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Imaging Characteristics in Rotational Panoramic Radiography

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Imaging Characteristics in Rotational Panoramic Radiography ISSN 0349-490X INIS-mf--11321 G.C.H. SANDERINK IMAGING CHARACTERISTICS IN ROTATIONAL PANORAMIC RADIOGRAPHY SUPPLEMENTS 9 OENTO-MAXILLO-FAaAL RAOOUCXSV JOURNAL OF THE tNTERNATtONAL ASSOCIATION OF DENTO-MAXILLO-FAC1AL RMXOLOGY \ Printing of this Supplenentum was supported by graats from KOVAtC and IMAGING CHARACTERISTICS IN ROTATIONAL PANORAMIC RADIOGRAPHY Practical testing and mathematical models using MTF and ROC analysis DENTO-MAXILLO-FACIAL RADIOLOGY SUPPLEMENTUM 9,1987 IMAGING CHARACTERISTICS IN ROTATIONAL PANORAMIC RADIOGRAPHY Practical testing and mathematical models usingMTF and ROC analysis De beeldkwaliteit bij panoramische tomografie (met een samenvatting in het nederlands) PROEFSCHRIFT ter verkrijging van de graad van doctor aan de Rijksuniversiteit te Utrecht, op gezag van de Rector Magnificus, Prof. Dr. J.A. van Ginkel, ingevolge het besiuit van het College van Dekanen in het openbaar te verdedigen op dinsdag 8 december 1987 des namiddags te 12.45 uur door Gerard Clemens Herman Sanderink geboren op 17 februari 1948 te Tubbergen PROMOTOR : PROF. J. VAN AKEN CO-PROMOTOR :PROFU.WELANDER (University of Umea, Sweden) From the Department of Oral Roentgenology, University of Utrecht, Dental School, The Netherlands. Part of this study was carried out during a stay at the Department of Oral Radiology, University of Umea, Dental School, Umea, Sweden. ••% Dedicated to Willeke and Dirk-Jan and the memory of my parents Prologue The completion of this dissertation is the result of the successful ; co-operation of a great many people. I would therefore like to thank j all those who contributed directly or indirectly to the completion of ' this thesis. [ First of all I am deeply indebted to my promotor Professor Jan van : Aken, who has been an inspiration to me in my work in the field of • radiology and encouraged my ambition to carry out research. Jan: many i of my ideas in the beginning still had to be crystallized and formulated in a well defined research scenario. You always carefully i guided me and never forced me to take directions in which I did not want to go. It was always a pleasure to take your advice and suggestions. I also wish to express my sincere gratitude to Professor Ulf Welander for his never exhausting enthusiasm and energy whilst guiding me trough the 'world' of rotational panoramic radiography. He made the theoretical models and computer programs more 'palatable' to me. The hospitality of your family, Ulf, made the stays in Sweden unforgettable. A great part of this work is based on the contribution of the observers Selma Uylenbroek-de Witte, Peter van Amerongen, Gert Boere, : Rob de Haan, Paul Janssen, Wim Schipaanboord and Wim Verhoeven who j spent many days voluntarily viewing thousands of radiographs. Without f their support this large scale observer performance study would not have been possible. I am also indebted to Rob de Haan also for his help on the sections on unsharpness measurements. I want to express my cordial thanks to Chantal Kemp-Scholte who helped me and who after graduation spent an additional year voluntarily assisting me in the performance of experiments. - My special thanks are due to Andries van der Bilt who perfected •- many computer programs based on my vague requests. '. I am also indebted to the Department of Oral Pathophysiology for • their hospitality and for making their facilities available to me. My thanks are furthermore due to Phil Mileman for expressing his view as an outsider of the manuscript in draft form and for his linguistic advise. In addition I would like to thank the folowing: The graduates Alex Roes, Andre Mol and Frank Lobbezoo who helped prepare the experiments and the figures and in the evaluation of the data. My colleagues in the department of Oral Roentgenology in Utrecht and in the Department of Oral Radiology in the Academic Centre for Dentistry in Amsterdam for deputizing for me and for taking over some of my regular duties. Finally all those persons who assisted indirectly in the realization of this dissertation. I hope that everyone concerned will remain assured of my appreciation and will accept my sincere thanks. Perhaps most of all I have received support at home. I would like to thank my wife, Willeke for organizing all the things I have neglected. Dirk-Jan, I would like to thank both you and Willeke for going without my companionship for so long. Utrecht, October 1987 8 CONTENTS Page Prologue 7 Contents 9 1. General Survey 13 1.1 Introduction 13 1.2 History of panoramic radiography 14 1.3 Aspects of objective radiographic image quality 16 1.4 The development of the mathematical image layer models 21 1.5 A review of the clinical test models dealing with image unsharpness 37 2. The aims of the investigation 41 3. General description of the materials and method 43 3.1 Test objects and phantoms 43 3.1.1 The aluminium test object 44 3.1.2 The phantom jaw 46 3.2 Application of ROC principles 54 3.2.1 Evaluation of signal detectability 55 3.2.2 Signal detection theory . 57 3.2.3 The receiver operating characteristic curve 59 3.2.4 Statistical analysis 59 3.2.5 Practical application of the ROC principles 60 3.3 The selection of the observers 62 3.3.1 Procedure to test the observers 63 3.3.2 Results of the initial and final observer test 65 3.4 Description of specific methods for measuring image unsharpness 69 3.4.1 The measurement of image unsharpness using the modulation transfer function 69 -The derivation of the modulation transfer function 71 -Modulation transfer function expressed in one single value 73 3.4.2 The measurement of the image unsharpness using the method of Klasens 75 -Comparison of both methods 76 4. Conventional radiography 77 4.1 Introduction 77 4.2 Materials and method 78 4.3 The results of the observer assessments when using the aluminium test object 83 4.4 The results of the observer assessments when using the aluminium test object combined and the phantom jaws 86 4.5 Conclusions and discussion 88 5. Tomography 90 5.1 Introduction 90 5.2 Materials and method 91 5.3 The results of the observer assessments when using the aluminium test object 94 5.4.1 The calculation of the unsharpness by means of the modulation transfer function 97 5.4.2 The measurement of the image unsharpness using experimentally derived modulation transfer functions 98 5.5 Conclusions and discussion 101 6. Rotational panoramic radiography 103 6.1 Introduction 103 6.2 Materials and method 105 6.3 Validation of the manufacturers specifications and the quality of performance of the rotational panoramic unit: 107 -The width of the beam 107 -The position of the central plane 112 •The alignment of the test phantoms in the Zonarc unit 117 6.4 The results of the observer assessments when using the aluminium test object 125 6.4.1 A small projection radius 125 6.4.2 A large projection radius 127 10 6.5 The results of the observer assessments when using the aluminium test objects in combination with phantom jaws 132 6.5.1 A small projection radius 132 6.5.2 A large projection radius 134 6.5.3 Use of a small projection radius and a phantom jaw without cervical vertebrae 135 -Comparison of the four combinations 137 6.6 The measurement of the image unsbarpness: the modulation transfer function and the method of Klasens 149 6.7 Conclusions and discussion 160 7. Evaluation of the relevaace of the mathematical models 165 7.1 Comparison of the mathematical models with the results of the experiments 165 7.2 Conclusions 170 7.3 Improvements in the models for evaluating unsharpness of the image layer 170 8. Summary 172 9. Samenvatting (summary in the Dutch language) 176 References 180 Appendix 195 Curriculum vitae 213 11 * V CHAPTER 1: GENERAL SURVEY 1.1 Introduction Rotational panoramic radiography is a recording technique which depicts a curved layer in the object. During the exposure a narrow x- ray beam rotates around the object whilst the image is detected on a moving film. The resulting image is of a curved layer within the object. In most dental applications the shape of the imaged layer is based on the average shape of the dental arch. In the centre of the image layer a plane can be found which is depicted with a minimum of unsharpness (Figure l.l.A). The image of that central plane has also equal horizontal and vertical magnification. Images of planes outside the central plane show more unsharpness and a relatively large change in the horizontal magnification whereas the change in the vertical magnification is only small. A large number of variables influence magnification and unsharpness. The effects of these variables on the image quality of the image layer have been analyzed with the help of mathematical models of the performance of the radiographic diagnostic system. The application of sophisticated methods to evaluate the theoretical characteristics of panoramic systems has raised the question as to whether the results of these calculations will in fact be able to predict the diagnostic efficacy of the systems. In this study a comparison is made between the theoretically calculated properties of the images and the results obtained with the human observer as a diagnostic quality measuring instrument. The observer study consists of an assessment of the systems physical parameters as well as of the constrains imposed by the perceptive ability of the observer. Although the primary goal of this study was to obtain information about the characteristics of rotational panoramic radiography, it seemed a good start to identify the most influential factors affecting final image quality by first exploring the properties of more simple recording techniques such as conventional radiography and conventional tomography.
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