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Dose Management and
                    Image Consistency / Quality




Bruce Apgar                             George Curley
Digital Imaging Specialist (Global)     Sr. Marketing Manager
                                        Sr
Image Consistency & Dose Management

 Why Image Quality & Dose Management? Why now?

 Image gently…
       gently

 “Better patient care” available,
 especially for neonatal patients
 and pediatrics

 And ALARA…




               Image Gently used with permission. Other Images from web sites, used w/o permission


                              Global D.I.R. Meeting
                              Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management

 Why Image Quality & Dose Management? Why now?

 New technology, new standards
     technology




                    Global D.I.R. Meeting
                    Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management

Why Dose Management & Image Consistency? Why now?

   1. Di it l I
   1 Digital Imaging is no longer a novelty or only available at large
                  i   i      l            lt     l     il bl t l
   luminary institutions. It is “everywhere”
   2. Agfa has the experience, technology & tools to meet you needs!


More importantly, education is lacking for technologists,
administrators and even for physicians
                            physicians…




                         Global D.I.R. Meeting
                         Mortsel, February 21 – 23, 2011
Image Quality and Dose Management
Begins with Image Acquisition

How? Agfa HealthCare offers:

Both CR and DR Technologies to meet your needs




                                 &




                     Global D.I.R. Meeting
                     Mortsel, February 21 – 23, 2011
Image Quality and Dose Management
Requires Advanced Technology
How? Agfa HealthCare offers:

Both Powder and Needle Phosphor Detectors for CR and DR

 Powder Phosphors Economical                    Needle Phosphors High Efficiency




 Gadolinium Oxysulfide (GOS) for DR                      Cesium Iodide for DR
 Barium Fluoride Bromide for CR                          Cesium Bromide for CR


                           Global D.I.R. Meeting
                           Mortsel, February 21 – 23, 2011
Image Quality and Dose Management
      Requires Advanced Technology
                                            Detective Quantum Efficiency
      0.60


                               DXD -CsI
                                    C I
      0.50




      0.40
                      DXG - CsBr                    Needle Phosphor
                                                      Technology
DQE




      0.30


                 DXD - GOS
      0.20

                       DXG - BaF
      0.10
                     Powder Phosphor
                       Technology
      0.00
             0       0.5       1      1.5       2        2.5       3       3.5   4   4.5   5
                                                    Freq (lp/mm)



                                            Global D.I.R. Meeting
                                            Mortsel, February 21 – 23, 2011
Agfa Needle Phosphor Technology                Conventional Phosphor Technology




                           Global D.I.R. Meeting
                           Mortsel, February 21 – 23, 2011
Image Quality and Dose Management
Requires Advanced Technology


How? Agfa HealthCare offers:

With Cesium based Needle Phosphor Plates for
  CR and Cesium based DR Detector options –
  20-
  20-50% dose reduction is “achievable”!

     And, that is not simply our opinion…




                    Global D.I.R. Meeting
                    Mortsel, February 21 – 23, 2011
Image Quality and Dose Management
Numerous Studies Support Dose Reduction!




                  Global D.I.R. Meeting
                  Mortsel, February 21 – 23, 2011
Image Quality and Dose Management
Numerous Studies Support Dose Reduction!




                Global D.I.R. Meeting
                Mortsel, February 21 – 23, 2011
Image Quality and Dose Management
  Requires Advanced Image Processing

MUSICA2
  • I lli
    Intelligent Image Processing!!!
                I     P      i !!!

      • Over 100 internal parameters are automatically adjusted

      • Improved visualization of wide-latitude exams e.g. (lumbar) spine,
        full leg...



  • Simultaneous quality bone and soft tissue rendering

      • Consistent Image Display

      • Virtually eliminates the need for image manipulation (W/L,etc.)
                                                             (W/L,etc.)


                          Global D.I.R. Meeting
                          Mortsel, February 21 – 23, 2011
Image Quality and Dose Management
Requires Advanced Image Processing




Original M i ®
O i i l Musica®                     MUSICA2
                  Global D.I.R. Meeting
                  Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
Requires DICOM Compliance from Start to Finish




                                                        NX Output to PACS Archive
                                                       15 bit P Value DICOM Output *




          Hi Quality LCD Monitors
        DICOM Calibration Software



                            Global D.I.R. Meeting
                            Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
Requires Compliance With Industry Standards




                 Images from web sites. Used w/o permission


                    Global D.I.R. Meeting
                    Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Compliance With Industry Standards



How?

