A search strategy of the databases Cochrane Library, Ovid Medline/Medline, PubMed, Scopus and Science Direct was conducted. The results were restricted to those published between 1985 and 2013 and those published in English. The following search terms were used: ‘lateral chest’, ‘radiograph’, ‘digital radiography’, ‘chest x-ray’, ‘plain film radiography’, ‘ionising radiation’. The results were restricted to publications with these terms in the title, abstract and/or keywords. Main findings: There are few national or international guidelines pertaining to the inclusion of the lateral chest x-ray as routine. Primary concerns are the increased radiation dose associated with the additional chest view and reduction of medical imaging services cost. Modern digital imaging systems result in a lower radiation dose. The diagnostic yield of the lateral chest x-ray is highly dependent on the clinical indications of the patient. Further research into the routine inclusion of the lateral chest x-ray is recommended. Conclusion: Review of the literature suggests that the lateral chest radiograph should not be performed routinely unless clinically indicated

  17. Computed tomography of the chest with model-based iterative reconstruction using a radiation exposure similar to chest X-ray examination: preliminary observations

    Energy Technology Data Exchange (ETDEWEB)

    Neroladaki, Angeliki; Botsikas, Diomidis; Boudabbous, Sana; Becker, Christoph D.; Montet, Xavier [Geneva University Hospital, Department of Radiology, Geneva 4 (Switzerland)

    2013-02-15

    The purpose of this study was to assess the diagnostic image quality of ultra-low-dose chest computed tomography (ULD-CT) obtained with a radiation dose comparable to chest radiography and reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR) in comparison with standard dose diagnostic CT (SDD-CT) or low-dose diagnostic CT (LDD-CT) reconstructed with FBP alone. Unenhanced chest CT images of 42 patients acquired with ULD-CT were compared with images obtained with SDD-CT or LDD-CT in the same examination. Noise measurements and image quality, based on conspicuity of chest lesions on all CT data sets were assessed on a five-point scale. The radiation dose of ULD-CT was 0.16 {+-} 0.006 mSv compared with 11.2 {+-} 2.7 mSv for SDD-CT (P < 0.0001) and 2.7 {+-} 0.9 mSv for LDD-CT. Image quality of ULD-CT increased significantly when using MBIR compared with FBP or ASIR (P < 0.001). ULD-CT reconstructed with MBIR enabled to detect as many non-calcified pulmonary nodules as seen on SDD-CT or LDD-CT. However, image quality of ULD-CT was clearly inferior for characterisation of ground glass opacities or emphysema. Model-based iterative reconstruction allows detection of pulmonary nodules with ULD-CT with radiation exposure in the range of a posterior to anterior (PA) and lateral chest X-ray. (orig.)

  18. Chest X-Ray

    Medline Plus

    Full Text Available ... Disorders Video: The Basketball Game: An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, I’m Dr. Geoffrey ...

  19. Computed radiography versus mobile direct radiography for bedside chest radiographs: Impact of dose on image quality and reader agreement

    International Nuclear Information System (INIS)

    De Boo, D.W.; Weber, M.; Deurloo, E.E.; Streekstra, G.J.; Freling, N.J.; Dongelmans, D.A.; Schaefer-Prokop, C.M.

    2011-01-01

    Aim: To asses the image quality and potential for dose reduction of mobile direct detector (DR) chest radiography as compared with computed radiography (CR) for intensive care unit (ICU) chest radiographs (CXR). Methods and materials: Three groups of age-, weight- and disease-matched ICU patients (n = 114 patients; 50 CXR per acquisition technique) underwent clinically indicated bedside CXR obtained with either CR (single read-out powder plates) or mobile DR (GOS-TFT detectors) at identical or 50% reduced dose (DR 50% ). Delineation of anatomic structures and devices used for patient monitoring, overall image quality and disease were scored by four readers. In 12 patients pairs of follow-up CR and DR images were available, and in 15 patients pairs of CR and DR 50% images were available. In these pairs the overall image quality was also compared side-by-side. Results: Delineation of anatomy in the mediastinum was scored better with DR or DR 50% than with CR. Devices used for patient monitoring were seen best with DR, with DR 50% being superior to CR. In the side-by-side comparison, the overall image quality of DR and DR 50% was rated better than CR in 96% (46/48) and 87% (52/60), respectively. Inter-observer agreement for the assessment of pathology was fair for CR and DR 50% (κ = 0.33 and κ = 0.39, respectively) and moderate for DR (κ = 0.48). Conclusion: Mobile DR units offer better image quality than CR for bedside chest radiography and allow for 50% dose reduction. Inter-observer agreement increases with image quality and is superior with DR, while DR 50% and CR are comparable.

  20. Ultrasonography of chest wall lesion

    Energy Technology Data Exchange (ETDEWEB)

    Park, Cheol Min; Kim, C. H.; Cha, I. H.; Chung, K. B.; Ser, W. H.; Choi, Y. H. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    Thirty-one patients with chest wall diseases were studied with ultrasound to evaluate its role in chest wall lesions. There were eight infectious conditions, 9 benign tumors, 11 malignant lesions and 3 miscellaneous cases. Diffuse chest wall thickening with heterogeneous echogenicity and obliteration of subcutaneous fat layer are findings of acute infection. In cases of tuberculous smpyema necessitates, pleural abnormality extended to the chest wall through intercostal space. Benign tumors were well demarcated, except in 4 cases of lipoma/lipomatosis. Malignant lesions showed irregular soft tissue masses, bone destruction, pleural effusion and subcutaneous invasion. Multiple enlarged lymph nodes were also shown. Ultrasound can demonstrate te internal structure, extent, depth and associated findings such as pleural effusion, bone destruction and peripheral lung involvement. Ultrasound is not only safe, non-invasive and an effective diagnostic imaging modality for chest wall disease, but can also guide aspiration or biopsy for pathologic diagnosis

  1. Ultrasonography of chest wall lesion

    International Nuclear Information System (INIS)

    Park, Cheol Min; Kim, C. H.; Cha, I. H.; Chung, K. B.; Ser, W. H.; Choi, Y. H.

    1989-01-01

    Thirty-one patients with chest wall diseases were studied with ultrasound to evaluate its role in chest wall lesions. There were eight infectious conditions, 9 benign tumors, 11 malignant lesions and 3 miscellaneous cases. Diffuse chest wall thickening with heterogeneous echogenicity and obliteration of subcutaneous fat layer are findings of acute infection. In cases of tuberculous smpyema necessitates, pleural abnormality extended to the chest wall through intercostal space. Benign tumors were well demarcated, except in 4 cases of lipoma/lipomatosis. Malignant lesions showed irregular soft tissue masses, bone destruction, pleural effusion and subcutaneous invasion. Multiple enlarged lymph nodes were also shown. Ultrasound can demonstrate te internal structure, extent, depth and associated findings such as pleural effusion, bone destruction and peripheral lung involvement. Ultrasound is not only safe, non-invasive and an effective diagnostic imaging modality for chest wall disease, but can also guide aspiration or biopsy for pathologic diagnosis

  2. Evaluation of a new system for chest tomosynthesis: aspects of image quality of different protocols determined using an anthropomorphic phantom

    Science.gov (United States)

    Sundin, A; Aspelin, P; Båth, M; Nyrén, S

    2015-01-01

    Objective: To compare the image quality obtained with the different protocols in a new chest digital tomosynthesis (DTS) system. Methods: A chest phantom was imaged with chest X-ray equipment with DTS. 10 protocols were used, and for each protocol, nine acquisitions were performed. Four observers visually rated the quality of the reconstructed section images according to pre-defined quality criteria in four different classes. The data were analysed with visual grading characteristics (VGC) analysis, using the vendor-recommended protocol [12-s acquisition time, source-to-image distance (SID) 180 cm] as reference, and the area under the VGC curve (AUCVGC) was determined for each protocol and class of criteria. Results: Protocols with a smaller swing angle resulted in a lower image quality for the classes of criteria “disturbance” and “homogeneity in nodule” but a higher image quality for the class “structure”. The class “demarcation” showed little dependency on the swing angle. All protocols but one (6.3 s, SID 130 cm) obtained an AUCVGC significantly <0.5 (indicating lower quality than reference) for at least one class of criteria. Conclusion: The study indicates that the DTS protocol with 6.3 s yields image quality similar to that obtained with the vendor-recommended protocol (12 s) but with the clinically important advantage for patients with respiratory impairment of a shorter acquisition time. Advances in knowledge: The study demonstrates that the image quality may be strongly affected by the choice of protocol and that the vendor-recommended protocol may not be optimal. PMID:26118300

  3. Potential of ultrasound in the pediatric chest

    Energy Technology Data Exchange (ETDEWEB)

    Trinavarat, Panruethai, E-mail: pantrinavarat@hotmail.com [Department of Radiology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330 (Thailand); Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at [Department of Radiology, Division of Pediatric Radiology, University Hospital Graz (Austria)

    2014-09-15

    Ultrasound (US) of chest, even with inherent limitations of the US beam and air, has been useful in many pediatric chest conditions. It has extended its role and is now widely used by many subspecialists in medicine. This review article will cover techniques, indications, and applications of chest US in neonates, infants and children, including also different common as well as some rare and modern aspects and applications, such as pleural effusion, pneumothorax, pulmonary lesions, mediastinum, diaphragm, and chest wall. Other related imaging modalities are also briefly discussed.

  4. SU-E-I-74: Image-Matching Technique of Computed Tomography Images for Personal Identification: A Preliminary Study Using Anthropomorphic Chest Phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Matsunobu, Y; Shiotsuki, K [Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Morishita, J [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, JP (Japan)

    2015-06-15

    Purpose: Fingerprints, dental impressions, and DNA are used to identify unidentified bodies in forensic medicine. Cranial Computed tomography (CT) images and/or dental radiographs are also used for identification. Radiological identification is important, particularly in the absence of comparative fingerprints, dental impressions, and DNA samples. The development of an automated radiological identification system for unidentified bodies is desirable. We investigated the potential usefulness of bone structure for matching chest CT images. Methods: CT images of three anthropomorphic chest phantoms were obtained on different days in various settings. One of the phantoms was assumed to be an unidentified body. The bone image and the bone image with soft tissue (BST image) were extracted from the CT images. To examine the usefulness of the bone image and/or the BST image, the similarities between the two-dimensional (2D) or threedimensional (3D) images of the same and different phantoms were evaluated in terms of the normalized cross-correlation value (NCC). Results: For the 2D and 3D BST images, the NCCs obtained from the same phantom assumed to be an unidentified body (2D, 0.99; 3D, 0.93) were higher than those for the different phantoms (2D, 0.95 and 0.91; 3D, 0.89 and 0.80). The NCCs for the same phantom (2D, 0.95; 3D, 0.88) were greater compared to those of the different phantoms (2D, 0.61 and 0.25; 3D, 0.23 and 0.10) for the bone image. The difference in the NCCs between the same and different phantoms tended to be larger for the bone images than for the BST images. These findings suggest that the image-matching technique is more useful when utilizing the bone image than when utilizing the BST image to identify different people. Conclusion: This preliminary study indicated that evaluating the similarity of bone structure in 2D and 3D images is potentially useful for identifying of an unidentified body.

  5. SU-E-I-74: Image-Matching Technique of Computed Tomography Images for Personal Identification: A Preliminary Study Using Anthropomorphic Chest Phantoms

    International Nuclear Information System (INIS)

    Matsunobu, Y; Shiotsuki, K; Morishita, J

    2015-01-01

    Purpose: Fingerprints, dental impressions, and DNA are used to identify unidentified bodies in forensic medicine. Cranial Computed tomography (CT) images and/or dental radiographs are also used for identification. Radiological identification is important, particularly in the absence of comparative fingerprints, dental impressions, and DNA samples. The development of an automated radiological identification system for unidentified bodies is desirable. We investigated the potential usefulness of bone structure for matching chest CT images. Methods: CT images of three anthropomorphic chest phantoms were obtained on different days in various settings. One of the phantoms was assumed to be an unidentified body. The bone image and the bone image with soft tissue (BST image) were extracted from the CT images. To examine the usefulness of the bone image and/or the BST image, the similarities between the two-dimensional (2D) or threedimensional (3D) images of the same and different phantoms were evaluated in terms of the normalized cross-correlation value (NCC). Results: For the 2D and 3D BST images, the NCCs obtained from the same phantom assumed to be an unidentified body (2D, 0.99; 3D, 0.93) were higher than those for the different phantoms (2D, 0.95 and 0.91; 3D, 0.89 and 0.80). The NCCs for the same phantom (2D, 0.95; 3D, 0.88) were greater compared to those of the different phantoms (2D, 0.61 and 0.25; 3D, 0.23 and 0.10) for the bone image. The difference in the NCCs between the same and different phantoms tended to be larger for the bone images than for the BST images. These findings suggest that the image-matching technique is more useful when utilizing the bone image than when utilizing the BST image to identify different people. Conclusion: This preliminary study indicated that evaluating the similarity of bone structure in 2D and 3D images is potentially useful for identifying of an unidentified body

  6. Chest X-Ray

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos ... x-ray is used to evaluate the lungs, heart and chest wall and may be used to ...

  7. Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients

    Directory of Open Access Journals (Sweden)

    Omar Hesham R

    2011-09-01

    Full Text Available Abstract Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

  8. Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients.

    Science.gov (United States)

    Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

    2011-09-27

    Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

  9. Chest X-ray : a cost-diagnostic benefit analysis

    International Nuclear Information System (INIS)

    Winter, L.H.L.

    1991-01-01

    Although plain chest radiography is one of the most useful diagnostic tools available to the physician, this procedure has not evolved into a consistent method. Two Large Field of View Image Intensifiers (LFOV-II) became available; the large imaging area makes them suitable for chest imaging. Both modalities supply 100 mm images to the radiologist. In this thesis the 'diagnostic benefits and 'costs' of these modalities are evaluated and related to the 'gold' standard (conventional full-size). The emphasis is on diagnostic image quality using phantoms for observer performance qualities. (author). 170 refs.; 21 figs.; 47 tabs

  10. Transmission dynamic range in chest radiology

    International Nuclear Information System (INIS)

    Lemmers, H.E.A.S.J.; Schultze Kool, L.J.; van Elburg, H.J.; Boelens, F.

    1989-01-01

    Due to the large difference in transmission between the lung area and the mediastinum, the human chest is a challenging object for radiographic imaging. This study is performed in order to define the dynamic range needed for a chest imaging chain. Eight hundred seventy-five consecutive outpatients were imaged with a prototype AMBER (advanced multiple beam equalization radiography) unit at 141 kVp. The equalization facility was disabled, allowing for the simultaneous capture of a film image and a digital dataset representing the local patient transmission in fields of approximately 2x2 cm. The datasets were analyzed to obtain the relation between the average transmission distribution in a subset of the population and physical parameters characterizing this subset, such as body weight or length

  11. Revisit image control for pediatric chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Kohda, Ehiichi; Nagamoto, Masashi; Gomi, Tatsuya; Terada, Hitoshi; Kawawa, Yohko [Toho Univ., School of Medicine, Tokyo (Japan); Tsutsumi, Yoshiyuki; Masaki, Hidekazu [National Center for Child Health and Development, Tokyo (Japan); Shiraga, Nobuyuki [Kyousai Tachikawa Hospital, Tachikawa, Tokyo (Japan)

    2007-02-15

    The aim of this study was to analyze the fraction defectiveness and efficacy of the patient immobilization device (PID) for pediatric chest radiography. We examined 840 plain chest radiographs in six hospitals, including four children's hospitals and two general hospitals. The mean age of the patients was 1.9 years (range 0-5 years). Two boardqualified pediatric radiologists rated (into three grades, by consensus) the degree of inspiration, rotation, lordosis, scoliosis, and cutoff or coning as well as the quality of the chest radiographs. The incidence of ''poor'' and ''very poor'' quality examinations was 2/140 and 3/140 in each of two children's hospitals using PID. The corresponding figures were 9/139 and 17/140 in the two children's hospitals that did not use PID. The general hospital using PID had 14/140 ''poor'' and ''very poor'' examinations. The general hospital that did not use PID had 28/140 ''poor'' and ''very poor'' examinations. Thus, statistically better quality chest radiography was obtained with the use of PID (P<0.001). Likewise, rotation, lordosis, and scoliosis were less frequently diagnosed as present when PID was used (P<0.001, 0.001, 0.05). Cutoff or coning had no relation to the use of PID (P=0.13). No significant difference was found between the degree of inspiration and the use of PID (P=0.56). Fraction defectiveness in the general hospital that did not use PID was as much as 14 times higher than that of the children's hospitals that used PID. The patient immobilization device is recommended for hospitals with technologists not specifically trained for pediatric examination. (author)

  12. Revisit image control for pediatric chest radiography

    International Nuclear Information System (INIS)

    Kohda, Ehiichi; Nagamoto, Masashi; Gomi, Tatsuya; Terada, Hitoshi; Kawawa, Yohko; Tsutsumi, Yoshiyuki; Masaki, Hidekazu; Shiraga, Nobuyuki

    2007-01-01

    The aim of this study was to analyze the fraction defectiveness and efficacy of the patient immobilization device (PID) for pediatric chest radiography. We examined 840 plain chest radiographs in six hospitals, including four children's hospitals and two general hospitals. The mean age of the patients was 1.9 years (range 0-5 years). Two boardqualified pediatric radiologists rated (into three grades, by consensus) the degree of inspiration, rotation, lordosis, scoliosis, and cutoff or coning as well as the quality of the chest radiographs. The incidence of ''poor'' and ''very poor'' quality examinations was 2/140 and 3/140 in each of two children's hospitals using PID. The corresponding figures were 9/139 and 17/140 in the two children's hospitals that did not use PID. The general hospital using PID had 14/140 ''poor'' and ''very poor'' examinations. The general hospital that did not use PID had 28/140 ''poor'' and ''very poor'' examinations. Thus, statistically better quality chest radiography was obtained with the use of PID (P<0.001). Likewise, rotation, lordosis, and scoliosis were less frequently diagnosed as present when PID was used (P<0.001, 0.001, 0.05). Cutoff or coning had no relation to the use of PID (P=0.13). No significant difference was found between the degree of inspiration and the use of PID (P=0.56). Fraction defectiveness in the general hospital that did not use PID was as much as 14 times higher than that of the children's hospitals that used PID. The patient immobilization device is recommended for hospitals with technologists not specifically trained for pediatric examination. (author)

  13. Nontuberculous Mycobacterial (NTM) Disease in Immunocompetent Patients: Expanding Image Findings on Chest CT

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hyo Hyun; Seon, Hyun Ju; Kim, Mok Hee; Choi, Song; Song, Sang Gook; Shin, Sang Soo; Kim, Yun Hyeon; Park, Jin Gyoon [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2010-04-15

    The aim of this study was to evaluate the chest CT features of nontuberculous mycobacterial (NTM) disease regardless of the specific organisms. This study included 74 consecutive patients (35 men, 39 women; mean age, 63 years; age range, 25-89 years) who were diagnosed with NTM disease according to the American Thoracic Society Guidelines (1997 and 2007) between January 2005 and July 2007. Chest CT images were randomly reviewed by two radiologists with consensus. The most common organism associated with NTM disease is M. avium-intracellulare complex (87.8%), followed by M. abscesses, M. kansasii, and M. chelonae. The most common chest CT finding was a nodular bronchiectatic lesion (n = 35, 46.7%), followed by a cavitary lesion of the upper lobe (n = 21, 28.0%), combined lesions of two prior subtypes (n = 6, 8.0%), consolidative lesion (s) (n = 5, 6.7%), a bronchogenic spreading pulmonary tuberculosis-like lesion (n = 5, 6.7%), a cavitary mass lesion with small satellite nodules (n = 2, 2.7%), and a miliary nodular lesion (n = 1, 1.3%). More than 5 segments were involved in 60 cases (81.1%). The nodular bronchiectatic lesion or cavitary lesion of upper lobe presents with multi-segmental involvement and the occurrence of combined consolidation is indicative of NTM disease

  14. Pulmonary effects of synthetic marijuana: chest radiography and CT findings.

    Science.gov (United States)

    Berkowitz, Eugene A; Henry, Travis S; Veeraraghavan, Srihari; Staton, Gerald W; Gal, Anthony A

    2015-04-01

    The purpose of this article is to present the first chest radiographic and CT descriptions of organizing pneumonia in response to smoking synthetic marijuana. Chest radiographs showed a diffuse miliary-micronodular pattern. Chest CT images showed diffuse centrilobular nodules and tree-in-bud pattern and a histopathologic pattern of organizing pneumonia with or without patchy acute alveolar damage. This distinct imaging pattern should alert radiologists to include synthetic marijuana abuse in the differential diagnosis.

  15. Quality criteria for chest X-ray image

    International Nuclear Information System (INIS)

    Krieg, R.

    1985-01-01

    A distinction has to be made between invariable and variable criteria in the determination of chest X-ray picture quality criteria. The invariable criteria are defined by the properties of the object and the psychophysiological laws of perception and cognition, and the variable criteria are determined by the prevailing state of the art of technology. An agreement on these criteria is based on the knowledge of the nature and the technical conditions of X-ray picture production and reproduction. The slogan 'the best picture at the lowest dose' dominates, too, the discussion centering around the X-ray picture of the chest, its quality and criteria. (orig./MG) [de

  16. Multiple-beam equalization radiography in chest radiology

    International Nuclear Information System (INIS)

    Axelsson, B.; Forsberg, H.; Hansson, B.; Haverling, M.

    1991-01-01

    The large difference in transmission between the mediastinum and the part of the chest mainly containing lungs causes major problems in chest radiography. A system for advanced multiple beam equalization radiography has been evaluated. Evaluation of image quality has been performed both using standard phantoms and from clinical radiographs. Measurements of radiation dose burden to the patient have been made both in clinical examinations and using an anthropomorphic phantom. The image quality, in areas with low transmission, is substantially increased using the equalization system. In parts of the chest mainly containing lung tissue, conventional systems show an equal or slightly better image quality. The radiation dose burden to the patient is increased by 25 percent using the equation system, as compared to a low-dose air-gap system. In our opinion, the slight increase in radiation dose burden is well motivated by the high quality of the radiographs produced. (orig.)

  17. ACR appropriateness criteria blunt chest trauma.

    Science.gov (United States)

    Chung, Jonathan H; Cox, Christian W; Mohammed, Tan-Lucien H; Kirsch, Jacobo; Brown, Kathleen; Dyer, Debra Sue; Ginsburg, Mark E; Heitkamp, Darel E; Kanne, Jeffrey P; Kazerooni, Ella A; Ketai, Loren H; Ravenel, James G; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D

    2014-04-01

    Imaging is paramount in the setting of blunt trauma and is now the standard of care at any trauma center. Although anteroposterior radiography has inherent limitations, the ability to acquire a radiograph in the trauma bay with little interruption in clinical survey, monitoring, and treatment, as well as radiography's accepted role in screening for traumatic aortic injury, supports the routine use of chest radiography. Chest CT or CT angiography is the gold-standard routine imaging modality for detecting thoracic injuries caused by blunt trauma. There is disagreement on whether routine chest CT is necessary in all patients with histories of blunt trauma. Ultimately, the frequency and timing of CT chest imaging should be site specific and should depend on the local resources of the trauma center as well as patient status. Ultrasound may be beneficial in the detection of pneumothorax, hemothorax, and pericardial hemorrhage; transesophageal echocardiography is a first-line imaging tool in the setting of suspected cardiac injury. In the blunt trauma setting, MRI and nuclear medicine likely play no role in the acute setting, although these modalities may be helpful as problem-solving tools after initial assessment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Predictors of image quality of coronary computed tomography in the acute care setting of patients with chest pain

    Energy Technology Data Exchange (ETDEWEB)

    Bamberg, Fabian; Abbara, Suhny; Schlett, Christopher L.; Cury, Ricardo C.; Truong, Quynh A.; Rogers, Ian S. [Cardiac MR PET CT Program, Department of Radiology and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Nagurney, John T. [Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Brady, Thomas J. [Cardiac MR PET CT Program, Department of Radiology and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Hoffmann, Udo [Cardiac MR PET CT Program, Department of Radiology and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)], E-mail: uhoffmann@partners.org

    2010-04-15

    Objective: We aimed to determine predictors of image quality in consecutive patients who underwent coronary computed tomography (CT) for the evaluation of acute chest pain. Method and materials: We prospectively enrolled patients who presented with chest pain to the emergency department. All subjects underwent contrast-enhanced 64-slice coronary multi-detector CT. Two experienced readers determined overall image quality on a per-patient basis and the prevalence and characteristics of non-evaluable coronary segments on a per-segment basis. Results: Among 378 subjects (143 women, age: 52.9 {+-} 11.8 years), 345 (91%) had acceptable overall image quality, while 33 (9%) had poor image quality or were unreadable. In adjusted analysis, patients with diabetes, hypertension and a higher heart rate during the scan were more likely to have exams graded as poor or unreadable (odds ratio [OR]: 2.94, p = 0.02; OR: 2.62, p = 0.03; OR: 1.43, p = 0.02; respectively). Of 6253 coronary segments, 257 (4%) were non-evaluable, most due to severe calcification in combination with motion (35%). The presence of non-evaluable coronary segments was associated with age (OR: 1.08 annually, 95%-confidence interval [CI]: 1.05-1.12, p < 0.001), baseline heart rate (OR: 1.35 per 10 beats/min, 95%-CI: 1.11-1.67, p = 0.003), diabetes, hypertension, and history of coronary artery disease (OR: 4.43, 95%-CI: 1.93-10.17, p < 0.001; OR: 2.27, 95-CI: 1.01-4.73, p = 0.03; OR: 5.12, 95%-CI: 2.0-13.06, p < 0.001; respectively). Conclusion: Coronary CT permits acceptable image quality in more than 90% of patients with chest pain. Patients with multiple risk factors are more likely to have impaired image quality or non-evaluable coronary segments. These patients may require careful patient preparation and optimization of CT scanning protocols.

  19. Computed tomography of chest wall abscess

    International Nuclear Information System (INIS)

    Ikezoe, Junpei; Morimoto, Shizuo; Akira, Masanori

    1986-01-01

    Inflammatory lesions of the chest wall become less common because of the improvement of antibiotics and chemotherapeutic agents. Over a 5-year period, 7 patients with chest wall inflammatory diseases underwent chest computed tomography. These were 2 tuberculous pericostal abscesses, 2 empyema necessitatis, 1 spinal caries, and 2 bacterial chest wall abscesses (unknown organisms). Computed tomography (CT) helped in demonstrating the density, border, site, and extent of the lesions. CT images also demonstrated the accompaning abnormalities which included bone changes, pleural calcification, or old tuberculous changes of the lung. CT was very effective to demonstrate the communicating portions from the inside of the bony thorax to the outside of the bony thorax in 2 empyema necessitatis. (author)

  20. Detecting parathyroid adenoma using technetium-99m tetrofosmin: comparison with P-glycoprotein and multidrug resistance related protein expression--a preliminary report

    International Nuclear Information System (INIS)

    Shiau, Y.C.; Tsai, S.C.; Wang, J.J.; Ho, S.T.; Kao, A.

    2002-01-01

    The aim of this study was to investigate the relationships among technetium-99m tetrofosmin (Tc-TF) accumulation in parathyroid adenoma and the expression of P-glycoprotein (Pgp) or multidrug resistance related protein (MRP). Before operation, 33 patients with parathyroid adenomas (larger than 1.5 gm) were studied with parathyroid scintigraphy 10 minutes and 2 hours after intravenous injection of Tc-TF before operation. Immunohistochemical analyses (IHA) were performed on multiple nonconsecutive sections of operative parathyroid specimens to detect Pgp or MRP expression. According to the results of IHA, the 33 parathyroid adenomas were separated into four groups: (1) 2 adenomas with both positive Pgp and positive MRP expression, (2) 1 adenomas with positive Pgp but negative MRP expression, (3) 2 adenomas with negative Pgp but positive MRP expression, and (4) 28 adenomas with both negative Pgp and negative MRP expression. All of 28 adenomas in the group 4 could be detected by Tc-TF parathyroid imaging. All of 5 adenomas in the groups 1 to 3 could not be detected by TcTF parathyroid imaging (p < 0.05). Not only the size of parathyroid adenomas, but also significant Pgp or MRP expression limited the sensitivity of Tc-TF parathyroid imaging to localize parathyroid adenomas before operation

  1. The role of imaging for the surgeon in primary malignant bone tumors of the chest wall

    Energy Technology Data Exchange (ETDEWEB)

    Rocca, M., E-mail: michele.rocca@ior.it [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Salone, M. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Galletti, S. [Ultrasound Unit, The Rizzoli Orthopaedic Institute, Bologna (Italy); Balladelli, A. [Laboratory of Experimental Oncology, The Rizzoli Orthopaedic Institute, Bologna (Italy); Vanel, D. [Research in Imaging Musculo Skeletal Tumors, The Rizzoli Orthopaedic Institute, Bologna (Italy); Briccoli, A. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy)

    2013-12-01

    Primary malignant chest wall tumors are rare. The most frequent primary malignant tumor of the chest wall is chondrosarcoma, less common are primary bone tumors belonging to the Ewing Family Bone Tumors (EFBT), or even rarer are osteosarcomas. They represent a challenging clinical entities for surgeons as the treatment of choice for these neoplasms is surgical resection, excluding EFBT which are normally treated by a multidisciplinary approach. Positive margins after surgical procedure are the principal risk factor of local recurrence, therefore to perform adequate surgery a correct preoperative staging is mandatory. Imaging techniques are used for diagnosis, to determine anatomic site and extension, to perform a guided biopsy, for local and general staging, to evaluate chemotherapy response, to detect the presence of a recurrence. This article will focus on the role of imaging in guiding this often difficult surgery and the different technical possibilities adopted in our department to restore the mechanics of the thoracic cage after wide resections.

  2. Assessment of chest pain in the emergency room: What is the role of multidetector CT?

    International Nuclear Information System (INIS)

    White, Charles; Read, Katrina; Kuo, Dick

    2006-01-01

    Chest pain is one of the most frequent complaints for patients seen in the emergency department. The current article describes the clinical stratification of patients who present to the emergency department with chest pain and discusses imaging options and analysis for these patients. It reviews conventional imaging approaches to assessing chest pain including chest radiography and stress testing. The main discussion focuses on the potential utility use of cross-sectional imaging, particularly multidetector CT, in the evaluation of chest pain in the emergency department

  3. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    International Nuclear Information System (INIS)

    Palas, J.; Matos, A.P.; Ramalho, M.; Mascarenhas, V.; Heredia, V.

    2014-01-01

    Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  4. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    Directory of Open Access Journals (Sweden)

    João Palas

    2014-01-01

    Full Text Available Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  5. Quantitative evaluation of changes in pleural effusion using digital images of the chest

    International Nuclear Information System (INIS)

    Nishiike, Shigeaki; Fujimura, Ichiro; Sagara, Kenji; Sakashita, Keiji

    2000-01-01

    Exposure data recognition (EDR) is a function of FCR that automatically determines the optimal density of images. This function makes it difficult to evaluate changes in pleural effusion on sequential chest CR. We developed a method to quantify the amount of pleural effusion using the digital value and S value of chest CR. We evaluated the efficacy of the method to quantify the amount of pleural effusion using these values of chest CR in clinical settings. The study period was from December 1996 to January 1999. Study 1: Chest CR was carried out before and after pleural cavity drainage in 70 cases. The volume calculated with the method using the digital value and S value of CR [x(ml)] was compared with the drained volume [y1] on both sides. Study 2: Change in pleural effusion was estimated with a method using CT (y2) and with the method using the digital value and S value of CR (x). The relationship of these two data was investigated. Study 1: The regression equations between x and y1 were y1=1.05x+21.1 (r 2 =0.89) on the right side and y1=0.95x+69.7 (r 2 =0.68) on the left side. Study 2: The regression equations between x and y2 were y2=0.75x-1.88 (r 2 =0.70) on the right side and y2=0.87x-1.27 (r 2 =0.65) on the left side. The method using the digital value and S value of CR was effective for quantifying changes in pleural effusion. (author)

  6. Application of a simple phantom in assessing the effects of dose reduction on image quality in chest radiography

    International Nuclear Information System (INIS)

    Egbe, N.O.; Heaton, B.; Sharp, P.F.

    2010-01-01

    Purpose: Firstly, to evaluate a commercial chest phantom incorporating a quasi anthropomorphic insert by comparing exposure measurements on the phantom with those of actual patients and, secondly, to assess the value of the phantom for image quality and dose optimisation. Methods: In the first part of the study entrance surface doses (ESD), Beam transmission (BT), and optical density (OD) were obtained for 77 chest radiography patients and compared with measurements made from exposures of the phantom using the respective patient exposure factors from chest examination. Differences were assessed with a student t-test, while the Pearson's linear correlation coefficient was used to test for any linear relationship. The second part assessed the applicability of the phantom to image quality studies by investigating the effect, on the clarity and detectability of lung lesions made from gelatine, of reducing patient dose below current dose levels. Clarity of linear objects of different dimensions was also studied. Lesion detectability and clarity was assessed by four observers. The possibility of extending dose reduction below current dose levels (D ref ) was assessed from comparison of doses that produced statistically significant differences in image quality from D ref . Results: Results show that, with the exception of entrance doses and beam transmission through the diaphragm (P > 0.05), differences in OD and beam transmission between patients and phantom were statistically significant (P ref produced significant changes in both clarity and detectability. Conclusion: Within limits posed by the observed differences, the phantom can be applied to image quality studies in diagnostic radiology.

  7. Performance evaluation of 3-D enhancement filters for detection of lung cancer from 3-D chest X-ray CT images

    International Nuclear Information System (INIS)

    Shimizu, Akinobu; Hagai, Makoto; Toriwaki, Jun-ichiro; Hasegawa, Jun-ichi.

    1995-01-01

    This paper evaluates the performance of several three dimensional enhancement filters used in procedures for detecting lung cancer shadows from three dimensional (3D) chest X-ray CT images. Two dimensional enhancement filters such as Min-DD filter, Contrast filter and N-Quoit filter have been proposed for enhancing cancer shadows in conventional 2D X-ray images. In this paper, we extend each of these 2D filters to a 3D filter and evaluate its performance experimentally by using CT images with artificial and true lung cancer shadows. As a result, we find that these 3D filters are effective for determining the position of a lung cancer shadow in a 3D chest CT image, as compared with the simple procedure such as smoothing filter, and that the performance of these filters become lower in the hilar area due to the influence of the vessel shadows. (author)

  8. Chest Tomosynthesis: Technical Principles and Clinical Update

    Science.gov (United States)

    Dobbins, James T.; McAdams, H. Page

    2009-01-01

    Digital tomosynthesis is a radiographic technique that can produce an arbitrary number of section images of a patient from a single pass of the x-ray tube. It utilizes a conventional x-ray tube, a flat-panel detector, a computer-controlled tube mover, and special reconstruction algorithms to produce section images. While it does not have the depth resolution of computed tomography (CT), tomosynthesis provides some of the tomographic benefits of CT but at lower cost and radiation dose than CT. Compared to conventional chest radiography, chest tomosynthesis results in improved visibility of normal structures such as vessels, airway and spine. By reducing visual clutter from overlying normal anatomy, it also enhances detection of small lung nodules. This review article outlines the components of a tomosynthesis system, discusses results regarding improved lung nodule detection from the recent literature, and presents examples of nodule detection from a clinical trial in human subjects. Possible implementation strategies for use in clinical chest imaging are discussed. PMID:19616909

  9. Three-dimensional automatic computer-aided evaluation of pleural effusions on chest CT images

    Science.gov (United States)

    Bi, Mark; Summers, Ronald M.; Yao, Jianhua

    2011-03-01

    The ability to estimate the volume of pleural effusions is desirable as it can provide information about the severity of the condition and the need for thoracentesis. We present here an improved version of an automated program to measure the volume of pleural effusions using regular chest CT images. First, the lungs are segmented using region growing, mathematical morphology, and anatomical knowledge. The visceral and parietal layers of the pleura are then extracted based on anatomical landmarks, curve fitting and active contour models. The liver and compressed tissues are segmented out using thresholding. The pleural space is then fitted to a Bezier surface which is subsequently projected onto the individual two-dimensional slices. Finally, the volume of the pleural effusion is quantified. Our method was tested on 15 chest CT studies and validated against three separate manual tracings. The Dice coefficients were 0.74+/-0.07, 0.74+/-0.08, and 0.75+/-0.07 respectively, comparable to the variation between two different manual tracings.

  10. Computerized detection of lung nodules in digital chest radiographs

    International Nuclear Information System (INIS)

    Giger, M.L.; Doi, K.; MacMahon, H.

    1987-01-01

    Detection of cancerous lung nodules in chest radiographs is one of the more important tasks performed by a radiologist. In addition, the ''miss rate'' associated with the radiographic detection of lung nodules is approximately 30%. A computerized scheme that alerts the radiologist to possible locations of lung nodules should allow this number of false-negative diagnoses to be reduced. The authors are developing a computer-aided nodule detection scheme based on a difference image approach. They attempt to eliminate the camouflaging background structure of the normal lung anatomy by creating, from a single-projection chest image, two images: one in which the signal-to-noise ratio (SNR) of the nodule is maximized and another in which that SNR is suppressed while the processed background remains essentially the same. Thus, the difference between these two processed images should consist of the nodule superimposed on a relatively uniform background in which the detection task may be simplified. This difference image approach is fundamentally different from conventional subtraction techniques (e.g., temporal or dual-energy subtraction) in that the two images which are subtracted arise from the same single-projection chest radiograph. Once the difference image is obtained, thresholding is performed along with tests for circularity, size and growth in order to extract the nodules. It should be noted that once an original chest image is input to the computer the nodule detection process is totally automated

  11. Development and image quality assessment of a contrast-enhancement algorithm for display of digital chest radiographs

    International Nuclear Information System (INIS)

    Rehm, K.

    1992-01-01

    This dissertation presents a contrast-enhancement algorithm Artifact-Suppressed Adaptive Histogram Equalization (ASAHE). This algorithm was developed as part of a larger effort to replace the film radiographs currently used in radiology departments with digital images. Among the expected benefits of digital radiology are improved image management and greater diagnostic accuracy. Film radiographs record X-ray transmission data at high spatial resolution, and a wide dynamic range of signal. Current digital radiography systems record an image at reduced spatial resolution and with coarse sampling of the available dynamic range. These reductions have a negative impact on diagnostic accuracy. The contrast-enhancement algorithm presented in this dissertation is designed to boost diagnostic accuracy of radiologists using digital images. The ASAHE algorithm is an extension of an earlier technique called Adaptive Histogram Equalization (AHE). The AHE algorithm is unsuitable for chest radiographs because it over-enhances noise, and introduces boundary artifacts. The modifications incorporated in ASAHE suppress the artifacts and allow processing of chest radiographs. This dissertation describes the psychophysical methods used to evaluate the effects of processing algorithms on human observer performance. An experiment conducted with anthropomorphic phantoms and simulated nodules showed the ASAHE algorithm to be superior for human detection of nodules when compared to a computed radiography system's algorithm that is in current use. An experiment conducted using clinical images demonstrating pneumothoraces (partial lung collapse) indicated no difference in human observer accuracy when ASAHE images were compared to computed radiography images, but greater ease of diagnosis when ASAHE images were used. These results provide evidence to suggest that Artifact-Suppressed Adaptive Histogram Equalization can be effective in increasing diagnostic accuracy and efficiency

  12. Radiologic images of an aggressive implant-associated fibromatosis of the breast and chest wall: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Lourdes Alanis, MD, MPH

    2017-09-01

    Full Text Available Fibromatosis of the breast is a rare benign disease compromising <0.2% of all primary breast tumors. Although the chest wall is a common location, occurrences of implant-associated fibromatosis of the breast are extremely rare; only 33 cases have been reported. We present a case of a 42-year-old female who underwent breast augmentation with silicone breast implants, and 2 years later developed an aggressive implant-associated fibromatosis of the breast and chest wall. On imaging studies, the tumor mimicked breast carcinoma, and despite chemotherapy, the fibromatosis rapidly enlarged and was locally invasive requiring wide surgical excision. Unlike previously reported imaging findings, magnetic resonance imaging revealed an oval circumscribed mass with fringe-like internal architecture. We provide a review of the literature and discuss the imaging features of implant-associated fibromatosis of the breast.

