Radiation Detectors and Sensors in Medical Imaging

Medical imaging instrumentation design and construction is based on radiation sources and radiation detectors/sensors. This review focuses on the detectors and sensors of medical imaging systems. These systems are subdivided into various categories depending on their structure, the type of radiation they capture, how the radiation is measured, how the images are formed, and the medical goals they serve. Related to medical goals, detectors fall into two major areas: (i) anatomical imaging, which mainly concerns the techniques of diagnostic radiology, and (ii) functional-molecular imaging, which mainly concerns nuclear medicine. An important parameter in the evaluation of the detectors is the combination of the quality of the diagnostic result they offer and the burden of the patient with radiation dose. The latter has to be minimized; thus, the input signal (radiation photon flux) must be kept at low levels. For this reason, the detective quantum efficiency (DQE), expressing signal-to-noise ratio transfer through an imaging system, is of primary importance. In diagnostic radiology, image quality is better than in nuclear medicine; however, in most cases, the dose is higher. On the other hand, nuclear medicine focuses on the detection of functional findings and not on the accurate spatial determination of anatomical data. Detectors are integrated into projection or tomographic imaging systems and are based on the use of scintillators with optical sensors, photoconductors, or semiconductors. Analysis and modeling of such systems can be performed employing theoretical models developed in the framework of cascaded linear systems analysis (LCSA), as well as within the signal detection theory (SDT) and information theory.

MTF of columnar phosphors with a homogenous part: an analytical approach

A method for the theoretical estimation of the MTF of columnar phosphors with a homogeneous part at the end used in X-ray imaging has been developed. This method considers the light transport inside the scintillator through an analytical modelling, the optical photon beams distribution on the scintillator-optical sensor interface, and uses the definition of the PSF and a Gauss fitted LSF to estimate the MTF of an indirect detector. This method was applied to a columnar CsI:Tl scintillator and validated against experimental results found in literature, and a good agreement was observed. It was found that, by increasing the pixel size of the optical detector and the thickness of the scintillator, the MTF decreased as expected. This method may be used in evaluating the performance of the columnar phosphors used in medical imaging, given their physical and geometrical characteristics.Graphical abstract (a) Side view of a part of the scintillator where five crystal columns with homogeneous ends attached to an optical sensor is shown. (b) Propagation of two random optical photon beams emitted from point K with different angles of emission is shown. All the symbols are explained analytically in the text.

Automated quality control assessment of clinical chest images

PURPOSE

The purpose of this study was to determine whether a proposed suite of objective image quality metrics for digital chest radiographs is useful for monitoring image quality in a clinical setting unique from the one where the metrics were developed.

METHODS

Seventeen gridless AP chest radiographs from a GE Optima portable digital radiography (DR) unit ("sub-standard" images; Group 2) and 17 digital PA chest radiographs ("standard-of-care" images; Group 1) and 15 gridless (non-routine) PA chest radiographs (images with a gross technical error; Group 3) from a Discovery DR unit were chosen for analysis. Group 2 images were acquired with a lower kVp (100 vs 125) and shorter source-to-image distance (127 cm vs 183 cm) and were expected to have lower quality than Group 1 images. Group 3 images were expected to have degraded contrast vs Group 1 images. Images were anonymized and securely transferred to the Duke University Clinical Imaging Physics Group for analysis using software described and validated previously. Individual image quality was reported in terms of lung gray level, lung detail, lung noise, rib-lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm-lung contrast, and subdiaphragm area. Metrics were compared across groups. To improve precision of means and confidence intervals for routine exams, an additional 66 PA images were acquired, processed, and pooled with Group 1. Three observer studies were conducted to assess whether humans were able to identify images classified by the algorithm as abnormal.

RESULTS

Metrics agreed with published Quality Consistency Ranges with three exceptions: higher lung gray level, lower rib-lung contrast, and lower subdiaphragm-lung contrast. Higher (stored) bit depth (14 vs 12) accounted for higher lung gray level values in our images. Values were most internally consistent for Group 1. The most sensitive metric for distinguishing between groups was mediastinum noise, followed closely by lung noise. The least sensitive metrics were mediastinum detail and rib-lung contrast. The algorithm was more sensitive than human observers at detecting suboptimal diagnostic quality images.

CONCLUSIONS

The software appears promising for objectively and automatically identifying suboptimal images in a clinical imaging operation. The results can be used to establish local quality consistency ranges and action limits per facility preferences.

An analytical approach to the light transport in columnar phosphors. Detector Optical Gain, angular distribution and the CsI:Tl paradigm

PURPOSE

An analytical model has been developed for the light propagation in columnar phosphors, based on the optical photon propagation physical and geometrical principles.

