Neonatal digital chest radiography- should we be using additional copper filtration?

Area of Science:

• Medical Imaging
• Radiological Physics
• Pediatric Radiology

Background:

• Copper filtration in X-ray imaging reduces low-energy photons, decreasing patient radiation dose.
• Neonatal chest imaging requires careful optimization to balance image quality and radiation exposure.
• The impact of additional copper filtration on neonatal mobile chest radiography is not well-established.

Purpose of the Study:

• To investigate the effect of additional copper filtration on image quality and radiation dose in neonatal mobile chest imaging.
• To determine optimal copper filtration levels and exposure parameters for this specific patient group.
• To establish best practices for dose reduction and image quality optimization in neonatal radiography.

Main Methods:

• A controlled factorial experiment was conducted using varying copper filtration levels (0, 0.1, 0.2 Cu).
• Image quality was assessed using visual grading analysis (VGA) and contrast-to-noise ratio (CNR).
• Radiation dose was measured as entrance surface dose (ESD) using an ionising chamber.

Main Results:

• Added copper filtration significantly reduced VGA, CNR, and ESD (p < 0.01).
• 0.1 mm copper filtration yielded a 60% reduction in ESD, 14% in VGA, and 20% in CNR.
• Optimized parameters with 0.1 mm copper filtration improved image quality at the same dose or maintained quality at a reduced dose.

Conclusions:

• Additional copper filtration, particularly 0.1 mm, effectively reduces radiation dose in neonatal chest imaging.
• The use of copper filtration with adjusted exposure factors (kV, mAs) is recommended for optimizing neonatal radiography.
• This study provides foundational data for standardizing and improving digital radiography practices for infant chest imaging.