Second in a two-part series comparing measurement techniques for the assessment of basic image quality metrics in digital radiography, in this paper we focus on the measurement of the image noise power spectrum (NPS). Three methods were considered: (1) a method published by Dobbins et al. [Med. Phys. 22, 1581-1593 (1995)], (2) a method published by Samei et al. [Med. Phys. 30, 608-622 (2003)], and (3) a new method sanctioned by the International Electrotechnical Commission (IEC 62220-1, 2003), developed as part of an international standard for the measurement of detective quantum efficiency. In addition to an overall comparison of the estimated NPS between the three techniques, the following factors were also evaluated for their effect on the measured NPS: horizontal versus vertical directional dependence, the use of beam-limiting apertures, beam spectrum, and computational methods of NPS analysis, including the region-of-interest (ROI) size and the method of ROI normalization. Of these factors, none was found to demonstrate a substantial impact on the amplitude of the NPS estimates (< or = 3.1% relative difference in NPS averaged over frequency, for each factor considered separately). Overall, the three methods agreed to within 1.6% +/- 0.8% when averaged over frequencies > 0.15 mm(-1).

The modulation transfer function (MTF) and the noise power spectrum (NPS) are widely recognized as the most relevant metrics of resolution and noise performance in radiographic imaging. These quantities have commonly been measured using various techniques, the specifics of which can have a bearing on the accuracy of the results. As a part of a study aimed at comparing the relative performance of different techniques, in this paper we report on a comparison of two established MTF measurement techniques: one using a slit test device [Dobbins et al., Med. Phys. 22, 1581-1593 (1995)] and another using a translucent edge test device [Samei et al., Med. Phys. 25, 102-113 (1998)], with one another and with a third technique using an opaque edge test device recommended by a new international standard (IEC 62220-1, 2003). The study further aimed to substantiate the influence of various acquisition and processing parameters on the estimated MTF. The slit test device was made of 2 mm thick Pb slabs with a 12.5 microm opening. The translucent edge test device was made of a laminated and polished Pt(0.9)Ir(0.1). alloy foil of 0.1 mm thickness. The opaque edge test device was made of a 2 mm thick W slab. All test devices were imaged on a representative indirect flat-panel digital radiographic system using three published beam qualities: 70 kV with 0.5 mm Cu filtration, 70 kV with 19 mm Al filtration, and 74 kV with 21 mm Al filtration (IEC-RQA5). The latter technique was also evaluated in conjunction with two external beam-limiting apertures (per IEC 62220-1), and with the tube collimator limiting the beam to the same area achieved with the apertures. The presampled MTFs were deduced from the acquired images by Fourier analysis techniques, and the results analyzed for relative values and the influence of impacting parameters. The findings indicated that the measurement technique has a notable impact on the resulting MTF estimate, with estimates from the overall IEC method 4.0% +/- 0.2% lower than that of Dobbins et al. and 0.7% +/- 0.4% higher than that of Samei et al. averaged over the zero to cutoff frequency range. Over the same frequency range, keeping beam quality and limitation constant, the average MTF estimate obtained with the edge techniques differed by up to 5.2% +/- 0.2% from that of the slit, with the opaque edge providing lower MTF estimates at lower frequencies than those obtained with the translucent edge or slit. The beam quality impacted the average estimated MTF by as much as 3.7% +/- 0.9% while the use of beam limiting devices alone increased the average estimated MTF by as much as 7.0% +/- 0.9%. While the slit method is inherently very sensitive to misalignment, both edge techniques were found to tolerate misalignments by as much as 6 cm. The results suggest the use of the opaque edge test device and the tube internal collimator for beam limitation in order to achieve an MTF result most reflective of the overall performance of the imaging system and least susceptible to misalignment and scattered radiation...

