The purpose of this study was first to analyze the utilization of dental examination through questionnaire to develop a diagnostic reference level of patient doses for dental radiography in korea. 77 dental institutions were classified into three groups: A group for the dental hospitals of the college of dentistry (11 institutions), B group for dental hospitals (30 institutions) and C group for dental clinics (36 institutions). The results were as follows : The mean numbers of unit chairs and medical staffs were 140.2, 15.3 and 5.8 sets, 112.6, 7.3 and 1.7 dentists, 3.1, 0.5 and no one radiologic technologists, and 19.7, 12.5 and 3.3 dental hygienists in A, B and C groups, respectively. The mean numbers of dental X-ray equipments were 14.64, 3.21 and 2.19 in A, B and C groups, respectively. Intraoral dental X-ray unit was used the most, the following equipments were panoramic, cephalometric, and cone-beam CT units. The most used X-ray imaging system was also digital system (above 50%) in all three groups. Insight dental film (Kodak, USA) having high sensitivity was routinely used for periapical radiography. The automatic processor was not used in many dental institutions, but the film-holding device was used in many dental institutions. The utilization rates of PACS in A, B and C groups were 90.9%, 83.3% and 16.7% respectively, and the PACS software program was used the most PiView STAR (Infinitt, Korea). The annual mean number of radiographic cases in one dental institution in 2008 for A group was 6.8 times and 21.2 times more than those for B and C groups, and periapical and panoramic radiographs were taken mostly. Tube voltage (kVp) and tube current (mA) for periapical radiography were similar in all three groups, but exposure time in C group was 12.0 times and 3.5 times longer than those in B and C groups. The amount of radiation exposure in C group, in which dental hygienists take dental radiographs, was more than those in other groups. The exposure parameters for panoramic radiography were similar in all three groups. In conclusion, the exposure parameters in dental radiography should be determined with reference level, not past experiences. Use of automatic processor and film-holding devices reduces the radiation exposure in film system. The quality assurance of dental equipments are necessary for the reduction of the patient dose and the improvement of X-ray image quality.
The purpose of this study is to evaluate propriety of using SID 180cm at Chest PA examination and to find effect of geometrical cause to the image. XGEO-GC80, INNOVISION-SH, CXDI-40EG detector and a chest phantom designed self-production was used for this study. Images were acquired at SID 180cm with changing the factor OID as 0, 75 and 83mm and were analyzed by Centricity Radiography RA1000 PACS system. Statistical program was used the SPSS (Version 22.0, SPSS, Chicago, IL, USA), p-value(under 0.05) was considered to be statistically significant. In OID 0 mm was enlarged about 2.7~3.5 mm than the actual degree of the HS, BS of phantom in all equipments. Compared with the calculated magnification has been expanded 1.6~2.8% when viewed. The OID 75 mm with OID 83 mm was extended from the CS and BS 6~8 mm range. Compared to the calculated values, the measured values are expanded from 6.1 to 7.9%. CS and BS according to the OID change showed a statistically significant difference (p<0.05) among each group, the post-analysis only OID 0 mm group appeared as an independent group, 75 mm and 83 mm are separated in the same group It was. But had no statistically significant difference could change depending on the OID (p>0.05), post-mortem analysis showed, both in the same group. Heart sizes appears larger than actual size 6~8 mm at chest PA examination which is enlarged 6.1~7.9% more than the actual theoretical value. We can find magnification of the image because of the increase of the OID due to technical limitations between cover of standing detector and the image plate. so we suggest to have occurred between them when considering the need to adjust the equipment installed by the SID to match the characteristics of the equipment.
