Optimizing image quality using automatic exposure control based on the signal-difference-to-noise ratio: a phantom...

This study proposes to adjust the sensitivity of automatic exposure control (AEC) for achieving consistent image quality over a range of subject thicknesses in abdominal radiography simulations. The relation between image quality and subject thickness was investigated using a digital radiography system with 10-, 15-, 20-, and 25-cm-thick acrylic phantom. Simple pixel signal-to-noise ratio (SNR) was measured to check the default AEC accuracy for each thickness, and image quality was evaluated using the signal-difference-to-noise ratio (SDNR) with an additional acrylic plate and bone-equivalent material. Based on the figure of merit theory, dose ratios to obtain constant image quality regardless of the subject thickness were calculated from SDNR results. The AEC setup was manually modified using this dose ratio, and visibility was examined using a CDRAD 2.0 contrast-detail analysis phantom. Moreover, the entrance surface dose (ESD) was estimated as an index of exposure dose using exposure parameters. The default AEC setup provided a constant simple pixel SNR for each subject thickness with a high accuracy. SDNRs decreased with an increase in the subject thickness. The calculated dose ratios relative to the results for 20 cm thickness were 0.424, 0.647, and 1.43 for 10, 15 and 25 cm, respectively, and a > 25% decrease in ESD was observed for smaller patients. CDRAD analysis using the modified AEC setup showed almost identical visibility for each thickness. Adjusting the sensitivity of AEC according to subject thickness can contribute toward the optimization of the exposure condition.