F R Verdun

University Hospital of Lausanne, Lausanne, Vaud, Switzerland

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Publications (87)111.36 Total impact

  • A H Clavel · P Monnin · J M Létang · F R Verdun · A Darbon
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    ABSTRACT: As opposed to the standard detective quantum efficiency (DQE), effective DQE (eDQE) is a figure of merit that allows comparing the performances of imaging systems in the presence of scatter rejection devices. The geometry of the EOS™ slot-scanning system is such that the detector is self-collimated and rejects scattered radiation. In this study, the EOS system was characterised using the eDQE in imaging conditions similar to those used in clinical practice: with phantoms of different widths placed in the X-ray beam, for various incident air kerma and tube voltages corresponding to the phantom thickness. Scatter fractions in EOS images were extremely low, around 2 % for all configurations. Maximum eDQE values spanned 9-14.8 % for a large range of air kerma at the detector plane from 0.01 to 1.34 µGy. These figures were obtained with non-optimised EOS setting but still over-performed most of the maximum eDQEs recently assessed for various computed radiology and digital radiology systems with antiscatter grids.
    No preview · Article · Nov 2015 · Radiation Protection Dosimetry
  • F.R. Verdun · D. Racine · A. Ba · J. Ott · N. Ryckx · F. Bochud

    No preview · Article · Nov 2015 · Physica Medica
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    ABSTRACT: Evaluation of image quality (IQ) in Computed Tomography (CT) is important to ensure that diagnostic questions are correctly answered, whilst keeping radiation dose to the patient as low as is reasonably possible. The assessment of individual aspects of IQ is already a key component of routine quality control of medical x-ray devices. These values together with standard dose indicators can be used to give rise to ‘figures of merit’ (FOM) to characterise the dose efficiency of the CT scanners operating in certain modes. The demand for clinically relevant IQ characterisation has naturally increased with the development of CT technology (detectors efficiency, image reconstruction and processing), resulting in the adaptation and evolution of assessment methods. The purpose of this review is to present the spectrum of various methods that have been used to characterise image quality in CT: from objective measurements of physical parameters to clinically task-based approaches (i.e. model observer (MO) approach) including pure human observer approach. When combined together with a dose indicator, a generalised dose efficiency index can be explored in a framework of system and patient dose optimisation. We will focus on the IQ methodologies that are required for dealing with standard reconstruction, but also for iterative reconstruction algorithms. With this concept the previously used FOM will be presented with a proposal to update them in order to make them relevant and up to date with technological progress. The MO that objectively assesses IQ for clinically relevant tasks represents the most promising method in terms of radiologist sensitivity performance and therefore of most relevance in the clinical environment.
    Full-text · Article · Oct 2015 · Physica Medica
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    ABSTRACT: Task-based medical image quality is often assessed by model observers for single slice images. The goal of the study was to determine if model observers can predict human detection performance of low contrast signals in CT for clinical multi-slice (ms) images. We collected 24 different data subsets from a low contrast phantom: 3 dose levels (40, 90, 150 mAs), 4 signals (6 and 8 mm diameter; 10 and 20 HU at 120kV) and 2 reconstruction algorithms (FBP and iterative (IR)). Images were assessed by human and model observers in 4-alternative forced choice (4AFC) experiments with ms data set in a signal-known-exactly (SKE) paradigm. Model observers with single (msCHOa) and multiple (msCHOb) templates were implemented in a train and test method analysis with Dense Difference of Gaussian (DDoG) and Gabor spatial channels. For human observers, we found that percent correct increased with the dose and was higher for iterative reconstructed images than FBP in all investigated conditions. All model observers implemented overestimated human performance in any condition except one case (6mm and 10HU) for msCHOa and msCHOb with Gabor channels. Internal noise could be implemented and a good agreement was found but necessitates independent fits according to the reconstruction method. Generally msCHOb shows higher detection performance than msCHOa with both types of channels. Gabor channels were less efficient than DDoG in this context. These results allow further developments in 3D analysis technique for low contrast CT.
    No preview · Article · Jan 2015
  • P Monnin · H Bosmans · F R Verdun · N W Marshall
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    ABSTRACT: Given the adverse impact of image noise on the perception of important clinical details in digital mammography, routine quality control measurements should include an evaluation of noise. The European Guidelines, for example, employ a second-order polynomial fit of pixel variance as a function of detector air kerma (DAK) to decompose noise into quantum, electronic and fixed pattern (FP) components and assess the DAK range where quantum noise dominates. This work examines the robustness of the polynomial method against an explicit noise decomposition method. The two methods were applied to variance and noise power spectrum (NPS) data from six digital mammography units. Twenty homogeneously exposed images were acquired with PMMA blocks for target DAKs ranging from 6.25 to 1600 µGy. Both methods were explored for the effects of data weighting and squared fit coefficients during the curve fitting, the influence of the additional filter material (2 mm Al versus 40 mm PMMA) and noise de-trending. Finally, spatial stationarity of noise was assessed.