The most critical point in the medical use of radiation is to minimize the patient's entrance dose while maintaining the diagnostic function. Low-energy photons (long wave X-ray) among diagnostic X-rays are unnecessary because they are mostly absorbed and contribute the increase of patient's entrance dose. The most effective method to eliminate the low-energy photons is to use the filtering plate. The experiments were performed by observing the image quality. The skin entrance dose was 0.3 mmCu (copper) filter. A total of 80 images were prepared as two sets of 40 cuts. In the first set (of 40 cuts), 20 cuts were prepared for the non-filter set and another 20 cuts for the Cu filter of signal + noise image set. In the second set of 40 cuts, 20 cuts were prepared for the non-filter set and another 20 cuts for the Cu filter of non-signal image (noisy image) with random location of diameter 4 mm and 3 mm thickness of acryl disc for ROC signal at the chest phantom. P(S/s) and P(S/n) were calculated and the ROC curve was described in terms of sensitivity and specificity. Accuracy were evaluated after reading by five radiologists. The number of optically observable lesions was counted through ANSI chest phantom and contrast-detail phantom by recommendation of AAPM when non-filter or Cu filter was used, and the skin entrance dose was also measured for both conditions. As the result of the study, when the Cu filter was applied, favorable outcomes were observed on, the ROC Curve was located on the upper left area, sensitivity, accuracy and the number of CD phantom lesions were reasonable. Furthermore, if skin entrance dose was reduced, the use of additional filtration may be required to be considered in many other cases.
Chest digital tomosynthesis has become a practical imaging modality because it can solve the problem of anatomy overlapping in conventional chest radiography. However, because of both limited scan angle and finite-size detector, a portion of chest cannot be represented in some or all of the projection. These bring a discontinuity in intensity across the field of view boundaries in the reconstructed slices, which we refer to as the truncation artifacts. The purpose of this study was to reduce truncation artifacts using a weighted normalization approach and to investigate the performance of this approach for our prototype chest digital tomosynthesis system. The system source-to-image distance was 1100 mm, and the center of rotation of X-ray source was located on 100 mm above the detector surface. After obtaining 41 projection views with ${\pm}20^{\circ}$ degrees, tomosynthesis slices were reconstructed with the filtered back projection algorithm. For quantitative evaluation, peak signal to noise ratio and structure similarity index values were evaluated after reconstructing reference image using simulation, and mean value of specific direction values was evaluated using real data. Simulation results showed that the peak signal to noise ratio and structure similarity index was improved respectively. In the case of the experimental results showed that the effect of artifact in the mean value of specific direction of the reconstructed image was reduced. In conclusion, the weighted normalization method improves the quality of image by reducing truncation artifacts. These results suggested that weighted normalization method could improve the image quality of chest digital tomosynthesis.
PXLM(Phosphor based x-ray light modulator) has a combined structure by phosphor, photoconductor, and liquid crystal and it can realize x-ray image of high resolution in clinical diagnosis area. In this study, we fabricated a photoconductor and investigated electrical and optical properties to confirm application possibility of radiator detector of PXLM structure. As photoconductor, amorphous selenium(a-Se), which is used most in DR(Digital radiography) of direct conversion method, was used and for formation of thin film, it was formed as $20{\mu}m-thick$ by using thermal vacuum evaporation system. For a produced a-Se film, through XRD(X-ray diffraction) and SEM(Scanning electron microscope), we investigated that amorphous structure was uniformly established and through optical measurement, for visible light of 40 $0\sim630nm$, it had absorption efficiency of 95 % and more. After fabricated a-Se film on the top of ITP substrate, hybrid structure was manufactured through forming $Gd_2O_3:Eu$ phosphor of $270{\mu}m-thick$ on the bottom of the substrate. As the result to confirm electrical property of the manufactured hybrid structure, in the case of appling $10V/{\mu}m$, leakage current of $2.5nA/cm^2$ and x-ray sensitivity of $7.31nC/cm^2/mR$ were investigated. Finally, we manufactured PXLM structure combined with hybrid structure and liquid crystal cell of TN(Twisted nematic) mode and then, investigated T-V(Transmission vs. voltage) curve of external light source for induced x-ray energy. PXLM structure showed a similar optical response with T-V curve that common TN mode liquid crystal cell showed according to electric field increase and in appling $50\sim100V$, it showed linear transmission efficiency of $12\sim18%$. This result suggested an application possibility of PXLM structure as radiation detector.
Scatter radiation considerably affects radiographic image quality by reducing image contrast and contributing to a non-uniform background. Images containing a large portion of scatter radiation may result in an incorrect diagnosis. In the past few years, many efforts have been made to reduce the effects of scatter radiation on radiographic images. The purpose of this study is to accurately measure scatter fractions and evaluate the effectiveness of beam-stop arrays. To measure scatter fraction accurately, a beam-stop array and the SFC (Scatter Fraction Calculator) program were developed. Images were obtained using the beam-stop array for both an anti-scatter technique with an anti-scatter grid and an air gap technique. The scatter fractions of the images were measured using the SFC program. Scatter fractions obtained with an anti-scatter grid were evaluated and compared to scatter fractions obtained without an anti-scatter grid. Scatter fractions were also quantitatively measured and evaluated with an air gap technique. The effectiveness of the beam-stop array was demonstrated by quantifying scatter fractions under various conditions. The results showed that a beam-stop array and the SFC program can be used to accurately measure scatter fractions in radiographic images and can be applied for both developing scatter correction methods as well as systems.
