Background: Technical failures and incorrect usage of digital X-ray systems may lead to a decreasing image quality, artefacts and a higher dose exposure of staff and patients. Although there are no regulations regarding constancy testing in veterinary radiology all operators are required to avoid unnecessary exposure. The aim of this study was to develop a reasonably inexpensive zoomorphic 3D-printed test specimen for constancy testing that allows the detection of changing image quality by visual analysis. Primarily, a calibration curve of the attenuation factor of the 3D-printing material (ZP150) was determined. MATLAB converted every pixel value of a thorax X-ray image of a Beagle dog into an equivalent thickness of printing material. The thickness distribution was printed using a 3D-printer. This printed test specimen was additionally provided with five thin aluminium discs to simulate lung nodules. To evaluate the usability for constancy testing 12 X-ray images of the test specimen were made. Two images (reference and control) were taken with the minimum dose in order to obtain images suitable for diagnosis purposes. Eight images were taken with a dose differing 30-140% from the reference dose by varying current-time product (mAs) or tube voltage (kVp). Two images were taken with the same parameters as the reference image but edited with different image processing. Six veterinarians (general practitioners) evaluated ten chosen structures in the X-ray images in a Visual Grading Analysis and scored the image quality of these structures for every image in comparison to the reference image. A Visual Grading Analysis Score was calculated and statistically analysed.
Results: A higher current-time product led to a negligibly better evaluation of the X-ray image. The lower the current-time product the worse the X-ray images were scored. Likewise, both increasing and decreasing of the tube voltage led to lower scores.
Conclusions: A zoomorphic test specimen can be used for constancy testing of digital X-ray systems in veterinary medicine. Especially a lower dose can be recognised due to deviation in the image quality when compared to the reference image. The 3D-printed test specimen is less expensive than test equipment used in human medicine.
Keywords: 3D-print; Digital radiography; Image quality; Visual grading analysis.