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"This study characterizes the image quality parameters of a clinical full-field digital mammography system at various x-ray spectral conditions. The energy of the incident x-ray beam, the spectral characteristics, and breast thickness impact the physical performance such as the detective quantum efficiency of the system, thereby affecting the overall performance. The modulation transfer function, noise power spectrum were measured without the anti-scatter grid, and the detective quantum efficiency was calculated for different incident x-ray conditions. Detective quantum efficiency was also calculated with the anti-scatter grid placed above the detector to study its impact. Results indicate a substantial drop in the detective quantum efficiency with the anti-scatter grid under certain conditions. It was also determined that detective quantum efficiency decreases as x-ray beam hardening is increased. A spatial frequency-dependent cascaded liner systems model was developed to predict the detective quantum efficiency of the system for different target-filter combinations. This theoretical model is based upon a serial cascade approach in which the system is conceptually divided into a number of discrete stages. Each stage represents a physical process having intrinsic signal and noise transfer properties. A match between the predicted data and the experimental detective quantum efficiency data confirmed the validity of the model. Contrast-detail performance, a widely used quality control tool to assess clinical imaging systems, for the clinical full-field digital mammography was studied using a commercially available CDMAM phantom to learn the effects of Joint Photographic Experts Group 2000 (JPEG2000) compression technique on detectability. A 4-alternative forced choice experiment was conducted. The images were compressed at three different compression ratios (10:1, 20:1 and 30:1). From the contrast-detail curves generated from the observer data at 50% and 75% threshold levels, it was concluded that uncompressed images exhibit lower (better) contrast-detail characteristics than compressed images but a certain limit to compression, without substantial loss of visual quality, can be used."

Este trabalho apresenta um método que simula o desempenho dos sistemas de registro radiológicos, considerando tanto a capacidade de absorção, a eficiência de conversão, o espectro de emissão e a eficiência intrínseca do écran quanto a distribuição espacial dos fótons de luz, o ruído quântico, o espectro de sensibilidade do filme, a quantidade de fótons necessários para tomar o grão haleto de prata revelável e um fator que engloba os parâmetros que não são diretamente fornecidos pelos fabricantes. Implementamos os algoritmos empregando o ambiente de programação Delphi, uma ferramenta de desenvolvimento de aplicações para plataforma Windows e microcomputador, que possibilitou o desenvolvimento de uma interface amigável de interação com o usuário. O método prevê a influência de qualquer combinação écran-filme usada ou planejada sobre a nitidez de imagens radiográficas e permite simular o contraste e a nitidez da imagem a ser obtida para uma dada combinação écran-filme em função da exposição quanto a sua curva H&D. / This work presents a method that simulates the performance of radiological recording systems, considering the absorption capacity, the conversion efficiency, the emission spectrum and the intrinsic efficiency of the intensifying screen, the spatial distribution of the light photon, the quantum noise, the sensibility spectrum of the radiographic film, the necessary photons to become the silver halide grain developable and a factor that includes the parameters that are not supplied directly by the manufacturer. We have implemented the algorithms using the Delphi programming language, an application development tool for Windows and personal computer, which allowed the development of a friendly interface of interaction with the user. The method predicts the influence of any screen-film system used or planned on radiographic image sharpness and allows one to simulate the contrast and the image sharpness to be obtained with a given screen-film combination in function of the x-ray exposure as well as the H&D curve this combination.

