[Evaluation of underexposed conventional x-ray films following digitization]

Inadequate exposure of analogue radiographs is reported in the literature to occur in 5-25% of cases. Therefore, the present study was performed to test whether selective image processing after digitization could reveal diagnostic details on underexposed radiographs. In addition, the minimal exposure values required for diagnostic purposes after adequate image processing were studied. Phantom studies, organ preparations and measurements of physical parameters with decreasing exposure values were performed. The detection of anatomic and pathologic (nondisplaced fracture lines, microcalcification and renal stones) structures were evaluated by 12 readers. Radiographs with exposure values 20-40% lower than "ideal" values can provide adequate diagnostic images after digital processing. The diagnostic information is significantly impaired with values under 50% of the correct exposure values. In conclusion, this method is adequate to save underexposed radiographs for diagnostic purposes and to avoid repeated examinations.