<p>The Swedish field of digital X-ray imaging has since several years relied heavily on distributed information systems and digital storage containers. </p><p>To ensure accurate and safe radiological reporting, Swedish software-firm eCare AB delivers a system called Feedback—the first and only quality assurance IT support product of its kind. This thesis covers several aspects of the design and implementation of future versions of this software platform. </p><p>The focus lies on distributed directory services and models for secure and robust data propagation in TCP/IP networks. For data propagation, a new application, InfoBroker, has been designed and implemented to facilitate integration between Feedback and other medical IT support systems. The directory services, introduced in this thesis as the Feedback Directory Services, have been designed on the architectural level. A combination of CORBA and Java Enterprise Edition is suggested as the implementation platform.</p>

The Swedish field of digital X-ray imaging has since several years relied heavily on distributed information systems and digital storage containers. To ensure accurate and safe radiological reporting, Swedish software-firm eCare AB delivers a system called Feedback—the first and only quality assurance IT support product of its kind. This thesis covers several aspects of the design and implementation of future versions of this software platform. The focus lies on distributed directory services and models for secure and robust data propagation in TCP/IP networks. For data propagation, a new application, InfoBroker, has been designed and implemented to facilitate integration between Feedback and other medical IT support systems. The directory services, introduced in this thesis as the Feedback Directory Services, have been designed on the architectural level. A combination of CORBA and Java Enterprise Edition is suggested as the implementation platform.

The term“Digital X-ray Imaging" refers to a variety of technologies that electronically capture x-ray images. Once captured the images may be electronically processed, stored, displayed and communicated. Digital imaging has the potential to overcome weaknesses inherent in traditional screen-film imaging, with high detection efficiency, high dynamic range and the capability for contrast enhancement. Image processing also makes possible innovative techniques such as computer-aided diagnosis, tomosynthesis, dual-energy imaging, and digital subtraction imaging. Several different approaches to digital imaging are being studied, and in some cases, have been developed and are being marketed. Common to all these approaches are a number of technological and medical issues to be resolved. One of the technological issues is the optimal pixel size for any particular image sensor technology. In general, the spatial resolution of the digital image is limited by the pixel size. Unfortunately while reducing pixel size improves spatial resolution this comes at the expense of signal to noise ratio (SNR). In a scintillator-charge-coupled device (CCD) system, the signal can be increased by improving the efficiency of the scintillator or by reducing noise. This study used a very low noise CCD to determine if image quality, as indicated by the modulation transfer function (MTF), the noise power spectrum (NPS) and the detective quantum efficiency (DQE), could be maintained while reducing pixel size. Two scintillators, one a commonly used radiographic screen the other a thallium doped cesium iodide scintillator, were used and the results compared. The results of this study show that image quality can be maintained as pixel size is reduced and that high DQE can be attained and maintained over a wide range of spatial frequencies with a well designed scintillator.