  13. Non-traumatic thoracic emergencies: acute chest pain: diagnostic strategies

    International Nuclear Information System (INIS)

    Bonomo, Lorenzo; Di Fabio, Francesca; Rita Larici, Anna; Merlino, Biagio; Luigia Storto, Maria

    2002-01-01

    Acute chest pain may represent the initial and/or accompanying symptom in a variety of disease processes that may occur in the cardiovascular system, respiratory system, gastrointestinal tract, or musculoskeletal system. Although clinical history, risk factors, and physical examination are important factors in establishing the etiology of symptoms in patients presenting with acute chest pain, imaging modalities are frequently utilized. Noncardiac causes of acute chest pain are reviewed in this paper with special reference to the most recently published literature and emphasis on acute aortic diseases. Imaging modalities with indication of appropriateness, optimal technique and practical keys for interpretation are discussed. (orig.)

  14. Automated detection system for pulmonary emphysema on 3D chest CT images

    Science.gov (United States)

    Hara, Takeshi; Yamamoto, Akira; Zhou, Xiangrong; Iwano, Shingo; Itoh, Shigeki; Fujita, Hiroshi; Ishigaki, Takeo

    2004-05-01

    An automatic extraction of pulmonary emphysema area on 3-D chest CT images was performed using an adaptive thresholding technique. We proposed a method to estimate the ratio of the emphysema area to the whole lung volume. We employed 32 cases (15 normal and 17 abnormal) which had been already diagnosed by radiologists prior to the study. The ratio in all the normal cases was less than 0.02, and in abnormal cases, it ranged from 0.01 to 0.26. The effectiveness of our approach was confirmed through the results of the present study.

  15. Use of morphologic filters in the computerized detection of lung nodules in digital chest images

    International Nuclear Information System (INIS)

    Yoshimura, H.; Giger, M.L.; Doi, K.; Ahn, N.; MacMahon, H.

    1989-01-01

    The authors have previously described a computerized scheme for the detection of lung nodules based on a difference-image approach, which had a detection accuracy of 70% with 7--8 false positives per image. Currently, they are investigating morphologic filters for the further enhancement/suppression of nodule-signals and the removal of false-positives. Gray-level morphologic filtering is performed on clinical chest radiographs digitized with an optical drum scanner. Various shapes and sequences of erosion and dilation filters (i.e., determination of the minimum and maximum gray levels, respectively) were examined for signal enhancement and suppression for sue in the difference- image approach

  16. Homogeneous Canine Chest Phantom Construction: A Tool for Image Quality Optimization.

    Science.gov (United States)

    Pavan, Ana Luiza Menegatti; Rosa, Maria Eugênia Dela; Giacomini, Guilherme; Bacchim Neto, Fernando Antonio; Yamashita, Seizo; Vulcano, Luiz Carlos; Duarte, Sergio Barbosa; Miranda, José Ricardo de Arruda; de Pina, Diana Rodrigues

    2016-01-01

    Digital radiographic imaging is increasing in veterinary practice. The use of radiation demands responsibility to maintain high image quality. Low doses are necessary because workers are requested to restrain the animal. Optimizing digital systems is necessary to avoid unnecessary exposure, causing the phenomenon known as dose creep. Homogeneous phantoms are widely used to optimize image quality and dose. We developed an automatic computational methodology to classify and quantify tissues (i.e., lung tissue, adipose tissue, muscle tissue, and bone) in canine chest computed tomography exams. The thickness of each tissue was converted to simulator materials (i.e., Lucite, aluminum, and air). Dogs were separated into groups of 20 animals each according to weight. Mean weights were 6.5 ± 2.0 kg, 15.0 ± 5.0 kg, 32.0 ± 5.5 kg, and 50.0 ± 12.0 kg, for the small, medium, large, and giant groups, respectively. The one-way analysis of variance revealed significant differences in all simulator material thicknesses (p optimize veterinary X-ray procedures.

  17. MRI of the Chest

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    Full Text Available ... is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no ... Chest? Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose medical conditions. ...

  18. MRI of the Chest

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    Full Text Available ... to a CD or uploaded to a digital cloud server. MRI of the chest gives detailed pictures ... over time. top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging ...

  19. MRI of the Chest

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    Full Text Available ... or headphones during the exam. MRI scanners are air-conditioned and well-lit. Music may be played ... the limitations of MRI of the Chest? High-quality images are assured only if you are able ...

  20. MRI of the Chest

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    Full Text Available ... determine the presence of certain diseases. The images can then be examined on a computer monitor, transmitted ... of the chest cavity (arteries and veins). MRA can also demonstrate an abnormal ballooning out of the ...

  1. MRI of the Chest

    Medline Plus

    Full Text Available ... etc.). top of page What are some common uses of the procedure? MR imaging of the chest ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  2. MRI of the Chest

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    Full Text Available ... around the heart) disease. characterize mediastinal or pleural lesions seen by other imaging modalities, such as chest ... ports artificial limbs or metallic joint prostheses implanted nerve stimulators metal pins, screws, plates, stents or surgical ...

  3. Imaging of blunt chest trauma; Bildgebung des stumpfen Thoraxtraumas

    Energy Technology Data Exchange (ETDEWEB)

    Prosch, H. [Medizinische Universitaet Wien, Allgemeines Krankenhaus, Univ.-Klinik fuer Radiologie und Nuklearmedizin, Wien (Austria); Negrin, L. [Medizinische Universitaet Wien, Allgemeines Krankenhaus, Univ.-Klinik fuer Unfallchirurgie, Wien (Austria)

    2014-09-15

    Blunt chest trauma is associated with high morbidity and mortality. Consequently, all patients should be evaluated radiologically after blunt chest trauma to allow timely and appropriate treatment. Conventional chest radiographs and computed tomography (CT) are proven modalities with which to evaluate patients after blunt chest trauma. Over the last several years extended focused assessment with sonography for trauma (eFAST) has gained increasing importance for the initial assessment of seriously injured patients. In the acute phase of severely injured patients eFAST examinations are helpful to exclude pneumothorax, hemothorax and hemopericardium. Chest radiographs may also be used to diagnose a pneumothorax or hemothorax; however, the sensitivity is limited and CT is the diagnostic modality of choice to evaluate severely injured patients. (orig.) [German] Stumpfe Thoraxtraumen gehen mit einer hohen Morbiditaet und Mortalitaet einher. Daher sollten Patienten mit Verdacht auf ein stumpfes Thoraxtrauma rasch radiologisch untersucht werden, damit die entsprechenden therapeutischen Schritte zeitgerecht eingeleitet werden koennen. Zur Abklaerung von Patienten nach einem stumpfen Thoraxtrauma sind seit Jahren das konventionelle Lungenroentgen und die Computertomographie bewaehrte Verfahren. In den letzten Jahren hat die fokussierte Ultraschalluntersuchung (eFAST, Extended Focused Assessment with Sonography for Trauma) von schwerverletzten Patienten vermehrt an Bedeutung gewonnen. Durch eine eFAST-Untersuchung kann in der Akutphase rasch geklaert werden, ob bei dem Patienten ein therapiebeduerftiger Pneumothorax, Haematoperikard oder Haematothorax vorliegen. Auch das Lungenroentgen wird zur Diagnose eines Pneumothorax oder Haematothorax eingesetzt, wenngleich seine Sensitivitaet deutlich eingeschraenkt ist. Die CT ist das diagnostische Verfahren der Wahl, um v. a. Patienten mit einem schweren Thoraxtrauma abzuklaeren. (orig.)

  4. Noncontrast chest computed tomography immediately after transarterial chemoembolization in patients with hepatocellular carcinoma: Clinical benefits and effect of radiation reduction on image quality in low-dose scanning

    International Nuclear Information System (INIS)

    Choi, Joon-Il; Kim, Hyun Beom; Kim, Min Ju; Lee, Jong Seok; Koh, Young Whan; An, Sang Bu; Ko, Heung-kyu; Park, Joong-Won

    2011-01-01

    Purpose: To evaluate the clinical benefits of noncontrast chest computed tomography (CT) immediately after transarterial chemoembolization in patients with hepatocellular carcinoma and to assess the effect of radiation reduction on image quality in low-dose scanning. Materials and methods: From June to October 2010, we performed standard-dose, noncontrast chest CTs immediately after transarterial chemoembolization in 160 patients and low-dose CTs in 88 patients. We reviewed the entire noncontrast chest CTs and follow-up CTs to reveal the clinical benefits of CT evaluation immediately after transarterial chemoembolization. Using two independent readers, we also retrospectively evaluated the radiation dose and image quality in terms of the image noise, contrast between the liver parenchyma and iodized oil and diagnostic acceptability for the evaluation of treatment response after transarterial chemoembolization. Results: In 5.2% of the patients, additional treatment was performed immediately after the interpretation of the noncontrast chest CT, and additional pulmonary lesions were found in 8.5% of the patients. The measured mean dose-length product for the low-dose scanning was 18.4% of that of the standard-dose scanning. The image noise was significantly higher with the low-dose scanning (p < 0.001). However, all of the low-dose CT scans were diagnostically acceptable, and the mean scores for the subjective assessments of the contrast and diagnostic acceptability showed no significant differences for either reader. Conclusion: A noncontrast chest CT immediately after transarterial chemoembolization has some clinical benefits for immediate decision making and detecting pulmonary lesions. Low-dose, noncontrast chest CTs immediately after transarterial chemoembolization consistently provide diagnostically acceptable images and information on treatment response in patients who have undergone transarterial chemoembolization.

  5. A software system for the simulation of chest lesions

    Science.gov (United States)

    Ryan, John T.; McEntee, Mark; Barrett, Saoirse; Evanoff, Michael; Manning, David; Brennan, Patrick

    2007-03-01

    We report on the development of a novel software tool for the simulation of chest lesions. This software tool was developed for use in our study to attain optimal ambient lighting conditions for chest radiology. This study involved 61 consultant radiologists from the American Board of Radiology. Because of its success, we intend to use the same tool for future studies. The software has two main functions: the simulation of lesions and retrieval of information for ROC (Receiver Operating Characteristic) and JAFROC (Jack-Knife Free Response ROC) analysis. The simulation layer operates by randomly selecting an image from a bank of reportedly normal chest x-rays. A random location is then generated for each lesion, which is checked against a reference lung-map. If the location is within the lung fields, as derived from the lung-map, a lesion is superimposed. Lesions are also randomly selected from a bank of manually created chest lesion images. A blending algorithm determines which are the best intensity levels for the lesion to sit naturally within the chest x-ray. The same software was used to run a study for all 61 radiologists. A sequence of images is displayed in random order. Half of these images had simulated lesions, ranging from subtle to obvious, and half of the images were normal. The operator then selects locations where he/she thinks lesions exist and grades the lesion accordingly. We have found that this software was very effective in this study and intend to use the same principles for future studies.

  6. Uso da cintilografia miocárdica em repouso durante dor torácica para descartar infarto agudo do miocárdio Utilización de la centellografía miocárdica en reposo durante dolor torácico para descartar infarto agudo de miocardio Use of resting myocardial scintigraphy during chest pain to exclude diagnosis of acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Gustavo Borges Barbirato

    2009-04-01

    miocardio. MÉTODOS: Un total de 108 pacientes ingresados con dolor torácico, o hasta tras 4 horas del término de los síntomas, con electrocardiograma no diagnostico, realizaron centellografía en reposo y dosificaciones de troponina I. No se excluyeron a los pacientes con pasado de infarto de miocardio (IM (24 pacientes. Se dosificó troponina I al ingreso y tras 6 horas del ingreso. Médicos nucleares realizaron análisis ciego de las imágenes. Se confirmó infarto de miocardio, con elevación de la troponina I mayor que tres veces el control. RESULTADOS: La imagen de perfusión en reposo se mostró anormal en todos los seis pacientes con IM. Sólo un paciente presentó imagen normal y elevación de la troponina. Otros 55 pacientes obtuvieron imagen positiva sin IM y 46 pacientes presentaron imágenes y troponinas normales. La prevalencia de la enfermedad fue de un 6,5%. Fue de un 85,7% la sensibilidad de la imagen de reposo durante dolor torácico para la evidencia de IM, y la especificidad de un 45,5%. El valor predictivo negativo fue de un 97,7%. CONCLUSIÓN: Pacientes sometidos al protocolo de dolor torácico con centellografía de perfusión miocárdica demostraron un excelente valor predictivo negativo para la exclusión del diagnóstico de infarto de miocardio. Estos resultados sugieren que la imagen de perfusión en reposo es una herramienta importante en la unidad de dolor torácico.BACKGROUND: Images of myocardial perfusion taken during an episode of chest pain have been used for patients in the emergency department. OBJECTIVE: To evaluate the operating characteristics of 99mTc-Tetrofosmin scintigraphy during an episode of chest pain to exclude the diagnosis of acute myocardial infarction. METHODS: One hundred and eight patients admitted with chest pain, or up to four hours after the end of symptoms and nondiagnostic electrocardiogram, underwent resting scintigraphy and measurement of troponin I concentrations. Patients with a history of myocardial

  7. The evaluation of usefulness of quantitative analysis method with {sup 99m}Tc-tetrofosmin on effective dicision of reperfusion therapy to acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Takagi, Hitoshi; Sone, Takahito [Ogaki Municipal Hospital, Gifu (Japan)

    1998-01-01

    SPECT on acute and chronic period of {sup 99m}Tc-tetrofosmin on 46 patients with acute myocardial infarction were analyzed to evaluate about usefulness of quantitative analysis method used by unfolding image that was gotten by Bull`s eye analysis on reperfusion therapy in acute myocardial infarction, and we could get undermentioned results. 60% black out area in resional of interested was best on the obstacle myocardium using analysis of unfolding image. Significantly betterment from acute to chronic phase on the obstacle area of myocardium and the mean uptake ratio of the obstacle area was confirmed by this method. The relation between myocardial salvage and factors of myocardial damage, for example reperfusion time TIMI grade, rentrop grade and reperfusion phenomenon could be analyzed by this method. This method was suspected to underestimate the areas of obstacle myocardium on the cases of defect of apex. Error of analysis was suspected on the case of accumulation of TF to other than myocardium. The problems were minimised by some techniques mention in this paper. (author)

  8. Chest radiography after minor chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Rossen, B.; Laursen, N.O.; Just, S.

    The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma.

  9. Chest radiography after minor chest trauma

    International Nuclear Information System (INIS)

    Rossen, B.; Laursen, N.O.; Just, S.

    1987-01-01

    The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma. (orig.)

  10. Adequacy of source to image receptor distance with chest postero-anterior projection in digital radiology system

    International Nuclear Information System (INIS)

    Joo, Young Cheol; Lim, Cheong Hwan; Jung, Hong Ryang; You, In Gyu; Lee, Sang Ho

    2016-01-01

    The purpose of this study is to evaluate propriety of using SID 180cm at Chest PA examination and to find effect of geometrical cause to the image. XGEO-GC80, INNOVISION-SH, CXDI-40EG detector and a chest phantom designed self-production was used for this study. Images were acquired at SID 180cm with changing the factor OID as 0, 75 and 83mm and were analyzed by Centricity Radiography RA1000 PACS system. Statistical program was used the SPSS (Version 22.0, SPSS, Chicago, IL, USA), p-value(under 0.05) was considered to be statistically significant. In OID 0 mm was enlarged about 2.7⁓3.5 mm than the actual degree of the HS, BS of phantom in all equipments. Compared with the calculated magnification has been expanded 1.6⁓2.8% when viewed. The OID 75 mm with OID 83 mm was extended from the CS and BS 6⁓8 mm range. Compared to the calculated values, the measured values are expanded from 6.1 to 7.9%. CS and BS according to the OID change showed a statistically significant difference (p<0.05) among each group, the post-analysis only OID 0 mm group appeared as an independent group, 75 mm and 83 mm are separated in the same group It was. But had no statistically significant difference could change depending on the OID (p>0.05), post-mortem analysis showed, both in the same group. Heart sizes appears larger than actual size 6⁓8 mm at chest PA examination which is enlarged 6.1~7.9% more than the actual theoretical value. We can find magnification of the image because of the increase of the OID due to technical limitations between cover of standing detector and the image plate. so we suggest to have occurred between them when considering the need to adjust the equipment installed by the SID to match the characteristics of the equipment

  11. Adequacy of source to image receptor distance with chest postero-anterior projection in digital radiology system

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Young Cheol [Dept. of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Lim, Cheong Hwan; Jung, Hong Ryang [Dept. of Radiology, Science, Hanseo University, Seosan (Korea, Republic of); You, In Gyu [Dept. of Radiology, Hallym University Hospital, Chuncheon (Korea, Republic of); Lee, Sang Ho [Dept. of Radiology, Science, Seonam University, Namwon (Korea, Republic of)

    2016-06-15

    The purpose of this study is to evaluate propriety of using SID 180cm at Chest PA examination and to find effect of geometrical cause to the image. XGEO-GC80, INNOVISION-SH, CXDI-40EG detector and a chest phantom designed self-production was used for this study. Images were acquired at SID 180cm with changing the factor OID as 0, 75 and 83mm and were analyzed by Centricity Radiography RA1000 PACS system. Statistical program was used the SPSS (Version 22.0, SPSS, Chicago, IL, USA), p-value(under 0.05) was considered to be statistically significant. In OID 0 mm was enlarged about 2.7⁓3.5 mm than the actual degree of the HS, BS of phantom in all equipments. Compared with the calculated magnification has been expanded 1.6⁓2.8% when viewed. The OID 75 mm with OID 83 mm was extended from the CS and BS 6⁓8 mm range. Compared to the calculated values, the measured values are expanded from 6.1 to 7.9%. CS and BS according to the OID change showed a statistically significant difference (p<0.05) among each group, the post-analysis only OID 0 mm group appeared as an independent group, 75 mm and 83 mm are separated in the same group It was. But had no statistically significant difference could change depending on the OID (p>0.05), post-mortem analysis showed, both in the same group. Heart sizes appears larger than actual size 6⁓8 mm at chest PA examination which is enlarged 6.1~7.9% more than the actual theoretical value. We can find magnification of the image because of the increase of the OID due to technical limitations between cover of standing detector and the image plate. so we suggest to have occurred between them when considering the need to adjust the equipment installed by the SID to match the characteristics of the equipment.

  12. Effects of tube potential and scatter rejection on image quality and effective dose in digital chest X-ray examination: An anthropomorphic phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, D.J., E-mail: daniel.shaw@christie.nhs.uk [Diagnostic Radiology, Department of Medical Physics and Engineering, Leeds Teaching Hospitals, Leeds General Infirmary, Great George Street, Leeds LS1 3EX (United Kingdom); Crawshaw, I. [Diagnostic X-ray Department, York Teaching Hospital NHS Foundation Trust, The York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Rimmer, S. D. [Diagnostic Radiology, Department of Medical Physics and Engineering, Leeds Teaching Hospitals, Leeds General Infirmary, Great George Street, Leeds LS1 3EX (United Kingdom)

    2013-11-15

    Objectives: The purpose of this study was to investigate the effects of tube potential and scatter rejection techniques on image quality of digital posteroanterior (PA) chest radiographs. Methods: An anthropomorphic phantom was imaged using a range of tube potentials (81–125 kV{sub p}) without scatter rejection, with an anti-scatter grid, and using a 10 cm air gap. Images were anonymised and randomised before being evaluated using a visual graded analysis (VGA) method. Results: The effects of tube potential on image quality were found to be negligible (p > 0.63) for the flat panel detector (FPD). Decreased image quality (p = 0.031) was noted for 125 kV{sub p} relative to 109 kV{sub p}, though no difference was noted for any of the other potentials (p > 0.398) for computed radiography (CR). Both scatter rejection techniques improved image quality (p < 0.01). For FPD imaging the anti-scatter grid offered slightly improved image quality relative to the air gap (p = 0.038) but this was not seen for CR (p = 0.404). Conclusions: For FPD chest imaging of the anthropomorphic phantom there was no dependence of image quality on tube potential. Scatter rejection improved image quality, with the anti-scatter grid giving greater improvements than an air-gap, but at the expense of increased effective dose. CR imaging of the chest phantom demonstrated negligible dependence on tube potential except at 125 kV{sub p}. Scatter rejection improved image quality, but with no difference found between techniques. The air-gap resulted in a smaller increase in effective dose than the anti-scatter grid and would be the preferred scatter rejection technique.

  13. MRI of the Chest

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    Full Text Available ... Imaging (MRI) - Chest Sponsored by Please note RadiologyInfo.org is not a medical facility. Please contact your ... links: For the convenience of our users, RadiologyInfo .org provides links to relevant websites. RadiologyInfo.org , ACR ...

  14. Rib Radiography versus Chest Computed Tomography in the Diagnosis of Rib Fractures.

    Science.gov (United States)

    Sano, Atsushi

    2018-05-01

     The accurate diagnosis of rib fractures is important in chest trauma. Diagnostic images following chest trauma are usually obtained via chest X-ray, chest computed tomography, or rib radiography. This study evaluated the diagnostic characteristics of rib radiography and chest computed tomography.  Seventy-five rib fracture patients who underwent both chest computed tomography and rib radiography between April 2008 and December 2013 were included. Rib radiographs, centered on the site of pain, were taken from two directions. Chest computed tomography was performed using a 16-row multidetector scanner with 5-mm slice-pitch without overlap, and axial images were visualized in a bone window.  In total, 217 rib fractures were diagnosed in 75 patients. Rib radiography missed 43 rib fractures in 24 patients. The causes were overlap with organs in 15 cases, trivial fractures in 21 cases, and injury outside the imaging range in 7 cases. Left lower rib fractures were often missed due to overlap with the heart, while middle and lower rib fractures were frequently not diagnosed due to overlap with abdominal organs. Computed tomography missed 21 rib fractures in 17 patients. The causes were horizontal fractures in 10 cases, trivial fractures in 9 cases, and insufficient breath holding in 1 case.  In rib radiography, overlap with organs and fractures outside the imaging range were characteristic reasons for missed diagnoses. In chest computed tomography, horizontal rib fractures and insufficient breath holding were often responsible. We should take these challenges into account when diagnosing rib fractures. Georg Thieme Verlag KG Stuttgart · New York.

  15. The study of diagnostic accuracy of chest nodules by using different compression methods

    International Nuclear Information System (INIS)

    Liang Zhigang; Kuncheng, L.I.; Zhang Jinghong; Liu Shuliang

    2005-01-01

    Background: The purpose of this study was to compare the diagnostic accuracy of small nodules in the chest by using different compression methods. Method: Two radiologists with 5 years experience twice interpreted 39 chest images by using lossless and lossy compression methods. The time interval was 3 weeks. Each time the radiologists interpreted one kind of compressed images. The image browser used the Unisight software provided by Atlastiger Company in Shanghai. The interpreting results were analyzed by the ROCKIT software and the ROC curves were painted by Excel 2002. Results: In studies of receiver operating characteristics for scoring the presence or absence of nodules, the images with lossy compression method showed no statistical difference as compared with the images with lossless compression method. Conclusion: The diagnostic accuracy of chest nodules by using the lossless and lossy compression methods had no significant difference, we could use the lossy compression method to transmit and archive the chest images with nodules

  16. Algorithm for optimisation of paediatric chest radiography

    International Nuclear Information System (INIS)

    Kostova-Lefterova, D.

    2016-01-01

    The purpose of this work is to assess the current practice and patient doses in paediatric chest radiography in a large university hospital. The X-ray unit is used in the paediatric department for respiratory diseases. Another purpose was to recommend and apply optimized protocols to reduce patient dose while maintaining diagnostic image quality for the x-ray images. The practice of two different radiographers was studied. The results were compared with the existing practice in paediatric chest radiography and the opportunities for optimization were identified in order to reduce patient doses. A methodology was developed for optimization of the x-ray examinations by grouping children in age groups or according to other appropriate indication and creating an algorithm for proper selection of the exposure parameters for each group. The algorithm for the optimisation of paediatric chest radiography reduced patient doses (PKA, organ dose, effective dose) between 1.5 and 6 times for the different age groups, the average glandular dose up to 10 times and the dose for the lung between 2 and 5 times. The resulting X-ray images were of good diagnostic quality. The subjectivity in the choice of exposure parameters was reduced and standardization has been achieved in the work of the radiographers. The role of the radiologist, the medical physicist and radiographer in the process of optimization was shown. It was proven the effect of teamwork in reducing patient doses at keeping adequate image quality. Key words: Chest Radiography. Paediatric Radiography. Optimization. Radiation Exposure. Radiation Protection

  17. Quality image and incident air kerma evaluation in X-ray chest exams

    International Nuclear Information System (INIS)

    Campos de O, P. M.; Do Carmo S, P.; De Sousa L, M. A.; Da Silva, T. A.

    2017-10-01

    The procedures optimization for obtaining diagnostic quality images is an important factor to the patients radiation levels submitted to diagnostic radiology examinations was the lowest as reasonably practicable. Two methodologies for image quality parameters evaluation were applied in the routine of three diagnostic radiology clinics (A, B and C), two with digital image processing and one with chemical processing in Belo Horizonte, Brazil. The incident air kerma was evaluated for the radiographic techniques used in the clinic routine chest exams, approved in accordance with European Image Quality Criteria. It was possible to determine that the Fluke Biomedical X-ray Phantom test objects coupled to the Leeds Test Objects (TOR CDR) obtained better results than Gammex s Radiographic Survey Phantom (RSV), because the low and high contrast structures present in the RSV were not visualized in lower energies. The three clinics presented very similar results in all image quality parameters in the evaluation with the TOR CDR test object. However, clinic C presented an low contrast structures result 28.1 % lower than clinical B, although the average Ka,i to obtain their images was 33.4 % superior. The clinic A results present the best relation between image quality and radiation dose in patients. It was verified the optimization doses possibility in diagnostic radiology services with digital processing system, without significant reduction in image quality. Patients submitted to the highest radiation levels belonged to the clinic that presented the worst results in the image quality parameters evaluated. (Author)

  18. Pulmonary disease in cystic fibrosis: assessment with chest CT at chest radiography dose levels.

    Science.gov (United States)

    Ernst, Caroline W; Basten, Ines A; Ilsen, Bart; Buls, Nico; Van Gompel, Gert; De Wachter, Elke; Nieboer, Koenraad H; Verhelle, Filip; Malfroot, Anne; Coomans, Danny; De Maeseneer, Michel; de Mey, Johan

    2014-11-01

    To investigate a computed tomographic (CT) protocol with iterative reconstruction at conventional radiography dose levels for the assessment of structural lung abnormalities in patients with cystic fibrosis ( CF cystic fibrosis ). In this institutional review board-approved study, 38 patients with CF cystic fibrosis (age range, 6-58 years; 21 patients 18 years) underwent investigative CT (at minimal exposure settings combined with iterative reconstruction) as a replacement of yearly follow-up posteroanterior chest radiography. Verbal informed consent was obtained from all patients or their parents. CT images were randomized and rated independently by two radiologists with use of the Bhalla scoring system. In addition, mosaic perfusion was evaluated. As reference, the previous available conventional chest CT scan was used. Differences in Bhalla scores were assessed with the χ(2) test and intraclass correlation coefficients ( ICC intraclass correlation coefficient s). Radiation doses for CT and radiography were assessed for adults (>18 years) and children (chest CT protocol can replace the two yearly follow-up chest radiographic examinations without major dose penalty and with similar diagnostic quality compared with conventional CT.

  19. Scatter and cross-talk correction for one-day acquisition of 123I-BMIPP and 99mtc-tetrofosmin myocardial SPECT.

    Science.gov (United States)

    Kaneta, Tomohiro; Kurihara, Hideyuki; Hakamatsuka, Takashi; Ito, Hiroshi; Maruoka, Shin; Fukuda, Hiroshi; Takahashi, Shoki; Yamada, Shogo

    2004-12-01

    123I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) and 99mTc-tetrofosmin (TET) are widely used for evaluation of myocardial fatty acid metabolism and perfusion, respectively. ECG-gated TET SPECT is also used for evaluation of myocardial wall motion. These tests are often performed on the same day to minimize both the time required and inconvenience to patients and medical staff. However, as 123I and 99mTc have similar emission energies (159 keV and 140 keV, respectively), it is necessary to consider not only scattered photons, but also primary photons of each radionuclide detected in the wrong window (cross-talk). In this study, we developed and evaluated the effectiveness of a new scatter and cross-talk correction imaging protocol. Fourteen patients with ischemic heart disease or heart failure (8 men and 6 women with a mean age of 69.4 yr, ranging from 45 to 94 yr) were enrolled in this study. In the routine one-day acquisition protocol, BMIPP SPECT was performed in the morning, with TET SPECT performed 4 h later. An additional SPECT was performed just before injection of TET with the energy window for 99mTc. These data correspond to the scatter and cross-talk factor of the next TET SPECT. The correction was performed by subtraction of the scatter and cross-talk factor from TET SPECT. Data are presented as means +/- S.E. Statistical analyses were performed using Wilcoxon's matched-pairs signed-ranks test, and p corrected total count was 26.0 +/- 5.3%. EDV and ESV after correction were significantly greater than those before correction (p = 0.019 and 0.016, respectively). After correction, EF was smaller than that before correction, but the difference was not significant. Perfusion scores (17 segments per heart) were significantly lower after as compared with those before correction (p correction revealed significant differences in EDV, ESV, and perfusion scores. These observations indicate that scatter and cross-talk correction is required for one

  20. Comparison of Model Predictions of Image Quality with Results of Clinical Trials in Chest and Lumbar Spine Screen-film Imaging

    International Nuclear Information System (INIS)

    Sandborg, M.; McVey, G.; Dance, D.R.; Carlsson, G.A.

    2000-01-01

    The ability to predict image quality from known physical and technical parameters is a prerequisite for making successful dose optimisation. In this study, imaging systems have been simulated using a Monte Carlo model of the imaging systems. The model includes a voxelised human anatomy and quantifies image quality in terms of contrast and signal-to-noise ratio for 5-6 anatomical details included in the anatomy. The imaging systems used in clinical trials were simulated and the ranking of the systems by the model and radiologists compared. The model and the results of the trial for chest PA both show that using a high maximum optical density was significantly better than using a low one. The model predicts that a good system is characterised by a large dynamic range and a high contrast of the blood vessels in the retrocardiac area. The ranking by the radiologists and the model agreed for the lumbar spine AP. (author)

  1. Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve

    Energy Technology Data Exchange (ETDEWEB)

    Nahum, E.; Ben-Ari, J.; Schonfeld, T. [Pediatric Intensive Care Unit, Schneider Children' s Medical Center of Israel, Petah Tiqva (Israel); Horev, G. [Dept. of Diagnostic Radiology, Schneider Children' s Medical Center of Israel, Petah Tiqva (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2001-06-01

    A 3{sup 1}/{sub 2}-year-old child developed unilateral diaphragmatic paralysis after chest drain insertion. Plain chest X-ray demonstrated paravertebral positioning of the chest-tube tip, and magnetic resonance imaging revealed hematomas in the region of the chest-tube tip and the phrenic nerve fibers. The trauma to the phrenic nerve was apparently secondary to malposition of the chest tube. This is a rare complication and has been reported mainly in neonates. Radiologists should notify the treating physicians that the correct position of a chest drain tip is at least 2 cm distant from the vertebrae. (orig.)

  2. Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve

    International Nuclear Information System (INIS)

    Nahum, E.; Ben-Ari, J.; Schonfeld, T.; Horev, G.

    2001-01-01

    A 3 1 / 2 -year-old child developed unilateral diaphragmatic paralysis after chest drain insertion. Plain chest X-ray demonstrated paravertebral positioning of the chest-tube tip, and magnetic resonance imaging revealed hematomas in the region of the chest-tube tip and the phrenic nerve fibers. The trauma to the phrenic nerve was apparently secondary to malposition of the chest tube. This is a rare complication and has been reported mainly in neonates. Radiologists should notify the treating physicians that the correct position of a chest drain tip is at least 2 cm distant from the vertebrae. (orig.)

  3. Subtle pulmonary nodules: detection and identification with storage phosphor radiographs and conventional chest films

    International Nuclear Information System (INIS)

    Scheck, R.J.; Schaetzl, M.; Kandziora, C.; Panzer, M.; Rienmueller, R.

    1994-01-01

    To determine the value of digital storagephosphor radiography (SR) on the detection and identification of subtle lung nodules, postero-anterior (PA) and lateral (LAT) film-screen (FR) chest radiographs were compared with isodose SR images of 45 patients with metastatic malignancies. The SR postprocessing was done with a particular mode previously optimized for routine chest radiography. Pulmonary metastases were found in 34 patients and were proved or excluded by CT (n=28) or longterm follow-up FR (n=17). Chest images were divided into four regions for evaluation of image quality, number of lung nodules per region and marked pulmonary structures by receiver-operating characteristics (ROC) analysis (45 patients; 125 nodules; 2810 observations; five readers). Of the nodules selected for an ROC study 82% were 0.5-1.0 cm in diameter. Overall image quality was rated better for FR concerning lung fields (PA) and mediastinum/hilum (LAT). More lung-field nodules were detected on FR than on SR chest images. Use of FR was superior to SR in the general identification of nodules (PA chest), especially concerning intermediate and subtle abnormalities, whereas there was no significant difference for LAT chest images. Our results show, that currently FR still has advantages over SR in the detection and identification of subtle lung nodules in routine clinical radiography. (orig.)

  4. Advanced-stage Hodgkin lymphoma: US/chest radiography for detection of relapse in patients in first complete remission--a randomized trial of routine surveillance imaging procedures.

    Science.gov (United States)

    Picardi, Marco; Pugliese, Novella; Cirillo, Michele; Zeppa, Pio; Cozzolino, Imma; Ciancia, Giuseppe; Pettinato, Guido; Salvatore, Claudia; Quintarelli, Concetta; Pane, Fabrizio

    2014-07-01

    To compare the use of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) with the use of a combination of ultrasonography (US) and chest radiography for systematic follow-up of patients with high-risk Hodgkin lymphoma. Institutional review board approval and informed consent were obtained. In a single center between January 2001 and December 2009, patients with advanced-stage Hodgkin lymphoma who had responded completely to first-line treatment were randomly assigned (1:1) to follow-up with either PET/CT or US/chest radiography. Follow-up included clinical and imaging procedures at 4, 8, 12, 16, 20, 24, 30, 36, 48, 60, 84, and 108 months after treatment discontinuation. When clinical and/or imaging results were positive, recurrence was confirmed histologically. The primary endpoint was to compare the sensitivity of the two follow-up imaging approaches. Secondary endpoints were their specificity, positive and negative predictive values, time to recurrence detection, radiation risks, and costs. A total of 300 patients were randomized into the two arms. The study was closed after a median follow-up time of 60 months, with a relapse rate of 27%. Sensitivity for detection of Hodgkin lymphoma was similar for the two follow-up approaches. All of the relapses (40 of 40) were identified with FDG PET/CT (100%) and 39 of 40 relapses were identified with US/chest radiography (97.5%; P = .0001 for the equivalence test). US/chest radiography showed significantly higher specificity and positive predictive value than did PET/CT (96% [106 of 110] vs 86% [95 of 110], respectively; P = .02; and 91% [39 of 43] vs 73% [40 of 55], respectively; P = .01). Exposure to ionizing radiation was estimated to be 14.5 mSv for one PET/CT examination versus 0.1 mSv for one chest radiographic examination. Estimated cost per relapse diagnosed with routine PET/CT was 10-fold higher compared with that diagnosed with routine US/chest radiography. US and

  5. Effect of Radioactivity of Technetium-99m on the Autosterilization Process of non-sterile Tetrofosmin Kits

    Directory of Open Access Journals (Sweden)

    Widyastuti Widyastuti

    2017-03-01

    Full Text Available Technetium-99m labeled radiopharmaceutical is commonly used in nuclear medicines as a diagnostic agent, by mixing the sterile kit with Tc-99m. Manufacturing of kits requires an aseptic facility which need to be well designed and maintained according to cGMP, since mostly kits can not be terminally sterilized. Radiopharmaceuticals as pharmaceuticals containing radionuclide is assumed to have an autosterilization property, but correlation between radioactivity and capability of killing microorganisms has to be studied so far. The aim of this study is to investigate the effect of radioactivity on the autosterilization process of radiopharmaceuticals. The study was carried out by adding Tc-99m of various radioactivity into non-sterile tetrofosmin kits, then the samples were tested for sterility. Sterile tetrofosmin kit and non-sterile kit with no Tc-99m added will be used as a negative control and positive control respectively. The sterility was tested using standard direct inoculation method, by inoculating samples in culture media for both bacteria and fungi and observing qualitatively within 14 days. The results showed that the samples with radioactivity of 1, 3 and 5 mCi changed the clarity of the media to turbid, conformed with the performance of positive controls but samples with radioactivity of 10 mCi and 20 mCi did not change the clarity of the media, conformed with the performance of negative control, indicating neither growth of bacteria nor fungi. It is concluded that Tc-99m behaves as an autosterilizing agent at certain radioactivity. Therefore the preparation of Tc-99m radiopharmaceutical can be considered as terminal sterilization rather than aseptic preparation.

  6. Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and 99mTc-tetrofosmin: Method and validation.

    Science.gov (United States)

    Shrestha, Uttam; Sciammarella, Maria; Alhassen, Fares; Yeghiazarians, Yerem; Ellin, Justin; Verdin, Emily; Boyle, Andrew; Seo, Youngho; Botvinick, Elias H; Gullberg, Grant T

    2017-02-01

    The objective of this study was to measure myocardial blood flow (MBF) in humans using 99m Tc-tetrofosmin and dynamic single-photon emission computed tomography (SPECT). Dynamic SPECT using 99m Tc-tetrofosmin and dynamic positron emission tomography (PET) was performed on a group of 16 patients. The SPECT data were reconstructed using a 4D-spatiotemporal iterative reconstruction method. The data corresponding to 9 patients were used to determine the flow-extraction curve for 99m Tc-tefrofosmin while data from the remaining 7 patients were used for method validation. The nonlinear tracer correction parameters A and B for 99m Tc-tefrofosmin were estimated for the 9 patients by fitting the flow-extraction curve [Formula: see text] for K 1 values estimated with 99m Tc-tefrofosmin using SPECT and MBF values estimated with 13 N-NH 3 using PET. These parameters were then used to calculate MBF and coronary flow reserve (CFR) in three coronary territories (LAD, RCA, and LCX) using SPECT for an independent cohort of 7 patients. The results were then compared with that estimated with 13 N-NH 3 PET. The flow-dependent permeability surface-area product (PS) for 99m Tc-tefrofosmin was also estimated. The estimated flow-extraction parameters for 99m Tc-tefrofosmin were found to be A = 0.91 ± 0.11, B = 0.34 ± 0.20 (R 2  = 0.49). The range of MBF in LAD, RCA, and LCX was 0.44-3.81 mL/min/g. The MBF between PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (P < .001). However, the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (P = .037). The PS for 99m Tc-tefrofosmin was (0.019 ± 0.10)*MBF + (0.32 ± 0.16). Dynamic cardiac SPECT using 99m Tc-tetrofosmin and a clinical two-headed SPECT/CT scanner can be a useful tool for estimation of MBF.

