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  1. Abdullah KA, Reed W
    J Med Radiat Sci, 2018 Sep;65(3):237-239.
    PMID: 29971971 DOI: 10.1002/jmrs.292
    Three-dimensional (3D) printing technology has demonstrated a huge potential for the future of medicine. Since its introduction, it has been used in various areas, for example building anatomical models, personalising medical devices and implants, aiding in precision medical interventions and the latest development, 3D bioprinting. This commentary is provided to outline the current use of 3D printing in medical imaging and its future directions for advancing the healthcare services.
  2. Reed WM, Schrader DL
    Poult Sci, 1989 May;68(5):631-8.
    PMID: 2547209
    An avian pox virus was isolated from cutaneous proliferative lesions removed from greater hill mynahs (Gracula religiosa) imported from Malaysia. Cutaneous inoculation of specific pathogen-free chickens and bobwhite quail with the mynah pox virus resulted in severe proliferative cutaneous lesions similar to those seen in the naturally infected mynah birds. Microscopically, the reaction in the chickens and quail at sites of virus inoculation was characterized by marked epithelial hyperplasia with ballooning degeneration and formation of cytoplasmic inclusion bodies. Inoculation of conjunctival and oral mucosae of chickens by applying pox virus with a cotton swab did not result in gross or microscopic lesions. In cross-protection studies, chickens and bobwhite quail immunized with either quail, fowl, pigeon, turkey, or psittacine pox vaccines were not protected from challenge with mynah pox virus. Following vaccination of quail and chickens with mynah pox virus vaccine, there was no resistance to challenge by quail, fowl, pigeon, turkey, or psittacine pox viruses. Significant protection against development of lesions following inoculation with mynah pox virus was attained only when the homologous virus was used as a vaccine.
  3. Abdullah KA, McEntee MF, Reed W, Kench PL
    J Med Imaging Radiat Oncol, 2016 Aug;60(4):459-68.
    PMID: 27241506 DOI: 10.1111/1754-9485.12473
    The aim of this systematic review is to evaluate the radiation dose reduction achieved using iterative reconstruction (IR) compared to filtered back projection (FBP) in coronary CT angiography (CCTA) and assess the impact on diagnostic image quality. A systematic search of seven electronic databases was performed to identify all studies using a developed keywords strategy. A total of 14 studies met the criteria and were included in a review analysis. The results showed that there was a significant reduction in radiation dose when using IR compared to FBP (P  0.05). The mean ± SD difference of image noise, signal-noise ratio (SNR) and contrast-noise ratio (CNR) were 1.05 ± 1.29 HU, 0.88 ± 0.56 and 0.63 ± 1.83 respectively. The mean ± SD percentages of overall image quality scores were 71.79 ± 12.29% (FBP) and 67.31 ± 22.96% (IR). The mean ± SD percentages of coronary segment analysis were 95.43 ± 2.57% (FBP) and 97.19 ± 2.62% (IR). In conclusion, this review analysis shows that CCTA with the use of IR leads to a significant reduction in radiation dose as compared to the use of FBP. Diagnostic image quality of IR at reduced dose (30-41%) is comparable to FBP at standard dose in the diagnosis of CAD.
  4. Mohd Norsuddin N, Mello-Thoms C, Reed W, Lewis S
    Asian Pac J Cancer Prev, 2019 Feb 26;20(2):537-543.
    PMID: 30803217
    Rationale and objectives: Target recall rates are often used as a performance indicator in mammography screening
    programs with the intention of reducing false positive decisions, over diagnosis and anxiety for participants. However,
    the relationship between target recall rates and cancer detection is unclear, especially when readers are directed to
    adhere to a predetermined rate. The purpose of this study was to explore the effect of setting different recall rates on
    radiologist’s performance. Materials and Methods: Institutional ethics approval was granted and informed consent
    was obtained from each participating radiologist. Five experienced breast imaging radiologists read a single test set
    of 200 mammographic cases (20 abnormal and 180 normal). The radiologists were asked to identify each case that
    they required to be recalled in three different recall conditions; free recall, 15% and 10% and mark the location of any
    suspicious lesions. Results: Wide variability in recall rates was observed when reading at free recall, ranging from
    18.5% to 34.0%. Readers demonstrated significantly reduced performance when reading at prescribed recall rates,
    with lower sensitivity (H=12.891, P=0.002), case location sensitivity (H=12.512, P=0.002) and ROC AUC (H=11.601,
    P=0.003) albeit with an increased specificity (H=12.704, P=0.002). However, no significant changes were evident in
    lesion location sensitivity (H=1.982, P=0.371) and JAFROC FOM (H=1.820, P=0.403). Conclusion: In this laboratory
    study, reducing the number of recalled cases to 10% significantly reduced radiologists’ performance with lower detection
    sensitivity, although a significant improvement in specificity was observed.
  5. Abdullah KA, McEntee MF, Reed W, Kench PL
    J Med Radiat Sci, 2020 Sep;67(3):170-176.
    PMID: 32219989 DOI: 10.1002/jmrs.387
    INTRODUCTION: 3D-printed imaging phantoms are now increasingly available and used for computed tomography (CT) dose optimisation study and image quality analysis. The aim of this study was to evaluate the integrated 3D-printed cardiac insert phantom when evaluating iterative reconstruction (IR) algorithm in coronary CT angiography (CCTA) protocols.

