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The purpose of this study was to compare traditional and task dependent assessments of CT image quality. Chest CT examinations were obtained with a standard protocol for subjects participating in a lung cancer-screening project. Images were selected for patients whose weight ranged from 45 kg to 159 kg. Six ABR certified radiologists subjectively ranked these images using a traditional six-point ranking scheme that ranged from 1 (inadequate) to 6 (excellent). Three subtle diagnostic tasks were identified: (1) a lung section containing a sub-centimeter nodule of ground-glass opacity in an upper lung (2) a mediastinal section with a lymph node of soft tissue density in the mediastinum; (3) a liver section with a rounded low attenuation lesion in the liver periphery. Each observer was asked to estimate the probability of detecting each type of lesion in the appropriate CT section using a six-point scale ranging from 1 (< 10%) to 6 (> 90%). Traditional and task dependent measures of image quality were plotted as a function of patient weight. For the lung section, task dependent evaluations were very similar to those obtained using the traditional scoring scheme, but with larger inter-observer differences. Task dependent evaluations for the mediastinal section showed no obvious trend with subject weight, whereas there the traditional score decreased from ~4.9 for smaller subjects to ~3.3 for the larger subjects. Task dependent evaluations for the liver section showed a decreasing trend from ~4.1 for the smaller subjects to ~1.9 for the larger subjects, whereas the traditional evaluation had a markedly narrower range of scores. A task-dependent method of assessing CT image quality can be implemented with relative ease, and is likely to be more meaningful in the clinical setting.
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