Scholars@Duke
Francesco Ria

Francesco Ria

Adjunct Assistant Professor in Radiology
Radiology
Department of Radiology, Durham, NC 27710
Department of Radiology, Durham, NC 27710

Scholarly Works - Journal articles

Correlation of Automated in Vivo Image Quality With Radiologist's Performance in Abdomen Computed Tomography Across Conventional and Deep Learning Reconstructions.

Journal article J Comput Assist Tomogr · July 2026 OBJECTIVE: Image quality evaluation in radiology is most relevant when reflects radiologists' performance. This study assessed how image quality measurement in terms of in vivo -characterized detectability index ( ) for low-contrast liver lesion assessment ... Full text Open Access Link to item Cite

Systems of Digital Twins: A Systematic Literature Review and a formal framework

Journal article Digital Engineering · May 1, 2026 The adoption of Digital Twins (DTs) in complex domains has motivated the formalization of systems of DTs to model complex physical entities with system-level properties. The current literature is characterized by a non-standardized and, in some cases, inco ... Full text Open Access Cite

Intraindividual Comparison of Half-Dose Gadopiclenol and Standard-Dose Gadobenate Dimeglumine for Contrast-Enhanced Abdominal MRI.

Journal article J Magn Reson Imaging · April 2026 BACKGROUND: Gadopiclenol is a high-relaxivity contrast agent enabling dose reduction while maintaining image quality. However, comparison with conventional agents remains limited in body MRI. PURPOSE: To intra-individually compare half-dose gadopiclenol an ... Full text Open Access Link to item Cite

Patient-specific organ dose and in-vivo image quality assessment in clinical CT.

Journal article Phys Med · August 2025 PURPOSE: To develop and characterize individualized dose and quality measures at organ level compared to their generic counterparts across a clinical CT dataset. MATERIALS AND METHODS: The study included 9801 chest-abdomen-pelvis and abdomen-pelvis CT exam ... Full text Open Access Link to item Cite

Development and Clinical Evaluation of a Contrast Optimizer for Contrast-Enhanced CT Imaging of the Liver.

Journal article J Comput Assist Tomogr · March 2025 OBJECTIVE: Patient characteristics, iodine injection, and scanning parameters can impact the quality and consistency of contrast enhancement of hepatic parenchyma in CT imaging. Improving the consistency and adequacy of contrast enhancement can enhance dia ... Full text Open Access Link to item Cite

Virtual imaging trials in medicine: A brief takeaway of the lessons from the first international summit.

Journal article Med Phys · March 2025 BACKGROUND: The rapid advancement of medical technologies presents significant challenges for researchers and practitioners. While traditional clinical trials remain the gold standard, they are often limited by high costs, lengthy durations, and ethical co ... Full text Open Access Link to item Cite

Technology Characterization Through Diverse Evaluation Methodologies: Application to Thoracic Imaging in Photon-Counting Computed Tomography.

Journal article J Comput Assist Tomogr · January 2025 OBJECTIVE: Different methods can be used to condition imaging systems for clinical use. The purpose of this study was to assess how these methods complement one another in evaluating a system for clinical integration of an emerging technology, photon-count ... Full text Open Access Link to item Cite

Optimization of abdominal CT based on a model of total risk minimization by putting radiation risk in perspective with imaging benefit.

Journal article Commun Med (Lond) · December 19, 2024 BACKGROUND: Risk-versus-benefit optimization required a quantitative comparison of the two. The latter, directly related to effective diagnosis, can be associated to clinical risk. While many strategies have been developed to ascertain radiation risk, ther ... Full text Open Access Link to item Cite

Proceedings Virtual Imaging Trials in Medicine 2024.

Journal article ArXiv · May 8, 2024 This submission comprises the proceedings of the 1st Virtual Imaging Trials in Medicine conference, organized by Duke University on April 22-24, 2024. The listed authors serve as the program directors for this conference. The VITM conference is a pioneerin ... Open Access Link to item Cite

Myelography Using Energy-Integrating Detector CT Versus Photon-Counting Detector CT for Detection of CSF-Venous Fistulas in Patients With Spontaneous Intracranial Hypotension.

Journal article AJR Am J Roentgenol · April 2024 BACKGROUND. CSF-venous fistulas (CVFs), which are an increasingly recognized cause of spontaneous intracranial hypotension (SIH), are often diminutive in size and exceedingly difficult to detect by conventional imaging. OBJECTIVE. This purpose of this stud ... Full text Open Access Link to item Cite

Characterizing imaging radiation risk in a population of 8918 patients with recurrent imaging for a better effective dose.

