Antiscatter grid use in pediatric digital tomosynthesis imaging

Abstract

The objective of this study was to assess the effect of antiscatter grid use on tomosynthesis image quality. We performed an observer study that rated the image quality of digital tomosynthesis scout radiographs and slice images of a Leeds TO.20 contrast‐detail test object embedded in acrylic with and without a grid. We considered 10, 15, 20 and 25 cm of acrylic to represent the wide range of patient thicknesses encountered in pediatric imaging. We also acquired and rated images without a grid at an increased patient dose. The readers counted the total number of visible details in each image as a measure of relative image quality. We observed that the antiscatter grid improves tomosynthesis image quality compared to the grid‐out case, which received image quality scores similar to grid‐in radiography. Our results suggest that, in order to achieve the best image quality in exchange for the increase in patient dose, it may often be appropriate to include an antiscatter grid for pediatric tomosynthesis imaging, particularly if the patient thickness is greater than 10 cm.PACS number: 87.57.‐s

The effect of anti-scatter grid on radiation dose in chest radiography in children

“…In fact the image quality not only remained diagnostically appropriate, but in some cases the quality of the images taken without a grid received even better grades than those taken with a grid. This statement is contrary to the findings of the reviewed literature that report a significant decline in image quality after removal of the grid (1,(8)(9). This discrepancy may be due to the fact that we focused on the diagnostic value of the images rather than on the physical parameters of image quality, such as contrast and signal-to-noise ratio.…”

“…Another relevant factor may be the detector technology used in the study. As reported previously, the improved technical characteristics of modern digital detectors may make them less affected by the removal of the anti-scatter grid than was the case with conventional technologies used in older studies (9,(10)(11). One of the main limitations of this study is that the images were graded by a single evaluator.…”

Comparison of pediatric radiation dose and vessel visibility on angiographic systems using piglets as a surrogate: antiscatter grid removal vs. lower detector air kerma settings with a grid — a preclinical investigation

“…Conventionally, pediatric imaging has been viewed as an opportunity to reduce patient dose by removing the antiscatter grid. The reduction of pediatric patient dose has been quantified numerous times, 7 , 13 , 16 , 17 , 18 , 19 but the loss of image quality, due to the increase in scatter (increased scatter/primary) when evaluated, was quantified with phantoms as opposed to live animal models 7 , 9 , 14 , 16 , 17 , 20 . This manuscript suggests the alternative of leaving the grid in place to preserve contrast, but lowering detector ${\mathrm{K}}_{\text{air}}$ setting to reduce piglet ${\mathrm{K}}_{\text{air}}/\text{fr}$ which reduces the piglet's dose.…”

“…To this end, numerous authors over a number of years have recommended removing the antiscatter grid from the X‐ray beam during fluoroscopic examinations of small children 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 . While some authors have quantified the reduction in patient dose to these pediatric patients, 7 , 13 , 16 , 17 , 18 , 19 the loss of image quality associated with this reduction in patient dose has been measured only on a limited basis 7 , 9 , 14 , 16 , 17 , 20 with phantoms as opposed to live models. In addition, the studies that do exist 7 , 20 , 21 tend to address the pediatric interventional cardiology laboratory application as opposed to the pediatric interventional radiology laboratory.…”

White Paper on P4 Concepts for Pediatric Imaging

“…Tomosynthesis has demonstrated a substantial reduction in radiation compared to low-dose CT [1, 2]. Early applications in children are promising, including evaluation of the lungs in children with cystic fibrosis [3–5]. …”