  7. Role of computed tomography in blunt chest trauma

    International Nuclear Information System (INIS)

    Cho, Jae Hyun; Kim, Sang Jin; Lee, Chan Wha; Kim, Hae Kyoon

    1994-01-01

    In patient with blunt trauma of chest, supine AP x-ray cannot differentiate the lung contusion, laceration, atelectasis, and hemothorax definitely. Therefore, computed tomographic evaluation is needed for accurate evaluation of the injuries. In our knowledge, there are few reports about CT findings of blunt chest trauma, in our country, therefore we tried to fluid the characteristic CT findings in patients with blunt trauma. We analyzed the plain x-ray and CT image of 4 patients with blunt chest trauma. Location and morphology of lung parenchymal contusion and laceration, hemopneumothorax, chest wall injuries and location of chest tube. Lung parenchymal contusion was noted in 53 segments., of 16 patients infiltration(n=27 segment), and multiple nodular pattern was noted in 15 segment, pattern of consolidation along the lung periphery was seen in 11 segment. Laceration was noted in 18 lesion and most commonly located in paravertebral area(b=8). CT scan of chest in patient with blunt chest trauma, provides accurate information of the pattern of injuries, and localization, therefore, should be performed as possible

  8. Performance of Myocardial Perfusion Imaging Using Multi-focus Fan Beam Collimator with Resolution Recovery Reconstruction in a Comparison with Conventional SPECT

    International Nuclear Information System (INIS)

    Matsutomo, Norikazu; Nagaki, Akio; Sasaki, Masayuki

    2014-01-01

    IQ-SPECT is an advanced high-speed SPECT modality for myocardial perfusion imaging (MPI), which uses a multi-focus fan beam collimator with resolution recovery reconstruction. The aim of this study was to compare IQ-SPECT with conventional SPECT in terms of performance, based on standard clinical protocols. In addition, we examined the concordance between conventional and IQ-SPECT in patients with coronary artery disease (CAD). Fifty-three patients, undergoing rest-gated MPI for the evaluation of known or suspected CAD, were enrolled in this study. In each patient, conventional SPECT ( 99m Tc-tetrofosmin, 9.6 min and 201 Tl, 12.9 min) was performed, immediately followed by IQ-SPECT, using a short acquisition time (4.3 min for 99m Tc-tetrofosmin and 6.2 min for 201 Tl). A quantitative analysis was performed on an MPI polar map, using a 20-segment model of the left ventricle. An automated analysis by gated SPECT was carried out to determine the left ventricular volume and function including end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF). The degree of concordance between conventional SPECT and IQ-SPECT images was evaluated according to linear regression and Bland-Altman analyses. The segmental percent uptake exhibited a significant correlation between IQ-SPECT and conventional SPECT (P<0.05). The mean differences in 99m Tc-tetrofosmin studies were 1.1±6.6% (apex), 2.8±5.7% (anterior wall), 2.9±6.2% (septal wall), 4.9±6.7% (lateral wall), and 1.8±5.6% (inferior wall). Meanwhile, regarding the 201 Tl-SPECT studies, these values were 1.6±6.9%, 2.0±6.6%, 2.1±5.9%, 3.3±7.2%, and 2.4±5.8%, respectively. Although the mean LVEF in IQ-SPECT tended to be higher than that observed in conventional SPECT (conventional SPECT=64.8±11.8% and IQ-SPECT=68.3±12.1% for 99m Tc-tetrofosmin; conventional SPECT= 56.0±11.7% and IQ-SPECT=61.5±12.2% for 201 Tl), quantitative parameters were not significantly different between

  9. First determination of the heart-to-mediastinum ratio using cardiac dual isotope ({sup 123}I-MIBG/{sup 99m}Tc-tetrofosmin) CZT imaging in patients with heart failure: the ADRECARD study

    Energy Technology Data Exchange (ETDEWEB)

    Bellevre, Dimitri; Desmonts, Cedric [CHU Cote de Nacre, Department of Nuclear Medicine, Caen (France); Manrique, Alain; Agostini, Denis [CHU Cote de Nacre, Department of Nuclear Medicine, Caen (France); EA 4650, Normandie Universite, Caen (France); Legallois, Damien [EA 4650, Normandie Universite, Caen (France); CHU Cote de Nacre, Cardiology Department, Caen (France); Bross, Samy; Baavour, Rafael; Roth, Nathaniel [Spectrum Dynamics, Biosensors, Caesarea (Israel); Blaire, Tanguy; Bailliez, Alban [EA 4650, Normandie Universite, Caen (France); IRIS, Polyclinique du Bois, Nuclear Medicine Department, Lille (France)

    2015-11-15

    Cardiac innervation is assessed using the heart-to-mediastinum ratio (HMR) of metaiodobenzylguanidine (MIBG) on planar imaging using Anger single photon emission computed tomography (A-SPECT). The aim of the study was to determine the HMR of MIBG obtained using a CZT-based camera (D-SPECT; Spectrum Dynamics, Israel) in comparison with that obtained using conventional planar imaging. The ADRECARD study prospectively evaluated 44 patients with heart failure. They underwent planar acquisition using the A-SPECT camera 4 h after {sup 123}I-MIBG injection (236.4 ± 39.7 MBq). To localize the heart using D-SPECT, {sup 99m}Tc-tetrofosmin (753 ± 133 MBq) was administered and dual isotope acquisition was performed using the D-SPECT system. HMR was calculated using both planar A-SPECT imaging and front view D-SPECT cine data. In a phantom study, we estimated a model fitting the A-SPECT and the D-SPECT data that was further applied to correct for differences between the cameras. A total of 44 patients (39 men and 5 women, aged 60 ± 11 years) with ischaemic (31 patients) and nonischaemic (13 patients) cardiomyopathy completed the study. Most patients (28 of 44) were NYHA class II, and the mean left ventricular ejection fraction was 33 ± 7 %. The mean HMR values were 1.34 ± 0.15 and 1.45 ± 0.27 from A-SPECT and D-SPECT, respectively (p < 0.0001). After correction, Lin's concordance correlation showed an almost perfect concordance between corrected D-SPECT HMR and A-SPECT HMR, and Bland-Altman analysis demonstrated a high agreement between the two measurements. The ADRECARD study demonstrated that determination of late HMR during cardiac MIBG imaging using dual isotope ({sup 123}I and {sup 99m}Tc) acquisition on a CZT camera (D-SPECT) is feasible in patients with heart failure. A linear correction based on the phantom study yielded a high agreement between {sup 123}I MIBG HMR obtained using a CZT camera and that from conventional planar imaging. (orig.)

  10. Assessment of coronary flow reserve by sestamibi imaging in patients with typical chest pain and normal coronary arteries

    International Nuclear Information System (INIS)

    Storto, Giovanni; Sorrentino, Anna R.; Pellegrino, Teresa; Liuzzi, Raffaele; Cuocolo, Alberto; Petretta, Mario

    2007-01-01

    We assessed coronary flow reserve (CFR) by sestamibi imaging in patients with typical chest pain, positive exercise stress test and normal coronary vessels. Thirty-five patients with typical chest pain and normal angiogram and 12 control subjects with atypical chest pain underwent dipyridamole/rest 99m Tc-sestamibi imaging. Myocardial blood flow (MBF) was estimated by measuring first transit counts in the pulmonary artery and myocardial counts from SPECT images. Estimated CFR was expressed as the ratio of stress to rest MBF. Rest MBF and CFR were corrected for rate-pressure product (RPP) and expressed as normalised MBF (MBF n ) and normalised CFR (CFR n ). Coronary vascular resistances (CVR) were calculated as the ratio between mean arterial pressure and estimated MBF. At rest, estimated MBF and MBF n were lower in controls than in patients (0.98 ± 0.4 vs 1.30 ± 0.3 counts/pixel/s and 1.14 ± 0.5 vs 1.64 ± 0.6 counts/pixel/s, respectively, both p n was still higher in controls than in patients (2.1 ± 0.5 vs 1.29 ± 0.5, p < 0.0001). At baseline, CVR values were lower (p < 0.01) in patients than in controls. Dipyridamole-induced changes in CVR were greater (p < 0.0001) in controls (-63%) than in patients (-35%). In the overall study population, a significant correlation between dipyridamole-induced changes in CVR and CFR was observed (r = -0.88, p < 0.0001). SPECT might represent a useful non-invasive method for assessing coronary vascular function in patients with angina and a normal coronary angiogram. (orig.)

  11. Chest X-ray of the neonate

    International Nuclear Information System (INIS)

    Puig, S.; Hoermann, M.; Rand, T.; Schaefer-Prokop, C.; Ponhold, W.; Kuhle, S.; Rebhandl, W.

    2000-01-01

    In diagnostic imaging of thoracic pathologies in mature and especially immature neonates, chest X-ray has a leading position. Profound knowledge of the normal chest X-ray and the potential physiological perinatal changes is the basic requirement for interpretation of the X-ray of a neonate. Childhood pathologie: Many congenital and acquired diseases that the radiologist is faced with in neonatology are unknown in the imaging of adults. Many of these changes are life-threatening or may have an impact on the patient's future quality of life. Therefore, early diagnosis in close cooperation with the paediatrician is essential. We give here an overview of the most important pathologic changes that the radiologist may be confronted with in daily routine. (orig.) [de

  12. Clinical application of 99Tcm-tetrofosmin in diagnosis patients with coronary heart disease

    International Nuclear Information System (INIS)

    Li Na; Chen Song; Wang Xiaobei; Wang Ying; Yin Yafu; Li Xuena; Li Yaming; Wang Lijuan; He Zuoxiang

    2012-01-01

    Objective: To evaluate the diagnostic value of 99 Tc m -tetrofosmin(TF) stress-rest MPI in detecting CHD. Methods: Eighty patients with suspected CHD who had stress-rest MPI from October 2009 to April 2011 were retrospectively analyzed.Forty underwent 99 Tc m -TF (group A) and 40 received 99 Tc m -MIBI (group B) stress-rest MPI. Heart/lung (H/L) ratios of these two groups were compared.CAG was performed on group A patients 3 months before and after MPI. Stenosis of more than 50% in CAG was used as a standard to evaluate the diagnostic efficiency of 99 Tc m -TF MPI. Paired t test and χ 2 test were used to compare the data. Results: H/L ratios of rest and stress from 99 Tc m -TF images were 6.73 ± 1.21 and 6.94 ± 1.69, while those from 99 Tc m -MIBI images were 6.58 ± 1.94 and 6.64 ± 1.81, respectively. There was no difference between 99 Tc m -TF and 99 Tc m -MIBI imaging in both rest and stress (t=0.41, 0.78, both P>0.05). There was no difference between H/L ratios from stress and rest 99 Tc m -TF imaging (t=0.69, P >0.05). Twenty-four patients who underwent 99 Tc m -TF imaging had abnormal perfusion (60.0%, 24/40), including 20 LAD, 11 LCX and 14 RCA. Twenty-three among these 40 patients had abnormal CAG results (57.5%, 23/40), including 19 LAD, 12 LCX, and 11 RCA. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 99 Tc m -TF stress-rest MPI were 87.0% (20/23), 76.5% (13/17), 82.5% (33/40), 83.3% (20/24) and 81.2% (13/16), respectively. The sensitivities of 99 Tc m -TF stress-rest MPI for detection of LAD, LCX and RCA were 89.5% (17/19), 83.3% (10/12) and 90.9% (10/11), respectively,and positive predictive values were 85.0% (17/20), 90.9% (10/11) and 71.4% (10/14), respectively. There was no significant difference for sensitivity and positive predictive value of 99 Tc m -TF MPI among different vessels (χ 2 =0.377 and 1.789, both P>0.05). Conclusions: 99 Tc m -TF MPI has comparative imaging quality to 99 Tc m

  13. The impact of an early-morning radiologist work shift on the timeliness of communicating urgent imaging findings on portable chest radiography.

    Science.gov (United States)

    Kaewlai, Rathachai; Greene, Reginald E; Asrani, Ashwin V; Abujudeh, Hani H

    2010-09-01

    The aim of this study was to assess the potential impact of staggered radiologist work shifts on the timeliness of communicating urgent imaging findings that are detected on portable overnight chest radiography of hospitalized patients. The authors conducted a retrospective study that compared the interval between the acquisition and communication of urgent findings on portable overnight critical care chest radiography detected by an early-morning shift for radiologists (3 am to 11 am) with historical experience with a standard daytime shift (8 am to 5 pm) in the detection and communication of urgent findings in a similar patient population a year earlier. During a 4-month period, 6,448 portable chest radiographic studies were interpreted on the early-morning radiologist shift. Urgent findings requiring immediate communication were detected in 308 (4.8%) studies. The early-morning shift of radiologists, on average, communicated these findings 2 hours earlier compared with the historical control group (P chest radiography of hospitalized patients. Published by Elsevier Inc.

  14. Digitizing pediatric chest radiographs: comparison of low-cost, commercial off-the-shelf technologies

    International Nuclear Information System (INIS)

    Ruess, L.; Shiels, K.C.; Cho, K.H.; O'Connor, S.C.; Uyehara, C.F.T.; Person, D.A.; Whitton, R.K.

    2001-01-01

    Objective: To compare low-cost, off-the-shelf technology for digitizing pediatric chest radiographs. Materials and methods: Forty pediatric chest radiographs (hard copy), each with a single abnormality, were digitized using a commercial film digitizer and two low-cost methods: a digital camera and a flatbed scanner. A stratified, randomized, block design was used where 20 readers evaluated 40 different images to determine the ability to accurately detect the abnormality. Readers then rated all 160 images (40 images x 4 methods) for conspicuity of the abnormality and overall image quality. Results: Abnormalities were correctly identified on 82.3 % of hard copy images, 82.9 % of flatbed scanner images, 74.3 % of film digitizer images, and 69.7 % of digital camera images (p flatbed scanner > film digitizer > digital camera images. Conclusion: A low-cost flatbed scanner yielded digital pediatric chest images which were significantly superior to digital camera images While flatbed scanner images were interpreted with the equivalent diagnostic accuracy of hard copy images, they were rated lower for image quality and lesion conspicuity. (orig.)

  15. Chest X ray effective doses estimation in computed radiography

    International Nuclear Information System (INIS)

    Abdalla, Esra Abdalrhman Dfaalla

    2013-06-01

    Conventional chest radiography is technically difficult because of wide in tissue attenuations in the chest and limitations of screen-film systems. Computed radiography (CR) offers a different approach utilizing a photostimulable phosphor. photostimulable phosphors overcome some image quality limitations of chest imaging. The objective of this study was to estimate the effective dose in computed radiography at three hospitals in Khartoum. This study has been conducted in radiography departments in three centres Advanced Diagnostic Center, Nilain Diagnostic Center, Modern Diagnostic Center. The entrance surface dose (ESD) measurement was conducted for quality control of x-ray machines and survey of operators experimental techniques. The ESDs were measured by UNFORS dosimeter and mathematical equations to estimate patient doses during chest X rays. A total of 120 patients were examined in three centres, among them 62 were males and 58 were females. The overall mean and range of patient dosed was 0.073±0.037 (0.014-0.16) mGy per procedure while the effective dose was 3.4±01.7 (0.6-7.0) mSv per procedure. This study compared radiation doses to patients radiographic examinations of chest using computed radiology. The radiation dose was measured in three centres in Khartoum- Sudan. The results of the measured effective dose showed that the dose in chest radiography was lower in computed radiography compared to previous studies.(Author)

  16. Development of a fully automated adaptive unsharp masking technique in digital chest radiograph

    International Nuclear Information System (INIS)

    Abe, Katsumi; Katsuragawa, Shigehiko; Sasaki, Yasuo

    1991-01-01

    We are developing a fully automated adaptive unsharp masking technique with various parameters depending on regional image features of a digital chest radiograph. A chest radiograph includes various regions such as lung fields, retrocardiac area and spine in which their texture patterns and optical densities are extremely different. Therefore, it is necessary to enhance image contrast of each region by each optimum parameter. First, we investigated optimum weighting factors and mask sizes of unsharp masking technique in a digital chest radiograph. Then, a chest radiograph is automatically divided into three segments, one for the lung field, one for the retrocardiac area, and one for the spine, by using histogram analysis of pixel values. Finally, high frequency components of the lung field and retrocardiac area are selectively enhanced with a small mask size and mild weighting factors which are previously determined as optimum parameters. In addition, low frequency components of the spine are enhanced with a large mask size and adequate weighting factors. This processed image shows excellent depiction of the lung field, retrocardiac area and spine simultaneously with optimum contrast. Our image processing technique may be useful for diagnosis of chest radiographs. (author)

  17. Trauma of the chest

    International Nuclear Information System (INIS)

    Reuter, M.

    1996-01-01

    This paper describes the typical radiologic findings in chest trauma, and the value of conventional radiography, CT, MRI, and aortography is discussed. Conventional radiography rather than cross-sectional imaging is the mainstay in diagnosing thoracic trauma. During the critical phase with often concomitant shock, pelvic and spinal injuries tailored raiographic views or even upright chest radiographs are impractical. The severely traumatized patient is usually radiographed in the supine position and suboptimal roentgenograms may have to be accepted for several reasons. It is well documented that many abnormalities detected on CT were not apparent on conventional radiographs, but CT is reserved for hemodynamical stable patients. Nevertheless certain situations like aortic rupture require further evaluation by CT and aortography. (orig./MG)

  18. Inadvertent chest tube insertion in congenital cystic adenomatoid malformation and congenital lobar emphysema-highlighting an important problem

    International Nuclear Information System (INIS)

    Prabhu, Shailesh M; Choudhury, Subhasis Roy; Solanki, Ravi S; Shetty, Gurucharan S; Agarwala, Surenderkumar

    2013-01-01

    Chest tube insertion in congenital cystic lung lesions is an important problem in children with acute respiratory distress having a cystic lucent lesion on chest radiograph. To evaluate the imaging findings and complications in cases of congenital cystic lung lesions with chest tube insertion and suggest the role of appropriate imaging for management of these patients. Chest radiographs and CT scans of children with congenital cystic lung lesions who had inadvertent chest tube insertion preoperatively were retrospectively reviewed for imaging appearances and complications. Fifteen patients comprising 10 cases of congenital cystic adenomatoid malformation (CCAM) and 5 cases of congenital lobar emphysema (CLE) were included. Majority of the cases were infants. CCAM was misdiagnosed as complicated pneumatocele (n = 5) and pneumothorax (n = 5), while CLE was misdiagnosed as tension pneumothorax (n = 5) on the chest radiograph findings. Final diagnosis was made on CT and operative findings with histopathology. Complications noted were pneumothorax, hydropneumothorax, and infection in cases of CCAM, and change in imaging appearance and pneumothorax in cases of CLE. Chest tube insertion in congenital cystic lesions increases the rate of associated complications. Chest CT has a definite role in early diagnosis and deciding appropriate management in these cases

  19. Comparison of the accumulation and efflux kinetics of technetium-99m sestamibi and technetium-99m tetrofosmin in an MRP-expressing tumour cell line

    International Nuclear Information System (INIS)

    Utsunomiya, K.; Su, Z.-F.; Ichise, M.; Ballinger, J.R.; Piquette-Miller, M.; Tang, W.; Rauth, A.M.

    2000-01-01

    The potential clinical use of technetium-99m labeled sestamibi (Tc-MIBI) and tetrofosmin (Tc-Tfos) to image tumours is currently being evaluated. In this study, the accumulation and efflux of Tc-MIBI and Tc-Tfos in the nasopharyngeal carcinoma cell line CNE-1 were examined in the presence or absence of various inhibitors of P-glycoprotein (PGP) and/or multidrug resistance associated protein (MRP) activity [GG918, PSC833, verapamil (Vrp), cyclosporin A (CsA) and buthionine sulfoximine (BSO)]. Reverse-transcriptase polymerase chain reaction analysis and immunodetection of the CNE-1 cells detected expression of MRP, MRP1 and MRP2 but not PGP. Tc-MIBI and Tc-Tfos accumulation was increased (P 2 times greater than for Tc-MIBI). However, no qualitative differences in inhibitors were seen between Tc-MIBI and Tc-Tfos. These results suggest that both Tc-MIBI and Tc-Tfos are substrates for the MRP transporter and that PSC833, Vrp, CsA and BSO but not GG918 can inhibit MRP activity. These results indicate that Tc-MIBI and Tc-Tfos may be suitable imaging agents for detecting MRP-mediated drug resistance in human cancers. (orig.)

  20. Intrathoracic tuberculous lymphadenopathy in children: a guide to chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    George, Anthony; Andronikou, Savvas [Bristol Royal Hospital for Children and the University of Bristol, Department of Paediatric Radiology, Bristol (United Kingdom); Pillay, Tanyia; Zar, Heather J. [University of Cape Town and Medical Research Council Unit on Child and Adolescent Health, Department of Paediatrics and Child Health, Red Cross War Memorial Children' s Hospital, Cape Town (South Africa); Goussard, Pierre [Tygerberg Hospital and the University of Stellenbosch, Department of Paediatrics and Child Health, Cape Town (South Africa)

    2017-09-15

    Making the diagnosis of pulmonary tuberculosis in children can be difficult because microbiological confirmation is not often achieved. Diagnosis is therefore often based on clinical features in combination with chest radiograph findings. Chest radiographs can demonstrate lymphadenopathy of the hilar and para-tracheal regions on the anteroposterior view, and subcarinal lymphadenopathy on the lateral view. However poor interobserver agreement has been reported for radiologist and clinician assessment of lymphadenopathy. This might reflect the lack of standardised imaging criteria for diagnosis as well as radiologists' objectives for achieving sensitivity rather than specificity. In this paper the authors provide a pictorial aid of chest radiographs in children with culture-confirmed tuberculosis to help clinicians identify lymph node enlargement in primary pulmonary tuberculosis. This collection of images comprises chest radiographs accompanied by schematics and either CT or MRI scan confirmation of pathological lymph node enlargement at the positions commonly affected in tuberculosis. (orig.)

  1. Multicentre chest computed tomography standardisation in children and adolescents with cystic fibrosis

    DEFF Research Database (Denmark)

    Kuo, Wieying; Kemner-van de Corput, Mariette P. C.; Perez-Rovira, Adria

    2016-01-01

    Progressive cystic fibrosis (CF) lung disease is the main cause of mortality in CF patients. CF lung disease starts in early childhood. With current standards of care, respiratory function remains largely normal in children and more sensitive outcome measures are needed to monitor early CF lung...... disease. Chest CT is currently the most sensitive imaging modality to monitor pulmonary structural changes in children and adolescents with CF. To quantify structural lung disease reliably among multiple centres, standardisation of chest CT protocols is needed. SCIFI CF (Standardised Chest Imaging...

  2. Analysis the findings of chest radiograph and CT scan in 217 acute thoracic trauma

    International Nuclear Information System (INIS)

    Huang Shaoying

    2005-01-01

    Objective: To evaluate chest radiograph and CT scan in assessing acute thoracic trauma. Methods: Retrospectively analyzed the findings of chest radiograph and CT scan in 217 cases of acute thoracic trauma and positive rate of each modality was compared. Results: The positive rate of rib and clavicle fracture was higher in chest radiograph than these in CT scan. But the positive rate of chest wall hematoma, mediastinum and subcutaneous emphysema, pneumothorax, hydropneumothorax, damage of lung parenchyma and traumatic pulmonary atelectasis was higher in CT scan than those in chest radiograph. Conclusion: The application of the combined imaging modalities improves assessing of acute thoracic trauma, because the imaging manifestation of the lesion is various. (authors)

  3. Nodule detection in digital chest radiography: Effect of anatomical noise

    International Nuclear Information System (INIS)

    Baath, M.; Haakansson, M.; Boerjesson, S.; Hoeschen, C.; Tischenko, O.; Kheddache, S.; Vikgren, J.; Maansson, L. G.

    2005-01-01

    The image background resulting from imaged anatomy can be divided into those components that are meaningful to the observers, in the sense that they are recognised as separate structures, and those that are not. These latter components (referred to as anatomical noise) can be removed using a method developed within the RADIUS group. The aim of the present study was to investigate whether the removal of the anatomical noise results in images where lung nodules with lower contrast can be detected. A receiver operating characteristic (ROC) study was therefore conducted using two types of images: clinical chest images and chest images in which the anatomical noise had been removed. Simulated designer nodules with a full-width-at-fifth-maximum of 10 mm but with varying contrast were added to the images. The contrast needed to obtain an area under the ROC curve of 0.80, C0.8, was used as a measure of detectability (a low value of C0.8 represents a high delectability). Five regions of the chest X ray were investigated and it was found that in all regions the removal of anatomical noise led to images with lower C0.8 than the original images. On average, C0.8 was 20% higher in the original images, ranging from 7% (the lateral pulmonary regions) to 41% (the upper mediastinal regions). (authors)

  4. A Monte Carlo-based model for simulation of digital chest tomo-synthesis

    International Nuclear Information System (INIS)

    Ullman, G.; Dance, D. R.; Sandborg, M.; Carlsson, G. A.; Svalkvist, A.; Baath, M.

    2010-01-01

    The aim of this work was to calculate synthetic digital chest tomo-synthesis projections using a computer simulation model based on the Monte Carlo method. An anthropomorphic chest phantom was scanned in a computed tomography scanner, segmented and included in the computer model to allow for simulation of realistic high-resolution X-ray images. The input parameters to the model were adapted to correspond to the VolumeRAD chest tomo-synthesis system from GE Healthcare. Sixty tomo-synthesis projections were calculated with projection angles ranging from + 15 to -15 deg. The images from primary photons were calculated using an analytical model of the anti-scatter grid and a pre-calculated detector response function. The contributions from scattered photons were calculated using an in-house Monte Carlo-based model employing a number of variance reduction techniques such as the collision density estimator. Tomographic section images were reconstructed by transferring the simulated projections into the VolumeRAD system. The reconstruction was performed for three types of images using: (i) noise-free primary projections, (ii) primary projections including contributions from scattered photons and (iii) projections as in (ii) with added correlated noise. The simulated section images were compared with corresponding section images from projections taken with the real, anthropomorphic phantom from which the digital voxel phantom was originally created. The present article describes a work in progress aiming towards developing a model intended for optimisation of chest tomo-synthesis, allowing for simulation of both existing and future chest tomo-synthesis systems. (authors)

  5. Myocardial viability assessment with gated SPECT Tc-99m tetrofosmin % wall thickening. Comparison with F-18 FDG-PET

    International Nuclear Information System (INIS)

    Maruyama, Atsushi; Hasegawa, Shinji; Paul, A.K.; Xiuli, M.; Yoshioka, Jun; Maruyama, Kaoru; Hori, Masatsugu; Nishimura, Tsunehiko

    2002-01-01

    This study was designed to assess the value of gated SPECT Tc-99m-tetrofosmin (TF) wall thickening (WT) in addition to TF exercise (Ex)/rest myocardial SPECT, in comparison with F-18 fluorodeoxyglucose (FDG)-PET. The study population consisted of 33 patients with old myocardial infarction (27 men and 6 women; mean age, 62±8 years old). All patients underwent Ex/rest TF SPECT and glucose loading FDG-PET. Polar map images of Ex/rest TF were generated and divided into 24 segments for further analysis. We classified LV segments according to the exercise-rest perfusion scintigraphy. LV segments with less than 70% of the maximum TF activity on the exercise image were defined as stress-induced defects. Among these, the segments whose TF acitvity increased by 10% from exercise to rest images or exceeded 70% of the maximum uptake were defined as reversible (viable) defects. The remaining defects on the rest image were irreversible (non-viable) defect segments, and were considered for viability study on the basis of %WT. %WT was calculated according to the standard method: {(counts ES-counts ED)/ counts ED} x 100. A viable segment on gated SPECT was defined as a segment whose %WT exceeded the lower limit of the normal value (mean-SD). PET viability was defined as FDG uptake exceeding 50% of the maximum count. Among the 792 segments evaluated in the 33 patients studied, there were 689 PET viable segments. Of the 689 segments analyzed, 198 (29%) were identified as having defects on Ex images. Among these defects, 55 (8%) were reversible or partially reversible, as evidenced by rest images, and 143 (21%) were irreversible. Of the irreversible segments on Ex/rest images, 106 (15%) demonstrated no apparent WT by gated TF SPECT, whereas 37 (6%) segments with irreversible defects did have apparent WT. Overall, the sensitivity of Ex/rest TF perfusion imaging was 79%. Sensitivity was improved from 79% to 85% by combining %WT and perfusion data, but specificity was reduced from 70

  6. Segmentation of lung fields using Chan-Vese active contour model in chest radiographs

    Science.gov (United States)

    Sohn, Kiwon

    2011-03-01

    A CAD tool for chest radiographs consists of several procedures and the very first step is segmentation of lung fields. We develop a novel methodology for segmentation of lung fields in chest radiographs that can satisfy the following two requirements. First, we aim to develop a segmentation method that does not need a training stage with manual estimation of anatomical features in a large training dataset of images. Secondly, for the ease of implementation, it is desirable to apply a well established model that is widely used for various image-partitioning practices. The Chan-Vese active contour model, which is based on Mumford-Shah functional in the level set framework, is applied for segmentation of lung fields. With the use of this model, segmentation of lung fields can be carried out without detailed prior knowledge on the radiographic anatomy of the chest, yet in some chest radiographs, the trachea regions are unfavorably segmented out in addition to the lung field contours. To eliminate artifacts from the trachea, we locate the upper end of the trachea, find a vertical center line of the trachea and delineate it, and then brighten the trachea region to make it less distinctive. The segmentation process is finalized by subsequent morphological operations. We randomly select 30 images from the Japanese Society of Radiological Technology image database to test the proposed methodology and the results are shown. We hope our segmentation technique can help to promote of CAD tools, especially for emerging chest radiographic imaging techniques such as dual energy radiography and chest tomosynthesis.

  7. Tree-structured vector quantization of CT chest scans: Image quality and diagnostic accuracy

    International Nuclear Information System (INIS)

    Cosman, P.C.; Tseng, C.; Gray, R.M.; Olshen, R.A.; Moses, L.E.; Davidson, H.C.; Bergin, C.J.; Riskin, E.A.

    1993-01-01

    The quality of lossy compressed images is often characterized by signal-to-noise ratios, informal tests of subjective quality, or receiver operating characteristic (ROC) curves that include subjective appraisals of the value of an image for a particular application. The authors believe that for medical applications, lossy compressed images should be judged by a more natural and fundamental aspect of relative image quality: their use in making accurate diagnoses. They apply a lossy compression algorithm to medical images, and quantify the quality of the images by the diagnostic performance of radiologists, as well as by traditional signal-to-noise ratios and subjective ratings. The study is unlike previous studies of the effects of lossy compression in that they consider non-binary detection tasks, simulate actual diagnostic practice instead of using paired tests or confidence rankings, use statistical methods that are more appropriate for non-binary clinical data than are the popular ROC curves, and use low-complexity predictive tree-structured vector quantization for compression rather than DCT-based transform codes combined with entropy coding. Their diagnostic tasks are the identification of nodules (tumors) in the lungs and lymphadenopathy in the mediastinum from computerized tomography (CT) chest scans. For the image modality, compression algorithm, and diagnostic tasks they consider, the original 12 bit per pixel (bpp) CT image can be compressed to between 1 bpp and 2 bpp with no significant changes in diagnostic accuracy

  8. A computerized method for automated identification of erect posteroanterior and supine anteroposterior chest radiographs

    International Nuclear Information System (INIS)

    Kao, E-Fong; Chou, Ming-Chung; Lin, Wei-Chen; Hsu, Jui-Sheng; Jaw, Twei-Shiun; Liu, Gin-Chung

    2011-01-01

    A computerized scheme was developed for automated identification of erect posteroanterior (PA) and supine anteroposterior (AP) chest radiographs. The method was based on three features, the tilt angle of the scapula superior border, the tilt angle of the clavicle and the extent of radiolucence in lung fields, to identify the view of a chest radiograph. The three indices A scapula , A clavicle and C lung were determined from a chest image for the three features. Linear discriminant analysis was used to classify PA and AP chest images based on the three indices. The performance of the method was evaluated by receiver operating characteristic analysis. The proposed method was evaluated using a database of 600 PA and 600 AP chest radiographs. The discriminant performances Az of A scapula , A clavicle and C lung were 0.878 ± 0.010, 0.683 ± 0.015 and 0.962 ± 0.006, respectively. The combination of the three indices obtained an Az value of 0.979 ± 0.004. The results indicate that the combination of the three indices could yield high discriminant performance. The proposed method could provide radiologists with information about the view of chest radiographs for interpretation or could be used as a preprocessing step for analyzing chest images.

  9. Entrance surface dose and image quality: Comparison of adult chest and abdominal X-ray examinations in general practitioner clinics, public and private hospitals in Malaysia

    International Nuclear Information System (INIS)

    Hambali, A. S.; Ng, K. H.; Abdullah, B. J. J.; Wang, H. B.; Jamal, N.; Spelic, D. C.; Suleiman, O. H.

    2009-01-01

    This study was undertaken to compare the entrance surface dose (ESD) and image quality of adult chest and abdominal X-ray examinations conducted at general practitioner (GP) clinics, and public and private hospitals in Malaysia. The surveyed facilities were randomly selected within a given category (28 GP clinics, 20 public hospitals and 15 private hospitals). Only departmental X-ray units were involved in the survey. Chest examinations were done at all facilities, while only hospitals performed abdominal examinations. This study used the x-ray attenuation phantoms and protocols developed for the Nationwide Evaluation of X-ray Trends (NEXT) survey program in the United States. The ESD was calculated from measurements of exposure and clinical geometry. An image quality test tool was used to evaluate the low-contrast detectability and high-contrast detail performance under typical clinical conditions. The median ESD value for the adult chest X-ray examination was the highest (0.25 mGy) at GP clinics, followed by private hospitals (0.22 mGy) and public hospitals (0.17 mGy). The median ESD for the adult abdominal X-ray examination at public hospitals (3.35 mGy) was higher than that for private hospitals (2.81 mGy). Results of image quality assessment for the chest X-ray examination show that all facility types have a similar median spatial resolution and low-contrast detectability. For the abdominal X-ray examination, public hospitals have a similar median spatial resolution but larger low-contrast detectability compared with private hospitals. The results of this survey clearly show that there is room for further improvement in performing chest and abdominal X-ray examinations in Malaysia. (authors)

  10. Comparison of chest radiography, chest digital tomosynthesis and low dose MDCT to detect small ground-glass opacity nodules: an anthropomorphic chest phantom study

    International Nuclear Information System (INIS)

    Doo, Kyung Won; Kang, Eun-Young; Yong, Hwan Seok; Ham, Soo-Youn; Lee, Ki Yeol; Choo, Ji Yung

    2014-01-01

    The purpose of this study was to evaluate the diagnostic performance of chest radiography (CXR), chest digital tomosynthesis (DT) and low dose multidetector computed tomography (LDCT) for the detection of small pulmonary ground-glass opacity (GGO) nodules, using an anthropomorphic chest phantom. Artificial pulmonary nodules were placed in a phantom and a total of 40 samples of different nodule settings underwent CXR, DT and LDCT. The images were randomly read by three experienced chest radiologists. Free-response receiver-operating characteristics (FROC) were used. The figures of merit for the FROC curves averaged for the three observers were 0.41, 0.37 and 0.76 for CXR, DT and LDCT, respectively. FROC analyses revealed significantly better performance of LDCT over CXR or DT for the detection of GGO nodules (P < 0.05). The difference in detectability between CXR and DT was not statistically significant (P = 0.73). The diagnostic performance of DT for the detection of pulmonary small GGO nodules was not significantly different from that of CXR, but LDCT performed significantly better than both CXR and DT. DT is not a suitable alternative to CT for small GGO nodule detection, and LDCT remains the method of choice for this purpose. (orig.)

  11. Comparison of chest radiography, chest digital tomosynthesis and low dose MDCT to detect small ground-glass opacity nodules: an anthropomorphic chest phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Doo, Kyung Won; Kang, Eun-Young; Yong, Hwan Seok [Korea University Guro Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Ham, Soo-Youn [Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Ki Yeol; Choo, Ji Yung [Korea University Ansan Hospital, Korea University College of Medicine, Department of Radiology, Ansan (Korea, Republic of)

    2014-12-15

    The purpose of this study was to evaluate the diagnostic performance of chest radiography (CXR), chest digital tomosynthesis (DT) and low dose multidetector computed tomography (LDCT) for the detection of small pulmonary ground-glass opacity (GGO) nodules, using an anthropomorphic chest phantom. Artificial pulmonary nodules were placed in a phantom and a total of 40 samples of different nodule settings underwent CXR, DT and LDCT. The images were randomly read by three experienced chest radiologists. Free-response receiver-operating characteristics (FROC) were used. The figures of merit for the FROC curves averaged for the three observers were 0.41, 0.37 and 0.76 for CXR, DT and LDCT, respectively. FROC analyses revealed significantly better performance of LDCT over CXR or DT for the detection of GGO nodules (P < 0.05). The difference in detectability between CXR and DT was not statistically significant (P = 0.73). The diagnostic performance of DT for the detection of pulmonary small GGO nodules was not significantly different from that of CXR, but LDCT performed significantly better than both CXR and DT. DT is not a suitable alternative to CT for small GGO nodule detection, and LDCT remains the method of choice for this purpose. (orig.)

