European Radiology

, Volume 14, Issue 1, pp 48–58 | Cite as

Comparison of visual grading analysis and determination of detective quantum efficiency for evaluating system performance in digital chest radiography

  • Patrik Sund
  • Magnus BåthEmail author
  • Susanne Kheddache
  • Lars Gunnar Månsson


A study was conducted to compare physical and clinical system performance in digital chest radiography. Four digital X-ray modalities, two storage-phosphor based systems and two generations of a CCD-based system, were evaluated in terms of both their imaging properties (determination of presampling MTF and DQE) and clinical image quality (grading of the reproduction of anatomical details of 23 healthy volunteers using both absolute and relative visual grading analysis). One of the two storage-phosphor systems performed best in both evaluations and the first generation of the CCD-based system was rated worst; however, the other two systems were ranked differently with the two methods. The newest CCD-based system yielded a higher clinical image quality than the second storage-phosphor system, although the latter presented a DQE substantially higher than the former. The results show that clinical performance cannot be predicted from determinations of DQE alone, and that a system with lower DQE, under the quantum-saturated conditions in chest radiography, can outperform a system with higher DQE if the image processing used on the former is more effective in presenting the information in the image to the radiologist.


Image quality Digital radiography Computed radiography Visual grading analysis Detective quantum efficiency 



The authors thank the following radiologists, technicians, engineers and physicists for their participation in the study: A. Flinck, B. Gottfridsson and U. Tylén for reading the images; L. Björneld and M. Widell for taking care of the X-ray exposures and numerous other practical matters; A. Karlsson for writing the software for the soft-copy evaluation; and M. Håkansson for characterising the grids. Many persons at IMIX ADR Oy, Fuji Photo Film and Agfa-Gevaert contributed by helping us with equipment and valuable advice.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Patrik Sund
    • 1
    • 3
  • Magnus Båth
    • 1
    • 3
    Email author
  • Susanne Kheddache
    • 2
    • 4
  • Lars Gunnar Månsson
    • 1
    • 3
  1. 1.Department of Radiation PhysicsGöteborg University
  2. 2.Department of RadiologyGöteborg University
  3. 3.Department of Medical Physics and Biomedical EngineeringSahlgrenska University Hospital
  4. 4.Department of RadiologySahlgrenska University Hospital

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