Radiation dose considerations in digital radiography with an anti-scatter grid: A study using adult and pediatric phantoms

BACKGROUND

When using an anti-scatter grid, a decrease in receptor dose caused by its X-ray absorption seems to lead to the misperception that radiation dose needs to be increased even in digital radiography (DR).

OBJECTIVE

To demonstrate that there is no need to increase radiation dose in DR with a grid, based on a visual evaluation using an adult and a pediatric abdomen phantom (PAD and PPD , respectively).

MATERIALS AND METHODS

Phantom images with and without a grid were obtained with exposure parameters determined based on a preliminarily measured signal-to-noise ratio improvement factor (SIF), an index for potential dose reduction when using a grid. In visual evaluation, four radiologists compared phantom images with a grid applied at different dose reduction rates (0% [no reduction], 18%, 36%, and 59% for PAD and 0% and 11% for PPD ) against an image without a grid at the baseline dose (as the reference). They graded the overall image quality of the former relative to that of the latter (reference) on a 3-point scale (3 = better, 2 = almost equal, 1 = worse).

RESULTS

The mean scores for dose reduction rates of 0%, 18%, 36%, and 59% were 3.00, 3.00, 2.75, and 1.00, respectively, for PAD ; those for 0% and 11% were 2.13 and 1.63, respectively, for PPD . These results support the validity of our view that no dose increase is necessary when using an anti-scatter grid. Actually, there is even a potential for improvement in image quality with dose reduction rates of ≤36% for PAD .

CONCLUSION

It is worth reconsidering the necessity of increasing radiation dose in the DR imaging of the adult and pediatric abdomens with an anti-scatter grid.

A new stationary grid, with grid lines aligned to pixel lines with submicron-order precision, to suppress grid artifacts

PURPOSE

We have developed a new stationary grid named a pixel-aligned grid (PA grid), in which the grid lines are aligned to the pixel lines with submicron-order precision. Further, we have evaluated its performance relative to that of a conventional grid combined with grid-line removal (GLR) processing.

METHODS

A flat-panel detector system of an indirect type, with a pixel pitch of 150 μm, was employed. Four PA grids having a grid ratio of 6:1 associated with abdominal bedside radiography, with the grid-line pitch (GP) varied around the target value of 150 μm, were produced. Blank images were obtained with four PA grids for measuring the period and amplitude of the grid artifact. In performance evaluation, acrylic and anthropomorphic abdominal phantom images were used with the PA grid, a conventional grid (40 lines/cm, grid ratio 6:1), and no grids. The grid artifacts were evaluated by power spectrum (PS) analysis. Also, the signal-to-noise ratio (SNR) improvement factor (K_SNR ) was measured.

RESULTS

Grid artifacts were hardly recognizable with PA grids with GP errors of 0.3 μm and 0.6 μm because of the prolonged grid artifact periods. The measured artifact amplitudes of these PA grids were less than 0.6%. Furthermore, the PA grids did not produce notable frequency peaks in PS. In contrast, the conventional grid without GLR processing produced two conspicuous peaks. With GLR processing, notable reductions in PS were observed around the two peak frequencies, which caused blurring in bone structures. For the acrylic thickness of 20 cm, the K_SNR s for the PA grid were around 1.4, suggesting some SNR improvement in abdominal bedside radiography.

CONCLUSION

The present study has demonstrated that PA grids with their grid-line pitches close to the pixel-line pitch within errors of 0.6 μm produce grid artifact-free images without any signal losses. Thus, the proposed PA grid will prove to be effective and useful in various clinical applications.