    METHODS: The 3D-printed cardiac insert phantom was positioned into a chest phantom and scanned with a 16-slice CT scanner. Acquisitions were performed with CCTA protocols using 120 kVp at four different tube currents, 300, 200, 100 and 50 mA (protocols A, B, C and D, respectively). The image data sets were reconstructed with a filtered back projection (FBP) and three different IR algorithm strengths. The image quality metrics of image noise, signal-noise ratio (SNR) and contrast-noise ratio (CNR) were calculated for each protocol.

    RESULTS: Decrease in dose levels has significantly increased the image noise, compared to FBP of protocol A (P 

  6. Abdullah KA, McEntee MF, Reed W, Kench PL
    J Med Radiat Sci, 2018 Sep;65(3):175-183.
    PMID: 29707915 DOI: 10.1002/jmrs.279
    INTRODUCTION: An ideal organ-specific insert phantom should be able to simulate the anatomical features with appropriate appearances in the resultant computed tomography (CT) images. This study investigated a 3D printing technology to develop a novel and cost-effective cardiac insert phantom derived from volumetric CT image datasets of anthropomorphic chest phantom.

    METHODS: Cardiac insert volumes were segmented from CT image datasets, derived from an anthropomorphic chest phantom of Lungman N-01 (Kyoto Kagaku, Japan). These segmented datasets were converted to a virtual 3D-isosurface of heart-shaped shell, while two other removable inserts were included using computer-aided design (CAD) software program. This newly designed cardiac insert phantom was later printed by using a fused deposition modelling (FDM) process via a Creatbot DM Plus 3D printer. Then, several selected filling materials, such as contrast media, oil, water and jelly, were loaded into designated spaces in the 3D-printed phantom. The 3D-printed cardiac insert phantom was positioned within the anthropomorphic chest phantom and 30 repeated CT acquisitions performed using a multi-detector scanner at 120-kVp tube potential. Attenuation (Hounsfield Unit, HU) values were measured and compared to the image datasets of real-patient and Catphan® 500 phantom.

    RESULTS: The output of the 3D-printed cardiac insert phantom was a solid acrylic plastic material, which was strong, light in weight and cost-effective. HU values of the filling materials were comparable to the image datasets of real-patient and Catphan® 500 phantom.

    CONCLUSIONS: A novel and cost-effective cardiac insert phantom for anthropomorphic chest phantom was developed using volumetric CT image datasets with a 3D printer. Hence, this suggested the printing methodology could be applied to generate other phantoms for CT imaging studies.

  7. Mohd Norsuddin N, Mello-Thoms C, Reed W, Rickard M, Lewis S
    Br J Radiol, 2017 Aug;90(1076):20170048.
    PMID: 28621548 DOI: 10.1259/bjr.20170048
    OBJECTIVE: This study investigated whether certain mammographic appearances of breast cancer are missed when radiologists read at lower recall rates.

    METHODS: 5 radiologists read 1 identical test set of 200 mammographic (180 normal cases and 20 abnormal cases) 3 times and were requested to adhere to 3 different recall rate conditions: free recall, 15% and 10%. The radiologists were asked to mark the locations of suspicious lesions and provide a confidence rating for each decision. An independent expert radiologist identified the various types of cancers in the test set, including the presence of calcifications and the lesion location, including specific mammographic density.

    RESULTS: Radiologists demonstrated lower sensitivity and receiver operating characteristic area under the curve for non-specific density/asymmetric density (H = 6.27, p = 0.04 and H = 7.35, p = 0.03, respectively) and mixed features (H = 9.97, p = 0.01 and H = 6.50, p = 0.04, respectively) when reading at 15% and 10% recall rates. No significant change was observed on cancer characterized with stellate masses (H = 3.43, p = 0.18 and H = 1.23, p = 0.54, respectively) and architectural distortion (H = 0.00, p = 1.00 and H = 2.00, p = 0.37, respectively). Across all recall conditions, stellate masses were likely to be recalled (90.0%), whereas non-specific densities were likely to be missed (45.6%).

    CONCLUSION: Cancers with a stellate mass were more easily detected and were more likely to continue to be recalled, even at lower recall rates. Cancers with non-specific density and mixed features were most likely to be missed at reduced recall rates. Advances in knowledge: Internationally, recall rates vary within screening mammography programs considerably, with a range between 1% and 15%, and very little is known about the type of breast cancer appearances found when radiologists interpret screening mammograms at these various recall rates. Therefore, understanding the lesion types and the mammographic appearances of breast cancers that are affected by readers' recall decisions should be investigated.

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