Este trabalho apresenta um método que simula o desempenho dos sistemas de registro radiológicos, considerando tanto a capacidade de absorção, a eficiência de conversão, o espectro de emissão e a eficiência intrínseca do écran quanto a distribuição espacial dos fótons de luz, o ruído quântico, o espectro de sensibilidade do filme, a quantidade de fótons necessários para tomar o grão haleto de prata revelável e um fator que engloba os parâmetros que não são diretamente fornecidos pelos fabricantes. Implementamos os algoritmos empregando o ambiente de programação Delphi, uma ferramenta de desenvolvimento de aplicações para plataforma Windows e microcomputador, que possibilitou o desenvolvimento de uma interface amigável de interação com o usuário. O método prevê a influência de qualquer combinação écran-filme usada ou planejada sobre a nitidez de imagens radiográficas e permite simular o contraste e a nitidez da imagem a ser obtida para uma dada combinação écran-filme em função da exposição quanto a sua curva H&D. / This work presents a method that simulates the performance of radiological recording systems, considering the absorption capacity, the conversion efficiency, the emission spectrum and the intrinsic efficiency of the intensifying screen, the spatial distribution of the light photon, the quantum noise, the sensibility spectrum of the radiographic film, the necessary photons to become the silver halide grain developable and a factor that includes the parameters that are not supplied directly by the manufacturer. We have implemented the algorithms using the Delphi programming language, an application development tool for Windows and personal computer, which allowed the development of a friendly interface of interaction with the user. The method predicts the influence of any screen-film system used or planned on radiographic image sharpness and allows one to simulate the contrast and the image sharpness to be obtained with a given screen-film combination in function of the x-ray exposure as well as the H&D curve this combination.

Diagnostic radiology plays an important role in the assessment and treatment of neonates, mainly premature, requiring intensive care in the Special Baby Care Unit (SBCU), because they have highly mitotic state of their cells and thus they are more radiosensitive. It is often necessary to perform a large number of X-ray examinations depending upon the infant's birth-weight, gestational age and respiratory problems. It is therefore important to ensure that radiation doses from radiographic examinations carried out in neo-natal units are kept to a minimum while maintaining the quality of radiographic images in a high level. An optimization study on radiation dose and image quality in neonatal radiography is presented. Our sample consists of 135 neonatal radiographic examinations, which performed on 54 neonates. All examinations were performed using the same mobile unit and under manual exposure control. Neonates were categorized into four groups depending on birth-weight. ESD was estimated from the exposure parameters (kVp, mAs) and tube output and also with using of Dose-Area Product (DAP). For the evaluation of image quality, our sample consists of 195 images (75 screen film images, 60 CR images in printed form and 60 CR images in electronic form) were assessed by two observers and were based on the visibility of certain anatomical features using a five-grade scale. ESDoutput values increased with increasing weight and ranged from 16.8 μGy to 64.7 μGy, with a mean value of 36 μGy for all radiographs. Similarly, ESDDAP values ranged from 14.8 μGy to 48.5 μGy with a mean of 29 μGy. Analyzing, the