The Practice of Chest Radiography Using Different Digital Imaging Systems: Dose and Image Quality

Document Type : Original Paper

Authors

1 International Islamic University Malaysia

2 Department of Diagnostic Imaging and Radiotherapy, Kulliyah of Allied Health Sciences, International Islamic University Malaysia

Abstract

Introduction: The study was undertaken to evaluate the practice of chest radiography using different digital imaging systems and its influence on dose and image quality.
 Materials and Methods: The study was carried out in two hospitals from March 2016 to June 2016. Sixty ambulatory patients aged 21 to 60 years who were able to cooperate without difficulty and weighed between 60 to 80 kg were selected randomly. The active matrix flat panel imagers technology was employed in the direct radiography (DR) system for Hospital A, whilst Hospital B used the single read out computed radiography (CR) system. The dose area product (DAP) meter was utilized in measuring the entrance surface air kerma. The chest radiographs were evaluated by two radiologists.
 Results: The mean entrance surface doses (ESDs) for posteroanterior chest in Hospital A (0.098 mGy) was lower than that obtained in Hospital B (0.161 mGy). However, the ESDs at both centres were lower than the recommended value by the International Atomic Energy Agency (IAEA; 0.3 mGy). The quality of the images for chest radiography in both hospitals was adequate to make a diagnosis with ESDs and effective doses lower than those recommended by IAEA and United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR).
 Conclusion: The study serves to highlight the practice of chest radiography with two different systems and its influence on image quality and dose. It can be concluded that there were significant differences in image quality and radiation dose for chest radiography practice using CR and DR.

