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Purpose: Optimization studies in digital radiology help to reduce the radiological risk to patients and maximize the benefits associated with their clinical purpose. The aim of this study was to assess the optimization of lateral lumbar spine projection via a combination of exposure parameters adjustments and additional filtration using a sectional anthropomorphic phantom. Materials and methods: We evaluated the effects of peak voltage, tube loading, and low-cost filters made of copper, titanium, brass, and nickel on both the perceived and physical quality of 125 radiographs obtained in a computer radiography system. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) with their Figure of Merit (FOM), based on the entrance surface air kerma with backscatter (ESAK), was used to assess physical image quality. Results: The standard image had a perceived image quality, SNR, FOMSNR, CNR, FOMCNR and ESAK of 3.4, 22.3, 386.4, 23.6, 433.7 and 1.28 mGy, respectively. Copper (90.3% purity) and titanium (95.0% purity) filters reduced ESAK by an average of 60% without compromising diagnostic quality, while brass and nickel filters increased dose under the conditions of the study. Conclusions: Our findings show that optimizing lumbar spine projection can reduce radiation dose without compromising image quality. Low-cost copper and titanium filters can be valuable in resource-limited settings. Further research can explore additional strategies for radiological optimization.

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ABSTRACT The transition from analog to digital radiology has expanded the capabilities of radiological imaging but has also made it possible to increase the radiation dose received by patients. Image quality in radiology is determined by factors such as radiographic techniques (kVp and mAs), which directly impact the dose and image quality. This study focuses on pediatric radiological exams considering their greater radiosensitivity and longer life expectancy. The study aimed to investigate the correlation between image quality and applied radiographic techniques using the CDRAD contrast-detail phantom. The results showed a direct linear relationship between the increase in kVp and the corresponding increase in image quality. Nonetheless, there was a significant variation in image quality between current-time products ranging from 0.5 to 2.5 mAs, in contrast to the nearly linear relationship observed within the 2.5 and 10 mAs range

RESUMEN La transición de la radiología analógica a la digital ha ampliado las capacidades de las imágenes radiológicas, pero ha también permitió aumentar la dosis de radiación que reciben los pacientes. La calidad de la imagen en radiología está determinada por factores como las técnicas radiográficas (kVp y mAs), que impactan directamente en la dosis y la calidad de la imagen. Este estudio se centra en exámenes radiológicos pediátricos considerando su mayor radiosensibilidad y mayor espe ranza de vida. El estudio está dirigido a investigar la correlación entre la calidad de la imagen y las técnicas radiográficas aplicadas utilizando el detalle de contraste CDRAD fantasma. Los resultados mostraron una relación lineal directa entre el aumento de kVp y el correspondiente aumento de calidad de la imagen. No obstante, hubo una variación significativa en la calidad de la imagen entre los productos actuales que van desde 0,5 a 2,5 mAs, en contraste con la relación casi lineal observada dentro del rango de 2,5 y 10 mAs.

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Comparative anatomy the basis for studies of evolution, and radiographic and tomographic aspects, as auxiliary methods in the investigation of anatomical particularities, reinforce evolutionary research. Therefore, the aim of this study was to describe the vertebrae, sternum, and ribs of the capuchin monkey (Sapajus libidinosus) by means of anatomical dissection and radiographic and tomographic images. To this purpose, four cadavers were used in the anatomical analysis and five living animals for the imaging exams. The bones were described and compared with data from other primates species found in literature. Student's t-test for independent samples was performed. The vertebral column of the comprises seven cervical, 13 or 14 thoracic, five or six lumbar, two or three sacral, and 23 or 24 caudal vertebrae. The atlas is characterized by three foramina on the wing. The seventh cervical vertebra had a transverse foramen in one specimen. The anticlinal vertebra is always the penultimate thoracic one, the ninth pair of ribs is always the last sternal pair, and the last two are buoyant. The sternal was composed of five or six sternebrae. The lumbar vertebrae showed a bifurcated spinous process. Three different sacral morphologies were observed. The structures identified macroscopically could be well determined through radiographic and tomographic images. S. libidinosus presented anatomical characteristics more similar to those of man and of platirrinos monkeys. The knowledge obtained by macroscopic anatomy and tomographic and radiological exams contributes significantly to comparative evolutionary studies.

