European Radiology

, Volume 16, Issue 2, pp 333–341 | Cite as

Contrast-detail evaluation and dose assessment of eight digital chest radiography systems in clinical practice

  • Wouter J. H. VeldkampEmail author
  • Lucia J. M. Kroft
  • Mireille V. Boot
  • Bart J. A. Mertens
  • Jacob Geleijns


The purpose of this study was to assess contrast-detail performance and effective dose of eight different digital chest radiography systems. Digital chest radiography systems from different manufacturers were included: one storage phosphor system, one selenium-coated drum system, and six direct readout systems including four thin-film transistor (TFT) systems and two charge-coupled device (CCD) systems. For measuring image quality, a contrast-detail test object was used in combination with a phantom that simulates the primary and scatter transmission through lung fields (LucAl). Six observers judged phantom images of each modality by soft-copy reading in a four-alternative-forced-choice experiment. The entrance dose was also measured, and the effective dose was calculated for an average patient. Contrast-detail curves were constructed from the observer data. The blocked two-way ANOVA test was used for statistical analysis. Significant difference in contrast-detail performance was found between the systems. Best contrast-detail performance was shown by a CCD system with slot-scan technology, and the selenium-coated drum system was compared to the other six systems (p values ≤0.003). Calculated effective dose varied between 0.010 mSv and 0.032 mSv. Significant differences in contrast-detail performance and effective dose levels were found between different digital chest radiography systems in clinical practice.


Digital radiography Flat-panel detector Chest radiography 



The authors gratefully acknowledge the participation of the following persons in the panel of observers: J.P. van Delft, V. Schembri MSc, and D. Zweers BSc (Leiden University Medical Center, Department of Radiology).


