Dose Optimization in Lumbar Spine Radiographic Examination by Air Gap Method at CR and DR Systems: A Phantom Study

Chan, Charles T. P.; Fung, Karl Ka Lok

doi:10.1016/j.jmir.2014.08.003

Cited by 3 publications

(11 citation statements)

References 38 publications

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“…From here, subsequent manipulations were made to produce images with lower dose. The manipulated SDD ranged from 100 to 150 cm as proposed by European Commission guidelines, being selected the extremes and a middle value (130 cm) to verify if differences on IQ and dose were noticeable [3,7,8,14,20]. The tube potentials varied from 75, 85, and 95 kVp as suggested in multiple studies previously performed [2,3,7,20,21] and also by the European Commission guidelines [20].…”

Section: Phase 1: Image Acquisitionmentioning

confidence: 99%

“…The highest reported effective dose (ED) for this examination was 1.5 mSv [2][3][4], which is considered a high-radiation exposure, when compared to the average annual background radiation dose of 2 mSv received by the Australian population [5]. This high dose level is mainly related to the exposure settings, considering that examination is performed in one of the body areas that has the highest x-ray attenuation, thus requiring higher beam energy to penetrate the pelvic bones [3]. The imaging of this anatomical area also involves the exposure of radiosensitive reproductive organs [2,6] and, for that reason, optimisation is critical since there is a potential risk of developing radiation-induced biological changes [2,3,6].…”

Section: Introductionmentioning

confidence: 96%

“…Lumbar spine radiography is a routine imaging examination performed to assess various conditions such as trauma, degenerative and neurologic symptoms [1]. The highest reported effective dose (ED) for this examination was 1.5 mSv [2][3][4], which is considered a high-radiation exposure, when compared to the average annual background radiation dose of 2 mSv received by the Australian population [5]. This high dose level is mainly related to the exposure settings, considering that examination is performed in one of the body areas that has the highest x-ray attenuation, thus requiring higher beam energy to penetrate the pelvic bones [3].…”

Section: Introductionmentioning

confidence: 99%

“…This high dose level is mainly related to the exposure settings, considering that examination is performed in one of the body areas that has the highest x-ray attenuation, thus requiring higher beam energy to penetrate the pelvic bones [3]. The imaging of this anatomical area also involves the exposure of radiosensitive reproductive organs [2,6] and, for that reason, optimisation is critical since there is a potential risk of developing radiation-induced biological changes [2,3,6]. This is even more important in chronic conditions such as scoliosis and other spine congenital anomalies requiring repeated examinations.…”

Section: Introductionmentioning

confidence: 99%

“…Since the principle "As Low As Reasonably Achievable" (ALARA) must be applied in clinical context [2,3,8,19], this study aims to address the research gap through the investigation of imaging parameters impact on lateral lumbar spine radiography reducing the ED whilst maintaining image quality (IQ) that allows the identifications of all relevant anatomical details.…”

Section: Introductionmentioning

confidence: 99%

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Effective dose and image optimisation of lateral lumbar spine radiography: a phantom study

2020

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Background: To investigate lateral lumbar spine radiography technical parameters for reduction of effective dose whilst maintaining image quality (IQ). Methods: Thirty-six radiograms of an anthropomorphic phantom were acquired using different exposure parameters: source-to-detector distance (SDD) (100, 130 or 150 cm), tube potential (75, 85 or 95 kVp), tube current × exposure time product (4.5, 9, 18 mAs) and additional copper (Cu) filter (no filter, 0.1-, 0.2-, or 0.3-mm thickness. IQ was assessed using an objective approach (contrast-to-noise-ratio [CNR] calculation and magnification measurement) and a perceptual approach (six observers); ED was estimated using the PCXMC 2.0 software. Descriptive statistics, paired t test, and intraclass correlation coefficient (ICC) were used. Results: The highest ED (0.022 mSv) was found with 100 cm SSD, 75 kVp, 18 mAs, and without Cu filter, whilst the highest CNR (7.23) was achieved at 130 cm SSD, 75 kVp, 18 mAs, and without Cu filter. The lowest ED and CNR were generated at 150 cm SDD, 95 kVp, 4.5 mAs, and 0.3-mm Cu filter. All observers identified the relevant anatomical structures on all images with the lowest ED and IQ. The intra-observer (0.61-0.79) and inter-observer (0.55-0.82) ICC ranged from moderate to excellent. Conclusion: All relevant anatomical structures were identified on the lateral lumbar spine radiographs despite using low-dose protocols. The lowest ED (0.002 mSv) was obtained with 150 cm SDD, 95 kVp, 4.5 mAs, and 0.3-mm Cu filter. Further technical and clinical studies are needed to verify these preliminary findings.

