Evaluating the use of higher kVp and copper filtration as a dose optimisation tool in digital planar radiography. 2022

K Mifsud, and J L Portelli, and F Zarb, and J G Couto
Radiography Department, Faculty of Health Sciences, University of Malta, Msida, MSD2090, Malta. Electronic address: katrina.mifsud.17@um.edu.mt.

To identify the potential of beam hardening techniques, specifically the use of higher kilo voltage (kV) and copper (Cu) filtration, to optimise digital planar radiographic projections. The study assessed the suitability of such techniques in radiation dose reductions while maintaining diagnostic image quality for four common radiographic projections: antero-posterior (AP) abdomen, AP-knee, AP-lumbar spine, and lateral lumbar spine. Anthropomorphic phantom radiographs were obtained at varying kVp (standard kVp, +10 kVp, and +20 kVp) and varying Cu filtration thickness (0 mm, 0.1 mm, and 0.2 mm Cu). The Dose Area Product (DAP), mAs and time (s) were recorded as an indication of the emitted radiation dose. Image quality was assessed objectively via Contrast-Noise-Ratio (CNR) calculations and subjectively via Visual Grading Analysis (VGA) performed by radiographers and radiologists. Optimised exposure protocols were established for the AP-abdomen (100 kVp with 0.2 mm Cu), AP-knee (85 kVp, and 0.1 mm Cu), AP-lumbar spine (110 kVp and 0.2 mm Cu), and lateral lumbar spine (110 kVp and 0.2 mm Cu). This strategy resulted in respective DAP reductions of 71.98%, 62.50%, 64.51% and 71.85%. While CNR values decreased as beam hardening techniques were applied, VGA demonstrated either a lack of statistical variation or improved image quality between the standard and the optimised exposure protocols. DAP reductions without compromising image quality can be achieved through beam hardening for the AP-abdomen, AP-knee, AP-lumbar spine, and lateral lumbar spine projections. Beam hardening techniques should be considered as an optimisation strategy in medical imaging departments. Research into the applicability of this strategy for other radiographic projections is recommended.

UI MeSH Term Description Entries
D008159 Lumbar Vertebrae VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE. Vertebrae, Lumbar
D011829 Radiation Dosage The amount of radiation energy that is deposited in a unit mass of material, such as tissues of plants or animal. In RADIOTHERAPY, radiation dosage is expressed in gray units (Gy). In RADIOLOGIC HEALTH, the dosage is expressed by the product of absorbed dose (Gy) and quality factor (a function of linear energy transfer), and is called radiation dose equivalent in sievert units (Sv). Sievert Units,Dosage, Radiation,Gray Units,Gy Radiation,Sv Radiation Dose Equivalent,Dosages, Radiation,Radiation Dosages,Units, Gray,Units, Sievert
D011856 Radiographic Image Enhancement Improvement in the quality of an x-ray image by use of an intensifying screen, tube, or filter and by optimum exposure techniques. Digital processing methods are often employed. Digital Radiography,Image Enhancement, Radiographic,Radiography, Digital,Enhancement, Radiographic Image,Enhancements, Radiographic Image,Image Enhancements, Radiographic,Radiographic Image Enhancements
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D003300 Copper A heavy metal trace element with the atomic symbol Cu, atomic number 29, and atomic weight 63.55. Copper-63,Copper 63
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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