Sharpness and noise in digital chest radiographs, assessed by visual rating
DOI:
https://doi.org/10.7577/radopen.1528Keywords:
Digital imaging, exposure techniques, image acquiring, image quality, optimization, radiographic interpretationAbstract
Missed lung lesions are one of the most frequent causes of malpractice issues, caused by several reasons; among them suboptimal radiography. When radiographers interpret acquired images of a patient, an acceptance or rejection must be decided. When a retake is required, radiographers need to know how to improve the image quality. Improvements in image quality properties as contrast, sharpness and noise often lead to improved perception, which in turn should enable more information to the observer and also allow computer-assisted detection (CAD) to be more successful.
Our aim was to create a scoring system of the principal limiting factors sharpness and noise, in a clinical setting, and to determine whether it is possible to agree on image quality on digital chest radiographs. To enable a variation in rating due to body habits, a three-graded scale for each of sharpness and noise were created. Five different anatomical landmarks in each of patients having body sizes lean, normal and large were evaluated by 27 radiographers; totally 810 scores were given.
The results showed a high inter-observer agreement with respect to rating grades of both sharpness and noise, independent of projection, anatomical landmark and body habits. The present study is a first step in the development of a scale for assessing sharpness and noise in digital chest radiography. The method of quality assessment might become more valid with increased use. We propose that this study can be followed up by a systematic mentor-guided training program that links perception of image quality to feedback about the image retake decisions if required.
References
2. Bach PB, Kelley MJ, Tate RC, McCrory DC. Screening for lung cancer: a review of the current literature. Chest. 2003 Jan; 123 (1 Suppl):72S-82S. https://https://doi.org/10.1378/chest.123.1_suppl.72S
3. Fryback DG, Thornbury JR. The efficacy of diagnostic imaging. Medical Descision Making 1991;11(2):88-94. https://https://doi.org/10.1177/0272989X9101100203
4. Garland LH. Studies on the accuracy of diagnostic procedures. American Journal of Roentgenolgy, Radium Therapy and Nuclear Medicine 1959;July(82):1-25.
5. European Society of Radiology. Risk Management in Radiology in Europe. European Society of Radiology; 2007.
6. Monnier-Cholley L, Arrivè L, Procel A, Dahan H, Urban T, Febcre M, et al. Characteristics of missed lung cancer on chest radiographs: a French experience. European Radiology 2005;11(4):597-605. https://https://doi.org/10.1007/s003300000595
7. Quekel L, Kessels A, Goei R, van Engelshoven J. Miss rate of lung cancer on the chest radiograph in clinical practice. Chest 1999 Mar 1;115(3):720-4. https://https://doi.org/10.1378/chest.115.3.720
8. Turkington PM, Kennan N, Greenstone MA. Misinterpretation of the chest x ray as a factor in the delayed diagnosis of lung cancer. Postgraduate Medicine Journal 2002 Mar 1;78(917):158-60. https://https://doi.org/10.1136/pmj.78.917.158
9. Forrest JV, Friedman PJ. Radiologic Errors in Patients With Lung Cancer. Western Journal of Medicine 1981;134(6):485-90.
10. Lazarioti F, Boulikas T. Diagnostic and Therapeutic Efficacy of Imaging Modalities in Non-Small Cell Lung Cancer (NSCLC): experience from a Phase III clinical study using tumor targeted Lipoplatin nanoparticles. Cancer Therapy 2008;6:629-46.
11. Muhm JR, Miller WE, Fontana RS, Sanderson DR, Uhlenhopp MA. Lung cancer detected during a screening program using four-month chest radiographs. Radiology 1983 Sep;148(3):609-15. https://https://doi.org/10.1148/radiology.148.3.6308709
12. Austin JH, Romney BM, Goldsmith LS. Missed bronchogenic carcinoma: radiographic findings in 27 patients with a potentially resectable lesion evident in retrospect. Radiology 1992 Jan 1;182(1):115-22. https://https://doi.org/10.1148/radiology.182.1.1727272
13. Sone S, Li F, Yang ZG, Takashima S, Maruyama Y, Hasegava M, et al. Characteristics of small lung cancers invisible on conventional chest radiography and detected by population based screening using spiral CT. British Journal of Radiology 2000 Feb 1;73(866):137-45. https://https://doi.org/10.1259/bjr.73.866.10884725
14. Shah PK, Austin JHM, White CS, Patel P, Haramati LB, Pearson GDN, et al. Missed Non-Small Cell Lung Cancer: Radiographic Findings of Potentially Resectable Lesions Evident Only in Retrospect. Radiology 2003 Jan 1;226(1):235-41. https://https://doi.org/10.1148/radiol.2261011924
15. White CS, Flukinger T, Jeudy J, Chen JJ. Use of a Computer-aided Detection System to Detect Missed Lung Cancer at Chest Radiography. Radiology, 2009: 252:1 273-281; https://doi:10.1148/radiol.2522081319
16. Nedumaran PA, Olson S, Gomersall L, Weir J. Missed Lung Cancers in Chest X-Ray. Aberdeen Royal Infirmary, University of Aberdeen: Royal College of Radiologists, Annual Scientific Meeting; 2004. Report No.: 2004, Audit Poster Prize.
17. Chotas HG, Ravin CE. Chest radiography: estimated lung volume and projected area obscured by the heart, mediastinum, and diaphragm. Radiology 1994 Nov 1;193(2):403-4. https://https://doi.org/10.1148/radiology.193.2.7972752
18. Berlin L. Accuracy of Diagnostic Procedures: Has It Improved Over the Past Five Decades? American Journal of Roentgenology 2007 May 1;188(5):1173-8. https://https://doi.org/10.2214/AJR.06.1270
19. Polunin N, Lim TA, Tan KP. Reduction in retake rates and radiation dosage through computed radiography. Annals, Academy of Medicine, Singapore 1998;27:805-7.
20. Wu MH, Gotway MB, Lee TJ, Chern MS, Cheng HC, Ko JSC, et al. Features of non-small cell lung carcinomas overlooked at digital chest radiography. Clinical Radiology 2008 May;63(5):518-28. https://https://doi.org/10.1016/j.crad.2007.09.011
21. Foos DH, Sehnert J, Reiner B, Siegel EL, Sagel A, Waldman DL. Digital Radiography Reject Analysis: Data Collection Methodology, Results, and Recommendations from an In-depth Investigation at Two Hospitals. Journal of Digital Imaging 2009;1618-727X (Online). https://https://doi.org/10.1007/s10278-008-9112-5
22. White CS, Flukinger T, Jeudy J, Chen JJ. Use of a Computer-aided Detection System to Detect Missed Lung Cancer at Chest Radiography. Radiology, 2009: 252:1 273-281; https://doi:10.1148/radiol.2522081319
23. Institute of Physics and Engineering in Medicine. Recommended standards for the routine performance testing of diagnostic x-ray imaging systems, 2005. IPEM Report No. 77.
24. Reiner BI, Siegel EL, Siddiqui KM, Musk AE. Quality Assurance: The Missing Link. Radiology 2006 Jan 1;238(1):13-5. https://https://doi.org/10.1148/radiol.2381050357
25. European Commission. European guidelines for quality criteria for diagnostic radiographic images. Luxembourg: Office for Official Publications of the European Communities; 1996. Report No.: EUR 16260.
26. DIMOND III. Final report. Image Quality and Dose Management for Digital Radiography.Work Package 1. Clinical Quality Criteria and Technical Parameters. Diagnostic Requirements for Digital Projection Radiography. 2009. Report No.: Chapter III.
27. Vyborny C, Bunch P, Chotas J, Dobbins JTI, Niklason L, Schaefer-Prokop C. Image quality in chest radiography. Nuclear Technology Publishing, Ashford, Kent, UK; 2003. Report No. 3.
28. Kroft LJM, Veldkamp WJH, Mertens BJA, Boot MV, Geleijns J. Comparison of Eight Different Digital Chest Radiography Systems: Variation in Detection of Simulated Chest Disease. American Journal of Roentgenology 2005;185:339-46. https://https://doi.org/10.2214/ajr.185.2.01850339
29. Vano E, Guibelalde E, Morillo A, Alvarez-Pedrosa CS, Fernandez JM. Evaluation of the European image quality criteria for chest examinations. British Journal of Radiology 1995 Dec;68(16):1359-5.
30. American College of Radiology. Radiologic Technologist Quality Control Forms. Mammography, Testing and QC Forms. http://www.acr.org/Quality-Safety/Accreditation/Mammography/Testing-and-QC-Forms/RadTech-QC-Forms . (Accessed on November 11, 2015.)
31. Hofvind S, Vee B, Sørum R, Hauge M, Ertzaas AK. Quality assurance of mammograms in the Norwegian Breast Cancer Screening Program. European Journal of Radiography 2009Mar;1(1):22-9. https://https://doi.org/10.1016/j.ejradi.2008.11.002
32. Carrino JA. Digital image quality; A clinical perspective. In: Reiner BI, Siegel EL, Carrino JA, editors. Quality Assurance. Meeting the Challenge in the Digital Medical Enterprise. Society for Computer Applications in Radiology; 2002. p. 29-37.
33. Sprawls, P. Physical Principles of Medical Imaging, 2005 Gaithersburg, Aspen Publishers
34. Marshall NW, Kotre CJ, Robson KJ, Lecomber AR. Receptor dose in digital fluorography: a comparison between theory and practice. Physics in Medicine & Biology 2001;46:1283-96. https://https://doi.org/10.1088/0031-9155/46/4/325
35. Van Metter Rl, Yorkston L. Factors influencing image quality in digital radiographic systems", Proc. SPIE 4320, Medical Imaging 2001: Physics of Medical Imaging, 244 (June 28, 2001); https://doi:10.1117/12.430923; http://dx.https://doi.org/10.1117/12.430923
36. Vyborny C, Bunch P, Chotas J, Dobbins JTI, Niklason L, Schaefer-Prokop C. Image quality in chest radiography. Nuclear Technology Publishing, Ashford, Kent, UK; 2003. Report No. 3.