     Agfa HealthCare was the
           first company
to be fully compliant with the new
    IEC Exposure Index Standard!
           p




                     Global D.I.R. Meeting
                     Mortsel, February 21 – 23, 2011
Global D.I.R. Meeting
Mortsel, February 21 – 23, 2011
RE: LL-PHE1111
    LL-
New Digital Radiography Standards Simplified for
Radiologists and Technologists

Dear Dr Don:

It is my great pleasure to congratulate you on receiving the
Certificate of Merit Award for your education exhibit at the 96th
                                y
Scientific Assembly and Annual Meeting of the Radiological
Society of North America, November 28-December 3, 2010,
McCormick Place, Chicago, Illinois
             Place Chicago Illinois.

Each education exhibit presentation is reviewed by the Education
Awards C
A   d Committee, a separate entity f
             itt            t     tit from th Ed
                                           the Education E hibit
                                                     ti Exhibits
Committee… After reviewing 1915 education exhibits, the
awards committee chose to present … 273 Certificate of Merit
                              p
Awards….
                        Global D.I.R. Meeting
                        Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Agfa Dose Monitoring Tools
                Continuous technologist feedback on exposure!
                Also assists the Radiologist & QC Personnel…




                 Global D.I.R. Meeting
                 Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Agfa Dose Monitoring Tools
                Continuous technologist feedback on exposure!
                Also assists the Radiologist & QC Personnel…




                 Global D.I.R. Meeting
                 Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Agfa Dose Monitoring Tools
                Continuous technologist feedback on exposure!
                Also assists the Radiologist & QC Personnel…




                 Global D.I.R. Meeting
                 Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Agfa Dose Monitoring Tools
                Continuous technologist feedback on exposure!
                Also assists the Radiologist & QC Personnel…




                 Global D.I.R. Meeting
                 Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Agfa Dose Monitoring Tools
                Continuous technologist feedback on exposure!
                Also assists the Radiologist & QC Personnel…




                 Global D.I.R. Meeting
                 Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Agfa Dose Monitoring Tools


 View exposure results on NX, CMS or
 Export as XML & Combine…




                  Global D.I.R. Meeting
                  Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Agfa Dose Monitoring Tools on Central Station…




                  Global D.I.R. Meeting
                  Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Agfa Dose Monitoring Tools on Central Station…




                  Global D.I.R. Meeting
                  Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Operator ID


Operator ID required before
the exam can begin…



                                  Rad-Tech




                   Global D.I.R. Meeting
                   Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Repeat Reject Tools

R/R Reasons configurable…




                  Global D.I.R. Meeting
                  Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires Repeat Reject Tools


                                           • R/R Stats can be
                                           exported
                                           • Images can be sent to
                                           Archive destination
                                           A hi d ti ti
                                           • R/R Stats can be
                                           combined on CMS




                 Global D.I.R. Meeting
                 Mortsel, February 21 – 23, 2011
Repeat / Reject Structured Reports




              Global D.I.R. Meeting
              Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires a Comprehensive QA Program!!!




                  Global D.I.R. Meeting
                  Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Requires a Comprehensive QA Program!!!




                  Global D.I.R. Meeting
                  Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
     Requires a Comprehensive QA Program!!!
•    Periodic Quality Control (PQC)           •    Acceptance Test (ATP)
     •   Overshoots/Ringing                         • Dark Noise
     •   Signal-to-Noise Ratio (SNR)                • Erasure Efficiency
     •   System Sensitivity
         S t      S    iti it                       • + all PQC tests
                                                         ll     t t
     •   System Linearity (Dose response)
     •   Dynamic Range determination      •        Monitor Check (MC)
     •   S o Scan a d g
         Slow Sca Banding                           • Visual Check
     •   Scan-Line Uniformity
     •   Spatial Resolution (MTF)         •        Plate Inventory (PI)
     •   Laser-Beam Jitter                          • Intra- & Inter- Detector Uniformity
     •   Laser beam positioning error               • Detector to Detector Deviation
         (Sweep Error)
                                                    • Artifact Analysis
     •   Pixel Aspect Ratio
     •   Pixel Size / Resolution
     •   Image Skew
     •   Image Width and Height
     •   Radiation Quality
     •   Artifact Analysis