METHODS

This model accounts for the multiple reflections on the sides of the crystal column, as well as for the infinite forward and backward reflections of the propagated optical photon beams created in the crystal bulk. Additionally it considers the lateral propagated optical photon beams after multiple refractions from the neighbor columns and the optical photon attenuation inside the scintillator. The model was used to predict the Detector Optical Gain (DOG), and the angular distribution, of the columnar CsI:Tl scintillators, used in medical imaging.

RESULTS

The model was validated against CsI:Tl optical photon transmission published results and good agreement was observed. It was, also, found that the DOG is affected by the length of the columns, as well as the incident X-ray energy spectrum. The results of the angular distribution are in accordance with the theory that the longer crystal columns have more directional light distribution.

CONCLUSIONS

The results of DOG are in accordance with the use of short crystal columns for lower energies (mammography) and the use of long crystal columns for higher energies (general radiology). Angular distribution was found more directive for long crystal columns.

A GPU Simulation Tool for Training and Optimisation in 2D Digital X-Ray Imaging

Conventional radiology is performed by means of digital detectors, with various types of technology and different performance in terms of efficiency and image quality. Following the arrival of a new digital detector in a radiology department, all the staff involved should adapt the procedure parameters to the properties of the detector, in order to achieve an optimal result in terms of correct diagnostic information and minimum radiation risks for the patient. The aim of this study was to develop and validate a software capable of simulating a digital X-ray imaging system, using graphics processing unit computing. All radiological image components were implemented in this application: an X-ray tube with primary beam, a virtual patient, noise, scatter radiation, a grid and a digital detector. Three different digital detectors (two digital radiography and a computed radiography systems) were implemented. In order to validate the software, we carried out a quantitative comparison of geometrical and anthropomorphic phantom simulated images with those acquired. In terms of average pixel values, the maximum differences were below 15%, while the noise values were in agreement with a maximum difference of 20%. The relative trends of contrast to noise ratio versus beam energy and intensity were well simulated. Total calculation times were below 3 seconds for clinical images with pixel size of actual dimensions less than 0.2 mm. The application proved to be efficient and realistic. Short calculation times and the accuracy of the results obtained make this software a useful tool for training operators and dose optimisation studies.

Performance evaluation of two computed radiography systems and patient dose in pelvic examination

This study was carried out to evaluate the performance of two computed radiography (CR) units. These evaluations became necessary following the introduction of CR systems in Sudan. Evaluation of the CR systems was performed using physical image quality parameters: signal transfer property, modulation transfer function, normalised noise power spectrum, detective quantum efficiency and the subjective contrast detail detectability. Patient dose was measured in terms of entrance surface air kerma estimated from tube output and exposure factors for 100 patients who had undergone pelvic X-ray examinations. Fuji computed radiography velocity system with columnar screen dose results was much lower than those using CR975 system with granular screen. Patient doses delivered by both systems were within the international diagnostic reference levels.

Should processed or raw image data be used in mammographic image quality analyses? A comparative study of three full-field digital mammography systems

The purpose of this study is to compare a number of measured image quality parameters using processed and unprocessed or raw images in two full-field direct digital units and one computed radiography mammography system. This study shows that the difference between raw and processed image data is system specific. The results have shown that there are no significant differences between raw and processed data in the mean threshold contrast values using the contrast-detail mammography phantom in all the systems investigated; however, these results cannot be generalised to all available systems. Notable differences were noted in contrast-to-noise ratios and in other tests including: response function, modulation transfer function , noise equivalent quanta, normalised noise power spectra and detective quantum efficiency as specified in IEC 62220-1-2. Consequently, the authors strongly recommend the use of raw data for all image quality analyses in digital mammography.

Free software for performing physical analysis of systems for digital radiography and mammography

PURPOSE

In this paper, the authors present a free software for assisting users in achieving the physical characterization of x-ray digital systems and image quality checks.

METHODS

The program was developed as a plugin of a well-known public-domain suite ImageJ. The software can assist users in calculating various physical parameters such as the response curve (also termed signal transfer property), modulation transfer function (MTF), noise power spectra (NPS), and detective quantum efficiency (DQE). It also includes the computation of some image quality checks: defective pixel analysis, uniformity, dark analysis, and lag.

RESULTS

The software was made available in 2009 and has been used during the last couple of years by many users who gave us valuable feedback for improving its usability. It was tested for achieving the physical characterization of several clinical systems for digital radiography and mammography. Various published papers made use of the outcomes of the plugin.

CONCLUSIONS

This software is potentially beneficial to a variety of users: physicists working in hospitals, staff working in radiological departments, such as medical physicists, physicians, engineers. The plugin, together with a brief user manual, are freely available and can be found online (www.medphys.it/downloads.htm). With our plugin users can estimate all three most important parameters used for physical characterization (MTF, NPS, and also DQE). The plugin can run on any operating system equipped with ImageJ suite. The authors validated the software by comparing MTF and NPS curves on a common set of images with those obtained with other dedicated programs, achieving a very good agreement.

Dose reduction in general radiography for adult patients by use of a dual-side-reading photostimulable phosphor plate in a computed radiography system

Our purpose in this study was to evaluate the potential of dose reduction in general radiography for adult patients by use of a dual-side-reading (DSR) photostimulable phosphor plate in a computed radiography system. The image quality and low-contrast detectability in terms of the contrast-detail diagram of the DSR system with use of the X-ray beam quality of the RQA 5 defined by the International Electrotechnical Commission 61267 were compared with those of a conventional single-side-reading (SSR) system. The radiographic noise of the DSR system was lower compared to that of the SSR system under the same exposure conditions. Although there were no statistical differences in low-contrast detectabilities between the SSR system and the DSR system under the same exposure levels, the DSR system showed superior detectability compared to the SSR system. We conclude that the DSR system for general radiography has the potential to reduce the patient dose.

Clinical study in phase- contrast mammography: image-quality analysis

The first clinical study of phase-contrast mammography (PCM) with synchrotron radiation was carried out at the Synchrotron Radiation for Medical Physics beamline of the Elettra synchrotron radiation facility in Trieste (Italy) in 2006-2009. The study involved 71 patients with unresolved breast abnormalities after conventional digital mammography and ultrasonography exams carried out at the Radiology Department of Trieste University Hospital. These cases were referred for mammography at the synchrotron radiation facility, with images acquired using a propagation-based phase-contrast imaging technique. To investigate the contribution of phase-contrast effects to the image quality, two experienced radiologists specialized in mammography assessed the visibility of breast abnormalities and of breast glandular structures. The images acquired at the hospital and at the synchrotron radiation facility were compared and graded according to a relative seven-grade visual scoring system. The statistical analysis highlighted that PCM with synchrotron radiation depicts normal structures and abnormal findings with higher image quality with respect to conventional digital mammography.

[Physical image properties of digital radiography systems in low dose range]

We measured physical image properties of a flat panel detector (FPD) system and a computed radiography (CR) system, targeting to a low dose range (reference dose: 2.58×10(-7) C/kg: to 1/20 dose). Input-output properties, pre-sampled modulation transfer functions (pre-sampled MTFs), and normalized noise power spectra for an FPD system equipped with a CsI scintillator (FPDcsi) and a CR system with an imaging plate coated with storage phosphor (CR) were measured at the low dose range for radiation quality of RQA3 (≍50 skV) and RQA5 (≍70 kV), and detective quantum efficiencies (DQEs) were calculated. In addition, in order to validate the DQE results, component fractions of Poisson and multiplicative and additive noise were analyzed using relative standard deviation analysis. The DQE values of FPDcsi were decreased with dose decrease, and contrarily to these, those of CR were increased. At the 1/10 and 1/20 doses for RQA3, the DQEs of FPDcsi and CR became almost the same. From the results of RSD analysis, it was proved that the main cause of DQE deterioration on FPDcsi are non-negligible additive (electronic) noise, and the DQE improvement on CR was caused by both of significant multiplicative (structure) noise and very low electronic noise. The DQE results were validated by comparing burger phantom images of each dose and radiation quality.

Factors for conversion between human and automatic read-outs of CDMAM images

PURPOSE

According to the European protocol for the quality control of the physical and technical aspects of mammography screening (EPQCM) image quality of digital mammography devices has to be assessed using human evaluation of the CDMAM contrast-detail phantom. This is accomplished by the determination of threshold thicknesses of gold disks with different diameters (0.08-2 mm) and revealed to be very time consuming. Therefore a software solution based on a nonprewhitening matched filter (NPW) model was developed at the University of Nijmegen. Factors for the conversion from automatic to human readouts have been determined by Young et al. [Proc. SPIE 614206, 1-13 (2006) and Proc. SPIE 6913, 69131C1 (2008)] using a huge amount of data of both human and automatic readouts. These factors depend on the observer groups and are purely phenomenological. The authors present an alternative approach to determine the factors by using the Rose observer model.

METHODS

Their method uses the Rose theory which gives a relationship between threshold contrast, diameter of the object and number of incident photons. To estimate the conversion factors for the five diameters from 0.2 to 0.5 mm they exposed with five different current-time products which resulted in 25 equations with five unknowns.

RESULTS

The theoretical conversion factors (in dependence of the diameters) amounted to be 1.61 ± 0.02 (0.2 mm diameter), 1.67 ± 0.02 (0.25 mm), 1.85 ± 0.02 (0.31 mm), 2.09 ± 0.02 (0.4 mm), and 2.28 ± 0.02 (0.5 mm). The corresponding phenomenological factors found in literature are 1.74 (0.2 mm), 1.78 (0.25 mm), 1.83 (0.31 mm), 1.88 (0.4 mm), and 1.93 (0.5 mm).

CONCLUSIONS

They transferred the problem of determining the factors to a well known observer model which has been examined for many years and is also well established. This method reveals to be reproduceable and produces factors comparable to the phenomenological ones.