Yes / This study aimed to determine whether a reduction in radiation dose was found for percutaneous coronary interventional (PCI) patients using a cardiac interventional x-ray system with state-of-the-art image enhancement and x-ray optimization, compared to the current generation x-ray system, and to determine the corresponding impact on clinical image quality. Patient procedure dose area product (DAP) and fluoroscopy duration of 131 PCI patient cases from each x-ray system were compared using a Wilcoxon test on median values. Significant reductions in patient dose (p ≪ 0.001) were found for the new system with no significant change in fluoroscopy duration (p ¼ 0.2); procedure DAP reduced by 64%, fluoroscopy DAP by 51%, and “cine” acquisition DAP by 76%. The image quality of 15 patient angiograms from each x-ray system (30 total) was scored by 75 clinical professionals on a continuous scale for the ability to determine the presence and severity of stenotic lesions; image quality scores were analyzed using a two-sample t -test. Image quality was reduced by 9% (p ≪ 0.01) for the new x-ray system. This demonstrates a substantial reduction in patient dose, from acquisition more than fluoroscopy imaging, with slightly reduced image quality, for the new x-ray system compared to the current generation system. / This research was funded by Philips Healthcare (the Netherlands)

Yes / Digital image processing used in modern cardiac interventional x-ray systems may have the potential to enhance image quality such that it allows for lower radiation doses. The aim of this research was to quantify the reduction in radiation dose facilitated by image processing alone for percutaneous coronary intervention (PCI) patient angiograms, without reducing the perceived image quality required to confidently make a diagnosis. Incremental amounts of image noise were added to five PCI patient angiograms, simulating the angiogram having been acquired at corresponding lower dose levels (by 10-89% dose reduction). Sixteen observers with relevant and experience scored the image quality of these angiograms in three states - with no image processing and with two different modern image processing algorithms applied; these algorithms are used on state-of-the-art and previous generation cardiac interventional x-ray systems. Ordinal regression allowing for random effects and the delta method were used to quantify the dose reduction allowed for by the processing algorithms, for equivalent image quality scores. The dose reductions [with 95% confidence interval] from the state-of-the-art and previous generation image processing relative to no processing were 24.9% [18.8- 31.0%] and 15.6% [9.4-21.9%] respectively. The dose reduction enabled by the state-of-the-art image processing relative to previous generation processing was 10.3% [4.4-16.2%]. This demonstrates that statistically significant dose reduction can be facilitated with no loss in perceived image quality using modern image enhancement; the most recent processing algorithm was more effective in preserving image quality at lower doses. / The study was funded by Philips Healthcare (the Netherlands).

No

Yes / Cardiologists use x-ray image sequences of the moving heart acquired in real-time to diagnose and treat cardiac patients. The amount of radiation used is proportional to image quality; however, exposure to radiation is damaging to patients and personnel. The amount by which radiation dose can be reduced without compromising patient care was determined. For five patient image sequences, increments of computer-generated quantum noise (white + colored) were added to the images, frame by frame using pixel-to-pixel addition, to simulate corresponding increments of dose reduction. The noise adding software was calibrated for settings used in cardiac procedures, and validated using standard objective and subjective image quality measurements. The degraded images were viewed next to corresponding original (not degraded) images in a two-alternativeforced- choice staircase psychophysics experiment. Seven cardiologists and five radiographers selected their preferred image based on visualization of the coronary arteries. The point of subjective equality, i.e., level of degradation where the observer could not perceive a difference between the original and degraded images, was calculated; for all patients the median was 33% 15% dose reduction. This demonstrates that a 33% 15% increase in image noise is feasible without being perceived, indicating potential for 33% 15% dose reduction without compromising patient care. / Funded in part by Philips Healthcare, the Netherlands. Part of this work has been performed in the project PANORAMA, co-funded by grants from Belgium, Italy, France, the Netherlands, and the United Kingdom, and the ENIAC Joint Undertaking.

Yes / Objectives: Pelvis radiographs are usually acquired supine despite standing imaging reflecting functional anatomy. We compared supine and erect radiographic examinations for anatomical features, radiation dose and image quality. Methods: 60 patients underwent pelvis radiography in both supine and erect positions at the same examination appointment. Measures of body mass index and sagittal diameter were obtained. Images were evaluated using visual grading analysis and pelvic tilt was compared. Dose–area product values were recorded and inputted into the CalDose_X software to estimate effective dose (ED). The CalDose_X software allowed comparisons using data from the erect and supine sex-specific phantoms (MAX06 & FAX06). Results: Patient sagittal diameter was greater on standing with an average 20.6% increase at the iliac crest (median 30.0, interquartile range [26.0 to 34.0] cm), in comparison to the supine position [24.0 (22.3 to 28.0) cm; p < 0.001]. 57 (95%) patients had posterior pelvic tilt on weight-bearing. Erect image quality was significantly decreased with median image quality scores of 78% (69 to 85) compared to 87% for the supine position [81 to 91] (p < 0.001). In the erect position, the ED was 47% higher [0.17 (0.13 to 0.33) mSv vs 0.12 (0.08 to 0.18) mSv (p < 0.001)], influenced by the increased sagittal diameter. 42 (70%) patients preferred the standing examination. Conclusion: Patient diameter and pelvic tilt were altered on weightbearing. Erect images demonstrated an overall decrease in image quality with a higher radiation dose. Optimal acquisition parameters are required for erect pelvis radiography as the supine technique is not directly transferable. / College of Radiographers Industry Partnership Scheme grant.

