Congress:
EuroSafe Imaging 2016
Keywords:
Action 7 - Medical radiation protection research: MELODI, EURAMED, Action 6 - Education and training in medical radiation protection, Action 3 - Optimisation, diagnostic reference levels, image quality, Action 2 - Clinical diagnostic reference levels (DRLs), Action 8 - Radiation protection training and learning material, Action 9 - Facilitation of research in advanced topics of radiation protection
Authors:
W. Stiller, G. Pahn, A. Steuwe, J. Hansen, S. Skornitzke, H. U. Kauczor
DOI:
10.1594/esi2016/ESI-0052
Conclusion and Recommendations
The image quality which is to be seen as the “minimum necessary” or,
in the sense of radiation protection,
as the “appropriate” image quality for a particular diagnostic task,
must be ensured for all patients to be examined independent of their constitution,
with minimum radiation exposure [5].
The definition of such diagnostic task-based “appropriate image quality” should be based on standardized quality criteria as set by the clinicians’ requirements of everyday clinical routine by subspecialty.
To this end,
the development of a questionnaire for the identification of the determinants of “appropriate image quality” in terms of spatial resolution,
low-contrast detectability and image noise is currently discussed for the ten most important indications of each subspecialty as identified by a panel of specialists on a “per-organ” basis,
founding on the following criteria:
- Spatial resolution: Definition of the minimum size of features (in millimeters [mm]) that need to be detectable in view of critical findings
- Low-contrast detectability: Definition of the minimal difference (in Hounsfield units [HU]) that should be visually distinguishable,
and its link to feature/lesion size
- Image noise: Rating of the impact of image noise on the detectability/visibility of
- (a) fine structure detail
-
(b) low-contrast detail
e.g.
on a 3-point scale of sensitivity to image noise (1 - none
to negligible sensitivity; 2 – medium sensitivity; 3 – critical sensitivity
directly impacting diagnostic findings/reliability).
The questionnaires’ idea is to provide an initial insight into the image quality parameters potentially defining and governing “appropriate image quality” for a certain diagnostic task.
It will provide standardized criteria for direct judgement of whether the achieved image quality is appropriate for enabling reliable and reproducible diagnosis with regard to each specific diagnostic question encountered in clinical routine.
In addition,
these criteria are needed as an input for research on algorithmic approaches for automatic analysis and reporting of “appropriate image quality” on a “per-exam” basis.