Journal article Sci Rep · March 14, 2024 An updated extension of effective dose was recently introduced, namely relative effective dose ( E r ), incorporating age and sex factors. In this study we extended E r application to a population of about 9000 patients who underwent multiple CT imaging ... Full text Open Access Link to item Cite

Image quality of photon counting and energy integrating chest CT - Prospective head-to-head comparison on same patients.

Journal article Eur J Radiol · September 2023 PURPOSE: To prospectively compare the image quality of high-resolution, low-dose photon-counting detector CT (PCD-CT) with standard energy-integrating-detector CT (EID) on the same patients. METHOD: IRB-approved, prospective study; patients received same-d ... Full text Open Access Link to item Cite

Making CT Dose Monitoring Meaningful: Augmenting Dose with Imaging Quality.

Journal article Tomography · April 7, 2023 Due to the concerns about radiation dose associated with medical imaging, radiation dose monitoring systems (RDMSs) are now utilized by many radiology providers to collect, process, analyze, and manage radiation dose-related information. Currently, most co ... Full text Open Access Link to item Cite

Comparative Assessment of the Absorbed Doses Resulted from Occupational Exposure and Computed Tomography

Journal article Medical Radiology and Radiation Safety · January 1, 2023 A comparative assessment of the absorbed doses resulted from computed tomography (CT) examinations, and the dose resulted from occupational external gamma exposure of the “Mayak” workers was carried out. The patients’ diagnostic radiation dose was reconstr ... Full text Open Access Cite

A patient-informed approach to predict iodinated-contrast media enhancement in the liver.

Journal article Eur J Radiol · November 2022 OBJECTIVE: To devise a patient-informed time series model that predicts liver contrast enhancement, by integrating clinical data and pharmacokinetics models, and to assess its feasibility to improve enhancement consistency in contrast-enhanced liver CT sca ... Full text Open Access Link to item Cite

Dose coefficients for organ dosimetry in tomosynthesis imaging of adults and pediatrics across diverse protocols.

Journal article Med Phys · August 2022 PURPOSE: The gold-standard method for estimation of patient-specific organ doses in digital tomosynthesis (DT) requires protocol-specific Monte Carlo (MC) simulations of radiation transport in anatomically accurate computational phantoms. Although accurate ... Full text Open Access Link to item Cite

Organ doses and cancer risk assessment in patients exposed to high doses from recurrent CT exams.

Journal article Eur J Radiol · April 2022 PURPOSE: To estimate cumulative organ doses and age- and gender-stratified cancer mortality risks in patients undergoing recurrent computed tomography (CT) exams. METHODS: Cohorts of patients who received cumulative effective dose ≥ 100 mSv were stratified ... Full text Open Access Link to item Cite

Statement of the Italian Association of Medical Physics (AIFM) task group on radiation dose monitoring systems.

Journal article Insights Imaging · February 5, 2022 The evaluation of radiation burden in vivo is crucial in modern radiology as stated also in the European Directive 2013/59/Euratom-Basic Safety Standard. Although radiation dose monitoring can impact the justification and optimization of radiological proce ... Full text Open Access Link to item Cite

Deep learning classification of COVID-19 in chest radiographs: performance and influence of supplemental training.

Journal article J Med Imaging (Bellingham) · November 2021 Purpose: Accurate classification of COVID-19 in chest radiographs is invaluable to hard-hit pandemic hot spots. Transfer learning techniques for images using well-known convolutional neural networks show promise in addressing this problem. These methods ca ... Full text Open Access Link to item Cite

Comparison of 12 surrogates to characterize CT radiation risk across a clinical population.

Journal article Eur Radiol · September 2021 OBJECTIVES: Quantifying radiation burden is essential for justification, optimization, and personalization of CT procedures and can be characterized by a variety of risk surrogates inducing different radiological risk reflections. This study compared how t ... Full text Open Access Link to item Cite

Patient-Informed Organ Dose Estimation in Clinical CT: Implementation and Effective Dose Assessment in 1048 Clinical Patients.

Journal article AJR Am J Roentgenol · March 2021 OBJECTIVE. The purpose of this study is to comprehensively implement a patient-informed organ dose monitoring framework for clinical CT and compare the effective dose (ED) according to the patient-informed organ dose with ED according to the dose-length pr ... Full text Open Access Link to item Cite

Classification of COVID-19 in chest radiographs: assessing the impact of imaging parameters using clinical and simulated images

Journal article Proc. SPIE 11597, Medical Imaging 2021: Computer-Aided Diagnosis, 115970A · February 15, 2021 As computer-aided diagnostics develop to address new challenges in medical imaging, including emerging diseases such as COVID-19, the initial development is hampered by availability of imaging data. Deep learning algorithms are particularly notorious for p ... Full text Open Access Link to item Cite

Estimation of in vivo noise in clinical CT images: comparison and validation of three different methods against ensemble noise gold-standard

Journal article Proc. SPIE 11595, Medical Imaging 2021: Physics of Medical Imaging, 115952P · February 15, 2021 Image quality estimation is crucial in modern CT with noise magnitude playing a key role. Several methods have been proposed to estimate noise surrogates in vivo. This study aimed to ascertain the accuracy of three different noise-magnitude estimation meth ... Open Access Link to item Cite

A database of 40 patient-based computational models for benchmarking organ dose estimates in CT.