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Section: Phase 1: Image Acquisitionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effective dose and image optimisation of lateral lumbar spine radiography: a phantom study

2020

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Air gap technique is recommended in axiolateral hip radiographs

Kivistö

Kotiaho

Henner

et al. 2020

J Applied Clin Med Phys

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Purpose To investigate the replacement of conventional grid by air gap in axiolateral hip radiographs. The optimal air gap distance was studied with respect to radiation dose and image quality using phantom images, as well as 26 patient axiolateral hip radiographs. Methods The CDRAD phantom, along with polymethylmethacrylate slabs with thicknesses of 10.0, 14.6, and 20.0 cm was employed. The inverse image quality index and dose area product (DAP), as well as their combination, so called figure‐of‐merit (FOM) parameter, were evaluated for these images, with air gaps from 20 to 50 cm in increments of 10 cm. Images were compared to those acquired using a conventional grid utilized in hip radiography. Radiation dose was measured and kept constant at the surface of the detector by using a reference dosimeter. Verbal consent was asked from 26 patients to participate to the study. Air gap distances from 20 to 50 cm and tube current‐time products from 8 to 50 mAs were employed. Exposure index, DAP, as well as patient height and weight were recorded. Two radiologists evaluated the image quality of 26 hip axiolateral projection images on a 3‐point nondiagnostic — good/sufficiently good — too good scale. Source‐to‐image distance of 200 cm and peak tube voltage of 90 kVp were used in both studies. Results and conclusion Based on the phantom study, it is possible to reduce radiation dose by replacing conventional grid with air gap without compromising image quality. The optimal air gap distance appears to be 30 cm, based on the FOM analysis. Patient study corroborates this observation, as sufficiently good image quality was found in 24 of 26 patient radiographs, with 7 of 26 images obtained with 30 cm air gap. Thus, air gap method, with an air gap distance of 30 cm, is recommended in axiolateral hip radiography.

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Radiation dose and image quality optimization in lumbar spine digital radiography for overweight and obese patients: Phantom study

Prapan,

Chuprempri,

Fong-in

et al. 2024

JAMS

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Background: Lumbar spine radiography plays an important role in routine use for clinical practice in overweight and obese patients. The radiographer is responsible for setting suitable exposure factors for the tradeoffs between radiation dose and image quality (IQ). Objective: To investigate the effect of different kVp values combined with AEC used on radiation dose and IQ for routine lumbar spine radiography in overweight and obese patients. Materials and methods: A 1.5 and 3 cm thickness of frozen pork lard was placed on a pelvis phantom to simulate an overweight and obese patient, respectively. The phantom was imaged at 10 kVp intervals in combination with AEC used. For IQ evaluation, CNR and SNR were calculated, and the observer study was determined using visual grading scores (VGS) with a 5-point Likert scale. The radiation dose was measured using a DAP meter, and then the figure of merit (FOM) was calculated. Results: SNR and CNR for both AP and lateral projection showed a slightly decreasing trend when kVp increased in all groups. The DAP values decreased when the higher kVp was selected with AEC used in each group. The VGS by five radiographers showed good image quality in all groups, while the FOM at 100 and 109 kVp was the highest score for both AP and lateral projections. Conclusion: The optimal kVp setting in this study ranged from 100 to 109 kVp in combination with AEC used, indicating minimal radiation dose, while maintaining diagnostic IQ.

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Dose Optimization in Lumbar Spine Radiographic Examination by Air Gap Method at CR and DR Systems: A Phantom Study

Cited by 3 publications

References 38 publications

Effective dose and image optimisation of lateral lumbar spine radiography: a phantom study

Effective dose and image optimisation of lateral lumbar spine radiography: a phantom study

Air gap technique is recommended in axiolateral hip radiographs

Radiation dose and image quality optimization in lumbar spine digital radiography for overweight and obese patients: Phantom study

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