The influence of the inverse square law on exposure indicators and image quality for pelvic radiographic examinations

Authors

DOI:

https://doi.org/10.33448/rsd-v13i4.45448

Keywords:

Process optimization; Imaging diagnosis; Pelvis; Signal to noise ratio.

Abstract

The aim of this study was to investigate the influence of increasing the distance between the radiographic tube focus and the detector (known as Focal-Detector Distance (FDD)) on image quality (IQ) and radiation dose applied to the patient during pelvic radiographic examinations. For this purpose, we employed a radiographic system, a semi-anatomical model of the pelvis, and a computerized radiology system (CR) for image acquisition and digitization. We varied the FDD according to the inverse square law and maintained the exposure index (IE) with five different voltage values. We measured Incident air kerma (INAK) with a dosimetric set and analyzed IQ using public software for histogram and regions of interest (ROI). We evaluated the signal-to-noise ratio (SNR) and the radiographic contrast (CR) as IQ descriptors. Comparing the images obtained with the standard 1-meter technique, we found that increasing the FDD by 50% (from 1.0 to 1.5 m) and the voltage by 24.68% (from 77 to 96 kVp) resulted in a significant 43.1% reduction in INAK, with no significant alteration in SNR, and the IE remained within the limits established by the manufacturer. Additionally, there was a minimal 0.2% reduction in CR (from 43.0 to 42.0). Our results indicate that using an FDD larger than the standard for pelvic examinations offers a highly favorable cost-benefit ratio.

References

Alzyoud, K., Hogg, P., Snaith, B., Flintham, K., & England, A. (2019). Impact of body part thickness on AP pelvis radiographic image quality and effective dose. Radiography, 25(1), e11-e17.

American Association of Physicists in Medicine. (2015). Ongoing Quality Control in Digital Radiography. Report of the Task Group, (151).

Biasoli Jr, A. (2015). Técnicas radiográficas: princípios físicos, anatomia básica, posicionamento, radiologia digital, tomografia computadorizada. Editora Rubio.

Bongtrager, Kenneth L.; Lampignano, John P. Tratado de posicionamento radiográfico e anatomia associada. Elsevier Brasil, 2017.

Bushberg, J. T., & Boone, J. M. (2011). The essential physics of medical imaging. Lippincott Williams & Wilkins.

Bushong, S. C. (2010). Radiologic science for technologists.

Dance, D. R., Christofides, S., Maidment, A. D. A., McLean, I. D., & Ng, K. H. (2014). Diagnostic radiology physics: A handbook for teachers and students. endorsed by: American association of physicists in medicine, asia-oceania federation of organizations for medical physics, european federation of organisations for medical physics.

Davies, B. H., Manning-Stanley, A. S., Hughes, V. J., & Ward, A. J. (2020). The impact of gonad shielding in anteroposterior (AP) pelvis projections in an adult: a phantom study utilising digital radiography (DR). Radiography, 26(3), 240-247.

Eisberg, Robert; Resnick, Robert. Física Quântica, Ed. Campus, 1979.

England, A., Evans, P., Harding, L., Taylor, E. M., Charnock, P., & Williams, G. (2015). Increasing source-to-image distance to reduce radiation dose from digital radiography pelvic examinations. Radiologic technology, 86(3), 246-256.

European Commission. European guidelines on quality criteria for diagnostic radiographic images. EUR 16260 EN. http://www.sprmn.pt/legislacao/ficheiros/European Guidelineseur16260.pdf. Published 1996.

Flintham, K., Alzyoud, K., England, A., Hogg, P., & Snaith, B. (2021). Comparing the supine and erect pelvis radiographic examinations: an evaluation of anatomy, image quality and radiation dose. The British Journal of Radiology, 94, 20210047.

Heath, R., England, A., Ward, A., Charnock, P., Ward, M., Evans, P., & Harding, L. (2011). Digital pelvic radiography: increasing distance to reduce dose. Radiologic technology, 83(1), 20-28.

Holmes, K., Elkington, M., & Harris, P. (2021). Clark's essential physics in imaging for radiographers. CRC Press.

Mekiš, N., & Starc, T. (2012). Increasing source-to-image-receptor distance reduces entrance surface dose. Bulletin: Newsletter of the Society of Radiographers of Slovenia & the Chamber of Radiographers of Slovenia, 29(1).

Metaxas, V. I., Messaris, G. A., Lekatou, A. N., Petsas, T. G., & Panayiotakis, G. S. (2019). Patient doses in common diagnostic X-ray examinations. Radiation protection dosimetry, 184(1), 12-27.

Möller, T. B., Reif, E., Stark, P., & Stark, P. (2000). Pocket atlas of radiographic anatomy (pp. 140-155). Thieme.

Shepard, S. J., Wang, J., Flynn, M., Gingold, E., Goldman, L., Krugh, K., ... & Willis, C. E. (2009). An exposure indicator for digital radiography: AAPM Task Group 116 (executive summary). Medical physics, 36(7), 2898-2914.

Trozic, S., England, A., & Mekis, N. (2023). Erect pelvic radiography with fat tissue displacement: Impact on radiation dose and image quality. Radiography, 29(3), 546-551.

Wayne R. (2024). Software para processamento e análise de imagens. USA: National Institute of Mental Health, java, Homepage: http://rsbweb.nih.gov/ij/download.html.

Published

06/04/2024

How to Cite

CLAUS, T. V. .; SOARES, T. .; ROSA, J. F. da C. .; BAIL, F. .; SILVA, M. S. da; LOPES, R. H. .; BAUMHARDT, T. . The influence of the inverse square law on exposure indicators and image quality for pelvic radiographic examinations. Research, Society and Development, [S. l.], v. 13, n. 4, p. e1013445448, 2024. DOI: 10.33448/rsd-v13i4.45448. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/45448. Acesso em: 22 dec. 2024.

Issue

Section

Health Sciences