Technical evaluation of a prototype ratio 29:1 grid for adult patient cardiovascular angiography imaging conditions

The purpose of this work was to assess technical performance of a prototype high-ratio (r29), 80 line cm^-1grid for imaging conditions which mimic those for adult cardiovascular angiography. The standard equipment r15, 80 line cm^-1grid was used as a reference. Plastic Water^®LR phantoms with thickness in the range 20-44 cm were used to simulate adult patient attenuation and scatter. Grids were tested using x-ray field of view 20 and 25 cm and x-ray source to detector distance (SID) 107 and 120 cm. The primary transmission fraction (T_P) was measured using both narrow beam geometry and a lead beam stop (BS) technique. Scatter transmission (T_S) was measured with the lead BS technique. The quantum signal to noise ratio improvement factor (K_SNR) was used to describe relative grid performance. The experimental conditions required revised theory to assess grid performance. Theory to account for the detector glare and underestimation of scatter intensity by the lead BS method was developed. Also, novelK_SNRtheory was developed to allow direct comparison of two grids operated at different SID. MeanT_Pwas modestly lower for the r29 versus r15 grid (0.69 versus 0.75). When tested under equivalent scatter condition, T_Sof the r29 grid was approximately ½ that of the r15 grid (0.18 versus 0.34).K_SNRof the r29 grid at SID 120 cm compared to the r15 grid at SID 107 cm increased linearly with phantom thickness (range 1.0 to ∼1.16). Findings of this work indicate that the r29 grid used at SID 120 cm is expected to provide improved image quality (or reduced patient radiation dose) when compared to the r15 grid used at SID 107 cm for adult cardiovascular patients and that the potential benefit of the r29 grid increases with patient thickness >20 cm.

[Usefulness of Combining Post-processing Scatter Correction and an Anti-scatter Grid in Chest Standing Radiography]

PURPOSE

The aim of this study was to evaluate the usefulness of combining post-processing scatter correction (IG) and an anti-scatter grid (RG) in chest radiography.

METHOD

To determine the combination protocol (Hyb) that was closed to RG 12:1 (RG12), we measured the content rate of scattered radiation for each combination (RG12, IG12, RG3-12+IG3-12). Task-based modulation transfer function (MTF_Task) and SDNR were evaluated using RG12, IG12, and Hyb. Additionally, seven radiologists performed visual evaluation by using chest phantom.

RESULT

The protocol of Hyb was RG8+IG3. In SDNR, Hyb (RG8+IG3) was equal to or higher than RG12, and MTF_Task was equal in all grid systems. Hyb (RG8+IG3) was significantly superior to RG12 in visual evaluation.

CONCLUSION

The combining post-processing scatter correction should be useful for improving inspection throughput and reducing the risk of grid's damage.

Characterization of anti-scatter grids via a modulation transfer function improvement factor using an edge device

In optimizing the imaging conditions, changes in image quality due to scattered radiation are important evaluation targets. This study focuses on the evaluation of the image quality improvement characteristics obtained using anti-scatter grids in digital x-ray imaging, and proposes a frequency-dependent modulation transfer function (MTF) improvement factor,MIFG(u),as a new evaluation index. Accordingly, the purpose of this study is to clarify the validity and the usefulness of this proposed index in the performance evaluation of grids. The proposedMIFG(u)method is applied to evaluate several types of grids with different grid densities and ratios, and the characteristics of grids exhibiting different performances are examined. The proposed index is calculated based on the MTF measurement by using an edge test device. The results show thatMIFG(u)changed according to grid type and scatter conditions. In particular, a remarkable difference was observed in the high scatter condition compared with the low condition.MIFG(u)in the vertical direction with regards to the absorbing strips shows a peak at 0.2-0.5 cycles/mm and be a constant value from approximately 1 cycle/mm; whileMIFG(u)in the parallel direction is a constant value with respect to changes in spatial frequency. It is shown thatMIFG(u)could be used to accurately describe the characteristics of a grid under different imaging conditions. We believe that the use of the proposed index could expand the options for optimizing imaging conditions when using grids.

[Usefulness of Post-processing Scatter Correction in Portable Abdominal Radiography Using a Low Ratio Anti-scatter Grid]

OBJECTIVES

The aim of this study was to evaluate an influence of post-processing scatter correction in portable abdominal radiography using a low ratio anti-scatter grid (grid).