  1. 1.
    Kotter E, Langer M (2002) Digital radiography with large-area flat-panel detectors. Eur Radiol 12:2562–2570PubMedGoogle Scholar
  2. 2.
    Schaefer-Prokop C, Uffmann M, Eisenhuber E, Prokop M (2003) Digital radiography of the chest: detector techniques and performance parameters. J Thorac Imaging 18:124–137CrossRefPubMedGoogle Scholar
  3. 3.
    Huda W, Slone R. Review of radiologic physics 1995 Lippincott Wiliams & Wilkins, USAGoogle Scholar
  4. 4.
    International Commission on Radiation Units and Measurements (1996) Medical imaging—the assessment of image quality. ICRU Report no. 54 Bethesda, Md: International Commission on Radiation Units and Measurements, p. 54Google Scholar
  5. 5.
    Thijssen MA, Thijssen HO, Merx JL, van Woensel MP (1988) Quality analysis of DSA equipment. Neuroradiology 30:561–568CrossRefPubMedGoogle Scholar
  6. 6.
    Conway BJ, Butler PF, Duff JE et al (1984) Beam quality independent attenuation phantom for estimating patient exposure from x-ray automatic exposure controlled chest examinations. Med Phys 11:827–832CrossRefPubMedGoogle Scholar
  7. 7.
    AAPM Report No. 73, American Association of Physicists in Medicine, Quality Control in Diagnostic Radiology (2002) Diagnostic X-ray Imaging Committee Task Group No. 12, July 2002Google Scholar
  8. 8.
    Peer S, Giacomuzzi SM, Peer R, Gassner E, Steingruber I, Jaschke W (2003) Resolution requirements for monitor viewing of digital flat-panel detector radiographs: a contrast detail analysis. Eur Radiol 13:413–417PubMedGoogle Scholar
  9. 9.
    Servomaa A, Tapoivaara M (1998) Organ dose calculation in medical x-ray examinations by the program PCXMC. Radiat Prot Dosim 80:213–219Google Scholar
  10. 10.
    Veldkamp WJ, Thijssen MA, Karssemeijer N (2003) The value of scatter removal by a grid in full field digital mammography. Med Phys 30:1712–1718CrossRefPubMedGoogle Scholar
  11. 11.
    Samei E, Saunders RS, Lo JY, Dobbins JT III, Jesneck JL, Floyd CE, Ravin CE (2004) Fundamental imaging characteristics of a slot-scan digital chest radiographic system. Med Phys 31:1298–2687CrossRefGoogle Scholar
  12. 12.
    Diekmann F, Diekmann S, Richter K, Bick U, Fischer T, Lawaczeck R, Press WR, Schon K, Weinmann HJ, Arkadiev V, Bjeoumikhov A, Langhoff N, Rabe J, Roth P, Tilgner J, Wedell R, Krumrey M, Linke U, Ulm G, Hamm B (2004) Near monochromatic X-rays for digital slot-scan mammography: initial findings. Eur Radiol 14:1641–1646CrossRefPubMedGoogle Scholar
  13. 13.
    Veldkamp WJ, Kroft LJ, Mertens BJ, Geleijns J (2005) Comparison of image quality between a digital slot-scan CCD chest radiography system and AMBER and Bucky screen-film radiography chest systems. Radiology 235:857–866PubMedGoogle Scholar
  14. 14.
    Kroft LJ, Geleijns J, Mertens BJ, Veldkamp WJ, Zonderland HM, de Roos A (2004) Digital slot-scan charged coupled device chest radiography versus AMBER and Bucky screen-film radiography: detection of simulated chest nodules and interstitial disease using a chest phantom. Radiology 231:156–163PubMedGoogle Scholar
  15. 15.
    Kroft LJ, Veldkamp WJ, Mertens BJ, Boot MV, Geleijns J. Comparison of eight digital chest radiography systems: variation in detection of simulated chest disease. Am J Roengenol 185:339–346Google Scholar
  16. 16.
    Bernhardt TM, Rapp-Bernhardt U, Hausmann T, Reichel G, Krause UW, Doehring W (2000) Digital selenium radiography: anti-scatter grid for chest radiography in a clinical study. Br J Radiol 73:963–968PubMedGoogle Scholar
  17. 17.
    Neitzel U, Maack I, Gunther-Kohfahl S (1994) Image quality of a digital chest radiography system based on a selenium detector. Med Phys 21:509–516CrossRefPubMedGoogle Scholar
  18. 18.
    Samei E, Flynn MJ (2003) An experimental comparison of detector performance for direct and indirect digital radiography systems. Med Phys 30:608–622CrossRefPubMedGoogle Scholar
  19. 19.
    Awai K, Komi M, Hori S (2001) Selenium-based digital radiography versus high-resolution storage phosphor radiography in the detection of solitary pulmonary nodules without calcification: receiver operating characteristic curve analysis. Am J Roentgenol 177:1141–1144Google Scholar
  20. 20.
    Goo JM, Im J-G, Kim JH, et al (2000) Digital chest radiography with selenium-based flat-panel detector versus a storage phosphor system: comparison of soft-copy images. Am J Roentgenol 175:1013–1018Google Scholar
  21. 21.
    Mansson LG, Kheddache S, Lanhede B, Tylen U (1999) Image quality for five modern chest radiography techniques: a modified FROC study with an anthropomorphic chest phantom. Eur Radiol 9:1826–1834CrossRefPubMedGoogle Scholar
  22. 22.
    Beute GH, Flynn MJ, Eyler WR, Samei E, Spizarny DL, Zylak CJ (1998) Chest radiographic image quality: comparison of asymmetric screen-film, digital storage phosphor, and digital selenium drum systems—preliminary study. Radiographics 18:745–754PubMedGoogle Scholar
  23. 23.
    Borasi G, Nitrosi A, Ferrari P, Tassoni D (2003) On site evaluation of three flat panel detectors for digital radiography. Med Phys 30:1719–1731CrossRefPubMedGoogle Scholar
  24. 24.
    Samei E (2003) Image quality in two phosphor-based flat panel digital radiographic detectors. Med Phys 30:1747–1757CrossRefPubMedGoogle Scholar
  25. 25.
    Granfors PR, Aufrichtig R (2000) Performance of a 41×41-cm2 amorphous silicon flat panel x-ray detector for radiographic imaging applications. Med Phys 27:1324–1331CrossRefPubMedGoogle Scholar
  26. 26.
    Volk M, Hamer OW, Feuerbach S, Strotzer M (2004) Dose reduction in skeletal and chest radiography using a large-area flat-panel detector based on amorphous silicon and thallium-doped cesium iodide: technical background, basic image quality parameters, and review of the literature. Eur Radiol 14:827–834CrossRefPubMedGoogle Scholar
  27. 27.
    Bath M, Sund P, Mansson LG (2002) Evaluation of the imaging properties of two generations of a CCD-based system for digital chest radiography. Med Phys 29:2286–2297CrossRefPubMedGoogle Scholar
  28. 28.
    Herrmann KA, Bonél H, Stäbler A et al (2002) Chest imaging with flat-panel detector at low and standard doses: comparison with storage phosphor technology in normal patients. Eur Radiol 12:385–390CrossRefPubMedGoogle Scholar
  29. 29.
    Bacher K, Smeets P, Bonnarens K, De Hauwere A, Verstraete K, Thierens H (2003) Dose reduction in patients undergoing chest imaging: digital amorphous silicon flat-panel detector radiography versus conventional film-screen radiography and phosphor-based computed radiography. Am J Roentgenol 181:923–929Google Scholar
  30. 30.
    Goo JM, Im J-G, Lee HJ et al (2002) Detection of simulated chest lesions by using soft-copy reading: comparison of an amorphous silicon flat-panel detector system and a storage-phosphor system. Radiology 224:242–246PubMedGoogle Scholar
  31. 31.
    Aufrichtig R (1999) Comparison of low contrast detectability between a digital amorphous silicon and a screen-film based imaging system for thoracic radiography. Med Phys 26:1349–1358CrossRefPubMedGoogle Scholar
  32. 32.
    Sund P, Bath M, Kheddache S, Mansson LG (2004) Comparison of visual grading analysis and determination of detective quantum efficiency for evaluating system performance in digital chest radiography. Eur Radiol 14:48–58CrossRefPubMedGoogle Scholar
  33. 33.
    Burgess AE, Jacobson FL, Judy PF (2001) Human observer detection experiments with mammograms and power-law noise. Med Phys 28:419–437CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Wouter J. H. Veldkamp
    • 1
    • 3
    Email author
  • Lucia J. M. Kroft
    • 1
  • Mireille V. Boot
    • 1
  • Bart J. A. Mertens
    • 2
  • Jacob Geleijns
    • 1
  1. 1.Department of Radiology, C2SLeiden University Medical CenterLeidenThe Netherlands
  2. 2.Department of Medical Statistics, C2SLeiden University Medical CenterLeidenThe Netherlands
  3. 3.Department of Radiology, C2SLeiden University Medical CenterLeidenThe Netherlands

Personalised recommendations