title: Comparison of entrance exposure and signal-to-noise ratio between an SBDX prototype and a wide-beam cardiac angiographic system.
abstract: The scanning-beam digital x-ray (SBDX) system uses an inverse geometry, narrow x-ray beam, and a 2-mm thick CdTe detector to improve the dose efficiency of the coronary angiographic procedure. Entrance exposure and large-area iodine signal-to-noise ratio (SNR) were measured with the SBDX prototype and compared to that of a clinical cardiac interventional system with image intensifier (II) and charge coupled device (CCD) camera (Philips H5000, MRC-200 x-ray tube, 72 kWp max). Phantoms were 18.6-35.0 cm acrylic with an iohexol-equivalent disk placed at midthickness (35 mg/cm2 iodine radiographic density). Imaging was performed at 15 frame/s, with the disk at mechanical isocenter and an 11-cm object-plane field width. The II/CCD system was operated in cine mode with automatic exposure control. With the SBDX prototype at maximum x-ray output (120 kVp, 24.3 kWp), the SBDX SNR was 107%-69% of the II/CCD SNR, depending on phantom thickness, and the SBDX entrance exposure rate was 10.7-9.3 R/min (9.4-8.2 cGy/min air kerma). For phantoms where an equal-kVp imaging comparison was possible (> or = 23.3 cm), the SBDX SNR ranged from 47% to 69% of the II/CCD SNR while delivering 6% to 9% of the II/CCD entrance exposure rate. From these measurements it was determined that the relative SBDX entrance exposure at equal SNR would be 31%-16%. Results were consistent with a model for relative entrance exposure at equal SNR, which predicted a 3-7 times reduction in entrance exposure due to SBDX's comparatively low scatter fraction (5.5%-8.1% measured, including off-focus radiation), high detector detective quantum efficiency (66%-73%, measured from 70 to 120 kVp), and large entrance field area (1.7x - 2.3x, for the same object-plane field width). With improvements to the system geometry, detector, and x-ray source, SBDX technology is projected to achieve conventional cine-quality SNR over a full range of patient thicknesses, with 5-10 times lower skin dose.
authors.affiliation: Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA. speidel@wisc.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Speidel
authors.forename: Brian P
authors.initials: BP
authors.lastname: Wilfley
authors.forename: Josh M
authors.initials: JM
authors.lastname: Star-Lack
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Heanue
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Betts
authors.forename: Michael S
authors.initials: MS
authors.lastname: Van Lysel
mesh_terms: D000792:Angiography / Q000295:instrumentation* / Q000379:methods; D016477:Artifacts; D001709:Biotechnology / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D010865:Pilot Projects; D011856:Radiographic Image Enhancement / Q000295:instrumentation* / Q000379:methods; D015642:Radiology, Interventional / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D014159:Transducers