METHODS

To assess tube voltage on portable abdominal radiography, a burger phantom was used to measure for inverse of image quality figure (IQF_inv). For evaluation of the influence on using or not the grid, IQF_inv were measured. Abdominal phantom radiographies were assessed subjectively, in random order, by six radiologic technologists. The radiographies were performed without scatter correction [IG (-)] and with scatter correction at equivalent for grid ratio 6 [IG (6)] and 8 [IG (8)].

RESULTS

There was no significant decrease in IQF_inv with 75 and 80 kV in comparison of 70 kV. Even processing scatter correction, IQF_inv with using the grid was significantly higher than that without using the grid. The ability to detect nasogastric tube and stomach gas were significantly better in the scatter correction. Deviation index for IG (6) and IG (8) were significantly lower than that of IG (-).

DISCUSSION

Portable abdominal radiographies will be improved image quality by utilizing scatter correction, although, it is necessary to consider the scatter correction processing as this may significant decrease deviation index in the practical situation.

CONCLUSION

The post-processing scatter correction should be useful for detection nasogastric tube and stomach gas in portable abdominal radiography.

[Invention of Optical Sight in Mobile Radiography with Anti-scatter Grid]

In radiography with anti-scatter grid, it is important to make sure that the X-ray beam direct exactly perpendicular to the grid plane. However, it is so difficult to ensure in mobile radiography. An optical sight to ensure X-ray alignment in mobile radiography with anti-scatter grid was devised. The device measures the X-ray beam angle respect to the grid plane by utilizing collimator-lamp. Computed radiography of water phantom on inclined bedding with anti-scatter grid (6 : 1) were done by aid of devised optical sight 20 times. The result showed that the average alignment error of the radiographies by aid of devised optical sight was within 1°, and the maximum error was<2°.

[Improvement of the Radiographic Contrast in Off-center Radiography with Focused Grid]

In radiography with focused grid, it is important to agree the X-ray center on the grid center. Actually, radiography is often put the off-center alignment which disagrees the X-ray center to the grid center. This misalignment decreases radiographic contrast because of cutoff the primary X-rays. The grid-tilt technique which makes the grid tilt corresponding to the misalignment of the X-ray center and the grid center was investigated. Using solid state dosimeter and 10 cm water phantom, transited dose of focused grids (focal distance 120 cm, grid ratio 6:1 and 8:1) were measured at off-center. The transited dose at 6 cm off-center by conventional manner was lower 20% (6:1) and 30% (8:1) to center's one. While by grid-tilt technique, the transited dose at off-center was same to the center's one. Axial radiography of hip joint was applied by this technique.

[Effect of Interspaces of Anti-scatter Grid on the Image Improvement Factor]

The standard general purpose of anti-scatter girds: JIS Z 4910: 2015 (IEC 60627: 2013) has been revised, with the new addition of an image improvement factor (Q) to the physical characteristic. Using aluminum (Al) and fiber-interspaced anti-scatter grids; we studied the meaning of Q by calculating each of the physical characteristics and assessing the image. The experimental method was based on JIS Z 4910: 2015. The two anti-scatter grids had a grid ratio of 12: 1 and a strip frequency of 40 cm^-1. Assessment items consisted of grid exposure factor (B), grid selectivity (Σ), contrast improvement ratio (K), and Q. In addition, the contrast to noise ratio (CNR) and contrast-detail curve (CD-curve) were determined from the contrast-detail phantom image, and the inverse image quality figure (IQF) was then calculated from the CD-curve. Compared to the Al-interspaced anti-scatter grid, the fiber-interspaced anti-scatter grid had B at 0.87, Σ at 0.95, K at 0.99, and Q at 1.14. In the assessment of the contrast-detail phantom image, the fiber-interspaced anti-scatter grid had an IQF of 1.02 times and a CNR of approximately 1.24 times when compared to the Al interspaced anti-scatter grid. The fiber-interspaced anti-scatter grid was superior with respect to the B and Q of the physical characteristics and to the CNR of image quality assessment.

