An optimisation strategy in a digital environment applied to neonatal chest imaging

Area of Science:

• Medical Imaging
• Radiography
• Pediatric Radiology

Background:

• Optimizing imaging parameters in neonatal chest computed radiography (CR) is essential for accurate diagnosis.
• Digital imaging allows for adjustments in tube voltage while maintaining a constant effective dose.

Purpose of the Study:

• To determine the optimal tube voltage for neonatal chest imaging in computed radiography.
• To compare image quality at various tube voltages (40-90 kVp) at a constant effective dose.

Main Methods:

• A phantom study using a living rabbit was conducted, acquiring images at tube voltages from 40 to 90 kVp.
• Ten radiologists evaluated the reproduction of four key structures: central vessels, peripheral vessels, carina, and thoracic vertebrae.
• A follow-up study compared 70 kVp (hospital standard) with 90 kVp in neonates.

Main Results:

• Vessel reproduction was largely independent of tube voltage.
• Carina reproduction improved with higher tube voltages (90 kVp), while thoracic vertebrae were better visualized at lower voltages.
• The follow-up study confirmed that 90 kVp provided better carina reproduction than 70 kVp in neonates.

Conclusions:

• 90 kVp is the optimal tube voltage for neonatal chest imaging in CR when aiming for the best reproduction of important structures, particularly the carina, at a consistent effective dose.
• This contrasts with the commonly used 70 kVp, suggesting a need to update imaging protocols for improved diagnostic quality in pediatric patients.