Journal article Med Phys · December 2020 PURPOSE: Patient radiation burden in computed tomography (CT) can best be characterized through risk estimates derived from organ doses. Organ doses can be estimated by Monte Carlo simulations of the CT procedures on computational phantoms assumed to emula ... Full text Open Access Link to item Cite

A comparison of COVID-19 and imaging radiation risk in clinical patient populations.

Journal article J Radiol Prot · November 11, 2020 The outbreak of coronavirus SARS-COV2 affected more than 180 countries necessitating fast and accurate diagnostic tools. Reverse transcriptase polymerase chain reaction (RT-PCR) has been identified as a gold standard test with Chest CT and Chest Radiograph ... Full text Open Access Link to item Cite

Technical Note: Validation of TG 233 phantom methodology to characterize noise and dose in patient CT data.

Journal article Med Phys · April 2020 PURPOSE: Phantoms are useful tools in diagnostic CT, but practical limitations reduce phantoms to being only a limited patient surrogate. Furthermore, a phantom with a single cross sectional area cannot be used to evaluate scanner performance in modern CT ... Full text Open Access Link to item Cite

Patient-Informed and Physiology-Based Modelling of Hepatic Contrast Dynamics in Contrast-Enhanced CT Imaging

Journal article · March 16, 2020 PURPOSE Iodinated contrast agents are commonly used in CT imaging to enhance tissue contrast. Consistency in contrast enhancement (CE) is critical in radiological diagnosis. Contrast material circulation in individual patients is affected by factors such a ... Open Access Cite

Modeling Patient-Informed Liver Contrast Perfusion in Contrast-enhanced Computed Tomography.

Journal article J Comput Assist Tomogr · 2020 OBJECTIVE: To determine the correlation between patient attributes and contrast enhancement in liver parenchyma and demonstrate the potential for patient-informed prediction and optimization of contrast enhancement in liver imaging. METHODS: The study incl ... Full text Open Access Link to item Cite

Expanding the Concept of Diagnostic Reference Levels to Noise and Dose Reference Levels in CT.

Journal article AJR Am J Roentgenol · October 2019 OBJECTIVE. Diagnostic reference levels were developed as guidance for radiation dose in medical imaging and, by inference, diagnostic quality. The objective of this work was to expand the concept of diagnostic reference levels to explicitly include noise o ... Full text Open Access Link to item Cite

Awareness of medical radiation exposure among patients: A patient survey as a first step for effective communication of ionizing radiation risks.

Journal article Phys Med · November 2017 INTRODUCTION: The European Directive 2013/59/EURATOM requires patient radiation dose information to be included in the medical report of radiological procedures. To provide effective communication to the patient, it is necessary to first assess the patient ... Full text Open Access Link to item Cite

Image noise and dose performance across a clinical population: Patient size adaptation as a metric of CT performance.

Journal article Med Phys · June 2017 PURPOSE: Modern CT systems adjust X-ray flux accommodating for patient size to achieve certain image noise values. The effectiveness of this adaptation is an important aspect of CT performance and should ideally be characterized in the context of real pati ... Full text Open Access Link to item Cite

Adaptability index: quantifying CT tube current modulation performance from dose and quality informatics

Journal article Proc. SPIE 10132, Medical Imaging 2017: Physics of Medical Imaging, 101322N (March 9, 2017) · March 9, 2017 The balance between risk and benefit in modern CT scanners is governed by the automatic adaptation mechanisms that adjust x-ray flux for accommodating patient size to achieve certain image noise values. The effectiveness of this adaptation is an important ... Full text Open Access Link to item Cite

Risk assessment and economic impact analysis of the implementation of new European legislation on radiopharmaceuticals in Italy: the case of the new monograph chapter Compounding of Radiopharmaceuticals (PHARMEUROPA, Vol. 23, No. 4, October 2011).

Journal article Curr Radiopharm · December 2013 An assessment of the new monograph chapter Compounding of Radiopharmaceuticals has been conducted on the basis of the first period of implementation of Italian legislation on Good Radiopharmaceuticals Practice (NBP) in the preparation of radiopharmaceutica ... Full text Open Access Link to item Cite