ObjectivesWe evaluated the different Virtual Grid software ratios (Fujifilm, Tokyo, Japan) on gridless clinical chest radiographs with visual grading analysis (VGA). In addition, we investigated the 2 image quality assessment algorithms (IQAAs).Materials and MethodsGridless chest radiographs of 50 different intensive care unit patients were collected and afterward processed with Virtual Grid software. Different software (SW) grid ratios—6:1, 10:1, 13:1, 17:1, and 20:1—were applied to investigate the image quality (IQ) improvement. Image quality improvement was assessed by 4 radiologists in a relative VGA study where the reference image was processed with SW grid ratio of 10:1. One of the IQAAs used to analyze the radiographs was implemented in our department but was originally developed by the research group of the Duke University Medical Center. A general IQ score (IQS) was calculated based on contrast, detail, and noise. Another IQAA—NIQE (naturalness image quality evaluator)—available in Matlab (MATLAB Research R2019b; the MathWorks, Inc) was evaluated. Both methods were compared with VGA.ResultsVisual grading analysis scores of gridless radiographs are significantly lower (P < 0.001). Image quality increases with increasing SW grid ratios, up to grid ratio of 17:1. However, some anatomical structures—spine and ribs—are negatively affected by the higher grid ratios. A correlation coefficient of 0.99 between the VGA and the IQS was observed. The correlation coefficient between VGA and NIQE was 1.00.ConclusionsVirtual Grid with SW grid ratio of 6:1 improves the IQ of gridless chest bedside radiographs. The grid ratios 17:1 and 20:1 should be considered carefully as the SW negatively affects parts of the ribs and spine. Therefore, grid ratios up to 13:1 can be advised. The IQAAs are promising and could be used to detect differences in IQ when different scatter correction SW settings are used.

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In this case report, an illustrative case of pulmonary hydatidosis in a young South African girl is presented. The acute symptomatology, rapidly worsening clinical condition and the extremely atypical appearance of the hydatid cysts on imaging were initially misleading and raised suspicion for malignant disease.

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Extraosseous or extraskeletal Ewing’s sarcoma is a very rare mesenchymal soft tissue malignancy. We report on a case of abdominal swelling in an 80-year-old woman caused by a large intra-abdominal EES. This case report illustrates that Ewing’s sarcoma can occur in adults and elderly, and highlights the importance of early diagnosis because of poor prognosis.