mean ESD for CR images was found 34.8 μGy and for screen film images 36.9 μGy. ESD values for CR images have the same behavior as ESD values for SF images. However, the majority of the acquired values are lower than the proposed Dose Reference Levels by Commission of European Communities (CEC: 80 μGy) and National Radiological Protection Board (NRPB: 50 μGy). Image quality evaluation revealed the feasibility of achieving a diagnostically satisfactory image using both low and high tube voltage techniques, with the latter resulting in reduced ESDs. The results suggest that the use of high tube voltage techniques could result in further reductions in neonatal dose, without image quality degradation, underlying the requirement for establishing standard examination protocols for neonatal radiography with respect to neonatal weight. / Η Διαγνωστική ακτινολογία παίζει σημαντικό ρόλο στην αξιολόγηση και τη θεραπεία των νεογνών, κυρίως των πρόωρων, καθώς απαιτείται η εντατική φροντίδα τους στην Ειδική Μονάδα Φροντίδας Νεογνών, λόγω της μεγάλης μιτωτικής δραστηριότητας των κυττάρων τους και κατα συνέπεια της ακτινοευαισθησίας τους. Είναι συχνά απαραίτητο να πραγματοποιηθεί ένας μεγάλος αριθμός ακτινογραφικών εξετάσεων που εξαρτώνται από το βάρος γέννησης, την περίοδο κύησης και τα αναπνευστικά προβλήματα. Επομένως, είναι σημαντικό να εξασφαλιστεί ότι οι δόσεις ακτινοβολίας από ακτινογραφικές εξετάσεις που πραγματοποιούνται σε μονάδες νεογνών περιορίζονται στο ελάχιστο, ενώ η ποιότητα των ακτινογραφικών εικόνων διατηρείται σε υψηλά επίπεδα. Μια μελέτη για τη βελτιστοποίηση της δόσης της ακτινοβολίας και της ποιότητας της εικόνας σε ακτινογραφίες νεογνών παρουσιάζεται παρακάτω. Το δείγμα μας αποτελείται από 135 ακτινογραφικές εξετάσεις νεογνών, οι οποίες πραγματοποιήθηκαν σε 54 νεογνά. Όλες οι εξετάσεις πραγματοποιήθηκαν χρησιμοποιώντας την ίδια φορητή ακτινογραφική μονάδα και με χειροκίνητο έλεγχο έκθεσης. Τα νεογνά ταξινομήθηκαν σε τέσσερις ομάδες ανάλογα με το βάρος γέννησης. Η Επιφανειακή δόση (ESD) εκτιμήθηκε από τις παραμέτρους της έκθεσης (kVp, mΑs), αλλά και με τη χρήση του DAP. Για την αξιολόγηση της ποιότητας της εικόνας, το δείγμα αποτελούνταν από 195 εικόνες (75 συμβατικές, 60 ψηφιακές (CR) σε έντυπη μορφή και 60 ψηφιακές εικόνες (CR) σε ηλεκτρονική μορφή) οι οποίες αξιολογήθηκαν από δύο παρατηρητές και βασίστηκαν στην ορατότητα ορισμένων ανατομικών χαρακτηριστικών χρησιμοποιώντας μια πενταβάθμια κλίμακα. Οι ESDoutput τιμές αυξάνονται με την αύξηση του βάρους και κυμαίνονται από 16.8μGy σε 64.7μGy, με μέση τιμή 36μGy για όλες τις ακτινογραφίες. Ομοίως, οι ESDDAP τιμές κυμαίνονται από 14.8 μGy σε 48.5 μGy, με μέση τιμή 29 μGy. Αναλυτικά, η μέση τιμή ESD για τις ψηφιακές (CR) εικόνες βρέθηκε 34.8μGy και για τις συμβατικές 36.9μGy. Η ESD για CR εικόνες έχει στατιστικά την ίδια συμπεριφορά με την ESD για SF εικόνες. Η πλειοψηφία των αποκτηθέντων τιμών είναι χαμηλότερες από τα Διαγνωστικά Επίπεδα Αναφοράς που έχουν προταθεί από την Επιτροπή της Ευρωπαϊκής Ένωσης (CEC: 80μGy) και το National Radiological Protection Board (NRPB: 50μGy) για προσθοπίσθιες ακτινογραφίες θώρακος νεογνών. Η αξιολόγηση της ποιότητας της εικόνας αποκάλυψε την δυνατότητα επίτευξης μιας διαγνωστικά ικανοποιητικής εικόνας χρησιμοποιώντας τόσο χαμηλές όσο και υψηλές τάσεις, με τις τελευταίες να οδηγούν σε μείωση των επιφανειακών δόσεων (ESDs). Τα αποτελέσματα δείχνουν ότι η χρήση τεχνικών υψηλής τάσης μπορούν να οδηγήσουν σε περαιτέρω μείωση των δόσεων στα νεογνά, χωρίς να υποβαθμίζεται η ποιότητα της εικόνας, τα οποία βασίζονται στην απαίτηση καθορισμού τυποποιημένων πρωτοκόλλων εξέτασης για ακτινογραφίες σε νεογνά σε σχέση με το βάρος τους.

