The use of computed tomography (CT) has become a common practice in medical diagnosis in Indonesia. Its number, however, is not matched by the availability of dedicated-performance-check phantoms. This paper aims to describe the design, construction, and evaluation of an in-house phantom for CT performance check that accommodates both radiation dose measurement and image quality performance checks. The phantom is designed as laser-cut polymethyl methacrylate (PMMA) slabs glued together to form a standard cylindrical shape, with spaces to place dose measurement and image quality modules. In this paper, measurement results on both aspects are discussed and compared with standard phantoms and other works. For dose measurement, the constructed phantom exhibited the greatest absolute discrepancy against the reference standard phantom of 8.89 %. Measurement of the CT number linearity and modulation transfer function (MTF) yielded, at most, 7.51 % and 5.07 % discrepancies against Catphan 604, respectively. Meanwhile, although found to be more linear in the phantom-based contrast linearity test, the use of the in-house phantom for clinical image contrast threshold determination requires further study. For noise power spectrum (NPS) measurement, accurate results were obtained within a limited range of spatial frequency.

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The purpose of this study was to obtain information on optimum exposure parameter combination on simulated thorax and abdomen examinations using Direct-Digital Radiography (DR) and Computed Radiography (CR) systems. An in-house phantom dedicated for quick QC was utilized as an image quality quantification tool in term of contrast. The optimization was performed on Philips Essenta DR, CR Fuji Profect CS, and CR Agfa 10-X. Exposures were performed using corresponding clinical setting with combinations of kVp, mAs, filters, and a variation of simulated patient thicknesses. The Figure of Merit (FOM) was employed as optimization parameter, calculated as ratio of squared Signal Difference to Noise Ratio (SDNR) and surface dose for every measurement. The image quality was evaluated using Modulation Transfer Function (MTF) and Contrast Consistency (CV). Based on FOM, MTF, and CV calculations, acquisitions optimization for thorax examination using DR was obtained on 55-63 kVp, 5-8 mAs, with additional filter 1 mm Al + 0.1 mm Cu. For abdomen examination, the optimized results were 81-102 kVp, 8-12.5 mAs, with additional filters 1 mm Al+0.1 mm Cu and 1 mm Al+0.2 mm Cu. On the other hand, the optimized results using CR on thorax examination were on the range of 55-63 kV, 4-8 mAs, also with the same additional filters with DR. The results of optimization of abdomen examination were on the range of 85-102 kV, 8-20 mAs, and again with the same additional filters. This gave information that different receptors used on the same x-ray unit produced almost similar optimization conditions.

Optimization is one of the radiation protection efforts by giving radiation doses to patients as low as possible without reducing the quality of clinical images or what is often referred to as ALARA (As Low as Reasonably Achievable). A Diagnostic Reference Level (DRL) is an investigative indicator to optimize radiation protection for diagnostic and interventional radiology patients. The typical radiation dose value in AP thoracic examination patients at Gading Pluit Hospital is higher than the Indonesian DRL (I-DRL) value, so it is necessary to optimize the dose. Optimization of radiation dose aims to protect patients by evaluating exposure factors without compromising the quality of clinical images. AP chest image acquisition was performed using clinical exposure factors and their variations on the general radiographic X-Ray Listem REX 525-R. Evaluation of dose and image quality was carried out by a reading doctor/radiologist using a blind test. Optimizing results show that a lower exposure factor can reduce the radiation dose in AP thoracic examination of adult patients without affecting image quality. Exposure factor 80 kVp; 150 mA; 3.75 mAs is recommended to replace the exposure factor used before optimization, namely 80 kVp; 200 mA; 7 mAs. Keywords: optimization, DRL, radiation protection.