37. Fink C, Hallscheidt PJ, Noeldge G, Kampschulte A, Radeleff B, Hosch WP, et al. Clinical Comparative Study with a Large-Area Amorphous Silicon Flat-Panel Detector. Image Quality and Visibility of Anatomic Structures on Chest Radiography. American Journal of Radiology 2002;178:481-6.
38. Vyborny C. Image quality and the clinical radiographic examination. RadioGraphics 1997 Mar 1;17(2):479-98. https://https://doi.org/10.1148/radiographics.17.2.9084085
39. De Groote A, Wantier M, Cheron G, Estenne M, Paiva M. Chest wall motion during tidal breathing. Journal of Applied Physiology 1997 Nov 1;83(5):1531-7.
40. Håkansson M, Bath M, Borjesson S, Kheddache S, Flinck A, Ullman G, et al. Nodule detection in digital chest radiography: effect of nodule location. Radiation Protection Dosimetry 2005 May 17;114(1-3):92-6. https://doi.org/10.1093/rpd/nch525
41. Van Ongeval C, Van Steen A, Geniets C, Dekeyzer F, Bosmans H, Marchal G. Clinical image quality criteria for full field digital mammography: a first practical application. Radiation Protection Dosimetry 2008 Mar 1;129(1-3):265-70. https://doi.org/10.1093/rpd/ncn029
42. Taplin SH, Rutter CM, Finder C, Mandelson MT, Houn F, White E. Screening mammography: Clinical image quality and the risk of interval breast cancer. American Journal of Roentgenology 2002 Apr 1;178(4):797-803. https://doi.org/10.2214/ajr.178.4.1780797
43. Bath M, Mansson LG. Visual grading characteristics (VGC) analysis: a non-parametric rank-invariant statistical method for image quality evaluation. British Journal of Radiology 2007 Mar 1;80(951):169-76. https://doi.org/10.1259/bjr/35012658
44. Verschakelen J, Bellon E, Deprez T. Digital chest radiography: Quality assurance. Journal of Thoracic Imaging 2003 Jul;18(3):169-77. https://doi.org/10.1097/00005382-200307000-00006
45. Lazarus E, Mainiero MB, Schepps B, Koelliker SL, Livingston LS. BI-RADS Lexicon for US and Mammography: Interobserver Variability and Positive Predictive Value. Radiology 2006 Mar 28;2392042127. https://doi.org/10.1148/radiol.2392042127
46. Ween B, Kristoffersen DT, Hamilton GA, Olsen DR. Image quality preferences among radiographers and radiologists. A conjoint analysis. Radiography 2005 Aug;11(3):191-7. https://doi.org/10.1016/j.radi.2005.03.002
47. Kraemer.H.C., Periyakoil VS, Noda A. Kappa coefficients in medical research. Tutorials in Biostatistics. John Wiley & Sons, Ltd.; 2002. p. 85-105.
48. Nodine CF, Kundel HL, Mello-Thoms C, Weinstein SP, Orel SG, Sullivan DC, et al. How experience and training influence mammography expertise. Academic Radiology 1999 Oct;6(10):575-85. https://doi.org/10.1016/S1076-6332(99)80252-9
49. MacMahon H. Digital chest radiography: Practical issues. Journal of Thorasic Imaging 2003 Jul 1;18(3):138-47. https://doi.org/10.1097/00005382-200307000-00003
50. Krupinski EA, Roehrig H, Dallas W, Fan J. Differential Use of Image Enhancement Techniques by Experienced and Inexperienced Observers. Journal of Digital Imaging 2005;18(4):311-5. https://doi.org/10.1007/s10278-005-7666-z
51. Fitzmaurice C, Dicker D, et al. Global Burden of Disease Cancer Collaboration. The Global Burden of Cancer 2013. JAMA Oncol 2015; 1:505 https://doi.org/10.1001/jamaoncol.2015.0735
52. Deffebach DE, Humphrey L. Screening for lung cancer. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on November 11, 2015.) https://doi.org/10.1016/j.suc.2015.05.006
53. Howarth N, Tack D. Missed lung lesions. In: Coche E, Ghaye E, de May J, Duyck P (eds). Comparative Interpretation of CT and Standard Radiograpy of the Chest. Springer 2011 https://doi.org/10.1007/978-3-540-79942-9_15
54. Doyle P, Martin CJ, Gentle D. Dose-image quality optimisation in digital chest radiography. Radiation Protection Dosimetry 2005 May 17;114(1-3):269-72 https://doi.org/10.1093/rpd/nch546
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