Kelly Paul, Lewis Annie K, Sima Haoji, Dennett Amy M
Department of Medical Imaging, Eastern Health, Melbourne, Australia.
School of Health & Biomedical Sciences RMIT University, Melbourne, Australia.
J Med Radiat Sci. 2025 Sep;72(3):385-391. doi: 10.1002/jmrs.890. Epub 2025 May 14.
X-rays of bone fractures immobilised with Plaster of Paris (POP) produce images of reduced diagnostic quality due to the increased density and irregular pattern of the POP overlying the anatomy of interest. Post-processing parameters in digital radiography (DR) can be applied to POP images to increase diagnostic quality without increasing radiation dose. The aim of this study was to evaluate the preferred image quality of POP immobilised distal radius fractures using optimised digital image manipulation algorithms.
A cross-sectional, quantitative survey study was conducted between November 2021 and December 2023 at a large metropolitan health network. The manufacturer standard algorithm and three new image post-processing algorithms were applied to pre-selected image sets. Orthopaedic surgeons (n = 34) and radiologists (n = 35) were surveyed to rank image quality of 10 random image sets (80 images in total). Data were described and analysed using median rankings, Mann-Whitney U tests and Friedman rank tests with post hoc Wilcoxin rank tests.
A total of 13 orthopaedic surgeons and 14 radiologists participated. A highly enhanced algorithm using contrast boost (Algorithm D) was the most preferred set (n = 18/27) due to better visibility of bony detail and fracture sites. There was no difference in rankings between clinician groups.
In this single site survey, both orthopaedic surgeons and radiologists preferred the highly enhanced post-processing algorithm (D) indicating that image quality can be improved using optimised digital manipulation. POP post-processing parameters with contrast boosting could be implemented to potentially increase diagnostic accuracy without increasing radiation dose for x-ray imaging of the wrist with POP.
用巴黎石膏（POP）固定的骨折部位进行X线检查时，由于覆盖在感兴趣解剖结构上的POP密度增加且图案不规则，会产生诊断质量降低的图像。数字X线摄影（DR）中的后处理参数可应用于POP图像，以提高诊断质量而不增加辐射剂量。本研究的目的是使用优化的数字图像处理算法评估POP固定的桡骨远端骨折的最佳图像质量。
2021年11月至2023年12月在一个大型都市健康网络中进行了一项横断面定量调查研究。将制造商标准算法和三种新的图像后处理算法应用于预先选择的图像集。对34名骨科医生和35名放射科医生进行调查，对10个随机图像集（共80张图像）的图像质量进行排名。使用中位数排名、曼-惠特尼U检验和弗里德曼秩检验以及事后威尔科克森秩检验对数据进行描述和分析。
共有13名骨科医生和14名放射科医生参与。由于骨细节和骨折部位的可见性更好，使用对比度增强的高度增强算法（算法D）是最受欢迎的一组（n = 18/27）。临床医生组之间的排名没有差异。
在这项单中心调查中，骨科医生和放射科医生都更喜欢高度增强的后处理算法（D），这表明使用优化的数字操作可以提高图像质量。对于用POP进行手腕X线成像，可以实施具有对比度增强的POP后处理参数，以在不增加辐射剂量的情况下潜在地提高诊断准确性。