  12. TU-FG-209-11: Validation of a Channelized Hotelling Observer to Optimize Chest Radiography Image Processing for Nodule Detection: A Human Observer Study

    International Nuclear Information System (INIS)

    Sanchez, A; Little, K; Chung, J; Lu, ZF; MacMahon, H; Reiser, I

    2016-01-01

    Purpose: To validate the use of a Channelized Hotelling Observer (CHO) model for guiding image processing parameter selection and enable improved nodule detection in digital chest radiography. Methods: In a previous study, an anthropomorphic chest phantom was imaged with and without PMMA simulated nodules using a GE Discovery XR656 digital radiography system. The impact of image processing parameters was then explored using a CHO with 10 Laguerre-Gauss channels. In this work, we validate the CHO’s trend in nodule detectability as a function of two processing parameters by conducting a signal-known-exactly, multi-reader-multi-case (MRMC) ROC observer study. Five naive readers scored confidence of nodule visualization in 384 images with 50% nodule prevalence. The image backgrounds were regions-of-interest extracted from 6 normal patient scans, and the digitally inserted simulated nodules were obtained from phantom data in previous work. Each patient image was processed with both a near-optimal and a worst-case parameter combination, as determined by the CHO for nodule detection. The same 192 ROIs were used for each image processing method, with 32 randomly selected lung ROIs per patient image. Finally, the MRMC data was analyzed using the freely available iMRMC software of Gallas et al. Results: The image processing parameters which were optimized for the CHO led to a statistically significant improvement (p=0.049) in human observer AUC from 0.78 to 0.86, relative to the image processing implementation which produced the lowest CHO performance. Conclusion: Differences in user-selectable image processing methods on a commercially available digital radiography system were shown to have a marked impact on performance of human observers in the task of lung nodule detection. Further, the effect of processing on humans was similar to the effect on CHO performance. Future work will expand this study to include a wider range of detection/classification tasks and more

  13. Clinical evaluation of adenosine and exercise stress 99Tcm-MIBI myocardial imaging in detection of myocardial ischemia in patients with untypical chest pain

    International Nuclear Information System (INIS)

    Tian Yueqin; He Zuoxiang; Wang Qi; Hu Fenghuan; Yang Weixian; Qiao Shubing; Liu Xiujie

    2005-01-01

    Objective: To evaluate the value of adenosine and exercise stress 99 Tc m -methoxyisobutylisonitrile (MIBI) myocardial imaging for the diagnosis of myocardial ischemia in patients with untypical chest pain. Methods: Two groups included. Group 1: 67 cases of adenosine 99 Tc m -MIBI myocardial imaging. Group 2: 81 cases of exercise stress 99 Tc m -MIBI myocardial imaging. All of the patients had coronary angiography (CAG). The results of them were compared. Results: 23 out of 67 patients in group 1 had significant coronary stenosis after CAG, 16 showed reversible perfusion abnormalities in adenosine imaging. 41 of 44 patients with normal CAG showed normal adenosine imaging. The sensitivity, specificity and accuracy of adenosine imaging for coronary artery disease detection were 70%, 93% and 85%, respectively. Group 2: 22 out of 31 patients with significant coronany stenosis after CAG showed reversible perfusion abnormalities, 48 of 50 patients with normal CAG showed normal exercise imaging. The sensitivity, specificity and accuracy of exercise imaging for coronary artery disease detection were 71%, 96% and 86%, respectively. Conclusion: Reversible perfusion abnormalities found both in adenosine and exercise stress 99 Tc m -MIBI myocardial imaging were the key point for diagnosis of myocardial ischemia in patients with untypical chest pain. (authors)

  14. Chest computed tomography in children undergoing extra-corporeal membrane oxygenation: a 9-year single-centre experience

    Energy Technology Data Exchange (ETDEWEB)

    Goodwin, Susie J.; Calder, Alistair D. [Great Ormond Street Hospital for Children NHS Foundation Trust, Radiology Department, London (United Kingdom); Randle, Elise; Iguchi, Akane; Brown, Katherine; Hoskote, Aparna [Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiac Intensive Care and ECMO, London (United Kingdom)

    2014-06-15

    We retrospectively reviewed the imaging findings, indications, technique and clinical impact in children who had undergone chest CT while undergoing extra-corporeal membrane oxygenation (ECMO). Radiology and ECMO databases were searched to identify all 19 children who had undergone chest CT (20 scans in total) while on ECMO at our institution between May 2003 and May 2012. We reviewed all CT scans for imaging findings. Chest CT is performed in a minority of children on ECMO (4.5% in our series). Timing of chest CT following commencement of ECMO varied among patient groups but generally it was performed earlier in the neonatal group. Clinically significant imaging findings were found in the majority of chest CT scans. Many scans contained several findings, with most cases demonstrating parenchymal or pleural abnormalities. Case examples illustrate the spectrum of imaging findings, including underlying pathology such as necrotising pneumonia and severe barotrauma, and ECMO-related complications such as tension haemothoraces and cannula migration. The results of chest CT led to a change in patient management in 16 of 19 children (84%). There were no adverse events related to patient transfer. An understanding of scan technique and awareness of potential findings is important for the radiologist to provide prompt and optimal image acquisition and interpretation in appropriate patients. (orig.)

  15. Computer-aided Detection Fidelity of Pulmonary Nodules in Chest Radiograph

    Directory of Open Access Journals (Sweden)

    Nikolaos Dellios

    2017-01-01

    Full Text Available Aim: The most ubiquitous chest diagnostic method is the chest radiograph. A common radiographic finding, quite often incidental, is the nodular pulmonary lesion. The detection of small lesions out of complex parenchymal structure is a daily clinical challenge. In this study, we investigate the efficacy of the computer-aided detection (CAD software package SoftView™ 2.4A for bone suppression and OnGuard™ 5.2 (Riverain Technologies, Miamisburg, OH, USA for automated detection of pulmonary nodules in chest radiographs. Subjects and Methods: We retrospectively evaluated a dataset of 100 posteroanterior chest radiographs with pulmonary nodular lesions ranging from 5 to 85 mm. All nodules were confirmed with a consecutive computed tomography scan and histologically classified as 75% malignant. The number of detected lesions by observation in unprocessed images was compared to the number and dignity of CAD-detected lesions in bone-suppressed images (BSIs. Results: SoftView™ BSI does not affect the objective lesion-to-background contrast. OnGuard™ has a stand-alone sensitivity of 62% and specificity of 58% for nodular lesion detection in chest radiographs. The false positive rate is 0.88/image and the false negative (FN rate is 0.35/image. From the true positive lesions, 20% were proven benign and 80% were malignant. FN lesions were 47% benign and 53% malignant. Conclusion: We conclude that CAD does not qualify for a stand-alone standard of diagnosis. The use of CAD accompanied with a critical radiological assessment of the software suggested pattern appears more realistic. Accordingly, it is essential to focus on studies assessing the quality-time-cost profile of real-time (as opposed to retrospective CAD implementation in clinical diagnostics.

  16. Where Does It Lead? Imaging Features of Cardiovascular Implantable Electronic Devices on Chest Radiograph and CT

    Energy Technology Data Exchange (ETDEWEB)

    Lanzman, Rotem S.; Blondin, Dirk; Furst, Gunter; Scherer, Axel; R Miese, Falk; Kroepil, Patric [University of Duesseldorf, Medical Faculty, 40225 Duesseldorf (Germany); Winter, Joachim [University Hospital Duesseldorf, 40225 Duesseldorf (Germany); Abbara, Suhny [Massachusetts General Hospital, Boston, MA (US)

    2011-10-15

    Pacemakers and implantable cardioverter defibrillators (ICDs) are being increasingly employed in patients suffering from cardiac rhythm disturbances. The principal objective of this article is to familiarize radiologists with pacemakers and ICDs on chest radiographs and CT scans. Therefore, the preferred lead positions according to pacemaker types and anatomic variants are introduced in this study. Additionally, the imaging features of incorrect lead positions and defects, as well as complications subsequent to pacemaker implantation are demonstrated herein.

  17. Where Does It Lead? Imaging Features of Cardiovascular Implantable Electronic Devices on Chest Radiograph and CT

    International Nuclear Information System (INIS)

    Lanzman, Rotem S.; Blondin, Dirk; Furst, Gunter; Scherer, Axel; R Miese, Falk; Kroepil, Patric; Winter, Joachim; Abbara, Suhny

    2011-01-01

    Pacemakers and implantable cardioverter defibrillators (ICDs) are being increasingly employed in patients suffering from cardiac rhythm disturbances. The principal objective of this article is to familiarize radiologists with pacemakers and ICDs on chest radiographs and CT scans. Therefore, the preferred lead positions according to pacemaker types and anatomic variants are introduced in this study. Additionally, the imaging features of incorrect lead positions and defects, as well as complications subsequent to pacemaker implantation are demonstrated herein.

  18. Anthropomorphic chest phantom imaging – The potential for dose creep in computed radiography

    International Nuclear Information System (INIS)

    Ma, W.K.; Hogg, P.; Tootell, A.; Manning, D.; Thomas, N.; Kane, T.; Kelly, J.; McKenzie, M.; Kitching, J.

    2013-01-01

    For film-based radiography the operator had to be exact in the selection of acquisition parameters or the image could easily become under- or over-exposed. By contrast, digital technology allows for a much greater tolerance of acquisition factor selection which would still give an image of acceptable diagnostic quality. In turn this greater tolerance allows for the operator to increase effective dose for little or no penalty in image quality. The purpose of this article is to determine how image quality and lesion visibility vary with effective dose (E) in order to identify how much overexposure could be tolerated within the radiograph. Using an anthropomorphic chest phantom with ground glass lesions we determined how perceptual image quality and E varied over a wide range of acquisition conditions. Perceptual image quality comprised of image quality and lesion visibility. E was calculated using Monte Carlo method; image quality was determined using a two alternative forced choice (2AFC) method and the quality criteria were partly informed from European guidelines. Five clinicians with significant experience in image reading scored the images for quality (intraclass correlation coefficient 0.869). Image quality and lesion visibility had a close correlation (R 2 > 0.8). The tolerance for over-exposure, whilst still acquiring an image of acceptable quality, increases with decreasing kV and increasing source to image distance (SID). The maximum over-exposure factor (ratio of maximum E to minimum E that produce images of acceptable quality) possible was 139 (at 125 cm and 60 kV). Given the phantom had characteristics similar to the human thorax we propose that that potential for overexposure in a human whilst still obtaining an image of acceptable perceptual image quality is very high. Further research into overexposure tolerance and dose creep should be undertaken

  19. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

    Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

  20. Clinical assessment of chest pain and guidelines for imaging

    International Nuclear Information System (INIS)

    Gruettner, J.; Henzler, T.; Sueselbeck, T.; Fink, C.; Borggrefe, M.; Walter, T.

    2012-01-01

    For many emergency facilities, risk assessment of patients with diffuse chest pain still poses a major challenge. In their currently valid recommendations, the international cardiological societies have defined a standardized assessment of the prognostically relevant cardiac risk criteria. Here the classic sequence of basic cardiac diagnostics including case history (cardiac risk factors), physical examination (haemodynamic and respiratory vital parameters), ECG (ST segment analysis) and laboratory risk markers (troponin levels) is paramount. The focus is, on the one hand, on timely indication for percutaneous catheterization, especially in patients at high cardiac risk with or without ST-segment elevation in the ECG, and, on the other hand, on the possibility of safely discharging patients with intermediate or low cardiac risk after non-invasive exclusion of a coronary syndrome. For patients in the intermediate or low risk group, physical or pharmacological stress testing in combination with scintigraphy, echocardiography or magnetic resonance imaging is recommended in addition to basic diagnostics. Moreover, the importance of non-invasive coronary imaging, primarily cardiac CT angiography (CCTA), is increasing. Current data show that in intermediate or low risk patients this method is suitable to reliably rule out coronary heart disease. In addition, attention is paid to the major differential diagnoses of acute coronary syndrome, particularly pulmonary embolism and aortic dissection. Here the diagnostic method of choice is thoracic CT, possibly also in combination with CCTA aiming at a triple rule-out.

  1. Clinical assessment of chest pain and guidelines for imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gruettner, J., E-mail: joachim.gruettner@umm.de [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Henzler, T. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Sueselbeck, T. [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Fink, C. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Borggrefe, M.; Walter, T. [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany)

    2012-12-15

    For many emergency facilities, risk assessment of patients with diffuse chest pain still poses a major challenge. In their currently valid recommendations, the international cardiological societies have defined a standardized assessment of the prognostically relevant cardiac risk criteria. Here the classic sequence of basic cardiac diagnostics including case history (cardiac risk factors), physical examination (haemodynamic and respiratory vital parameters), ECG (ST segment analysis) and laboratory risk markers (troponin levels) is paramount. The focus is, on the one hand, on timely indication for percutaneous catheterization, especially in patients at high cardiac risk with or without ST-segment elevation in the ECG, and, on the other hand, on the possibility of safely discharging patients with intermediate or low cardiac risk after non-invasive exclusion of a coronary syndrome. For patients in the intermediate or low risk group, physical or pharmacological stress testing in combination with scintigraphy, echocardiography or magnetic resonance imaging is recommended in addition to basic diagnostics. Moreover, the importance of non-invasive coronary imaging, primarily cardiac CT angiography (CCTA), is increasing. Current data show that in intermediate or low risk patients this method is suitable to reliably rule out coronary heart disease. In addition, attention is paid to the major differential diagnoses of acute coronary syndrome, particularly pulmonary embolism and aortic dissection. Here the diagnostic method of choice is thoracic CT, possibly also in combination with CCTA aiming at a triple rule-out.

  2. Development of a prototype chest digital tomosynthesis (CDT) R/F system with fast image reconstruction using graphics processing unit (GPU) programming

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sunghoon, E-mail: choi.sh@yonsei.ac.kr [Department of Radiological Science, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Lee, Seungwan [Department of Radiological Science, College of Medical Science, Konyang University, 158 Gwanjeodong-ro, Daejeon, 308-812 (Korea, Republic of); Lee, Haenghwa [Department of Radiological Science, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Lee, Donghoon; Choi, Seungyeon [Department of Radiation Convergence Engineering, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Shin, Jungwook [LISTEM Corporation, 94 Donghwagongdan-ro, Munmak-eup, Wonju (Korea, Republic of); Seo, Chang-Woo [Department of Radiological Science, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Kim, Hee-Joung, E-mail: hjk1@yonsei.ac.kr [Department of Radiological Science, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of); Department of Radiation Convergence Engineering, College of Health Science, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710 (Korea, Republic of)

    2017-03-11

    Digital tomosynthesis offers the advantage of low radiation doses compared to conventional computed tomography (CT) by utilizing small numbers of projections (~80) acquired over a limited angular range. It produces 3D volumetric data, although there are artifacts due to incomplete sampling. Based upon these characteristics, we developed a prototype digital tomosynthesis R/F system for applications in chest imaging. Our prototype chest digital tomosynthesis (CDT) R/F system contains an X-ray tube with high power R/F pulse generator, flat-panel detector, R/F table, electromechanical radiographic subsystems including a precise motor controller, and a reconstruction server. For image reconstruction, users select between analytic and iterative reconstruction methods. Our reconstructed images of Catphan700 and LUNGMAN phantoms clearly and rapidly described the internal structures of phantoms using graphics processing unit (GPU) programming. Contrast-to-noise ratio (CNR) values of the CTP682 module of Catphan700 were higher in images using a simultaneous algebraic reconstruction technique (SART) than in those using filtered back-projection (FBP) for all materials by factors of 2.60, 3.78, 5.50, 2.30, 3.70, and 2.52 for air, lung foam, low density polyethylene (LDPE), Delrin{sup ®} (acetal homopolymer resin), bone 50% (hydroxyapatite), and Teflon, respectively. Total elapsed times for producing 3D volume were 2.92 s and 86.29 s on average for FBP and SART (20 iterations), respectively. The times required for reconstruction were clinically feasible. Moreover, the total radiation dose from our system (5.68 mGy) was lower than that of conventional chest CT scan. Consequently, our prototype tomosynthesis R/F system represents an important advance in digital tomosynthesis applications.

  3. Diagnostic imaging costs before and after digital tomosynthesis implementation in patient management after detection of suspected thoracic lesions on chest radiography.

    Science.gov (United States)

    Quaia, Emilio; Grisi, Guido; Baratella, Elisa; Cuttin, Roberto; Poillucci, Gabriele; Kus, Sara; Cova, Maria Assunta

    2014-02-01

    To evaluate diagnostic imaging costs before and after DTS implementation in patients with suspected thoracic lesions on CXR. Four hundred sixty-five patients (263 male, 202 female; age, 72.47 ± 11.33 years) with suspected thoracic lesion(s) after CXR underwent DTS. Each patient underwent CT when a pulmonary non-calcified lesion was identified by DTS while CT was not performed when a benign pulmonary or extrapulmonary lesion or pseudolesion was identified. The average per-patient imaging cost was calculated by normalising the costs before and after DTS implementation. In 229/465 patients who underwent DTS after suspicious CXR, DTS showed 193 pulmonary lesions and 36 pleural lesions, while in the remaining 236/465 patients, lesions were ruled out as pseudolesions of CXR. Chest CT examination was performed in 127/465 (27 %) patients while in the remaining 338/465 patients (73 %) CXR doubtful findings were resolved by DTS. The average per-patient costs of CXR, DTS and CT were 15.15, 41.55 and 113.66. DTS allowed an annual cost saving of 8,090.2 considering unenhanced CT and 19,298.12 considering contrast-enhanced CT. Considering a DTS reimbursement rate of 62.7 the break even point corresponds to 479 DTS examinations. Per-patient diagnostic imaging costs decreased after DTS implementation in patients with suspected thoracic lesions. • Digital tomosynthesis improves the diagnostic accuracy and confidence in chest radiography • Digital tomosynthesis reduces the need for CT for a suspected pulmonary lesion • Digital tomosynthesis requires a dose level equivalent to that of around two chest radiographies • Digital tomosynthesis produces a significant per-patient saving in diagnostic imaging costs.

  4. Chest X-ray and chest CT findings in patients diagnosed with pulmonary tuberculosis following solid organ transplantation: a systematic review.

    Science.gov (United States)

    Giacomelli, Irai Luis; Schuhmacher Neto, Roberto; Marchiori, Edson; Pereira, Marisa; Hochhegger, Bruno

    2018-04-01

    The objective of this systematic review was to select articles including chest X-ray or chest CT findings in patients who developed pulmonary tuberculosis following solid organ transplantation (lung, kidney, or liver). The following search terms were used: "tuberculosis"; "transplants"; "transplantation"; "mycobacterium"; and "lung". The databases used in this review were PubMed and the Brazilian Biblioteca Virtual em Saúde (Virtual Health Library). We selected articles in English, Portuguese, or Spanish, regardless of the year of publication, that met the selection criteria in their title, abstract, or body of text. Articles with no data on chest CT or chest X-ray findings were excluded, as were those not related to solid organ transplantation or pulmonary tuberculosis. We selected 29 articles involving a collective total of 219 patients. The largest samples were in studies conducted in Brazil and South Korea (78 and 35 patients, respectively). The imaging findings were subdivided into five common patterns. The imaging findings varied depending on the transplanted organ in these patients. In liver and lung transplant recipients, the most common pattern was the classic one for pulmonary tuberculosis (cavitation and "tree-in-bud" nodules), which is similar to the findings for pulmonary tuberculosis in the general population. The proportion of cases showing a miliary pattern and lymph node enlargement, which is most similar to the pattern seen in patients coinfected with tuberculosis and HIV, was highest among the kidney transplant recipients. Further studies evaluating clinical data, such as immunosuppression regimens, are needed in order to improve understanding of the distribution of these imaging patterns in this population.

  5. ACR Appropriateness Criteria® Routine Chest Radiography.

    Science.gov (United States)

    McComb, Barbara L; Chung, Jonathan H; Crabtree, Traves D; Heitkamp, Darel E; Iannettoni, Mark D; Jokerst, Clinton; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Mohammed, Tan-Lucien H; Ravenel, James G

    2016-03-01

    Chest radiographs are sometimes taken before surgeries and interventional procedures on hospital admissions and outpatients. This manuscript summarizes the American College of Radiology review of the literature and recommendations on routinely performed chest radiographies in these settings. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  6. Potential usefulness of a video printer for producing secondary images from digitized chest radiographs

    Science.gov (United States)

    Nishikawa, Robert M.; MacMahon, Heber; Doi, Kunio; Bosworth, Eric

    1991-05-01

    Communication between radiologists and clinicians could be improved if a secondary image (copy of the original image) accompanied the radiologic report. In addition, the number of lost original radiographs could be decreased, since clinicians would have less need to borrow films. The secondary image should be simple and inexpensive to produce, while providing sufficient image quality for verification of the diagnosis. We are investigating the potential usefulness of a video printer for producing copies of radiographs, i.e. images printed on thermal paper. The video printer we examined (Seikosha model VP-3500) can provide 64 shades of gray. It is capable of recording images up to 1,280 pixels by 1,240 lines and can accept any raster-type video signal. The video printer was characterized in terms of its linearity, contrast, latitude, resolution, and noise properties. The quality of video-printer images was also evaluated in an observer study using portable chest radiographs. We found that observers could confirm up to 90 of the reported findings in the thorax using video- printer images, when the original radiographs were of high quality. The number of verified findings was diminished when high spatial resolution was required (e.g. detection of a subtle pneumothorax) or when a low-contrast finding was located in the mediastinal area or below the diaphragm (e.g. nasogastric tubes).

  7. Attenuation-based automatic kilovolt (kV)-selection in computed tomography of the chest: Effects on radiation exposure and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Eller, Achim; Wuest, Wolfgang; Scharf, Michael; Brand, Michael [Department of Radiology, University Erlangen (Germany); Achenbach, Stephan [Department of Cardiology, University Erlangen (Germany); Uder, Michael [Department of Radiology, University Erlangen (Germany); Imaging Science Institute, Erlangen (Germany); Lell, Michael M., E-mail: Michael.lell@uk-erlangen.de [Department of Radiology, University Erlangen (Germany); Imaging Science Institute, Erlangen (Germany)

    2013-12-01

    Objectives: To evaluate an automated attenuation-based kV-selection in computed tomography of the chest in respect to radiation dose and image quality, compared to a standard 120 kV protocol. Materials and methods: 104 patients were examined using a 128-slice scanner. Fifty examinations (58 ± 15 years, study group) were performed using the automated adaption of tube potential (100–140 kV), based on the attenuation profile of the scout scan, 54 examinations (62 ± 14 years, control group) with fixed 120 kV. Estimated CT dose index (CTDI) of the software-proposed setting was compared with a 120 kV protocol. After the scan CTDI volume (CTDIvol) and dose length product (DLP) were recorded. Image quality was assessed by region of interest (ROI) measurements, subjective image quality by two observers with a 4-point scale (3 – excellent, 0 – not diagnostic). Results: The algorithm selected 100 kV in 78% and 120 kV in 22%. Overall CTDIvol reduction was 26.6% (34% in 100 kV) overall DLP reduction was 22.8% (32.1% in 100 kV) (all p < 0.001). Subjective image quality was excellent in both groups. Conclusion: The attenuation based kV-selection algorithm enables relevant dose reduction (∼27%) in chest-CT while keeping image quality parameters at high levels.

  8. Attenuation-based automatic kilovolt (kV)-selection in computed tomography of the chest: Effects on radiation exposure and image quality

    International Nuclear Information System (INIS)

    Eller, Achim; Wuest, Wolfgang; Scharf, Michael; Brand, Michael; Achenbach, Stephan; Uder, Michael; Lell, Michael M.

    2013-01-01

    Objectives: To evaluate an automated attenuation-based kV-selection in computed tomography of the chest in respect to radiation dose and image quality, compared to a standard 120 kV protocol. Materials and methods: 104 patients were examined using a 128-slice scanner. Fifty examinations (58 ± 15 years, study group) were performed using the automated adaption of tube potential (100–140 kV), based on the attenuation profile of the scout scan, 54 examinations (62 ± 14 years, control group) with fixed 120 kV. Estimated CT dose index (CTDI) of the software-proposed setting was compared with a 120 kV protocol. After the scan CTDI volume (CTDIvol) and dose length product (DLP) were recorded. Image quality was assessed by region of interest (ROI) measurements, subjective image quality by two observers with a 4-point scale (3 – excellent, 0 – not diagnostic). Results: The algorithm selected 100 kV in 78% and 120 kV in 22%. Overall CTDIvol reduction was 26.6% (34% in 100 kV) overall DLP reduction was 22.8% (32.1% in 100 kV) (all p < 0.001). Subjective image quality was excellent in both groups. Conclusion: The attenuation based kV-selection algorithm enables relevant dose reduction (∼27%) in chest-CT while keeping image quality parameters at high levels

  9. Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules.

    Science.gov (United States)

    Dobbins, James T; McAdams, H Page; Sabol, John M; Chakraborty, Dev P; Kazerooni, Ella A; Reddy, Gautham P; Vikgren, Jenny; Båth, Magnus

    2017-01-01

    Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board-approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3-20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3-4 mm, >4 mm to 6 mm, >6 mm to 8 mm, and >8 mm to 20 mm). Results Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P chest radiography for all nodules (1.49-fold, P chest radiography, as given by the area under the receiver operating characteristic curve (1.23-fold, P chest radiography or tomosynthesis. Conclusion Tomosynthesis outperformed conventional chest radiography for lung nodule detection and determination of case management; DE imaging did not show significant differences over conventional chest

  10. Paediatrician awareness of radiation dose and inherent risks in chest imaging studies--a questionnaire study.

    Science.gov (United States)

    Heyer, Christoph M; Hansmann, Jan; Peters, Sören A; Lemburg, Stefan P

    2010-11-01

    To assess paediatricians' knowledge regarding radiation exposure of chest imaging. German paediatricians were surveyed using a questionnaire. Participants were asked to estimate effective dose (ED) of radiographs (CR) and computed tomography (CT). Further questions included dose-saving of paediatric CT-protocols, ALARA principle, and awareness of the link between radiation and cancer development. Length and type of occupation and amount of ordered procedures were evaluated. 137 paediatricians participated with 59% and 39% correctly estimating ED of an adult (0.01-0.1mSv) and newborn CR (0.01-0.1mSv), respectively. ED of an adult chest CT (1-10mSv) was underestimated by 28%, whereas ED of cardiac CT (10-100mSv) was underestimated by 54%. 35% of participants correctly estimated ED of a chest CT in an infant (10-100mSv) which was underestimated by 56%. Neither length nor type of occupation showed significant impact on dose estimations. 14% of paediatricians stated that MRI causes radiation, whereas 4% correctly estimated the potential of paediatric CT-protocols. 15% were familiar with the ALARA principle and 26% were aware of a publication concerning radiation and malignancy. Paediatricians demonstrated an increased level of awareness compared to previous surveys. However, estimation of ED of CT remained difficult. Increased information transfer and education seem pressing in the light of increasing radiological examinations. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  11. [Standard chest x-ray: from film to all digital!].

    Science.gov (United States)

    Ducou Le Pointe, H

    2000-04-01

    Conventional imaging will be totally replaced by digital imaging because of the lower exposure dosage and the clear advantages in terms of image processing, transfer and storage. Reports in the literature have demonstrated that a 2.5 pl/mm spatial resolution is satisfactory to detect a pneumothorax, a parenchymal nodule or a mediastinal mass. For most authors, this resolution is also sufficient to detect an interstitial syndrome. Digitalization by amplification or by particle detectors using wire chambers are not, for the time being, acceptable for interpretation of a simple chest image because of the low spatial resolution. The selenium cylinder is an adapted technology dedicated to chest imaging. Memory display screens can be used to digitalize the entire radiology unit. They are perfectly adapted for bedside imaging. Flat detectors are based on direct or indirect conversion of the X photons into an electrical signal during the clinical evaluation. The early results appear most promising.

  12. Prototype system for enhancement of frontal chest radiographs using eigenimage processing

    International Nuclear Information System (INIS)

    Butler, A.; Bones, P.; Hurrell, M.

    2008-01-01

    A prototype system is described for enhancement of radiographic images in the eigen domain. The images chosen to enhance are frontal chest radiographs. This class of images has been chosen because it is both a clinically important examination and an example of the high-resolution images used within radiology. The enhancement method is based on principal components analysis, a multivariate statistical technique first used within image processing for face recognition. The method requires a training set of normal images to identify normal patterns of variance. The enhancement process then removes these normal patterns of variance, often increasing the relative intensity of pathologies. Enhanced images presented in this paper include a range of common pathologies found on chest radiographs. Details of implementation, computing expense and possible applications within radiology are discussed.

  13. Imaging of non-cardiac, non-traumatic causes of acute chest pain

    Energy Technology Data Exchange (ETDEWEB)

    Kienzl, Daniela, E-mail: daniela.kienzl@meduniwien.ac.at [Department of Radiology, Medical University of Vienna (Austria); Prosch, Helmut; Töpker, Michael; Herold, Christian [Department of Radiology, Medical University of Vienna (Austria)

    2012-12-15

    Non-traumatic chest pain is a common symptom in patients who present in the emergency department. From a clinical point of view, it is important to differentiate cardiac chest pain from non-cardiac chest pain (NCCP). Among the plethora of potential causes of NCCP, life-threatening diseases, such as aortic dissection, pulmonary embolism, tension pneumothorax, and esophageal rupture, must be differentiated from non-life threatening causes. The majority of NCCP, however, is reported to be benign in nature. The presentation of pain plays an important role in narrowing the differential diagnosis and initiating further diagnostic management and treatment. As the benign causes tend to recur, and may lead to patient anxiety and great costs, a meticulous evaluation of the patient is necessary to diagnose the underlying disorder or disease.

  14. Clinical aspects of plain film radiography of the chest

    International Nuclear Information System (INIS)

    Ravin, C.E.

    1988-01-01

    In spite of the introduction of a number of intriguing new imaging modalities including Computed Tomography and Magnetic Resonance Imaging, the plain film of the chest remains the mainstay of thoracic imaging. It is estimated that more than fifty million chest radiographs are performed each year in the United States. In the attempt to compare newer imaging modalities with the standard plain film of the chest, investigators have been forced to adopt specific structures and or disease processes to be analyzed. To some extent identification of normally appearing structures in the mediastinum and lung parenchyma serves as a clue as to the ability of a newer technology to compete with or be compared with the plain film. However, as most authors would acknowledge, the ability to portray normal underlying anatomy is only the first step in analysis in intrathoracic disease. Experimental design becomes somewhat more complicated when one wishes to move beyond normal anatomy to analysis of disease processes. The challenge of digital radiography in whatever form it may take will be to equal or exceed the standard established by conventional plain film radiography and deliver such service at reasonable cost in a manner which allows for appropriate patient throughput

  15. Chest imaging characteristics of hand-foot-mouth disease in children

    International Nuclear Information System (INIS)

    Ma Bo; Chen Ruigang; Dou Shewei; Zhu Xiaonian; Shi Dapeng

    2010-01-01

    Objective: To study radiological characteristics of hand-foot-mouth disease (HFMD) in children. Methods: The chest X-ray films of 1295 children patients of HFMD were analyzed, for the general X-ray manifestations and the evolution. Results: A total of 1427 films was obtained from all patients, in which 1203 cases were normal and 224 cases were abnormal. The interstitial changes characterized the abnormal group, mainly as increased and vague lung markings, increased hilar shadows (137 cases). The parenchyma changes appeared as patchy exudative shadows(49 cases). Short-term dynamic observation was applied in 62 cases, 38 cases pulmonary disease progression manifested as normal and the interstitial type changing into the parenchyma type and the mixed type, the localized type changing into the diffuse type. Conclusions: Most children patients of' HFMD showed normal chest films, while the abnormal patients were characterized by interstitial and parenchyma pulmonary edema. Serial chest X-ray examination and short-term dynamic observation were important to identify the severe cases and assess patients' condition. (authors)

  16. The relationship between image quality and CT dose index of multi-slice low-dose chest CT

    International Nuclear Information System (INIS)

    Zhu Xiaohua; Shao Jiang; Shi Jingyun; You Zhengqian; Li Shijun; Xue Yongming

    2003-01-01

    Objective: To explore the rationality and possibility of multi-slice low-dose CT scan in the examination of the chest. Methods: (1) X-ray dose index measurement: 120 kV tube voltage, 0.75 s rotation, 8 mm and 3 mm slice thickness, and the tube current setting of 115.0, 40.0, 25.0, and 7.5 mAs were employed in every section. The X-ray radiation dose was measured and compared statistically. (2) phantom measurement of homogeneity and noise: The technical parameters were 120 kV, 0.75 s, 8 mm and 3 mm sections, and every slice was scanned using tube current of 115.0, 40.0, 25.0, and 7.5 mAs. Five same regions of interest were measured on every image. The homogeneity and noise level of CT were appraised. (3) The multi-slice low-dose CT in patients: 30 patients with mass and 30 with patch shadow in the lung were selected randomly. The technical parameters were 120 kV, 0.75 s, 8 mm and 3 mm slice thickness. 115.0, 40.0, 25.0, 15.0, and 7.5 mAs tube current were employed in each same slice. Otherwise, 15 cases with helical scan were examined using 190, 150, 40, 25, and 15 mAs tube current. The reconstruction images of MIP, MPR, CVR, HRCT, 3D, CT virtual endoscopy, and variety of interval reconstruction were compared. (4) Evaluation of image quality: CT images were evaluated by four doctors using single-blind method, and 3 degrees including normal image, image with few artifact, and image with excessive artifact, were employed and analyzed statistically. Results: (1) The CT dose index with 115.0 mAs tube current exceeded those of 40.0, 25.0, and 7.5 mAs by about 60%, 70%, and 85%, respectively. (2) The phantom measurement showed that the lower of CT dose the lower of homogeneity, the lower of CT dose the higher of noise level. (3) Result of image quality evaluation: The percentage of the normal image had no significant difference between 8 and 3 mm in 115, 40, and 25 mAs (P>0.05). Conclusion: Multi-slice low-dose chest CT technology may protect the patients and guarantee the

  17. Chest X-Ray

    Medline Plus

    Full Text Available ... about chest radiography also known as chest x-rays. Chest x-rays are the most commonly performed x-ray exams and use a very small dose of ... of the inside of the chest. A chest x-ray is used to evaluate the lungs, heart and ...

  18. CT of the chest in suspected child abuse using submillisievert radiation dose

    International Nuclear Information System (INIS)

    Sanchez, Thomas R.; Seibert, J.A.; Stein-Wexler, Rebecca; Lee, Justin S.; Coulter, Kevin P.

    2015-01-01

    The cornerstone of child abuse imaging is the skeletal survey, but initial imaging with radiographs may not demonstrate acute and non-displaced fractures, especially those involving the ribs. Given the high mortality of undiagnosed non-accidental trauma, timely diagnosis is crucial. CT is more sensitive in assessing rib fractures; however the effective radiation dose of a standard chest CT is high. We retrospectively identified four children (three boys, one girl; age range 1-4 months) admitted between January 2013 and February 2014 with high suspicion for non-accidental trauma from unexplained fractures of the long bones; these children all had CT of the chest when no rib fractures were evident on the skeletal survey. The absorbed radiation dose estimates for organs and tissue from the four-view chest radiographs and subsequent CT were determined using Monte Carlo photon transport software, and the effective dose was calculated using published tissue-weighting factors. In two children, CT showed multiple fractures of the ribs, scapula and vertebral body that were not evident on the initial skeletal survey. The average effective dose for a four-view chest radiograph across the four children was 0.29 mSv and the average effective dose for the chest CT was 0.56 mSv. Therefore the effective dose of a chest CT is on average less than twice that of a four-view chest radiograph. Our protocol thus shows that a reduced-dose chest CT may be useful in the evaluation of high specificity fractures of non-accidental trauma when the four-view chest radiographs are negative. (orig.)

  19. CT of the chest in suspected child abuse using submillisievert radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, Thomas R.; Seibert, J.A.; Stein-Wexler, Rebecca [Medical Center Children' s Hospital, Division of Pediatric Radiology, University of California-Davis, Sacramento, CA (United States); Lee, Justin S. [University of California-Davis, Department of Radiology, Sacramento, CA (United States); Coulter, Kevin P. [Medical Center Children' s Hospital, Department of Pediatrics, University of California-Davis, Sacramento, CA (United States)

    2015-07-15

    The cornerstone of child abuse imaging is the skeletal survey, but initial imaging with radiographs may not demonstrate acute and non-displaced fractures, especially those involving the ribs. Given the high mortality of undiagnosed non-accidental trauma, timely diagnosis is crucial. CT is more sensitive in assessing rib fractures; however the effective radiation dose of a standard chest CT is high. We retrospectively identified four children (three boys, one girl; age range 1-4 months) admitted between January 2013 and February 2014 with high suspicion for non-accidental trauma from unexplained fractures of the long bones; these children all had CT of the chest when no rib fractures were evident on the skeletal survey. The absorbed radiation dose estimates for organs and tissue from the four-view chest radiographs and subsequent CT were determined using Monte Carlo photon transport software, and the effective dose was calculated using published tissue-weighting factors. In two children, CT showed multiple fractures of the ribs, scapula and vertebral body that were not evident on the initial skeletal survey. The average effective dose for a four-view chest radiograph across the four children was 0.29 mSv and the average effective dose for the chest CT was 0.56 mSv. Therefore the effective dose of a chest CT is on average less than twice that of a four-view chest radiograph. Our protocol thus shows that a reduced-dose chest CT may be useful in the evaluation of high specificity fractures of non-accidental trauma when the four-view chest radiographs are negative. (orig.)

  20. Visual grading analysis of digital neonatal chest phantom X-ray images: Impact of detector type, dose and image processing on image quality.

    Science.gov (United States)

    Smet, M H; Breysem, L; Mussen, E; Bosmans, H; Marshall, N W; Cockmartin, L

    2018-07-01

    To evaluate the impact of digital detector, dose level and post-processing on neonatal chest phantom X-ray image quality (IQ). A neonatal phantom was imaged using four different detectors: a CR powder phosphor (PIP), a CR needle phosphor (NIP) and two wireless CsI DR detectors (DXD and DRX). Five different dose levels were studied for each detector and two post-processing algorithms evaluated for each vendor. Three paediatric radiologists scored the images using European quality criteria plus additional questions on vascular lines, noise and disease simulation. Visual grading characteristics and ordinal regression statistics were used to evaluate the effect of detector type, post-processing and dose on VGA score (VGAS). No significant differences were found between the NIP, DXD and CRX detectors (p>0.05) whereas the PIP detector had significantly lower VGAS (pProcessing did not influence VGAS (p=0.819). Increasing dose resulted in significantly higher VGAS (plevels but not image post-processing changes. VGA showed a DAK/image value above which perceived IQ did not improve, potentially useful for commissioning. • A VGA study detects IQ differences between detectors and dose levels. • The NIP detector matched the VGAS of the CsI DR detectors. • VGA data are useful in setting initial detector air kerma level. • Differences in NNPS were consistent with changes in VGAS.

  1. Segmentation of ribs in digital chest radiographs

    Science.gov (United States)

    Cong, Lin; Guo, Wei; Li, Qiang

    2016-03-01

    Ribs and clavicles in posterior-anterior (PA) digital chest radiographs often overlap with lung abnormalities such as nodules, and cause missing of these abnormalities, it is therefore necessary to remove or reduce the ribs in chest radiographs. The purpose of this study was to develop a fully automated algorithm to segment ribs within lung area in digital radiography (DR) for removal of the ribs. The rib segmentation algorithm consists of three steps. Firstly, a radiograph was pre-processed for contrast adjustment and noise removal; second, generalized Hough transform was employed to localize the lower boundary of the ribs. In the third step, a novel bilateral dynamic programming algorithm was used to accurately segment the upper and lower boundaries of ribs simultaneously. The width of the ribs and the smoothness of the rib boundaries were incorporated in the cost function of the bilateral dynamic programming for obtaining consistent results for the upper and lower boundaries. Our database consisted of 93 DR images, including, respectively, 23 and 70 images acquired with a DR system from Shanghai United-Imaging Healthcare Co. and from GE Healthcare Co. The rib localization algorithm achieved a sensitivity of 98.2% with 0.1 false positives per image. The accuracy of the detected ribs was further evaluated subjectively in 3 levels: "1", good; "2", acceptable; "3", poor. The percentages of good, acceptable, and poor segmentation results were 91.1%, 7.2%, and 1.7%, respectively. Our algorithm can obtain good segmentation results for ribs in chest radiography and would be useful for rib reduction in our future study.

