Grant: Discovery Horizons

Introduction: Nearly two-thirds of the world’s population has no access to diagnostic medical imaging; this is a startling statistic, considering that it has been well over a century since Roentgen’s discovery of x-rays. We believe that a transdisciplinary research approach will result in the development of cost-effective digital radiography systems for low- and middle-income countries and other low-resource settings (LRS). Goals: The specific goals of this program are to (1) to develop and evaluate a peripheral digital radiography system, incorporating a portable x-ray source, phosphor screen, and full-frame digital camera; (2) to develop and implement advanced image processing tools to eliminate motion blur and increase the useful field-of-view for diagnosis of long-bone fracture; (3) to perform rigorous performance evaluation, in comparison with current digital radiography solutions in a local clinic. Approach: The approach that we propose is part of the “frugal biomedical innovation” strategy that we have developed at Western University. This involves the careful selection of cost-effective core technology, which can be adapted and augmented for biomedical applications in LRS. In this case, one of our approaches will be to combine consumer-grade digital SLR cameras with x-ray detectors. Methods: We will investigate the use of commercial digital camera technology, using large-format CMOS detectors, coupled by a lens to a commercial x-ray phosphor screen. The camera that we have selected for initial tests has a full-frame detector with very low-noise performance characteristics. System characteristics will be optimized in partnership with colleagues in Kenya. Performance will be quantified using objective measures (modulation transfer function, detective quantum efficiency), as well as with qualitative evaluations (anthropomorphic quality assurance phantoms). Team: Our team comprises experts in medical imaging and device development (Holdsworth), x-ray imaging and image quality assessment (Cunningham) and clinical radiography (Paul). The co-applicants have also established partnerships in LRS, specifically in Kenya (Kenyatta University and University of Nairobi). Training Plan: Our transdisciplinary approach will provide outstanding training opportunities in medical biophysics, biomedical engineering, and radiology. Students will have the opportunity for international exchange and internship in low-resource settings.