    No preview · Article · Sep 2014 · Physics in Medicine and Biology
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    ABSTRACT: Purpose: EOS (EOS imaging S.A, Paris, France) is an x-ray imaging system that uses slot-scanning technology in order to optimize the trade-off between image quality and dose. The goal of this study was to characterize the EOS system in terms of occupational exposure, organ doses to patients as well as image quality for full spine examinations. Methods: Occupational exposure was determined by measuring the ambient dose equivalents in the radiological room during a standard full spine examination. The patient dosimetry was performed using anthropomorphic phantoms representing an adolescent and a five-year-old child. The organ doses were measured with thermoluminescent detectors and then used to calculate effective doses. Patient exposure with EOS was then compared to dose levels reported for conventional radiological systems. Image quality was assessed in terms of spatial resolution and different noise contributions to evaluate the detector's performances of the system. The spatial-frequency signal transfer efficiency of the imaging system was quantified by the detective quantum efficiency (DQE). Results: The use of a protective apron when the medical staff or parents have to stand near to the cubicle in the radiological room is recommended. The estimated effective dose to patients undergoing a full spine examination with the EOS system was 290 μSv for an adult and 200 μSv for a child. MTF and NPS are nonisotropic, with higher values in the scanning direction; they are in addition energy-dependent, but scanning speed independent. The system was shown to be quantum-limited, with a maximum DQE of 13%. The relevance of the DQE for slot-scanning system has been addressed. Conclusions: As a summary, the estimated effective dose was 290 μSv for an adult; the image quality remains comparable to conventional systems.
    No preview · Article · Jun 2014 · Medical Physics
  • N Ryckx · F Verdun
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    ABSTRACT: Purpose: The number and complexity of interventional cardiology (IC) procedures has been steadily increasing over the last twenty years. This implies an increased risk of stochastic and even deterministic effects to the patient, as well as an increased exposure of IC staff. Radiation protection must thus become of prime importance and should be promoted by all possible means. Methods: We are currently developing a mobile application that will help the physician to evaluate his/her current state of practice regarding radiation protection. The key elements to achieve this goal would be:‐Comparing his/her patient delivered doses to the local diagnostic reference levels (DRL).‐Estimate the risk and severity of potential radiation‐induced skin burns and the necessity of patient follow‐up.‐Estimate one's average personal dose.‐Give advice in order to reduce patient and staff exposure.‐Give general information about radiation protection. Results: As radiation‐induced erythema occurs several days or weeks the X‐ray exposure, it can be easily diagnosed as being caused by another factor, such as medication or allergy. Giving the patient more information about his/her personal risk would greatly improve his/her follow‐up to minimize negative side effects of a high dose IC procedure. As for the staff, it will help them with their daily practice by giving them useful tips aiming to reduce the dose delivered to the patient and, as a consequence, their own personal dose. Conclusion: The promotion of radiation protection must be done using all available means. The tremendous growth of mobile devices in the recent years called for a gap to be filled. When ready, our mobile application will help the physician to reach the lowest dose possible while still keeping diagnostic accuracy by estimating his/her practice with respect to the local diagnostic reference levels and giving useful working tips.
    No preview · Article · Jun 2013 · Medical Physics
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    ABSTRACT: This article expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about radiation protection for endoscopic procedures, in particular endoscopic retrograde cholangiopancreatography (ERCP). Particular cases, including pregnant women and pediatric patients, are also discussed. This Guideline was developed by a group of endoscopists and medical physicists to ensure that all aspects of radiation protection are adequately dealt with. A two-page executive summary of evidence statements and recommendations is provided. The target readership for this Guideline mostly includes endoscopists, anesthesiologists, and endoscopy assistants who may be exposed to X-rays during endoscopic procedures.
    Full-text · Article · Apr 2012 · Endoscopy
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    ABSTRACT: Physicians who frequently perform fluoroscopic examinations are exposed to high intensity radiation fields. The exposure monitoring is performed with a regular personal dosimeter under the apron in order to estimate the effective dose. However, large parts of the body are not protected by the apron (e.g. arms, head). Therefore, it is recommended to wear a supplemental dosimeter over the apron to obtain a better representative estimate of the effective dose. The over-apron dosimeter can also be used to estimate the eye lens dose. The goal of this study was to investigate the relevance of double dosimetry in interventional radiology. First the calibration procedure of the dosimeters placed over the apron was tested. Then, results of double dosimetry during the last five years were analyzed. We found that the personal dose equivalent measured over a lead apron was underestimated by ∼20% to ∼40% for X-ray beam qualities used in radiology. Measurements made over five-year period confirm that the use of a single under-apron dosimeter is inadequate for personnel monitoring. Relatively high skin dose (>10mSv/month) would have remained undetected without a second dosimeter placed on the apron.
    No preview · Article · Dec 2011 · Radiation Measurements