  2. Diagnostic value of 123I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT) in patients with chest pain. Comparison with rest-stress 99mTc-tetrofosmin SPECT and coronary angiography

    International Nuclear Information System (INIS)

    Kawai, Yuko; Nozaki, Yoichi; Ohkusa, Takanori; Sakurai, Masayuki; Morita, Koichi; Tamaki, Nagara

    2004-01-01

    Basic and clinical studies have indicated that 15-(p-[ 123 I] iodophenyl)-3-(R, S) methylpentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT) can identify ischemic myocardium without evidence of myocardial infarction by the regional decline of tracer uptake. The present study compared BMIPP SPECT with rest-stress myocardial perfusion imaging (MPI) findings and coronary angiography (CAG) in 150 patients with acute chest pain. Patients with acute chest pain who underwent all of the following tests were selected: MPI at rest-stress, BMIPP SPECT at rest and CAG. Organic coronary artery stenosis (≥75%) was observed in 46 patients, 27 patients had total or subtotal coronary occlusion by spasm in the spasm provocation test on CAG and the remaining 77 patients had no significant coronary artery stenosis or spasm. The sensitivity of BMIPP at rest to detect organic stenosis was significantly higher (54%) than that of rest-MPI (33%, p<0.005), but lower than that of stress-MPI (76%, p=0.05). The sensitivity of BMIPP at rest to detect spasm was significantly higher (63%) than that of both rest-MPI (15%; p<0.001) and stress-MPI (19%; p<0.001). Overall, the sensitivity of BMIPP at rest to detect both organic stenosis and spasm was significantly higher (58%) than that of rest-MPI (26%; p<0.001), despite having no significance with that of stress-MPI (55%). The specificity was not significantly different among the three imaging techniques. Resting BMIPP SPECT is an alternative method to stress MPI for identifying patients with not only organic stenosis but also spasm without the need for a stress examination. (author)

  3. Comparison of image quality and effective dose by additional filtration on digital chest tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kye Sun [Dept. of Dignostic Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Kim, Sung Chul [Dept. of Radiological Science, Gachon University, Sungnam (Korea, Republic of)

    2015-12-15

    The purpose of this study is to suggest proper additional filtration by comparisons patient dose and image quality among additional filters in digital chest tomosynthesis (DTS). We measured the effective dose, dose area product (DAP) by changing thickness of Cu, Al and Ni filter to compare image quality by CD curve and SNR, CNR. Cu, Al and Ni exposure dose were similar thickness 0.3 mm, 3 mm and 0.3 mm respectively. The exposure dose using filter was decreased average about 33.1% than non filter. The DAP value of 0.3 mm Ni were decreased 72.9% compared to non filter and the lowest dose among 3 filter. The effective dose of 0.3 mm Ni were decreased 48% compared to 0.102 mSv effective dose of non filter. At the result of comparison of image quality through CD curve there were similar aspect graph among Cu, Al and Ni. SNR was decreased average 19.07%, CNR was average decreased 18.17% using 3 filters. In conclusion, Ni filtration was considered to be most suitable when considered comprehensive thickness, character, sort of filter, dose reduction and image quality evaluation in DTS.

  4. Usefulness of 2D fusion of postmortem CT and antemortem chest radiography studies for human identification.

    Science.gov (United States)

    Shinkawa, Norihiro; Hirai, Toshinori; Nishii, Ryuichi; Yukawa, Nobuhiro

    2017-06-01

    To determine the feasibility of human identification through the two-dimensional (2D) fusion of postmortem computed tomography (PMCT) and antemortem chest radiography. The study population consisted of 15 subjects who had undergone chest radiography studies more than 12 months before death. Fused images in which a chest radiograph was fused with a PMCT image were obtained for those subjects using a workstation, and the minimum distance gaps between corresponding anatomical landmarks (located at soft tissue and bone sites) in the images obtained with the two modalities were calculated. For each fused image, the mean of all these minimum distance gaps was recorded as the mean distance gap (MDG). For each subject, the MDG obtained for the same-subject fused image (i.e., where both of the images that were fused derived from that subject) was compared with the MDGs for different-subject fused images (i.e., where only one of the images that were fused derived from that subject; the other image derived from a different subject) in order to determine whether same-subject fused images can be reliably distinguished from different-subject fused images. The MDGs of the same-subject fused images were found to be significantly smaller than the MDGs of the different-subject fused images (p chest radiography and postmortem CT images may assist in human identification.

  5. Temporal subtraction in chest radiography: Automated assessment of registration accuracy

    International Nuclear Information System (INIS)

    Armato, Samuel G. III; Doshi, Devang J.; Engelmann, Roger; Croteau, Charles L.; MacMahon, Heber

    2006-01-01

    Radiologists routinely compare multiple chest radiographs acquired from the same patient over time to more completely understand changes in anatomy and pathology. While such comparisons are achieved conventionally through a side-by-side display of images, image registration techniques have been developed to combine information from two separate radiographic images through construction of a 'temporal subtraction image'. Although temporal subtraction images provide a powerful mechanism for the enhanced visualization of subtle change, errors in the clinical evaluation of these images may arise from misregistration artifacts that can mimic or obscure pathologic change. We have developed a computerized method for the automated assessment of registration accuracy as demonstrated in temporal subtraction images created from radiographic chest image pairs. The registration accuracy of 150 temporal subtraction images constructed from the computed radiography images of 72 patients was rated manually using a five-point scale ranging from '5-excellent' to '1-poor'; ratings of 3, 4, or 5 reflected clinically acceptable subtraction images, and ratings of 1 or 2 reflected clinically unacceptable images. Gray-level histogram-based features and texture measures are computed at multiple spatial scales within a 'lung mask' region that encompasses both lungs in the temporal subtraction images. A subset of these features is merged through a linear discriminant classifier. With a leave-one-out-by-patient training/testing paradigm, the automated method attained an A z value of 0.92 in distinguishing between temporal subtraction images that demonstrated clinically acceptable and clinically unacceptable registration accuracy. A second linear discriminant classifier yielded an A z value of 0.82 based on a feature subset selected from an independent database of digitized film images. These methods are expected to advance the clinical utility of temporal subtraction images for chest

  6. Selective common and uncommon imaging manifestations of blunt nonaortic chest trauma: when time is of the essence.

    Science.gov (United States)

    Altoos, Rola; Carr, Robert; Chung, Jonathan; Stern, Eric; Nevrekar, Dipti

    2015-01-01

    This is a pictorial essay in which we review and illustrate a variety of thoracic injuries related to blunt trauma. Non-aortic blunt thoracic trauma can be divided anatomically into injuries of the chest wall, lungs, pleura, mediastinum, and diaphragm. Some injuries involve more than one anatomic compartment, and multiple injuries commonly coexist. This article provides common imaging findings and discussion of both common and uncommon but critical thoracic injuries encountered. Published by Elsevier Inc.

  7. Assessment of coronary flow reserve by sestamibi imaging in patients with typical chest pain and normal coronary arteries

    Energy Technology Data Exchange (ETDEWEB)

    Storto, Giovanni; Sorrentino, Anna R.; Pellegrino, Teresa; Liuzzi, Raffaele; Cuocolo, Alberto [University Federico II, Department of Biomorphological and Functional Sciences, Institute of Biostructures and Bioimages of the National Council of Research, Naples (Italy); Petretta, Mario [University Federico II, Department of Internal Medicine, Cardiovascular and Immunological Sciences, Naples (Italy)

    2007-08-15

    We assessed coronary flow reserve (CFR) by sestamibi imaging in patients with typical chest pain, positive exercise stress test and normal coronary vessels. Thirty-five patients with typical chest pain and normal angiogram and 12 control subjects with atypical chest pain underwent dipyridamole/rest {sup 99m}Tc-sestamibi imaging. Myocardial blood flow (MBF) was estimated by measuring first transit counts in the pulmonary artery and myocardial counts from SPECT images. Estimated CFR was expressed as the ratio of stress to rest MBF. Rest MBF and CFR were corrected for rate-pressure product (RPP) and expressed as normalised MBF (MBF{sub n}) and normalised CFR (CFR{sub n}). Coronary vascular resistances (CVR) were calculated as the ratio between mean arterial pressure and estimated MBF. At rest, estimated MBF and MBF{sub n} were lower in controls than in patients (0.98 {+-} 0.4 vs 1.30 {+-} 0.3 counts/pixel/s and 1.14 {+-} 0.5 vs 1.64 {+-} 0.6 counts/pixel/s, respectively, both p < 0.02). Stress MBF was not different between controls and patients (2.34 {+-} 0.8 vs 2.01 {+-} 0.7 counts/pixel/s, p=NS). Estimated CFR was 2.40 {+-} 0.3 in controls and 1.54 {+-} 0.3 in patients (p < 0.0001). After correction for the RPP, CFR{sub n} was still higher in controls than in patients (2.1 {+-} 0.5 vs 1.29 {+-} 0.5, p < 0.0001). At baseline, CVR values were lower (p < 0.01) in patients than in controls. Dipyridamole-induced changes in CVR were greater (p < 0.0001) in controls (-63%) than in patients (-35%). In the overall study population, a significant correlation between dipyridamole-induced changes in CVR and CFR was observed (r = -0.88, p < 0.0001). SPECT might represent a useful non-invasive method for assessing coronary vascular function in patients with angina and a normal coronary angiogram. (orig.)

  8. Attenuation-based automatic kilovolt (kV)-selection in computed tomography of the chest: effects on radiation exposure and image quality.

    Science.gov (United States)

    Eller, Achim; Wuest, Wolfgang; Scharf, Michael; Brand, Michael; Achenbach, Stephan; Uder, Michael; Lell, Michael M

    2013-12-01

    To evaluate an automated attenuation-based kV-selection in computed tomography of the chest in respect to radiation dose and image quality, compared to a standard 120 kV protocol. 104 patients were examined using a 128-slice scanner. Fifty examinations (58 ± 15 years, study group) were performed using the automated adaption of tube potential (100-140 kV), based on the attenuation profile of the scout scan, 54 examinations (62 ± 14 years, control group) with fixed 120 kV. Estimated CT dose index (CTDI) of the software-proposed setting was compared with a 120 kV protocol. After the scan CTDI volume (CTDIvol) and dose length product (DLP) were recorded. Image quality was assessed by region of interest (ROI) measurements, subjective image quality by two observers with a 4-point scale (3--excellent, 0--not diagnostic). The algorithm selected 100 kV in 78% and 120 kV in 22%. Overall CTDIvol reduction was 26.6% (34% in 100 kV) overall DLP reduction was 22.8% (32.1% in 100 kV) (all pimage quality was excellent in both groups. The attenuation based kV-selection algorithm enables relevant dose reduction (~27%) in chest-CT while keeping image quality parameters at high levels. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Temporal subtraction of chest radiographs compensating pose differences

    Science.gov (United States)

    von Berg, Jens; Dworzak, Jalda; Klinder, Tobias; Manke, Dirk; Kreth, Adrian; Lamecker, Hans; Zachow, Stefan; Lorenz, Cristian

    2011-03-01

    Temporal subtraction techniques using 2D image registration improve the detectability of interval changes from chest radiographs. Although such methods are well known for some time they are not widely used in radiologic practice. The reason is the occurrence of strong pose differences between two acquisitions with a time interval of months to years in between. Such strong perspective differences occur in a reasonable number of cases. They cannot be compensated by available image registration methods and thus mask interval changes to be undetectable. In this paper a method is proposed to estimate a 3D pose difference by the adaptation of a 3D rib cage model to both projections. The difference between both is then compensated for, thus producing a subtraction image with virtually no change in pose. The method generally assumes that no 3D image data is available from the patient. The accuracy of pose estimation is validated with chest phantom images acquired under controlled geometric conditions. A subtle interval change simulated by a piece of plastic foam attached to the phantom becomes visible in subtraction images generated with this technique even at strong angular pose differences like an anterior-posterior inclination of 13 degrees.

  10. Chest X-Ray

    Medline Plus

    Full Text Available ... talk with you about chest radiography also known as chest x-rays. Chest x-rays are the ... treatment for a variety of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray ...

  11. Objective quantification of pulmonary effects in X-ray chest images; Quantificacao objetiva das sequelas pulmonares em imagens de raios-X de torax

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Marcela de; Giacomini, Guilherme; Alvarez, Matheus; Pereira, Paulo M.C.; Ribeiro, Sergio M.; Pina, Diana R. de [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil)

    2016-07-01

    Tuberculosis (TB) is an infectious lung disease of great concern worldwide. Even after treatment, TB leaves pulmonary sequelae that compromise the quality of life of patients. The exam of diagnostic imaging done more frequently is the X-ray chest. The evaluation of pulmonary involvement of these patients is performed visually by the radiologist. The detection and quantification aided by computer systems are of great importance for the more accurate assessment of pulmonary involvement. The objective of this study was to evaluate computationally the reduction of lung damage in X-ray of chest in patients treated with two different medication regimens. (author)

  12. FLAIL CHEST

    Directory of Open Access Journals (Sweden)

    Anton Crnjac

    2003-12-01

    Full Text Available Background. Major thoracic trauma is consistent with high mortality rate because of associated injuries of vital thoracic organs and dangerous complications. The flail chest occurs after disruption of the skeletal continuity of chest wall and demands because of its pathophysiological complexity rapid and accurate diagnosis and treatment.Conclusions. Basic pathophysiological mechanism of the flail chest is respiratory distress, which is provoked by pulmonary contusions and paradoxical chest wall motion. The treatment should be pointed to improvement and support of respiratory functions and include aggressive pain control, pulmonary physiotherapy and selective mechanical ventilation. Views about operative fixation of the flail chest are still controversial. Neither mortality rate neither long-term disability are improved after operative fixation.

  13. Effect of Clinical Experience of Chest Tomosynthesis on Detection of Pulmonary Nodules

    International Nuclear Information System (INIS)

    Zachrisson, S.; Svalkvist, A.; Maansson, L.G.; Baath, M.; Vikgren, J.; Johnsson, Aa.A.; Boijsen, M.; Flinck, A.; Kheddache, S.

    2009-01-01

    Background: The new technique chest tomosynthesis refers to the principle of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest at a radiation dose comparable to that of chest radiography. Purpose: To investigate if, for experienced thoracic radiologists, the detectability of pulmonary nodules obtained after only a short initial learning period of chest tomosynthesis improves with additional clinical experience of the new technique. Material and Methods: Two readings of the same clinical chest tomosynthesis cases, the first performed after 6 months of clinical experience and the second after an additional period of 1 year, were conducted. Three senior thoracic radiologists, with more than 20 years of experience of chest radiography, acted as observers, with the task of detecting pulmonary nodules in a jackknife free-response receiver operating characteristics (JAFROC1) study. The image material consisted of 42 patients with and 47 patients without pulmonary nodules examined with chest tomosynthesis. Multidetector computed tomography (MDCT) was used as a reference. The total number of nodules was 131. The JAFROC1 figure of merit (FOM) was used as the principal measure of detectability. Results: The difference in the observer-averaged JAFROC1 FOM of the two readings was 0.004 (95% confidence interval: -0.11, 0.12; F-statistic: 0.01 on 1 and 2.65 df; P=0.91). Thus, no significant improvement in detectability was found after the additional clinical experience of tomosynthesis. Conclusion: The study indicates that experienced thoracic radiologists already within the first months of clinical use of chest tomosynthesis are able to take advantage of the new technique in the task of detecting pulmonary nodules

  14. Assessment of chest pain in hypertrophic cardiomyopathy using exercise thallium-201 myocardial scintigraphy

    International Nuclear Information System (INIS)

    Pitcher, D.; Wainwright, R.; Maisey, M.; Curry, P.; Sowton, E.

    1980-01-01

    Exercise thallium-201 myocardial scintigraphy was performed in 23 patients with hypertrophic cardiomyopathy. Eighteen patients presented with chest pain which was a persistent symptom in 11. Selective coronary arteriography was performed in 16 patients and showed normal coronary arteries in 15 and insignificant luminal irregularities in one patient. Eighteen patients had abnormal scintigrams. Three had an abnormal distribution of tracer entirely attributable to asymmetric septal hypertrophy, whereas 15 had discrete tracer uptake defects which could not be explained solely by myocardial hypertrophy. In this latter group of patients three scintigraphic patterns were identified: (1) in 10 patients defects were seen in scintigrams immediately after exercise but not in delayed images obtained four to six hours later. Eight of these patients had chest pain. (2) Four patients had uptake defects seen in both initial and delayed images. One patient had chest pain. (3) In three patients, one of whom had chest pain, tracer defects were seen only in delayed images and were not apparent in the initial scintigrams. Chest pain occurred in eight out of 10 patients with scintigraphic evidence of myocardial ischaemia but was present in only three out of 13 patients with non-ischaemic scintigrams. The value of exercise thallium-201 myocardial imaging as a diagnostic technique in hypertrophic cardiomyopathy appears limited. Scintigraphic evidence of regional myocardial ischaemia in the absence of significant coronary artery disease, however, contributes to an understanding of the mechanism of angina production in patients with hypertrophic cardiomyopathy. (author)

  15. Computerized detection of pneumothorax on digital chest radiographs

    International Nuclear Information System (INIS)

    Sanada, S.; Doi, K.; MacMahon, H.; Montner, S.M.

    1990-01-01

    This paper reports on neumothoraces that are clinically important abnormalities that usually appear as a subtle, fine line pattern on chest radiographs. We are developing a computer vision system for automated detection of pneumothorax to aid radiologists diagnosis. Chest images were digitized with a 0.175-mm pixel size, yielding a 2,000 x 2,430 matrix size, and 10 bits of gray scale. After indentification of the lung regions, an edge detection filter was employed in the apical areas to enhance a pneumothorax pattern. Ribs were detected with a technique based on statistical analysis of edge gradients and their orientations. Points located on a curved line suggestive of a pneumothorax in this enhanced image were detected with a Hough transform

  16. Comparison of scatter rejection and low-contrast performance of scan equalization digital radiography (SEDR), slot-scan digital radiography, and full-field digital radiography systems for chest phantom imaging

    International Nuclear Information System (INIS)

    Liu Xinming; Shaw, Chris C.; Lai, Chao-Jen; Wang Tianpeng

    2011-01-01

    Purpose: To investigate and compare the scatter rejection properties and low-contrast performance of the scan equalization digital radiography (SEDR) technique to the slot-scan and conventional full-field digital radiography techniques for chest imaging. Methods: A prototype SEDR system was designed and constructed with an a-Se flat-panel (FP) detector to improve image quality in heavily attenuating regions of an anthropomorphic chest phantom. Slot-scanning geometry was used to reject scattered radiation without attenuating primary x rays. The readout scheme of the FP was modified to erase accumulated scatter signals prior to image readout. A 24-segment beam width modulator was developed to regulate x-ray exposures regionally and compensate for the low x-ray flux in heavily attenuating regions. To measure the scatter-to-primary ratios (SPRs), a 2 mm thick lead plate with a 2-D array of aperture holes was used to measure the primary signals, which were then subtracted from those obtained without the lead plate to determine scatter components. A 2-D array of aluminum beads (3 mm in diameter) was used as the low-contrast objects to measure the contrast ratios (CRs) and contrast-to-noise ratios (CNRs) for evaluating the low-contrast performance in chest phantom images. A set of two images acquired with the same techniques were subtracted from each other to measure the noise levels. SPRs, CRs, and CNRs of the SEDR images were measured in four anatomical regions of chest phantom images and compared to those of slot-scan images and full-field images acquired with and without antiscatter grid. Results: The percentage reduction of SPR (percentage of SPRs reduced with scatter removal/rejection methods relative to that for nongrid full-field imaging) averaged over four anatomical regions was measured to be 80%, 83%, and 71% for SEDR, slot-scan, and full-field with grid, respectively. The average CR over four regions was found to improve over that for nongrid full

  17. Comparison of scatter rejection and low-contrast performance of scan equalization digital radiography (SEDR), slot-scan digital radiography, and full-field digital radiography systems for chest phantom imaging

    Energy Technology Data Exchange (ETDEWEB)

    Liu Xinming; Shaw, Chris C.; Lai, Chao-Jen; Wang Tianpeng [Department of Imaging Physics, Digital Imaging Research Laboratory, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009 (United States)

    2011-01-15

    Purpose: To investigate and compare the scatter rejection properties and low-contrast performance of the scan equalization digital radiography (SEDR) technique to the slot-scan and conventional full-field digital radiography techniques for chest imaging. Methods: A prototype SEDR system was designed and constructed with an a-Se flat-panel (FP) detector to improve image quality in heavily attenuating regions of an anthropomorphic chest phantom. Slot-scanning geometry was used to reject scattered radiation without attenuating primary x rays. The readout scheme of the FP was modified to erase accumulated scatter signals prior to image readout. A 24-segment beam width modulator was developed to regulate x-ray exposures regionally and compensate for the low x-ray flux in heavily attenuating regions. To measure the scatter-to-primary ratios (SPRs), a 2 mm thick lead plate with a 2-D array of aperture holes was used to measure the primary signals, which were then subtracted from those obtained without the lead plate to determine scatter components. A 2-D array of aluminum beads (3 mm in diameter) was used as the low-contrast objects to measure the contrast ratios (CRs) and contrast-to-noise ratios (CNRs) for evaluating the low-contrast performance in chest phantom images. A set of two images acquired with the same techniques were subtracted from each other to measure the noise levels. SPRs, CRs, and CNRs of the SEDR images were measured in four anatomical regions of chest phantom images and compared to those of slot-scan images and full-field images acquired with and without antiscatter grid. Results: The percentage reduction of SPR (percentage of SPRs reduced with scatter removal/rejection methods relative to that for nongrid full-field imaging) averaged over four anatomical regions was measured to be 80%, 83%, and 71% for SEDR, slot-scan, and full-field with grid, respectively. The average CR over four regions was found to improve over that for nongrid full

  18. Low-dosage helical CT applications for chest medical checkup and lung cancer screening

    International Nuclear Information System (INIS)

    Wang Ping; Cui Fa; Liang Huanqing; Zheng Minfei

    2005-01-01

    Objective: A discussion on low-dosage helical CT applications on chest medical checkup and lung cancer screening. Methods: On the 100 chest medical check up with three different of protocols, including standard-dosage (the tube current was 230 mAs) were compared with low-dose (tube current was 50 mAs or 30 mAs). Results: Low-dosage helical CT scan provides excellent images. In 100 chest medical checkup, 39 nodules or masses were revealed, enlarged lymph node was noted in 1 case; emphysema or bullae was demonstrated in 3 segments; thickening of bronchial wall was shown in 2 cases; and localized pleural thickening was found in 1 case. Conclusion: In chest checkup or lung cancer screening low-dosage helical CT (tube current 30 mAs) will not only guarantee image quality but also reduce the radiation dose during the examination. (authors)

  19. Chest wall tuberculosis simulating breast carcinoma: Imaging appearance

    International Nuclear Information System (INIS)

    Goyal, M.; Sharma, R.; Sharma, A.; Swahney, S.; Berry, M.; Chumber, S.

    1998-01-01

    Tuberculosis of the breast is a rare disease. Tubercular abscesses predominantly affecting the soft tissues are also very infrequent. A case of chest wall tuberculosis secondarily involving the breast presenting as a hard, fixed lump simulating mammary carcinoma is presented here. There was no evidence of pleural or pulmonary tuberculosis. Copyright (1998) Blackwell Science Pty Ltd

  20. Foreign object detection and removal to improve automated analysis of chest radiographs

    International Nuclear Information System (INIS)

    Hogeweg, Laurens; Sánchez, Clara I.; Melendez, Jaime; Maduskar, Pragnya; Ginneken, Bram van; Story, Alistair; Hayward, Andrew

    2013-01-01

    Purpose: Chest radiographs commonly contain projections of foreign objects, such as buttons, brassier clips, jewellery, or pacemakers and wires. The presence of these structures can substantially affect the output of computer analysis of these images. An automated method is presented to detect, segment, and remove foreign objects from chest radiographs.Methods: Detection is performed using supervised pixel classification with a kNN classifier, resulting in a probability estimate per pixel to belong to a projected foreign object. Segmentation is performed by grouping and post-processing pixels with a probability above a certain threshold. Next, the objects are replaced by texture inpainting.Results: The method is evaluated in experiments on 257 chest radiographs. The detection at pixel level is evaluated with receiver operating characteristic analysis on pixels within the unobscured lung fields and an A z value of 0.949 is achieved. Free response operator characteristic analysis is performed at the object level, and 95.6% of objects are detected with on average 0.25 false positive detections per image. To investigate the effect of removing the detected objects through inpainting, a texture analysis system for tuberculosis detection is applied to images with and without pathology and with and without foreign object removal. Unprocessed, the texture analysis abnormality score of normal images with foreign objects is comparable to those with pathology. After removing foreign objects, the texture score of normal images with and without foreign objects is similar, while abnormal images, whether they contain foreign objects or not, achieve on average higher scores.Conclusions: The authors conclude that removal of foreign objects from chest radiographs is feasible and beneficial for automated image analysis

  1. Spatial resolution and chest nodule detection: an interesting incidental finding

    Science.gov (United States)

    Toomey, R. J.; McEntee, M. F.; Ryan, J. T.; Evanoff, M. G.; Hayes, A.; Brennan, P. C.

    2010-02-01

    This study reports an incidental finding from a larger work. It examines the relationship between spatial resolution and nodule detection for chest radiographs. Twelve examining radiologists with the American Board of Radiology read thirty chest radiographs in two conditions - full (1500 × 1500 pixel) resolution, and 300 × 300 pixel resolution linearly interpolated to 1500 × 1500 pixels. All images were surrounded by a 10-pixel sharp grey border to aid in focussing the observer's eye when viewing the comparatively unsharp interpolated images. Fifteen of the images contained a single simulated pulmonary nodule. Observers were asked to rate their confidence that a nodule was present on each radiograph on a scale of 1 (least confidence, certain no lesion is present) to 6 (most confidence, certain a lesion was present). All other abnormalities were to be ignored. No windowing, levelling or magnification of the images was permitted and viewing distance was constrained to approximately 70cm. Images were displayed on a 3 megapixel greyscale monitor. Receiver operating characteristic (ROC) analysis was applied to the results of the readings using the Dorfman-Berbaum-Metz multiplereader, multiple-case method. No statistically significant differences were found with either readers and cases treated as random or with cases treated as fixed. Low spatial frequency information appears to be sufficient for the detection of chest lesion of the type used in this study.

  2. Volume-monitored chest CT: a simplified method for obtaining motion-free images near full inspiratory and end expiratory lung volumes

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Kathryn S. [The Ohio State University College of Medicine, Columbus, OH (United States); Long, Frederick R. [Nationwide Children' s Hospital, The Children' s Radiological Institute, Columbus, OH (United States); Flucke, Robert L. [Nationwide Children' s Hospital, Department of Pulmonary Medicine, Columbus, OH (United States); Castile, Robert G. [The Research Institute at Nationwide Children' s Hospital, Center for Perinatal Research, Columbus, OH (United States)

    2010-10-15

    Lung inflation and respiratory motion during chest CT affect diagnostic accuracy and reproducibility. To describe a simple volume-monitored (VM) method for performing reproducible, motion-free full inspiratory and end expiratory chest CT examinations in children. Fifty-two children with cystic fibrosis (mean age 8.8 {+-} 2.2 years) underwent pulmonary function tests and inspiratory and expiratory VM-CT scans (1.25-mm slices, 80-120 kVp, 16-40 mAs) according to an IRB-approved protocol. The VM-CT technique utilizes instruction from a respiratory therapist, a portable spirometer and real-time documentation of lung volume on a computer. CT image quality was evaluated for achievement of targeted lung-volume levels and for respiratory motion. Children achieved 95% of vital capacity during full inspiratory imaging. For end expiratory scans, 92% were at or below the child's end expiratory level. Two expiratory exams were judged to be at suboptimal volumes. Two inspiratory (4%) and three expiratory (6%) exams showed respiratory motion. Overall, 94% of scans were performed at optimal volumes without respiratory motion. The VM-CT technique is a simple, feasible method in children as young as 4 years to achieve reproducible high-quality full inspiratory and end expiratory lung CT images. (orig.)

  3. Regional improvement of signal-to-noise and contrast-to-noise ratios in dual-screen CR chest imaging - a phantom study

    International Nuclear Information System (INIS)

    Liu Xinming; Shaw, Chris C.

    2001-01-01

    The improvement of signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in dual-screen computed radiography (CR) has been investigated for various regions in images of an anthropomorphic chest phantom. With the dual-screen CR technique, two image plates are placed in a cassette and exposed together during imaging. The exposed plates are separately scanned to form a front image and a back image, which are then registered and superimposed to form a composite image with improved SNRs and CNRs. The improvement can be optimized by applying specifically selected weighting factors during superimposition. In this study, dual-screen CR images of an anthropomorphic chest phantom were acquired and formed with four different combinations of standard resolution (ST) and high-resolution (HR) screens: ST-ST, ST-HR, HR-ST, and HR-HR. SNRs and their improvements were measured and compared over twelve representative regions-of-interest (ROIs) in these images. A 19.1%-45.7% increase of the SNR was observed, depending on the ROI and screen combination used. The optimal weighting factors were found to vary by only 4.5%-12.4%. Largest improvement was found in the lung field for all screen combinations. Improvement of CNRs was investigated over two ROIs in the lung field using the rib bones as the contrast objects and a 29.2%-43.9% improvement of the CNR was observed. Among the four screen combinations, ST-ST resulted in the most SNR and CNR improvement, followed in order by HR-ST, HR-HR, and ST-HR. The HR-ST combination yielded the lowest spatial variation of the optimal weighting factors with improved SNRs and CNRs close to those of the ST-ST combination

  4. Chest X-Ray

    Medline Plus

    Full Text Available ... I’d like to talk with you about chest radiography also known as chest x-rays. Chest x-rays are the most ... far outweighs any risk. For more information about chest x-rays, visit Radiology Info dot org. Thank you for your time! ...

  5. The Beatles, the Nobel Prize, and CT scanning of the chest.

    Science.gov (United States)

    Goodman, Lawrence R

    2010-01-01

    From its first test scan on a mouse, in 1967, to current medical practice, the CT scanner has become a core imaging tool in thoracic diagnosis. Initially financed by money from Beatles' record sales, the first patient scan was performed in 1971. Only 8 years later, a Nobel Prize in Physics and Medicine was awarded to Hounsfield and Cormack for their discovery. This article traces the history of CT scanner development and how each technical advance expanded chest diagnostic frontiers. Chest imaging now accounts for 30% of all CT scanning.

  6. Development of a computerized method for identifying the posteroanterior and lateral views of chest radiographs by use of a template matching technique

    International Nuclear Information System (INIS)

    Arimura, Hidetaka; Katsuragawa, Shigehiko; Li Qiang; Ishida, Takayuki; Doi, Kunio

    2002-01-01

    In picture archiving and communications systems (PACS) or digital archiving systems, the information on the posteroanterior (PA) and lateral views for chest radiographs is often not recorded or is recorded incorrectly. However, it is necessary to identify the PA or lateral view correctly and automatically for quantitative analysis of chest images for computer-aided diagnosis. Our purpose in this study was to develop a computerized method for correctly identifying either PA or lateral views of chest radiographs. Our approach is to examine the similarity of a chest image with templates that represent the average chest images of the PA or lateral view for various types of patients. By use of a template matching technique with nine template images for patients of different size in two steps, correlation values were obtained for determining whether a chest image is either a PA or a lateral view. The templates for PA and lateral views were prepared from 447 PA and 200 lateral chest images. For a validation test, this scheme was applied to 1,000 test images consisting of 500 PA and 500 lateral chest radiographs, which are different from training cases. In the first step, 924 (92.4%) of the cases were correctly identified by comparison of the correlation values obtained with the three templates for medium-size patients. In the second step, the correlation values with the six templates for small and large patients were compared, and all of the remaining unidentifiable cases were identified correctly

  7. Pediatric chest CT after trauma: impact on surgical and clinical management

    International Nuclear Information System (INIS)

    Patel, Rina P.; Hernanz-Schulman, Marta; Hilmes, Melissa A.; Kan, J.H.; Yu, Chang; Ray, Jackie

    2010-01-01

    Chest CT after pediatric trauma is frequently performed but its clinical impact, particularly with respect to surgical intervention, has not been adequately evaluated. To assess the impact of chest CT compared with chest radiography on pediatric trauma management. Two hundred thirty-five consecutive pediatric trauma patients who had both chest CT and radiography were identified. Images were reviewed and findings were categorized and correlated with subsequent chest interventions, blinded to final outcome and management. Of the 235 children, 38.3% (90/235) had an abnormal chest radiograph and 63.8% (150/235) had an abnormal chest CT (P < 0.0001). Chest interventions followed in 4.7% (11/235); of these, the findings could be made 1 cm above the dome of the liver in 91% (10/11). Findings requiring chest intervention included pneumothorax (PTX) and vertebral fractures. PTX was found on 2.1% (5/235) of chest radiographs and 20.0% (47/235) of chest CTs (P < 0.0001); 1.7% (4/235) of the children received a chest tube for PTX, 0.85% (2/235) seen on chest CT only. Vertebral fractures were present in 3.8% of the children (9/235) and 66.7% (6/9) of those cases were treated with spinal fusion or brace. There were no instances of mediastinal vascular injury. Most intrathoracic findings requiring surgical management in our population were identified in the lower chest and would be included in routine abdominopelvic CT exams; this information needs to be taken into consideration in the diagnostic algorithm of pediatric trauma patients. (orig.)

  8. Pediatric chest CT after trauma: impact on surgical and clinical management

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Rina P. [Vanderbilt University School of Medicine, Nashville, TN (United States); Hernanz-Schulman, Marta; Hilmes, Melissa A.; Kan, J.H. [Vanderbilt University, Department of Radiology and Radiological Sciences, Vanderbilt Children' s Hospital, Nashville, TN (United States); Yu, Chang [Vanderbilt University, Department of Biostatistics, Nashville, TN (United States); Ray, Jackie [Vanderbilt University, Department of Pediatric Surgery, Vanderbilt Children' s Hospital, Nashville, TN (United States)

    2010-07-15

    Chest CT after pediatric trauma is frequently performed but its clinical impact, particularly with respect to surgical intervention, has not been adequately evaluated. To assess the impact of chest CT compared with chest radiography on pediatric trauma management. Two hundred thirty-five consecutive pediatric trauma patients who had both chest CT and radiography were identified. Images were reviewed and findings were categorized and correlated with subsequent chest interventions, blinded to final outcome and management. Of the 235 children, 38.3% (90/235) had an abnormal chest radiograph and 63.8% (150/235) had an abnormal chest CT (P < 0.0001). Chest interventions followed in 4.7% (11/235); of these, the findings could be made 1 cm above the dome of the liver in 91% (10/11). Findings requiring chest intervention included pneumothorax (PTX) and vertebral fractures. PTX was found on 2.1% (5/235) of chest radiographs and 20.0% (47/235) of chest CTs (P < 0.0001); 1.7% (4/235) of the children received a chest tube for PTX, 0.85% (2/235) seen on chest CT only. Vertebral fractures were present in 3.8% of the children (9/235) and 66.7% (6/9) of those cases were treated with spinal fusion or brace. There were no instances of mediastinal vascular injury. Most intrathoracic findings requiring surgical management in our population were identified in the lower chest and would be included in routine abdominopelvic CT exams; this information needs to be taken into consideration in the diagnostic algorithm of pediatric trauma patients. (orig.)

  9. Derivation and validation of two decision instruments for selective chest CT in blunt trauma: a multicenter prospective observational study (NEXUS Chest CT).

    Science.gov (United States)

    Rodriguez, Robert M; Langdorf, Mark I; Nishijima, Daniel; Baumann, Brigitte M; Hendey, Gregory W; Medak, Anthony J; Raja, Ali S; Allen, Isabel E; Mower, William R

    2015-10-01

    Unnecessary diagnostic imaging leads to higher costs, longer emergency department stays, and increased patient exposure to ionizing radiation. We sought to prospectively derive and validate two decision instruments (DIs) for selective chest computed tomography (CT) in adult blunt trauma patients. From September 2011 to May 2014, we prospectively enrolled blunt trauma patients over 14 y of age presenting to eight US, urban level 1 trauma centers in this observational study. During the derivation phase, physicians recorded the presence or absence of 14 clinical criteria before viewing chest imaging results. We determined injury outcomes by CT radiology readings and categorized injuries as major or minor according to an expert-panel-derived clinical classification scheme. We then employed recursive partitioning to derive two DIs: Chest CT-All maximized sensitivity for all injuries, and Chest CT-Major maximized sensitivity for only major thoracic injuries (while increasing specificity). In the validation phase, we employed similar methodology to prospectively test the performance of both DIs. We enrolled 11,477 patients-6,002 patients in the derivation phase and 5,475 patients in the validation phase. The derived Chest CT-All DI consisted of (1) abnormal chest X-ray, (2) rapid deceleration mechanism, (3) distracting injury, (4) chest wall tenderness, (5) sternal tenderness, (6) thoracic spine tenderness, and (7) scapular tenderness. The Chest CT-Major DI had the same criteria without rapid deceleration mechanism. In the validation phase, Chest CT-All had a sensitivity of 99.2% (95% CI 95.4%-100%), a specificity of 20.8% (95% CI 19.2%-22.4%), and a negative predictive value (NPV) of 99.8% (95% CI 98.9%-100%) for major injury, and a sensitivity of 95.4% (95% CI 93.6%-96.9%), a specificity of 25.5% (95% CI 23.5%-27.5%), and a NPV of 93.9% (95% CI 91.5%-95.8%) for either major or minor injury. Chest CT-Major had a sensitivity of 99.2% (95% CI 95.4%-100%), a specificity of

  10. The Yield from Routine Chest X-Rays in Stage 3 Breast Cancer ...

    African Journals Online (AJOL)

    Context: Cancer of the breast is a common malignancy in Nigerian women and various imaging examinations, including the chest radiograph are routinely requested in all patients with this disease. Objective: The objective of this study was to determine the positive yield from routine chest radiographs in Nigerian patients ...

  11. Development of a chest digital tomosynthesis R/F system and implementation of low-dose GPU-accelerated compressed sensing (CS) image reconstruction.