                              Global D.I.R. Meeting
                              Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
 Is Available With Agfa HealthCare Digital Imaging!!!
Agfa HealthCare Provides:

•   Technology choices (CR and DR)
•   Detector choices (Powder and Needle Phosphors)
•   MUSICA2
    MUSICA2 Intelligent Image Processing
•   High Quality, DICOM Calibrated P-Value Monitors
                                    P-
•   Compliance with IEC, IHE and DICOM Standards
•   Operator ID
•   Exposure Monitoring with Structured Reporting
•   Repeat Reject & Analysis with Structured Reporting
       p      j          y                     p     g
•   Central Monitoring Systems with Structured Reporting
•   Auto QC 2 for ATP, QA/QC and AAPM Testing


                       Global D.I.R. Meeting
                       Mortsel, February 21 – 23, 2011
Image Consistency & Dose Management
Agfa HealthCare…




           Thank You !!!




                 Global D.I.R. Meeting
                 Mortsel, February 21 – 23, 2011

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AGFA - Dose Management for Image Quality

  • 1. Dose Management and Image Consistency / Quality Bruce Apgar George Curley Digital Imaging Specialist (Global) Sr. Marketing Manager Sr
  • 2. Image Consistency & Dose Management Why Image Quality & Dose Management? Why now? Image gently… gently “Better patient care” available, especially for neonatal patients and pediatrics And ALARA… Image Gently used with permission. Other Images from web sites, used w/o permission Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 3. Image Consistency & Dose Management Why Image Quality & Dose Management? Why now? New technology, new standards technology Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 4. Image Consistency & Dose Management Why Dose Management & Image Consistency? Why now? 1. Di it l I 1 Digital Imaging is no longer a novelty or only available at large i i l lt l il bl t l luminary institutions. It is “everywhere” 2. Agfa has the experience, technology & tools to meet you needs! More importantly, education is lacking for technologists, administrators and even for physicians physicians… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 5. Image Quality and Dose Management Begins with Image Acquisition How? Agfa HealthCare offers: Both CR and DR Technologies to meet your needs & Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 6. Image Quality and Dose Management Requires Advanced Technology How? Agfa HealthCare offers: Both Powder and Needle Phosphor Detectors for CR and DR Powder Phosphors Economical Needle Phosphors High Efficiency Gadolinium Oxysulfide (GOS) for DR Cesium Iodide for DR Barium Fluoride Bromide for CR Cesium Bromide for CR Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 7. Image Quality and Dose Management Requires Advanced Technology Detective Quantum Efficiency 0.60 DXD -CsI C I 0.50 0.40 DXG - CsBr Needle Phosphor Technology DQE 0.30 DXD - GOS 0.20 DXG - BaF 0.10 Powder Phosphor Technology 0.00 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Freq (lp/mm) Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 8. Agfa Needle Phosphor Technology Conventional Phosphor Technology Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 9. Image Quality and Dose Management Requires Advanced Technology How? Agfa HealthCare offers: With Cesium based Needle Phosphor Plates for CR and Cesium based DR Detector options – 20- 20-50% dose reduction is “achievable”! And, that is not simply our opinion… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 10. Image Quality and Dose Management Numerous Studies Support Dose Reduction! Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 11. Image Quality and Dose Management Numerous Studies Support Dose Reduction! Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 12. Image Quality and Dose Management Requires Advanced Image Processing MUSICA2 • I lli Intelligent Image Processing!!! I P i !!! • Over 100 internal parameters are automatically adjusted • Improved visualization of wide-latitude exams e.g. (lumbar) spine, full leg... • Simultaneous quality bone and soft tissue rendering • Consistent Image Display • Virtually eliminates the need for image manipulation (W/L,etc.) (W/L,etc.) Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 13. Image Quality and Dose Management Requires Advanced Image Processing Original M i ® O i i l Musica® MUSICA2 Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 14. Image Consistency & Dose Management Requires DICOM Compliance from Start to Finish NX Output to PACS Archive 15 bit P Value DICOM Output * Hi Quality LCD Monitors DICOM Calibration Software Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 15. Image Consistency & Dose Management Requires Compliance With Industry Standards Images from web sites. Used w/o permission Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 16. Image Consistency & Dose Management Requires Compliance With Industry Standards How? Agfa HealthCare was the first company to be fully compliant with the new IEC Exposure Index Standard! p Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 17. Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 18. RE: LL-PHE1111 LL- New Digital Radiography Standards Simplified for Radiologists and Technologists Dear Dr Don: It is my great pleasure to congratulate you on receiving the Certificate of Merit Award for your education exhibit at the 96th y Scientific Assembly and Annual Meeting of the Radiological Society of North America, November 28-December 3, 2010, McCormick Place, Chicago, Illinois Place Chicago Illinois. Each education exhibit presentation is reviewed by the Education Awards C A d Committee, a separate entity f itt t tit from th Ed the Education E hibit ti Exhibits Committee… After reviewing 1915 education exhibits, the awards committee chose to present … 273 Certificate of Merit p Awards…. Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 19. Image Consistency & Dose Management Requires Agfa Dose Monitoring Tools Continuous technologist feedback on exposure! Also assists the Radiologist & QC Personnel… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 20. Image Consistency & Dose Management Requires Agfa Dose Monitoring Tools Continuous technologist feedback on exposure! Also assists the Radiologist & QC Personnel… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 21. Image Consistency & Dose Management Requires Agfa Dose Monitoring Tools Continuous technologist feedback on exposure! Also assists the Radiologist & QC Personnel… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 22. Image Consistency & Dose Management Requires Agfa Dose Monitoring Tools Continuous technologist feedback on exposure! Also assists the Radiologist & QC Personnel… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 23. Image Consistency & Dose Management Requires Agfa Dose Monitoring Tools Continuous technologist feedback on exposure! Also assists the Radiologist & QC Personnel… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 24. Image Consistency & Dose Management Requires Agfa Dose Monitoring Tools View exposure results on NX, CMS or Export as XML & Combine… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 25. Image Consistency & Dose Management Agfa Dose Monitoring Tools on Central Station… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 26. Image Consistency & Dose Management Agfa Dose Monitoring Tools on Central Station… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 27. Image Consistency & Dose Management Requires Operator ID Operator ID required before the exam can begin… Rad-Tech Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 28. Image Consistency & Dose Management Requires Repeat Reject Tools R/R Reasons configurable… Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 29. Image Consistency & Dose Management Requires Repeat Reject Tools • R/R Stats can be exported • Images can be sent to Archive destination A hi d ti ti • R/R Stats can be combined on CMS Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 30. Repeat / Reject Structured Reports Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 31. Image Consistency & Dose Management Requires a Comprehensive QA Program!!! Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 32. Image Consistency & Dose Management Requires a Comprehensive QA Program!!! Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 33. Image Consistency & Dose Management Requires a Comprehensive QA Program!!! • Periodic Quality Control (PQC) • Acceptance Test (ATP) • Overshoots/Ringing • Dark Noise • Signal-to-Noise Ratio (SNR) • Erasure Efficiency • System Sensitivity S t S iti it • + all PQC tests ll t t • System Linearity (Dose response) • Dynamic Range determination • Monitor Check (MC) • S o Scan a d g Slow Sca Banding • Visual Check • Scan-Line Uniformity • Spatial Resolution (MTF) • Plate Inventory (PI) • Laser-Beam Jitter • Intra- & Inter- Detector Uniformity • Laser beam positioning error • Detector to Detector Deviation (Sweep Error) • Artifact Analysis • Pixel Aspect Ratio • Pixel Size / Resolution • Image Skew • Image Width and Height • Radiation Quality • Artifact Analysis Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 34. Image Consistency & Dose Management Is Available With Agfa HealthCare Digital Imaging!!! Agfa HealthCare Provides: • Technology choices (CR and DR) • Detector choices (Powder and Needle Phosphors) • MUSICA2 MUSICA2 Intelligent Image Processing • High Quality, DICOM Calibrated P-Value Monitors P- • Compliance with IEC, IHE and DICOM Standards • Operator ID • Exposure Monitoring with Structured Reporting • Repeat Reject & Analysis with Structured Reporting p j y p g • Central Monitoring Systems with Structured Reporting • Auto QC 2 for ATP, QA/QC and AAPM Testing Global D.I.R. Meeting Mortsel, February 21 – 23, 2011
  • 35. Image Consistency & Dose Management Agfa HealthCare… Thank You !!! Global D.I.R. Meeting Mortsel, February 21 – 23, 2011