Visual Grading Analysis of image quality in pediatric abdominal images acquired by Direct Digital Radiography and Computer Radiography Systems

Abstract

The advent of digital technology allowed for great improvements in radiology and lead the way for digital radiology, leaving behind conventional x-ray techniques, [1]. Digital post-processing of image is the main advantage of digital image systems (e.g., computed radiology and direct digital radiology) over the conventional systems. Image quality can indeed be improved avoiding the increase of patient dose and the number of unnecessary exposures [1-3]. Image quality is directly linked to the dose of radiation applied to the patient. The literature points out the need for appropriate image evaluation in order to reduce the patient dose. Optimization and practice justification are of great relevance in diagnostic radiology. In pediatric patients a good practice justification is even more important as radiation exposure on the first 10 years of life increases the possibility of negative effects on the patient's health compared to an exposure between the ages of 30 to 40 years old [4, 5]. In the past, the main concern of radiology technicians was image quality, leaving radiation dose to a second plan. Nowadays, dose reduction and the cost/benefit ratio represent the main concerns in radiology. The radiographer is responsible for applying the ALARA (As Low As Reasonable Acceptable) concept in every study involving the use of ionizing radiation [4, 6]. According to the ALARA concept, the necessary level of diagnostic image quality should be attained with the lowest patient dose possible. In Pediatric radiology, besides the ALARA principle, the International Commission on Radiological Protection (ICRP) adds a new concept - the SMART message, also related with optimization and radiation protection when applied to pediatric radiology (Figure 1) [6].