Comparison of image quality among three X-ray systems for chest radiography: first step in optimisation

The aim of this study was to compare the performance of three digital X-ray systems [one flat-panel (DR) and two computed radiography (CR)] for chest radiography in terms of the entrance surface air kerma (ESAK) delivered to a polymethyl methacrylate phantom of 20 cm (equivalent to an adult patient) and image quality through of numerical evaluations using a test object (TO). The tube charge applied was ranged from 0.6 to 32 mAs, to a fixed tension of 125 kVp. The DR system presented the highest mean values of ESAK (615.9 µGy) along with the highest signal-to-noise ratio values, whereas CR systems showed a better high-contrast spatial resolution. Differences were statistically significant in both cases regarding the tube charge used. Thus, this parameter should be mainly considered to optimise the radiological protection through exposure settings selected. This survey represents the first effort to achieve optimisation in digital radiology for Chile.