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Updated: May 22, 2026

X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
Optimizing image quality and dose for digital radiography of distal pediatric extremities using the contrast-to-noise
Purpose:
To investigate the influence of X-ray tube voltage and filtration on image quality in terms of contrast-to-noise ratio (CNR) and dose for digital radiography of distal pediatric extremities and to determine conditions that give the best balance of CNR and patient dose.
Materials And Methods:
In a phantom study simulating the absorption properties of distal extremities, the CNR and the related patient dose were determined as a function of tube voltage in the range 40 - 66 kV, both with and without additional filtration of 0.1 mm Cu/1 mm Al. The measured CNR was used as an indicator of image quality, while the mean absorbed dose (MAD) - determined by a combination of measurement and simulation - was used as an indicator of the patient dose.
Results:
The most favorable relation of CNR and dose was found for the lowest tube voltage investigated (40 kV) without additional filtration. Compared to a situation with 50 kV or 60 kV, the mean absorbed dose could be lowered by 24 % and 50 %, respectively, while keeping the image quality (CNR) at the same level.
Conclusion:
For digital radiography of distal pediatric extremities, further CNR and dose optimization appears to be possible using lower tube voltages. Further clinical investigation of the suggested parameters is necessary.
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