    Science.gov (United States)

    Choi, Sunghoon; Lee, Haenghwa; Lee, Donghoon; Choi, Seungyeon; Lee, Chang-Lae; Kwon, Woocheol; Shin, Jungwook; Seo, Chang-Woo; Kim, Hee-Joung

    2018-05-01

    This work describes the hardware and software developments of a prototype chest digital tomosynthesis (CDT) R/F system. The purpose of this study was to validate the developed system for its possible clinical application on low-dose chest tomosynthesis imaging. The prototype CDT R/F system was operated by carefully controlling the electromechanical subsystems through a synchronized interface. Once a command signal was delivered by the user, a tomosynthesis sweep started to acquire 81 projection views (PVs) in a limited angular range of ±20°. Among the full projection dataset of 81 images, several sets of 21 (quarter view) and 41 (half view) images with equally spaced angle steps were selected to represent a sparse view condition. GPU-accelerated and total-variation (TV) regularization strategy-based compressed sensing (CS) image reconstruction was implemented. The imaged objects were a flat-field using a copper filter to measure the noise power spectrum (NPS), a Catphan ® CTP682 quality assurance (QA) phantom to measure a task-based modulation transfer function (MTF T ask ) of three different cylinders' edge, and an anthropomorphic chest phantom with inserted lung nodules. The authors also verified the accelerated computing power over CPU programming by checking the elapsed time required for the CS method. The resultant absorbed and effective doses that were delivered to the chest phantom from two-view digital radiographic projections, helical computed tomography (CT), and the prototype CDT system were compared. The prototype CDT system was successfully operated, showing little geometric error with fast rise and fall times of R/F x-ray pulse less than 2 and 10 ms, respectively. The in-plane NPS presented essential symmetric patterns as predicted by the central slice theorem. The NPS images from 21 PVs were provided quite different pattern against 41 and 81 PVs due to aliased noise. The voxel variance values which summed all NPS intensities were inversely

  12. March 2018 imaging case of the month

    Directory of Open Access Journals (Sweden)

    Gotway MB

    2018-03-01

    Full Text Available No abstract available. Article truncated after first page. Clinical History: A 56-year-old woman with no significant past medical history underwent routine breast imaging (MRI which showed an abnormality outside the breast (images not shown. She has a sister with recently-diagnosed breast malignancy. The patient smoked for 30 years, quitting 10 years ago. Her surgical history is remarkable only for a tubal ligation and hysterectomy, and she is asymptomatic. Her medications consist only of vitamins and supplements. Laboratory evaluation showed a normal complete blood count, electrolyte panel, and liver function tests. Frontal and lateral chest radiography (Figure 1 was performed. Which of the following represents the most accurate assessment of the frontal chest imaging findings? 1. Chest frontal imaging shows a focal right lung nodule 2. Chest frontal imaging shows basilar fibrosis 3. Chest frontal imaging shows mediastinal and peribronchial lymphadenopathy 4. Chest frontal imaging shows multiple, bilateral small nodules 5. Chest frontal imaging shows normal findings …

  13. Assessment of ischemic heart disease by dipyridamole stress electrocardiographic gated myocardial single photon emission computed tomography with technetium-99m tetrofosmin

    International Nuclear Information System (INIS)

    Kanna, Masahiko; Mitani, Isao; Nakamaru, Masashi; Shibuya, Ken; Takeda, Kazuyoshi; Asahina, Shigeru; Kitamura, Yutaka; Higuma, Kikuhiko; Ishii, Masao

    1998-01-01

    Simultaneous assessment of stress perfusion and rest function is possible with gated single photon emission computed tomography (SPECT) using stress injected technetium-99m ( 99m Tc) tetrofosmin (TF). The feasibility of dipyridamole stress electrocardiographic gated myocardial SPECT (GSPECT) with TF was examined as an alternative to conventional stress/rest imaging. Fifty-one patients underwent stress GSPECT. 740 MBq of TF was administered 3 min after dipyridamole infusion. GSPECT acquisition was performed one hour after the injection. Additional rest SPECT was performed on another day only in patients with abnormal perfusion on stress images. Perfusion and thickening were analyzed visually on 17 segments of the left ventricle. Percentage of wall thickening (%WT) was also calculated in 17 segments of the polar map. Thirty-two of 51 patients (63%) had normal stress perfusion and normal rest thickening. Nineteen of 51 patients (37%) had abnormal perfusion on stress images. Among 157 abnormal perfusion segments of the 19 patients, 139 segments (89%) had thickening and the rest (11%) had no thickening. %WT was higher in the reversible segments with or without thickening. There was better agreement for the identification of normal segments and the presence of reversibility between stress GSPECT and the conventional stress/rest study in patients without previous myocardial infarction than in those with previous myocardial infarction (89% vs 79%). These results suggest that stress GSPECT may substitute for conventional stress/rest perfusion study in patients without previous myocardial infarction, allowing shorter examination time and lower cost. However, stress GSPECT does not replace the need for rest perfusion study in patients with previous myocardial infarction, because of underestimation of viability, but %WT may eliminate this underestimation. (author)

  14. Heartburn or Chest Pain: When Is It Heart Attack?

    Science.gov (United States)

    ... of cardiovascular imaging in emergency department patients with chest pain: A joint document of the American College of Radiology Appropriateness Criteria Committee and the American College of ...

  15. Digital luminescent radiography: A substitute for conventional chest radiography?

    International Nuclear Information System (INIS)

    Neufang, K.F.R.; Krug, B.; Lorenz, R.; Steinbrich, W.

    1990-01-01

    The image quality of digital luminescent radiography (DLR) is sufficient for routine biplane chest radiography and for follow-up studies of heart size, pulmonary congestion, coin lesions, infiltrations, atelectasis, pleural effusions, and mediastinal and hilar lymph node enlargement. Chest radiography in the intensive care unit may in most cases be performed using the DLR technique. there is no need for repeat shots because of incorrect exposure, and the position of catheters, tubes, pacemakers, drains and artificial heart valves, the mediastinum, and the retrocardiac areas of the left lung are more confidently assessed on the edge-enhanced DLR films than on conventional films. Nevertheless, DLR is somewhat inferior to conventional film-screen radiography of the chest as it can demonstrate or rule out subtle pulmonary interstitial disease less confidently. There is no reduction of radiation exposure of the chest in DLR compared with modern film-screen systems. As a consequence, DLR is presently not in a position to replace traditional film-screen radiography of the chest completely. (orig.) [de

  16. Compton radiography, 2. Clinical significance of Compton radiography of a chest phantom

    Energy Technology Data Exchange (ETDEWEB)

    Okuyama, S; Sera, K; Fukuda, H; Shishido, F [Tohoku Univ., Sendai (Japan). Research Inst. for Tuberculosis, Leprosy and Cancer; Mishina, H

    1977-09-01

    Compton radiography, a tomographic technic with Compton-scattered rays of a monochromatic gamma ray beam, was feasible of tomographing a chest phantom. The result suggested that the technic could be extended to imaging of the lung and the surrounding structures of the chest wall, mediastinum and liver in Compton tomographic mode.

  17. A study on computer-aided diagnosis based on temporal subtraction of sequential chest radiographs (in Japanese)

    International Nuclear Information System (INIS)

    Kano, Akiko

    2001-01-01

    An automated digital image subtraction technique for use with pairs of temporally sequential chest radiographs has been developed to aid radiologists in the detection of interval changes. Automated image registration based on nonlinear geometric warping is performed prior to subtraction in order to deal with complicated radiographic misregistration. Processing includes global matching, to achieve rough registration between the entire lung fields in the two images, and local matching, based on a cross-correlation method, to determine local shift values for a number of small regions. A proper warping of x,y-coordinates is determined by fitting two-dimensional polynomials to the distributions of the shift values. One image is warped and then subtracted from the other. The resultant subtraction images were able to enhance the conspicuity of various types of interval changes. Improved global matching based on a weighted template matching method achieved robust registration even with photofluorographs taken in chest mass screening programs, which had previously presented us with a relatively large number of poor-registration images. The new method was applied to 129 pairs of chest mass screening images, and offered registration accuracy as good as manual global matching. An observer test using 114 cases including 57 lung cancer cases presented better sensitivity and specificity on average compared to conventional comparison readings. In addition, newly developed image processing that eliminates the rib edge artifacts in subtraction images was applied to 26 images having pathological interval changes; results showed the potential for application to automated schemes for the detection of interval change patterns. With its capacity to improve the diagnostic accuracy of chest radiographs, the chest temporal subtraction technique promises to become an important element of computer-aided diagnosis (CAD) systems

  18. Chest wall – underappreciated structure in sonography. Part I: Examination methodology and ultrasound anatomy

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński

    2017-09-01

    Full Text Available Chest wall ultrasound has been awarded little interest in the literature, with chest wall anatomy described only in limited extent. The objective of this study has been to discuss the methodology of chest wall ultrasound and the sonographic anatomy of the region to facilitate professional evaluation of this complex structure. The primarily used transducer is a 7–12 MHz linear one. A 3–5 MHz convex (curvilinear transducer may also be helpful, especially in obese and very muscular patients. Doppler and panoramic imaging options are essential. The indications for chest wall ultrasound include localized pain or lesions found or suspected on imaging with other modalities (conventional radiography, CT, MR or scintigraphy. The investigated pathological condition should be scanned in at least two planes. Sometimes, evaluation during deep breathing permits identification of pathological mobility (e.g. in rib or sternum fractures, slipping rib syndrome. Several structures, closely associated with each other, need to be considered in the evaluation of the chest wall. The skin, which forms a hyperechoic covering, requires a high frequency transducer (20–45 MHz. The subcutaneous fat is characterized by clusters of hypoechoic lobules. Chest muscles have a very complex structure, but their appearance on ultrasound does not differ from the images of muscles located in other anatomical regions. As far as cartilaginous and bony structures of the chest are concerned, the differences in the anatomy of the ribs, sternum, scapula and sternoclavicular joints have been discussed. The rich vascular network which is only fragmentarily accessible for ultrasound assessment has been briefly discussed. A comprehensive evaluation of the chest wall should include the axillary, supraclavicular, apical and parasternal lymph nodes. Their examination requires the use of elastography and contrast-enhanced ultrasound.

  19. Radiological study of the chest using the digital method (FCR 101)

    International Nuclear Information System (INIS)

    Ferri, G.; Battolla, L.; Palla, L.; D'Alessandro, F.; Torri, T.; Tagliagambe, A.

    1991-01-01

    A computed radiography system with solid state detectors (FCR 101) was employed to evaluate the quality of digital images, with optimal and progressively lowered doses, in the study of the chest. Routine chest radiographs of in patients with no pathologic conditions of the chest were studied. The patients were divided into 3 groups: each patient in group A underwent two radiographs, one at 100% andthe other at 50% exposure; patients in group B were imaged with 100% and 25% doses, and those in group C received 50% and 25% exposure. Several parameters were employed for image evaluation, and a value was given to each of them (1=good, 2=sufficient, 3=insufficient). Upon comparison of the average values obtained, we observed that the digital technique allowed a most accurate and well-defined representation of the examined parameters at 100% exposure dose and that a 50% reduction did not decrease the informative content of the least. A 25% reduction, however, determined a high degree of background noise and a subsequent, though slight, loss of information

  20. The cost-effectiveness of carbon-fibre cassettes in mobile chest radiography

    International Nuclear Information System (INIS)

    Brennan, P.C.; Hourihan, S.P.

    1998-01-01

    Employment of carbon fibre materials is an effective method of reducing radiation dose, yet the increased associated costs have led to a reluctance in implementation. This study investigates the level of dose reduction achievable, while maintaining image quality, in mobile chest radiography using carbon-fibre cassettes, compared with plastic cassettes, and balances this against increased expense of the cassettes. Dose measurements using thermoluminescent dosimeters were carried out on intensive therapy unit (ITU) patients undergoing an anteroposterior chest X-ray examination. Resultant image quality was assessed using objective Commission of European Communities (CEC) criteria. A retrospective audit recorded number of ITU patients currently having chest X-rays to determine total dose savings over the life of the cassettes. The results show significant reductions (p < 0.0001) of 32 % for entrance surface and effective dose with carbon-fibre cassettes. No deterioration in total image quality was noted. The added expense of ≤ 2260 per personSievert (calculated from the effective dose reduction) for employing carbon-fibre cassettes is minimal compared with the estimated cost of manSievert exposures reported by other workers. (orig.)

  1. Comparison of Tc-99m-tetrofosmin and Tc-99m-MIBI scintimammography in differential diagnosis of breast mass

    International Nuclear Information System (INIS)

    Park, Jung Mi; Choi, Joon Young; Lee, Kyung Han; Choi, Yong; Choe, Yearn Seong; Kim, Sang Eun; Kim, Byung Tae; Nam, Seok Jin; Yang, Jeong Hyun

    2000-01-01

    Tc-99m-MIBI (MIBI) and Tc-99m-Tetrofosmin (TF) are commonly used for scintimammog (SMM). We compared the diagnostic ability of SMM using Tc-99m-MIBI and Tc-99m-TF for the differ diagnosis of breast mass. The study subjects were comprised of 123 breast lesior 86 normal breasts of 114 patients who underwent SMM. Bilateral prone images and anterior supine images obtained at 5 minutes and 1 or 3 hours after intravenous injection of 740 MBq of either MIBI or TF. of tumors were not significantly different between the MIBI and TF groups. First, two observers independ read the SMM without clinical information (1st interpretation), then read again with information about location (2nd interpretation). Sensitivity and specificity of each radiopharmaceutical for the diagnosis of cancer were evaluated in terms of image acquisition time, tumor size, and location. The SMM sb a good agreement between two observers for 1st and 2nd interpretation, except for TF SMM at hr. For first interpretation, the sensitivities at 5 min, 1 hr, and 3 hr were not significantly different between MIE TF SMM (81.6%, 80.0%, 60.9% in MIBI vs. 88.9%, 80.6%, 42.9% in TF), although the sensitivities of images were significantly lower than 5 min images in both MIBI and TF SMM. The specificity of TF at was superior to that of MIBI (81.5%, 90.0%, 82.9% in MIBI vs. 96.7%, 100%, 90.0% in TF, p<0.01 MB TF at 5 min). For the second interpretation with information of mass location, the sensitivities at 3 hr in were significantly lower than 5 min images (86.8%, 86.7%, 78.3% in MIBI vs. 88.9%, 93.5%, 57.1% in between MIBI and TF SMM. However, there was no significant difference in the specificity (60.0%, 5 75.0% for MIBI vs. 86.7%, 100%, 100% for TF). MIBI and TF SMM showed lower sensitivities for the t with less than 1 cm than tumors with more than 1 cm. However, the location of tumors did not influence sensitivity and specificity between MIBI and TF SMM. The ability for the differential diag of breast tumor is

  2. Free-breathing high-pitch 80 kVp dual-source computed tomography of the pediatric chest: Image quality, presence of motion artifacts and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Bodelle, Boris, E-mail: bbodelle@googlemail.com; Fischbach, Constanze; Booz, Christian; Yel, Ibrahim; Frellesen, Claudia; Beeres, Martin; Vogl, Thomas J.; Scholtz, Jan-Erik

    2017-04-15

    Objectives: To investigate image quality, presence of motion artifacts and effects on radiation dose of 80 kVp high-pitch dual-source CT (DSCT) in combination with an advanced modeled iterative reconstruction algorithm (ADMIRE) of the pediatric chest compared to single-source CT (SSCT). Materials and methods: The study was approved by the institutional review board. Eighty-seven consecutive pediatric patients (mean age 9.1 ± 4.9 years) received either free-breathing high-pitch (pitch 3.2) chest 192-slice DSCT (group 1, n = 31) or standard-pitch (pitch 1.2) 128-slice SSCT (group 2, n = 56) with breathing-instructions by random assignment. Tube settings were similar in both groups with 80 kVp and 74 ref. mAs. Images were reconstructed using FBP for both groups. Additionally, ADMIRE was used in group 1. Effective thorax diameter, image noise, and signal-to-noise ratio (SNR) of the pectoralis major muscle and the thoracic aorta were calculated. Motion artifacts were measured as doubling boarders of the diaphragm and the heart. Images were rated by two blinded readers for overall image quality and presence of motion artifacts on 5-point-scales. Size specific dose estimates (SSDE, mGy) and effective dose (ED, mSv) were calculated. Results: Age and effective thorax diameter showed no statistically significant differences in both groups. Image noise and SNR were comparable (p > 0.64) for SSCT and DSCT with ADMIRE, while DSCT with FBP showed inferior results (p < 0.01). Motion artifacts were reduced significantly (p = 0.001) with DSCT. DSCT with ADMIRE showed the highest overall IQ (p < 0.0001). Radiation dose was lower for DSCT compared to SSCT (median SSDE: 0.82 mGy vs. 0.92 mGy, p < 0.02; median ED: 0.4 mSv vs. 0.48 mSv, p = 0.02). Conclusions: High-pitch 80 kVp chest DSCT in combination with ADMIRE reduces motion artifacts and increases image quality while lowering radiation exposure in free-breathing pediatric patients without sedation.

  3. Free-breathing high-pitch 80 kVp dual-source computed tomography of the pediatric chest: Image quality, presence of motion artifacts and radiation dose

    International Nuclear Information System (INIS)

    Bodelle, Boris; Fischbach, Constanze; Booz, Christian; Yel, Ibrahim; Frellesen, Claudia; Beeres, Martin; Vogl, Thomas J.; Scholtz, Jan-Erik

    2017-01-01

    Objectives: To investigate image quality, presence of motion artifacts and effects on radiation dose of 80 kVp high-pitch dual-source CT (DSCT) in combination with an advanced modeled iterative reconstruction algorithm (ADMIRE) of the pediatric chest compared to single-source CT (SSCT). Materials and methods: The study was approved by the institutional review board. Eighty-seven consecutive pediatric patients (mean age 9.1 ± 4.9 years) received either free-breathing high-pitch (pitch 3.2) chest 192-slice DSCT (group 1, n = 31) or standard-pitch (pitch 1.2) 128-slice SSCT (group 2, n = 56) with breathing-instructions by random assignment. Tube settings were similar in both groups with 80 kVp and 74 ref. mAs. Images were reconstructed using FBP for both groups. Additionally, ADMIRE was used in group 1. Effective thorax diameter, image noise, and signal-to-noise ratio (SNR) of the pectoralis major muscle and the thoracic aorta were calculated. Motion artifacts were measured as doubling boarders of the diaphragm and the heart. Images were rated by two blinded readers for overall image quality and presence of motion artifacts on 5-point-scales. Size specific dose estimates (SSDE, mGy) and effective dose (ED, mSv) were calculated. Results: Age and effective thorax diameter showed no statistically significant differences in both groups. Image noise and SNR were comparable (p > 0.64) for SSCT and DSCT with ADMIRE, while DSCT with FBP showed inferior results (p < 0.01). Motion artifacts were reduced significantly (p = 0.001) with DSCT. DSCT with ADMIRE showed the highest overall IQ (p < 0.0001). Radiation dose was lower for DSCT compared to SSCT (median SSDE: 0.82 mGy vs. 0.92 mGy, p < 0.02; median ED: 0.4 mSv vs. 0.48 mSv, p = 0.02). Conclusions: High-pitch 80 kVp chest DSCT in combination with ADMIRE reduces motion artifacts and increases image quality while lowering radiation exposure in free-breathing pediatric patients without sedation.

  4. Chest Computed Tomographic Image Screening for Cystic Lung Diseases in Patients with Spontaneous Pneumothorax Is Cost Effective.

    Science.gov (United States)

    Gupta, Nishant; Langenderfer, Dale; McCormack, Francis X; Schauer, Daniel P; Eckman, Mark H

    2017-01-01

    Patients without a known history of lung disease presenting with a spontaneous pneumothorax are generally diagnosed as having primary spontaneous pneumothorax. However, occult diffuse cystic lung diseases such as Birt-Hogg-Dubé syndrome (BHD), lymphangioleiomyomatosis (LAM), and pulmonary Langerhans cell histiocytosis (PLCH) can also first present with a spontaneous pneumothorax, and their early identification by high-resolution computed tomographic (HRCT) chest imaging has implications for subsequent management. The objective of our study was to evaluate the cost-effectiveness of HRCT chest imaging to facilitate early diagnosis of LAM, BHD, and PLCH. We constructed a Markov state-transition model to assess the cost-effectiveness of screening HRCT to facilitate early diagnosis of diffuse cystic lung diseases in patients presenting with an apparent primary spontaneous pneumothorax. Baseline data for prevalence of BHD, LAM, and PLCH and rates of recurrent pneumothoraces in each of these diseases were derived from the literature. Costs were extracted from 2014 Medicare data. We compared a strategy of HRCT screening followed by pleurodesis in patients with LAM, BHD, or PLCH versus conventional management with no HRCT screening. In our base case analysis, screening for the presence of BHD, LAM, or PLCH in patients presenting with a spontaneous pneumothorax was cost effective, with a marginal cost-effectiveness ratio of $1,427 per quality-adjusted life-year gained. Sensitivity analysis showed that screening HRCT remained cost effective for diffuse cystic lung diseases prevalence as low as 0.01%. HRCT image screening for BHD, LAM, and PLCH in patients with apparent primary spontaneous pneumothorax is cost effective. Clinicians should consider performing a screening HRCT in patients presenting with apparent primary spontaneous pneumothorax.

  5. Chest x-ray generation and data augmentation for cardiovascular abnormality classification

    Science.gov (United States)

    Madani, Ali; Moradi, Mehdi; Karargyris, Alexandros; Syeda-Mahmood, Tanveer

    2018-03-01

    Medical imaging datasets are limited in size due to privacy issues and the high cost of obtaining annotations. Augmentation is a widely used practice in deep learning to enrich the data in data-limited scenarios and to avoid overfitting. However, standard augmentation methods that produce new examples of data by varying lighting, field of view, and spatial rigid transformations do not capture the biological variance of medical imaging data and could result in unrealistic images. Generative adversarial networks (GANs) provide an avenue to understand the underlying structure of image data which can then be utilized to generate new realistic samples. In this work, we investigate the use of GANs for producing chest X-ray images to augment a dataset. This dataset is then used to train a convolutional neural network to classify images for cardiovascular abnormalities. We compare our augmentation strategy with traditional data augmentation and show higher accuracy for normal vs abnormal classification in chest X-rays.

  6. Evaluation of a Chest Circumference-Adapted Protocol for Low-Dose 128-Slice Coronary CT Angiography with Prospective Electrocardiogram Triggering

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Chenying; Wang, Zufei; Ji, Jiansong; Wang, Hailin; Hu, Xianghua; Chen, Chunmiao [Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang 323000 (China)

    2015-11-01

    To assess the effect of chest circumference-adapted scanning protocol on radiation exposure and image quality in patients undergoing prospective electrocardiogram (ECG)-triggered coronary CT angiography (CCTA). One hundred-eighty-five consecutive patients, who had undergone prospective ECG triggering CCTA with a 128-slice CT, were included in the present study. Nipple-level chest circumference, body weight and height were measured before CT examinations. Patients were divided into four groups based on kV/ref·mAs = 100/200, 100/250, 120/200, and 120/250, when patient's chest circumference was ≤ 85.0 (n = 56), 85.0-90.0 (n = 53), 90.0-95.0 (n = 44), and > 95.0 (n = 32), respectively. Image quality per-segment was independently assessed by two experienced observers. Image noise and attenuation were also measured. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The effective radiation dose was calculated using CT dose volume index and the dose-length product. A significant correlation was observed between patients' chest circumference and body mass index (r = 0.762, p < 0.001). Chest circumference ranged from 74 to 105 cm, and the mean effective radiation dose was 1.9-3.8 mSv. Diagnostic image quality was obtained in 98.5% (2440/2478) of all evaluated coronary segments without any significant differences among the four groups (p = 0.650). No significant difference in image noise was observed among the four groups (p = 0.439), thus supporting the validity of the chest circumference-adapted scanning protocol. However, vessel attenuation, SNR and CNR were significantly higher in the 100 kV groups than in the 120 kV groups (p < 0.05). A measure of chest circumference can be used to adapt tube voltage and current for individualized radiation dose control, with resultant similar image noise and sustained diagnostic image quality.

  7. Chest tube placement in thorax trauma - comparison chest X-ray and computed tomography (CT)

    International Nuclear Information System (INIS)

    Heim, P.; Maas, R.; Buecheler, E.; Tesch, C.

    1998-01-01

    Estimation of chest tube placement in patients with thoracic trauma with regard to chest tube malposition in chest radiography in the supine position compared to additional computed tomography of the thorax. Material and methods: Apart from compulsory chest radiography after one or multiple chest tube insertions, 31 severely injured patients with thoracic trauma underwent a CT scan of the thorax. These 31 patients with 40 chest tubes constituted the basis for the present analysis. Results: In chest radiography in the supine position there were no chest tube malpositions (n=40); In the CT scans 25 correct positions, 7 pseudo-malpositions, 6 intrafissural and 2 intrapulmonary malpositions were identified. Moreover 16 sufficient, 18 insufficient and 6 indifferent functions of the chest tubes were seen. Conclusion: In case of lasting clinical problems and questionable function of the chest tube, chest radiography should be supplemented by a CT scan of the thorax in order to estimate the position of the chest tube. (orig.) [de

  8. Herniation of unruptured tuberculous lung abscess into chest wall without pleural or bronchial spillage

    Directory of Open Access Journals (Sweden)

    Rahul Magazine

    2011-01-01

    Full Text Available A 22-year-old unmarried man presented to the chest outpatient department with a history of productive cough of two-month duration. He also complained of pain and swelling on the anterior aspect of right side of chest of one-month duration. Imaging studies of the thorax, including chest roentgenography and computerized tomography, revealed an unruptured lung abscess which had herniated into the chest wall. Culture of pus aspirated from the chest wall swelling grew Mycobacterium tuberculosis. He was diagnosed to have a tuberculous lung abscess which had extended into the chest wall, without spillage into the pleural cavity or the bronchial tree. Antituberculosis drugs were prescribed, and he responded to the treatment with complete resolution of the lesion.

  9. Time course evaluation of myocardial perfusion after reperfusion therapy by 99mTc-tetrofosmin SPECT in patients with acute myocardial infarction.

    Science.gov (United States)

    Tanaka, R; Nakamura, T

    2001-09-01

    Myocardial perfusion imaging with 99mTc-labeled agents immediately after reperfusion therapy can underestimate myocardial salvage. It is also conceivable that delayed imaging is useful for assessing the risk area. However, to our knowledge, very few studies have sequentially evaluated these image changes. We conducted 99mTc-tetrofosmin (TF) and 123I-beta-methyl-p-iodophenylpentadecanoic acid (BMIPP) SPECT before and after reperfusion to treat acute myocardial infarction and quantified changes in TF myocardial accumulation and reverse redistribution. Seventeen patients with a first myocardial infarction underwent successful reperfusion. We examined SPECT images obtained at the onset (preimage), those acquired 30 min (early image) and 6 h (delayed image) after TF injection, and images acquired 1, 4, 7, and 20 d after reperfusion (post-1-d, post-4-d, post-7-d, and post-20-d image, respectively). We also examined BMIPP SPECT images after 7 +/- 1.8 d (BMIPP image). Polar maps were divided into 48 segments to calculate percentage uptake, and time course changes in segment numbers below 60% were observed as abnormal area. Moreover, cardiac function was analyzed by gated TF SPECT on 1 and 20 d after reperfusion. In reference to the abnormal area on the early images, the post-1-d image was significantly improved compared with the preimage (P < 0.01) as was the post-7-d image compared with the post-1-d and post-4-d images (P < 0.05, respectively). However, post-20-d and post-7-d images did not significantly differ. Therefore, the improvement in myocardial accumulation reached a plateau 7 d after reperfusion. On the other hand, the abnormal area on the delayed images was significantly greater (P < 0.01) compared with that on the early images from 4 to 20 d after reperfusion, as the value was essentially constant. The correlations of the abnormal area between the preimage and the post-7-d delayed image, the preimage and the BMIPP image, and the post-7-d delayed image and the

  10. Evaluation of Chest Ultrasound Integrated Teaching of Respiratory System Physiology to Medical Students

    Science.gov (United States)

    Paganini, Matteo; Bondì, Michela; Rubini, Alessandro

    2017-01-01

    Ultrasound imaging is a widely used diagnostic technique, whose integration in medical education is constantly growing. The aim of this study was to evaluate chest ultrasound usefulness in teaching respiratory system physiology, students' perception of chest ultrasound integration into a traditional lecture in human physiology, and short-term…

  11. April 2018 imaging case of the month

    Directory of Open Access Journals (Sweden)

    Viggiano RW

    2018-04-01

    Full Text Available No abstract available. Article truncated after first page. Clinical History: A 65-year-old non-smoking man with a past medical history significant for hyperlipidemia, hypertension, coronary artery disease, and pacemaker placement, presented for a routine medical evaluation. The patient was allergic to penicillin, and his list of medications included aspirin, a diuretic, an ACE inhibitor, and a statin, in addition to over-the-counter vitamin supplements. Laboratory evaluation showed a normal complete blood count, electrolyte panel, and liver function tests. Frontal and chest radiography (Figure 1 was performed. Which of the following represents the most accurate assessment of the frontal chest imaging findings? 1.\tChest frontal imaging shows a mediastinal mass 2.\tChest frontal imaging shows bilateral peribronchial and mediastinal lymph node enlargement 3.\tChest frontal imaging shows bilateral pleural fluid collections 4.\tChest frontal imaging shows focal masses 5.\tChest frontal imaging shows reduced lung volumes with basilar fibrotic changes …

  12. Fat segmentation on chest CT images via fuzzy models

    Science.gov (United States)

    Tong, Yubing; Udupa, Jayaram K.; Wu, Caiyun; Pednekar, Gargi; Subramanian, Janani Rajan; Lederer, David J.; Christie, Jason; Torigian, Drew A.

    2016-03-01

    Quantification of fat throughout the body is vital for the study of many diseases. In the thorax, it is important for lung transplant candidates since obesity and being underweight are contraindications to lung transplantation given their associations with increased mortality. Common approaches for thoracic fat segmentation are all interactive in nature, requiring significant manual effort to draw the interfaces between fat and muscle with low efficiency and questionable repeatability. The goal of this paper is to explore a practical way for the segmentation of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) components of chest fat based on a recently developed body-wide automatic anatomy recognition (AAR) methodology. The AAR approach involves 3 main steps: building a fuzzy anatomy model of the body region involving all its major representative objects, recognizing objects in any given test image, and delineating the objects. We made several modifications to these steps to develop an effective solution to delineate SAT/VAT components of fat. Two new objects representing interfaces of SAT and VAT regions with other tissues, SatIn and VatIn are defined, rather than using directly the SAT and VAT components as objects for constructing the models. A hierarchical arrangement of these new and other reference objects is built to facilitate their recognition in the hierarchical order. Subsequently, accurate delineations of the SAT/VAT components are derived from these objects. Unenhanced CT images from 40 lung transplant candidates were utilized in experimentally evaluating this new strategy. Mean object location error achieved was about 2 voxels and delineation error in terms of false positive and false negative volume fractions were, respectively, 0.07 and 0.1 for SAT and 0.04 and 0.2 for VAT.

  13. Direct digital acquisition of neonatal portable chest radiographs

    International Nuclear Information System (INIS)

    Cohen, M.D.; Cory, D.A.; Broderick, N.J.; Smith, J.A.

    1987-01-01

    The Philips computerized radiography system utilizes a phosphor plate instead of an x-ray film to acquire radiographic images. The latent image on the plate is converted to a digital format. The authors report their initial experience with the system in more than 300 studies on intensive care neonates. The digital images provide very uniform image density. Tubes and catheters are more easily visualized than on conventional images. Soft tissues of the chest wall and bony structures are also more clearly seen on the digital images. The authors' initial experience indicates that portable digital imaging of neonates is technically feasible and provides good-quality diagnostic images

  14. A patient with type I CD36 deficiency whose myocardium accumulated 123I-BMIPP after 4 years.

    Science.gov (United States)

    Ito, K; Sugihara, H; Tanabe, T; Zen, K; Hikosaka, T; Adachi, Y; Katoh, S; Azuma, A; Nakagawa, M

    2001-06-01

    A 73-year-old man with aortic regurgitation was examined by 123I-alpha-methyl-p-iodophenylpentadecanoic acid (BMIPP) myocardial single photon emission computed tomography (SPECT) in 1995. Myocardial accumulation was not evident on either the early or the delayed image obtained 15 minutes and 3 hours, respectively, after injecting 123I-BMIPP. Flow cytometric analysis of CD36 expression in monocytes and platelets identified a type I CD36 deficiency. The patient was hospitalized for severe heart failure in 1999. Upon admission, the cardiothoracic ratio on chest X-rays was 73%, and the left ventricular end-diastolic diameter on echocardiograms was enlarged to 77 mm. On the second day, we performed 123I-BMIPP myocardial SPECT. Myocardial accumulation was evident in the delayed, but not in the early image. We repeated 123I-BMIPP myocardial SPECT on the 10th day after admission. Myocardial accumulation was evident on both early and delayed images. 99mTc-tetrofosmin myocardial SPECT was immediately performed after 123I-BMIPP myocardial SPECT to distinguish myocardial from pooling images in the left ventricle, but, because the images from both 99Tc-tetrofosmin and 123I-BMIPP myocardial SPECT were idential, we considered that the 123I-BMIPP myocardial SPECT images reflected the actual myocardial condition. The CD36 molecule transports long-chain fatty acid (LCFA) on the myocardial membrane, but 123I-BMIPP scintigraphy does not show any myocardial accumulation in patients with type I CD36 deficiency, indicating that myocardial LCFA uptake occurs through CD36 on the human myocardial membrane. Even though our patient had type I CD36 deficiency, BMIPP was uptaken by the myocardium during heart failure, suggesting a variant pathway on the human myocardial membrane for LCFA uptake.

  15. Rate of transformation and normal range about cardiac size and cardiothoracic ratio according to patient position and age at chest radiography of Korean adult man

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Young Cheol [Dept. of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Lim, Cheong Hwan; Jung, Hong Ryang [Dept. of Radiological Science, Hanseo University, Seosan (Korea, Republic of); Kim, Yun Min [Dept. of Radiotechnology, Wonkwang Health Science University, Iksan (Korea, Republic of); Hong, Dong Hee [Dept. of Radiological Science, Far East University, Eumseong (Korea, Republic of)

    2017-06-15

    Purpose of this study is present the normal range of cardiac size and cardiothoracic ratio according to patient position(chest PA and AP) and age of Korean adult male on digital chest X - ray, And to propose a mutually compatible conversion rate. 1,024 males were eligible for this study, among 1,300 normal chest patients who underwent chest PA and low-dose CT examinations on the same day at the 'S' Hospital Health Examination Center in Seoul From January to December 2014. CS and CTR were measured by Danzer (1919). The mean difference between CS and CTR was statistically significant (p<0.01) in Chest PA (CS 135.48 mm, CTR 43.99%) and Chest AP image (CS 155.96 mm, CTR 51.75%). There was no statistically significant difference between left and right heart in chest PA and AP images(p>0.05). CS showed statistically significant difference between Chest PA (p>0. 05) and Chest AP (p<0.05). The thorax size and CTR were statistically significant (p<0.01) in both age and chest PA and AP. Result of this study, On Chest AP image CS was magnified 15%, CTR was magnified 17% compare with Chest PA image. CS and CTR were about 10% difference by changing posture at all ages.

  16. Effect of contrast material on image noise and radiation dose in adult chest computed tomography using automatic exposure control: A comparative study between 16-, 64- and 128-slice CT

    Energy Technology Data Exchange (ETDEWEB)

    Paul, Jijo, E-mail: jijopaul1980@gmail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Haus 23C UG, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Goethe University, Department of Biophysics, Max von Laue-Strasse 1, 60438 Frankfurt am Main (Germany); Schell, Boris, E-mail: boris.schell@googlemail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Haus 23C UG, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Kerl, J. Matthias, E-mail: matthias.kerl@gmai.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Haus 23C UG, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Maentele, Werner, E-mail: maentele@biophysik.uni-frankfurt.de [Goethe University, Department of Biophysics, Max von Laue-Strasse 1, 60438 Frankfurt am Main (Germany); Vogl, Thomas J., E-mail: t.vogl@em.uni-frankfurt.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Haus 23C UG, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Bauer, Ralf W., E-mail: ralfwbauer@aol.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Haus 23C UG, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany)

    2011-08-15

    Purpose: To determine the difference in radiation dose between non-enhanced (NECT) and contrast-enhanced (CECT) chest CT examinations contributed by contrast material with different scanner generations with automatic exposure control (AEC). Methods and materials: Each 42 adult patients received a NECT and CECT of the chest in one session on a 16-, 64- or 128-slice CT scanner with the same scan protocol settings. However, AEC technology (Care Dose 4D, Siemens) underwent upgrades in each of the three scanner generations. DLP, CTDIvol and image noise were compared. Results: Although absolute differences in image noise were very small and ranged between 10 and 13 HU for NECT and CECT in median, the differences in image noise and dose (DLP: 16-slice:+2.8%; 64-slice:+3.9%; 128-slice:+5.6%) between NECT and CECT were statistically significant in all groups. Image noise and dose parameters were significantly lower in the most recent 128-slice CT generation for both NECT and CECT (DLP: 16-slice:+35.5-39.2%; 64-slice:+6.8-8.5%). Conclusion: The presence of contrast material lead to an increase in dose for chest examinations in three CT generations with AEC. Although image noise values were significantly higher for CECT, the absolute differences were in a range of 3 HU. This can be regarded as negligible, thus indicating that AEC is able to fulfill its purpose of maintaining image quality. However, technological developments lead to a significant reduction of dose and image noise with the latest CT generation.

  17. Indications for chest CT. Retrospective study of cases with normal chest CT

    International Nuclear Information System (INIS)

    Obata, Shiro

    1995-01-01

    The usefulness of computed tomography (CT) in thoracic radiology is now well appreciated, and the number of chest CTs has greatly increased. There are, however, many chest CT cases that are completely or almost completely normal. Indications for chest CT should be re-evaluated considering the cost and radiation exposure associated with the examination. Reviewing the reports of 4930 chest CT examinations performed in three hospitals during the period of two years, the author found 620 (12.6%) negative CT examinations. In 312 of the 620, the CT was requested because of 'abnormal shadow' on chest radiograph. When the same chest radiographs were re-evaluated by two radiologists, no abnormality was noted in 257 cases (82.4%). CT examinations were considered justified in only 55 cases (17.6%). There was a significant difference in the frequency of normal chest CT examinations between the university hospital and two other hospitals. The causes of false positive interpretation of chest radiographs were analyzed, and it was felt that fundamental knowledge necessary to interpret chest radiographs was lacking. The importance of close cooperation between clinicians and radiologists should be emphasized. (author)

  18. Examination of the constancy of the medium optical density of conventional chest radiographs

    International Nuclear Information System (INIS)

    Stieve, F.E.; Rupp, N.; Niederhofer, F.; Gfirtner, H.

    2002-01-01

    Purpose: To determine whether the medium optical density of conventional chest radiographs is constant. Materials and Methods: 47 PA chest radiographs were digitized to measure the optical density and its dynamic range of normal and pathologically altered lungs. Results: For constant exposure factors and a correctly positioned region of interest, the medium optical density deviates only minimal despite differences in AP chest diameter, entry dose and dynamic range, and is largely independent of the pathologic pulmonary findings. Conclusion: Digitization of the radiograph enables the determination of the physical parameters used to operate the imaging system, such as medium optical density, image contrast, image latitude and density distribution, in accordance to the guidelines of the German Medical Association. If the region of interest encompasses the clinically relevant region of the lung, the measured value of the optical density corresponds with only minor variation to the average value of the entire lung region. (orig.) [de

  19. American College of Chest Physicians

    Science.gov (United States)

    ... Foundation Participate in the e-Community Get Social Career Connection Publications CHEST Journal CHEST SEEK Guidelines & Consensus Statements CHEST Physician CHEST NewsBrief Coding for Chest Medicine Tobacco Dependence Toolkit (3rd Ed.) Mobile Websites and Apps CHEST Journal ...

  20. Two cases of Chest Heating Sensation treated by Hwangryunhaedok-tang Herbal-Acupuncture

    Directory of Open Access Journals (Sweden)

    Gwon-Il Cho

    2003-06-01

    Full Text Available The purpose of this study is to evaluate the clinical effect of Hwangryunhaedok-tang Herbal-Acupuncture. Hwangryunhaedok-tang is used in all heating diseases. Chest Heating Sensation is a unique concept in Oriental Medicine. So we applied Hwangryunhaedok-tang Herbal-Acupuncture to treat the Chest Heating Sensation. We used DITI(Digital Infrared Thermographic Imaging to estimate the temperatures of chest surface for the outcome assessment. We came to know that the chest surface temperatures were all reduced in both cases after Herbal-Acupuncture treatment. The reduced average temperature was 1.5℃ in case 1 and 0.9℃ in case 2. The above result indicates that Hwangryunhaedok-tang Herbal-Acupuncture treatment has an effect on Chest Heating Sensation, thus continuous Hwangryunhaedok-tang Herbal-Acupuncture study will be needed for more clinical applications.

