Chest Radiography With a Large-Area Detector Based on Cesium-Iodide/Amorphous-Silicon Technology

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Abstract
The purpose of this study was to evaluate a large-area, flat-panel X-ray detector, which uses cesium-iodide (CsI) and amorphous silicon (a-Si). Conventional images were compared with digital images acquired with equal dose (2.5 μ Gy) and with 50% dose reduction. Fifteen consecutive patients were studied prospectively using an asymmetric screen–film system (detector dose, 2.5 μ Gy). Digital images were taken from the same patients in a posteroanterior view with detector doses of 2.5 and 1.25 μ Gy, respectively. The CsI/a-Si active-matrix imager had a panel-size of 43 × 43 cm, a matrix of 3 × 3k, and a pixel-pitch of 143 μ m. Hard copies were presented in a random order to eight independent observers, who rated image quality according to six subjective quality criteria. Statistical significance of differences was evaluated with Student's t test for paired samples (confidence level, 95%). Digital radiographs with 2.5 and 1.25 μ Gy were superior to conventional images regarding all quality criteria. Statistically significant differences were observed for five of six criteria at a detector dose of 2.5 μ Gy and for only one quality feature at 1.25 μ Gy. Flat-panel digital imagers based on CsI/a-Si technique have the potential to replace conventional systems and might allow a reduction of radiation dose by 50% without loss of image quality.

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