title: Effects of radiographic techniques on the low-contrast detail detectability performance of digital radiography systems.
abstract: OBJECTIVE
  To evaluate the effects of the radiation exposure factors kilovolt peak and tube current time (milliampere seconds) on the low-contrast detail detectability performance of 3 types of planar digital radiography systems. Detectability performance of an imaging system refers to its ability to detect and present the low-contrast details of organs in the acquired image. The authors also compare detectability performance between computed radiography, indirect digital radiography, and direct digital radiography by evaluating low-contrast details of the obtained images.
  
  
  METHODS
  A low-contrast detail phantom was inserted within 10-cm thicknesses of Perspex plastic sheets. The images were obtained with various kilovolt peak and milliampere second settings for each of the 3 digital radiography systems. Artinis CDRAD Analyser software was used to score the images and calculate the inverse image quality figure (IQFinv).
  
  
  RESULTS
  The higher milliampere second levels in each kilovolt peak selection resulted in higher IQFinv in computed radiography and indirect and direct digital radiography. IQFinv values significantly increased in indirect digital radiography with increasing kilovolt peak in only 1 and 2 mAs. There were insignificant differences in IQFinv values when altering kilovolt peak in each milliampere second level in direct digital radiography. The indirect digital radiography system generally demonstrated better detectability performance than computed radiography and direct digital radiography. However, direct digital radiography demonstrated better detectability performance than indirect digital radiography at lower kilovolt peak and milliampere second settings, as did computed radiography at lower kilovolt peak settings.
  
  
  CONCLUSIONS
  Higher milliampere second settings increase photon count, which results in a higher signal-to-noise ratio and thus increased detectability. Lower milliampere second settings increase noise level on images, which increases the risk of diagnostic detail loss. Changing the kilovolt peak at the different milliampere second settings essentially did not affect the IQFinv of the different digital radiography systems.
  
  
  CONCLUSIONS
  Increasing milliampere seconds in all digital imaging systems generally improves detectability performance. However, altering the kilovolt peak setting does not significantly change the IQFinv and detectability of objects in a digital radiograph. Imaging system selection should be based on typical radiographic examinations. Indirect digital radiography systems are better for studies that require higher kilovolt peak, such as large organs, and direct digital radiography is better for studies that require low kilovolt peak, such as small organs and mammography, which is used to examine fine tissue details.
authors.forename: Haney
authors.initials: H
authors.lastname: Alsleem
authors.forename: Paul
authors.initials: P
authors.lastname: U
authors.forename: Kam Shan
authors.initials: KS
authors.lastname: Mong
authors.forename: Robert
authors.initials: R
authors.lastname: Davidson
mesh_terms: D000465:Algorithms; D006801:Humans; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000295:instrumentation* / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity