title: Digital chest radiography system with amorphous selenium flat-panel detectors: Qualitative and dosimetric comparison with a dedicated film-screen system.
abstract: OBJECTIVE
  To compare the quality and radiation dose of a conventional film-screen system and a digital system with amorphous selenium detectors in the study of the chest, by verifying overall performance and exposure levels for the main chest structures in patients of different sizes.
  
  
  METHODS
  An analogic system (Chest-Changer, Dupont, Day-light model 1000) and a digital system (Directray Rad 1000C, Hologic) were tested on a total of 1000 patients randomly assigned to one of two groups of 500 subjects. The patients were further subdivided according to BMI (Body Mass Index). Image quality was determined by two chest radiologists who evaluated eight anatomical structures. The entrance surface dose (skin-dose), calculated based on the exposure parameters, was taken as the patient dose.
  
  
  RESULTS
  Mean dose delivered was very similar for both techniques in the PA view (0.28 mGy), but it was greater in the LL projections obtained with the digital system (1.20 mGy versus 0.83 mGy). The highest overall scores were assigned to 43% and 23.2% analogic radiograms and 64% and 70.2% digital radiograms, for the PA and LL projections respectively. The scores assigned to the various anatomical structures confirmed the better performance of the digital system in almost all of the regions considered.
  
  
  CONCLUSIONS
  The mean quality of radiograms is definitely higher with the digital system, in particular in the LL projections, where the higher patient doses are counterbalanced by fewer repeated scans. The greater level of exposure in the digital system appears nonetheless tolerable on account of the greater informativeness and therefore diagnostic gain and also considering the possibilities for improving the system.
authors.affiliation: Istituto di Radiologia, Università di Torino, Ospedale San Luigi Gonzaga, Orbassano, Torino, Italy. aprato@sirm.org
authors.forename: Antoni
authors.initials: A
authors.lastname: Prato
authors.forename: Roberto
authors.initials: R
authors.lastname: Ropolo
authors.forename: Cesare
authors.initials: C
authors.lastname: Fava
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011786:Quality Control; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement; D013902:Radiography, Thoracic / Q000295:instrumentation*; D012643:Selenium; D014963:X-Ray Intensifying Screens
chemical_list: D012643:Selenium