title: Schemes for the optimization of chest radiography using a computer model of the patient and x-ray imaging system.
abstract: A computer program has been developed to model chest radiography. It incorporates a voxel phantom of an adult and includes antiscatter grid, radiographic screen, and film. Image quality is quantified by calculating the contrast (deltaOD) and the ideal observer signal-to-noise ratio (SNR(I)) for a number of relevant anatomical details at various positions in the anatomy. Detector noise and system unsharpness are modeled and their influence on image quality is considered. A measure of useful dynamic range is computed and defined as the fraction of the image that is reproduced at an optical density such that the film gradient exceeds a preset value. The effective dose is used as a measure of the radiation risk for the patient. A novel approach to patient dose and image quality optimization has been developed and implemented. It is based on a reference system acknowledged to yield acceptable image quality in a clinical trial. Two optimizations schemes have been studied, the first including the contrast of vessels as measure of image quality and the second scheme using also the signal-to-noise ratio of calcifications. Both schemes make use of our measure of useful dynamic range as a key quantity. A large variety of imaging conditions was simulated by varying the tube voltage, antiscatter device, screen-film system, and maximum optical density in the computed image. It was found that the optical density is crucial in screen-film chest radiography. Significant dose savings (30%-50%) can be accomplished without sacrificing image quality by using low-atomic-number grids with a low grid ratio or an air gap and more sensitive screen-film system. Dose-efficient configurations proposed by the model agree well with the example of good radiographic technique suggested by the European Commission.
authors.affiliation: Department of Radiation Physics, Faculty of Health Sciences, Linköping University, Sweden. michael.sandborg@raf.liu.se
authors.forename: M
authors.initials: M
authors.lastname: Sandborg
authors.forename: G
authors.initials: G
authors.lastname: McVey
authors.forename: D R
authors.initials: DR
authors.lastname: Dance
authors.forename: G
authors.initials: G
authors.lastname: Alm Carlsson
mesh_terms: D004307:Dose-Response Relationship, Radiation; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D009010:Monte Carlo Method; D013902:Radiography, Thoracic / Q000295:instrumentation / Q000379:methods*; D011874:Radiometry; D012984:Software; D014962:X-Ray Film; D014965:X-Rays