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Brooke N, Elliott J, Murphy T, Vera Stimpson L. Development of a radiographic technique for porcine head ballistic research. Radiography (Lond) 2023; 29:980-983. [PMID: 37595528 DOI: 10.1016/j.radi.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023]
Abstract
INTRODUCTION The porcine model shows structural features comparable to that of humans and are routinely used within research, due to the ethical, legal, and practical use of post-mortem human samples. Methods for obtaining high quality and comparable reference data using standardised acquisition protocols are essential. METHODS The decapitated heads of three adult white sows were subjected to radiographic imaging before and after cranial trauma (9 mm, Heckler and Koch MP5). Digital radiographs were generated using a Siemens MULTIX TOP system with an Agfa digital detector, with foam blocks and sandbags as ancillary equipment. An iterative approach was adopted by the authors to generate reproducible radiographic views from two perpendicular angles. Specimens were kept at 5 °C and wrapped in polythene bags to reduce the impact of putrefaction. RESULTS Standardised head radiography technique was developed for superior-inferior and lateral views demonstrating porcine anatomy. Key parameters included: automatic exposure control for tube current (∼4 mAs), tube voltage of 73 kVp, 100 cm source to image receptor distance, and an anti-scatter grid. Slight variances in specimen morphology, developmental status, and soft tissue changes did not affect imaging outcomes. CONCLUSION The technique and positioning proposed in this study allows for the acquisition of high quality and reproducible radiographic images for comparable ballistic research datasets. Specimen positioning and centring of the primary beam may be applied across porcine breeds, although individual radiographic parameters may differ according to equipment specifications and specimen size. IMPLICATIONS FOR PRACTICE Development of a reproducible radiographic technique of porcine heads in forensic and veterinary research.
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Affiliation(s)
- N Brooke
- School of Law, Policing and Social Sciences, Canterbury Christ Church University, Kent, United Kingdom
| | - J Elliott
- School of Allied and Public Health Professions, Canterbury Christ Church University, Kent, United Kingdom
| | - T Murphy
- Kent Police Tactical Firearms Unit, Kent, United Kingdom
| | - L Vera Stimpson
- School of Law, Policing and Social Sciences, Canterbury Christ Church University, Kent, United Kingdom.
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Al-Humairi A, Ip RHL, Spuur K, Zheng X, Huang B. Visual grading experiments and optimization in CBCT dental implantology imaging: preliminary application of integrated visual grading regression. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2022; 61:133-145. [PMID: 34988606 DOI: 10.1007/s00411-021-00959-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 11/13/2021] [Indexed: 06/14/2023]
Abstract
This study uses a general formulation of integrated visual grading regression (IVGR) and applies it to cone beam computed tomography (CBCT) scan data related to anatomical landmarks for dental implantology. The aim was to assess and predict a minimum acceptable dose for diagnostic imaging and reporting. A skull phantom was imaged with a CBCT unit at various diagnostic exposures. Key anatomical landmarks within the images were independently reviewed by three trained observers. Each provided an overall image quality score. Statistical analysis was carried out to examine the acceptability of the images taken, using an IVGR analysis that was formulized as a three-stage protocol including defining an integrated score, development of an ordinal regression, and investigation of the possibility for dose reduction through estimated parameters. For a unit increase in the logarithm of radiation dose, the odds ratio that the integrated score for an image assessed by observers being rated in a higher category was 3.940 (95% confidence interval: 1.016-15.280). When assessed by the observers, the minimum dose required to achieve a 75% probability for an image to be classified as at least acceptable was 1346.91 mGy·cm2 dose area product (DAP), a 31% reduction compared to the 1962 mGy·cm2 DAP default dosage of the CBCT unit. The kappa values of the intra and inter-observer reliability indicated moderate agreements, while a discrepancy among observers was also identified because each, as expected, perceived visibility differently. The results of this work demonstrate the IVGR's predictive value of dose saving in the effort to reduce dose to patients while maintaining reportable diagnostic image quality.