  • No preview · Article · Sep 2011 · European Journal of Cancer
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    P Monnin · N W Marshall · H Bosmans · F O Bochud · F R Verdun
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    ABSTRACT: Assessment of image quality for digital x-ray mammography systems used in European screening programs relies mainly on contrast-detail CDMAM phantom scoring and requires the acquisition and analysis of many images in order to reduce variability in threshold detectability. Part II of this study proposes an alternative method based on the detectability index (d') calculated for a non-prewhitened model observer with an eye filter (NPWE). The detectability index was calculated from the normalized noise power spectrum and image contrast, both measured from an image of a 5 cm poly(methyl methacrylate) phantom containing a 0.2 mm thick aluminium square, and the pre-sampling modulation transfer function. This was performed as a function of air kerma at the detector for 11 different digital mammography systems. These calculated d' values were compared against threshold gold thickness (T) results measured with the CDMAM test object and against derived theoretical relationships. A simple relationship was found between T and d', as a function of detector air kerma; a linear relationship was found between d' and contrast-to-noise ratio. The values of threshold thickness used to specify acceptable performance in the European Guidelines for 0.10 and 0.25 mm diameter discs were equivalent to threshold calculated detectability indices of 1.05 and 6.30, respectively. The NPWE method is a validated alternative to CDMAM scoring for use in the image quality specification, quality control and optimization of digital x-ray systems for screening mammography.
    Full-text · Article · Jun 2011 · Physics in Medicine and Biology
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    N W Marshall · P Monnin · H Bosmans · F O Bochud · F R Verdun
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    ABSTRACT: In many European countries, image quality for digital x-ray systems used in screening mammography is currently specified using a threshold-detail detectability method. This is a two-part study that proposes an alternative method based on calculated detectability for a model observer: the first part of the work presents a characterization of the systems. Eleven digital mammography systems were included in the study; four computed radiography (CR) systems, and a group of seven digital radiography (DR) detectors, composed of three amorphous selenium-based detectors, three caesium iodide scintillator systems and a silicon wafer-based photon counting system. The technical parameters assessed included the system response curve, detector uniformity error, pre-sampling modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE). Approximate quantum noise limited exposure range was examined using a separation of noise sources based upon standard deviation. Noise separation showed that electronic noise was the dominant noise at low detector air kerma for three systems; the remaining systems showed quantum noise limited behaviour between 12.5 and 380 µGy. Greater variation in detector MTF was found for the DR group compared to the CR systems; MTF at 5 mm(-1) varied from 0.08 to 0.23 for the CR detectors against a range of 0.16-0.64 for the DR units. The needle CR detector had a higher MTF, lower NNPS and higher DQE at 5 mm(-1) than the powder CR phosphors. DQE at 5 mm(-1) ranged from 0.02 to 0.20 for the CR systems, while DQE at 5 mm(-1) for the DR group ranged from 0.04 to 0.41, indicating higher DQE for the DR detectors and needle CR system than for the powder CR phosphor systems. The technical evaluation section of the study showed that the digital mammography systems were well set up and exhibiting typical performance for the detector technology employed in the respective systems.
    Full-text · Article · Jun 2011 · Physics in Medicine and Biology
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    ABSTRACT: This work examines the use of a detectability index to control an Automatic Exposure Control (AEC) system for an amorphous-Selenium digital mammography detector. The default AEC mode for the system was evaluated using homogeneous poly(methyl methacrylate) (PMMA) plates of thickness 20, 40, 60 and 70 mm to find the tube potential and anode/filter settings selected by the system. Detectability index (d') using a non-prewhitened model observer with eye filter (NPWE) was calculated for these beam qualities as a function of air kerma at the detector. AEC settings were calculated that gave constant d' as a function of beam quality for a homogeneous background; a target d' was used that ensured the system passed the achievable image quality criterion for the 0.1 mm diameter disc in the European Guidelines. Threshold gold thickness was measured using the CDMAM test object as a function of beam quality for the AEC mode, which held pixel value (PV) constant, and for the constant d' mode. Threshold gold thickness for the 0.1 mm disc increased by a factor of 2.18 for the constant PV mode, while constant d' mode held threshold gold thickness constant to within 7% and signal-difference-to-noise-ratio (SdNR) constant to within 5%. The constant d' settings derived for homogeneous images were then applied to a phantom with a structured background. Threshold gold thickness for the 0.13 mm disc increased by a factor of 1.90 for the constant PV mode, while constant d' mode held threshold gold thickness constant within 38% for 0.13 mm disk.
