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Dose reduction and image quality improvement of chest radiography by using bone-suppression technique and low tube voltage: a phantom study

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Abstract

Objective

To clarify the relationship between entrance surface dose (ESD) and physical image quality of original and bone-suppressed chest radiographs acquired using high and low tube voltages.

Methods

An anthropomorphic chest phantom and a 12-mm diameter spherical simulated nodule with a CT value of approximately + 100 HU were used. The lung field in the chest radiograph was divided into seven areas, and the nodule was set in a total of 66 positions. A total of 264 chest radiographs were acquired using four ESD conditions: approximately 0.3 mGy at 140 and 70 kVp and approximately 0.2 and 0.1 mGy at 70 kVp. The radiographs were processed to produce bone-suppressed images. Differences in contrast and contrast-to-noise ratio (CNR) values of the nodule between each condition and between the original and bone-suppressed images were analyzed by a two-sided Wilcoxon signed-rank test.

Results

In the areas not overlapping with the ribs, both contrast and CNR values were significantly increased with the bone-suppression technique (p < 0.01). In the bone-suppressed images, these values of the three conditions at 70 kVp were equal to or significantly higher than those of the condition at 140 kVp. There was no apparent decrease in these values between the ESD of approximately 0.3 and 0.1 mGy at 70 kVp.

Conclusion

By using the shortest exposure time and the lowest tube voltage possible not to increase in blurring artifact and image noise, it is possible to improve the image quality of bone-suppressed images and reduce the patient dose.

Key Points

• The effectiveness of bone-suppression techniques differs in areas of lung field.

• Image quality of bone-suppressed chest radiographs is improved by lower tube voltage.

• Applying lower tube voltage to bone-suppressed chest radiographs leads to dose reduction.

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Abbreviations

CNR:

Contrast-to-noise ratio

ESD:

Entrance surface dose

mAs:

Milliampere-second

ROI:

Region of interest

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Acknowledgments

The authors thank to Naoki Miyamoto for providing an anthropomorphic phantom.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan

    Satoshi Takagi

  2. Department of Radiology, Hokkaido Memorial Hospital of Urology, 1-25, Kita 41, Higashi 1, Higashi-ku, Sapporo, Hokkaido, 007-0841, Japan

    Tatsuya Yaegashi

  3. Graduate School of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan

    Masayori Ishikawa

Authors
  1. Satoshi Takagi
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  2. Tatsuya Yaegashi
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  3. Masayori Ishikawa
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Corresponding author

Correspondence to Satoshi Takagi.

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Guarantor

The scientific guarantor of this publication is Satoshi Takagi.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required because this was a phantom study.

Ethical approval

This phantom study did not require institutional review board approval.

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• Performed at one institution

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Takagi, S., Yaegashi, T. & Ishikawa, M. Dose reduction and image quality improvement of chest radiography by using bone-suppression technique and low tube voltage: a phantom study. Eur Radiol 30, 571–580 (2020). https://doi.org/10.1007/s00330-019-06375-6

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  • DOI: https://doi.org/10.1007/s00330-019-06375-6

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