Doctor of Philosophy / Radiographic film/screen (F/S) images have a narrow latitude or dynamic range. The film’s ability to record and view all the anatomy within the x-ray field is limited by this narrow dynamic range. The advent of digital radiographic means of storing and displaying radiographic images has improved the ability to record and visualise all of the anatomy. The problem still exists in digital radiography (DR) when radiographic examinations of certain anatomical regions are undertaken. In this work, the value of anatomically shaped radiographic contrast-enhancement masks (RCMs) in improving image contrast and reducing the dynamic range of images in DR was examined. Radiographic contrast-enhancement masks are digital masks that alter the radiographic contrast in DR images. The shape of these masks can be altered by the user. Anatomically shaped RCMs have been modelled on tissue compensation filters (TCFs) commonly used in F/S radiographic examinations. The prime purpose of a TCF is to reduce the dynamic range of photons reaching the image receptor and hence improve radiographic contrast in the resultant image. RCMs affect the dynamic range of the image rather than the energy source of the image, that of the x-ray photons. The research consisted of three distinct phases. The first phase was to examine physical TCFs and their effects on F/S radiographic images. Physical TCFs are used in radiographic F/S examinations to attenuate the x-ray beam to compensate for varying patient tissue thicknesses and/or densities. The effect of the TCF is to reduce resultant radiographic optical density variations in the image, allowing the viewer to observe a range of densities within the image which would otherwise not be visualised. Physical TCFs are commonly aluminium- or lead-based materials that attenuate the x-ray beam. A TCF has varying physical thickness to differentially attenuate the iii beam and is shaped for specific anatomical situations. During this project, various commonly used physical TCFs were examined. Measurements of size and thickness were made. Characteristics of linear attenuation coefficients and half-value thicknesses were delineated for various TCF materials and at various energies. The second phase of the research was to model the physical TCFs in a digital environment and apply the RCMs to DR images. The digital RCMs were created with similar characteristics to mimic the shapes to the physical TCFs. The RCM characteristics can be adjusted by the viewer of the image to suit the anatomy being imaged. Anatomically shaped RCMs were designed to assist in overcoming a limitation when viewing digital radiographic images, that of the dynamic range of the image. Anatomically shaped RCMs differ from other means of controlling the dynamic range of a digital radiographic image. It has been shown that RCMs can reduce the range of optical densities within images with a large dynamic range, to facilitate visualisation of all anatomy within the image. Physical TCFs are used within a specific range of radiographic F/S examinations. Digital radiographic images from this range of examinations were collected from various clinical radiological centres. Anatomically shaped RCMs were applied to the images to improve radiographic contrast of the images. The third phase of the research was to ascertain the benefits of the use of RCMs. Various other methods are currently in use to reduce the dynamic range of digital radiographic images. It is generally accepted that these methods also introduce noise into the image and hence reduce image quality. Quantitative comparisons of noise within the image were undertaken. The anatomically shaped RCMs introduced less noise than current methods designed to reduce the dynamic range of digital radiographic images. It was shown that RCM methods do not affect image quality. Radiographers make subjective assessment of digital radiographic image quality as part of their professional practice. To assess the subjective quality of images enhanced with anatomically shaped RCMs, a survey of radiographers and other iv qualified people was undertaken to ascertain any improvement in RCM-modified images compared to the original images. Participants were provided with eight pairs of image to compare. Questions were asked in the survey as to which image had the better range of optical densities; in which image the anatomy was easiest to visualise; which image had the simplest contrast and density manipulation for optimal visualisation; and which image had the overall highest image quality. Responses from 123 participants were received and analysed. The statistical analysis showed a higher preference by radiographers for the digital radiographic images in which the RCMs had been applied. Comparisons were made between anatomical regions and between patient-related factors of size, age and whether pathology was present in the image or not. The conclusion was drawn that digital RCMs correctly applied to digital radiographic images decrease the dynamic range of the image, allowing the entire anatomy to be visualised in one image. Radiographic contrast in the image can be maximised whilst maintaining image quality. Using RCMs in some digital radiographic examinations, radiographers will be able to present optimised images to referring clinicians. It is envisaged that correctly applied RCMs in certain radiographic examinations will enhance radiographic image quality and possibly lead to improved diagnosis from these images.