    Full-text · Conference Paper · Feb 2011
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    ABSTRACT: A wide variation in patient exposure has been observed in interventional radiology and cardiology. The purpose of this study was to investigate the patient dose from fluoroscopy-guided procedures performed in non-academic centres when compared with academic centres. Four procedures (coronary angiography, percutaneous coronary intervention, angiography of the lower limbs and percutaneous transluminal angioplasty of the lower limbs) were evaluated. Data on the dose–area product, fluoroscopy time and number of images for 1000 procedures were obtained from 23 non-academic centres and compared with data from 5 academic centres. No differences were found for cardiology procedures performed in non-academic centres versus academic ones. However, significantly lower doses were delivered to patients for procedures of the lower limbs when they were performed in non-academic centres. This may be due to more complex procedures performed in the academic centres. Comparison between the centres showed a great variation in the patient dose for these lower limb procedures.
    No preview · Article · Feb 2011 · Radiation Protection Dosimetry
  • R Treier · A Aroua · F R Verdun · E Samara · A Stuessi · Ph R Trueb
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    ABSTRACT: Diagnostic reference levels (DRLs) were established for 21 indication-based CT examinations for adults in Switzerland. One hundred and seventy-nine of 225 computed tomography (CT) scanners operated in hospitals and private radiology institutes were audited on-site and patient doses were collected. For each CT scanner, a correction factor was calculated expressing the deviation of the measured weighted computed tomography dose index (CTDI) to the nominal weighted CTDI as displayed on the workstation. Patient doses were corrected by this factor providing a realistic basis for establishing national DRLs. Results showed large variations in doses between different radiology departments in Switzerland, especially for examinations of the petrous bone, pelvis, lower limbs and heart. This indicates that the concept of DRLs has not yet been correctly applied for CT examinations in clinical routine. A close collaboration of all stakeholders is mandatory to assure an effective radiation protection of patients. On-site audits will be intensified to further establish the concept of DRLs in Switzerland.
    No preview · Article · Oct 2010 · Radiation Protection Dosimetry
  • P Monnin · F O Bochud · F R Verdun
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    ABSTRACT: A method of objectively determining imaging performance for a mammography quality assurance programme for digital systems was developed. The method is based on the assessment of the visibility of a spherical microcalcification of 0.2 mm using a quasi-ideal observer model. It requires the assessment of the spatial resolution (modulation transfer function) and the noise power spectra of the systems. The contrast is measured using a 0.2-mm thick Al sheet and Polymethylmethacrylate (PMMA) blocks. The minimal image quality was defined as that giving a target contrast-to-noise ratio (CNR) of 5.4. Several evaluations of this objective method for evaluating image quality in mammography quality assurance programmes have been considered on computed radiography (CR) and digital radiography (DR) mammography systems. The measurement gives a threshold CNR necessary to reach the minimum standard image quality required with regards to the visibility of a 0.2-mm microcalcification. This method may replace the CDMAM image evaluation and simplify the threshold contrast visibility test used in mammography quality.
    No preview · Article · May 2010 · Radiation Protection Dosimetry
  • E T Samara · A Aroua · J-C Stauffer · F Bochud · F R Verdun