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Affiliation(s)
- Ahmed Al-Humairi
- School of Dentistry, The University of Queensland, Herston, QLD, Australia.
| | - Ryan H L Ip
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Kelly Spuur
- School of Dentistry and Medical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Xiaoming Zheng
- School of Dentistry and Medical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Boyen Huang
- Department of Primary Dental Care, University of Minnesota School of Dentistry, Minneapolis, MN, USA
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Flintham K, Snaith B, Field L. Review and optimisation of foot radiography technique. Radiography (Lond) 2020; 27:284-288. [PMID: 32950389 DOI: 10.1016/j.radi.2020.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 08/11/2020] [Accepted: 08/20/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Radiography is an important tool in the diagnosis of trauma and diseases of the foot. Consistent image quality and anatomical appearances are essential to ensure that images are interpreted correctly and this study aims to evaluate current technique and use anthropomorphical phantoms in order to investigate the most optimal radiographic technique. METHODS A two part study was conducted. An electronic survey was administered in order to ascertain the current radiographic technique utilised within the United Kingdom (UK) National Health Service (NHS) and compare this with techniques published within radiographic positioning textbooks in common use within the UK. A phantom experiment also sought to identify the most appropriate angulation of the central beam to employ in order to optimally visualise the anatomy for standard non-trauma radiography of the foot. A relative visual grading analysis technique was used to assess radiographic quality. RESULTS The electronic survey was completed by 38% of departments (n = 69/182) and demonstrated wide inconsistencies in projections, centring points and beam angulations employed across the NHS. The most commonly employed techniques no longer match the majority of positions described in textbooks. The phantom experiment modelled the ability to accurately visualise anatomy with a variation of the central beam angulation. The results demonstrated that the most commonly described textbook techniques remain the most optimal for accurately visualising the anatomy of the foot. CONCLUSION This study has validated the radiographic techniques of the foot described in many of the key texts, however self-reported current practice has diverged from this textbook description. IMPLICATIONS FOR PRACTICE Reinforcement of fundamental principles will benefit the patient with increased image quality, improved diagnosis and improved consistency of images, particularly when patient care is transferred between centres.
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Affiliation(s)
- K Flintham
- Mid Yorkshire Hospital NHS Trust, Aberford Road, Wakefield, West Yorkshire, WF1 4DG, United Kingdom
| | - B Snaith
- Mid Yorkshire Hospital NHS Trust, Aberford Road, Wakefield, West Yorkshire, WF1 4DG, United Kingdom; University of Bradford, Bradford, West Yorkshire, BD7 1DP, United Kingdom
| | - L Field
- Mid Yorkshire Hospital NHS Trust, Aberford Road, Wakefield, West Yorkshire, WF1 4DG, United Kingdom.
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Precht H, Hansson J, Outzen C, Hogg P, Tingberg A. Radiographers' perspectives' on Visual Grading Analysis as a scientific method to evaluate image quality. Radiography (Lond) 2019; 25 Suppl 1:S14-S18. [PMID: 31481182 DOI: 10.1016/j.radi.2019.06.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Radiographers routinely undertake many initiatives to balance image quality with radiation dose (optimisation). For optimisation studies to be successful image quality needs to be carefully evaluated. Purpose was to 1) discuss the strengths and limitations of a Visual Grading Analysis (VGA) method for image quality evaluation and 2) to outline the method from a radiographer's perspective. METHODS A possible method for investigating and discussing the relationship between radiographic image quality parameters and the interpretation and perception of X-ray images is the VGA method. VGA has a number of advantages such as being low cost and a detailed image quality assessment, although it is limited to ensure the images convey the relevant clinical information and relate the task based radiography. RESULTS Comparing the experience of using VGA and Receiver Operating Characteristic (ROC) it is obviously that less papers are published on VGA (Pubmed n=1.384) compared to ROC (Pubmed n=122.686). Hereby the scientific experience of the VGA method is limited compared to the use of ROC. VGA is, however, a much newer method and it is slowly gaining more and more attention. CONCLUSION The success of VGA requires a number of steps to be completed, such as defining the VGA criteria, choosing the VGA method (absolute or relative), including observers, finding the best image display platforms, training observers and selecting the best statistical method for the study purpose should be thoroughly considered. IMPLICATION FOR PRACTICE Detailed evaluation of image quality for optimisation studies related to technical definition of image quality.