Real time implementation of anti-scatter grid artifact elimination method for high resolution x-ray imaging CMOS detectors using Graphics Processing Units (GPUs)

Scatter is one of the most important factors effecting image quality in radiography. One of the best scatter reduction methods in dynamic imaging is an anti-scatter grid. However, when used with high resolution imaging detectors these grids may leave grid-line artifacts with increasing severity as detector resolution improves. The presence of such artifacts can mask important details in the image and degrade image quality. We have previously demonstrated that, in order to remove these artifacts, one must first subtract the residual scatter that penetrates through the grid followed by dividing out a reference grid image; however, this correction must be done fast so that corrected images can be provided in real-time to clinicians. In this study, a standard stationary Smit-Rontgen x-ray grid (line density - 70 lines/cm, grid ratio - 13:1) was used with a high-resolution CMOS detector, the Dexela 1207 (pixel size - 75 micron) to image anthropomorphic head phantoms. For a 15 × 15 cm field-of-view (FOV), scatter profiles of the anthropomorphic head phantoms were estimated then iteratively modified to minimize the structured noise due to the varying grid-line artifacts across the FOV. Images of the head phantoms taken with the grid, before and after the corrections, were compared, demonstrating almost total elimination of the artifact over the full FOV. This correction is done fast using Graphics Processing Units (GPUs), with 7-8 iterations and total time taken to obtain the corrected image of only 87 ms, hence, demonstrating the virtually real-time implementation of the grid-artifact correction technique.

Scatter estimation and removal of anti-scatter grid-line artifacts from anthropomorphic head phantom images taken with a high resolution image detector

In radiography, one of the best methods to eliminate image-degrading scatter radiation is the use of anti-scatter grids. However, with high-resolution dynamic imaging detectors, stationary anti-scatter grids can leave grid-line shadows and moiré patterns on the image, depending upon the line density of the grid and the sampling frequency of the x-ray detector. Such artifacts degrade the image quality and may mask small but important details such as small vessels and interventional device features. Appearance of these artifacts becomes increasingly severe as the detector spatial resolution is improved. We have previously demonstrated that, to remove these artifacts by dividing out a reference grid image, one must first subtract the residual scatter that penetrates the grid; however, for objects with anatomic structure, scatter varies throughout the FOV and a spatially differing amount of scatter must be subtracted. In this study, a standard stationary Smit-Rontgen X-ray grid (line density - 70 lines/cm, grid ratio - 13:1) was used with a high-resolution CMOS detector, the Dexela 1207 (pixel size - 75 micron) to image anthropomorphic head phantoms. For a 15 × 15cm FOV, scatter profiles of the anthropomorphic head phantoms were estimated then iteratively modified to minimize the structured noise due to the varying grid-line artifacts across the FOV. Images of the anthropomorphic head phantoms taken with the grid, before and after the corrections, were compared demonstrating almost total elimination of the artifact over the full FOV. Hence, with proper computational tools, anti-scatter grid artifacts can be corrected, even during dynamic sequences.

Design and evaluation of a grid reciprocation scheme for use in digital breast tomosynthesis

This work describes a methodology for efficient removal of scatter radiation during digital breast tomosynthesis (DBT). The goal of this approach is to enable grid image obscuration without a large increase in radiation dose by minimizing misalignment of the grid focal point (GFP) and x-ray focal spot (XFS) during grid reciprocation. Hardware for the motion scheme was built and tested on the dual modality breast tomosynthesis (DMT) scanner, which combines DBT and molecular breast tomosynthesis (MBT) on a single gantry. The DMT scanner uses fully isocentric rotation of tube and x-ray detector for maintaining a fixed tube-detector alignment during DBT imaging. A cellular focused copper prototype grid with 80 cm focal length, 3.85 mm height, 0.1 mm thick lamellae, and 1.1 mm hole pitch was tested. Primary transmission of the grid at 28 kV tube voltage was on average 74% with the grid stationary and aligned for maximum transmission. It fell to 72% during grid reciprocation by the proposed method. Residual grid line artifacts (GLAs) in projection views and reconstructed DBT images are characterized and methods for reducing the visibility of GLAs in the reconstructed volume through projection image flat-field correction and spatial frequency-based filtering of the DBT slices are described and evaluated. The software correction methods reduce the visibility of these artifacts in the reconstructed volume, making them imperceptible both in the reconstructed DBT images and their Fourier transforms.

