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Radiology Teaching Files
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- Imaging of the chest a teaching file?
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Other Books By Author. Food Security and Su George Mergos,Marina. New Book Releases. Contact Us. On the right is the dual x-ray beam acquisition at 60 kVp and kVp using the single, fast readout thin-film-transistor array detector. Advantages include better energy separation and better image quality at the same dose compared to the CR detector sandwich.
Disadvantages include potential for patient motion artifacts, and the need for a more complicated system interface and more costly system. Dual energy radiography can assist in the differential diagnosis of soft versus calcified lesions.
In the dual-energy image acquisition using a CR sandwich detector pair shown in the figure below, it is clear that the lesions on the composite image left are calcified as seen in the bone-only image. For the flat-panel dual energy image acquisition, note the clearly visible soft tissue lesion in the tissue-only image.
In retrospect, the lesion is reasonably easy to detect in the conventional composite image, but clearly the ribs project anatomical "noise" that interferes with the conspicuity of the relatively large lesion in the pulmonary tissues. Also of note is the cardiac motion visible in the bone-only image, where soft-tissue. Dual energy images can be manipulated with different grayscale presentations like any other digital image.
The next several sets of images demonstrate a variety of composite, tissue-only and bone-only images of the postero-anterior chest projection. Many of the images contain soft-tissue and calcified pulmonary lesions, and there are examples of energy-sensitive elements that project specific signals in either the tissue-only or bone-only images. On the left is the conventional single-energy image; in the middle is the bone-subtracted "soft-tissue only" image; on the right is the soft-tissue subtracted "bone only" image.
Imaging of the Chest: A Teaching File - Google книги
In the upper image set, the soft tissue pulmonary lesions are clearly visible in both the composite and soft-tissue only images, although there are other lesions in the heart region in the bone-only image that indicates the presence of calcium-containing lesions.
These might be due to calcium deposits in the vasculature.
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In the lower image set, there are no readily apparent lesions, but surgical clips are readily visualized on the bone only image. Image examples demonstrating grayscale manipulation. Of interest in these images is the presence of silicone in the breasts of this patient, and a soft-tissue lesion in the left upper quadrant of the lung. For flat-panel dual energy detector systems, motion can be a problem when the x-ray system is energized during the rapid contraction period of the heart end systole.
Most motion artifacts appear in and around the cardiac anatomy, and often in the pulmonary architecture and diaphragm area. Dual energy radiography can often improve the diagnostic information content and sensitivity of projection radiography in many situations by removing the anatomic shadows that can mask soft tissue lesions.
The basic principles of CT
In the example below, the composite image left does not show evidence of a pulmonary lesion, which is hidden by the overlying rib signal. By selectively removing the bone signal, a soft tissue lesion is clearly visible in the "tissue only" image middle. A subsequent CT scan for needle biopsy illustrates the cross-sectional volume of the lesion and the correlation to the dual-energy image. The value of cross-sectional imaging is nicely demonstrated, although with higher radiation dose and much higher costs.
Dual energy imaging provides the capability of selectively imaging two clinically relevant materials, namely soft tissue and bone tissue. Energy dependent differences of bone versus soft tissue are used to eliminate one tissue or the other, determined by energy spectra differences used for acquiring independent images.
X-ray beam spectra for the dual-energy approaches
Elimination of structured anatomy noise is the major benefit of the technique. Two major methods include a CR sandwich passive detector with inter-detector filter copper to achieve low front and high back image pairs. Attributes of the CR method is single-shot, no motion, but poor energy separation, resulting in noisy images for low dose typical of a chest x-ray examination. Characteristics of the DR dual energy images are the possibility of involuntary patient motion particularly the heart , but good energy separation and superior image noise properties for a given patient dose, resulting in images with excellent signal to noise ratio.
Dual Energy Radiography Acquisition and Processing. How is dual-energy radiography performed? Currently there are two clinical systems available for dual-energy radiography One specialized radiography system employs "passive" photostimulable storage phosphor imaging plates to acquire two images simultaneously.
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