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RESUMEN La especialidad de Imagenología comprende áreas del conocimiento médico que utilizan diferentes tecnologías en creciente desarrollo y métodos que exteriorizan partes del cuerpo humano, por tal motivo, educar a través del diagnóstico por imágenes informatizadas constituye un desafío en la actualidad. El presente artículo plantea describir las características principales de los medios de enseñanza y el interés que brinda especialmente la imagen radiológica digital como recurso didáctico. Se recopiló y revisó bibliografía de mayor novedad y profundidad en el tratamiento del tema. La estrategia de búsqueda adoptada fue la utilización de las palabras clave o descriptores en español e inglés. En la Universidad de Ciencias Médicas las tecnologías modernas traen diversidad de herramientas didácticas en el marco de escenarios docentes que impulsan y motivan el desarrollo rápido de habilidades perceptivas, la utilización cada vez más frecuente de imágenes digitales como medio de enseñanza la convierten en un recurso muy utilizado actualmente que exige habilidades y manejo eficaz. Las imágenes digitales con fines docentes son una alternativa importante, pues reflejan la modernidad e incorporan el conocimiento, debido a que se transforman en un nuevo recurso destinado a comunicar.

ABSTRACT The specialty of Imaging includes areas of medical knowledge that use different technologies in growing development and methods that externalize parts of the human body, for this reason, educating through computerized imaging diagnosis is a challenge today. This article proposes to describe the main characteristics of the teaching aids and the interest that the digital radiological image offers especially as a didactic resource. Bibliography of greater novelty and depth in the treatment of the subject was collected and reviewed. The search strategy adopted was the use of keywords or descriptors in Spanish and English. In the University of Medical Sciences, modern technologies bring diversity of didactic tools within the framework of teaching scenarios that promote and motivate the rapid development of perceptual skills, the increasingly frequent use of digital images as a means of teaching make it a very useful resource. Currently used that requires skills and effective handling. Digital images for teaching purposes are an important alternative, as they reflect modernity and incorporate knowledge, because they become a new resource for communicating.

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Macroscopic bone analysis and evaluation through imaging methods are essential in the recognition of natural and altered structures. Therefore, this study aimed at describing the osteology the thoracic limb of Sapajus libidinosus in bone pieces, identifying them in radiographic and tomographic images. For this, four cadavers were used in the macroscopic analysis and five animals for the imaging exams, of which four were euthanized and added to the macroscopic stage. For imaging exams, the animals were kept anesthetized. All bones were documented, structures described, and compared with literature data from human and nonhuman primates. There was no statistical difference between males and females regarding the length of the forelimb bones. Most of the bone structures of the scapula were well identified in the imaging methods, being more restricted in the ventrodorsal projection. The clavicle presented very limited visualization. The humerus, as well as the radius and ulna, were not well portrayed in their proximal and distal epiphyses by radiography. However, they were well identified on tomography. All structures described in the macroscopic image of the carpal and metacarpal bones could be identified through radiography and tomography, and the radiographic examination of this region is an excellent method for identifying fractures. The glenoid notch of the scapula was not visualized by any imaging method. S. libidinosus presented anatomical characteristics more similar to those of neotropical primates and man, being a great indicator of an experimental model for studies in these species.

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The knowledge of anatomy and imaging exams emerges as an important tool in the study of evolutionary processes of a species, in the elaboration of diagnosis, and the successful choice of the appropriate clinical and surgical procedures. Therefore, this study aims to describe the osteology of the hind limb of Sapajus libidinosus by means of gross, radiographic, and tomographic images. Four cadavers were used in the macroscopic analysis and five animals for the imaging exams, of which four were eventually euthanized and added to the macroscopic study. For imaging exams, they were kept anesthetized. All bones of the hind limb were documented, their structures were described, and compared with data in the literature from human and nonhuman primates. We have performed Student's t test for independent samples. There was no statistical difference between the sexes regarding the length of the hind limb bones. The coxal bone was largely well described using imaging methods. A small penile bone was present at the tip of the penis and it could be identified by all analysis methods. The femur, as well as the tibia and fibula, were not well portrayed in their proximal and distal epiphyses by radiography (Rx). However, they were well identified on tomography. No third trochanter was observed in the femur and the patella had a triangular shape. All the structures described by gross anatomy of the tarsus and metatarsus could be identified by Rx and tomography. More subtle structures, such as the popliteal notch on the tibia, and the gluteal tuberosity pectineal line and facies aspera on the coxal bone, were not identified by medical imaging. S. libidinosus presented anatomical characteristics that were similar to those of larger New World and Old World monkeys, including man. This suggests it's value as an experimental model for studies in recent primates.