Yes / This comprehensive review paper examines bone fracture detection techniques based on time-domain low-frequency and microwave radiofrequency (RF). Early and accurate diagnosis of bone fractures remains critical in healthcare, as it can significantly improve patient outcomes. This review focuses on the potential of low-frequency and microwave RF methods, particularly their combination and application of time-domain analysis for enhanced fracture detection. We begin by providing an overview of the fundamental concepts of RF techniques and then by examining biological tissues' dielectric properties. We then compare the advantages and limitations of various bone fracture detection techniques, such as low-frequency RF methods, microwave RF methods, ultrasonography, X-ray, and CT scans. The discussion then shifts to hybrid approaches that combine low-frequency and microwave techniques, emphasising the advantages of such combinations in fracture detection. Machine learning techniques, their applications in bone fracture detection, and the role of time-domain analysis in hybrid approaches are also investigated. Finally, we examine the accuracy and reliability of simulated models for bone fracture detection. We discuss recent advancements and future directions, such as novel sensor technologies, improved signal processing techniques, integration with medical imaging modalities, and personalised fracture detection approaches. This review aims to comprehensively understand the landscape and future potential of time-domain analysis in low-frequency and microwave RF techniques for bone fracture detection. / EU Horizon Europe H2020-MSCA-RISE-2022-2027 (ID: 101086492) and H2020-MSCA-RISE-2019-2024 (ID 872878), Marie Skłodowska-Curie, Research and Innovation Staff Exchange (RISE), and the financial support from the UK Engineering and Physical Sciences Research Council (EPSRC) under grant EP/ X039366/1.

No description available.

Orientador: Marco Antônio Rodrigues Fernandes / Resumo: A proposta do trabalho é a elaboração de um Plano de Radioproteção e a apresentação da rotina de procedimentos de dosimetria de feixes de teleterapia para a adequação em serviços de radioterapia dedicados à medicina veterinária. São apresentados os principais parâmetros radiométricos dos feixes de radiação que devem ser analisados com maior periodicidade pelos usuários de equipamentos de teleterapia. Os experimentos dosimétricos foram realizados no acelerador linear instalado no Setor Técnico de Radioterapia do Hospital das Clinicas da Faculdade de Medicina de Botucatu. Os ensaios de planura, simetria e de determinação da dose absoluta dos feixes de radiação mostraram-se exequíveis para a rotina da radioterapia veterinária. Os resultados apresentados dos parâmetros radiométricos medidos estão em conformidade com os protocolos de dosimetria nacionais e internacionais. O Plano de Radioproteção elaborado, pode subsidiar os profissionais e autoridades sanitárias envolvidas nas práticas da radioterapia veterinária quanto aos preceitos do uso seguro das fontes radioativas e feixes de teleterapia. / Abstract: The proposal of the work is the elaboration of a Radioprotection Plan and the presentation of the routine of dosimetry procedures of teletherapy beams for the adequacy in radiotherapy services dedicated to veterinary medicine. Presented the main radiometric parameters of the radiation beams that should be analyzed more frequently by users of teletherapy equipment. The dosimetric experiments were performed in the linear accelerator installed in the Technical Section of Radiotherapy of the Clinical Hospital of the Botucatu Medical School. The tests of flatness, symmetry and absolute dose determination of the radiation beams were shown feasible for the routine of veterinary radiotherapy. The presented results of the radiometric parameters measured are in accordance with national and international dosimetry protocols. The Radioprotection Plan elaborated may support the professionals and health authorities involved in veterinary radiotherapy practices regarding the safe use of radioactive sources and teletherapy beams. / Mestre

