Chest imaging plays a pivotal role in screening and monitoring patients, and various predictive artificial intelligence (AI) models have been developed in support of this. However, little is known about the effect of decreasing the radiation dose and, thus, image quality on AI performance. This study aims to design a low-dose simulation and evaluate the effect of this simulation on the performance of CNNs in plain chest radiography. Seven pathology labels and corresponding images from Medical Information Mart for Intensive Care datasets were used to train AI models at two spatial resolutions. These 14 models were tested using the original images, 50% and 75% low-dose simulations. We compared the area under the receiver operator characteristic (AUROC) of the original images and both simulations using DeLong testing. The average absolute change in AUROC related to simulated dose reduction for both resolutions was <0.005, and none exceeded a change of 0.014. Of the 28 test sets, 6 were significantly different. An assessment of predictions, performed through the splitting of the data by gender and patient positioning, showed a similar trend. The effect of simulated dose reductions on CNN performance, although significant in 6 of 28 cases, has minimal clinical impact. The effect of patient positioning exceeds that of dose reduction.
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Abstract gepubliceerd in Elsevier: Introduction: Recent research has identified the issue of ‘dose creep’ in diagnostic radiography and claims it is due to the introduction of CR and DR technology. More recently radiographers have reported that they do not regularly manipulate exposure factors for different sized patients and rely on pre-set exposures. The aim of the study was to identify any variation in knowledge and radiographic practice across Europe when imaging the chest, abdomen and pelvis using digital imaging. Methods: A random selection of 50% of educational institutes (n ¼ 17) which were affiliated members of the European Federation of Radiographer Societies (EFRS) were contacted via their contact details supplied on the EFRS website. Each of these institutes identified appropriate radiographic staff in their clinical network to complete an online survey via SurveyMonkey. Data was collected on exposures used for 3 common x-ray examinations using CR/DR, range of equipment in use, staff educational training and awareness of DRL. Descriptive statistics were performed with the aid of Excel and SPSS version 21. Results: A response rate of 70% was achieved from the affiliated educational members of EFRS and a rate of 55% from the individual hospitals in 12 countries across Europe. Variation was identified in practice when imaging the chest, abdomen and pelvis using both CR and DR digital systems. There is wide variation in radiographer training/education across countries.
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OBJECTIVES: To compare low contrast detail (LCD) detectability and radiation dose for routine paediatric chest X-ray (CXR) imaging protocols among various hospitals.METHODS: CDRAD 2.0 phantom and medical grade polymethyl methacrylate (PMMA) slabs were used to simulate the chest region of four different paediatric age groups. Radiographic acquisitions were undertaken on 17 X-ray machines located in eight hospitals using their existing CXR protocols. LCD detectability represented by image quality figure inverse (IQF inv) was measured physically using the CDRAD analyser software. Incident air kerma (IAK) measurements were obtained using a solid-state dosimeter. RESULTS: The range of IQF inv, between and within the hospitals, was 1.40-4.44 and 1.52-2.18, respectively for neonates; 0.96-4.73 and 2.33-4.73 for a 1-year old; 0.87-1.81 and 0.98-1.46 for a 5-year old and 0.90-2.39 and 1.27-2.39 for a 10-year old. The range of IAK, between and within the hospitals, was 8.56-52.62 μGy and 21.79-52.62 μGy, respectively for neonates; 5.44-82.82 μGy and 36.78-82.82 μGy for a 1-year old; 10.97-59.22 μGy and 11.75-52.94 μGy for a 5-year old and 13.97-100.77 μGy and 35.72-100.77 μGy for a 10-year old. CONCLUSIONS: Results show considerable variation, between and within hospitals, in the LCD detectability and IAK. Further radiation dose optimisation for the four paediatric age groups, especially in hospitals /X-ray rooms with low LCD detectability and high IAK, are required.
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