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BACKGROUND: TO COMPARE THE DIAGNOSTIC ACCURACY OF THREE DIFFERENT IMAGING SYSTEMS: Direct digital radiography system (DDR-CMOS), four types of filtered images, and a priori and a posteriori registration of digital subtraction radiography (DSR) in the diagnosis of proximal defects. MATERIALS AND METHODS: The teeth were arranged in pairs in 10 blocks of vinyl polysiloxane, and proximal defects were performed with drills of 0.25, 0.5, and 1 mm diameter. Kodak RVG 6100 sensor was used to capture the images. A posteriori DSR registrations were done with Regeemy 0.2.43 and subtraction with Image Tool 3.0. Filtered images were obtained with Kodak Dental Imaging 6.1 software. Images (n = 360) were evaluated by three raters, all experts in dental radiology. RESULTS: Sensitivity and specificity of the area under the receiver operator characteristic (ROC) curve (Az) were higher for DSR images with all three drills (Az = 0.896, 0.979, and 1.000 for drills 0.25, 0.5, and 1 mm, respectively). The highest values were found for 1-mm drills and the lowest for 0.25-mm drills, with negative filter having the lowest values of all (Az = 0.631). CONCLUSION: The best method of diagnosis was by using a DSR. The negative filter obtained the worst results. Larger drills showed the highest sensitivity and specificity values of the area under the ROC curve.

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La masificación de la radiología digital ha hecho posible el estudio de diferentes patologías mediante imágenes de alta calidad diagnóstica. Existen diferentes patologías que afectan al tejido óseo, y que producen pérdida del mineral(1). Aquellas patologías se caracterizan por la pérdida de la arquitectura trabecular y un adelgazamiento de la cortical(7), visibles en la radiología. Aquellos cambios llevan al paciente a caer en el riesgo de sufrir futuras fracturas(8), por lo que se considera importante realizar un análisis de la geometría de las trabéculas ante este tipo de patología, con el fin de prever riesgos de fractura. Material y Métodos. Para realizar este estudio, se escogió un fémur de bovino(19). Este fue sumergido en ácido acético al 4 por ciento, con el fin de producir su desmineralización. Se le realizó una medición cada 24 horas mediante la adquisición de imágenes radiológicas, que fueron obtenidas con un equipo digital directo hasta observar cambios radiológicos evidentes en la población trabecular. Las imágenes fueron evaluadas mediante un software de libre acceso llamado ImageJ®(23), realizando mediciones trabeculares mediante la herramienta ROI, y se adquirieron los valores de área, perímetro y circularidad. Resultados. En las 10 trabéculas estudiadas se observaron y cuantificaron cambios en la arquitectura trabecular, aumentando el área en un 124 por ciento, el perímetro en un 53 por ciento y la circularidad se mantuvo en promedio constante. Conclusiones: Mediante la radiología digital, es posible evaluar la arquitectura trabecular mediante parámetros geométricos, los cuales nos indican que existen cambios muy pequeños a lo largo del tiempo. Se observó un aumento de tamaño en las trabéculas, pero sin pérdida de su forma.

Introduction. The mass use of digital radiology has made possible the study of different pathologies through high quality diagnostic images. There are different diseases that affect bone tissue and which produce mineral loss (1). Those diseases are characterized by loss of trabecular architecture and cortical thinning (7), visible in radiology. Those changes lead the patient to suffer the risk of future fractures (8), therefore it is considered important to analyze the geometry of the trabeculae in this kind of pathology in order to anticipate fracture risk. Material and Methods. For this study, a bovine's femur was chosen(19). This was immersed in 4 percent acetic acid to produce demineralization. Measurement was performed (in Clinica Alemana Santiago) every 24 hours by radiological imagings, which were obtained with digital radiology (DR) to observe obvious radiological changes in trabecular population. The images were evaluated by a freely available software called ImageJ® (23), by performing Trabecular measurements using the ROI tool, acquiring the values of area, perimeter and circularity. Results. In the 10 trabeculae studied, we observed and quantified changes in trabecular architecture, increasing the value of average area in 124 percent, perimeter in 53 percent and no change in circularity during the demineralization process. Conclusions. With digital radiography, it is possible to evaluate the trabecular architecture using geometric parameters, which indicate that there are very small changes over time. An increase in size of the trabeculae was observed, trabeculae was observed, but without loss of shape.

