[Digital storage phosphor radiography. Doses and image quality]

Digital radiography (DR) based on storage phosphor technology is progressively replacing conventional screen-film system radiographic techniques (CR). However, many questions about image quality and dose reduction are still open. Thus, since DR spatial resolution is always lower than that of high quality screen-film images and image noise is conversely higher, for general radiography examinations especially, the signal-to-noise ratio is always lower with DR than with CR at the same dose level. However, the wide dynamic range, the linear response of storage phosphor detectors and the automatic read-out control of the digital system, enable lower DR X-ray imaging efficiency to be overcome, producing a nearly perfect readout of the image data every time an exposure is made. Moreover, post-processing can make the detection of abnormalities easier. This is why in many ROC clinical accuracy studies DR performed equally or better than CR. Good quality DR images, similar to conventional ones at the same dose levels, are therefore achievable in chest, abdomen, bone and soft-tissues examinations. Dose evaluation protocols are strongly needed in DR since overexposures due to technical mistakes may be overlooked; moreover, doses can be adjusted to the peculiar diagnostic need. The S values shown on any hard-copy image can be used to this purpose, even though it must be pointed out that they do not express the actual mean dose to the detector.