Jelena M Mihailovic, Yoshihisa Kanaji, Daniel Miller, Malcolm R Bell, Kenneth A Fetterly
{"title":"Comparison of human observer impression of X-ray fluoroscopy and angiography image quality with technical changes to image quality.","authors":"Jelena M Mihailovic, Yoshihisa Kanaji, Daniel Miller, Malcolm R Bell, Kenneth A Fetterly","doi":"10.1117/1.JMI.11.4.045502","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Spatio-temporal variability in clinical fluoroscopy and cine angiography images combined with nonlinear image processing prevents the application of traditional image quality measurements in the cardiac catheterization laboratory. We aimed to develop and validate methods to measure human observer impressions of the image quality.</p><p><strong>Approach: </strong>Multi-frame images of the thorax of a euthanized pig were acquired to provide an anatomical background. The detector dose was varied from 6 to 200 nGy (increments 2×), and 0.6 and 1.0 mm focal spots were used. Two coronary stents with/without 0.5 mm separation and a synthetic right coronary artery (RCA) with hemispherical defects were embedded into the background images as test objects. The quantitative observer ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>17</mn></mrow> </math> ) performance was measured using a two-alternating forced-choice test of whether stents were separated and by a count of visible right coronary artery defects. Qualitative impressions of noise, spatial resolution, and overall image quality were measured using a visual analog scale (VAS). A paired <math><mrow><mi>t</mi></mrow> </math> -test and multinomial logistic regression model were used to identify statistically significant factors affecting the observer's impression image quality.</p><p><strong>Results: </strong>The proportion of correct detection of stent separation and the number of reported right coronary artery defects changed significantly with detector dose increment in the 6 to 100 nGy ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> ). Although a trend favored the 0.6 versus 1.0 mm focal spot for these quantitative assessments, this was insignificant. Visual analog scale measurements changed significantly with detector dose increments in the range of 24 to 100 nGy and focal spot size ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> ). The application of multinomial logistic regression analysis to observer VAS scores demonstrated sensitivity matching of the paired <math><mrow><mi>t</mi></mrow> </math> -test applied to quantitative observer performance measurements.</p><p><strong>Conclusions: </strong>Both quantitative and qualitative measurements of observer impression of the image quality were sensitive to image quality changes associated with changing the detector dose and focal spot size. These findings encourage future work that uses qualitative image quality measurements to assess clinical fluoroscopy and angiography image quality.</p>","PeriodicalId":47707,"journal":{"name":"Journal of Medical Imaging","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316400/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1117/1.JMI.11.4.045502","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/10 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Spatio-temporal variability in clinical fluoroscopy and cine angiography images combined with nonlinear image processing prevents the application of traditional image quality measurements in the cardiac catheterization laboratory. We aimed to develop and validate methods to measure human observer impressions of the image quality.
Approach: Multi-frame images of the thorax of a euthanized pig were acquired to provide an anatomical background. The detector dose was varied from 6 to 200 nGy (increments 2×), and 0.6 and 1.0 mm focal spots were used. Two coronary stents with/without 0.5 mm separation and a synthetic right coronary artery (RCA) with hemispherical defects were embedded into the background images as test objects. The quantitative observer ( ) performance was measured using a two-alternating forced-choice test of whether stents were separated and by a count of visible right coronary artery defects. Qualitative impressions of noise, spatial resolution, and overall image quality were measured using a visual analog scale (VAS). A paired -test and multinomial logistic regression model were used to identify statistically significant factors affecting the observer's impression image quality.
Results: The proportion of correct detection of stent separation and the number of reported right coronary artery defects changed significantly with detector dose increment in the 6 to 100 nGy ( ). Although a trend favored the 0.6 versus 1.0 mm focal spot for these quantitative assessments, this was insignificant. Visual analog scale measurements changed significantly with detector dose increments in the range of 24 to 100 nGy and focal spot size ( ). The application of multinomial logistic regression analysis to observer VAS scores demonstrated sensitivity matching of the paired -test applied to quantitative observer performance measurements.
Conclusions: Both quantitative and qualitative measurements of observer impression of the image quality were sensitive to image quality changes associated with changing the detector dose and focal spot size. These findings encourage future work that uses qualitative image quality measurements to assess clinical fluoroscopy and angiography image quality.
期刊介绍:
JMI covers fundamental and translational research, as well as applications, focused on medical imaging, which continue to yield physical and biomedical advancements in the early detection, diagnostics, and therapy of disease as well as in the understanding of normal. The scope of JMI includes: Imaging physics, Tomographic reconstruction algorithms (such as those in CT and MRI), Image processing and deep learning, Computer-aided diagnosis and quantitative image analysis, Visualization and modeling, Picture archiving and communications systems (PACS), Image perception and observer performance, Technology assessment, Ultrasonic imaging, Image-guided procedures, Digital pathology, Biomedical applications of biomedical imaging. JMI allows for the peer-reviewed communication and archiving of scientific developments, translational and clinical applications, reviews, and recommendations for the field.