  1. Feasibility and diagnostic accuracy of Ecg-gated SPECT myocardial perfusion imaging by a two-hour protocol: The Myofast study;Faisabilite et precision diagnostique d'un protocole de scintigraphie myocardique synchronisee a l'ECG en deux heures: l'etude Myofast

    Energy Technology Data Exchange (ETDEWEB)

    Dunet, V.; Costo, S.; Sabatier, R.; Grollier, G.; Bouvard, G.; Agostini, D. [CHU Cote-de-Nacre, Service de medecine nucleaire, 14 - Caen (France)

    2010-04-15

    Aim of the study: To assess the feasibility of early stress and rest myocardial perfusion and function study using a fast {sup 99m}Tc-tetrofosmin gated-SPECT protocol in patients with known coronary artery disease. Materials and methods: Forty-three patients (pts) (37 M, 6 F, mean age 63.8 +- 9.8 years) underwent a {sup 99m}Tc-Tetrofosmin gated-SPECT (Axis Picker-Philips) myocardial study and a coronary angiography (C.A.) within 3 months. Images were acquired (LEHR, eight bins, 40 sec per image) after injection of {sup 99m}Tc-tetrofosmin (200 to 380 MBq) early (15 min) post-stress (36 dipyridamole, two dobutamine and five ergo-metric stress), and at rest after {sup 99m}Tc-tetrofosmin reinjection (600 to 1150 MBq), in a total time not exceeding 2 hours. Processing was performed with Q.G.S. software using the 17-segment model. Pathological study was defined as a summed difference score (SDS) greater than or equal to 4 4, a fixed defect with summed rest score greater than or equal to 4 and/or L.V. dysfunction defined as myocardial stunning (variation between stress and rest L.V.E.F. greater than or equal to 4 5%), stress L.V.E.F. less than or equal to 45% or rest L.V.E.F. less than or equal to 40%. Results were compared with C.A., and stenosis greater than or equal to 4 50% was considered as significant. Results: For 100% the quality of SPECT imaging was good or excellent. For six patients gating was impossible because of arrhythmia. The overall sensitivity, specificity and accuracy were 95%, 50%, and 91%, respectively. The concordance between gated SPECT and C.A. was moderate (kappa = 0.45, S.E. = 0.15). Interestingly, early-gated acquisition permitted to underline left ventricular dysfunction in 11 cases (30%), of whom eight had poly vascular disease. Stunning was detected in six of 37 cases (16%), of whom six had poly vascular disease. Conclusion: A one-day two-hour {sup 99m}Tc-tetrofosmin gated-SPECT protocol to assess left ventricular perfusion and function is

  2. New released DR detector (Canon CXDI 70C wireless) tested at premature neonates chest examination focusing on dose and image quality

    DEFF Research Database (Denmark)

    Precht, Helle

    2011-01-01

    maintaining image quality - in accordance with the ALARA principle. Dose reduction is particularly interesting in paediatrics because of the high radiation sensitivity of children. In preterm, a dose reduction has even greater importance, and because the anatomical structures in the chest are extra small...... Carlo and analyzed in conjunction with exposure index values. Statistical analysis supported the results. Results The IQF value from the technical phantom is clearly higher at the new detector at all exposure values as well as the VGA shows great potential for improving image quality and possibilities...

  3. A computerized scheme for lung nodule detection in multiprojection chest radiography

    International Nuclear Information System (INIS)

    Guo Wei; Li Qiang; Boyce, Sarah J.; McAdams, H. Page; Shiraishi, Junji; Doi, Kunio; Samei, Ehsan

    2012-01-01

    Purpose: Our previous study indicated that multiprojection chest radiography could significantly improve radiologists' performance for lung nodule detection in clinical practice. In this study, the authors further verify that multiprojection chest radiography can greatly improve the performance of a computer-aided diagnostic (CAD) scheme. Methods: Our database consisted of 59 subjects, including 43 subjects with 45 nodules and 16 subjects without nodules. The 45 nodules included 7 real and 38 simulated ones. The authors developed a conventional CAD scheme and a new fusion CAD scheme to detect lung nodules. The conventional CAD scheme consisted of four steps for (1) identification of initial nodule candidates inside lungs, (2) nodule candidate segmentation based on dynamic programming, (3) extraction of 33 features from nodule candidates, and (4) false positive reduction using a piecewise linear classifier. The conventional CAD scheme processed each of the three projection images of a subject independently and discarded the correlation information between the three images. The fusion CAD scheme included the four steps in the conventional CAD scheme and two additional steps for (5) registration of all candidates in the three images of a subject, and (6) integration of correlation information between the registered candidates in the three images. The integration step retained all candidates detected at least twice in the three images of a subject and removed those detected only once in the three images as false positives. A leave-one-subject-out testing method was used for evaluation of the performance levels of the two CAD schemes. Results: At the sensitivities of 70%, 65%, and 60%, our conventional CAD scheme reported 14.7, 11.3, and 8.6 false positives per image, respectively, whereas our fusion CAD scheme reported 3.9, 1.9, and 1.2 false positives per image, and 5.5, 2.8, and 1.7 false positives per patient, respectively. The low performance of the conventional

  4. Chest Pain: First Aid

    Science.gov (United States)

    First aid Chest pain: First aid Chest pain: First aid By Mayo Clinic Staff Causes of chest pain can vary from minor problems, such as indigestion ... 26, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-chest-pain/basics/ART-20056705 . Mayo ...

  5. Chest CT findings in pediatric Wegener's granulomatosis

    International Nuclear Information System (INIS)

    Levine, Daniel; Akikusa, Jonathan; Manson, David; Silverman, Earl; Schneider, Rayfel

    2007-01-01

    Although pulmonary involvement occurs in the majority of children and adolescents with Wegener's granulomatosis (WG), relatively little has been published regarding the CT imaging manifestations in this group of patients. To determine the frequency and types of chest CT abnormalities in active pediatric WG (pWG). The study was a retrospective examination of 29 chest CT examinations performed at diagnosis (n=14) and during disease flares (n=15) in 18 children. The most common abnormalities were nodules (seen in 90% of examinations), ground-glass opacification (52%), and air-space opacification (45%). Of examinations with nodules, 73% demonstrated nodules >5 mm in diameter and 69% demonstrated more than five nodules; 17% had cavitary lesions. The only abnormality with a significant difference in prevalence between diagnosis and disease flares was air-space opacification, present in 71% and 20%, respectively (P < 0.01). In accordance with the findings of published adult studies and at variance with those of prior pediatric studies, our findings indicate that chest CT abnormalities in active pWG are frequent, most commonly comprising nodules and ground-glass opacification, which may be difficult to detect on plain radiography. We therefore advocate the routine use of chest CT for all affected patients, both at the time of presentation and during disease flares. (orig.)

  6. Chest radiography and abdominal ultrasound in general practice

    NARCIS (Netherlands)

    Speets, Anouk Mariëlle

    2006-01-01

    Chest radiography (CXR) and abdominal ultrasound (US) are two widely used diagnostic imaging techniques in Western societies. General practitioners (GPs) in The Netherlands annually request approximately 500,000 CXRs and 200,000 abdominal US, and therefore clearly place a burden on health care.

  7. Effect of data compression on diagnostic accuracy in digital hand and chest radiography

    Science.gov (United States)

    Sayre, James W.; Aberle, Denise R.; Boechat, Maria I.; Hall, Theodore R.; Huang, H. K.; Ho, Bruce K. T.; Kashfian, Payam; Rahbar, Guita

    1992-05-01

    Image compression is essential to handle a large volume of digital images including CT, MR, CR, and digitized films in a digital radiology operation. The full-frame bit allocation using the cosine transform technique developed during the last few years has been proven to be an excellent irreversible image compression method. This paper describes the effect of using the hardware compression module on diagnostic accuracy in hand radiographs with subperiosteal resorption and chest radiographs with interstitial disease. Receiver operating characteristic analysis using 71 hand radiographs and 52 chest radiographs with five observers each demonstrates that there is no statistical significant difference in diagnostic accuracy between the original films and the compressed images with a compression ratio as high as 20:1.

  8. Interpretation of chest radiographs with a high-resolution (2,000 x 2,000 x 12 bit) display

    International Nuclear Information System (INIS)

    Cox, G.G.

    1989-01-01

    This paper presents an evaluation of high-resolution (2K x 2Kx 12 bit) display for interpretation of chest radiographs. Three radiologists chose a total of 165 chest radiographs to ensure representation of nine signs: apical pleural scarring, chronic obstructive pulmonary disease, interstitial processes, atelectasis, pneumothorax, hilar mass, pleural effusion, pneumonia, and nodules. Each chest film was digitized to 4Kx 4Kx 12 bit and averaged to 2Kx 2Kx 12 bit and printed on a laser film printer. The 2K x 2K x 12-bit images were displayed and interactively windowed on a 2K x 2K x 12-bit high-resolution gray-scale cathode ray tube display. Six radiologists, none of whom participated in the case selection process, then interpreted a mixture of the screen film chest radiographs, the laser printed 2K chest radiographs, and the high resolution displayed 2K images

  9. An automated patient recognition method based on an image-matching technique using previous chest radiographs in the picture archiving and communication system environment

    International Nuclear Information System (INIS)

    Morishita, Junji; Katsuragawa, Shigehiko; Kondo, Keisuke; Doi, Kunio

    2001-01-01

    An automated patient recognition method for correcting 'wrong' chest radiographs being stored in a picture archiving and communication system (PACS) environment has been developed. The method is based on an image-matching technique that uses previous chest radiographs. For identification of a 'wrong' patient, the correlation value was determined for a previous image of a patient and a new, current image of the presumed corresponding patient. The current image was shifted horizontally and vertically and rotated, so that we could determine the best match between the two images. The results indicated that the correlation values between the current and previous images for the same, 'correct' patients were generally greater than those for different, 'wrong' patients. Although the two histograms for the same patient and for different patients overlapped at correlation values greater than 0.80, most parts of the histograms were separated. The correlation value was compared with a threshold value that was determined based on an analysis of the histograms of correlation values obtained for the same patient and for different patients. If the current image is considered potentially to belong to a 'wrong' patient, then a warning sign with the probability for a 'wrong' patient is provided to alert radiology personnel. Our results indicate that at least half of the 'wrong' images in our database can be identified correctly with the method described in this study. The overall performance in terms of a receiver operating characteristic curve showed a high performance of the system. The results also indicate that some readings of 'wrong' images for a given patient in the PACS environment can be prevented by use of the method we developed. Therefore an automated warning system for patient recognition would be useful in correcting 'wrong' images being stored in the PACS environment

  10. Incidental findings in chest X-rays; Zufallsbefunde im Roentgenthorax

    Energy Technology Data Exchange (ETDEWEB)

    Wielpuetz, M.O.; Kauczor, H.U. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaet Heidelberg, Translational Lung Research Center (TLRC), Deutsches Zentrum fuer Lungenforschung (DZL), Heidelberg (Germany); Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik, Heidelberg (Germany); Weckbach, S. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaet Heidelberg, Translational Lung Research Center (TLRC), Deutsches Zentrum fuer Lungenforschung (DZL), Heidelberg (Germany)

    2017-04-15

    Conventional projection radiography (chest x-ray) is one of the most frequently requested procedures in radiology. Even though chest x-ray imaging is frequently performed in asymptomatic patients for preoperative assessment, clinically relevant incidental findings are relatively scarce. This is due to the relatively low sensitivity of chest x-rays where few clinically relevant incidental findings are to be expected, as any detectable pathologies will as a rule already be clinically symptomatic. Recommendations from relevant societies for the management of incidental findings, apart from the clarification of incidental nodules, do not exist. This review article therefore describes the most frequent and typical incidental findings of lung parenchyma (apart from pulmonary nodules), mediastinal structures including the hilum of the lungs, pleura, chest wall and major vessels. Also described are those findings which can be diagnosed with sufficient certainty from chest x-rays so that further clarification is not necessary and those which must be further clarified by multislice imaging procedures or other techniques. (orig.) [German] Eine der haeufigsten Untersuchungen in der Radiologie ist die konventionelle Projektionsradiographie des Thorax (Roentgenthorax). Auch wenn projektionsradiographische Aufnahmen im Rahmen einer praeoperativen Abklaerung haeufig als orientierende Untersuchung angefertigt werden, sind - bedingt durch die relativ geringe Sensitivitaet des Roentgenthorax - wenig klinisch relevante Zufallsbefunde zu erwarten, da nachweisbare Pathologien in der Regel bereits auch klinisch apparent sind. Empfehlungen entsprechender Fachgesellschaften zu Zufallsbefunden im Roentgenthorax jenseits der Abklaerung von Rundherden liegen nicht vor. Die vorliegende Arbeit beleuchtet daher haeufige und typische Zufallsbefunde des Lungenparenchyms (ausser den Lungenrundherden), der mediastinalen Strukturen einschliesslich der Hili, der Pleura, der Thoraxwand sowie der

  11. Community-Acquired Pneumonia Visualized on CT Scans but Not Chest Radiographs: Pathogens, Severity, and Clinical Outcomes.

    Science.gov (United States)

    Upchurch, Cameron P; Grijalva, Carlos G; Wunderink, Richard G; Williams, Derek J; Waterer, Grant W; Anderson, Evan J; Zhu, Yuwei; Hart, Eric M; Carroll, Frank; Bramley, Anna M; Jain, Seema; Edwards, Kathryn M; Self, Wesley H

    2018-03-01

    The clinical significance of pneumonia visualized on CT scan in the setting of a normal chest radiograph is uncertain. In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens present, and outcomes of patients with pneumonia visualized on a CT scan but not on a concurrent chest radiograph (CT-only pneumonia) and those with pneumonia visualized on a chest radiograph. All patients underwent chest radiography; the decision to obtain CT imaging was determined by the treating clinicians. Chest radiographs and CT images were interpreted by study-dedicated thoracic radiologists blinded to the clinical data. The study population included 2,251 adults with CAP; 2,185 patients (97%) had pneumonia visualized on chest radiography, whereas 66 patients (3%) had pneumonia visualized on CT scan but not on concurrent chest radiography. Overall, these patients with CT-only pneumonia had a clinical profile similar to those with pneumonia visualized on chest radiography, including comorbidities, vital signs, hospital length of stay, prevalence of viral (30% vs 26%) and bacterial (12% vs 14%) pathogens, ICU admission (23% vs 21%), use of mechanical ventilation (6% vs 5%), septic shock (5% vs 4%), and inhospital mortality (0 vs 2%). Adults hospitalized with CAP who had radiological evidence of pneumonia on CT scan but not on concurrent chest radiograph had pathogens, disease severity, and outcomes similar to patients who had signs of pneumonia on chest radiography. These findings support using the same management principles for patients with CT-only pneumonia and those with pneumonia seen on chest radiography. Copyright © 2017 American College of Chest Physicians. All rights reserved.

  12. A method to optimize the processing algorithm of a computed radiography system for chest radiography.

    Science.gov (United States)

    Moore, C S; Liney, G P; Beavis, A W; Saunderson, J R

    2007-09-01

    A test methodology using an anthropomorphic-equivalent chest phantom is described for the optimization of the Agfa computed radiography "MUSICA" processing algorithm for chest radiography. The contrast-to-noise ratio (CNR) in the lung, heart and diaphragm regions of the phantom, and the "system modulation transfer function" (sMTF) in the lung region, were measured using test tools embedded in the phantom. Using these parameters the MUSICA processing algorithm was optimized with respect to low-contrast detectability and spatial resolution. Two optimum "MUSICA parameter sets" were derived respectively for maximizing the CNR and sMTF in each region of the phantom. Further work is required to find the relative importance of low-contrast detectability and spatial resolution in chest images, from which the definitive optimum MUSICA parameter set can then be derived. Prior to this further work, a compromised optimum MUSICA parameter set was applied to a range of clinical images. A group of experienced image evaluators scored these images alongside images produced from the same radiographs using the MUSICA parameter set in clinical use at the time. The compromised optimum MUSICA parameter set was shown to produce measurably better images.

  13. Study of dosimetric quantities and image quality in pediatric examinations of chest and abdomen computed tomography

    International Nuclear Information System (INIS)

    Jornada, Tiago da Silva

    2013-01-01

    This work had the objective to achieve the knowledge of the dosimetric quantities related to chest and abdomen computed tomography (CT) examinations of pediatric patients, in Belo Horizonte city. The reason of this work is based on the fact that the probability of health detriment in children, which it may be caused by radiation, is higher than in adults. Besides, although in many countries the knowledge and control of patient doses is a normal procedure, this safety culture does not exist in Brazil. Another objective of this work was to compare the dosimetric quantity values with the Diagnostic Reference Levels (DRLs); when it was needed, an optimization process was applied and the quality of the diagnostic image obtained with the optimized technical parameters was analyzed. This study was carried out in five hospitals, where the weighted air kerma index (Cw), the volumetric air kerma index (Cvol), the air kerma - length product (PKL,CT), the Effective Dose (E) and the Normalized Effective Dose (En) were determined; three methods were adopted for measurements: the ionization chamber inside a chest pediatric phantom, radiochromic films and the CT-EXPO software. The optimization process was applied to a single hospital through variations in the current (mA) and voltage (kV) of the x-ray tube for the protocols used for abdomen CT examinations. The analysis of the quality of the diagnostic image was done by Normal Distribution and ROC analysis; spatial resolution analysis was used through MTF determination and the noise level was judged in terms quantitative and qualitative. Results of the dosimetric quantities showed that they significantly differed between single-slice and multi-slice tomography units, but their values were always below the recommended DRLs. The optimized values of the dosimetric quantities obtained after the optimization process showed that it was possible to reduce the radiation exposure of pediatric patient without losing the image quality

  14. The chest radiological manifestation in psittacosis

    International Nuclear Information System (INIS)

    Zhang Jun; Fu Jiazhen; Wang Shulan; Zhang Shuxin; Sun Guochang; Tang Guangjian

    2005-01-01

    Objective: To summarize the clinical characteristics and imaging features of psittacosis. Methods: The clinical features and imaging appearances of 3 cases with acute psittacosis were retrospectively analyzed. The related literature was reviewed. Results: The clinical manifestation of psittacosis was high fever in the patients. Physical findings included pulse-temperature dissociation, localized lung crackles, hepatomegaly, and splenomegaly. Laboratory findings showed elevation of ESR in all cases, and liver dysfunction was present in 2 cases. The counts of white blood cells were normal, but the percent of neutrophils might be increased. The chest X-ray and CT scan showed air-space consolidation and ground-glass attenuation in the lung, and miliary, nodular, or consolidated shadows were found in pathological areas. Pleural effusions were also present in 2 cases. Psittacosis was diagnosed from the history of exposure to infected parrots and elevation of the IgG and IgM titer for Chlamydia psittaci. Erythromycin was effective in all 3 patients. Conclusion: Although the appearance of psittacosis on clinical findings and chest X-ray and CT scan is not characteristic, psittacosis can be diagnosed with the combination of the history of exposure to infected parrots and laboratory findings. CT scan can reveal the focus earlier and accurately, and catching the imaging features of psittacosis is helpful in differential diagnosis. (authors)

  15. Chest computed tomography

    DEFF Research Database (Denmark)

    Loeve, Martine; Krestin, Gabriel P.; Rosenfeld, Margaret

    2013-01-01

    are not suitable to study CF lung disease in young children. Chest computed tomography (CT) holds great promise for use as a sensitive surrogate endpoint in CF. A large body of evidence has been produced to validate the use of chest CT as primary endpoint to study CF lung disease. However, before chest CT can...

  16. Dobutamine stress tetrofosmin SPECT. Evaluation of short rest-stress protocol and head to head comparison with MIBI in detection of coronary artery disease

    International Nuclear Information System (INIS)

    Turgut, B.; Unlu, M.; Cengel, A.

    2005-01-01

    The purpose of the present study was to evaluate the feasibility and diagnostic accuracy of same day short rest-dobutamine stress Tetrofosmin (TF) SPECT imaging protocol and to compare TF SPECT results with methoxyisobutyl isonitrile (MIBI) SPECT in the same subjects who were unable to perform treadmill exercise or were unsuitable for pharmacological vasodilator stress. The study group consisted of 19 patients (2 female and 17 male, with a mean age of 53.8±7.9 yrs) in whom coronary artery disease (CAD) had been proven or excluded at coronary angiography (CA). MIBI SPECT imaging was performed first. TF SPECT images were obtained one week after MIBI imaging. Immediately after the rest SPECT imaging in both of the MIBI and TF studies, patients underwent dobutamine stress tests. Rest-stress radiotracer doses and dobutamine doses were the same for both TF and MIBI studies. While 60 min waiting periods were applied for MIBI study, only 30 min waiting periods were applied for TF study after the rest and stress injections. Images were evaluated by visual and quantitative analysis. Dobutamine stress parameters were similar for both studies. Although in TF study, the time between radiopharmaceutical injection and imaging was shorter than in MIBI study, there was no significant difference between heart-to-liver (H/Li) and heart-to-lung (H/Lu) ratios. According to CA results, diagnostic accuracy was similar for TF and MIBI. While sensitivity, specificity and accuracy for TF study were calculated as 82%, 84% and 82%, respectively, the corresponding values for MIBI were 82%, 88% and 84%, respectively. This clinical study has shown comparable diagnostic performance for the detection of CAD between MIBI and TF. Good correlation was found between segmental analysis for both studies. MIBI and TF showed similar perfusion defects and good segmental correlation during dobutamine stress with the same quality images. Both radiopharmaceuticals may be acceptable with this imaging protocol

  17. Criteria for the selective use of chest computed tomography in blunt trauma patients

    International Nuclear Information System (INIS)

    Brink, Monique; Dekker, Helena M.; Kool, Digna R.; Blickman, Johan G.; Deunk, Jaap; Edwards, Michael J.R.; Vugt, Arie B. van; Kuijk, Cornelis van

    2010-01-01

    The purpose of this study was to derive parameters that predict which high-energy blunt trauma patients should undergo computed tomography (CT) for detection of chest injury. This observational study prospectively included consecutive patients (≥16 years old) who underwent multidetector CT of the chest after a high-energy mechanism of blunt trauma in one trauma centre. We included 1,047 patients (median age, 37; 70% male), of whom 508 had chest injuries identified by CT. Using logistic regression, we identified nine predictors of chest injury presence on CT (age ≥55 years, abnormal chest physical examination, altered sensorium, abnormal thoracic spine physical examination, abnormal chest conventional radiography (CR), abnormal thoracic spine CR, abnormal pelvic CR or abdominal ultrasound, base excess <-3 mmol/l and haemoglobin <6 mmol/l). Of 855 patients with ≥1 positive predictors, 484 had injury on CT (95% of all 508 patients with injury). Of all 192 patients with no positive predictor, 24 (13%) had chest injury, of whom 4 (2%) had injuries that were considered clinically relevant. Omission of CT in patients without any positive predictor could reduce imaging frequency by 18%, while most clinically relevant chest injuries remain adequately detected. (orig.)

  18. Criteria for the selective use of chest computed tomography in blunt trauma patients

    Energy Technology Data Exchange (ETDEWEB)

    Brink, Monique; Dekker, Helena M.; Kool, Digna R.; Blickman, Johan G. [Radboud University Nijmegen, Medical Centre, Department of Radiology, Nijmegen (Netherlands); Deunk, Jaap; Edwards, Michael J.R. [Radboud University Nijmegen, Medical Centre, Department of Surgery, Nijmegen (Netherlands); Vugt, Arie B. van [Radboud University Nijmegen, Medical Centre Nijmegen, Department of Emergency Medicine, Nijmegen (Netherlands); Kuijk, Cornelis van [VU (Vrije Universiteit) University, Medical Center Amsterdam, Department of Radiology, Amsterdam (Netherlands)

    2010-04-15

    The purpose of this study was to derive parameters that predict which high-energy blunt trauma patients should undergo computed tomography (CT) for detection of chest injury. This observational study prospectively included consecutive patients ({>=}16 years old) who underwent multidetector CT of the chest after a high-energy mechanism of blunt trauma in one trauma centre. We included 1,047 patients (median age, 37; 70% male), of whom 508 had chest injuries identified by CT. Using logistic regression, we identified nine predictors of chest injury presence on CT (age {>=}55 years, abnormal chest physical examination, altered sensorium, abnormal thoracic spine physical examination, abnormal chest conventional radiography (CR), abnormal thoracic spine CR, abnormal pelvic CR or abdominal ultrasound, base excess <-3 mmol/l and haemoglobin <6 mmol/l). Of 855 patients with {>=}1 positive predictors, 484 had injury on CT (95% of all 508 patients with injury). Of all 192 patients with no positive predictor, 24 (13%) had chest injury, of whom 4 (2%) had injuries that were considered clinically relevant. Omission of CT in patients without any positive predictor could reduce imaging frequency by 18%, while most clinically relevant chest injuries remain adequately detected. (orig.)

  19. Technetium-99m-Sestamibi in the diagnosis of acute chest pain

    International Nuclear Information System (INIS)

    Gilleece, T.; Salehi, N.; Better, N.

    1998-01-01

    Full text: A 45-year-old male was admitted to coronary care with a two-day history of recurrent chest pain. Despite maximal medical therapy, pain persisted. Examination and ECG with pain, were normal, suspicion of ischaemia was moderately high but coronary angiography was not immediately available. Technetium-99m-Sestamibi was prepared at the start of the day according to the standard preparation protocol (Du Pont). Coronary Care informed the Nuclear Medicine Department immediately the patient experienced a further episode of chest pain. Technetium-99m-Sestamibi was administered in coronary care, 4.30 minutes after being advised of the onset of further chest pain. Images were acquired 60 minute post-injection; 15 minutes after the patient had been given 200 mL of milk. A triple-headed gamma camera was used to acquire SPECT images over a 1200 arc, 30 frames of 30 seconds using a 64 x 64 matrix. The patient was laying prone with arms raised out of the field of view. Images showed a normal distribution of technetium-99m -Sestamibi throughout the myocardium. Due to ongoing clinical suspicion by the treating physician, coronary angiography was subsequently performed. This showed normal coronary arteries. Medical therapy was ceased and the patient discharged the next day. We concluded that the chest pain at the time of injection was not ischaemic. Previous trials had shown a 95% sensitivity for this method of diagnosing ischaemia. This method permits a novel and simple technique for diagnosing myocardial ischaemia and obviating the need for cardiac catheterization in this group of patients

  20. The Potential Role of Grid-Like Software in Bedside Chest Radiography in Improving Image Quality and Dose Reduction: An Observer Preference Study.

    Science.gov (United States)

    Ahn, Su Yeon; Chae, Kum Ju; Goo, Jin Mo

    2018-01-01

    To compare the observer preference of image quality and radiation dose between non-grid, grid-like, and grid images. Each of the 38 patients underwent bedside chest radiography with and without a grid. A grid-like image was generated from a non-grid image using SimGrid software (Samsung Electronics Co. Ltd.) employing deep-learning-based scatter correction technology. Two readers recorded the preference for 10 anatomic landmarks and the overall appearance on a five-point scale for a pair of non-grid and grid-like images, and a pair of grid-like and grid images, respectively, which were randomly presented. The dose area product (DAP) was also recorded. Wilcoxon's rank sum test was used to assess the significance of preference. Both readers preferred grid-like images to non-grid images significantly ( p software significantly improved the image quality of non-grid images to a level comparable to that of grid images with a relatively lower level of radiation exposure.

  1. Skeletal changes mimicking intrathoracic disease on chest radiographs

    International Nuclear Information System (INIS)

    Gelderen, WFC van

    2009-01-01

    Full text: Various chest radiographs are illustrated to demonstrate features where bony changes may mimic intrathoracic disease. To confirm the skeletal origin and nature, further conventional radiographs often suffice, and the need for CT or scintigraphy may therefore be obviated. At the time of presentation for radiography of the chest, further pertinent clinical details can be obtained from the patient by the department staff, as required. All previous radiographs and radiological reports should be readily available. In order to add to the educational value of the 13 cases illustrated, all are presented in quiz format, with the answers and further images included in the text.

  2. Quality of outpatient paediatric chest radiography - a pilot study

    International Nuclear Information System (INIS)

    Engelmann, D.; Duetting, T.; Wunsch, R.; Troeger, J.

    2001-01-01

    A quality control of outpatient paediatric chest X-rays was conducted in a sample of patients of one paediatric practice. During a period of eight months the technical image quality was analysed considering both diagnostic aspects and radiation protection. The quality of the 139 examined chest X-rays was inadequate concerning the collimation and focussing of the X-rays and the positioning of the patients. Exposure was estimated as average, sharpness was rated as good. In total 14% of the X-rays were not suitable for medical diagnosis. Image quality of the X-rays of infants (children younger than 6 years) was significantly lower compared to the total sample. Radiation protection standards were not fulfilled. As a conclusion from our results, improvements in outpatient paediatric radiography are urgently necessary. Quality control committees should pay particular attention in radiographs of infants. (orig.) [de

  3. Enhanced washout of 99mTc-tetrofosmin in hypertrophic cardiomyopathy: quantitative comparisons with regional 123I-BMIPP uptake and wall thickness determined by MRI

    International Nuclear Information System (INIS)

    Thet-Thet-Lwin, Tohoru; Takeda, Jin; Wu, Yuko; Fumikura, Keiji; Iida, Satoru; Kawano, Iwao; Yamaguchi, Yuji; Itai

    2003-01-01

    The diagnostic value of technetium-99m tetrofosmin (TF) washout in hypertrophic cardiomyopathy (HCM) was examined by investigating its relation to the metabolic abnormality depicted by iodine-123 β-methyl-p-iodophenylpentadecanoic acid (BMIPP) uptake and the left ventricular (LV) myocardial wall thickness as measured by magnetic resonance imaging (MRI). TF washout was evaluated in 31 patients with HCM and 23 normal control subjects using 30-min (early) and 3-h (delayed) TF single-photon emission tomography images. The LV myocardial wall was divided into 19 segments and the percentage TF washout, regional BMIPP uptake and LV wall thickness were measured in each segment. Mean TF washout in the patients with HCM was significantly faster than that in normal control subjects (23.7±5.7 vs 13.4±4.1, P<0.0001). In the patients with HCM, TF washout showed an excellent correlation with MRI wall thickness (r=0.82, P<0.0001) and a good inverse correlation with regional BMIPP uptake (r=-0.72, P<0.0001). In addition, a good linear correlation was observed between TF uptake and MRI wall thickness in the 19 regional segments. In conclusion, the degree of TF washout corresponds well with the severity of myocardial wall thickness and the degree of metabolic abnormality in patients with HCM. These results suggest that enhanced TF washout might provide additional clinical information regarding metabolic alterations in HCM. (orig.)

  4. Enhanced washout of 99mTc-tetrofosmin in hypertrophic cardiomyopathy: quantitative comparisons with regional 123I-BMIPP uptake and wall thickness determined by MRI.

    Science.gov (United States)

    Thet-Thet-Lwin; Takeda, Tohoru; Wu, Jin; Fumikura, Yuko; Iida, Keiji; Kawano, Satoru; Yamaguchi, Iwao; Itai, Yuji

    2003-07-01

    The diagnostic value of technetium-99m tetrofosmin (TF) washout in hypertrophic cardiomyopathy (HCM) was examined by investigating its relation to the metabolic abnormality depicted by iodine-123 beta-methyl- p-iodophenylpentadecanoic acid (BMIPP) uptake and the left ventricular (LV) myocardial wall thickness as measured by magnetic resonance imaging (MRI). TF washout was evaluated in 31 patients with HCM and 23 normal control subjects using 30-min (early) and 3-h (delayed) TF single-photon emission tomography images. The LV myocardial wall was divided into 19 segments and the percentage TF washout, regional BMIPP uptake and LV wall thickness were measured in each segment. Mean TF washout in the patients with HCM was significantly faster than that in normal control subjects (23.7+/-5.7 vs 13.4+/-4.1, P<0.0001). In the patients with HCM, TF washout showed an excellent correlation with MRI wall thickness ( r=0.82, P<0.0001) and a good inverse correlation with regional BMIPP uptake ( r=-0.72, P<0.0001). In addition, a good linear correlation was observed between TF uptake and MRI wall thickness in the 19 regional segments. In conclusion, the degree of TF washout corresponds well with the severity of myocardial wall thickness and the degree of metabolic abnormality in patients with HCM. These results suggest that enhanced TF washout might provide additional clinical information regarding metabolic alterations in HCM.

  5. Evaluation of a Thermoplastic Immobilization System for Breast and Chest Wall Radiation Therapy

    International Nuclear Information System (INIS)

    Strydhorst, Jared H.; Caudrelier, Jean-Michel; Clark, Brenda G.; Montgomery, Lynn A.; Fox, Greg; MacPherson, Miller S.

    2011-01-01

    We report on the impact of a thermoplastic immobilization system on intra- and interfraction motion for patients undergoing breast or chest wall radiation therapy. Patients for this study were treated using helical tomotherapy. All patients were immobilized using a thermoplastic shell extending from the shoulders to the ribcage. Intrafraction motion was assessed by measuring maximum displacement of the skin, heart, and chest wall on a pretreatment 4D computed tomography, while inter-fraction motion was inferred from patient shift data arising from daily image guidance procedures on tomotherapy. Using thermoplastic immobilization, the average maximum motion of the external contour was 1.3 ± 1.6 mm, whereas the chest wall was found to be 1.6 ± 1.9 mm. The day-to-day setup variation was found to be large, with random errors of 4.0, 12.0, and 4.5 mm in the left-right, superior-inferior, and anterior-posterior directions, respectively, and the standard deviations of the systematic errors were found to be 2.7, 9.8, and 4.1 mm. These errors would be expected to dominate any respiratory motion but can be mitigated by daily online image guidance. Using thermoplastic immobilization can effectively reduce respiratory motion of the chest wall and external contour, but these gains can only be realized if daily image guidance is used.

  6. Pneumothorax detection in chest radiographs using convolutional neural networks

    Science.gov (United States)

    Blumenfeld, Aviel; Konen, Eli; Greenspan, Hayit

    2018-02-01

    This study presents a computer assisted diagnosis system for the detection of pneumothorax (PTX) in chest radiographs based on a convolutional neural network (CNN) for pixel classification. Using a pixel classification approach allows utilization of the texture information in the local environment of each pixel while training a CNN model on millions of training patches extracted from a relatively small dataset. The proposed system uses a pre-processing step of lung field segmentation to overcome the large variability in the input images coming from a variety of imaging sources and protocols. Using a CNN classification, suspected pixel candidates are extracted within each lung segment. A postprocessing step follows to remove non-physiological suspected regions and noisy connected components. The overall percentage of suspected PTX area was used as a robust global decision for the presence of PTX in each lung. The system was trained on a set of 117 chest x-ray images with ground truth segmentations of the PTX regions. The system was tested on a set of 86 images and reached diagnosis accuracy of AUC=0.95. Overall preliminary results are promising and indicate the growing ability of CAD based systems to detect findings in medical imaging on a clinical level accuracy.

  7. Experiences with a new film-screen system in pediatric chest radiography

    International Nuclear Information System (INIS)

    Leenen, A.; Brandt, G.A.; Riebel, T.; Marciniak, H.

    1996-01-01

    Purpose: To compare the X-ray images made by the Kodak InSight Pediatric Imaging System (InSight P) with conventional film-screen systems in pediatric chest radiography. Material and methods: The comparison involved chest radiographs made using Quanta-Fast-Detail/Cronex 4 (DuPont), Trimax 16/XDA (3 M) and DuPont UVR/UVL systems. The image quality of critical structures and the physical parameters of quantum interference, contrast and resolution were assessed. The energy path of the system was assessed by preparing density curves. Test conditions were in accordance with the latest guidelines of the Bundesaerztekammer (German Physicians' Association). Results: The mediastinal area, retrocardiac and paravertebral spaces and the peripheral vessels of the lung were all displayed more distinctly using InSight P. The reason for this seems to be a lower degree of quantum interference associated with this system. With tube voltages between 60 and 80 kV, InSight P displayed a relatively low degree of sensitivity. Conclusion: InSight P can be used to produce predominantly high quality chest radiographs on infants between one and five years of age. However, this system has limited sensitivity in the tube voltage range recommended by the German Physicians' Association. (orig.) [de

  8. A simple method to retrospectively estimate patient dose-area product for chest tomosynthesis examinations performed using VolumeRAD.

    Science.gov (United States)

    Båth, Magnus; Söderman, Christina; Svalkvist, Angelica

    2014-10-01

    The purpose of the present work was to develop and validate a method of retrospectively estimating the dose-area product (DAP) of a chest tomosynthesis examination performed using the VolumeRAD system (GE Healthcare, Chalfont St. Giles, UK) from digital imaging and communications in medicine (DICOM) data available in the scout image. DICOM data were retrieved for 20 patients undergoing chest tomosynthesis using VolumeRAD. Using information about how the exposure parameters for the tomosynthesis examination are determined by the scout image, a correction factor for the adjustment in field size with projection angle was determined. The correction factor was used to estimate the DAP for 20 additional chest tomosynthesis examinations from DICOM data available in the scout images, which was compared with the actual DAP registered for the projection radiographs acquired during the tomosynthesis examination. A field size correction factor of 0.935 was determined. Applying the developed method using this factor, the average difference between the estimated DAP and the actual DAP was 0.2%, with a standard deviation of 0.8%. However, the difference was not normally distributed and the maximum error was only 1.0%. The validity and reliability of the presented method were thus very high. A method to estimate the DAP of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data in the scout image was developed and validated. As the scout image normally is the only image connected to the tomosynthesis examination stored in the picture archiving and communication system (PACS) containing dose data, the method may be of value for retrospectively estimating patient dose in clinical use of chest tomosynthesis.

  9. A simple method to retrospectively estimate patient dose-area product for chest tomosynthesis examinations performed using VolumeRAD

    Energy Technology Data Exchange (ETDEWEB)

    Båth, Magnus, E-mail: magnus.bath@vgregion.se; Svalkvist, Angelica [Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45, Sweden and Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg SE-413 45 (Sweden); Söderman, Christina [Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45 (Sweden)

    2014-10-15

    Purpose: The purpose of the present work was to develop and validate a method of retrospectively estimating the dose-area product (DAP) of a chest tomosynthesis examination performed using the VolumeRAD system (GE Healthcare, Chalfont St. Giles, UK) from digital imaging and communications in medicine (DICOM) data available in the scout image. Methods: DICOM data were retrieved for 20 patients undergoing chest tomosynthesis using VolumeRAD. Using information about how the exposure parameters for the tomosynthesis examination are determined by the scout image, a correction factor for the adjustment in field size with projection angle was determined. The correction factor was used to estimate the DAP for 20 additional chest tomosynthesis examinations from DICOM data available in the scout images, which was compared with the actual DAP registered for the projection radiographs acquired during the tomosynthesis examination. Results: A field size correction factor of 0.935 was determined. Applying the developed method using this factor, the average difference between the estimated DAP and the actual DAP was 0.2%, with a standard deviation of 0.8%. However, the difference was not normally distributed and the maximum error was only 1.0%. The validity and reliability of the presented method were thus very high. Conclusions: A method to estimate the DAP of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data in the scout image was developed and validated. As the scout image normally is the only image connected to the tomosynthesis examination stored in the picture archiving and communication system (PACS) containing dose data, the method may be of value for retrospectively estimating patient dose in clinical use of chest tomosynthesis.

