Comparison of image quality and radiation dose between an image-intensifier system and a newer-generation flat-panel detector system — technical phantom measurements and evaluation of clinical imaging in children.
BACKGROUND
Many image-intensifier fluoroscopy systems have been replaced by flat-panel detectors in recent years.


OBJECTIVE
To compare the level of contrast, image resolution and radiation dose between an image-intensifier and a newer-generation flat-panel detector system in a pediatric radiology unit.


METHODS
We compared two systems — a conventional image intensifier and a newer-generation flat-panel system. We measured image quality and radiation dose using a technical phantom. Additionally, we retrospectively compared age-matched fluoroscopic pediatric voiding cystourethrography (n = 15) and upper gastrointestinal investigations (n = 25).


RESULTS
In phantom studies image contrast was equal while image resolution was higher and mean radiation dose lower using the flat-panel system (P < 0.0001). In pediatric investigations, mean dose area product was significantly reduced on the flat-panel system for upper gastrointestinal investigation (45 ± 38 μGy*m2 vs. 11 ± 9 μGy*m2; P < 0.0001) and for voiding cystourethrography (18 ± 20 μGy*m2 vs. 10 ± 12 μGy*m2; P = 0.04).


CONCLUSIONS
The newer flat-panel system performs at lower dose levels with equal to better image quality and therefore seems to be the more suitable technique for pediatric fluoroscopy in comparison to image-intensifier systems.
Meike
M
Weis
Claudia
C
Hagelstein
Theo
T
Diehm
Stefan O
SO
Schoenberg
K Wolfgang
KW
Neff
D002648:Child; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis*; D011856:Radiographic Image Enhancement / Q000295:instrumentation*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D014963:X-Ray Intensifying Screens