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OBJETIVO: Propor um método reprodutível, de fácil utilização e de baixo custo para a digitalização de filmes radiográficos de todos os tamanhos padrões, concentrando nossos esforços em filmes radiográficos de tórax. MATERIAIS E MÉTODOS: O objetivo de baixo custo ditou o uso de um escâner A4 com adaptador de transparência, bem como um software de costura de imagens otimizado, que tira proveito da geometria do escâner e área de captura constante, bem como o conhecimento das dimensões dos filmes radiográficos padrões. RESULTADOS: O resultado final do método proposto é uma imagem de alta resolução com bom contraste e sem artefatos de costura perceptíveis. CONCLUSÃO: O método de digitalização proposto usando um escâner A4 possibilita reprodutibilidade, excelente qualidade de imagem e alto grau de certeza na identificação de lesões.

OBJECTIVE: To propose a reproducible, user friendly and low cost method for digitization of radiographic films of all the standard sizes, focusing efforts on chest X-ray films. MATERIALS AND METHODS: The focus on low cost have dictated the use of an A4 scanner with transparency adapter, as well as an optimized image stitching software that takes advantage of the scanner geometry and constant capture area, besides the knowledge of the standard X-ray film sizes. RESULTS: The end result of the proposed method is a high resolution image with good contrast and no perceptible stitching artifacts. CONCLUSION: The proposed digitization method with an A4 scanner allows reproducibility, excellent image quality and high degree of certainty in the identification of lesions.

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OBJETIVO: O objetivo deste trabalho foi avaliar o desempenho de 24 monitores LCD utilizados nos laudos médicos, segundo testes recomendados pelo AAPM Report 03, de 2005. MATERIAL E MÉ-TODO: Os testes foram realizados de acordo com o AAPM Report 03 de 2005, em parâmetros como: distorção geométrica, reflexão, uniformidade e resposta de luminância, contraste, resolução, ruído e velamento por reflexão interna, com auxílio de fotômetro ou visualmente. RESULTADOS: Apresentaram-se problemas de: ruído (38% das estações de trabalho), resposta de luminância econtraste (33%) e uniformidade da luminância (4%). CONCLUSÃO: Em razão de o modelo MDNC4130 estar configurado para maximizar a vida útil, sua luminância é baixa, fazendo com que ruídos causados por sujeira comprometam a imagem. Em retestes, mostrou-se que a limpeza periódica dosmonitores resolve este problema. Já no caso das não conformidades em luminância e contraste, percebeu-se que a calibração automática com o software do monitor nem sempre corrige as distorções apresentadas.

OBJECTIVE: The purpose of this paper was to investigate the imagequality of 24 display devices and to compare the results of performance. MATERIAL AND METHOD: Tests were executed following AAPM Report 03 on 24 display devices installed in the Instituto de Radiologia do Hospital das Clínicas, São Paulo, SP, Brazil.The evaluation of test pattern considered these parameters:geometric distortions, luminance uniformity and response, contrast,reflections, resolution, and noise. RESULTS: The problems found were: noise (38% of workstations), luminance and contrast (33%) and luminance uniformity (4%). CONCLUSION: The model MDNC4130 was setting to preserve the life of display device, then the luminance is low, making the noise caused by dirt compromising image. The new test showed that regular cleaning of displaydevices solves this problem. In the case of non compliance of luminance and constrast realized that the automatic calibration of the display devices is not always correct the distortions.

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OBJETIVO: O objetivo deste trabalho foi avaliar o desempenho de 24 monitores LCD utilizados noslaudos médicos, segundo testes recomendados pela AAPM Report 03, de 2005. MATERIAL E MÉ-TODO: Os testes foram realizados de acordo com o AAPM Report 03 de 2005 em parâmetros como:distorção geométrica, reflexão, uniformidade e resposta de luminância, contraste, resolução, ruído e velamento por reflexão interna, com auxílio de fotômetro ou visualmente. RESULTADOS: Apresentaram-se problemas de ruído (38% das estações de trabalho), resposta de luminância e contraste (33%) e uniformidade da luminância (4%). CONCLUSÃO: Em razão de o modelo MDNC4130 estarconfigurado para maximizar a vida útil, sua luminância é baixa, fazendo com que ruídos causados por sujeira comprometam a imagem. Em retestes, mostrou-se que a limpeza periódica dos monitores resolve este problema. Já no caso das não conformidades em luminância e contraste, percebeu-se que a calibração automática com o software do monitor nem sempre corrige as distorções apresentadas.

