Efficacy of a new detector automatic exposure control in portable anteroposterior chest radiography: a retrospective examination of radiation dose optimization and image quality

Abstract

Background

Automatic exposure control (AEC) devices are necessary to reduce the radiation dose and enhance image quality in radiography. However, AEC devices are not being used in portable X-ray systems due to technical issues.

Purpose

To evaluate the radiation dose and image quality of a new AEC for a wireless portable X-ray system compared to the standard fixed radiation dose of manual controls in chest radiography.

Material and Methods

This retrospective analysis evaluated the performance of a portable X-ray system equipped with software-based AEC on anteroposterior chest radiographs. A quantitative evaluation comparing the manual and AEC groups was conducted to ascertain the exposure index (EI) and dose-area product (DAP). We performed observer-based analysis of image quality for lowest exposure and average exposure images in the manual and AEC groups.

Results

Overall, 2093 examinations were conducted in 467 patients. AEC yielded a statistically significant reduction in the DAP (AEC: 1.64 dGycm²; manual: 1.99 dGycm²) and EI (AEC: 266; manual: 393) compared to manual control (P <0.001). Evaluation of the average and low exposure images revealed that the DAP and EI were consistently lower in the AEC group (P <0.01). Observer-based analysis of the lowest exposure images revealed that AEC yielded a statistically significant higher score compared to manual control (12.5 manual, 13.4 AEC; P <0.001).

Conclusion

AEC within a wireless portable X-ray system improves subjective image quality while reducing radiation exposure, as substantiated by quantitative and qualitative metrics.

Keywords

Thorax radiography radiation dosage automatic exposure control

Get full access to this article

View all access options for this article.

References

Doyle

Martin

. Calibrating automatic exposure control devices for digital radiography. Phys Med Biol 2006;51:5475–5485.

Rossi

Harnisch

Hendee

. Evaluation of an automatic exposure control device for mobile radiography. Radiology 1982;145:823–827.

International Electrotechnical Commission . Medical electrical equipment–Exposure index of digital X-ray imaging systems-Part 1: Definitions and requirements for general radiography. IEC, Geneva, Switzerland, BS EN 62494-1. Available at: http://higiene.unex.es/Bibliogr/ISO_BS_USDA/ISO_BS/BS%20EN/BS%20EN%2062494-1-2008.pdf (2008, accessed 1 October 2024).

Seibert

Morin

. The standardized exposure index for digital radiography: an opportunity for optimization of radiation dose to the pediatric population. Pediatr Radiol 2011;41:573–581.

Sund

Bath

Kheddache

, et al. Comparison of visual grading analysis and determination of detective quantum efficiency for evaluating system performance in digital chest radiography. Eur Radiol 2004;14:48–58.

Abdi

Mussmann

Mackenzie

, et al. Visual evaluation of image quality of a low dose 2D/3D slot scanner imaging system compared to two conventional digital radiography X-ray imaging systems. Diagnostics (Basel) 2021;11:1932.

Cohen

Cooper

Piersall

, et al. Quality assurance: using the exposure index and the deviation index to monitor radiation exposure for portable chest radiographs in neonates. Pediatr Radiol 2011;41:592–601.

Park

Kim

Kang

, et al. Feasibility of new patient dose management tool in digital radiography: using clinical exposure index data of mobile chest radiography in a large university hospital. Heliyon 2023;9:e20760.

Yoon

Park

Kim

, et al. Proper management of the clinical exposure index based on body thickness using dose optimization tools in digital chest radiography: a phantom study. Int J Environ Res Public Health 2021;18:5203.