Glandularity has a marked impact on the incidence of breast cancer and the missed lesion rate of mammography. The aim of this study was to develop a novel model for predicting glandularity and patient radiation dose using physical factors that are easily determined prior to mammography. Data regarding glandularity and mean glandular dose were obtained from 331 mammograms. A stepwise multiple regression analysis model was developed to predict glandularity using age, compressed breast thickness and body mass index (BMI), while a model to predict mean glandular dose was created using quantified glandularity, age, compressed breast thickness, height and body weight. The most significant factor for predicting glandularity was age, the influence of which was 1.8 times that of BMI. The most significant factor for predicting mean glandular dose was compressed breast thickness, the influence of which was 1.4 times that of glandularity, 3.5 times that of age and 6.1 times that of height. Both models were statistically significant (both p < 0.0001). Easily determined physical factors were able to explain 42.8% of the total variance in glandularity and 62.4% of the variance in mean glandular dose. Graphical abstract Validation results of the above prediction model made using physical factors in Japanese women. The plotted points of actual vs. prediction glandularity shown in a are distributed in the vicinity of the diagonal line, and the residual plot for predicted glandularity shows an almost random distribution as shown in b. These distributions indicate the appropriateness of the prediction model.

Many kinds of x-ray films having various characteristic curves have been developed for chest radiographs. In general, a phototiming device for determination of a mAs value which gives a proper exposure has been used for a chest radiography. For each film, however, the x-ray tube voltage has been determined by the subjective evaluation of radiologists or radiological technologists. In this paper, we propose a new method for determining the optimum tube voltage for chest radiographs using psychophysical analysis. The optimum density and the optimum density range of a screen/film system are obtained from the gradient curve of film and the minimum perceptible contrast delta Dmin [Acta Radiol. Diagnos. 4, 463-476 (1966)]. The optimum tube voltage, by which the lowest density of a mediastinum and the highest density of a lung field just cover the optimum density range, is obtained using the x-ray photon spectrum and sensitivity spectrum of the screen. This objective method does not depend on personal subjective evaluation, therefore it is available for the determination of optimum tube voltage for chest radiographs to be observed by many doctors of various departments.

The purpose of the present study was to evaluate the usefulness of a new gray-scale test pattern (NGTP) that was developed to easily adjust the gradients of thoracic CT imaging and enable visual consistency. The Society of Motion Picture and Television Engineers (SMPTE) pattern and the NGTP were used for comparison. The luminance character of two test patterns was evaluated by a luminance meter with three different window widths and levels (for default, mediastinum and lung). We also investigated whether SMPTE or NGTP is more suitable for adjusting the gradient of thoracic CT imaging. We found that it was easier to adjust the gradient of thoracic CT imaging with NGTP than with SMPTE, because the digital range of NGTP is 12 bits (the value of 4,096 HU, from -1,024 to 3,071 HU), and adjustable in any window width. We were able to adjust the gradients of hard-copy and soft-copy thoracic CT imaging within several hours using NGTP. We propose that NGTP is the most suitable tool for adjusting the gradients of thoracic CT imaging. NGTP can cope with any medical diagnostic display system connected with CT or MRI equipment in a network because it is in DICOM format.

Dosimetric properties of an amorphous silicon electronic portal imaging device (EPID) for verification of intensity-modulated radiation therapy (IMRT) were investigated as a replacement for conventional verification tools. The portal dosimetry system of Varian's EPID (aS1000) has an integrated image mode for portal dosimetry (PD). The source-to-imager distance was 105 cm, and there were no extra buildup materials on the surface of the EPID in this study. Several dosimetric properties were examined. For clinical dosimetry, the dose distributions of dynamic IMRT beams for prostate cancer (19 patients, 97 beams) were measured by EPID and compared with the results of ionization chamber (IC) measurements. In addition, pretreatment measurements for prostate IMRT (50 patients, 309 beams) were performed by EPID and were evaluated by the gamma method (criterion: 3 mm/3 %). The signal-to-monitor unit ratio of PD showed dose dependence, indicating ghosting effects. Tongue-and-groove effects were observed as a result of the dose difference in the measured EPID images. The results of PD for clinical IMRT beams were in good agreement with the predicted dose image with average values of 1.37 and 0.25 for γ (max) and γ (ave), respectively. The point doses of PD were slightly, but significantly, higher than the results of IC measurements (p < 0.05 paired t test). However, this small difference seems clinically acceptable. This portal dosimetry system is useful as a rapid and convenient verification tool for dynamic IMRT.

We evaluated the effect of the displayed image sizes on observers' ability to detect nodular ground-glass opacity (n-GGO) on CT and investigated the optimal viewing size for soft-copy reading at CT screening for lung cancer. A total of 46 patients' high-resolution computed tomography (HRCT) images (22 patients with one GGO; 24 without GGO) were displayed on a monochromatic liquid crystal display monitor at a resolution of 1,200 × 1,600. HRCT was presented on the screen with cine-mode display. We compared two viewing sizes (original size, i.e., the image displayed with a zoom factor of 1 in which each pixel value in the image is displayed as one pixel on the display: 13 cm × 13 cm; fit size, i.e., by zooming the captured image until it occupies the entire screen: 30 cm × 30 cm) in terms of radiologists' performance for detecting n-GGO on HRCT and the viewing times required for soft-copy reading decisions. Observer performance was analyzed in terms of the receiver operating characteristic (ROC) curve. A statistically significant improvement was found with the original size in the average area-under-the-ROC curve values for the accuracy of diagnosis and the viewing times compared to the fit size (P < 0.05). The original size with cine-mode display leads to increased lung GGO detection at CT screening for lung cancer, and the reduced time spent performing the diagnosis offers cost savings.