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    ABSTRACT: The number of fluoroscopy-guided procedures in cardiology is increasing over time and it is appropriate to wonder whether technological progress or change of techniques is influencing patient exposure. The aim of this study is to examine whether patient dose has been decreasing over the years. Patient dose data of more than 7700 procedures were collected from two cardiology centres. A steady increase in the patient dose over the years was observed in both the centres for the two cardiological procedures included in this study. Significant increase in dose was also observed after the installation of a flat-panel detector. The increasing use of radial access may lead to an increase in the patient exposure. The monitoring of dose data over time showed a considerable increase in the patient exposure over time. Actions have to be taken towards dose reduction in both the centres.
    No preview · Article · May 2010 · Radiation Protection Dosimetry
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    ABSTRACT: The aim of this study was to evaluate and compare organ doses delivered to patients in wrist and petrous bone examinations using a multislice spiral computed tomography (CT) and a C-arm cone-beam CT equipped with a flat-panel detector (XperCT). For this purpose, doses to the target organ, i.e. wrist or petrous bone, together with those to the most radiosensitive nearby organs, i.e. thyroid and eye lens, were measured and compared. Furthermore, image quality was compared for both imaging systems and different acquisition modes using a Catphan phantom. Results show that both systems guarantee adequate accuracy for diagnostic purposes for wrist and petrous bone examinations. Compared with the CT scanner, the XperCT system slightly reduces the dose to target organs and shortens the overall duration of the wrist examination. In addition, using the XperCT enables a reduction of the dose to the eye lens during head scans (skull base and ear examinations).
    No preview · Article · Mar 2010 · Radiation Protection Dosimetry
  • F R Verdun · A Aroua · S Baechler · S Schmidt · P R Trueb · F O Bochud
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    ABSTRACT: The aim of this work is to compare two methods used for determining the proper shielding of computed tomography (CT) rooms while considering recent technological advances in CT scanners. The approaches of the German Institute for Standardisation and the US National Council on Radiation Protection and Measurements were compared and a series of radiation measurements were performed in several CT rooms at the Lausanne University Hospital. The following three-step procedure is proposed for assuring sufficient shielding of rooms hosting new CT units with spiral mode acquisition and various X-ray beam collimation widths: (1) calculate the ambient equivalent dose for a representative average weekly dose length product at the position where shielding is required; (2) from the maximum permissible weekly dose at the location of interest, calculate the transmission factor F that must be taken to ensure proper shielding and (3) convert the transmission factor into a thickness of lead shielding. A similar approach could be adopted to use when designing shielding for fluoroscopy rooms, where the basic quantity would be the dose area product instead of the load of current (milliampere-minute).
    No preview · Article · Mar 2010 · Radiation Protection Dosimetry
  • F Miéville · S Beaumont · T Torfeh · F Gudinchet · F R Verdun
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    ABSTRACT: The purpose of this study was to assess the spatial resolution of a computed tomography (CT) scanner with an automatic approach developed for routine quality controls when varying CT parameters. The methods available to assess the modulation transfer functions (MTF) with the automatic approach were Droege's and the bead point source (BPS) methods. These MTFs were compared with presampled ones obtained using Boone's method. The results show that Droege's method is not accurate in the low-frequency range, whereas the BPS method is highly sensitive to image noise. While both methods are well adapted to routine stability controls, it was shown that they are not able to provide absolute measurements. On the other hand, Boone's method, which is robust with respect to aliasing, more resilient to noise and provides absolute measurements, satisfies the commissioning requirements perfectly. Thus, Boone's method combined with a modified Catphan 600 phantom could be a good solution to assess CT spatial resolution in the different CT planes.
    No preview · Article · Feb 2010 · Radiation Protection Dosimetry

Publication Stats

878 Citations
111.36 Total Impact Points

Institutions

  • 1994-2015
    • University Hospital of Lausanne
      • • Service de radiodiagnostic et radiologie interventionnelle
      • • Institut de radiophysique (IRA)
      Lausanne, Vaud, Switzerland
  • 1998-2011
    • University of Lausanne
      • Centre hospitalier universitaire vaudois (CHUV)
      Lausanne, Vaud, Switzerland
  • 1999
    • Mid Sweden University
      Härnösand, Västernorrland, Sweden