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Affiliation(s)
- H Precht
- Conrad Research Programme, University College Lillebelt, Niels Bohrs Alle 1, 5230, Odense M, Denmark; Medical Research Department, Odense University Hospital, Baagøes Àlle 15, 5700, Svendborg, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwsparken, 5000, Odense C, Denmark.
| | - J Hansson
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden; Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, SE-413 45, Gothenburg, Sweden
| | - C Outzen
- Conrad Research Programme, University College Lillebelt, Niels Bohrs Alle 1, 5230, Odense M, Denmark
| | - P Hogg
- School of Health and Society, University of Salford, Manchester, UK
| | - A Tingberg
- Medical Radiation Physics, Department of Clinical Sciences, Lund University, Sweden; Skåne University Hospital, 205 02, Malmö, Sweden
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Mount J. Reject analysis: A comparison of radiographer and radiologist perceptions of image quality. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2015.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mraity HAAB, England A, Cassidy S, Eachus P, Dominguez A, Hogg P. Development and validation of a visual grading scale for assessing image quality of AP pelvis radiographic images. Br J Radiol 2016; 89:20150430. [PMID: 26943836 PMCID: PMC4985444 DOI: 10.1259/bjr.20150430] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 02/22/2016] [Accepted: 03/02/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this article was to apply psychometric theory to develop and validate a visual grading scale for assessing the visual perception of digital image quality anteroposterior (AP) pelvis. METHODS Psychometric theory was used to guide scale development. Seven phantom and seven cadaver images of visually and objectively predetermined quality were used to help assess scale reliability and validity. 151 volunteers scored phantom images, and 184 volunteers scored cadaver images. Factor analysis and Cronbach's alpha were used to assess scale validity and reliability. RESULTS A 24-item scale was produced. Aggregated mean volunteer scores for each image correlated with the rank order of the visually and objectively predetermined image qualities. Scale items had good interitem correlation (≥0.2) and high factor loadings (≥0.3). Cronbach's alpha (reliability) revealed that the scale has acceptable levels of internal reliability for both phantom and cadaver images (α = 0.8 and 0.9, respectively). Factor analysis suggested that the scale is multidimensional (assessing multiple quality themes). CONCLUSION This study represents the first full development and validation of a visual image quality scale using psychometric theory. It is likely that this scale will have clinical, training and research applications. ADVANCES IN KNOWLEDGE This article presents data to create and validate visual grading scales for radiographic examinations. The visual grading scale, for AP pelvis examinations, can act as a validated tool for future research, teaching and clinical evaluations of image quality.
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Affiliation(s)
- Hussien A A B Mraity
- Department of Physics, Faculty of Science, University of Kufa, Najaf, Iraq
- School of Health Sciences, University of Salford, Salford, UK
| | - Andrew England
- School of Health Sciences, University of Salford, Salford, UK
| | - Simon Cassidy
- School of Health Sciences, University of Salford, Salford, UK
| | - Peter Eachus
- School of Health Sciences, University of Salford, Salford, UK
| | - Alejandro Dominguez
- Haute Ecole de Sante Vaud, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- School of Health Sciences, University Center of Legal Medecine, Lausanne, Switzerland
| | - Peter Hogg
- School of Health Sciences, University of Salford, Salford, UK
- Department of Radiography, Karolinska Institute, Stockholm, Sweden
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Hogg P. Radiation dose and image quality optimisation in medical imaging. J Med Radiat Sci 2015. [PMCID: PMC4592681 DOI: 10.1002/jmrs.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Peter Hogg
- Centre for Health Sciences Research University of Salford Manchester UK
- Karolinska Institute Stockholm Sweden
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