Optimization of exposure parameters (target, filter, and kVp) in digital mammography necessitates maximization of the image signal-to-noise ratio (SNR), while simultaneously minimizing patient dose. The goal of this study is to compare, for each of the major commercially available full field digital mammography (FFDM) systems, the impact of the selection of technique factors on image SNR and radiation dose for a range of breast thickness and tissue types. This phantom study is an update of a previous investigation and includes measurements on recent versions of two of the FFDM systems discussed in that article, as well as on three FFDM systems not available at that time. The five commercial FFDM systems tested, the Senographe 2000D from GE Healthcare, the Mammomat Novation DR from Siemens, the Selenia from Hologic, the Fischer Senoscan, and Fuji's 5000MA used with a Lorad M-IV mammography unit, are located at five different university test sites. Performance was assessed using all available x-ray target and filter combinations and nine different phantom types (three compressed thicknesses and three tissue composition types). Each phantom type was also imaged using the automatic exposure control (AEC) of each system to identify the exposure parameters used under automated image acquisition. The figure of merit (FOM) used to compare technique factors is the ratio of the square of the image SNR to the mean glandular dose. The results show that, for a given target/filter combination, in general FOM is a slowly changing function of kVp, with stronger dependence on the choice of target/filter combination. In all cases the FOM was a decreasing function of kVp at the top of the available range of kVp settings, indicating that higher tube voltages would produce no further performance improvement. For a given phantom type, the exposure parameter set resulting in the highest FOM value was system specific, depending on both the set of available target/filter combinations, and on the receptor type. In most cases, the AECs of the FFDM systems successfully identified exposure parameters resulting in FOM values near the maximum ones, however, there were several examples where AEC performance could be improved.

Quality control (QC) in medical imaging is an ongoing process and not just a series of infrequent evaluations of medical imaging equipment. The QC process involves designing and implementing a QC program, collecting and analyzing data, investigating results that are outside the acceptance levels for the QC program, and taking corrective action to bring these results back to an acceptable level. The QC process involves key personnel in the imaging department, including the radiologist, radiologic technologist, and the qualified medical physicist (QMP). The QMP performs detailed equipment evaluations and helps with oversight of the QC program, the radiologic technologist is responsible for the day-to-day operation of the QC program. The continued need for ongoing QC in digital radiography has been highlighted in the scientific literature. The charge of this task group was to recommend consistency tests designed to be performed by a medical physicist or a radiologic technologist under the direction of a medical physicist to identify problems with an imaging system that need further evaluation by a medical physicist, including a fault tree to define actions that need to be taken when certain fault conditions are identified. The focus of this final report is the ongoing QC process, including rejected image analysis, exposure analysis, and artifact identification. These QC tasks are vital for the optimal operation of a department performing digital radiography.

Prior studies on performance evaluation of digital radiographic systems have primarily focused on the assessment of the detector performance alone. However, the clinical performance of such systems is also substantially impacted by magnification, focal spot blur, the presence of scattered radiation, and the presence of an antiscatter grid. The purpose of this study is to evaluate an experimental methodology to assess the performance of a digital radiographic system, including those attributes, and to propose a new metric, effective detective quantum efficiency (eDQE), a candidate for defining the efficiency or speed of digital radiographic imaging systems. The study employed a geometric phantom simulating the attenuation and scatter properties of the adult human thorax and a representative indirect flat-panel-based clinical digital radiographic imaging system. The noise power spectrum (NPS) was derived from images of the phantom acquired at three exposure levels spanning the operating range of the clinical system. The modulation transfer function (MTF) was measured using an edge device positioned at the surface of the phantom, facing the x-ray source. Scatter measurements were made using a beam stop technique. The eDQE was then computed from these measurements, along with measures of phantom attenuation and x-ray flux. The MTF results showed notable impact from the focal spot blur, while the NPS depicted a large component of structured noise resulting from use of an antiscatter grid. The eDQE was found to be an order of magnitude lower than the conventional DQE. At 120 kVp, eDQE(0) was in the 8%-9% range, fivefold lower than DQE(0) at the same technique. The eDQE method yielded reproducible estimates of the system performance in a clinically relevant context by quantifying the inherent speed of the system, that is, the actual signal to noise ratio that would be measured under clinical operating conditions.