Effects of body part thickness on low-contrast detail detection and radiation dose during adult chest radiography

Sadeq Al-Murshedi; Kholoud Alzyoud; Mohamed Benhalim; Nadi Alresheedi; Stamatia Papathanasiou; Andrew England

doi:10.1002/jmrs.741

Effects of body part thickness on low-contrast detail detection and radiation dose during adult chest radiography

J Med Radiat Sci. 2024 Mar;71(1):85-90. doi: 10.1002/jmrs.741. Epub 2023 Dec 4.

Authors

Sadeq Al-Murshedi^{1

2}, Kholoud Alzyoud³, Mohamed Benhalim⁴, Nadi Alresheedi⁵, Stamatia Papathanasiou⁶, Andrew England⁷

Affiliations

¹ College of Health and Medical Technology, AL-Zahraa University for Women, Karbala, Iraq.
² Physics Department, College of Education for Pure Science, University of Babylon, Babil, Iraq.
³ Department of Medical Imaging, Faculty of Applied Health science, The Hashemite University, Zarqa, Jordan.
⁴ Collage of Medical Technology Misurata, Misurata, Libya.
⁵ Department of General studies, Royal Commission for Jubail and Yanbu, Yanbu Industrial College, Yanbu, Kingdom of Saudi Arabia.
⁶ City University of London, London, UK.
⁷ School of Medicine, University College Cork, Cork, Ireland.

Abstract

Introduction: Differences in patient size often provide challenges for radiographers, particularly when choosing the optimum acquisition parameters to obtain radiographs with acceptable image quality (IQ) for diagnosis. This study aimed to assess the effect of body part thickness on IQ in terms of low-contrast detail (LCD) detection and radiation dose when undertaking adult chest radiography (CXR).

Methods: This investigation made use of a contrast detail (CD) phantom. Polymethyl methacrylate (PMMA) was utilised to approximate varied body part thicknesses (9, 11, 15 and 17 cm) simulating underweight, standard, overweight and obese patients, respectively. Different tube potentials were tested against a fixed 180 cm source to image distance (SID) and automatic exposure control (AEC). IQ was analysed using bespoke software thus providing an image quality figure inverse (IQF_inv ) value which represents LCD detectability. Dose area product (DAP) was utilised to represent the radiation dose.

Results: IQF_inv values decreased statistically (P = 0.0001) with increasing phantom size across all tube potentials studied. The highest IQF_inv values were obtained at 80 kVp for all phantom thicknesses (2.29, 2.02, 1.8 and 1.65, respectively). Radiation dose increased statistically (P = 0.0001) again with increasing phantom thicknesses.

Conclusion: Our findings demonstrate that lower tube potentials provide the highest IQF_inv scores for various body part thicknesses. This is not consistent with professional practice because radiographers frequently raise the tube potential with increased part thickness. Higher tube potentials did result in radiation dose reductions. Establishing a balance between dose and IQ, which must be acceptable for diagnosis, can prevent the patient from receiving unnecessary additional radiation dose.

Keywords: CDRAD 2.0 phantom; chest radiography; image quality; low-contrast details detectability; obesity; radiation dose.

© 2023 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

MeSH terms

Adult
Human Body*
Humans
Phantoms, Imaging
Polymethyl Methacrylate*
Radiation Dosage
Radiography

Substances

Polymethyl Methacrylate