title: Needle image plates compared to conventional CR in chest radiography: is dose reduction possible?
abstract: OBJECTIVE
  To compare image quality of standard-dose computed radiography and dose reduced needle-technology CR for supine CXR in a clinical setting.
  
  
  METHODS
  We prospectively evaluated 128 radiographs of 32 immunocompromised patients. For each patient four clinical CXR were performed within one week, two with powder image plates (PIP; Fuji ST-V) and two with needle image plates (NIP; Agfa DXS) at standard and half dose, respectively. One experienced radiologist and two residents blinded to dose level and kind of imaging system rated different anatomical structures, image noise, tubes/lines and abnormalities on a image quality scale from 1 to 10 (1=poor, 10=excellent). The rating scores were tested for statistical differences using analysis of variance with repeated measures.
  
  
  RESULTS
  A statistical difference (p<0.05) was found for the two systems as well as for the two dose levels. Overall rating scores were 6.5 for PIP with full dose, 6.2 for PIP with half dose, 7.6 for NIP with full dose and 7.4 for NIP with half dose. There was a significant difference in favour of the NIP system at the same dose level. Also the NIP images obtained at half dose were ranked significantly better compared to the PIP images at standard dose. The differences in ranking of anatomical structures and abnormalities were more pronounced in low absorption areas (pulmonary vessels, parenchyma) than in high absorption areas (mediastinum, spine).
  
  
  CONCLUSIONS
  For supine chest radiograms the NIP technology allows for a dose reduction of 50% while providing higher image quality.
authors.affiliation: Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. vanessa.berger-kulemann@meduniwien.ac.at
authors.forename: Vanessa
authors.initials: V
authors.lastname: Berger-Kulemann
authors.forename: Sarah
authors.initials: S
authors.lastname: Pötter-Lang
authors.forename: Michael
authors.initials: M
authors.lastname: Gruber
authors.forename: Rudolf
authors.initials: R
authors.lastname: Berger
authors.forename: Karin
authors.initials: K
authors.lastname: Vonbank
authors.forename: Michael
authors.initials: M
authors.lastname: Weber
authors.forename: Werner
authors.initials: W
authors.lastname: Rabitsch
authors.forename: Martin
authors.initials: M
authors.lastname: Uffmann
mesh_terms: D000328:Adult; D001822:Body Burden; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009339:Needles; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D013902:Radiography, Thoracic / Q000295:instrumentation*; D012120:Respiration Disorders / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*; D014963:X-Ray Intensifying Screens