A pilot study evaluating erect chest imaging in children, using the Lodox Statscan digital X-ray machine

ABSTRACT Background: Chest radiography accounts for a significant proportion of ionising radiation in children. The radiation dose of radiographs performed on the Lodox Statscan system has been shown to be lower than that of a computed radiography (CR) system. The role of the Lodox Statscan (hereafter referred to as the Statscan) in routine erect chest radiography in children has not been evaluated. Objective: To evaluate the image quality and diagnostic accuracy of erect paediatric chest radiographs obtained with the Statscan and compare this with conventional erect chest images obtained with a CR system. Materials and Methods: Thirty three children with suspected chest pathology were enrolled randomly over a period of three months. Erect chest radiographs were obtained with the Statscan, and a Shimadzu R-20J X-ray machine coupled with a Fuji FCR 5000 CR system. Image quality and diagnostic accuracy and diagnostic capability were evaluated between the two modalities. Results: The erect Statscan allowed superior visualisation of the three major airways. Statscan images however, demonstrated exposure and movement artifacts with hemidiaphragms and ribs most prone to movement. Bronchovascular clarity was also considered unsatisfactory on the Statscan images. Conclusion: The Statscan has limitations in erect chest radiography in terms of movement artefacts, exposure fluctuations, and poor definition of lung markings. Despite this, the Statscan allows better visualisation of the major airways, equivalent to a ‘high KV’ film at a fraction of the radiation dose. This supports the finding of an earlier study evaluating Statscan images in trauma cases, where the images were taken supine. Statscan has great potential in assisting in the diagnosis of childhood tuberculosis where airway narrowing occurs as a result of nodal compression.

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The effect of radiation dose reduction on clinical image quality in chest radiography of premature neonates using a dual-side readout technique computed radiography system

Radiation Protection Dosimetry ◽

10.1093/rpd/ncq072 ◽

2010 ◽

Vol 139 (1-3) ◽

pp. 275-280 ◽

Cited By ~ 7

Author(s):

A. Carlander ◽

J. Hansson ◽

J. Soderberg ◽

K. Steneryd ◽

M. Bath

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Dose Reduction ◽

Chest Radiography ◽

Computed Radiography ◽

Radiation Dose Reduction ◽

Clinical Image ◽

Premature Neonates ◽

Radiography System

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New Generation X-ray Technology Reduces Radiation Dose Whilst Improving Image Quality During Diagnostic Coronary Angiography and Intervention

Heart Lung and Circulation ◽

10.1016/j.hlc.2016.06.429 ◽

2016 ◽

Vol 25 ◽

pp. S183

Author(s):

J. Crowhurst ◽

M. Whitby ◽

D. Murdoch ◽

K. Poon ◽

E. Shaw ◽

...

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Coronary Angiography ◽

Generation X ◽

X Ray ◽

New Generation ◽

Diagnostic Coronary Angiography

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Using 100- instead of 120-kVp computed tomography to diagnose pulmonary embolism almost halves the radiation dose with preserved diagnostic quality

Acta Radiologica ◽

10.3109/02841850903505222 ◽

2010 ◽

Vol 51 (3) ◽

pp. 260-270 ◽

Cited By ~ 24

Author(s):

Peter Björkdahl ◽

Ulf Nyman

Keyword(s):

Computed Tomography ◽

Pulmonary Embolism ◽

Image Quality ◽

Radiation Dose ◽

Effective Dose ◽

Ct Number ◽

Subjective Image Quality ◽

Diagnostic Quality ◽

X Ray ◽

Tube Potential

Background: Concern has been raised regarding the mounting collective radiation doses from computed tomography (CT), increasing the risk of radiation-induced cancers in exposed populations. Purpose: To compare radiation dose and image quality in a chest phantom and in patients for the diagnosis of pulmonary embolism (PE) at 100 and 120 peak kilovoltage (kVp) using 16-multichannel detector computed tomography (MDCT). Material and Methods: A 20-ml syringe containing 12 mg I/ml was scanned in a chest phantom at 100/120 kVp and 25 milliampere seconds (mAs). Consecutive patients underwent 100 kVp ( n = 50) and 120 kVp ( n = 50) 16-MDCT using a “quality reference” effective mAs of 100, 300 mg I/kg, and a 12-s injection duration. Attenuation (CT number), image noise (1 standard deviation), and contrast-to-noise ratio (CNR; fresh clot = 70 HU) of the contrast medium syringe and pulmonary arteries were evaluated on 3-mm-thick slices. Subjective image quality was assessed. Computed tomography dose index (CTDIvol) and dose–length product (DLP) were presented by the CT software, and effective dose was estimated. Results: Mean values in the chest phantom and patients changed as follows when X-ray tube potential decreased from 120 to 100 kVp: attenuation +23% and +40%, noise +38% and +48%, CNR −6% and 0%, and CTDIvol −38% and −40%, respectively. Mean DLP and effective dose in the patients decreased by 42% and 45%, respectively. Subjective image quality was excellent or adequate in 49/48 patients at 100/120 kVp. No patient with a negative CT had any thromboembolism diagnosed during 3-month follow-up. Conclusion: By reducing X-ray tube potential from 120 to 100 kVp, while keeping all other scanning parameters unchanged, the radiation dose to the patient may be almost halved without deterioration of diagnostic quality, which may be of particular benefit in young individuals.

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Neonatal digital chest radiography– should we be using additional copper filtration?

British Journal of Radiology ◽

10.1259/bjr.20211026 ◽

2021 ◽

Author(s):

Jenna Ruth Tugwell-Allsup ◽

Rhys Wyn Morris ◽

Kate Thomas ◽

Richard Hibbs ◽

Andrew England

Keyword(s):

Image Quality ◽

Radiation Dose ◽

Detrimental Effect ◽

Chest Imaging ◽

Anthropomorphic Phantom ◽

Visual Grading ◽

X Ray ◽

Visual Grading Analysis ◽

Designed Experiment ◽

Digital Chest

Objectives: Copper filtration removes lower energy X-ray photons, which do not enhance image quality but would otherwise contribute to patient dose. This study explores the use of additional copper filtration for neonatal mobile chest imaging. Methods: A controlled factorial-designed experiment was used to determine the effect of independent variables on image quality and radiation dose. These variables included: copper filtration (0Cu, 0.1Cu and 0.2Cu), exposure factors, SID and image receptor position (direct +tray). Image quality was evaluated using absolute visual grading analysis (VGA) and contrast-to-noise ratio (CNR) and entrance surface dose (ESD) was derived using an ionising chamber within the central X-ray beam. Results: VGA, CNR and ESD significantly reduced (p < 0.01) when using added copper filtration. For 0.1Cu, the percentage reduction was much greater for ESD (60%) than for VGA (14%) and CNR (20%), respectively. When compared to the optimal combinations of parameters for incubator imaging using no copper filtration, an increase in kV and mAs when using 0.1mmCu resulted in better image quality at the same radiation dose (direct) or, equal image quality at reduced dose (in-tray). The use of 0.1mmCu for neonatal chest imaging with a corresponding increase in kV and mAs is therefore recommended. Conclusions: Using additional copper filtration significantly reduces radiation dose (at increased mAs) without a detrimental effect on image quality. Advances in knowledge: This is the first study, using an anthropomorphic phantom, to explore the use of additional Cu for DR neonatal chest imaging and therefore helps inform practice to standardise and optimise this imaging examination.

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