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Priorities in optimisation of medical X-ray imaging - A contribution to the debate

Mansson, LG; Bath, M and Mattsson, Sören LU (2005) In Radiation Protection Dosimetry 114(1-3). p.298-302
Abstract
A simplistic approach to optimising medical imaging is to use the lowest effective dose to the patient that does not jeopardise a correct diagnosis. With limited resources and over 1000 different types of X-ray examinations, it is not always easy to set the right priorities and to decide how to perform the optimisation. Recent research shows that the 'Rose model' for the detection of specific structures does not hold for realistic backgrounds. A reasonable conclusion regarding methods for optimisation is therefore not to use contrast-detail phantoms. Phantoms producing clinically realistic background images or real clinical images-modified with respect to quantum noise levels-are preferred. The images should be evaluated using visual... (More)
A simplistic approach to optimising medical imaging is to use the lowest effective dose to the patient that does not jeopardise a correct diagnosis. With limited resources and over 1000 different types of X-ray examinations, it is not always easy to set the right priorities and to decide how to perform the optimisation. Recent research shows that the 'Rose model' for the detection of specific structures does not hold for realistic backgrounds. A reasonable conclusion regarding methods for optimisation is therefore not to use contrast-detail phantoms. Phantoms producing clinically realistic background images or real clinical images-modified with respect to quantum noise levels-are preferred. The images should be evaluated using visual grading or receiver operating characteristic methods. The quality of many common X-ray investigations. performed with projection techniques, is not limited by quantum noise. For these, the radiation dose to the patient can be lowered without seriously affecting the outcome of the detection task. For computed tomography (CT) investigations. the obscuring effect of anatomical structures and anatomical noise is less pronounced than in projection techniques. For (7, true optimisation in terms of a trade-off between radiation dose and image quality is therefore more likely to be effective. Both the number of CT examinations performed per year and the effective dose per examination are increasing owing to the technical advances in CT-jointly leading to a steady increase in the collective dose from CT examinations. Moreover. the smaller influence of the anatomical background in CT gives a high correlation between detection tasks and radiation dose. Thus. a reasonable view to take on which examinations to optimise is to give priority to CT examinations. The recommended distribution of a full working week for optimisation, based on the relative lifetime risk of lethal cancer from diagnostic X rays and the total collective dose from CT, is to use three out of five days to optimise CT examinations, of which one day should be devoted to paediatric CT. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Radiation Protection Dosimetry
volume
114
issue
1-3
pages
298 - 302
publisher
Nuclear Technology Publishing
external identifiers
  • wos:000229927400052
  • pmid:15933125
  • scopus:21244479013
ISSN
1742-3406
DOI
10.1093/rpd/nch578
language
English
LU publication?
yes
id
a870fb01-4f3c-4010-820d-6e099c8ab8b8 (old id 895227)
date added to LUP
2008-01-16 14:22:48
date last changed
2017-03-19 04:08:15
@article{a870fb01-4f3c-4010-820d-6e099c8ab8b8,
  abstract     = {A simplistic approach to optimising medical imaging is to use the lowest effective dose to the patient that does not jeopardise a correct diagnosis. With limited resources and over 1000 different types of X-ray examinations, it is not always easy to set the right priorities and to decide how to perform the optimisation. Recent research shows that the 'Rose model' for the detection of specific structures does not hold for realistic backgrounds. A reasonable conclusion regarding methods for optimisation is therefore not to use contrast-detail phantoms. Phantoms producing clinically realistic background images or real clinical images-modified with respect to quantum noise levels-are preferred. The images should be evaluated using visual grading or receiver operating characteristic methods. The quality of many common X-ray investigations. performed with projection techniques, is not limited by quantum noise. For these, the radiation dose to the patient can be lowered without seriously affecting the outcome of the detection task. For computed tomography (CT) investigations. the obscuring effect of anatomical structures and anatomical noise is less pronounced than in projection techniques. For (7, true optimisation in terms of a trade-off between radiation dose and image quality is therefore more likely to be effective. Both the number of CT examinations performed per year and the effective dose per examination are increasing owing to the technical advances in CT-jointly leading to a steady increase in the collective dose from CT examinations. Moreover. the smaller influence of the anatomical background in CT gives a high correlation between detection tasks and radiation dose. Thus. a reasonable view to take on which examinations to optimise is to give priority to CT examinations. The recommended distribution of a full working week for optimisation, based on the relative lifetime risk of lethal cancer from diagnostic X rays and the total collective dose from CT, is to use three out of five days to optimise CT examinations, of which one day should be devoted to paediatric CT.},
  author       = {Mansson, LG and Bath, M and Mattsson, Sören},
  issn         = {1742-3406},
  language     = {eng},
  number       = {1-3},
  pages        = {298--302},
  publisher    = {Nuclear Technology Publishing},
  series       = {Radiation Protection Dosimetry},
  title        = {Priorities in optimisation of medical X-ray imaging - A contribution to the debate},
  url          = {http://dx.doi.org/10.1093/rpd/nch578},
  volume       = {114},
  year         = {2005},
}