Optimizing left anterior oblique (LAO) caudal imaging in coronary angiography using the Taguchi method: A phantom study with clinical verification

Enhanced acrylic gauge with five eccentric circles for optimizing CT angiography spatial resolution via Taguchi's methodology

BACKGROUND

Cerebral examination via CTA is always the first choice for patients with unexpected brain injury or different types of brain lesions to detect ruptured hemangiomas, vascular infarcts, or other brain tissue lesions.

OBJECTIVE

This study innovated the acrylic gauge with five eccentric circles for computed tomography angiography (CTA) analysis to optimize the spatial resolution via Taguchi's methodology.

METHODS

The customized gauge was revised from the V-shaped slit gauge and transferred into five eccentric circles' slit gauge. The gauge was assembled with another six acrylic layers to simulate the human head. Taguchi's L18 orthogonal array was adopted to optimize the spatial resolution of CTA imaging quality. In doing so, six essential factors of CTA are kVp, mAs, spiral rotation pitch, FOV, rotation time of the CT and reconstruction filter, and each factor has either two or three levels to organize into eighteen combinations to simulate the full factor combination of 486 (21 × 35 = 486) times according to Taguchi's recommendation. Three well-trained radiologists ranked the gauge's 18 CTA scanned imaging qualities according to contrast, sharpness, and spatial resolution and derived the unique fish-bone-plot of six factors for further analysis. The optimal factor combination of CTA was proven by follow-up verification and ANOVA to obtain this study's dominant or minor factor.

RESULTS

The optimal factor combination of CTA was A2 (120 kVp), B3 (200 mAs), C1 (Pitch 0.6), D2 (FOV 220 mm2), E1 (rotation time 0.33 s), and F3 (Brain sharp, UC). Furthermore, deriving a quantified MDD (minimum detectable difference) to imply the spatial resolution of CTA, a semiauto profile analysis program run in MATLAB and OriginPro was recommended to evaluate the MDD and to suppress the manual error in calculation. Eventually, the derived MDDs of the conventional and optimal factor combinations of CTA were 2.35 and 2.26 mm, respectively, in this study.

CONCLUSION

Taguchi's methodology was found applicable for quantifying the CTA imaging quality in practical applications.

Applying Taguchi Methodology to Optimize the Brain Image Quality of 128-Sliced CT: A Feasibility Study

Injuries due to traffic accidents have been significant causes of death in Taiwan and traffic accidents have been most common in recent years. Brain computed tomography (CT) examinations can improve imaging quality and increase the value of an imaging diagnosis. The image quality of the brain gray/white matter was optimized using the Taguchi design with an indigenous polymethylmethacrylate (PMMA) slit gauge to imitate the adult brain and solid water phantoms. The two gauges without coating contrast media were located inside the center of a plate to simulate the brain and scanned to obtain images for further analysis. Five major parameters—CT slice thickness, milliampere-seconds, current voltage, filter type, and field of view—were optimized. Analysis of variance was used to determine individual interactions among all control parameters. The optimal experimental acquisition/settings were: slice thickness 2.5 mm, 300 mAs, 140 kVp, smooth filter, and FOV 200 mm2. Signal-to-noise was improved by 106% (p < 0.001) over a routine examination. The effective dose (HE) is approximately 1.33 mSv. Further clinical verification and the image quality of the ACR 464 head phantom is also discussed.

Optimizing cardiac CT angiography minimum detectable difference via Taguchi’s dynamic algorithm, a V-shaped line gauge, and three PMMA phantoms

BACKGROUND: Radiologists widely use the minimum detectable difference (MDD) concept for inspecting the imaging quality and quantify the spatial resolution of scans. OBJECTIVE: This study adopted Taguchi’s dynamic algorithm to optimize the MDD of cardiac CT angiography (CTA) using a V-shaped line gauge and three PMMA phantoms (50, 70, and 90 kg). METHODS: The phantoms were customized in compliance with the ICRU-48 report, whereas the V-shaped line gauge was indigenous to solidify the cardiac CTA scan image quality by two adjacent peaks along the V-shaped slit. Accordingly, the six factors A-F assigned in this study were A (kVp), B (mAs), C (CT pitch), D (FOV), E (iDose), and F (reconstruction filter). Since each factor could have two or three levels, eighteen groups of factor combinations were organized according to Taguchi’s dynamic algorithm. Three welltrained radiologists ranked the CTA scan images three times for three different phantoms. Thus, 27 (3 × 3 × 3) ranked scores were summed and averaged to imply the integrated performance of one specific group, and eventually, 18 groups of CTA scan images were analyzed. The unique signal-to-noise ratio (S/N, dB) and sensitivity in the dynamic algorithm were calculated to reveal the true contribution of assigned factors and clarify the situation in routine CTA diagnosis. RESULTS: Minimizing the cross-interactions among factors, the optimal factor combination was found to be as follows: A (100 kVp), B (600 mAs), C (pitch 0.200 mm), D (FOV 280 mm), E (iDose 5), and F (filter XCA). The respective MDD values were 2.15, 2.32, and 1.87 mm for 50, 70, and 90 kg phantoms, respectively. The MDD of the 90 kg phantom had the most precise spatial resolution, while that of the 70 kg phantom was the worst. CONCLUSION: The Taguchi static and dynamic optimization algorithms were compared, and the latter’s superiority was substantiated.

MINIMUM DETECTABLE DIFFERENCE OF CT ANGIOGRAPHY SCANS AT VARIOUS CARDIAC BEATS: EVALUATION VIA A CUSTOMIZED OBLIQUE V-SHAPED LINE GAUGE AND PMMA PHANTOM

The minimum detectable difference (MDD) at various beats/min (BPM) of CT angiography (CTA) was evaluated using an oblique V-shape line gauge and poly methyl methacrylate (PMMA) phantom in this study. The customized phantom with the size of [Formula: see text][Formula: see text]cm3 was made from a 1[Formula: see text]cm-thick PMMA. The reciprocating mechanism in the phantom was run by a step motor with an eccentric gear connected to a crank rod to provide a stable harmonic motion, simulating the cardiac beats. The MDD has a unique feature in defining the quality characteristic of CT-scanned images and provides more information than simple line pair/cm in the previous studies. The derived MDD was quantified according to various BPM, and the CTA factor combination was preset following either the conventional recommendation or the optimal one. In doing so, the performance was substantiated by the Taguchi-based signal-to-noise ratio and integrated by another index, namely, figure of merit (FOM). The MDD and corresponding [Formula: see text] (dB) changed from [Formula: see text][Formula: see text]mm to [Formula: see text][Formula: see text]mm and from 16.7[Formula: see text]dB to 14.2[Formula: see text]dB, respectively, for conventional settings; while those obtained for the optimal preset changed from [Formula: see text][Formula: see text]mm to [Formula: see text][Formula: see text]mm and from 12.2 dB to 16.4 dB, respectively of CTA at 0–90 BPM. The integrated FOM values for conventional or optimal cases were 1240 and 1337, respectively. The MDD proved to be a useful technique in justifying the CTA-scanned images. For compliance with previous studies, MDD results can be converted to the line pair/cm results, but it is more informative than the quantized number of line pairs.