Visual grading analysis of digital neonatal chest phantom X-ray images: Impact of detector type, dose and image processing on image quality

Smet, Maria-Helena; Breysem, Luc; Mussen, Elvier; Bosmans, Hilde; Marshall, Nicholas; Cockmartin, Lesley

doi:10.1007/s00330-017-5301-2

Cited by 20 publications

(19 citation statements)

References 35 publications

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“…In preclinical trials, NIPs and PIPs have been used on phantoms, where NIPs depicted lower contrast levels better than PIPs 8 . When tested on phantoms for chest radiology, NIPs were significantly superior to PIPs regarding image quality and the potential for dose reduction 9,10 . In one phantom study, dose reduction of up to 68% of the initial dose was possible 11 .…”

Section: Introductionmentioning

confidence: 99%

Needle-based storage-phosphor detector radiography is superior to a conventional powder-based storage phosphor detector and a high-resolution screen-film system in small patients (budgerigars and mice)

Tebrün

Ludewig

Köhler

et al. 2019

Sci Rep

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This method comparison study used radiographs of 20 mice and 20 budgerigars to investigate comparability between computed radiography (CR) and high-resolution screen-film systems and study the effects of reduced radiation doses on image quality of digital radiographs of small patients. Exposure settings used with the mammography screen-film system (SF) were taken as baseline settings. A powder-based storage-phosphor system (CR P ) and a needle-based storage-phosphor system (CR N ) were used with the same settings (D/100%) and half the detector dose (D/50%). Using a scoring system four reviewers assessed five criteria per species covering soft tissue and bone structures. Results were evaluated for differences between reviewers (interobserver variability), systems and settings (intersystem variability, using visual grading characteristic analysis). Correlations were significant (p ≤ 0.05) for interobserver variability in 86.7% of the cases. Correlation coefficients ranged from 0.206 to 0.772. For mice and budgerigars, the CR N system was rated as superior to the SF and CR P system for most criteria, being significant in two cases each. Comparing the SF and CR P system, the conventional method scored higher for all criteria, in one case significantly. For both species and both digital systems, dose reduction to 50% resulted in significantly worse scores for most criteria. In summary, the needle-based storage-phosphor technique proved to be superior compared to the conventional storage-phosphor and mammography screen-film system. Needle-based detector systems are suitable substitutes for high-resolution screen–film systems when performing diagnostic imaging of small patients. Dose reduction to 50% of the corresponding dose needed in high-resolution film-screen systems cannot be recommended.

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Section: Introductionmentioning

confidence: 99%

Needle-based storage-phosphor detector radiography is superior to a conventional powder-based storage phosphor detector and a high-resolution screen-film system in small patients (budgerigars and mice)

Tebrün

Ludewig

Köhler

et al. 2019

Sci Rep

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“…Radiographic settings do not reflect changes in image detection technology, 1 and new imaging equipment is not by default optimized for its intended clinical use or particular patient group. 35 There has been a change from screen film systems to computed radiography (CR), and since CR is more tolerant of over-or under exposure than screen film systems, unnecessarily high radiation doses can occur with CR compared with screen film. 36 Most of the studies included here used CR, with a few screen film systems.…”

Section: Technological Advancementmentioning

confidence: 99%

Patient X-ray exposure and ALARA in the neonatal intensive care unit: Global patterns

Gislason‐Lee

2021

Pediatrics & Neonatology

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A literature review was conducted to determine norms for practice in neonatal intensive care units (NICU) around the world, given the harmful risks associated with radiation exposure at a very young age; risk of radiation-induced harm later in life increases with every X-ray image taken, more so for younger premature babies. Empirical studies including a measurement of radiation dose in a NICU, published after the year 2000 in a peer-reviewed journal, were collected. Measured doses to patients or X-ray phantoms, number of X-rays per stay and conclusions with recommendations made in response to these values were compared for 25 studies from around the world. The number of X-rays a patient underwent during a NICU stay ranged from 0 to 159. Younger, lower birth weight patients consistently had the greatest number of Xrays per stay. Recommended action based on measured dose ranged from extensive (to minimize risk to neonates) to minimal (to reduce risk) to none (because imaging benefits outweigh patient risk), with no consistent pattern linking recommended action with dose quantity. This demonstrates a broad range of interpretations of the As Low As Reasonably Achievable (ALARA) concept. These findings indicate a disparity in the response to neonatal X-ray dose concerns on a global scale, posing a public health risk to this particular neonatal population. More up-todate imaging protocols and dose limits specifically for the NICU environment with standardized dose monitoring would help minimize this risk to achieve the public health goals of prevention and harm reduction.

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“…It is also recommended that not only the current diagnostic reference levels (LDR) are respected, but also that a comparison is carried out considering the most recent recommendations found in international guidelines, which are constantly updated, and the specialist literature [ 20 ].…”

Section: Good Practice For the Execution Of The Radiographic Exams Inmentioning

confidence: 99%

Italian inter-society expert panel position on radiological exposure in Neonatal Intensive Care Units

et al. 2020

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Background In the recent years, clinical progress and better medical assistance for pregnant women, together with the introduction of new complex technologies, has improved the survival of preterm infants. However, this result requires frequent radiological investigations mostly represented by thoracic and abdominal radiographs in incubators. This document was elaborated by an expert panel Italian inter-society working group (Radiologists, Paediatricians, Medical Physicists) with the aim to assist healthcare practitioners in taking choices involving radiation exposures of new-born infants and to provide practical recommendations about justification and optimization in Neonatal Intensive Care Units. The adherence to these practice recommendations could ensure a high quality and patient safety. More complex and less common radiological practice, such as CT scan or fluoroscopy have been excluded. Methods The consensus was reached starting from current good practice evidence shared by four scientific societies panel: AIFM (Italian Association of Physics in Medicine), SIN (Italian Neonatology Society), SIP (Italian Paediatric Society), SIRM (Italian Medical Radiology Society) in order to guarantee good standard practices for every professional involved in Neonatal Intensive Care Units (NICU). The report is divided into clinical and physical-dosimetric sections: clinical Indications, good practice in radiological exposures, devices, exposure parameters and modalities, patient positioning and immobilization, Reference Diagnostic Levels, operators and patient’s radiation protection. Another important topic was the evaluation of the different incubators in order to understand if the consequences of the technological evolution have had an impact on the increase of the dose to the small patients, and how to choose the best device in terms of radiation protection. At the end the working group faced the problem of setting up the correct communication between clinicians and parents following the most recent indications of the international paediatric societies. Results Taking into account the experience and expertise of 10 Italian Centres, the guideline sets out the criteria to ensure a high standard of neonatal care in NICU about procedures, facilities, recommended equipment, quality assurance, radiation protection measures for children and staff members and communication on radiation risk. Conclusions This document will allow a standardization of the approach to the exposures in NICU, although oriented to a flexible methodology.

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Visual grading analysis of digital neonatal chest phantom X-ray images: Impact of detector type, dose and image processing on image quality

Abstract: • 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.

Cited by 20 publications

References 35 publications

Needle-based storage-phosphor detector radiography is superior to a conventional powder-based storage phosphor detector and a high-resolution screen-film system in small patients (budgerigars and mice)

Needle-based storage-phosphor detector radiography is superior to a conventional powder-based storage phosphor detector and a high-resolution screen-film system in small patients (budgerigars and mice)

Patient X-ray exposure and ALARA in the neonatal intensive care unit: Global patterns

Italian inter-society expert panel position on radiological exposure in Neonatal Intensive Care Units

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