Effects of rare-earth filters on patient exposure and image contrast

Minimizing patient exposure while maintaining a diagnostically acceptable radiograph is a major goal in diagnostic radiography. Rare-earth filters may be the means to achieve this goal due to their "band-pass effect". The purpose of this study was to examine the image contrast effects and exposure reductions for various thicknesses of aluminum, samarium, gadolinium, gadolinium oxysulfide, and gadolinium oxysulfide added to 2.5 mm of aluminum. Trials were conducted on an intra-oral dental x-ray unit (range, 65 to 90 kVp). When compared with conventional aluminum, all of the rare-earth filters provided lower radiation exposures, with gadolinium in the metallic or oxysulfide form providing the lowest exposures. Samarium, at a thickness of 0.127 mm, yielded the highest image contrast. Gadolinium or gadolinium oxysulfide added to 2.5 mm of aluminum resulted in a slight loss of contrast when compared with conventional aluminum filtration. This loss may not be clinically significant, and when coupled with the reduced exposure afforded by these filters, they become viable as acceptable alternatives to aluminum filtration.