This study is to confirm the range of tube voltage for Chest X-ray in DR system by comparing with dose area product (DAP) and effective dose in efficient detector exposure index (DEI) range. GE definium 8000 was used to for the phantom study. The range of tube voltage is 60~130 kVp and of mAs is 2.5~40 mAs. The acquired images were classified into efficient DEI groups, then calculated effective dose with DAP by using a PC-Based Monte Carlo Program 2.0. The signal to noise ratio (SNR) was measured at 4 regions, including the thoracic spine, the lung area with the ribs, the lung area without the ribs, and the liver by using Picture Archiving and Communication System. The significance of the group for each tube voltage was verified by performing the kruskal-wallis test and the mann-whitney test as a post-test. When set to 4 groups dependned on the tube voltage, DAP showed significant differences; 60 kVp and 80 kVp, and 60 kVp and 90 kVp (p= 0.034, 0.021). Effective dose exhibited no statistically significant differences from the all of the group (p>0.05). SNR exhibited statistically significant differences from the all of the group in the liver except compared to 80 kVp and 90 kVp (p<0.05). Therefore, high tube voltages of 100 kVp or more need to be reconsidered in terms of patient dose and imaging in order to represent an appropriate chest X-ray image in a digital system.
To find out proper photographing conditions in the chest DR imaging, the evaluation of images using the C-D phantom was carried out on relationship of identification capability, graininess, and exposure ratio. The conclusions were obtained as follows. 1. The patient's entrance skin Exposure (ESE) was decreased as tube voltage was increased. 2. According to the tube voltage change, the C-D phantom's identification capability of the exposure conditions was most visible at 110 kVp. 3. The identification capability according to the exposure ratio (mAs) change was most visible at 90 kVp for 0.5 times of low exposure ratio and at 110 kVp for 1.5 times. Therefore, it is known that the images were able to be better identified at a high exposure than a low exposure. 4. The graininess according to the exposure ratio at tube voltage of 110 kVp resulted in the best thing at 1.5 times of ratio when the exposure ratio was 1.5 times increased and the tube voltage was changed, the graininess showed the best result at 110 kVp. Therefore, the patient's exposure dose was low when kVp was increased and the adequate kVp was found to be 110. The image was better identified when exposure ratio was 1.5 times compared to 1.0 times. The graininess was also good when the exposure ratio became 1.5 times. The tube voltage was good at 110 kVp. However, once the exposure ratio is increased, the amount of radiation dose that the patients received get increased, so that the exposure condition has to be thoroughly considered.
In megavoltage (MV) radiotherapy, delivering the dose to the target volume is important while protecting the surrounding normal tissue. The purpose of this study was to evaluate the modulation transfer function (MTF), the noise power spectrum (NPS), and the detective quantum efficiency (DQE) using an edge block in megavoltage X-ray imaging (MVI). We used an edge block, which consists of tungsten with dimensions of 19 (thickness) ${\times}$ 10 (length) ${\times}$ 1 (width) $cm^3$ and measured the pre-sampling MTF at 6 MV energy. Various radiation therapy (RT) devices such as TrueBeam$^{TM}$ (Varian), BEAMVIEW$^{PLUS}$ (Siemens), iViewGT (Elekta) and Clinac$^{(R)}$iX (Varian) were used. As for MTF results, TrueBeam$^{TM}$(Varian) flattening filter free(FFF) showed the highest values of $0.46mm^{-1}$ and $1.40mm^{-1}$ for MTF 0.5 and 0.1. In NPS, iViewGT (Elekta) showed the lowest noise distribution. In DQE, iViewGT (Elekta) showed the best efficiency at a peak DQE and $1mm^{-1}DQE$ of 0.0026 and 0.00014, respectively. This study could be used not only for traditional QA imaging but also for quantitative MTF, NPS, and DQE measurement for development of an electronic portal imaging device (EPID).
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