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A phantom approach to find the optimal technical parameters for plain chest radiography

Laboratory for Quality Control in Radiology, National Centre of Radiobiology and Radiation Protection, 132 Kliment Ohridski Blvd, Sofia 1756, Bulgaria

A simple approach based on phantom measurements is proposed in this study to find the filtration, tube potential and antiscatter device that are optimal in respect of patient dose and image quality, at constant film–screen combination, film processing and viewing conditions. An original quasi-anthropomorphic chest phantom was exposed with 18 different beam qualities and three antiscatter devices. The entrance surface dose, organ doses and effective dose were estimated for each radiograph. The image quality was compared using two objective quality indexes, a contrast index and a scatter fraction, as well as two subjective indexes, a low contrast visualization index and a high contrast visualization index. It was found that for this X-ray unit, routinely using a 7:1 antiscatter grid, the optimal imaging technique is added filtration of 0.1 mm Cu+1 mm Al at a tube potential 100 kVp. Using a 25 cm air gap instead of the grid allows the tube potential to be increased to the upper limit of 120 kVp for this unit. The entrance surface dose of 0.075 mGy at 120 kVp with an air gap is less than half the value of the same quantity with a grid at 100 kVp and is significantly below the European reference level of 0.3 mGy. This phantom method, comprising both objective measurements and subjective estimation, is suitable for dose-image quality optimization in a clinical environment.