Anti-scatter grid artifact elimination for high resolution x-ray imaging CMOS detectors

Higher resolution in dynamic radiological imaging such as angiography is increasingly being demanded by clinicians; however, when standard anti-scatter grids are used with such new high resolution detectors, grid-line artifacts become more apparent resulting in increased structured noise that may overcome the contrast signal improvement benefits of the scatter-reducing grid. Although grid-lines may in theory be eliminated by dividing the image of a patient taken with the grid by a flat-field image taken with the grid obtained prior to the clinical image, unless the remaining additive scatter contribution is subtracted in real-time from the dynamic clinical image sequence before the division by the reference image, severe grid-line artifacts may remain. To investigate grid-line elimination, a stationary Smit Röntgen X-ray grid (line density: 70 lines/cm, grid ratio 13:1) was used with both a 75 micron-pixel CMOS detector and a standard 194 micron-pixel flat panel detector (FPD) to image an artery block insert placed in a modified uniform frontal head phantom for a 20 × 20cm FOV (approximately). Contrast and contrast-to-noise ratio (CNR) were measured with and without scatter subtraction prior to grid-line correction. The fixed pattern noise caused by the grid was substantially higher for the CMOS detector compared to the FPD and caused a severe reduction of CNR. However, when the scatter subtraction corrective method was used, the removal of the fixed pattern noise (grid artifacts) became evident resulting in images with improved CNR.

Limitations of anti-scatter grids when used with high resolution image detectors

Anti-scatter grids are used in fluoroscopic systems to improve image quality by absorbing scattered radiation. A stationary Smit Rontgen X-ray grid (line density: 70 lines/cm, grid ratio: 13:1) was used with a flat panel detector (FPD) of pixel size 194 micron and a high-resolution CMOS detector, the Dexela 1207 with pixel size of 75 microns. To investigate the effectiveness of the grid, a simulated artery block was placed in a modified uniform frontal head phantom and imaged with both the FPD and the Dexela for an approximately 15 × 15 cm field of view (FOV). The contrast improved for both detectors with the grid. The contrast-to-noise ratio (CNR) does not increase as much in the case of the Dexela as it improves in the case of the FPD. Since the total noise in a single frame increases substantially for the Dexela compared to the FPD when the grid is used, the CNR is degraded. The increase in the quantum noise per frame would be similar for both detectors when the grid is used due to the attenuation of radiation, but the fixed pattern noise caused by the grid was substantially higher for the Dexela compared to the FPD and hence caused a severe reduction of CNR. Without further corrective methods this grid should not be used with high-resolution fluoroscopic detectors because the CNR does not improve significantly and the visibility of low contrast details may be reduced. Either an anti-scatter grid of different design or an additional image processing step when using a similar grid would be required to deal with the problem of scatter for high resolution detectors and the structured noise of the grid pattern.

Optimisation in general radiography

Radiography using film has been an established method for imaging the internal organs of the body for over 100 years. Surveys carried out during the 1980s identified a wide range in patient doses showing that there was scope for dosage reduction in many hospitals. This paper discusses factors that need to be considered in optimising the performance of radiographic equipment. The most important factor is choice of the screen/film combination, and the preparation of automatic exposure control devices to suit its characteristics. Tube potential determines the photon energies in the X-ray beam, with the selection involving a compromise between image contrast and the dose to the patient. Allied to this is the choice of anti-scatter grid, as a high grid ratio effectively removes the larger component of scatter when using higher tube potentials. However, a high grid ratio attenuates the X-ray beam more heavily. Decisions about grids and use of low attenuation components are particularly important for paediatric radiography, which uses lower energy X-ray beams. Another factor which can reduce patient dose is the use of copper filtration to remove more low-energy X-rays. Regular surveys of patient dose and comparisons with diagnostic reference levels that provide a guide representing good practice enable units for which doses are higher to be identified. Causes can then be investigated and changes implemented to address any shortfalls. Application of these methods has led to a gradual reduction in doses in many countries.