Article Figures & Data
Figures
- FIGURE 1.
Radiograph of plastic lung models inside thorax phantom.
- FIGURE 2.
Case 1: chosen patient radiographs (A) and defects inside lung containers (B). Same containers were used for both perfusion simulation and ventilation simulation. AP = anterior; LAO = left anterior oblique; LPO = left posterior oblique; PA = posterior; RAO = right anterior oblique; RPO = right posterior oblique.
- FIGURE 3.
Case 2: chosen patient radiographs (A) and defects inside lung containers (B). AP = anterior; LAO = left anterior oblique; LPO = left posterior oblique; PA = posterior; RAO = right anterior oblique; RPO = right posterior oblique.
- FIGURE 4.
Case 3: defects inside technical containers. AP = anterior; LAO = left anterior oblique; LPO = left posterior oblique; PA = posterior; RAO = right anterior oblique; RPO = right posterior oblique.
- FIGURE 5.
Histogram of individual results sent to all participating hospitals. Numbers of image sets in different hospitals are shown on x-axis and scores on y-axis. Mean values of scores, together with their own results, were sent to each hospital. Hospitals are coded to maintain anonymity.
- FIGURE 6.
Example of static perfusion images for case 1 from hospital B.
- FIGURE 7.
Example of static images for case 2 from hospital PQ: perfusion (A) and ventilation (B). Ant = anterior; DEX = right; LAO = left anterior oblique; LPO = left posterior oblique; Post = posterior; RAO = right anterior oblique; RPO = right posterior oblique; SIN = left.
- FIGURE 8.
SPECT images of phantom with technical lung containers.
Tables
- TABLE 1
Acquisition Parameters for Standard Lung Perfusion and Ventilation Imaging in 18 Participating Hospitals
Hospital Camera age (y) Collimator Matrix Patient position Perfusion dose (MBq) No. of projections Frame (kcts or time) Ventilation method Dose (MBq) Frame (kcts or time) No. of projections TU 8 HR 512 Supine 111 6 300 s Venticol 740 600 s 6 IJ 10 AP 256 Supine 50 4 300 s Venticol 1,100 300 s 4 B 6 HR 256 Supine 185 6 600 Venticol 111–1,110 100 4 H 10 HS 256 Supine 130 6 600 Solcovent 2,000 300 6 E 10 GP 256 Supine 148 6 700 Technegas 22–33 300 s 4 PQ1 3 HR 128 Supine 185 8 130 s Solcovent 2,220 180 s 8 PQ2 10 AP 128 Supine 15 6 600+t Solcovent 2,220 600+t 6 V1 15 GP 256 Supine 110 6 600 Technegas 20–40 200 6 V2 10 AP 128 Supine 110 6 600 Technegas 20–40 200 6 FG 16 AP 128 Supine 111–158 6 600 Technegas 370 400 6 R 8 HR 128 Supine 110 6 1,000+t Venticol 900 400+t 6 N 12 HR 128 Supine 185 6 90 s Venticol 740 150+t 6 Z 16 AP 128 Supine 148 4 600 Technegas 37 400 4 S 12 AP 256 Supine 100 6 400 Technegas 400 200 6 XY 4 GP 128 Supine 100 6 120 s Technegas 300 120 s 6 M 12 HS 128 Supine 74 6 400 Venticol 1,300 400 6 K 21 GP 256 Supine 110 4 1,000 Aerosol 740 300 s 4 O 1 AP 256 Supine 150–185 8 90 s Technegas 150–400 120 s 8 CD 11 GP 256 Supine 111 4 400 Venticol 740 150–300 4 L 15 GP 256 Sitting 74 4 600/500 Ultravent 1,480 300 4 HR = high resolution; AP = all purpose; HS = high sensitivity; GP = general purpose; 600+t = first frame is images at 600 kcts and rest are with same time.
Hospitals are coded to maintain anonymity.
