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Review
. 2008 Sep;18(9):1818-30.
doi: 10.1007/s00330-008-0948-3. Epub 2008 Apr 23.

Digital chest radiography: an update on modern technology, dose containment and control of image quality

Cornelia Schaefer-Prokop  1 , Ulrich Neitzel, Henk W Venema, Martin Uffmann, Mathias Prokop
Affiliations
Review

Digital chest radiography: an update on modern technology, dose containment and control of image quality

Cornelia Schaefer-Prokop et al. Eur Radiol. 2008 Sep.

Abstract

The introduction of digital radiography not only has revolutionized communication between radiologists and clinicians, but also has improved image quality and allowed for further reduction of patient exposure. However, digital radiography also poses risks, such as unnoticed increases in patient dose and suboptimum image processing that may lead to suppression of diagnostic information. Advanced processing techniques, such as temporal subtraction, dual-energy subtraction and computer-aided detection (CAD) will play an increasing role in the future and are all targeted to decrease the influence of distracting anatomic background structures and to ease the detection of focal and subtle lesions. This review summarizes the most recent technical developments with regard to new detector techniques, options for dose reduction and optimized image processing. It explains the meaning of the exposure indicator or the dose reference level as tools for the radiologist to control the dose. It also provides an overview over the multitude of studies conducted in recent years to evaluate the options of these new developments to realize the principle of ALARA. The focus of the review is hereby on adult applications, the relationship between dose and image quality and the differences between the various detector systems.

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Figures

Fig. 1
Fig. 1
Electron microscopic views from a powder- (a) and a needle-structured (b) storage phosphor plate (courtesy of Dr. Schaetzing, Agfa, Mortsel, Belgium)
Fig. 2
Fig. 2
Schematic view from a single read out (a) and a dual read-out (b) system of a storage phosphor plate
Fig. 3
Fig. 3
Postero-anterior radiograph of 3-year-old boy obtained with a needle-structured phosphor plate at 30% reduced acquisition dose (speed 600) (courtesy of Dr. Koerner, Grosshadern, Munich, Germany)
Fig. 4
Fig. 4
Storage phosphor radiographs of a patient with right-sided upper-lobe infiltrate obtained with 2K and 4K matrix size: there is no visually appreciable difference between the images
Fig. 5
Fig. 5
DQE curves for various detector systems: note the superiority of CsI-TFT over Se- and Gadox-TFT for spatial frequencies below two cycles/mm (source NHS/Kcare UK 2005)
Fig. 6
Fig. 6
Considerably increased transparency of high absorption areas in the PA chest radiograph obtained with the slot-scan CCD technique (b) compared to the film/screen radiograph (a) (courtesy of Dr. L. Kroft, LUMC, Leiden, The Netherlands)
Fig. 7
Fig. 7
Exposure indices for various manufacturers: note the different definitions using linear and logarithmic scales
Fig. 8
Fig. 8
Two follow-up bed-side chest radiographs in the same ICU patient obtained with standard dose CR (single read-out, a) and 50% dose reduced DR (CsI-TFT, b)
Fig. 9
Fig. 9
Two postero-anterior chest radiographs of a patient after pacemaker implantation: a was processed using simple unsharp masking, b was processed using an elaborate non-linear multifrequency processing
Fig. 10
Fig. 10
PA chest radiograph with computer-aided detection (CAD) marks: catch of an obvious nodule in the left lung and two subtle nodules in the right lung. One false-positive mark in the right lung apex on crossing of bone structures
See this image and copyright information in PMC

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