Keywords

Main Subjects


  1. Schaefer-Prokop C, Neitzel U, Venema HK, Uffmann M, Prokop M. Digital chest radiography: an update on modern technology, dose containment and control of image quality. European Radiology. 2008; 18(9): 1818-30.
  2. Grewal NY. Digital chest radiography image quality assessment with dose reduction. Australas Phys Eng Sci Med. 2012; 35(1): 71-80.
  3. ICRU Report 70 – Image quality in chest radiography. International Commission on Radiation Units and Measurements 2003: Nuclear Technology Publishing, Ashford, Kent, UK.
  4. ICRP, 2004. Managing Patient Dose in Digital Radiology. ICRP Publication 93. Ann. ICRP 34 (1).
  5. Uffman M, Schaefer-Prokop C. Digital radiography: the balance between image quality and required radiation dose. Eur J Radiol. 2009; 72: 202-8.
  6. Lanca L and Silva A. Digital radiography detectors. Digital imaging systems for plain radiography. New York: Springer Science; 2013.
  7. Williams MB, Krupinski E, Strauss KJ, Breeden WK, Rzeszotarski MS, et al. Digital radiography image quality: image acquisition. J Am Coll Radiol. 2012; 4: 371-88.
  8. Sun Z, Lin C, Tyan Y, Ng KH. Optimization of chest radiographic imaging parameters: a comparison of image quality and entrance skin dose for digital chest radiography systems. Clinical Imaging. 2012; 36:279-86.
  9. Kroft LJM, Veldkamp WJH, Mertens BJA, van Delft JPA, Geleijns J. Dose reduction in digital chest radiography and perceived image quality. Br J Radiol. 2007; 80: 984-8.
  10. Bernhardt TM, Rapp-Bernhardt U, Lenzen H, Rohl FW, Diederich S, Papke K, et al. Diagnostic performance of a flat panel detector at low tube voltage in chest radiography: a phantom study. Invest Radiol. 2004; 39: 97-103.
  11. Gruber M, Uffman M, Weber M, Prokop M, Balassy C, Schaefer-Prokop C. Direct detector radiography versus dual reading computed radiography: feasibility of dose reduction in chest radiography. Eur Radiol. 2006; 16: 1544-50.
  12. Uffman M, Neitzel U, Prokop M, Kabalan N, Weber M, Herold CJ, et al. Flat panel detector for chest radiography: effect of tube voltage on image quality. Radiology. 2005; 235: 642-50.
  13. European Commission. European guidelines on quality criteria for diagnostic radiographic images. Luxembourg: European Commission; 1996. EUR 16260 EN.
  14. Coakes SJ, Steed L, Ong C. SPSS version 16.0 for windows: Analysis without anguish. Milton: John Wiley; 2009.
  15. Hart D, Hillier M, Shrimpton P. (HPA CRCE-034) on Doses to patients from radiographic and fluoroscopic X-ray imaging procedures in the UK. Chilton: Health Protection Agency Centre for Radiation, Chemical and Environmental Hazards. 2010.
  16. Asadinezhad M, Toossi MTB. Doses to patients in some routine diagnostic x-ray examinations in Iran: Proposed the first Iranian diagnostic reference levels. Radiat prot dosimetry. 2008; 132(4): 409-14.
  17. Ministry of Health Malaysia report on medical radiation exposure study in Malaysia. MOH Malaysia 2009.
  18. Muhogora WE, Ahmed NA, Almosabihi A, Alsuwaidi JS, Beganovic A, Ciraj-Bjelac O, et al. Patient doses in radiographic examinations in 12 countries in Asia, Africa, and Eastern Europe: Initial results from IAEA projects. AJR Am J Roentgenol. 2008; 190(6): 1453-61.
  19. Wall B, Haylock R, Jansen J, Hillier M, Hart D, Shrimpton P. Radiation risks from medical X-ray examinations as a function of the age and sex of the patient. Chilton: Health Protection Agency Centre for Radiation, Chemical and Environmental Hazards. 2011.
  20. Ching W, Robinson J, McEntee M. Patient based radiographic exposure factor selection: a systematic review. Journal of Medical Radiation Science. 2014; 61(3): 176-90.
  21. Ofori EK, Ofori-Manteaw BB, Gawugah JN, Nathan JA. Relationship between patient anatomical thickness and radiographic exposure factors for selected radiological examination. Journal of Health, Medicine and Nursing 2016; 23:150-62.
  22. Gibson DJ, Davidson RA. Exposure creep in computed radiography: a longitudinal study. Acad Radiol. 2012; 19: 458-62.
  23. Herrmann TL, Fauber TL, Gill J, et al. Best practices in digital radiography.Radiol Technol. 2012; 84: 83-9.
  24. European Commission (RP 154) on European guidance of estimating population doses from medical x-ray procedures. Off J Eur Communities. 2008.
  25. Baker M. Investigation into factors influencing Fuji S-value using an extremity phantom. J Med Imaging Radiat Sci. 2012; 43:34–7.
  26. Mothiram U, Brennan PC, Robinson J, Lewis SJ, Moran B. Retrospective evaluation of exposure index (EI) values from plain radiographs reveals important considerations for quality improvement. J Med Radiat Sci. 2013; 60:115–22.
  27. Shepard SJ, Wang J, Flynn M, et al. An exposure indicator for digital radiography. American Association of Physicists in Medicine: AAPM Task Group 116 (executive summary). Medical physics. 2009 Jul 1;36(7):2898-914.
  28. Siebert JA. Digital radiography: The bottom line comparison of CR and DR. Applied Radiology. 2009 May 21;38(5):21-9.
  29. Siebert JA, Boone JM III, Cooper VN, Lindfors KK. Cassette based digital mammography. Technol Cancer Res Treat. 2004; 3: 413-27.
  30. Culley JD, Powell GF, Gingold EL, Reith K. Digital radiography systems: an overview.Available at http://www.hologic.com/oem/pdf/DROverviewR_Nov2000.pdf (2000).
  31. United Nations Scientific Committee on the effects of atomic radiation (Report to the general assembly Vol 11 with scientific annexes C, D, E) on the sources and effects of atomic radiation. New York: Off J UNSCEAR. 2008.