title: Diagnostic performance of a flat-panel detector at low tube voltage in chest radiography: a phantom study.
abstract: OBJECTIVE
  To evaluate a large area, cesium iodide amorphous silicon flat-panel detector (CsI/a-Si) at 3 tube voltages to detect simulated interstitial lung disease, nodules, and catheters.
  
  
  METHODS
  Simulated interstitial lung disease, nodules, and catheters were superimposed over a chest phantom. Images were generated at 125 kVp, 90 kVp, and 70 kVp at the same surface dose and reduced effective dose equivalent for 90 kVp and 70 kVp and printed on hard copies. Fifty-four thousand observations were analyzed by receiver operating characteristic (ROC).
  
  
  RESULTS
  Detectability of linear, miliary, reticular pattern, and nodules over lucent lung as well as of catheters and nodules over obscured chest areas increased at 90 and/or 70 kVp with higher Az values; however, only it was statistically significant for reticular pattern at 70 kVp and nodules at 90 kVp compared with 125 kVp (P < 0.05). The detection of ground-glass pattern was worse at lower kVp (P > 0.05).
  
  
  CONCLUSIONS
  For most simulated patterns, differences in diagnostic performance at 70 kVp/90 kVp and 125 kVp were not significant, except for reticular pattern and nodules over lucent lung.
authors.affiliation: Department of Clinical Radiology, University of Münster, Germany. bernhart@uni-muenster.de
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Bernhardt
authors.forename: Ulrike
authors.initials: U
authors.lastname: Rapp-Bernhardt
authors.forename: Horst
authors.initials: H
authors.lastname: Lenzen
authors.forename: Friedrich W
authors.initials: FW
authors.lastname: Röhl
authors.forename: Stefan
authors.initials: S
authors.lastname: Diederich
authors.forename: Karsten
authors.initials: K
authors.lastname: Papke
authors.forename: Karl
authors.initials: K
authors.lastname: Ludwig
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
mesh_terms: D002586:Cesium; D006801:Humans; D007454:Iodides; D008168:Lung / Q000000981:diagnostic imaging*; D008171:Lung Diseases / Q000000981:diagnostic imaging; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement; D012825:Silicon; D014963:X-Ray Intensifying Screens
chemical_list: D007454:Iodides; D002586:Cesium; C040050:cesium iodide; D012825:Silicon