Clinical utility of postprocessed low-dose radiographs in skeletal imaging

Objectives: Radiography remains the mainstay of diagnostic and follow-up imaging. In view of the risks and the increasing use of ionizing radiation, dose reduction is a key issue for research and development. The introduction of digital radiography and the associated access to image postprocessing have opened up new opportunities to minimize the radiation dosage. These advances are contingent upon quality controls to ensure adequate image detail and maintenance of diagnostic confidence. The purpose of this study was to investigate the clinical applicability of postprocessed low-dose images in skeletal radiography. Methods: In our study setting, the median radiation dose for full dose x-rays was 9.61 dGy*cm2 for pelvis, 1.20 dGy*cm2 for shoulder and 18.64 dGy*cm2 for lumbar spine exams. Based on these values, we obtained 200 radiographs for each anatomic region in four consecutive steps, gradually reducing the dose to 84%, 71%, 60 and 50% of the baseline using an automatic exposure control (AEC). 549 patients were enrolled for a total of 600 images. All x-rays were postprocessed with a spatial noise reduction algorithm. Two radiologists assessed the diagnostic value of the radiographs by rating the visualization of anatomical landmarks and image elements on a five-point Likert scale. A mean-sum score was calculated by averaging the two reader’s total scores. Given the non-parametric distribution, we used the Mann-Whitney U test to evaluate the scores. Results: Median dosage at full dose accounted for 38.4%, 48 and 53.2% of the German reference dose area product for shoulder, pelvis and lumbar spine, respectively. The applied radiation was incrementally reduced to 21.5%, 18.4% and 18.7% of the respective reference value for shoulder, pelvis and lumbar spine. Throughout the study, we observed an estimable tendency of superior quality at higher dosage in overall image quality. Statistically significant differences in image quality were restricted to the 50% dose groups in shoulder and lumbar spine images. Regardless of the applied dosage, 598 out of 600 images were of sufficient diagnostic value. Conclusion: In digital radiography image postprocessing allows for extensive reduction of radiation dosage. Despite a trend of superior image detail at higher dose levels, overall quality and, more importantly, diagnostic utility of low-dose images was not significantly affected. Therefore, our results not only confirm the clinical utility of postprocessed low-dose radiographs, but also suggest a widespread deployment of this advanced technology to ensure further dose limitations in clinical practice. Advances in knowledge: The diagnostic image quality of postprocessed skeletal radiographs is not significantly impaired even after extensive dose reduction by up to 20% of the reference value.

Improvement of CT Target Scanning Quality for Pulmonary Nodules by PDCA Management Method

High CT image quality is an important guarantee for doctors to correctly diagnose pulmonary nodules. The aim of this study was to explore the application value of PDCA management method in improving the quality of CT target scanning for pulmonary nodules. We identified 480 patients’ CT image with at least one pulmonary nodule admitted in Ninghai First hospital from September 1st, 2018, to April 30th, 2019. 240 CT images are carried out by the conventional target scanning method, and we analyzed the reasons for the low quality of some CT target scanning images of pulmonary nodules in the radiology department of our hospital. We established a new process of CT target scanning for pulmonary nodules based on the PDCA method and then tested 240 patients who were checked after January 1st, 2019. The excellent rate of CT target scanning image of pulmonary nodules in our department increased from 60.0% to more than 90.0%. The patients’ satisfaction with the examination was significantly higher than that without the implementation of PDCA management. The research result indicated that the process of CT target scanning image, postprocessing reconstruction, and numerical measurement of pulmonary nodules can be improved by standardized PDCA cycle, which benefits effectively improving the theoretical and operational skills of radiologists and significantly improving the image quality rate of CT target scanning of pulmonary nodules.

Spatial Domain-Based Nonlinear Residual Feature Extraction for Identification of Image Operations

In this paper, a novel approach that uses a deep learning technique is proposed to detect and identify a variety of image operations. First, we propose the spatial domain-based nonlinear residual (SDNR) feature extraction method by constructing residual values from locally supported filters in the spatial domain. By applying minimum and maximum operators, diversity and nonlinearity are introduced; moreover, this construction brings nonsymmetry to the distribution of SDNR samples. Then, we propose applying a deep learning technique to the extracted SDNR features to detect and classify a variety of image operations. Many experiments have been conducted to verify the performance of the proposed approach, and the results indicate that the proposed method performs well in detecting and identifying the various common image postprocessing operations. Furthermore, comparisons between the proposed approach and the existing methods show the superiority of the proposed approach.

Wedge prism approach for simultaneous multichannel microscopy

Multichannel (multicolor) imaging has become a powerful technique in biology research for performing in vivo neuronal calcium imaging, colocalization of fluorescent labels, non-invasive pH measurement, and other procedures. We describe a novel add-on approach for simultaneous multichannel optical microscopy based on simple wedge prisms. Our device requires no alignment and is simple, robust, user-friendly, and less expensive than current commercial instruments based on switchable filters or dual-view strategies. Point spread function measurements and simulations in Zemax indicate a reduction in resolution in the direction orthogonal to the wedge interface and in the axial direction, without introducing aberration. These effects depend on the objective utilized and are most significant near the periphery of the field of view. We tested a two-channel device on C. elegans neurons in vivo and demonstrated comparable signals to a conventional dual-view instrument. We also tested a four-channel device on fixed chick embryo Brainbow samples and identified individual neurons by their spectra without extensive image postprocessing. Therefore, we believe that this technology has the potential for broad use in microscopy.