The benefit of accounting for DQE variations in simulated dose reduction of digital radiographic systems

Adding noise to clinical radiographs to simulate dose reduction can be used to investigate the relationship between dose level and clinical image quality without exposing patients to additional radiation. The purpose of the present paper was to examine the benefits of using a method that accounts for detective quantum efficiency (DQE) variations that may occur in different dose ranges in the simulated dose reduction process. A method initially intended for simulated dose reduction in tomosynthesis was applied to extremely low-dose posterioanterior radiographs of an anthropomorphic chest phantom, selected from a group of projection images included in a tomosynthesis examination and compared with a previous method that do not account for DQE variations. A comparison of images simulated to be collected at a lower dose level (73 % of the original dose level) and images actually collected at this lower dose level revealed that the error in the integrated normalised noise power spectrum was smaller than 4 % for the method that accounts for DQE variations in the simulated dose reduction, whereas the error was larger than 20 % for the previous method. This indicates that an increased validity in dose reduction simulation of digital radiographic systems is obtained with a method accounting for DQE variations.