Abstract: Purpose: Initial auto-adjustment of the window level WL and width WW applied to mammographic images. The proposed intensity windowing (IW) method is based on the maximization of the mutual information (MI) between a perceptual decomposition of the original 12-bit sources and their screen displayed 8-bit version. Besides zoom, color inversion and panning operations, IW is the most commonly performed task in daily screening and has a direct impact on diagnosis and the time involved in the process. Methods: The authors present a human visual system and perception-based algorithm named GRAIL (Gabor-relying adjustment of image levels). GRAIL initially measures a mammogram's quality based on the MI between the original instance and its Gabor-filtered derivations. From this point on, the algorithm performs an automatic intensity windowing process that outputs the WL/WW that best displays each mammogram for screening. GRAIL starts with the default, high contrast, wide dynamic range 12-bit data, and then maximizes the graphical information presented in ordinary 8-bit displays. Tests have been carried out with several mammogram databases. They comprise correlations and an ANOVA analysis with the manual IW levels established by a group of radiologists. A complete MATLAB implementation of GRAIL is available at . Results: Auto-leveled images show superior quality both perceptually and objectively compared to their full intensity range and compared to the application of other common methods like global contrast stretching (GCS). The correlations between the human determined intensity values and the ones estimated by our method surpass that of GCS. The ANOVA analysis with the upper intensity thresholds also reveals a similar outcome. GRAIL has also proven to specially perform better with images that contain micro-calcifications and/or foreign X-ray-opaque elements and with healthy BI-RADS A-type mammograms. It can also speed up the initial screening time by a mean of 4.5 s per image. Conclusions: A novel methodology is introduced that enables a quality-driven balancing of the WL/WW of mammographic images. This correction seeks the representation that maximizes the amount of graphical information contained in each image. The presented technique can contribute to the diagnosis and the overall efficiency of the breast screening session by suggesting, at the beginning, an optimal and customized windowing setting for each mammogram.

Abstract: Purpose: In order to facilitate a smooth transition for brachytherapy dose calculations from the American Association of Physicists in Medicine (AAPM) Task Group No. 43 (TG-43) formalism to model-based dose calculation algorithms (MBDCAs), treatment planning systems (TPSs) using a MBDCA require a set of well-defined test case plans characterized by Monte Carlo (MC) methods. This also permits direct dose comparison to TG-43 reference data. Such test case plans should be made available for use in the software commissioning process performed by clinical end users. To this end, a hypothetical, generic high-dose rate (HDR) Ir-192 source and a virtual water phantom were designed, which can be imported into a TPS. Methods: A hypothetical, generic HDR Ir-192 source was designed based on commercially available sources as well as a virtual, cubic water phantom that can be imported into any TPS in DICOM format. The dose distribution of the generic Ir-192 source when placed at the center of the cubic phantom, and away from the center under altered scatter conditions, was evaluated using two commercial MBDCAs [Oncentra (R) Brachy with advanced collapsed-cone engine (ACE) and BrachyVision AcuRos (TM)]. Dose comparisons were performed using state-of-the-art MC codes for radiation transport, including ALGEBRA, BrachyDose, GEANT4, MCNP5, MCNP6, and pENELopE2008. The methodologies adhered to recommendations in the AAPM TG-229 report on high-energy brachytherapy source dosimetry. TG-43 dosimetry parameters, an along-away dose-rate table, and primary and scatter separated (PSS) data were obtained. The virtual water phantom of (201)(3) voxels (1 mm sides) was used to evaluate the calculated dose distributions. Two test case plans involving a single position of the generic HDR Ir-192 source in this phantom were prepared: (i) source centered in the phantom and (ii) source displaced 7 cm laterally from the center. Datasets were independently produced by different investigators. MC results were then compared against dose calculated using TG-43 and MBDCA methods. Results: TG-43 and PSS datasets were generated for the generic source, the PSS data for use with the ACE algorithm. The dose-rate constant values obtained from seven MC simulations, performed independently using different codes, were in excellent agreement, yielding an average of 1.1109 +/- 0.0004 cGy/(h U) (k = 1, Type A uncertainty). MC calculated dose-rate distributions for the two plans were also found to be in excellent agreement, with differences within type A uncertainties. Differences between commercial MBDCA and MC results were test, position, and calculation parameter dependent. On average, however, these differences were within 1% for ACUROS and 2% for ACE at clinically relevant distances. Conclusions: A hypothetical, generic HDR Ir-192 source was designed and implemented in two commercially available TPSs employing different MBDCAs. Reference dose distributions for this source were benchmarked and used for the evaluation of MBDCA calculations employing a virtual, cubic water phantom in the form of a CT DICOM image series. The implementation of a generic source of identical design in all TPSs using MBDCAs is an important step toward supporting univocal commissioning procedures and direct comparisons between TPSs.