Varied tube potential with constant effective dose at lumbar spine radiography using a flat-panel digital detector

The purpose of the study was to evaluate the image quality at different tube potential (kV) settings using anteroposterior lumbar spine radiography as a model. An Alderson phantom was used with a flat-panel detector. The tube potential varied between 48 and 125 kV while the tube charge (mAs) was adjusted to keep an effective dose of 0.11 mSv. Image quality was assessed with a visual grading analysis and with a CDRAD contrast-detail phantom together with a computer program. The VGA showed inferior image quality for the higher kV settings, > or =96 kVwith similar results for the contrast-detail phantom. When keeping the effective dose fixed, it seems beneficial to reduce kV to get the best image quality despite the fact that the mAs is not as high as with automatic exposure. However, this cannot be done with automatic exposure, which is set for a constant detector dose.