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Updated: Jul 30, 2026

X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
Comparison of computed radiography and film/screen combination using a contrast-detail phantom
Z F Lu1, E L Nickoloff, J C So
1Department of Radiology, Columbia University, MHB 3-265, 177 Ft. Washington Avenue, New York, New York 10032, USA. zfl1@columbia.edu
Abstract:
The purpose of this work is to compare computed radiography (Kodak CR 400) and film/screen combination (Speed 400) systems in regards of patient dose, technique settings, and contrast-detail detectability. A special contrast-detail phantom with drilled holes of varying diameter (detail) and varying depth (contrast) was utilized. Various thicknesses of the Lucite sheets were utilized to simulate scattering tissues. Images of the phantom were acquired using a range of 60-120 kVp for film/screen and CR with a conventional x-ray tube and then for CR with additional 2 mm aluminum added filtration to the x-ray beam. The patient entrance skin dose was measured while maintaining 1.6 o.d. for film/screen images and 1900 Exposure Index for CR images. CR phantom images were displayed on the diagnostic workstation for soft copy reading as well as printed on films for hard copy reading on viewbox. Four physicists evaluated the images by scoring the threshold target depth along the row of the same target diameter. Detection ratio was calculated by counting the number of detectable targets divided by the total number of targets in the phantom. The overall score was related to the patient entrance skin dose, kVp, and the thickness of the scattering material. The patient entrance skin dose was reduced as the additional aluminum filter was added to the x-ray beam. Our findings suggested using a higher kVp setting and additional added filtration would reduce the patient entrance skin dose without compromising the contrast-detail detectability, which was compensated by the contrast manipulation on soft-copy display workstations.
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