Conventional chest radiography is limited by the small useful exposure range of radiographic film. The wide variation in absorption thickness of different parts of the chest results in areas of under- and over-exposure. An advanced multiple-beam equalization system, AMBER, controls local exposure delivered to the film. The system has a row of 20 modulators in front of the x-ray tube, each able to change the height of the local slit beam during scanning. Changes are made in response to measurements from a linear detector array in front of the film cassette. This array consists of 20 individually functioning detectors coupled through electronic feedback loops to the 20 modulators. A scan is obtained in 0.8 second with a local exposure time of approximately 50 msec. AMBER results in radiographs with significantly improved exposure of the mediastinum without overexposure of the lungs.
To evaluate the efficacy of AMBER, a multiple-beam equalization system for chest radiography, the authors performed a nodule detection study using an anthropomorphic chest phantom. AMBER and conventional images were compared. The images were read by four observers, and analysis was done by means of modified receiver-operating characteristic (ROC) curves (free ROC curves [FROC]). The results of the FROC analysis show a significant increase in the detectability of nodules (P less than .001) projected over the mediastinum with the use of AMBER. No significant difference between AMBER and conventional images was noted in detectability of nodules projected over the lung.
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