Image quality and exposure dose in digital projection radiography

Purpose: Comparison of the imaging capabilities of storage phosphor (computed) radiography and flat plate radiography with conventional film-screen radiography to find new strategies for quality and dose management, i.e., optimizing imaging quality and dose depending on the imaging method and clinical situation. Materials and Methods: Images of a CDRAD-phantom, hand-phantom, abdomen-phantom and chest-phantom obtained with different exposure voltages (50 kV, 73 kV, 109 W) and different speeds (200, 400, 800, 1600) were processed with various digital systems (flat plate detector: Digital Diagnost [Philips]; storage phosphors: ADC-70 [Agfa], ADC-Solo [Agfa], FCRXG1 [Fuji]) and a conventional film-screen system (HT100G/Ortho Regular [Agfa]). Results: The evaluation of CDRAD images found the flat plate detector system to have the highest contrast detectability for all dose levels, followed by the FCRXG1, ADC-Solo and ADC-70 systems. Comparison of the organ-phantom images found the flat plate detector system to be equal to film-screen radiography and especially to storage phosphor systems even for low exposure doses. Conclusions: Flat plate radiography systems demonstrate the highest potential for high image quality when reducing the exposure dose. Depending on the system generation, the storage phosphor systems also show an improved image quality, but the possibility of a dose reduction is limited in comparison with the flat plate detector system.