Este trabalho tem como objetivo o desenvolvimento de um novo método para a simulação de redução da dose de radiação em imagens mamográficas clínicas. Assim, estudos sobre a influência da redução da dose de radiação no diagnóstico do câncer de mama podem ser realizados sem que o paciente se exponha a doses extras de radiação. Uma análise preliminar foi realizada para a caracterização do ruído produzido pelo equipamento mamográfico no processo de aquisição da imagem. Essa análise evidenciou a importância de um método local de simulação, uma vez que o ruído depende da posição ao longo do campo. O novo método proposto consiste em ajustar os níveis de cinza e adicionar uma máscara de ruído Poisson, dependente do sinal, nas imagens clínicas adquiridas com a dose de radiação padrão, simulando sua aquisição com doses de radiação reduzidas. A dependência entre ruído e sinal foi criada com o uso da transformada de Anscombe. O desempenho do método proposto foi avaliado utilizando-se imagens mamográficas de um phantom antropomórfico obtidas com diferentes doses de radiação. As imagens simuladas pelo método proposto foram comparadas com as imagens reais. A similaridade entre os espectros de ruído permitiu a comparação de métricas locais da imagem. O erro percentual entre os níveis de cinza das imagens reais e simuladas se manteve inferior a 1%. O ruído adicionado manteve um erro percentual inferior a 1%. Testes de t-Student mostraram que não existe diferença estatística significante (p < 0,05) entre as imagens reais e simuladas pelo método proposto. / This work aims to develop a new method for simulating reduction of the radiation dose in clinical digital mammography. Using such method, studies regarding the influence of dose reduction in cancer diagnosis can be performed without unnecessary exposure of patients to X-ray radiation. A preliminary study characterized the noise produced by the digital mammography equipment during the acquisition process. This analysis emphasized the importance of simulating noise locally, since noise is dependent on the spatial position of the pixel. Therefore, the proposed method consists of adjusting the gray levels and adding signal-dependent Poisson noise to images acquired at the standard radiation dose. Dependency between noise and signal was created using the Anscombe transformation. The performance of the proposed method was evaluated using mammographic images of an anthropomorphic phantom acquired at different radiation doses. Images simulated using the proposed method were compared to real images acquired using the clinical equipment. Similarity between noise power spectra and local metrics validated the similarity between images. The gray level of the simulated and real images were compared using local mean and reported averaged errors smaller than 1%. The added noise was also compared and the averaged error was smaller than 1%. Statistical Student\'s t-test tests showed no statistical difference (p < 0.05) between real images and the ones simulated using the proposed method.

Este trabalho tem por objetivo a composição e caracterização de um dosímetro à base de DL-Alanina e Ferro-ll em forma de gel para aplicações em dosimetría para campos de doses da radiação gama do Co-60 experimentadas em procedimentos de radioterapia. O aminoácido DL-Alanina é dissolvido em solução ácida contendo o Fe-ll e adicionado o gel. Procedeu-se a uma série de ensaios variando reagente a reagente e realizando procedimentos para avaliar o comportamento em função do tempo do gel dosimétrico obtido. Os espectros de absorção antes e após a irradiação apresentam máximos em 457 nm e 588 nm, respectivamente. Esses dois picos correspondem aos comprimentos de onda de absorção das espécies Fe-ll e Fe-lll, respectivamente; estando ambas as espécies em equilíbrio. Com a irradiação, ocorre a formação de radicais que oxidam o Fe-ll em Fe-lll, alterando com isso o balanço entre as duas espécies - daí o aumento da concentração de Fe-lll - fazendo com que mude a tonalidade do gel, sendo, portanto, possível de ser determinada a dose absorvida. Nas análises dos espectros e respectivas curvas dose-resposta observou-se que o gel dosimétrico apresenta linearidade no intervalo de doses entre 0,5 e 40 Gy. A partir dos resultados obtidos de linearidade, estabilidade e menor dose detectável - 0,3 Gy - conclui-se que o presente Gel Dosimétrico à base de DL-Alanina e Fe-ll apresenta excelente potencial para a finalidade que é proposto, qual seja a determinação do campo de doses em radioterapia e futura aplicação como padrão na determinação desses campos, em 3D, utilizando-se a técnica de Imagem por Ressonância Magnética - IRM. / The aim of this work is to develop a DL-Alanine, Fe-ll based gel dosimeter to be applied in the dosimetry of the Co-60 gamma-radiation fields in the dose range of radiation therapy procedures. The aminoacid DL-Alanine is dissolved in an acid solution containing the Fe-ll and added to the gel. A series of essays was performed with different chemicals and different procedures were made to evaluate the behavior of the obtained dosimetric gel as function of the time. The absorption spectra, before and after the irradiation, present maximum in 457 nm and 588 nm, respectively. These two peaks correspond to absorption wavelengths of the chemical species Fe-ll and Fe-lll, respectively, both species being in equilibrium. With the irradiation, the formation of the radicals that oxide the Fe-ll into Fe-lll occurs, altering the chemical balance of both species - hence the increase of the Fe-lll - and causing the gel to change its tonality, in such a way that it is possible to determine the absorved dose. In the analysis of the spectra and respective dose-response curves it was observed that the dosimetric gel shows linearity in dose range of 0.5 to 40 Gy. From the obtained linearity results, stability and lower detectable dose - 0,3 Gy - it is possible to conclude that the present DL-Alanine, Fe-ll based dosimetric gel presents an excellent potential to the application to which it is proposed, namely, the determination of the dose fields in radiation therapy and its future application as a standard in the determination of these fields, in 3D, using the Magnetic Resonance Imaging.