  10. A simple method to retrospectively estimate patient dose-area product for chest tomosynthesis examinations performed using VolumeRAD

    International Nuclear Information System (INIS)

    Båth, Magnus; Svalkvist, Angelica; Söderman, Christina

    2014-01-01

    Purpose: The purpose of the present work was to develop and validate a method of retrospectively estimating the dose-area product (DAP) of a chest tomosynthesis examination performed using the VolumeRAD system (GE Healthcare, Chalfont St. Giles, UK) from digital imaging and communications in medicine (DICOM) data available in the scout image. Methods: DICOM data were retrieved for 20 patients undergoing chest tomosynthesis using VolumeRAD. Using information about how the exposure parameters for the tomosynthesis examination are determined by the scout image, a correction factor for the adjustment in field size with projection angle was determined. The correction factor was used to estimate the DAP for 20 additional chest tomosynthesis examinations from DICOM data available in the scout images, which was compared with the actual DAP registered for the projection radiographs acquired during the tomosynthesis examination. Results: A field size correction factor of 0.935 was determined. Applying the developed method using this factor, the average difference between the estimated DAP and the actual DAP was 0.2%, with a standard deviation of 0.8%. However, the difference was not normally distributed and the maximum error was only 1.0%. The validity and reliability of the presented method were thus very high. Conclusions: A method to estimate the DAP of a chest tomosynthesis examination performed using the VolumeRAD system from DICOM data in the scout image was developed and validated. As the scout image normally is the only image connected to the tomosynthesis examination stored in the picture archiving and communication system (PACS) containing dose data, the method may be of value for retrospectively estimating patient dose in clinical use of chest tomosynthesis

  11. Clinical outcomes and cost effectiveness of accelerated diagnostic protocol in a chest pain center compared with routine care of patients with chest pain.

    Science.gov (United States)

    Asher, Elad; Reuveni, Haim; Shlomo, Nir; Gerber, Yariv; Beigel, Roy; Narodetski, Michael; Eldar, Michael; Or, Jacob; Hod, Hanoch; Shamiss, Arie; Matetzky, Shlomi

    2015-01-01

    The aim of this study was to compare in patients presenting with acute chest pain the clinical outcomes and cost-effectiveness of an accelerated diagnostic protocol utilizing contemporary technology in a chest pain unit versus routine care in an internal medicine department. Hospital and 90-day course were prospectively studied in 585 consecutive low-moderate risk acute chest pain patients, of whom 304 were investigated in a designated chest pain center using a pre-specified accelerated diagnostic protocol, while 281 underwent routine care in an internal medicine ward. Hospitalization was longer in the routine care compared with the accelerated diagnostic protocol group (pdiagnostic protocol patients (98%) vs. 57 (20%) routine care patients underwent non-invasive testing, (pdiagnostic imaging testing was performed in 125 (44%) and 26 (9%) patients in the routine care and accelerated diagnostic protocol patients, respectively (pdiagnostic protocol patients compared with those receiving routine care was associated with a lower incidence of readmissions for chest pain [8 (3%) vs. 24 (9%), pdiagnostic protocol remained a predictor of lower acute coronary syndromes and readmissions after propensity score analysis [OR = 0.28 (CI 95% 0.14-0.59)]. Cost per patient was similar in both groups [($2510 vs. $2703 for the accelerated diagnostic protocol and routine care group, respectively, (p = 0.9)]. An accelerated diagnostic protocol is clinically superior and as cost effective as routine in acute chest pain patients, and may save time and resources.

  12. Early experiences with crowdsourcing airway annotations in chest CT

    DEFF Research Database (Denmark)

    Cheplygina, Veronika; Perez-Rovira, Adria; Kuo, Wieying

    2016-01-01

    Measuring airways in chest computed tomography (CT) images is important for characterizing diseases such as cystic fibrosis, yet very time-consuming to perform manually. Machine learning algorithms offer an alternative, but need large sets of annotated data to perform well. We investigate whether...... a number of further research directions and provide insight into the challenges of crowdsourcing in medical images from the perspective of first-time users....

  13. Computer-aided diagnosis workstation and database system for chest diagnosis based on multi-helical CT images

    Science.gov (United States)

    Satoh, Hitoshi; Niki, Noboru; Mori, Kiyoshi; Eguchi, Kenji; Kaneko, Masahiro; Kakinuma, Ryutarou; Moriyama, Noriyuki; Ohmatsu, Hironobu; Masuda, Hideo; Machida, Suguru; Sasagawa, Michizou

    2006-03-01

    Multi-helical CT scanner advanced remarkably at the speed at which the chest CT images were acquired for mass screening. Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. To overcome this problem, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images and a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification. We also have developed electronic medical recording system and prototype internet system for the community health in two or more regions by using the Virtual Private Network router and Biometric fingerprint authentication system and Biometric face authentication system for safety of medical information. Based on these diagnostic assistance methods, we have now developed a new computer-aided workstation and database that can display suspected lesions three-dimensionally in a short time. This paper describes basic studies that have been conducted to evaluate this new system. The results of this study indicate that our computer-aided diagnosis workstation and network system can increase diagnostic speed, diagnostic accuracy and safety of medical information.

  14. Diagnostic value of chest ultrasound after cardiac surgery: a comparison with chest X-ray and auscultation.

    Science.gov (United States)

    Vezzani, Antonella; Manca, Tullio; Brusasco, Claudia; Santori, Gregorio; Valentino, Massimo; Nicolini, Francesco; Molardi, Alberto; Gherli, Tiziano; Corradi, Francesco

    2014-12-01

    Chest auscultation and chest x-ray commonly are used to detect postoperative abnormalities and complications in patients admitted to intensive care after cardiac surgery. The aim of the study was to evaluate whether chest ultrasound represents an effective alternative to bedside chest x-ray to identify early postoperative abnormalities. Diagnostic accuracy of chest auscultation and chest ultrasound were compared in identifying individual abnormalities detected by chest x-ray, considered the reference method. Cardiac surgery intensive care unit. One hundred fifty-one consecutive adult patients undergoing cardiac surgery. All patients included were studied by chest auscultation, ultrasound, and x-ray upon admission to intensive care after cardiac surgery. Six lung pathologic changes and endotracheal tube malposition were found. There was a highly significant correlation between abnormalities detected by chest ultrasound and x-ray (k = 0.90), but a poor correlation between chest auscultation and x-ray abnormalities (k = 0.15). Chest auscultation may help identify endotracheal tube misplacement and tension pneumothorax but it may miss most major abnormalities. Chest ultrasound represents a valid alternative to chest x-ray to detect most postoperative abnormalities and misplacements. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Properties of octagonal distance transformation (ODT) and its application to recognition of rib images of chest radiograms

    International Nuclear Information System (INIS)

    Ban, Tatsuya; Yokoi, Shigeki; Toriwaki, Jun-ichiro; Fukumura, Teruo.

    1980-01-01

    Digital image processing and image pattern recognition have lately become important, and are utilized in every field. The processing techniques common to these applications include smoothing, thinning, threshold processing, distance transformation, edge detection, etc. This paper describes the distance transformation, specifically the transformation based on octagonal distance (ODT). As the distance transformation, diamond distance or square distance has been employed so far, but these have the disadvantage of great deviation from the Euclid distance, and the octagonal distance transformation is considered to prevent such deviation. First, the basic concept and the definition of symbols are given, the octagonal distance skeleton (ODS) is defined, and the possibility of restoring original figure from the ODS is indicated. Next, the sequential algorithm is given, which executes the ODT and the inverse transformation to restore the original figure from the ODS by scanning on the figure 4 times. As an example of the application, the identification of rib images in chest radiograms is adopted, and the capability of reducing the effect of blood vessel images and noises by combining ODT with thinning or other processing, without quadratic function approximation, is described. (J.P.N.)

  16. Chest Seal Placement for Penetrating Chest Wounds by Prehospital Ground Forces in Afghanistan.

    Science.gov (United States)

    Schauer, Steven G; April, Michael D; Naylor, Jason F; Simon, Erica M; Fisher, Andrew D; Cunningham, Cord W; Morissette, Daniel M; Fernandez, Jessie Renee D; Ryan, Kathy L

    Thoracic trauma represents 5% of all battlefield injuries. Communicating pneumothoraces resulting in tension physiology remain an important etiology of prehospital mortality. In addressing penetrating chest trauma, current Tactical Combat Casualty Care (TCCC) guidelines advocate the immediate placement of a vented chest seal device. Although the Committee on TCCC (CoTCCC) has approved numerous chest seal devices for battlefield use, few data exist regarding their use in a combat zone setting. To evaluate adherence to TCCC guidelines for chest seal placement among personnel deployed to Afghanistan. We obtained data from the Prehospital Trauma Registry (PHTR). Joint Trauma System personnel linked patients to the Department of Defense Trauma Registry, when available, for outcome data upon reaching a fixed facility. In the PHTR, we identified 62 patients with documented gunshot wound (GSW) or puncture wound trauma to the chest. The majority (74.2%; n = 46) of these were due to GSW, with the remainder either explosive-based puncture wounds (22.6%; n = 14) or a combination of GSW and explosive (3.2%; n = 2). Of the 62 casualties with documented GSW or puncture wounds, 46 (74.2%) underwent chest seal placement. Higher proportions of patients with medical officers in their chain of care underwent chest seal placement than those that did not (63.0% versus 37.0%). The majority of chest seals placed were not vented. Of patients with a GSW or puncture wound to the chest, 74.2% underwent chest seal placement. Most of the chest seals placed were not vented in accordance with guidelines, despite the guideline update midway through the study period. These data suggest the need to improve predeployment training on TCCC guidelines and matching of the Army logistical supply chain to the devices recommended by the CoTCCC. 2017.

  17. Long-Term Clinical Impact of Coronary CT Angiography in Patients With Recent Acute-Onset Chest Pain

    DEFF Research Database (Denmark)

    Linde, Jesper J; Hove, Jens D; Sørgaard, Mathias

    2015-01-01

    . BACKGROUND: The prognostic implications of a coronary CTA-guided treatment strategy have not been compared in a randomized fashion to standard care in patients referred for acute-onset chest pain. METHODS: Patients with acute chest pain but normal electrocardiograms and troponin values were randomized...... to treatment guided by either coronary CTA or standard care (bicycle exercise electrocardiogram or myocardial perfusion imaging). In the coronary CTA-guided group, a functional test was included in cases of nondiagnostic coronary CTA images or coronary stenoses of borderline severity. The primary endpoint...... electrocardiograms and troponin values compared to standard care with a functional test. (Cardiac-CT in the Treatment of Acute Chest Pain [CATCH]; NCT01534000)....

  18. MRI of the Chest

    Medline Plus

    Full Text Available ... gives detailed pictures of structures within the chest cavity, including the mediastinum , chest wall, pleura, heart and ... helpful to assess the vessels of the chest cavity (arteries and veins). MRA can also demonstrate an ...

  19. MRI of the Chest

    Medline Plus

    Full Text Available ... to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI ... of the chest. assess disorders of the chest bones (vertebrae, ribs and sternum) and chest wall soft ...

  20. Quantitation of pulmonary nodule's border structure by means of Fourier transform by using chest X-ray CT images

    International Nuclear Information System (INIS)

    Shikata, Hidenori; Masuyama, Hiroshi; Kido, Shoji

    1998-01-01

    In order to evaluate quantitatively the border structure of pulmonary nodules by using chest X-ray CT images, we investigated whether the sum of high-frequency elements of the power spectrum in a Fourier-transformed nodule's contour line becomes a valuable measure of the border structure of pulmonary nodules. We expect that this measure clearly reflects the radiologic characteristics of a nodule, that is, the contour line is clear or unclear in benign or malignant nodules, respectively. We evaluated and analyzed images statistically for 31 patients (15 benign, 16 malignant), and we were able to recognize a measurable difference between the benign and malignant cases. We conclude that we can evaluate the border structure of a nodule by our proposed measure, and that this measure is valuable for quantitative differential diagnosis. (author)

  1. High-resolution computed tomography versus chest radiography in the diagnosis of interstitial lung disease in systemic sclerosis

    International Nuclear Information System (INIS)

    Azevedo, Ana Beatriz Cordeiro de; Calderaro, Debora; Moreira, Caio; Guimaraes, Silvana Mangeon Meirelles; Tavares Junior, Wilson Campos; Leao Filho, Hilton Muniz; Andrade, Diego Correa de; Ferreira, Cid Sergio; Vieira, Jose Nelson Mendes

    2005-01-01

    Objective: To compare the accuracy of high-resolution computed tomography (HRCT) with chest radiography in the diagnosis of interstitial lung disease in systemic sclerosis (SSc). Materials And Methods: HRCT scans and chest radiographs in postero-anterior and lateral views were performed in 34 patients with systemic sclerosis, according to the American College of Rheumatology preliminary criteria for the diagnosis of SSc. The prevalence of radiological findings suggestive of interstitial lung disease in SSc seen on both imaging methods was compared. Results: Interstitial disease was observed on HRCT images of 31 patients (91%) and in the chest radiographs of 16 patients (47%). The most frequent findings observed on HRCT were septal lines (74%), honeycombing (56%) and parenchymal bands (26%). Chest radiographs showed reticular areas of attenuation in 11 patients (32%) and parenchymal distortion in 12% of the patients. In 18 patients (53%) with normal chest radiographs HRCT showed septal lines in 55%, ground glass in 44%, honeycombing in 38.5% and cysts in 33%. Conclusion: HRCT is more sensitive than chest radiography in the evaluation of incipient interstitial lung involvement in patients with SSc and can provide a justification for immunosuppressive therapy in patients with early disease. (author)

  2. Chest Fat Quantification via CT Based on Standardized Anatomy Space in Adult Lung Transplant Candidates.

    Directory of Open Access Journals (Sweden)

    Yubing Tong

    Full Text Available Overweight and underweight conditions are considered relative contraindications to lung transplantation due to their association with excess mortality. Yet, recent work suggests that body mass index (BMI does not accurately reflect adipose tissue mass in adults with advanced lung diseases. Alternative and more accurate measures of adiposity are needed. Chest fat estimation by routine computed tomography (CT imaging may therefore be important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification and quality assessment based on a recently formulated concept of standardized anatomic space (SAS is presented. The goal of the paper is to seek answers to several key questions related to chest fat quantity and quality assessment based on a single slice CT (whether in the chest, abdomen, or thigh versus a volumetric CT, which have not been addressed in the literature.Unenhanced chest CT image data sets from 40 adult lung transplant candidates (age 58 ± 12 yrs and BMI 26.4 ± 4.3 kg/m2, 16 with chronic obstructive pulmonary disease (COPD, 16 with idiopathic pulmonary fibrosis (IPF, and the remainder with other conditions were analyzed together with a single slice acquired for each patient at the L5 vertebral level and mid-thigh level. The thoracic body region and the interface between subcutaneous adipose tissue (SAT and visceral adipose tissue (VAT in the chest were consistently defined in all patients and delineated using Live Wire tools. The SAT and VAT components of chest were then segmented guided by this interface. The SAS approach was used to identify the corresponding anatomic slices in each chest CT study, and SAT and VAT areas in each slice as well as their whole volumes were quantified. Similarly, the SAT and VAT components were segmented in the abdomen and thigh slices. Key parameters of the attenuation (Hounsfield unit (HU distributions were determined from each chest slice and from the

  3. [Chest trauma].

    Science.gov (United States)

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe. Copyright © 2011 Sociedad Española de Neumología y Cirugía Torácica. Published by Elsevier Espana. All rights reserved.

  4. The frequency of various indications for plain chest radiography in Nnamdi Azikiwe University Teaching Hospital, Nnewi (NAUTH).

    Science.gov (United States)

    Okpala, O C; Okafor, C; Aronu, M E

    2013-01-01

    With soaring advances in the field of medicine, the place of older radiologic imaging modalities is being reduced to basic screening tools. Yet the modern imaging modalities like computerized tomography (CT), magnetic resonance imaging (MRI), ultrasound and nuclear medicine are hardly available. To study the frequency of various indications of plain chest radiography, remind us of its uses and to enhance the preparedness of the department to maximally accomplish the ideals of this investigation. A total of 1476 consecutive patients for chest radiography in the department of radiology, NAUTH, Nnewi from the period of February 2009 and whose request form contain adequate data were recruited for this study. These data were analyzed using SSPS. A total of 1476 patient were included in this study. There was female preponderance with male to female ratio of 1.3:1. Mean Age of the patients is 39.32 years (std19.56). The most frequent indication for chest radiography is certain infections and parasitic diseases (40.9% and the greatest source of referral for this study is General outpatient (GOPD)/family medicine department. The most frequent indications for chest radiography in the study are certain infection and parasitic diseases. Chest Radiography is the most frequent plain radiography study in our environment where infectious diseases are still very rampant. This makes chest radiography an important study for screening patient for possible diagnosis and classifying the need for further radiographic investigation of our patients.

  5. Diagnosis and Treatment of Chest Injury and Emergency Diseases of Chest Organs

    Directory of Open Access Journals (Sweden)

    A. M. Khadjibaev

    2016-01-01

    Full Text Available Goal of research: to evaluate efficiency of videothoracoscopy in diagnosis and treatment of patients with injuries and emergency diseases ща chest organs.Material and methods: Study wasbased on treatment results analysis of 2111 patients with injuries and chest organs emergency diseases, who were treated at Republican Research Centre of Emergency Medicine in 2001-2014. Chest trauma made up 1396 (66,1% victims. There were 477 (22,6% patients with spontaneous pneumothorax. At the stages of initial diagnosis, the radiologic evaluations, CT investigations and videothoracoscopies were performed. In chest trauma patients the videothoracoscopy underwent in 844 cases, in spontaneous pneu#mothorax this method was employed in 290 patients. Complicated forms of lung echinococcosis were observed in 238 (11,3% patients and complicated forms of lung echinococcosis were evident in 72 patients.Results. Videothoracoscopy and video-assisted interventions allowed to eliminate lungs and pleura pathology in 1206 (57,1% patients, whereas the traditional methods were effective only in 905 cases (42,9%.Conclusions. Investigation methods such as multiplanar radioscopy, radiography, chest CT and videothora-coscopy must be included into algorithm of diagnosis and surgical treatment of chest injuries and emergency diseases of chest organs. At chest trauma the videothoracoscopy allows to avoid broad thoracotomy from 9,4% to 4,7% of cases, to reduce the frequency of repeated interventions from 17,4% to 0,5% and diminish a number of early postsurgery complications from 25,4% to 10,9%. Videothoracoscopy of chest traumas allows to reduce frequency of repeated interventions from 19,8 to 1,7%.

  6. Comparison study of noise reduction algorithms in dual energy chest digital tomosynthesis

    Science.gov (United States)

    Lee, D.; Kim, Y.-S.; Choi, S.; Lee, H.; Choi, S.; Kim, H.-J.

    2018-04-01

    Dual energy chest digital tomosynthesis (CDT) is a recently developed medical technique that takes advantage of both tomosynthesis and dual energy X-ray images. However, quantum noise, which occurs in dual energy X-ray images, strongly interferes with diagnosis in various clinical situations. Therefore, noise reduction is necessary in dual energy CDT. In this study, noise-compensating algorithms, including a simple smoothing of high-energy images (SSH) and anti-correlated noise reduction (ACNR), were evaluated in a CDT system. We used a newly developed prototype CDT system and anthropomorphic chest phantom for experimental studies. The resulting images demonstrated that dual energy CDT can selectively image anatomical structures, such as bone and soft tissue. Among the resulting images, those acquired with ACNR showed the best image quality. Both coefficient of variation and contrast to noise ratio (CNR) were the highest in ACNR among the three different dual energy techniques, and the CNR of bone was significantly improved compared to the reconstructed images acquired at a single energy. This study demonstrated the clinical value of dual energy CDT and quantitatively showed that ACNR is the most suitable among the three developed dual energy techniques, including standard log subtraction, SSH, and ACNR.

  7. Average chest wall thickness at two anatomic locations in trauma patients.

    Science.gov (United States)

    Schroeder, Elizabeth; Valdez, Carrie; Krauthamer, Andres; Khati, Nadia; Rasmus, Jessica; Amdur, Richard; Brindle, Kathleen; Sarani, Babak

    2013-09-01

    Needle thoracostomy is the emergent treatment for tension pneumothorax. This procedure is commonly done using a 4.5cm catheter, and the optimal site for chest wall puncture is controversial. We hypothesize that needle thoracostomy cannot be performed using this catheter length irrespective of the site chosen in either gender. A retrospective review of all chest computed tomography (CT) scans obtained on trauma patients from January 1, 2011 to December 31, 2011 was performed. Patients aged 18 and 80 years were included and patients whose chest wall thickness exceeded the boundary of the images acquired were excluded. Chest wall thickness was measured at the 2nd intercostal (ICS), midclavicular line (MCL) and the 5th ICS, anterior axillary line (AAL). Injury severity score (ISS), chest wall thickness, and body mass index (BMI) were analyzed. 201 patients were included, 54% male. Average (SD) BMI was 26 (7)kg/m(2). The average chest wall thickness in the overall cohort was 4.08 (1.4)cm at the 2nd ICS/MCL and 4.55 (1.7)cm at the 5th ICS/AAL. 29% of the overall cohort (27 male and 32 female) had a chest wall thickness greater than 4.5cm at the 2nd ICS/MCL and 45% (54 male and 36 female) had a chest wall thickness greater than 4.5cm at the 5th ICS/AAL. There was no significant interaction between gender and chest wall thickness at either site. BMI was positively associated with chest wall thickness at both the 2nd and 5th ICS/AAL. A 4.5cm catheter is inadequate for needle thoracostomy in most patients regardless of puncture site or gender. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Chest wall tuberculosis; CT findings in 14 patients

    Energy Technology Data Exchange (ETDEWEB)

    Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National Univ. School of Medicine, Chonju (Korea, Republic of); Kim, Dong Woo [Daejoen Eulji Hospital, Daejon (Korea, Republic of); Juhng, Seon Kwan [Wonkwang Univ. Medical School, Iksan (Korea, Republic of)

    1996-01-01

    To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis.

  9. Chest wall tuberculosis; CT findings in 14 patients

    International Nuclear Information System (INIS)

    Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul; Kim, Dong Woo; Juhng, Seon Kwan

    1996-01-01

    To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis

  10. Reconstruction with a patient-specific titanium implant after a wide anterior chest wall resection

    Science.gov (United States)

    Turna, Akif; Kavakli, Kuthan; Sapmaz, Ersin; Arslan, Hakan; Caylak, Hasan; Gokce, Hasan Suat; Demirkaya, Ahmet

    2014-01-01

    The reconstruction of full-thickness chest wall defects is a challenging problem for thoracic surgeons, particularly after a wide resection of the chest wall that includes the sternum. The location and the size of the defect play a major role when selecting the method of reconstruction, while acceptable cosmetic and functional results remain the primary goal. Improvements in preoperative imaging techniques and reconstruction materials have an important role when planning and performing a wide chest wall resection with a low morbidity rate. In this report, we describe the reconstruction of a wide anterior chest wall defect with a patient-specific custom-made titanium implant. An infected mammary tumour recurrence in a 62-year old female, located at the anterior chest wall including the sternum, was resected, followed by a large custom-made titanium implant. Latissimus dorsi flap and split-thickness graft were also used for covering the implant successfully. A titanium custom-made chest wall implant could be a viable alternative for patients who had large chest wall tumours. PMID:24227881

  11. Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT.

    Science.gov (United States)

    Cho, S H; Sung, Y M; Kim, M S

    2012-10-01

    The objective of this study was to review the prevalence and radiological features of rib fractures missed on initial chest CT evaluation, and to examine the diagnostic value of additional coronal images in a large series of trauma patients. 130 patients who presented to an emergency room for blunt chest trauma underwent multidetector row CT of the thorax within the first hour during their stay, and had follow-up CT or bone scans as diagnostic gold standards. Images were evaluated on two separate occasions: once with axial images and once with both axial and coronal images. The detection rates of missed rib fractures were compared between readings using a non-parametric method of clustered data. In the cases of missed rib fractures, the shapes, locations and associated fractures were evaluated. 58 rib fractures were missed with axial images only and 52 were missed with both axial and coronal images (p=0.088). The most common shape of missed rib fractures was buckled (56.9%), and the anterior arc (55.2%) was most commonly involved. 21 (36.2%) missed rib fractures had combined fractures on the same ribs, and 38 (65.5%) were accompanied by fracture on neighbouring ribs. Missed rib fractures are not uncommon, and radiologists should be familiar with buckle fractures, which are frequently missed. Additional coronal imagescan be helpful in the diagnosis of rib fractures that are not seen on axial images.

  12. Stress Tests for Chest Pain: When You Need an Imaging Test -- and When You Don't

    Science.gov (United States)

    ... Resources Adult , Geriatric Stress Tests for Chest Pain Stress Tests for Chest Pain When you need an ... pain isn’t from heart disease. A cardiac stress test makes the heart work hard so your ...

  13. Evaluation of a low-dose neonatal chest radiographic system

    International Nuclear Information System (INIS)

    Burton, E.M.; Kirks, D.R.; Strife, J.L.; Henry, G.C.; Kereiakes, J.G.

    1988-01-01

    A new low-dose chest radiographic system for use in the neonatal nursery was evaluated. This test system, composed of a Du Pont Kevlar fiber-front cassette, Quanta fast-detail screen, Cronex 4L film (wide latitude), and additional yttrium filtration (0.1 mm), reduced the radiation dose in neonatal chest radiography by 69% (0.9 vs 2.9 mrad [0.009 vs 0.029 mGy]) as compared with a conventional system without added yttrium filtration; the thyroid dose was reduced by 76% (0.9 vs 3.7 mrad [0.009 vs 0.037 mGy]). The cumulative dose reduction was achieved through a combination of factors, including (1) beam hardening by the added yttrium filter, (2) increased X-ray transmission through the Kevlar cassette, and (3) a fast film-screen combination. Scatter radiation at distances of 1 and 6 ft. (0.3 and 1.8 m) was negligible for both systems. Image sharpness was compared for the conventional system with and without added yttrium filtration and for the Kevlar system with yttrium. Although sharpness of bony detail was unchanged by adding yttrium filtration to the conventional system, a decrease in sharpness was noted with the Kevlar system. Because image sharpness was affected in the test system, we are not using the Kevlar-Cronex 4L system for mobile chest radiography in the neonatal intensive care unit, despite dose reductions. However, further study is recommended to determine if there is a slower film-screen combination with yttrium filtration that will not degrade image sharpness

  14. Chest CT findings in patients with non-cardiovascular causes of chest pain: Focusing on pulmonary tuberculosis in a tuberculosis endemic country

    International Nuclear Information System (INIS)

    Lee, So Won; Shim, Sung Shine; Kim, Yoo Kyung; Ryu, Yon Ju

    2015-01-01

    To review the common causes of non-cardiovascular chest pain (NCCP) according to the location and lesion type as seen on chest CT, and to evaluate CT findings in tuberculosis (TB) as a cause of NCCP. In the period 2009 to 2012, patients having NCCP without definitive evidence of acute myocardial infarction, pulmonary thromboembolism, and aortic dissection, were included. In total, 162 patients (60.5% male; 39.5% female), with a mean age of 51 years, were enrolled. CT images were evaluated by location and lesion type, for causes of NCCP. Chest CT revealed that the most common location for the cause of NCCP was the pleura (45.1%), followed by the subpleural lung parenchyma (30.2%). The most common lesion causing NCCP was TB (33.3%), followed by pneumonia (19.1%). Of the 54 TB cases, 40 (74.1%) were stable TB and 14 (25.9%) were active TB; among these 54 patients, NCCP was most commonly the result of fibrotic pleural thickening (55.6%), followed by subpleural stable pulmonary TB (14.8%). Results of chest CT revealed that TB was a major cause of NCCP in a TB endemic area. Among the TB patients, fibrotic pleural thickening in patients with stable TB was the most common cause of NCCP

  15. Chest CT findings in patients with non-cardiovascular causes of chest pain: Focusing on pulmonary tuberculosis in a tuberculosis endemic country

    Energy Technology Data Exchange (ETDEWEB)

    Lee, So Won; Shim, Sung Shine; Kim, Yoo Kyung; Ryu, Yon Ju [Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2015-10-15

    To review the common causes of non-cardiovascular chest pain (NCCP) according to the location and lesion type as seen on chest CT, and to evaluate CT findings in tuberculosis (TB) as a cause of NCCP. In the period 2009 to 2012, patients having NCCP without definitive evidence of acute myocardial infarction, pulmonary thromboembolism, and aortic dissection, were included. In total, 162 patients (60.5% male; 39.5% female), with a mean age of 51 years, were enrolled. CT images were evaluated by location and lesion type, for causes of NCCP. Chest CT revealed that the most common location for the cause of NCCP was the pleura (45.1%), followed by the subpleural lung parenchyma (30.2%). The most common lesion causing NCCP was TB (33.3%), followed by pneumonia (19.1%). Of the 54 TB cases, 40 (74.1%) were stable TB and 14 (25.9%) were active TB; among these 54 patients, NCCP was most commonly the result of fibrotic pleural thickening (55.6%), followed by subpleural stable pulmonary TB (14.8%). Results of chest CT revealed that TB was a major cause of NCCP in a TB endemic area. Among the TB patients, fibrotic pleural thickening in patients with stable TB was the most common cause of NCCP.

  16. Prevalence and Clinical Import of Thoracic Injury Identified by Chest Computed Tomography but Not Chest Radiography in Blunt Trauma: Multicenter Prospective Cohort Study.

    Science.gov (United States)

    Langdorf, Mark I; Medak, Anthony J; Hendey, Gregory W; Nishijima, Daniel K; Mower, William R; Raja, Ali S; Baumann, Brigitte M; Anglin, Deirdre R; Anderson, Craig L; Lotfipour, Shahram; Reed, Karin E; Zuabi, Nadia; Khan, Nooreen A; Bithell, Chelsey A; Rowther, Armaan A; Villar, Julian; Rodriguez, Robert M

    2015-12-01

    patients with occult injury (of 1,454, 13.9%) had major interventions, 343 of 1,454 (23.6%) had minor interventions, and 909 (62.5%) had no intervention. Patients with occult injury included 514 with pulmonary contusions (of 682 total, 75.4% occult), 405 with pneumothorax (of 597 total, 67.8% occult), 184 with hemothorax (of 230 total, 80.0% occult), those with greater than 2 rib fractures (n=672/1,120, 60.0% occult) or sternal fracture (n=269/281, 95.7% occult), 12 with great vessel injury (of 18 total, 66.7% occult), 5 with diaphragm injury (of 6, 83.3% occult), and 537 with multiple occult injuries. Interventions for patients with occult injury included mechanical ventilation for 31 of 514 patients with pulmonary contusion (6.0%), chest tube for 118 of 405 patients with pneumothorax (29.1%), and 75 of 184 patients with hemothorax (40.8%). Inpatient pain control or observation greater than 24 hours was conducted for 183 of 672 patients with rib fractures (27.2%) and 79 of 269 with sternal fractures (29.4%). Three of 12 (25%) patients with occult great vessel injuries had surgery. Repeated imaging was conducted for 50.6% of patients with occult injury (88.1% chest radiography, 11.9% chest CT, 7.5% both). For patients with occult injury, 90.9% (1,321/1,454) were admitted, with 9.1% observed in the ED for median 6.9 hours. Forty-four percent of observed patients were then admitted (4.0% of patients with occult injury). In a more seriously injured subset of patients with blunt trauma who had both chest radiography and chest CT, occult injuries were found by chest CT in 71% of those with thoracic injuries and one fourth of all those with blunt chest trauma. More than one third of occult injury had intervention (37.5%). Chest tubes composed 76.2% of occult injury major interventions, with observation or inpatient pain control greater than 24 hours in 32.4% of occult fractures. Only 1 in 20 patients with occult injury was discharged home from the ED. For these patients with

  17. Template-based automatic breast segmentation on MRI by excluding the chest region

    International Nuclear Information System (INIS)

    Lin, Muqing; Chen, Jeon-Hor; Wang, Xiaoyong; Su, Min-Ying; Chan, Siwa; Chen, Siping

    2013-01-01

    Purpose: Methods for quantification of breast density on MRI using semiautomatic approaches are commonly used. In this study, the authors report on a fully automatic chest template-based method. Methods: Nonfat-suppressed breast MR images from 31 healthy women were analyzed. Among them, one case was randomly selected and used as the template, and the remaining 30 cases were used for testing. Unlike most model-based breast segmentation methods that use the breast region as the template, the chest body region on a middle slice was used as the template. Within the chest template, three body landmarks (thoracic spine and bilateral boundary of the pectoral muscle) were identified for performing the initial V-shape cut to determine the posterior lateral boundary of the breast. The chest template was mapped to each subject's image space to obtain a subject-specific chest model for exclusion. On the remaining image, the chest wall muscle was identified and excluded to obtain clean breast segmentation. The chest and muscle boundaries determined on the middle slice were used as the reference for the segmentation of adjacent slices, and the process continued superiorly and inferiorly until all 3D slices were segmented. The segmentation results were evaluated by an experienced radiologist to mark voxels that were wrongly included or excluded for error analysis. Results: The breast volumes measured by the proposed algorithm were very close to the radiologist's corrected volumes, showing a % difference ranging from 0.01% to 3.04% in 30 tested subjects with a mean of 0.86% ± 0.72%. The total error was calculated by adding the inclusion and the exclusion errors (so they did not cancel each other out), which ranged from 0.05% to 6.75% with a mean of 3.05% ± 1.93%. The fibroglandular tissue segmented within the breast region determined by the algorithm and the radiologist were also very close, showing a % difference ranging from 0.02% to 2.52% with a mean of 1.03% ± 1.03%. The

  18. Template-based automatic breast segmentation on MRI by excluding the chest region

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Muqing [Tu and Yuen Center for Functional Onco-Imaging, Department of Radiological Sciences, University of California, Irvine, California 92697-5020 and National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Department of Biomedical Engineering, School of Medicine, Shenzhen University, 518060 China (China); Chen, Jeon-Hor [Tu and Yuen Center for Functional Onco-Imaging, Department of Radiological Sciences, University of California, Irvine, California 92697-5020 and Department of Radiology, E-Da Hospital and I-Shou University, Kaohsiung 82445, Taiwan (China); Wang, Xiaoyong; Su, Min-Ying, E-mail: msu@uci.edu [Tu and Yuen Center for Functional Onco-Imaging, Department of Radiological Sciences, University of California, Irvine, California 92697-5020 (United States); Chan, Siwa [Department of Radiology, Taichung Veterans General Hospital, Taichung 40407, Taiwan (China); Chen, Siping [National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Department of Biomedical Engineering, School of Medicine, Shenzhen University, 518060 China (China)

    2013-12-15

    Purpose: Methods for quantification of breast density on MRI using semiautomatic approaches are commonly used. In this study, the authors report on a fully automatic chest template-based method. Methods: Nonfat-suppressed breast MR images from 31 healthy women were analyzed. Among them, one case was randomly selected and used as the template, and the remaining 30 cases were used for testing. Unlike most model-based breast segmentation methods that use the breast region as the template, the chest body region on a middle slice was used as the template. Within the chest template, three body landmarks (thoracic spine and bilateral boundary of the pectoral muscle) were identified for performing the initial V-shape cut to determine the posterior lateral boundary of the breast. The chest template was mapped to each subject's image space to obtain a subject-specific chest model for exclusion. On the remaining image, the chest wall muscle was identified and excluded to obtain clean breast segmentation. The chest and muscle boundaries determined on the middle slice were used as the reference for the segmentation of adjacent slices, and the process continued superiorly and inferiorly until all 3D slices were segmented. The segmentation results were evaluated by an experienced radiologist to mark voxels that were wrongly included or excluded for error analysis. Results: The breast volumes measured by the proposed algorithm were very close to the radiologist's corrected volumes, showing a % difference ranging from 0.01% to 3.04% in 30 tested subjects with a mean of 0.86% ± 0.72%. The total error was calculated by adding the inclusion and the exclusion errors (so they did not cancel each other out), which ranged from 0.05% to 6.75% with a mean of 3.05% ± 1.93%. The fibroglandular tissue segmented within the breast region determined by the algorithm and the radiologist were also very close, showing a % difference ranging from 0.02% to 2.52% with a mean of 1.03% ± 1

  19. The transverse diameter of the chest on routine radiographs reliably estimates gestational age and weight in premature infants.

    Science.gov (United States)

    Dietz, Kelly R; Zhang, Lei; Seidel, Frank G

    2015-08-01

    Prior to digital radiography it was possible for a radiologist to easily estimate the size of a patient on an analog film. Because variable magnification may be applied at the time of processing an image, it is now more difficult to visually estimate an infant's size on the monitor. Since gestational age and weight significantly impact the differential diagnosis of neonatal diseases and determine the expected size of kidneys or appearance of the brain by MRI or US, this information is useful to a pediatric radiologist. Although this information may be present in the electronic medical record, it is frequently not readily available to the pediatric radiologist at the time of image interpretation. To determine if there was a correlation between gestational age and weight of a premature infant with their transverse chest diameter (rib to rib) on admission chest radiographs. This retrospective study was approved by the institutional review board, which waived informed consent. The maximum transverse chest diameter outer rib to outer rib was measured on admission portable chest radiographs of 464 patients admitted to the neonatal intensive care unit (NICU) during the 2010 calendar year. Regression analysis was used to investigate the association between chest diameter and gestational age/birth weight. Quadratic term of chest diameter was used in the regression model. Chest diameter was statistically significantly associated with both gestational age (P chest diameter on digital chest radiograph with the tables and graphs in our study.

  20. Free-breathing high-pitch 80kVp dual-source computed tomography of the pediatric chest: Image quality, presence of motion artifacts and radiation dose.

    Science.gov (United States)

    Bodelle, Boris; Fischbach, Constanze; Booz, Christian; Yel, Ibrahim; Frellesen, Claudia; Beeres, Martin; Vogl, Thomas J; Scholtz, Jan-Erik

    2017-04-01

    To investigate image quality, presence of motion artifacts and effects on radiation dose of 80kVp high-pitch dual-source CT (DSCT) in combination with an advanced modeled iterative reconstruction algorithm (ADMIRE) of the pediatric chest compared to single-source CT (SSCT). The study was approved by the institutional review board. Eighty-seven consecutive pediatric patients (mean age 9.1±4.9years) received either free-breathing high-pitch (pitch 3.2) chest 192-slice DSCT (group 1, n=31) or standard-pitch (pitch 1.2) 128-slice SSCT (group 2, n=56) with breathing-instructions by random assignment. Tube settings were similar in both groups with 80 kVp and 74 ref. mAs. Images were reconstructed using FBP for both groups. Additionally, ADMIRE was used in group 1. Effective thorax diameter, image noise, and signal-to-noise ratio (SNR) of the pectoralis major muscle and the thoracic aorta were calculated. Motion artifacts were measured as doubling boarders of the diaphragm and the heart. Images were rated by two blinded readers for overall image quality and presence of motion artifacts on 5-point-scales. Size specific dose estimates (SSDE, mGy) and effective dose (ED, mSv) were calculated. Age and effective thorax diameter showed no statistically significant differences in both groups. Image noise and SNR were comparable (p>0.64) for SSCT and DSCT with ADMIRE, while DSCT with FBP showed inferior results (pchest DSCT in combination with ADMIRE reduces motion artifacts and increases image quality while lowering radiation exposure in free-breathing pediatric patients without sedation. Copyright © 2017 Elsevier B.V. All rights reserved.