Large-area flat-panel detector versus conventional detector for full-spine digital radiography: a retrospective...

To compare workflow efficiency, tube current-exposure time product (mAs), and image quality between a DRX-LC large-area flat-panel detector and a conventional flat-panel detector for full-spine digital radiography.

In this retrospective comparative study, radiographs and examination records of 90 adult patients who underwent full-spine anteroposterior (AP) and lateral (LAT) digital radiography between August and September 2025 were retrospectively reviewed. Patients were categorized according to the detector used during clinical imaging into a DRX group (Carestream DRX-LC, 42.58 × 120.87 cm) or a conventional group (33.0 × 43.2 cm), with 45 patients in each group. The DRX group underwent single-exposure full-spine imaging, whereas the conventional group underwent 4-6 segmented acquisitions followed by automatic stitching. Examination duration and mAs values for AP and LAT imaging were recorded. Image quality was independently assessed by four experienced reviewers using a 4-point scoring system, and mean scores were analyzed.

Baseline characteristics were comparable between the two groups (all P > 0.05). The DRX group had a significantly shorter examination duration than the conventional group (3.63 ± 0.83 min vs. 11.59 ± 2.31 min, P < 0.001). Subjective image quality scores were significantly higher in the DRX group [median [IQR], 4 [3-4] vs. 3 [2.5-3]; P < 0.001]. Compared with the conventional group, the DRX group also showed lower AP mAs (39.12 ± 1.16 vs. 70.43 ± 10.45, P < 0.001), lower LAT mAs (54.56 ± 3.02 vs. 76.69 ± 12.83, P < 0.001), and lower cumulative mAs (93.88 ± 3.59 vs. 146.89 ± 21.82, P < 0.001). The single-exposure DRX-LC images showed clearer visualization of vertebral cortices and trabeculae and fewer artifacts.

For full-spine digital radiography, use of the DRX-LC large-area detector was associated with fewer exposures, shorter examination time, lower mAs requirements, and better subjective image quality. These findings support its clinical value for optimizing full-spine imaging workflows.