title: Effect of dose on image quality in a detector-based dual-exposure, dual-energy system for chest radiography.
abstract: OBJECTIVE
  To assess the image quality of subtracted soft tissue and bone images of a CsI-detector-based dual-energy system for chest radiography at varying dose levels.
  
  
  METHODS
  We evaluated a CsI-detector-based, dual-exposure, dual-energy prototype system; 126 patients were categorized into groups of small, medium, and large. Fixed values were applied for mAs and mA. The patients were randomized into two groups with intended higher and lower speed pairs of approximately 400/1000 (high and low energy shot) and 200/500, respectively. True speed equivalents were calculated retrospectively using the detector dose. Image quality was evaluated by two highly experienced radiologists in consensus applying a rating scale of 1 to 5 for quality indicators such as image noise, residual bone structures, motion artifacts, and others.
  
  
  RESULTS
  Significantly decreased noise and a significant improvement for display of bone details in the bone image were noted with the higher dose, whereas a significant increase in motion artifacts reduced image quality at the higher dose.
  
  
  CONCLUSIONS
  Radiation dose did not significantly influence the perception of dual-energy image quality. Dual-energy subtraction, as described, has the potential to become a future routine application in chest radiography.
authors.affiliation: Department of Radiology, Charité Campus Virchow-Klinikum, Humboldt-University, Berlin. torsten.freund@charite.de
authors.forename: T
authors.initials: T
authors.lastname: Freund
authors.forename: F
authors.initials: F
authors.lastname: Fischbach
authors.forename: U
authors.initials: U
authors.lastname: Teichgraeber
authors.forename: E Lopez
authors.initials: EL
authors.lastname: Haenninen
authors.forename: H
authors.initials: H
authors.lastname: Eichstaedt
authors.forename: R
authors.initials: R
authors.lastname: Felix
authors.forename: J
authors.initials: J
authors.lastname: Ricke
mesh_terms: D000368:Aged; D016477:Artifacts; D049628:Body Size; D003238:Connective Tissue / Q000000981:diagnostic imaging; D004307:Dose-Response Relationship, Radiation; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008875:Middle Aged; D015900:Radiography, Dual-Energy Scanned Projection / Q000295:instrumentation* / Q000379:methods; D013902:Radiography, Thoracic / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012272:Ribs / Q000000981:diagnostic imaging; D013131:Spine / Q000000981:diagnostic imaging