Doctor of Philosophy / Radiographic film/screen (F/S) images have a narrow latitude or dynamic range. The film’s ability to record and view all the anatomy within the x-ray field is limited by this narrow dynamic range. The advent of digital radiographic means of storing and displaying radiographic images has improved the ability to record and visualise all of the anatomy. The problem still exists in digital radiography (DR) when radiographic examinations of certain anatomical regions are undertaken. In this work, the value of anatomically shaped radiographic contrast-enhancement masks (RCMs) in improving image contrast and reducing the dynamic range of images in DR was examined. Radiographic contrast-enhancement masks are digital masks that alter the radiographic contrast in DR images. The shape of these masks can be altered by the user. Anatomically shaped RCMs have been modelled on tissue compensation filters (TCFs) commonly used in F/S radiographic examinations. The prime purpose of a TCF is to reduce the dynamic range of photons reaching the image receptor and hence improve radiographic contrast in the resultant image. RCMs affect the dynamic range of the image rather than the energy source of the image, that of the x-ray photons. The research consisted of three distinct phases. The first phase was to examine physical TCFs and their effects on F/S radiographic images. Physical TCFs are used in radiographic F/S examinations to attenuate the x-ray beam to compensate for varying patient tissue thicknesses and/or densities. The effect of the TCF is to reduce resultant radiographic optical density variations in the image, allowing the viewer to observe a range of densities within the image which would otherwise not be visualised. Physical TCFs are commonly aluminium- or lead-based materials that attenuate the x-ray beam. A TCF has varying physical thickness to differentially attenuate the iii beam and is shaped for specific anatomical situations. During this project, various commonly used physical TCFs were examined. Measurements of size and thickness were made. Characteristics of linear attenuation coefficients and half-value thicknesses were delineated for various TCF materials and at various energies. The second phase of the research was to model the physical TCFs in a digital environment and apply the RCMs to DR images. The digital RCMs were created with similar characteristics to mimic the shapes to the physical TCFs. The RCM characteristics can be adjusted by the viewer of the image to suit the anatomy being imaged. Anatomically shaped RCMs were designed to assist in overcoming a limitation when viewing digital radiographic images, that of the dynamic range of the image. Anatomically shaped RCMs differ from other means of controlling the dynamic range of a digital radiographic image. It has been shown that RCMs can reduce the range of optical densities within images with a large dynamic range, to facilitate visualisation of all anatomy within the image. Physical TCFs are used within a specific range of radiographic F/S examinations. Digital radiographic images from this range of examinations were collected from various clinical radiological centres. Anatomically shaped RCMs were applied to the images to improve radiographic contrast of the images. The third phase of the research was to ascertain the benefits of the use of RCMs. Various other methods are currently in use to reduce the dynamic range of digital radiographic images. It is generally accepted that these methods also introduce noise into the image and hence reduce image quality. Quantitative comparisons of noise within the image were undertaken. The anatomically shaped RCMs introduced less noise than current methods designed to reduce the dynamic range of digital radiographic images. It was shown that RCM methods do not affect image quality. Radiographers make subjective assessment of digital radiographic image quality as part of their professional practice. To assess the subjective quality of images enhanced with anatomically shaped RCMs, a survey of radiographers and other iv qualified people was undertaken to ascertain any improvement in RCM-modified images compared to the original images. Participants were provided with eight pairs of image to compare. Questions were asked in the survey as to which image had the better range of optical densities; in which image the anatomy was easiest to visualise; which image had the simplest contrast and density manipulation for optimal visualisation; and which image had the overall highest image quality. Responses from 123 participants were received and analysed. The statistical analysis showed a higher preference by radiographers for the digital radiographic images in which the RCMs had been applied. Comparisons were made between anatomical regions and between patient-related factors of size, age and whether pathology was present in the image or not. The conclusion was drawn that digital RCMs correctly applied to digital radiographic images decrease the dynamic range of the image, allowing the entire anatomy to be visualised in one image. Radiographic contrast in the image can be maximised whilst maintaining image quality. Using RCMs in some digital radiographic examinations, radiographers will be able to present optimised images to referring clinicians. It is envisaged that correctly applied RCMs in certain radiographic examinations will enhance radiographic image quality and possibly lead to improved diagnosis from these images.