OBJECTIVE: The purpose of this paper was to investigate the imagequality of 24 display devices and to compare the results of performance. MATERIAL AND METHOD: Tests were executed following AAPM Report 03 on 24 display devices installed in Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil. The evaluation of test pattern considered these parameters: geometric distortions, luminance uniformity and response, contrast, reflections, resolution, and noise. RESULTS: The problems found were: noise (38% of workstations), luminance and contrast (33%) and luminance uniformity (4%). CONCLUSION: The model MDNC4130 was setting to preserve the life of display device, then the luminance is low, making the noise caused by dirt compromising image. The new testshowed that regular cleaning of display devices solves this problem.In the case of non compliance of luminance and contrast realized that the automatic calibration of the display devices is not always correct the distortions.

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Diante das desvantagens da radiologia convencional surgiram diversas pesquisas para minimizá-las ou excluí-las. A radiologia digital foi introduzida em 1987, em Geneve, onde o dentista e inventor francês Francis Moyen demonstrou o primeiro sistema de radiografia digital intra-oral para a Odontologia. A imagem digital pode ser obtida de maneira indireta pela digitalização de radiografias convencionais ou de forma direta utilizando os sensores CCD (Charge Coupled Device – Dispositivo de Carga Acoplada), ligado ao computador diretamente por um cabo, ou os sensores com sistema de placas óticas, que necessitam de um scanner para serem lidos. As vantagens desse novo sistema são muitas tais como eliminar o processamento químico, a obtenção de cópias de imagem sem a necessidade de novas tomadas radiográficas, a facilidade de comunicação com outros profissionais e principalmente a redução da dose de exposição dos pacientes aos raios X. As limitações da radiologia digital ainda são bastante estudadas e questionadas e com isso algumas delas vão sendo resolvidas, como a sua validação jurídica, e outras ainda não, como a pequena perda de nitidez em relação ao filme convencional. O objetivo desse artigo é realizar uma revisão de literatura abordando a classificação, as vantagens e limitações, as aplicações clínicas e a validação jurídica da radiologia digital

Given the disadvantages of conventional radiology emerged several studies to minimize them or delete them. Surge digital radiology in 1987, in Geneva, the French dentist and inventor Francis Moyen demonstrated the first digital radiography system for intra-oral dentistry. The digital image can be obtained indirectly by scanning conventional radiographs or directly using the CCD (Charge Coupled Device) sensors, connected to the computer directly through a cable or the sensors with a phosphor storage system, which needs a scanner to read it. The advantages of this new system are too many as, to eliminate the chemical treatment, to obtain copies of the image without need new radiographs, ease of communication with other professionals and especially the reduction of the dose of patient exposure to X-rays. The limitations of digital radiology are still widely studied and questioned and therefore, some of them are being solved, as its legal validation, and others not, as a small loss of sharpness compared to conventional film. The objective of this article is to review the literature addressing the classification, the advantages and limitations, clinical applications and legal validation of digital radiology

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Se hizo un trabajo prospectivo para destacar el valor de la radiología digital en el diagnóstico de las afecciones causantes de disfagia. Se exploraron 168 pacientes a quienes se les aplicó dicha técnica y se compararon estos resultados con los obtenidos mediante la técnica convencional. Se observó que los resultados del estudio con doble contraste en el diagnóstico de las afecciones del intestino delgado fueron positivos en el 89,5 % y negativos en el 10,5 %. En todos los casos, el diagnóstico fue confirmado con otras técnicas. Se alcanzaron los resultados siguientes: 100 % de sensibilidad, 97 % de especificidad y 98,7 % de valores predictivos positivos. Se expusieron las ventajas y características de la técnica y se hizo una descripción de la misma.

A prospective work was done to stress the value of digital radiology in the diagnosis of affections causing dysphagia. 168 patients that were applied this technique were screened and the results were compared with those obtained by using the conventional technique. It was observed that the results of the double contrast study in the diagnosis of affections of the small intestine were positive in 89.5 % and negative in 10.5 %. In all cases, the diagnosis was confirmed by other techniques.The following results were attained: sensitivity - 100 %, specificity - 97 % and positive predictive values - 98.7 %. The advantages and characteristics of the technique were exposed and a description of it was made.