Parameter Maximum points Colors, shade, contrast 4 Material (shine/blurred, manageability, etc.) 3 Notes (projections, counts, etc.) 2 Layout 2 Visibility of lesions 8 Number of projections 8 Total 27 Final points were summed and normalized to 10.
Parameter Maximum points Average SD Structure 2 1.31 0.62 Length 1 0.82 0.33 Comparison between perfusion and ventilation 2 1.58 0.53 Acquired projections mentioned 1 0.75 0.52 Comparison to radiologic findings 1 0.95 0.11 Conclusions 3 1.87 0.62 Findings 1 0.78 0.35 Extent 3 2.25 0.64 Additional findings 3 1.01 0.71 Total 17 Final points were summed and normalized to 10.
Hospital Overall Report Image set Technical 1 Technical 2 TU 8.5 10.0 7.2 8.2 8.4 IJ 8.5 9.9 7.4 8.0 8.2 B 8.3 8.8 7.1 9.2 8.9 H 8.1 8.7 7.0 9.4 6.8 E 7.9 9.0 8.3 5.4 6.6 PQ 7.8 5.9 9.0 8.6 10.0 V 7.8 7.9 6.7 9.5 8.3 FG 7.8 8.1 9.7 4.2 5.7 R 7.5 7.2 8.5 5.5 9.1 N 7.2 6.8 7.6 6.6 9.1 Z 7.2 8.5 5.9 6.8 7.8 S 6.7 6.8 5.8 8.0 7.1 XY 6.5 6.9 8.5 1.6 7.1 M 5.9 4.8 6.1 7.1 7.5 K 5.8 5.7 5.7 5.8 6.8 O 5.7 5.1 7.1 3.0 8.9 CD 5.6 4.7 6.9 4.6 5.9 L 5.2 5.3 4.8 5.2 7.3 Average 7.1 7.2 7.2 6.5 7.8 SD 1.1 1.7 1.3 2.3 1.2 Technical 1 = local interpreters; technical 2 = expert.
Hospitals are coded to maintain anonymity.
- TABLE 5
Percentage Visibility of Defects Inside Technical Containers (Case 3) in All 8 Planar Views According to Participating Hospitals' Readers
Defect Visibility (%) Size (cm3) Side AP PA LPO RPO LAO RAO Left Right 2.5 Right 39 51 82 100† 100† 2.5 Right* 90 65 82 96† 2.5 Left* 16 75 100† 100† 59 100† 2.0 Left 92 47 69 92 92 2.0 Left* 8 69 100† 63 96 2.0 Right* 29 96† 61 1.5 Right 90† 27 75 78 1.5 Left 49 90 92† 1.5 Right* 27 37 53† 1.5 Right* 10 33† 14 1.0 Right 16 29† 16 1.0 Right 29 16 41 43† 1.0 Left 4 45 53 55† 1.0 Left* 10 16 20 41† 1.0 Left* 12 14† 2 1.0 Right* 12 10 20† 0.7 Left 14† 4 8 6 0.7 Right 6† 0.7 Left 18† 18† 14 0.7 Right 4 0.7 Right 8 12† 0.7 Left 12† 12† 12† 2 8 View Sensitivity (%) P AP–PA LPO–RPO LAO–RAO Left–right 37.7 AP–PA LPO–RPO LAO–RAO 35.1 0.006* AP–PA LPO–RPO 32.4 0.001* AP–PA 27.0 0.002* AP–PA LAO–RAO 32.1 0.014* AP–PA Left–right 35.9 0.140 AP–PA LPO–RPO Left–right 36.7 0.057 AP–PA LAO–RAO Left–right 36.6 0.199 LPO–RPO LAO–RAO 42.2 0.040* LPO–RPO LAO–RAO Left–right 42.8 0.006* Left–right 44.9 0.006* ↵* Statistically significant (P < 0.05) variation compared with all 8 views.
AP = anterior; LAO = left anterior oblique; LPO = left posterior oblique; PA = posterior; RAO = right anterior oblique; RPO = right posterior oblique.
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