Image quality and dose analysis for a PA chest X-ray: Comparison between AEC mode acquisition and manual mode using the 10 kVp ‘rule’

Reis, Cláudia Sà dos; Gonçalves, João Nikolai Vargas; Klompmaker, Corrie; Bárbara, Ana Rita; Bloor, Chloe; Hegarty, Ryan; Lagrange, Tania; Temming, Noëlle; Sønnesyn, Mathilde; Røkeness, Henriette; Yamasathien, Amandine; Hogg, Peter

doi:10.1016/j.radi.2014.06.001

Cited by 10 publications

(14 citation statements)

References 23 publications

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“…This is an expected outcome as the inverse square law states that the radiation intensity is inversely proportional to the radiation source distance [8,14,18]. In alignment with previous findings, this study also indicates the efficacy of applying the 10-kVp rule in reducing ED when manipulating kVp and mAs [7,9,10,14]. This is because increasing the kVp itself would increase the dose, but with a concomitant decrease of mAs, would reduce the resulting ED [7,9,29].…”

Section: Discussionsupporting

confidence: 82%

“…Another technique for ED reduction is the use of additional Cu filter. As evident in this study, as well as in previous studies [7,10,11,23], the selection of the higher thickness of Cu filter could produce lower ED values. With additional beam filtration, the low-energy spectrum of x-rays will be removed, which consequently increases the penetration energy reducing the radiation absorption by the body tissues [7,12,13,22,23].…”

Section: Discussionsupporting

confidence: 81%

“…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]. The baseline mAs was determined at 18 mAs using the central sensor of the automated exposure control system and the subsequent values were achieved in accordance to the 10-kVp rule, which means that the mAs was halved with an increase of tube potential by 10 kVp [7,10,14]. Additional copper (Cu) filters with varying thicknesses of 0.1, 0.2, and 0.3 mm were used [3,7,12,13,22,23].…”

Section: Phase 1: Image Acquisitionmentioning

confidence: 99%

“…The ED was estimated using PCXMC 2.0 software based on Monte-Carlo simulations [2,3,7,9,10]. The estimation was performed by selecting ICRP 103 tissue weighting factors and using the exposure factors (kVp, mAs), SDD, focal-skin distance, collimation field and additional filtration parameters [2,7,10,11] selected for each image acquisition.…”

Section: Phase 2: Effective Dose Estimationmentioning

confidence: 99%

“…Typically, the published literature that identified optimisation in radiography merely analysed the impact of a single-exposure parameter instead of taking into account all of them. The most widely studied exposure parameters identified in the literature were the source-to-detector distance (SDD) [7][8][9], tube voltage (kVp), tube current × exposure time product (mAs) [9,10], additional beam filtrations [11][12][13], and type of projection (anterior-posterior, posterior-anterior, horizontal beam lateral) [2,[14][15][16][17]. These studies showed that a posterior-anterior lumbar spine radiogram was associated with a 65% ED reduction when compared to the anterior-posterior due to the attenuation of primary beam by the iliac bones [15,16].…”

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: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 81%

Section: Phase 1: Image Acquisitionmentioning

confidence: 99%

Section: Phase 2: Effective Dose Estimationmentioning

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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Radiation dose and image quality optimisation in medical imaging

Hogg

2015

J of Medical Radiation Sci

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An evaluation of the effect of tube potential on clinical image quality using direct digital detectors for pelvis and lumbar spine radiographs

Peacock

Steward

Riley

2020

J of Medical Radiation Sci

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Introduction: High kVp techniques, 15% or 10-kVp rules, are well-known dose reduction methods. Traditionally, the use of high tube potential (i.e. increased kVp) is associated with decreased radiographic contrast and overall image quality. Recent studies suggest contrast and image quality are not heavily reliant on kVp with digital systems. This study aims to assess the effects of the high tube potential technique on clinical radiographic image quality when using digital systems, to validate high kVp as a dose saving technique. Methods: A selection of comparable pelvis and lumbar spine radiographs were collected from the hospital's picture archiving and communication system (PACS), with technical factors recorded. All clinical radiographs were assessed by 5 senior radiographers using a 15-point visual grading analysis (VGA) rubric. Results: For 40 AP pelvis radiographs and 40 lateral lumbar spine radiographs, reduction in the dose area product (DAP) with higher kVp is seen. Average pelvis DAP at 75 kVp = 14.06 mGy.cm 2 ; 85 kVp = 7.47 mGy.cm 2. Average lumbar spine DAP at 80 kVp = 15.76 mGy.cm 2 ; 90 kVp = 14.83 mGy.cm 2. Image quality and contrast scores showed no statistically significant difference between the high and low kVp groups (z = 0.06 and 0.12, respectively). Average pelvis VGA score at 75 kVp = 11.26; 85 kVp = 12.55. Average lumbar spine VGA score at 80 kVp = 9.23; 90 kVp = 10.64. Conclusions: The high tube potential techniques allowed for reduced patient radiation doses whilst showing no degradation of diagnostic image quality in a clinical setting. This study successfully validates the high kVp technique as a useful tool for reducing patient radiation doses whilst maintaining high diagnostic image quality for digital pelvis and lumbar spine radiography.

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Image quality and dose analysis for a PA chest X-ray: Comparison between AEC mode acquisition and manual mode using the 10 kVp ‘rule’

Cited by 10 publications

References 23 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

Radiation dose and image quality optimisation in medical imaging

An evaluation of the effect of tube potential on clinical image quality using direct digital detectors for pelvis and lumbar spine radiographs

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