Mr. Mark A. Forsberg Profile

Mark A. Forsberg

Student at Thomas Jefferson Universtiy Hospital

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Proceedings Article | 10 March 2017 Paper

Do quantitative metrics derived from standard fluoroscopy phantoms used for quality control assess vendor-specific advancements in interventional fluoroscopy systems?

Mark Forsberg, David Eschelman, Prakruti Talreja, Jaydev Dave

Proceedings Volume 10136, 1013619 (2017) https://doi.org/10.1117/12.2254561

KEYWORDS: Fluoroscopy, Image quality, Standards development, Image quality standards, Modulation transfer functions, Image processing, Control systems, Signal processing, Image analysis, Quantitative analysis, Spatial resolution, Sensors

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Approximately 9 million fluoroscopically-guided interventional procedures are performed annually in the USA. Recent technological advancements for interventional fluoroscopy systems have focused towards vendor-specific real-time image and signal processing. Hence, the purpose of this study was to evaluate if quantitative metrics derived from standard image quality phantoms, routinely used for quality control, are able to distinguish vendor-specific processing features for interventional fluoroscopy systems. Six standard image quality phantoms were used to measure contrast-to-noise ratio (CNR), full-width-at-half-maximum (for determining edge blurring) and modulation transfer function, to analyze contrast detail characteristics, and to assess digital subtraction angiography (DSA) performance of six flat-panel detector based interventional fluoroscopy systems from Philips (with and without ClarityIQ) and Siemens. Phantom data were acquired at different dose modes and field-of-view settings. Fluoroscopy loops and digital subtraction acquisitions were saved (duration 3 seconds; repeated 3 times). Images were analyzed off-line using ImageJ. CNR measurements showed no differences between systems, whereas the contrast-detail analysis and edge blurring characterization showed relatively low performance of Philips Clarity systems compared to Siemens and Philips non-Clarity systems. Conversely, the modulation transfer function showed that the limiting spatial resolution was higher for the Philips systems relative to the Siemens suite. However, with the DSA phantom the performance of Siemens and Philips Clarity-systems was similar. In conclusion, depending on the image quality phantom used for comparing different systems, the results may differ and therefore, quantitative metrics derived from standard fluoroscopy phantoms lack the discriminatory ability to assess vendor-specific advancements in interventional fluoroscopy systems.

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