title: Use of a digitally reconstructed radiograph-based computer simulation for the optimisation of chest radiographic techniques for computed radiography imaging systems.
abstract: OBJECTIVE
  The purpose of this study was to derive an optimum radiographic technique for computed radiography (CR) chest imaging using a digitally reconstructed radiograph computer simulator. The simulator is capable of producing CR chest radiographs of adults with various tube potentials, receptor doses and scatter rejection.
  
  
  METHODS
  Four experienced image evaluators graded images of average and obese adult patients at different potentials (average-sized, n=50; obese, n=20), receptor doses (n=10) and scatter rejection techniques (average-sized, n=20; obese, n=20). The quality of the images was evaluated using visually graded analysis. The influence of rib contrast was also assessed.
  
  
  RESULTS
  For average-sized patients, image quality improved when tube potential was reduced compared with the reference (102 kVp). No scatter rejection was indicated. For obese patients, it has been shown that an antiscatter grid is indicated, and should be used in conjunction with as low a tube potential as possible (while allowing exposure times <20 ms). It is also possible to reduce receptor air kerma by 50% without adversely influencing image quality. Rib contrast did not interfere at any tube potential.
  
  
  CONCLUSIONS
  A virtual clinical trial has been performed with simulated chest CR images. Results indicate that low tube potentials (<102 kVp) are optimal for average and obese adults, the former acquired without scatter rejection, the latter with an anti-scatter grid. Lower receptor (and therefore patient doses) than those used clinically are possible while maintaining adequate image quality.
authors.affiliation: Radiation Physics Department, Queen's Centre for Oncology and Haematology, Hull, UK. craig.moore@hey.nhs.uk
authors.forename: C S
authors.initials: CS
authors.lastname: Moore
authors.forename: G
authors.initials: G
authors.lastname: Avery
authors.forename: S
authors.initials: S
authors.lastname: Balcam
authors.forename: L
authors.initials: L
authors.lastname: Needler
authors.forename: A
authors.initials: A
authors.lastname: Swift
authors.forename: A W
authors.initials: AW
authors.lastname: Beavis
authors.forename: J R
authors.initials: JR
authors.lastname: Saunderson
mesh_terms: D000328:Adult; D003198:Computer Simulation; D006801:Humans; D008954:Models, Biological; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity